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Opportunity Cost: A Reexamination

ERIC Educational Resources Information Center

Parkin, Michael

2016-01-01

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

PubMed Central

Zhang, Ning; Ji, Li-Jun; Li, Ye

2017-01-01

Two studies were conducted to investigate cultural differences in opportunity cost consideration between Chinese and Euro-Canadians. Opportunity cost is defined as the cost of a benefit that must be forgone in order to pursue a better alternative (Becker et al., 1974). In both studies, participants read about hypothetical purchase scenarios, and then decided whether they would buy a certain product. Opportunity cost consideration was measured in two ways: (1) participants' thoughts pertaining to other (nonfocal) products while making decisions; (2) participants' decisions not to buy a focal product (Study 1) or a more expensive product (Study 2). Across both indexes, we found that after controlling for individual difference variables and amount of pocket money, Chinese participants in China considered financial opportunity cost more than Euro-Canadians in Study 1. Similar results were observed in Study 2 when comparing Chinese in Canada with Euro-Canadians However, the cultural effect on opportunity cost consideration was confounded by family income in Study 2. Implications for resource management, limitations of the current research and directions for future research are discussed. PMID:28184202
Cultural Differences in Opportunity Cost Consideration.

PubMed

Zhang, Ning; Ji, Li-Jun; Li, Ye

2017-01-01

Two studies were conducted to investigate cultural differences in opportunity cost consideration between Chinese and Euro-Canadians. Opportunity cost is defined as the cost of a benefit that must be forgone in order to pursue a better alternative (Becker et al., 1974). In both studies, participants read about hypothetical purchase scenarios, and then decided whether they would buy a certain product. Opportunity cost consideration was measured in two ways: (1) participants' thoughts pertaining to other (nonfocal) products while making decisions; (2) participants' decisions not to buy a focal product (Study 1) or a more expensive product (Study 2). Across both indexes, we found that after controlling for individual difference variables and amount of pocket money, Chinese participants in China considered financial opportunity cost more than Euro-Canadians in Study 1. Similar results were observed in Study 2 when comparing Chinese in Canada with Euro-Canadians However, the cultural effect on opportunity cost consideration was confounded by family income in Study 2. Implications for resource management, limitations of the current research and directions for future research are discussed.
Evidence for Opportunity Cost Neglect in the Poor.

PubMed

Plantinga, Arnoud; Krijnen, Job M T; Zeelenberg, Marcel; Breugelmans, Seger M

2018-01-01

People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an increased focus on trade-offs. We did not find support for this hypothesis in five high-powered experiments (total N = 2325). The experiments used different products (both material and experiential) with both high and low prices (from $8.50 to $249.99) and different methods of reminding participants of opportunity costs. High-income and low-income participants showed an equally strong decrease in willingness to buy when reminded of opportunity costs, implying that both the rich and the poor neglect opportunity costs. © 2017 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd.
Evidence for Opportunity Cost Neglect in the Poor

PubMed Central

Krijnen, Job M.T.; Zeelenberg, Marcel; Breugelmans, Seger M.

2017-01-01

Abstract People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an increased focus on trade‐offs. We did not find support for this hypothesis in five high‐powered experiments (total N = 2325). The experiments used different products (both material and experiential) with both high and low prices (from $8.50 to $249.99) and different methods of reminding participants of opportunity costs. High‐income and low‐income participants showed an equally strong decrease in willingness to buy when reminded of opportunity costs, implying that both the rich and the poor neglect opportunity costs. © 2017 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd. PMID:29353963
An opportunity cost approach to sample size calculation in cost-effectiveness analysis.

PubMed

Gafni, A; Walter, S D; Birch, S; Sendi, P

2008-01-01

The inclusion of economic evaluations as part of clinical trials has led to concerns about the adequacy of trial sample size to support such analysis. The analytical tool of cost-effectiveness analysis is the incremental cost-effectiveness ratio (ICER), which is compared with a threshold value (lambda) as a method to determine the efficiency of a health-care intervention. Accordingly, many of the methods suggested to calculating the sample size requirements for the economic component of clinical trials are based on the properties of the ICER. However, use of the ICER and a threshold value as a basis for determining efficiency has been shown to be inconsistent with the economic concept of opportunity cost. As a result, the validity of the ICER-based approaches to sample size calculations can be challenged. Alternative methods for determining improvements in efficiency have been presented in the literature that does not depend upon ICER values. In this paper, we develop an opportunity cost approach to calculating sample size for economic evaluations alongside clinical trials, and illustrate the approach using a numerical example. We compare the sample size requirement of the opportunity cost method with the ICER threshold method. In general, either method may yield the larger required sample size. However, the opportunity cost approach, although simple to use, has additional data requirements. We believe that the additional data requirements represent a small price to pay for being able to perform an analysis consistent with both concept of opportunity cost and the problem faced by decision makers. Copyright (c) 2007 John Wiley & Sons, Ltd.
Opportunity Cost: A Reply

ERIC Educational Resources Information Center

Parkin, Michael

2016-01-01

The author's objective for this reply in reexamining opportunity cost was to draw attention to two conflicting definitions of the concept in current use and to argue the case for dropping one of them. The comments of Daniel Arce, Rod O'Donnell, and Daniel Stone might be read as demonstration that the author has failed on both counts. Such a…
The Opportunity Cost of Capital

PubMed Central

Chit, Ayman; Chit, Ahmad; Papadimitropoulos, Manny; Krahn, Murray; Parker, Jayson; Grootendorst, Paul

2015-01-01

The opportunity cost of the capital invested in pharmaceutical research and development (R&D) to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D. PMID:25933615
Dopamine Manipulation Affects Response Vigor Independently of Opportunity Cost.

PubMed

Zénon, Alexandre; Devesse, Sophie; Olivier, Etienne

2016-09-14

Dopamine is known to be involved in regulating effort investment in relation to reward, and the disruption of this mechanism is thought to be central in some pathological situations such as Parkinson's disease, addiction, and depression. According to an influential model, dopamine plays this role by encoding the opportunity cost, i.e., the average value of forfeited actions, which is an important parameter to take into account when making decisions about which action to undertake and how fast to execute it. We tested this hypothesis by asking healthy human participants to perform two effort-based decision-making tasks, following either placebo or levodopa intake in a double blind within-subject protocol. In the effort-constrained task, there was a trade-off between the amount of force exerted and the time spent in executing the task, such that investing more effort decreased the opportunity cost. In the time-constrained task, the effort duration was constant, but exerting more force allowed the subject to earn more substantial reward instead of saving time. Contrary to the model predictions, we found that levodopa caused an increase in the force exerted only in the time-constrained task, in which there was no trade-off between effort and opportunity cost. In addition, a computational model showed that dopamine manipulation left the opportunity cost factor unaffected but altered the ratio between the effort cost and reinforcement value. These findings suggest that dopamine does not represent the opportunity cost but rather modulates how much effort a given reward is worth. Dopamine has been proposed in a prevalent theory to signal the average reward rate, used to estimate the cost of investing time in an action, also referred to as opportunity cost. We contrasted the effect of dopamine manipulation in healthy participants in two tasks, in which increasing response vigor (i.e., the amount of effort invested in an action) allowed either to save time or to earn more
The opportunity cost of time modulates cognitive effort.

PubMed

Otto, A Ross; Daw, Nathaniel D

2018-05-08

A spate of recent work demonstrates that humans seek to avoid the expenditure of cognitive effort, much like physical effort or economic resources. Less is clear, however, about the circumstances dictating how and when people decide to expend cognitive effort. Here we adopt a popular theory of opportunity costs and response vigor and to elucidate this question. This account, grounded in Reinforcement Learning, formalizes a trade-off between two costs: the harder work assumed necessary to emit faster actions and the opportunity cost inherent in acting more slowly (i.e., the delay that results to the next reward and subsequent rewards). Recent work reveals that the opportunity cost of time-operationalized as the average reward rate per unit time, theorized to be signaled by tonic dopamine levels, modulates the speed with which a person responds in a simple discrimination tasks. We extend this framework to cognitive effort in a diverse range of cognitive tasks, for which 1) the amount of cognitive effort demanded from the task varies from trial to trial and 2) the putative expenditure of cognitive effort holds measureable consequences in terms of accuracy and response time. In the domains of cognitive control, perceptual decision-making, and task-switching, we found that subjects tuned their level of effort exertion in accordance with the experienced average reward rate: when the opportunity cost of time was high, subjects made more errors and responded more quickly, which we interpret as a withdrawal of cognitive effort. That is, expenditure of cognitive effort appeared to be modulated by the opportunity cost of time. Further, and consistent with our account, the strength of this modulation was predicted by individual differences in efficacy of cognitive control. Taken together, our results elucidate the circumstances dictating how and when people expend cognitive effort. Copyright © 2018 Elsevier Ltd. All rights reserved.
Opportunity Cost and the Intelligence of Economists: A Comment

ERIC Educational Resources Information Center

Arce, Daniel G.

2016-01-01

In "Opportunity Cost: A Reexamination," Professor Parkin contrasts forgone physical quantities with forgone values as measures of the opportunity cost of basic economic decisions. The impetus for his study stems from an experiment conducted by Ferraro and Taylor (2005), in which professional economists could not reach a consensus over…
Estimating the opportunity costs of bed‐days

PubMed Central

Robotham, Julie V.; Deeny, Sarah R.; Edmunds, W. John; Jit, Mark

2017-01-01

Abstract Opportunity costs of bed‐days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second‐best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed‐days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed‐days in terms of health forgone for the second‐best patient, but expressed monetarily. This alternative approach effectively re‐connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed‐days. PMID:29105894
Estimating the opportunity costs of bed-days.

PubMed

Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark

2018-03-01

Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.
Resolving the "Cost-Effective but Unaffordable" Paradox: Estimating the Health Opportunity Costs of Nonmarginal Budget Impacts.

PubMed

Lomas, James; Claxton, Karl; Martin, Stephen; Soares, Marta

2018-03-01

Considering whether or not a proposed investment (an intervention, technology, or program of care) is affordable is really asking whether the benefits it offers are greater than its opportunity cost. To say that an investment is cost-effective but not affordable must mean that the (implicit or explicit) "threshold" used to judge cost-effectiveness does not reflect the scale and value of the opportunity costs. Existing empirical estimates of health opportunity costs are based on cross-sectional variation in expenditure and mortality outcomes by program budget categories (PBCs) and do not reflect the likely effect of nonmarginal budget impacts on health opportunity costs. The UK Department of Health regularly updates the needs-based target allocation of resources to local areas of the National Health Service (NHS), creating two subgroups of local areas (those under target allocation and those over). These data provide the opportunity to explore how the effects of changes in health care expenditure differ with available resources. We use 2008-2009 data to evaluate two econometric approaches to estimation and explore a range of criteria for accepting subgroup specific effects for differences in expenditure and outcome elasticities across the 23 PBCs. Our results indicate that health opportunity costs arising from an investment imposing net increases in expenditure are underestimated unless account is taken of likely nonmarginal effects. They also indicate the benefits (reduced health opportunity costs or increased value-based price of a technology) of being able to "smooth" these nonmarginal budget impacts by health care systems borrowing against future budgets or from manufacturers offering "mortgage" type arrangements. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Opportunity cost of funding drugs for rare diseases: the cost-effectiveness of eculizumab in paroxysmal nocturnal hemoglobinuria.

PubMed

Coyle, Doug; Cheung, Matthew C; Evans, Gerald A

2014-11-01

Both ethical and economics concerns have been raised with respect to the funding of drugs for rare diseases. This article reports both the cost-effectiveness of eculizumab for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) and its associated opportunity costs. Analysis compared eculizumab plus current standard of care v. current standard of care from a publicly funded health care system perspective. A Markov model covered the major consequences of PNH and treatment. Cost-effectiveness was assessed in terms of the incremental cost per life year and per quality-adjusted life year (QALY) gained. Opportunity costs were assessed by the health gains foregone and the alternative uses for the additional resources. Eculizumab is associated with greater life years (1.13), QALYs (2.45), and costs (CAN$5.24 million). The incremental cost per life year and per QALY gained is CAN$4.62 million and CAN$2.13 million, respectively. Based on established thresholds, the opportunity cost of funding eculizumab is 102.3 discounted QALYs per patient funded. Sensitivity and subgroup analysis confirmed the robustness of the results. If the acquisition cost of eculizumab was reduced by 98.5%, it could be considered cost-effective. The nature of rare diseases means that data are often sparse for the conduct of economic evaluations. When data were limited, assumptions were made that biased results in favor of eculizumab. This study demonstrates the feasibility of conducting economic evaluations in the context of rare diseases. Eculizumab may provide substantive benefits to patients with PNH in terms of life expectancy and quality of life but at a high incremental cost and a substantial opportunity cost. Decision makers should fully consider the opportunity costs before making positive reimbursement decisions. © The Author(s) 2014.
Potential Cost-Effective Opportunities for Methane Emission Abatement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warner, Ethan; Steinberg, Daniel; Hodson, Elke

2015-08-01

The energy sector was responsible for approximately 84% of carbon dioxide equivalent (CO 2e) greenhouse gas (GHG) emissions in the U.S. in 2012 (EPA 2014a). Methane is the second most important GHG, contributing 9% of total U.S. CO 2e emissions. A large portion of those methane emissions result from energy production and use; the natural gas, coal, and oil industries produce approximately 39% of anthropogenic methane emissions in the U.S. As a result, fossil-fuel systems have been consistently identified as high priority sectors to contribute to U.S. GHG reduction goals (White House 2015). Only two studies have recently attempted tomore » quantify the abatement potential and cost associated with the breadth of opportunities to reduce GHG emissions within natural gas, oil, and coal supply chains in the United States, namely the U.S. Environmental Protection Agency (EPA) (2013a) and ICF (2014). EPA, in its 2013 analysis, estimated the marginal cost of abatement for non-CO 2 GHG emissions from the natural gas, oil, and coal supply chains for multiple regions globally, including the United States. Building on this work, ICF International (ICF) (2014) provided an update and re-analysis of the potential opportunities in U.S. natural gas and oil systems. In this report we synthesize these previously published estimates as well as incorporate additional data provided by ICF to provide a comprehensive national analysis of methane abatement opportunities and their associated costs across the natural gas, oil, and coal supply chains. Results are presented as a suite of marginal abatement cost curves (MACCs), which depict the total potential and cost of reducing emissions through different abatement measures. We report results by sector (natural gas, oil, and coal) and by supply chain segment - production, gathering and boosting, processing, transmission and storage, or distribution - to facilitate identification of which sectors and supply chain segments provide the
Valuation of opportunity costs by rats working for rewarding electrical brain stimulation.

PubMed

Solomon, Rebecca Brana; Conover, Kent; Shizgal, Peter

2017-01-01

Pursuit of one goal typically precludes simultaneous pursuit of another. Thus, each exclusive activity entails an "opportunity cost:" the forgone benefits from the next-best activity eschewed. The present experiment estimates, in laboratory rats, the function that maps objective opportunity costs into subjective ones. In an operant chamber, rewarding electrical brain stimulation was delivered when the cumulative time a lever had been depressed reached a criterion duration. The value of the activities forgone during this duration is the opportunity cost of the electrical reward. We determined which of four functions best describes how objective opportunity costs, expressed as the required duration of lever depression, are translated into their subjective equivalents. The simplest account is the identity function, which equates subjective and objective opportunity costs. A variant of this function called the "sigmoidal-slope function," converges on the identity function at longer durations but deviates from it at shorter durations. The sigmoidal-slope function has the form of a hockey stick. The flat "blade" denotes a range over which opportunity costs are subjectively equivalent; these durations are too short to allow substitution of more beneficial activities. The blade extends into an upward-curving portion over which costs become discriminable and finally into the straight "handle," over which objective and subjective costs match. The two remaining functions are based on hyperbolic and exponential temporal discounting, respectively. The results are best described by the sigmoidal-slope function. That this is so suggests that different principles of intertemporal choice are involved in the evaluation of time spent working for a reward or waiting for its delivery. The subjective opportunity-cost function plays a key role in the evaluation and selection of goals. An accurate description of its form and parameters is essential to successful modeling and prediction of
Opportunity cost in the economic evaluation of da Vinci robotic assisted surgery.

PubMed

Fuertes-Guiró, Fernando; Girabent-Farrés, Montserrat; Viteri-Velasco, Eduardo

2016-04-01

This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic surgery, assisted by a comprehensive review of the literature to determine the differences in the total cost of surgery and operative time in traditional laparoscopic surgery and da Vinci robotic surgery. We identified the studies comparing the use of traditional laparoscopic surgery with robotics during the period 2002-2012 in the electronic economic evaluation databases, and another electronic search was performed for publications by Spanish hospitals in the same period to calculate the opportunity cost. A meta-analysis of response variables considering the total cost of the intervention and surgical time was completed using the items selected in the first revision, and their differences were analyzed. We then calculated the opportunity cost represented by these time differences using the data obtained from the studies in the second review of the literature. Nine items were selected in the first review and three in the second. Traditional laparoscopic surgery has a lower cost than the da Vinci (p < 0.00001). Robotic surgery takes longer (8.0-65.5 min) than traditional surgery (p < 0.00001), and this difference represents an average opportunity cost for robot use of € 489.98, with a unit cost factor/time which varies according to the pathology dealt with, from € 8.2 to 18.7/min. The opportunity cost is a quantity that must be included in the total cost of using a surgical technology within an economic cost analysis in the context of an economic evaluation.
Political economy of marine reserves: Understanding the role of opportunity costs

PubMed Central

Smith, Martin D.; Lynham, John; Sanchirico, James N.; Wilson, James A.

2010-01-01

The creation of marine reserves is often controversial. For decisionmakers, trying to find compromises, an understanding of the timing, magnitude, and incidence of the costs of a reserve is critical. Understanding the costs, in turn, requires consideration of not just the direct financial costs but also the opportunity costs associated with reserves. We use a discrete choice model of commercial fishermen’s behavior to examine both the short-run and long-run opportunity costs of marine reserves. Our results can help policymakers recognize the factors influencing commercial fishermen’s responses to reserve proposals. More generally, we highlight the potential drivers behind the political economy of marine reserves. PMID:20133732
Higher cost of single incision laparoscopic cholecystectomy due to longer operating time. A study of opportunity cost based on meta-analysis

PubMed Central

GIRABENT-FARRÉS, M.

2018-01-01

Background We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC). Methods We identified studies comparing use of both techniques during the period 2008–2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences. We subsequently calculated the opportunity cost of these time differences based on the design of a cost/time variable using the data from the second literature review. Results Twenty-seven articles were selected from the first review: 26 for operating time (3.138 patients) and 3 for the cost of surgery (831 patients), and 3 articles from the second review. Both techniques have similar operating costs. Single incision laparoscopy surgery takes longer (16.90min) to perform (p <0.00001) and this difference represents an opportunity cost of 755.97 € (cost/time unit factor of 44.73 €/min). Conclusions SILC costs the same as CLC, but the surgery takes longer to perform, and this difference involves an opportunity cost that increases the total cost of SILC. The value of the opportunity cost of the operating time can vary the total cost of a surgical technique and it should be included in the economic evaluation to support the decision to adopt a new surgical technique. PMID:29549678

Lost opportunity cost of surgical training in the Australian private sector.

PubMed

Aitken, R James

2012-03-01

To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.
Sexual selection and the opportunity cost of free mate choice.

PubMed

Apostolou, Menelaos

2016-06-01

The model of sexual selection under parental choice has been proposed to account for the control that parents exercise over their children's mating decisions. The present paper attempts to formalize and advance this model with the purpose of providing a better understanding of how parental choice mandates the course of sexual selection. In particular, in the proposed formulation, free mate choice involves an opportunity cost which motivates parents to place their children's mate choices under their control. When they succeed in doing so, they become a significant sexual selection force, as traits that appeal to parents in an in-law are selected and increase in frequency in the population. The degree of parental control over mating, and thus the strength of sexual selection under parental choice, is positively predicted by the size of the opportunity cost of free mate choice. The primary factors that affect the level of opportunity cost vary between society types, affecting the strength of parental choice as a sexual selection force.
Kinky thresholds revisited: opportunity costs differ in the NE and SW quadrants.

PubMed

Eckermann, Simon

2015-02-01

Historically, a kinked threshold line on the cost-effectiveness plane at the origin was suggested due to differences in willingness to pay (WTP) for health gain with trade-offs in the north-east (NE) quadrant versus willingness to accept (WTA) cost reductions for health loss with trade-offs in the south-west (SW) quadrant. Empirically, WTA is greater than WTP for equivalent units of health, a finding supported by loss aversion under prospect theory. More recently, appropriate threshold values for health effects have been shown to require an endogenous consideration of the opportunity cost of alternative actions in budget-constrained health systems, but also allocative and displacement inefficiency observed in health system practice. Allocative and displacement inefficiency arise in health systems where the least cost-effective program in contraction has a higher incremental cost-effectiveness ratio (ICER = m) than the most cost-effective program in expansion (ICER = n) and displaced services (ICER = d), respectively. The health shadow price derived by Pekarsky, [Formula: see text] reflects the opportunity cost of best alternative adoption and financing actions in reimbursing new technology with expected incremental costs and net effect allowing for allocative (n < m), and displacement, inefficiency (d < m). This provides an appropriate threshold value for the NE quadrant. In this paper, I show that for trade-offs in the SW quadrant, where new strategies have lower expected net cost while lower expected net effect than current practice, the opportunity cost is contraction of the least cost-effective program, with threshold ICER m. That is, in the SW quadrant, the cost reduction per unit of decreased effect should be compared with the appropriate opportunity cost, best alternative generation of funding. Consequently, appropriate consideration of opportunity cost produces a kink in the threshold at the origin, with the health shadow price in the NE quadrant
Complexities in the Examination of Opportunity Cost

ERIC Educational Resources Information Center

O'Donnell, Rod

2016-01-01

Rod O'Donnell writes here that there is a wide and deep confusion in contemporary economics about the concept and role of opportunity cost (OC). O'Donnell states that his main grounds for making this claim are the muddled, variable, and sometimes conflicting treatments of OC in modern textbooks; the disturbing empirical results in surveys of both…
Developing a Value Framework: The Need to Reflect the Opportunity Costs of Funding Decisions.

PubMed

Sculpher, Mark; Claxton, Karl; Pearson, Steven D

2017-02-01

A growing number of health care systems internationally use formal economic evaluation methods to support health care funding decisions. Recently, a range of organizations have been advocating forms of analysis that have been termed "value frameworks." There has also been a push for analytical methods to reflect a fuller range of benefits of interventions through multicriteria decision analysis. A key principle that is invariably neglected in current and proposed frameworks is the need to reflect evidence on the opportunity costs that health systems face when making funding decisions. The mechanisms by which opportunity costs are realized vary depending on the system's financial arrangements, but they always mean that a decision to fund a specific intervention for a particular patient group has the potential to impose costs on others in terms of forgone benefits. These opportunity costs are rarely explicitly reflected in analysis to support decisions, but recent developments to quantify benefits forgone make more appropriate analyses feasible. Opportunity costs also need to be reflected in decisions if a broader range of attributes of benefit is considered, and opportunity costs are a key consideration in determining the appropriate level of total expenditure in a system. The principles by which opportunity costs can be reflected in analysis are illustrated in this article by using the example of the proposed methods for value-based pricing in the United Kingdom. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Ecosystem services and opportunity costs shift spatial priorities for conserving forest biodiversity.

PubMed

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

2014-01-01

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

PubMed Central

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

2014-01-01

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

PubMed

Roes, Frans L

2007-07-21

Descriptions of interactions between ants and their 'guests' serve to illustrate the thesis that Ewald's theory of the 'evolution of virulence' not only applies to interactions between micro-organisms causing infectious diseases and their hosts, but also to interactions between individuals belonging to differing species. For instance, the prediction is put forward and discussed that guests of army ants are, relative to guests of other species of ants, more often parasitic. A key variable in Ewald's theory is 'transmissibility'. It shows some resemblance to similar variables used in micro-economic theory and in Emerson's sociological Power-Dependence Relations theory. In this article, this variable is called 'outside opportunities'. In an A-B relation, an outside opportunity for A is anything which constitutes an alternative to what B can provide. It is concluded that in A-B interactions, the more outside opportunities are available to A, the more costs are incurred by B. Differences and similarities between this idea and Game Theory are discussed.
[Variability and opportunity costs among the surgical alternatives for breast cancer].

PubMed

Angulo-Pueyo, Ester; Ridao-López, Manuel; Martínez-Lizaga, Natalia; García-Armesto, Sandra; Bernal-Delgado, Enrique

2014-01-01

To analyze medical practice variation in breast cancer surgery (either inpatient-based or day-case surgery), by comparing conservative surgery (CS) plus radiotherapy vs. non-conservative surgery (NCS). We also analyzed the opportunity costs associated with CS and NCS. We performed an observational study of age- and sex-standardized rates of CS and NCS, performed in 199 Spanish healthcare areas in 2008-2009. Costs were calculated by using two techniques: indirectly, by using All-Patients Diagnosis Related Groups (AP-DRG) based on hospital admissions, and directly by using full costing from the Spanish Network of Hospital Costs (SNHC) data. Standardized surgery rates for CS and NCS were 6.84 and 4.35 per 10,000 women, with variation across areas ranging from 2.95 to 3.11 per 10,000 inhabitants. In 2009, 9% of CS was performed as day-case surgery, although a third of the health care areas did not perform this type of surgery. Taking the SNHC as a reference, the cost of CS was estimated at 7,078 € and that of NCS was 6,161 €. Using AP-DRG, costs amounted to 9,036 € and 8,526 €, respectively. However, CS had lower opportunity costs than NCS when day-case surgery was performed frequently-more than 46% of cases (following SNHC estimates) or 23% of cases (following AP-DRG estimates). Day-case CS for breast cancer was found to be the best option in terms of opportunity-costs beyond a specific threshold, when both CS and NCS are elective. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Comparative and cost-effectiveness research: Competencies, opportunities, and training for nurse scientists.

PubMed

Stone, Patricia W; Cohen, Catherine; Pincus, Harold Alan

Comparative and cost-effectiveness research develops knowledge on the everyday effectiveness and value of treatments and care delivery models. To describe comparative and cost-effectiveness research; identify needed competencies for this research; identify federal funding; and describe current training opportunities. Published recommended competencies were reviewed. Current federal funding and training opportunities were identified. A federally funded training program and other training opportunities are described. Fourteen core competencies were identified that have both analytic and theoretical foci from nursing and other fields. There are multiple sources of federal funding for research and training. Interdisciplinary training is needed. Comparative and cost-effectiveness research has the opportunity to transform health care delivery and improve the outcomes of patients. Nurses, as clinicians and scientists, are in a unique position to contribute to this important research. We encourage nurses to seek the needed interdisciplinary research training to participate in this important endeavor. We also encourage educators to use the competencies and processes identified in current training programs to help shape their doctoral programs. Copyright © 2017 Elsevier Inc. All rights reserved.
Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

PubMed

Asaria, Miqdad; Grasic, Katja; Walker, Simon

2016-02-01

This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.
The earnings of informal carers: wage differentials and opportunity costs.

PubMed

Heitmueller, Axel; Inglis, Kirsty

2007-07-01

A substantial proportion of working age individuals in Britain are looking after sick, disabled or elderly people, often combining their work and caring responsibilities. Previous research has shown that informal care is linked with substantial opportunity costs for the individual due to forgone wages as a result of non-labour market participation. In this paper we show that informal carers exhibit further disadvantages even when participating. Using the British Household Panel Study (BHPS) we decompose wage differentials and show that carers can expect lower returns for a given set of characteristics, with this wage penalty varying along the pay distribution and by gender. Furthermore, opportunity costs from forgone wages and wage penalties are estimated and found to be substantial.
Over-Education and Its Opportunity Cost in Japan

ERIC Educational Resources Information Center

Kucel, Aleksander; Molina, Ivette Fuentes; Raya, Josep Maria

2016-01-01

In this paper, we investigate the determinants of over-education in Japan and evaluate its opportunity costs for university graduates. To this end, we use the REFLEX data. Results reveal that over-education level in Japan is high and it brings an important wage penalty for Japanese workers. Large firm and high occupations point toward a…
The opportunity cost of capital: development of new pharmaceuticals.

PubMed

Chit, Ayman; Chit, Ahmad; Papadimitropoulos, Manny; Krahn, Murray; Parker, Jayson; Grootendorst, Paul

2015-01-01

The opportunity cost of the capital invested in pharmaceutical research and development (R&D) to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this "hidden" cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D. © The Author(s) 2015.
Minimizing opportunity costs to aquatic connectivity restoration while controlling an invasive species.

PubMed

Milt, Austin W; Diebel, Matthew W; Doran, Patrick J; Ferris, Michael C; Herbert, Matthew; Khoury, Mary L; Moody, Allison T; Neeson, Thomas M; Ross, Jared; Treska, Ted; O'Hanley, Jesse R; Walter, Lisa; Wangen, Steven R; Yacobson, Eugene; McIntyre, Peter B

2018-03-08

Controlling invasive species is critical for conservation but can have unintended consequences for native species and divert resources away from other efforts. This dilemma occurs on a grand scale in the North American Great Lakes, where dams and culverts block tributary access to habitat of desirable fish species and are a lynchpin of long-standing efforts to limit ecological damage inflicted by the invasive, parasitic sea lamprey (Petromyzon marinus). Habitat restoration and sea-lamprey control create conflicting goals for managing aging infrastructure. We used optimization to minimize opportunity costs of habitat gains for 37 desirable migratory fishes that arose from restricting sea lamprey access (0-25% increase) when selecting barriers for removal under a limited budget (US$1-105 million). Imposing limits on sea lamprey habitat reduced gains in tributary access for desirable species by 15-50% relative to an unconstrained scenario. Additional investment to offset the effect of limiting sea-lamprey access resulted in high opportunity costs for 30 of 37 species (e.g., an additional US$20-80 million for lake sturgeon [Acipenser fulvescens]) and often required ≥5% increase in sea-lamprey access to identify barrier-removal solutions adhering to the budget and limiting access. Narrowly distributed species exhibited the highest opportunity costs but benefited more at less cost when small increases in sea-lamprey access were allowed. Our results illustrate the value of optimization in limiting opportunity costs when balancing invasion control against restoration benefits for diverse desirable species. Such trade-off analyses are essential to the restoration of connectivity within fragmented rivers without unleashing invaders. © 2018 Society for Conservation Biology.
Patient level costing in Ireland: process, challenges and opportunities.

PubMed

Murphy, A; McElroy, B

2015-03-01

In 2013, the Department of Health released their policy paper on hospital financing entitled Money Follows the Patient. A fundamental building block for the proposed financing model is patient level costing. This paper outlines the patient level costing process, identifies the opportunities and considers the challenges associated with the process in the Irish hospital setting. Methods involved a review of the existing literature which was complemented with an interview with health service staff. There are considerable challenges associated with implementing patient level costing including deficits in information and communication technologies and financial expertise as well as timeliness of coding. In addition, greater clinical input into the costing process is needed compared to traditional costing processes. However, there are long-term benefits associated with patient level costing; these include empowerment of clinical staff, improved transparency and price setting and greater fairness, especially in the treatment of outliers. These can help to achieve the Government's Health Strategy. The benefits of patient level costing need to be promoted and a commitment to investment in overcoming the challenges is required.
The Influence of School Factors on Racial Opportunity Cost for High-Achieving Students of Color

ERIC Educational Resources Information Center

Venzant Chambers, Terah T.; Huggins, Kristin Shawn

2014-01-01

Previous work on racial opportunity cost--that is, the price that students of color pay in their pursuit of academic success--is extended here using organizational culture literature to more closely explore the interplay of school culture with the racial opportunity cost experienced by the study participants. Eighteen African American and Latina/o…
An opportunity cost model of subjective effort and task performance

PubMed Central

Kurzban, Robert; Duckworth, Angela; Kable, Joseph W.; Myers, Justus

2013-01-01

Why does performing certain tasks cause the aversive experience of mental effort and concomitant deterioration in task performance? One explanation posits a physical resource that is depleted over time. We propose an alternate explanation that centers on mental representations of the costs and benefits associated with task performance. Specifically, certain computational mechanisms, especially those associated with executive function, can be deployed for only a limited number of simultaneous tasks at any given moment. Consequently, the deployment of these computational mechanisms carries an opportunity cost – that is, the next-best use to which these systems might be put. We argue that the phenomenology of effort can be understood as the felt output of these cost/benefit computations. In turn, the subjective experience of effort motivates reduced deployment of these computational mechanisms in the service of the present task. These opportunity cost representations, then, together with other cost/benefit calculations, determine effort expended and, everything else equal, result in performance reductions. In making our case for this position, we review alternate explanations both for the phenomenology of effort associated with these tasks and for performance reductions over time. Likewise, we review the broad range of relevant empirical results from across subdisciplines, especially psychology and neuroscience. We hope that our proposal will help to build links among the diverse fields that have been addressing similar questions from different perspectives, and we emphasize ways in which alternate models might be empirically distinguished. PMID:24304775
Time-driven activity-based costing to identify opportunities for cost reduction in pediatric appendectomy.

PubMed

Yu, Yangyang R; Abbas, Paulette I; Smith, Carolyn M; Carberry, Kathleen E; Ren, Hui; Patel, Binita; Nuchtern, Jed G; Lopez, Monica E

2016-12-01

As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. Process maps were created using medical record time stamps. Labor capacity cost rates were calculated using national median physician salaries, weighted nurse-patient ratios, and hospital cost data. Consumable costs for supplies, pharmacy, laboratory, and food were derived from the hospital general ledger. Time-driven activity-based costing resulted in precise per-minute calculation of personnel costs. Highest costs were in the operating room ($747.07), hospital floor ($388.20), and emergency department ($296.21). Major contributors to length of stay were emergency department evaluation (270min), operating room availability (395min), and post-operative monitoring (1128min). The TDABC model led to $1712.16 in personnel costs and $1041.23 in consumable costs for a total appendicitis cost of $2753.39. Inefficiencies in healthcare delivery can be identified through TDABC. Triage-based standing delegation orders, advanced practice providers, and same day discharge protocols are proposed cost-reducing interventions to optimize value-based care for simple appendicitis. II. Copyright Â© 2016 Elsevier Inc. All rights reserved.
[Opportunity cost for men who visit family medicine units in the city of Querétaro, Mexico].

PubMed

Martínez Carranza, Edith Olimpia; Villarreal Ríos, Enrique; Vargas Daza, Emma Rosa; Galicia Rodríguez, Liliana; Martínez González, Lidia

2010-12-01

To determine the opportunity cost for men who seek care in the family medicine units (FMU) of the Mexican Social Security Institute (IMSS, Instituto Mexicano del Seguro Social) in the city of Querétaro. A sample was selected of 807 men, ages 20 to 59 years, who sought care through the family medicine, laboratory, and pharmacy services provided by the FMU at the IMSS in Querétaro. Patients referred for emergency services and those who left the facilities without receiving care were excluded. The sample (n = 807) was calculated using the averages for an infinite population formula, with a confidence interval of 95% (CI95%) and an average opportunity cost of US$5.5 for family medicine, US$3.1 for laboratory services, and US$2.3 for pharmacy services. Estimates included the amount of time spent on travel, waiting, and receiving care; the number of people accompanying the patient, and the cost per minute of paid and unpaid job activities. The opportunity cost was calculated using the estimated cost per minute for travel, waiting, and receiving care for patients and their companions. The opportunity cost for the patient travel was estimated at US$0.97 (CI95%: 0.81-1.15), while wait time was US$5.03 (CI95%: 4.08-6.09) for family medicine, US$0.06 (CI95%: 0.05-0.08) for pharmacy services, and US$1.89 (CI95%: 1.56-2.25) for laboratory services. The average opportunity cost for an unaccompanied patient visit varied between US$1.10 for pharmacy services alone and US$8.64 for family medicine, pharmacy, and laboratory services. The weighted opportunity cost for family medicine was US$6.24. Given that the opportunity cost for men who seek services in FMU corresponds to more than half of a minimum salary, it should be examined from an institutional perspective whether this is the best alternative for care.

Spatially explicit estimates of forest carbon emissions, mitigation costs and REDD+ opportunities in Indonesia

NASA Astrophysics Data System (ADS)

Graham, Victoria; Laurance, Susan G.; Grech, Alana; Venter, Oscar

2017-04-01

Carbon emissions from the conversion and degradation of tropical forests contribute to anthropogenic climate change. Implementing programs to reduce emissions from tropical forest loss in Southeast Asia are perceived to be expensive due to high opportunity costs of avoided deforestation. However, these costs are not representative of all REDD+ opportunities as they are typically based on average costs across large land areas and are primarily for reducing deforestation from oil palm or pulp concessions. As mitigation costs and carbon benefits can vary according to site characteristics, spatially-explicit information should be used to assess cost-effectiveness and to guide the allocation of scarce REDD+ resources. We analyzed the cost-effectiveness of the following REDD+ strategies in Indonesia, one of the world’s largest sources of carbon emissions from deforestation: halting additional deforestation in protected areas, timber and oil palm concessions, reforesting degraded land and employing reduced-impact logging techniques in logging concessions. We discover that when spatial variation in costs and benefits is considered, low-cost options emerged even for the two most expensive strategies: protecting forests from conversion to oil palm and timber plantations. To achieve a low emissions reduction target of 25%, we suggest funding should target deforestation in protected areas, and oil palm and timber concessions to maximize emissions reductions at the lowest cumulative cost. Low-cost opportunities for reducing emissions from oil palm are where concessions have been granted on deep peat deposits or unproductive land. To achieve a high emissions reduction target of 75%, funding is allocated across all strategies, emphasizing that no single strategy can reduce emissions cost-effectively across all of Indonesia. These findings demonstrate that by using a spatially-targeted approach to identify high priority locations for reducing emissions from deforestation and
Behavioral Economics and Physician Board Meetings: Opportunity Cost, Regret, and Their Mitigation in Orthopaedic Surgery.

PubMed

Sinicrope, Brent J; Roberts, Craig S; Sussman, Lyle

2018-01-01

Health care is a business. Health care providers must become familiar with terms such as opportunity costs, the potential loss or gain when one choice is made in lieu of another. The purpose of this study was to calculate the opportunity cost of two orthopaedic surgery society board meetings and discuss these in the context of behavioral economics and regret. A literature search was conducted to determine an orthopaedic surgeon's average yearly salary, hours worked per week, and weeks worked per year. The details of two orthopaedic surgery professional society meetings that one senior author (CSR) attended were used to calculate opportunity cost. Although the true benefits are multifactorial and difficult to objectively quantify, awareness of the cost-benefit ratio can help guide time and resource management to maximize the return on investment while minimizing buyer's remorse and perhaps influence the media by which medical meetings are held in the future. (Journal of Surgical Orthopaedic Advances 27(1):10-13, 2018).
Conserving rare species can have high opportunity costs for common species.

PubMed

Neeson, Thomas M; Doran, Patrick J; Ferris, Michael C; Fitzpatrick, Kimberly B; Herbert, Matthew; Khoury, Mary; Moody, Allison T; Ross, Jared; Yacobson, Eugene; McIntyre, Peter B

2018-04-13

Conservation practitioners face difficult choices in apportioning limited resources between rare species (to ensure their existence) and common species (to ensure their abundance and ecosystem contributions). We quantified the opportunity costs of conserving rare species of migratory fishes in the context of removing dams and retrofitting road culverts across 1,883 tributaries of the North American Great Lakes. Our optimization models show that maximizing total habitat gains across species can be very efficient in terms of benefits achieved per dollar spent, but disproportionately benefits common species. Conservation approaches that target rare species, or that ensure some benefits for every species (i.e., complementarity) enable strategic allocation of resources among species but reduce aggregate habitat gains. Thus, small habitat gains for the rarest species necessarily come at the expense of more than 20 times as much habitat for common ones. These opportunity costs are likely to occur in many ecosystems because range limits and conservation costs often vary widely among species. Given that common species worldwide are declining more rapidly than rare ones within major taxa, our findings provide incentive for triage among multiple worthy conservation targets. © 2018 John Wiley & Sons Ltd.
Learning the opportunity cost of time in a patch-foraging task

PubMed Central

Constantino, Sara; Daw, Nathaniel D.

2015-01-01

Although most decision research concerns choice between simultaneously presented options, in many situations options are encountered serially and the decision is whether to exploit an option or search for a better one. Such problems have a rich history in animal foraging but we know little about the psychological processes involved. In particular, it is unknown whether learning in these problems is supported by the well studied neurocomputational mechanisms involved in more conventional tasks. We investigated how humans learn in a foraging task, which requires deciding whether to harvest a depleting resource or switch to a replenished one. The optimal choice (given by the Marginal Value Theorem; MVT) requires comparing the immediate return from harvesting to the opportunity cost of time, which is given by the long-run average reward. In two experiments, we varied opportunity cost across blocks. Subjects adjusted their behavior to blockwise changes in environmental characteristics. We examined how subjects learned their choice strategies by comparing choice adjustments to a learning rule suggested by the MVT (where the opportunity cost threshold is estimated as an average over previous rewards) and to the predominant incremental learning theory in neuroscience, temporal-difference learning (TD). Trial-by-trial decisions were better explained by the MVT threshold learning rule. These findings expand on the foraging literature, which has focused on steady-state behavior, by elucidating a computational mechanism for learning in switching tasks that is distinct from those used in traditional tasks, and suggest connections to research on average reward rates in other domains of neuroscience. PMID:25917000
Crowdsourcing healthcare costs: Opportunities and challenges for patient centered price transparency.

PubMed

Meisel, Zachary F; VonHoltz, Lauren A Houdek; Merchant, Raina M

2016-03-01

Efforts to improve health care price transparency have garnered significant attention from patients, policy makers, and health insurers. In response to increasing consumer demand, state governments, insurance plans, and health care providers are reporting health care prices. However, such data often do not provide consumers with the most salient information: their own actual out-of-pocket cost for medical care. Although untested, crowdsourcing, a mechanism for the public to help answer complex questions, represents a potential solution to the problem of opaque hospital costs. This article explores, the challenges and potential opportunities for crowdsourcing out-of-pocket costs for healthcare consumers. Copyright © 2015 Elsevier Inc. All rights reserved.
Estimating the economic opportunity cost of water use with river basin simulators in a computationally efficient way

NASA Astrophysics Data System (ADS)

Rougé, Charles; Harou, Julien J.; Pulido-Velazquez, Manuel; Matrosov, Evgenii S.

2017-04-01

The marginal opportunity cost of water refers to benefits forgone by not allocating an additional unit of water to its most economically productive use at a specific location in a river basin at a specific moment in time. Estimating the opportunity cost of water is an important contribution to water management as it can be used for better water allocation or better system operation, and can suggest where future water infrastructure could be most beneficial. Opportunity costs can be estimated using 'shadow values' provided by hydro-economic optimization models. Yet, such models' use of optimization means the models had difficulty accurately representing the impact of operating rules and regulatory and institutional mechanisms on actual water allocation. In this work we use more widely available river basin simulation models to estimate opportunity costs. This has been done before by adding in the model a small quantity of water at the place and time where the opportunity cost should be computed, then running a simulation and comparing the difference in system benefits. The added system benefits per unit of water added to the system then provide an approximation of the opportunity cost. This approximation can then be used to design efficient pricing policies that provide incentives for users to reduce their water consumption. Yet, this method requires one simulation run per node and per time step, which is demanding computationally for large-scale systems and short time steps (e.g., a day or a week). Besides, opportunity cost estimates are supposed to reflect the most productive use of an additional unit of water, yet the simulation rules do not necessarily use water that way. In this work, we propose an alternative approach, which computes the opportunity cost through a double backward induction, first recursively from outlet to headwaters within the river network at each time step, then recursively backwards in time. Both backward inductions only require linear
OPPORTUNITY COSTS OF REWARD DELAYS AND THE DISCOUNTING OF HYPOTHETICAL MONEY AND CIGARETTES

PubMed Central

Johnson, Patrick S.; Herrmann, Evan S.; Johnson, Matthew W.

2015-01-01

Humans are reported to discount delayed rewards at lower rates than nonhumans. However, nonhumans are studied in tasks that restrict reinforcement during delays, whereas humans are typically studied in tasks that do not restrict reinforcement during delays. In nonhuman tasks, the opportunity cost of restricted reinforcement during delays may increase delay discounting rates. The present within-subjects study used online crowdsourcing (Amazon Mechanical Turk, or MTurk) to assess the discounting of hypothetical delayed money (and cigarettes in smokers) under four hypothetical framing conditions differing in the availability of reinforcement during delays. At one extreme, participants were free to leave their computer without returning, and engage in any behavior during reward delays (modeling typical human tasks). At the opposite extreme, participants were required to stay at their computer and engage in little other behavior during reward delays (modeling typical nonhuman tasks). Discounting rates increased as an orderly function of opportunity cost. Results also indicated predominantly hyperbolic discounting, the “magnitude effect,” steeper discounting of cigarettes than money, and positive correlations between discounting rates of these commodities. This is the first study to test the effects of opportunity costs on discounting, and suggests that procedural differences may partially account for observed species differences in discounting. PMID:25388973
Opportunity costs of reward delays and the discounting of hypothetical money and cigarettes.

PubMed

Johnson, Patrick S; Herrmann, Evan S; Johnson, Matthew W

2015-01-01

Humans are reported to discount delayed rewards at lower rates than nonhumans. However, nonhumans are studied in tasks that restrict reinforcement during delays, whereas humans are typically studied in tasks that do not restrict reinforcement during delays. In nonhuman tasks, the opportunity cost of restricted reinforcement during delays may increase delay discounting rates. The present within-subjects study used online crowdsourcing (Amazon Mechanical Turk, or MTurk) to assess the discounting of hypothetical delayed money (and cigarettes in smokers) under four hypothetical framing conditions differing in the availability of reinforcement during delays. At one extreme, participants were free to leave their computer without returning, and engage in any behavior during reward delays (modeling typical human tasks). At the opposite extreme, participants were required to stay at their computer and engage in little other behavior during reward delays (modeling typical nonhuman tasks). Discounting rates increased as an orderly function of opportunity cost. Results also indicated predominantly hyperbolic discounting, the "magnitude effect," steeper discounting of cigarettes than money, and positive correlations between discounting rates of these commodities. This is the first study to test the effects of opportunity costs on discounting, and suggests that procedural differences may partially account for observed species differences in discounting. © Society for the Experimental Analysis of Behavior.
[Examination of the opportunity costs and turnover situation in patients with deep sternal infections].

PubMed

Ennker, I C; Kojcici, B; Ennker, J; Vogt, P; Melichercik, J

2012-06-01

Each and every hospital of any kind is forced, due to increased cost pressure, to work as economically and as efficiently as possible. This even applies when the operational orientations of the hospitals institutions are different. In the present article an analysis of the repercussions of the treatment of postoperative complications in terms of entrepreneurial practice is given. Our focus is on the opportunity cost. A theoretical calculation of opportunity costs is made based on the example of postoperative infections following cardiac surgery and the resulting treatment. The bases of the examinations are the results collected at the hospital Mediclin Herzentrum Lahr / Baden in 2008. The wound healing disorders were recorded from November 2004 until November 2007 and include 3675 patients who were operated on using a median sternotomy. Out of the 3675 patients 45 (1.2 %) were affected. Various treatment options are at hand. The used therapy algorithm in our practice is dependent on the stage and the development of the infection. If the high trim point, the medial trim point and the low trim point of the mediastinitis patients, as well as the average revenue and the surcharge omission on exceeding the high trim point (these data can be found in the annual accounts) and knowledge of the actual length of stay of the mediastinitis patient are known, the opportunity cost, respectively potential turnover increases, can be calculated. Reducing the medial trim point from 48.43 to, for example, 36.37 days could potentially produce a turnover increase of as much as 10 633.41 €. Keeping patient safety in mind, significant turnover increases can be achieved with adequate planning. The considered sales situation, however, can only be achieved under the same terms: these being free operating room and bed capacities, available personnel, equal cost of materials as well as enough patients. The consideration of opportunity costs could be important for entrepreneurs
Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

PubMed Central

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

2016-01-01

Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072
Opportunities and challenges for implementing cost accounting systems in the Kenyan health system.

PubMed

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K

2016-01-01

Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context.
The Race to Refinance Debt: Market Offers Opportunities to Reduce Interest Costs.

ERIC Educational Resources Information Center

DuPont, Lorrie A.

1992-01-01

In this interest market, colleges and universities could benefit from careful evaluation of debt portfolios. Refinancing debt is an opportunity to lower debt service costs, ease cash flow, change security pledges, eliminate debt service reserves, update bond documents. Timing is important. Existing and new bonds can also be combined…
Limitations and opportunities for the social cost of carbon (Invited)

NASA Astrophysics Data System (ADS)

Rose, S. K.

2010-12-01

Estimates of the marginal value of carbon dioxide-the social cost of carbon (SCC)-were recently adopted by the U.S. Government in order to satisfy requirements to value estimated GHG changes of new federal regulations. However, the development and use of SCC estimates of avoided climate change impacts comes with significant challenges and controversial decisions. Fortunately, economics can provide some guidance for conceptually appropriate estimates. At the same time, economics defaults to a benefit-cost decision framework to identify socially optimal policies. However, not all current policy decisions are benefit-cost based, nor depend on monetized information, or even have the same threshold for information. While a conceptually appropriate SCC is a useful metric, how far can we take it? This talk discusses potential applications of the SCC, limitations based on the state of research and methods, as well as opportunities for among other things consistency with climate risk management and research and decision-making tools.
Opportunity Costs in Paediatric Training: The Specialist Registrars Experience.

PubMed

O'Neill, M B; Nabialek, T; Kandamany, N

2017-08-08

In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression, 2) perceived functional effectiveness at work, 3) psychological impact of hospital based training, and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.
Opportunities for cost reduction and improved environmental impact in the lead and lead/acid battery industries

NASA Astrophysics Data System (ADS)

Lewis, N.

The opportunities for cost reduction through improved environmental performance exist in many companies, but often are not realized. This paper describes the efforts of a typical firm — Calder Industrial Materials (CIM) — that is experiencing ever-tighter environmental controls and profit erosion through the effects of new environmental legislation. At the same time, however, CIM sees opportunities to reduce its environmental burden and cut costs. As the story unfolds, readers may well discover many parallels with their own companies. It may even spur some into action, for remember, every £1000 saved requires ten times the turnover to generate the same profit.
A case study assessing opportunity costs and ecological benefits of streamside management zones and logging systems for eastern hardwood forests

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2006-01-01

Forest landowners, managers, loggers, land-use planners, and other decision and policy-makers need to understand the opportunity costs and ecological benefits associated with different widths of streamside management zones (SMZs). In this paper, a simulation model was used to assess the opportunity costs of SMZ retention for four different logging systems, two mature...
Opportunity Analysis and Selection: 50 or More Ways To Reduce Costs. Mendip Papers.

ERIC Educational Resources Information Center

Kedney, Bob; Davies, Trefor

This paper discusses activity analysis and the identification of options as the first two stages of a structured approach to achieving budget savings at postsecondary institutions, focusing on schools and practices in the United Kingdom. It presents five checklists of opportunities for reducing spending and controlling costs. The checklists cover:…
Assessing the ecological benefits and opportunity costs of alternative stream management zone widths

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

Leaving buffer zones adjacent to waterways can effectively reduce the water quality concerns associated with timber harvesting. However, riparian areas are also some of the most productive sites and can yield high quality wood. The amount of unharvested timber left in SMZs (Streamside Management Zones) can represent a substantial opportunity cost to landowners. In this...
Assessing the opportunity cost of implementing streamside management zone guidelines in eastern hardwood forests

Treesearch

Chris B. LeDoux

2006-01-01

Forest landowners, managers, loggers, land-use planners, and other decision/policy makers need to understand the opportunity cost associated with different levels of allowable management and required/voluntary protection in streamside management zones (SMZs). Four different logging technologies, two mature hardwood stands, three levels of streamside zone protection,...
The opportunity costs of caring for people with dementia in Southern Spain.

PubMed

Ruiz-Adame Reina, Manuel; Correa, Manuel; Burton, Katherine

2017-08-11

The aim of this paper is to study the opportunity costs (OC) that are involved in being a caregiver and to compare them with the direct costs assumed by the State and the families. We evaluate direct cost (those that imply a payment-out-of-pocket) and indirect cost (those that imply a dedication in time). We hypothesized that costs increase with the severity of the dementia, with the educational level and active occupational situation of caregiver. They are greater if the caregiver is male, but if the patient and caregiver cohabit they are reduced. 778 surveys were analyzed. Data was collected using a questionnaire specifically designed for the purpose, with the collaboration of Alzheimer's Diseases Associations in Andalusia (Spain). For the indirect cost, we used the reveal preferences method. For the comparison between groups an ANOVA and a MANOVA was done. The hypotheses were confirmed. The OC exponentially increases with severity. More than 55% of costs are assumed by families. Occupied people have higher educational level and incomes and contract more external support. Costs are significantly higher for male caregivers. Cohabiting reduces all kinds of costs. The relationship between educational level and employment situation lead to think that if these variables are greater more people will seek professional support. Cultural reasons still maintain women as main caregivers for all educational levels. The existence of these informal caregivers as the main care providers is a saving for the State, and a brake for the development of professional supply. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Comments on "Opportunity Cost: A Reexamination": A Case in Point of No Free Lunch

ERIC Educational Resources Information Center

Stone, Daniel F.

2016-01-01

Ferraro and Taylor (2005) and Potter and Sanders (2012) have sparked a debate about the definition of opportunity cost (OC). This is, of course, ostensibly a very basic term, but Ferraro and Taylor said that most economists do not readily know its correct definition, and Potter and Sanders argued that this can be explained by the fact that there…
Achieving Conservation when Opportunity Costs Are High: Optimizing Reserve Design in Alberta's Oil Sands Region

PubMed Central

Schneider, Richard R.; Hauer, Grant; Farr, Dan; Adamowicz, W. L.; Boutin, Stan

2011-01-01

Recent studies have shown that conservation gains can be achieved when the spatial distributions of biological benefits and economic costs are incorporated in the conservation planning process. Using Alberta, Canada, as a case study we apply these techniques in the context of coarse-filter reserve design. Because targets for ecosystem representation and other coarse-filter design elements are difficult to define objectively we use a trade-off analysis to systematically explore the relationship between conservation targets and economic opportunity costs. We use the Marxan conservation planning software to generate reserve designs at each level of conservation target to ensure that our quantification of conservation and economic outcomes represents the optimal allocation of resources in each case. Opportunity cost is most affected by the ecological representation target and this relationship is nonlinear. Although petroleum resources are present throughout most of Alberta, and include highly valuable oil sands deposits, our analysis indicates that over 30% of public lands could be protected while maintaining access to more than 97% of the value of the region's resources. Our case study demonstrates that optimal resource allocation can be usefully employed to support strategic decision making in the context of land-use planning, even when conservation targets are not well defined. PMID:21858046
FIA BioSum: a tool to evaluate financial costs, opportunities and effectiveness of fuel treatments.

Treesearch

Jeremy Fried; Glenn Christensen

2004-01-01

FIA BioSum, a tool developed by the USDA Forest Services Forest Inventory and Analysis (FIA) Program, generates reliable cost estimates, identifies opportunities and evaluates the effectiveness of fuel treatments in forested landscapes. BioSum is an analytic framework that integrates a suite of widely used computer models with a foundation of attribute-rich,...
"That "Fuego," That Fire in Their Stomach": Academically Successful Latinas/os and "Racial Opportunity Cost"

ERIC Educational Resources Information Center

Venzant Chambers, Terah T.; Locke, Leslie A.; Tagarao, Annel M.

2015-01-01

This article discusses the racial opportunity cost of academic achievement for Latina/o students who graduated from urban high schools and participated in a larger study of 18 high-achieving students of color. The article focuses on the ways the school context influenced their success. Interviews with the seven Latina/o participants reveal that…
Quantifying opportunities for hospital cost control: medical device purchasing and patient discharge planning.

PubMed

Robinson, James C; Brown, Timothy T

2014-09-01

To quantify the potential reduction in hospital costs from adoption of best local practices in supply chain management and discharge planning. We performed multivariate statistical analyses of the association between total variable cost per procedure and medical device price and length of stay, controlling for patient and hospital characteristics. Ten hospitals in 1 major metropolitan area supplied patient-level administrative data on 9778 patients undergoing joint replacement, spine fusion, or cardiac rhythm management (CRM) procedures in 2008 and 2010. The impact on each hospital of matching lowest local market device prices and lowest patient length of stay (LOS) was calculated using multivariate regression analysis controlling for patient demographics, diagnoses, comorbidities, and implications. Average variable costs ranged from $11,315 for joint replacement to $16,087 for CRM and $18,413 for spine fusion. Implantable medical devices accounted for a large share of each procedure's variable costs: 44% for joint replacement, 39% for spine fusion, and 59% for CRM. Device prices and patient length-of-stay exhibited wide variation across hospitals. Total potential hospital cost savings from achieving best local practices in device prices and patient length of stay are 14.5% for joint replacement, 18.8% for spine fusion;,and 29.1% for CRM. Hospitals have opportunities for cost reduction from adoption of best local practices in supply chain management and discharge planning.
Opportunity Costs and Financial Incentives for Hispanic Youth Participating in a Family-Based HIV and Substance Use Preventive Intervention

PubMed Central

McCollister, Kathryn E.; Freitas, Derek M.; Prado, Guillermo; Pantin, Hilda

2013-01-01

This paper presents results from a pilot study of the synergies between the opportunity costs incurred by research participants, participant compensation, and program attendance in a family-based substance use and HIV preventive intervention for Hispanic adolescents in Miami-Dade County, Florida. To estimate parent/caretaker cost per session and cost for the duration of the intervention, we administered the Caretaker Drug Abuse Treatment Cost Analysis Program (Caretaker DATCAP) to a random sample of 34 families who participated in a recent clinical trial of Familias Unidas. The total opportunity cost per parent/caretaker was under $40 per group session, under $30 per family session, and just over $570 for the duration of the intervention. Participants were compensated between $40 and $50 per session and attended more than 79% of family and group sessions. Parents and caretakers incurred a cost of approximately $30–40 per intervention session for which they were adequately compensated. Attendance was very good overall for this group (>79%) and significantly higher than attendance in a comparable uncompensated study group from another recent Familias Unidas trial that targeted similar youth. Findings suggest that incentives should be considered important for future implementations of Familias Unidas and similar family-based interventions that target minority and low-SES populations. PMID:24162106
Opportunity costs and financial incentives for Hispanic youth participating in a family-based HIV and substance use preventive intervention.

PubMed

McCollister, Kathryn E; Freitas, Derek M; Prado, Guillermo; Pantin, Hilda

2014-02-01

This paper presents results from a pilot study of the synergies between the opportunity costs incurred by research participants, participant compensation, and program attendance in a family-based substance use and HIV preventive intervention for Hispanic adolescents in Miami-Dade County, Florida. To estimate parent/caretaker cost per session and cost for the duration of the intervention, we administered the Caretaker Drug Abuse Treatment Cost Analysis Program to a random sample of 34 families who participated in a recent clinical trial of Familias Unidas. The total opportunity cost per parent/caretaker was under $40 per group session, under $30 per family session, and just over $570 for the duration of the intervention. Participants were compensated between $40 and $50 per session and attended more than 79% of family and group sessions. Parents and caretakers incurred a cost of approximately $30-40 per intervention session for which they were adequately compensated. Attendance was very good overall for this group (>79%) and significantly higher than attendance in a comparable uncompensated study group from another recent Familias Unidas trial that targeted similar youth. Findings suggest that incentives should be considered important for future implementations of Familias Unidas and similar family-based interventions that target minority and low-SES populations.
Sharing the opportunity cost among power companies to support hydropower-to-environment water transfers

NASA Astrophysics Data System (ADS)

Tilmant, Amaury; Marques, Guilherme

2016-04-01

Among the environmental impacts caused by dams, the alteration of flow regimes is one of the most critical to river ecosystems given its influence in long river reaches and its continuous pattern. Provided it is technically feasible, the reoperation of hydroelectric reservoir systems can, in principle, mitigate the impacts on degraded freshwater ecosystems by recovering some of the natural flow regime. The typical approach to implement hydropower-to-environment water transfers focuses on the reoperation of the dam located immediately upstream of the environmentally sensitive area, meaning that only one power station will bear the brunt of the benefits forgone for the power sector. By ignoring the contribution of upstream infrastructures to the alteration of the flow regime, the opportunity cost associated with the restoration of a flow regime is not equitably distributed among the power companies in the river basin, therefore slowing the establishment of environmental flow programs. Yet, there is no criterion, nor institutional mechanisms, to ensure a fair distribution of the opportunity cost among power stations. This paper addresses this issue by comparing four rules to redistribute the costs faced by the power sector when environmental flows must be implemented in a multireservoir system. The rules are based on the the installed capacity of the power plants, the live storage capacity of the reservoirs, the ratio between the incremental flows and the live storage capacity, and the extent of the storage services; that is, the volume of water effectively transferred by each reservoir. The analysis is carried out using the Parana River Basin (Brazil) as a case study.
Aging infrastructure creates opportunities for cost-efficient restoration of aquatic ecosystem connectivity.

PubMed

Neeson, Thomas M; Moody, Allison T; O'Hanley, Jesse R; Diebel, Matthew; Doran, Patrick J; Ferris, Michael C; Colling, Timothy; McIntyre, Peter B

2018-06-09

A hallmark of industrialization is the construction of dams for water management and roads for transportation, leading to fragmentation of aquatic ecosystems. Many nations are striving to address both maintenance backlogs and mitigation of environmental impacts as their infrastructure ages. Here, we test whether accounting for road repair needs could offer opportunities to boost conservation efficiency by piggybacking connectivity restoration projects on infrastructure maintenance. Using optimization models to align fish passage restoration sites with likely road repair priorities, we find potential increases in conservation return-on-investment ranging from 17% to 25%. Importantly, these gains occur without compromising infrastructure or conservation priorities; simply communicating openly about objectives and candidate sites enables greater accomplishment at current funding levels. Society embraces both reliable roads and thriving fisheries, so overcoming this coordination challenge should be feasible. Given deferred maintenance crises for many types of infrastructure, there could be widespread opportunities to enhance the cost effectiveness of conservation investments by coordinating with infrastructure renewal efforts. © 2018 by the Ecological Society of America.
Estimating the Hospital Burden of Norovirus-Associated Gastroenteritis in England and its Opportunity Costs for Non-Admitted Patients.

PubMed

Sandmann, Frank G; Shallcross, Laura; Adams, Natalie; Allen, David J; Coen, Pietro G; Jeanes, Annette; Kozlakidis, Zisis; Larkin, Lesley; Wurie, Fatima; Robotham, Julie V; Jit, Mark; Deeny, Sarah R

2018-02-26

Norovirus places a substantial burden on healthcare systems, arising from infected patients, disease outbreaks, beds kept unoccupied for infection control, and staff absences due to infection. In settings with high rates of bed occupancy, opportunity costs arise from patients who cannot be admitted due to beds being unavailable. With several treatments and vaccines against norovirus in development, quantifying the expected economic burden is timely. The number of inpatients with norovirus-associated gastroenteritis in England were modelled using infectious and non-infectious gastrointestinal Hospital Episode Statistics codes and laboratory reports of gastrointestinal pathogens collected at Public Health England. The excess length of stay from norovirus was estimated with a multi-state model and local outbreak data. Unoccupied bed-days and staff absences were estimated from national outbreak surveillance. The burden was valued conventionally using accounting expenditures and wages, which we contrasted to the opportunity costs from forgone patients using a novel methodology. Between July 2013 and June 2016, 17.7% (95%-confidence interval: 15.6%‒21.6%) of primary and 23.8% (20.6%‒29.9%) of secondary gastrointestinal diagnoses were norovirus-attributable. Annually, the estimated median 290,000 (interquartile range: 282,000‒297,000) occupied and unoccupied bed-days used for norovirus displaced 57,800 patients. Conventional costs for the National Health Service reached £107.6 million; the economic burden approximated to £297.7 million and a loss of 6,300 quality-adjusted life years annually. In England, norovirus is now the second-largest contributor of the gastrointestinal hospital burden. With the projected impact being greater than previously estimated, improved capture of relevant opportunity costs seems imperative for diseases like norovirus.
Daily variation in natural disaster casualties: information flows, safety, and opportunity costs in tornado versus hurricane strikes.

PubMed

Zahran, Sammy; Tavani, Daniele; Weiler, Stephan

2013-07-01

Casualties from natural disasters may depend on the day of the week they strike. With data from the Spatial Hazard Events and Losses Database for the United States (SHELDUS), daily variation in hurricane and tornado casualties from 5,043 tornado and 2,455 hurricane time/place events is analyzed. Hurricane forecasts provide at-risk populations with considerable lead time. Such lead time allows strategic behavior in choosing protective measures under hurricane threat; opportunity costs in terms of lost income are higher during weekdays than during weekends. On the other hand, the lead time provided by tornadoes is near zero; hence tornados generate no opportunity costs. Tornado casualties are related to risk information flows, which are higher during workdays than during leisure periods, and are related to sheltering-in-place opportunities, which are better in permanent buildings like businesses and schools. Consistent with theoretical expectations, random effects negative binomial regression results indicate that tornado events occurring on the workdays of Monday through Thursday are significantly less lethal than tornados that occur on weekends. In direct contrast, and also consistent with theory, the expected count of hurricane casualties increases significantly with weekday occurrences. The policy implications of observed daily variation in tornado and hurricane events are considered. © 2012 Society for Risk Analysis.
Assessing the ecological benefits and opportunity costs of alternative stream management zone widths for eastern hardwoods

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

Leaving buffer zones adjacent to waterways can effectively reduce the water quality concerns associated with timber harvesting. However, riparian areas are also some of the most productive sites and can yield high quality wood. The amount of unharvested timber left in SMZs (Streamside Management Zones) can represent a substantial opportunity cost to landowners. In this...
20 Years Experience with using Low Cost Launch Opportunities for 20 Small Satellite Missions

NASA Astrophysics Data System (ADS)

Meerman, Maarten; Sweeting, Martin, , Sir

To realise the full potential of modern low cost mini-micro-nano-satellite missions, regular and affordable launch opportunities are required. It is simply not economic to launch individual satellites of 5-300kg on single dedicated launchers costing typically 15-20M per launch. Whilst there have been periodic 'piggy-back' launches of small satellites on US launchers since the 1960's, these have been infrequent and often experienced significant delays due the vagaries of the main (paying!) payload. In 1989, Arianespace provided a critical catalyst to the microsatellite community when it imaginatively developed the ASAP platform on Ariane-4 providing, for the first time, a standard interface and affordable launch contracts for small payloads up to 50kg. During the 1990's, some 20 small satellites have been successfully launched on the Ariane-4 ASAP ring for international customers carrying out a range of operational, technology demonstration and training missions. However, most of these microsatellite missions seek low Earth orbit and especially sun-synchronous orbits, but the number of primary missions into these orbit has declined since 1996 and with it the availability of useful low cost launch opportunities for microsatellites. Whilst Ariane-5 has an enhanced capacity ASAP, it has yet to be widely used due both to the infrequent launches, higher costs, and the GTO orbit required by the majority of customers. China, Japan and India have also provided occasional secondary launches for small payloads, but not yet on a regular basis. Fortunately, the growing interest and demand for microsatellite missions coincided with the emergence of regular, low cost launch opportunities from the former Soviet Union (FSU) - both as secondary 'piggy-back' missions or as multiple microsatellite payloads on converted military ICBMs. Indeed, the FSU now supplies the only affordable means of launching minisatellites (200-500kg) into LEO as dedicated missions on converted missiles as
Opportunity cost based analysis of corporate eco-efficiency: a methodology and its application to the CO2-efficiency of German companies.

PubMed

Hahn, Tobias; Figge, Frank; Liesen, Andrea; Barkemeyer, Ralf

2010-10-01

In this paper, we propose the return-to-cost-ratio (RCR) as an alternative approach to the analysis of operational eco-efficiency of companies based on the notion of opportunity costs. RCR helps to overcome two fundamental deficits of existing approaches to eco-efficiency. (1) It translates eco-efficiency into managerial terms by applying the well-established notion of opportunity costs to eco-efficiency analysis. (2) RCR allows to identify and quantify the drivers behind changes in corporate eco-efficiency. RCR is applied to the analysis of the CO(2)-efficiency of German companies in order to illustrate its usefulness for a detailed analysis of changes in corporate eco-efficiency as well as for the development of effective environmental strategies. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Energy Efficiency Improvement and Cost Saving Opportunities for Breweries: An ENERGY STAR(R) Guide for Energy and Plant Managers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Galitsky, Christina; Martin, Nathan; Worrell, Ernst

2003-09-01

Annually, breweries in the United States spend over $200 million on energy. Energy consumption is equal to 38 percent of the production costs of beer, making energy efficiency improvement an important way to reduce costs, especially in times of high energy price volatility. After a summary of the beer making process and energy use, we examine energy efficiency opportunities available for breweries. We provide specific primary energy savings for each energy efficiency measure based on case studies that have implemented the measures, as well as references to technical literature. If available, we have also listed typical payback periods. Our findingsmore » suggest that given available technology, there are still opportunities to reduce energy consumption cost-effectively in the brewing industry. Brewers value highly the quality, taste and drinkability of their beer. Brewing companies have and are expected to continue to spend capital on cost-effective energy conservation measures that meet these quality, taste and drinkability requirements. For individual plants, further research on the economics of the measures, as well as their applicability to different brewing practices, is needed to assess implementation of selected technologies.« less
Time-driven activity-based costing of multivessel coronary artery bypass grafting across national boundaries to identify improvement opportunities: study protocol

PubMed Central

Erhun, F; Mistry, B; Platchek, T; Milstein, A; Narayanan, V G; Kaplan, R S

2015-01-01

Introduction Coronary artery bypass graft (CABG) surgery is a well-established, commonly performed treatment for coronary artery disease—a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the USA was $32 201±$23 059. The same operation reportedly costs less than $2000 to produce in India. The goals of the proposed study are to (1) identify the difference in the costs incurred to perform CABG surgery by three Joint Commission accredited hospitals with reputations for high quality and efficiency and (2) characterise the opportunity to reduce the cost of performing CABG surgery. Methods and analysis We use time-driven activity-based costing (TDABC) to quantify the hospitals’ costs of producing elective, multivessel CABG. TDABC estimates the costs of a given clinical service by combining information about the process of patient care delivery (specifically, the time and quantity of labour and non-labour resources utilised to perform each activity) with the unit cost of each resource used to provide the care. Resource utilisation was estimated by constructing CABG process maps for each site based on observation of care and staff interviews. Unit costs were calculated as a capacity cost rate, measured as a $/min, for each resource consumed in CABG production. Multiplying together the unit costs and resource quantities and summing across all resources used will produce the average cost of CABG production at each site. We will conclude by conducting a variance analysis of labour costs to reveal opportunities to bend the cost curve for CABG production in the USA. Ethics and dissemination All our methods were exempted from review by the Stanford Institutional Review Board. Results will be published in peer-reviewed journals and presented at scientific meetings. PMID:26307621
Agribusiness Opportunity Costs and Environmental Legal Protection: Investigating Trade-Off on Hotspot Preservation in the State of São Paulo, Brazil

NASA Astrophysics Data System (ADS)

Igari, Alexandre Toshiro; Tambosi, Leandro Reverberi; Pivello, Vânia Regina

2009-08-01

Prior to deforestation, São Paulo State had 79,000 km2 covered by Cerrado (Brazilian savanna) physiognomies, but today less than 8.5% of this biodiversity hotspot remains, mostly in private lands. The global demand for agricultural goods has imposed strong pressure on natural areas, and the economic decisions of agribusiness managers are crucial to the fate of Cerrado domain remaining areas (CDRA) in Brazil. Our aim was to investigate the effectiveness of Brazilian private protected areas policy, and to propose a feasible alternative to promote CDRA protection. This article assessed the main agribusiness opportunity costs for natural areas preservation: the land use profitability and the arable land price. The CDRA percentage and the opportunity costs were estimated for 349 municipal districts of São Paulo State through secondary spatial data and profitability values of 38 main agricultural products. We found that Brazilian private protected areas policy fails to preserve CDRA, although the values of non-compliance fines were higher than average opportunity costs. The scenario with very restrictive laws on private protected areas and historical high interest rates allowed us to conceive a feasible cross compliance proposal to improve environmental and agricultural policies.
Agribusiness opportunity costs and environmental legal protection: investigating trade-off on hotspot preservation in the state of São Paulo, Brazil.

PubMed

Igari, Alexandre Toshiro; Tambosi, Leandro Reverberi; Pivello, Vânia Regina

2009-08-01

Prior to deforestation, São Paulo State had 79,000 km(2) covered by Cerrado (Brazilian savanna) physiognomies, but today less than 8.5% of this biodiversity hotspot remains, mostly in private lands. The global demand for agricultural goods has imposed strong pressure on natural areas, and the economic decisions of agribusiness managers are crucial to the fate of Cerrado domain remaining areas (CDRA) in Brazil. Our aim was to investigate the effectiveness of Brazilian private protected areas policy, and to propose a feasible alternative to promote CDRA protection. This article assessed the main agribusiness opportunity costs for natural areas preservation: the land use profitability and the arable land price. The CDRA percentage and the opportunity costs were estimated for 349 municipal districts of São Paulo State through secondary spatial data and profitability values of 38 main agricultural products. We found that Brazilian private protected areas policy fails to preserve CDRA, although the values of non-compliance fines were higher than average opportunity costs. The scenario with very restrictive laws on private protected areas and historical high interest rates allowed us to conceive a feasible cross compliance proposal to improve environmental and agricultural policies.
Objectives, Budgets, Thresholds, and Opportunity Costs-A Health Economics Approach: An ISPOR Special Task Force Report [4].

PubMed

Danzon, Patricia M; Drummond, Michael F; Towse, Adrian; Pauly, Mark V

2018-02-01

The fourth section of our Special Task Force report focuses on a health plan or payer's technology adoption or reimbursement decision, given the array of technologies, on the basis of their different values and costs. We discuss the role of budgets, thresholds, opportunity costs, and affordability in making decisions. First, we discuss the use of budgets and thresholds in private and public health plans, their interdependence, and connection to opportunity cost. Essentially, each payer should adopt a decision rule about what is good value for money given their budget; consistent use of a cost-per-quality-adjusted life-year threshold will ensure the maximum health gain for the budget. In the United States, different public and private insurance programs could use different thresholds, reflecting the differing generosity of their budgets and implying different levels of access to technologies. In addition, different insurance plans could consider different additional elements to the quality-adjusted life-year metric discussed elsewhere in our Special Task Force report. We then define affordability and discuss approaches to deal with it, including consideration of disinvestment and related adjustment costs, the impact of delaying new technologies, and comparative cost effectiveness of technologies. Over time, the availability of new technologies may increase the amount that populations want to spend on health care. We then discuss potential modifiers to thresholds, including uncertainty about the evidence used in the decision-making process. This article concludes by discussing the application of these concepts in the context of the pluralistic US health care system, as well as the "excess burden" of tax-financed public programs versus private programs. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Building Commissioning: A Golden Opportunity for Reducing Energy Costs and Greenhouse-gas Emissions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mills, Evan

2009-07-16

The aim of commissioning new buildings is to ensure that they deliver, if not exceed, the performance and energy savings promised by their design. When applied to existing buildings, commissioning identifies the almost inevitable 'drift' from where things should be and puts the building back on course. In both contexts, commissioning is a systematic, forensic approach to quality assurance, rather than a technology per se. Although commissioning has earned increased recognition in recent years - even a toehold in Wikipedia - it remains an enigmatic practice whose visibility severely lags its potential. Over the past decade, Lawrence Berkeley National Laboratorymore » has built the world's largest compilation and meta-analysis of commissioning experience in commercial buildings. Since our last report (Mills et al. 2004) the database has grown from 224 to 643 buildings (all located in the United States, and spanning 26 states), from 30 to 100 million square feet of floorspace, and from $17 million to $43 million in commissioning expenditures. The recorded cases of new-construction commissioning took place in buildings representing $2.2 billion in total construction costs (up from 1.5 billion). The work of many more commissioning providers (18 versus 37) is represented in this study, as is more evidence of energy and peak-power savings as well as cost-effectiveness. We now translate these impacts into avoided greenhouse gases and provide new indicators of cost-effectiveness. We also draw attention to the specific challenges and opportunities for high-tech facilities such as labs, cleanrooms, data centers, and healthcare facilities. The results are compelling. We developed an array of benchmarks for characterizing project performance and cost-effectiveness. The median normalized cost to deliver commissioning was $0.30/ft2 for existing buildings and $1.16/ft2 for new construction (or 0.4% of the overall construction cost). The commissioning projects for which data are

Solving the negative impact of congestion in the postanesthesia care unit: a cost of opportunity analysis.

PubMed

Ruiz-Patiño, Alejandro; Acosta-Ospina, Laura Elena; Rueda, Juan-David

2017-04-01

Congestion in the postanesthesia care unit (PACU) leads to the formation of waiting queues for patients being transferred after surgery, negatively affecting hospital resources. As patients recover in the operating room, incoming surgeries are delayed. The purpose of this study was to establish the impact of this phenomenon in multiple settings. An operational mathematical study based on the queuing theory was performed. Average queue length, average queue waiting time, and daily queue waiting time were evaluated. Calculations were based on the mean patient daily flow, PACU length of stay, occupation, and current number of beds. Data was prospectively collected during a period of 2 months, and the entry and exit time was recorded for each patient taken to the PACU. Data was imputed in a computational model made with MS Excel. To account for data uncertainty, deterministic and probabilistic sensitivity analyses for all dependent variables were performed. With a mean patient daily flow of 40.3 and an average PACU length of stay of 4 hours, average total lost surgical opportunity time was estimated at 2.36 hours (95% CI: 0.36-4.74 hours). Cost of opportunity was calculated at $1592 per lost hour. Sensitivity analysis showed that an increase of two beds is required to solve the queue formation. When congestion has a negative impact on cost of opportunity in the surgical setting, queuing analysis grants definitive actions to solve the problem, improving quality of service and resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.
Trends in Opportunity Costs of U.S. Postsecondary Education: A National HRD and Human Capital Theory Analysis

ERIC Educational Resources Information Center

Cornacchione, Edgard; Daugherty, Jenny L.

2013-01-01

The purpose of this study was to explore opportunity costs of postsecondary education in the U.S. in the past three decades (1975-2005), as a measure to support investment decisions at national levels and as experienced by individuals deciding on pursuing further education. Based on human capital theory and inspired by a set of studies aiming at…
Time-driven activity-based costing of multivessel coronary artery bypass grafting across national boundaries to identify improvement opportunities: study protocol.

PubMed

Erhun, F; Mistry, B; Platchek, T; Milstein, A; Narayanan, V G; Kaplan, R S

2015-08-25

Coronary artery bypass graft (CABG) surgery is a well-established, commonly performed treatment for coronary artery disease--a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the USA was $32, 201 ± $23,059. The same operation reportedly costs less than $2000 to produce in India. The goals of the proposed study are to (1) identify the difference in the costs incurred to perform CABG surgery by three Joint Commission accredited hospitals with reputations for high quality and efficiency and (2) characterise the opportunity to reduce the cost of performing CABG surgery. We use time-driven activity-based costing (TDABC) to quantify the hospitals' costs of producing elective, multivessel CABG. TDABC estimates the costs of a given clinical service by combining information about the process of patient care delivery (specifically, the time and quantity of labour and non-labour resources utilised to perform each activity) with the unit cost of each resource used to provide the care. Resource utilisation was estimated by constructing CABG process maps for each site based on observation of care and staff interviews. Unit costs were calculated as a capacity cost rate, measured as a $/min, for each resource consumed in CABG production. Multiplying together the unit costs and resource quantities and summing across all resources used will produce the average cost of CABG production at each site. We will conclude by conducting a variance analysis of labour costs to reveal opportunities to bend the cost curve for CABG production in the USA. All our methods were exempted from review by the Stanford Institutional Review Board. Results will be published in peer-reviewed journals and presented at scientific meetings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Modulation of Habitat-Based Conservation Plans by Fishery Opportunity Costs: A New Caledonia Case Study Using Fine-Scale Catch Data

PubMed Central

Deas, Marilyn; Andréfouët, Serge; Léopold, Marc; Guillemot, Nicolas

2014-01-01

Numerous threats impact coral reefs and conservation actions are urgently needed. Fast production of marine habitat maps promotes the use of habitat-only conservation plans, where a given percentage of the area of each habitat is set as conservation objectives. However, marine reserves can impact access to fishing grounds and generate opportunity costs for fishers that need to be minimized. In New Caledonia (Southwest Pacific), we used fine-scale fishery catch maps to define nineteen opportunity costs layers (expressed as biomass catch loss) considering i) total catches, ii) target fish families, iii) local marine tenure, and iv) gear type. The expected lower impacts on fishery catch when using the different cost constraints were ranked according to effectiveness in decreasing the costs generated by the habitat-only scenarios. The exercise was done for two habitat maps with different thematic richness. In most cases, habitat conservation objectives remained achievable, but effectiveness varied widely between scenarios and between habitat maps. The results provide practical guidelines for coral reef conservation and management. Habitat-only scenarios can be used to initiate conservation projects with stakeholders but the costs induced by such scenarios can be lowered by up to 50–60% when detailed exhaustive fishery data are used. When using partial data, the gain would be only in the 15–25% range. The best compromises are achieved when using local data. PMID:24835216
Modulation of habitat-based conservation plans by fishery opportunity costs: a New Caledonia case study using fine-scale catch data.

PubMed

Deas, Marilyn; Andréfouët, Serge; Léopold, Marc; Guillemot, Nicolas

2014-01-01

Numerous threats impact coral reefs and conservation actions are urgently needed. Fast production of marine habitat maps promotes the use of habitat-only conservation plans, where a given percentage of the area of each habitat is set as conservation objectives. However, marine reserves can impact access to fishing grounds and generate opportunity costs for fishers that need to be minimized. In New Caledonia (Southwest Pacific), we used fine-scale fishery catch maps to define nineteen opportunity costs layers (expressed as biomass catch loss) considering i) total catches, ii) target fish families, iii) local marine tenure, and iv) gear type. The expected lower impacts on fishery catch when using the different cost constraints were ranked according to effectiveness in decreasing the costs generated by the habitat-only scenarios. The exercise was done for two habitat maps with different thematic richness. In most cases, habitat conservation objectives remained achievable, but effectiveness varied widely between scenarios and between habitat maps. The results provide practical guidelines for coral reef conservation and management. Habitat-only scenarios can be used to initiate conservation projects with stakeholders but the costs induced by such scenarios can be lowered by up to 50-60% when detailed exhaustive fishery data are used. When using partial data, the gain would be only in the 15-25% range. The best compromises are achieved when using local data.
A cost-benefit analysis of produced water management opportunities in selected unconventional oil and gas plays

NASA Astrophysics Data System (ADS)

Marsters, P.; Macknick, J.; Bazilian, M.; Newmark, R. L.

2013-12-01

fracturing and produced water issues relate to the larger water-energy nexus. Specifically, this study develops a play-specific model to compare the decision factors and costs involved in managing produced water. For example, when transport distances to a wastewater disposal site are far enough, options for recycling water become more favorable, depending on the characteristics of each play. This model can provide policymakers and other interested parties with cost estimates of different water management options, including a better understanding of the costs and opportunities associated with recycling produced water. This work provides a cross-play assessment of produced water management options and costs and could serve as the foundation for more detailed analyses of opportunities to minimize hydraulic fracturing's impacts on freshwater resources.
Can the real opportunity cost stand up: displaced services, the straw man outside the room.

PubMed

Eckermann, Simon; Pekarsky, Brita

2014-04-01

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

DOT National Transportation Integrated Search

2016-06-01

Cost Benefit Analysis (CBA or Benefit Cost Analysis BCA) is an evaluation tool that state transportation agencies can : use to compare infrastructure project options across transportation modes and gauge if the discounted value of benefits : exce...
New Suborbital Flight Opportunities and Funding

NASA Astrophysics Data System (ADS)

Saltman, Alexander

2013-07-01

New opportunities for suborbital research are on the horizon. Reusable suborbital vehicles will offer immediate and routine space access for scientific payloads, provide access to altitudes around 100 kilometers, create opportunities for low-cost monitoring of upper atmospheric phenomena, as well as small scale solar observation. Reduced operational cost and quick turn-around will enable equipment to be flown opportunistically, in response to specific solar activity, or in continuous test and improvement cycles. Suborbital test flights will also provide opportunities to test prospective satellite instruments in an extended microgravity environment before being launched to orbit, raising the technology readiness level (TRL) of flight hardware and reducing the risk of anomalies during missions. I discuss the capabilities of emerging suborbital vehicles, payload and integration requirements, and funding opportunities for suborbital flights at NASA.
Guide to resource conservation and cost savings opportunities in the soap, detergents and related products sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1998-10-01

This guide was prepared to help those involved in the manufacturing of soap, detergent, and related products to identify potential process improvements that will reduce production costs and conserve resources. The guide offers a series of generic process descriptions and checklists of improvement opportunities specific to each of five major processes used in the industry: Soap production, surfactant production, solid cake product formulation, liquid product formulation, and granulated powdered product formulation. The checklists identify thermal, electrical, environmental, water use, and low- or no-cost measures that can be implemented, as well as retrofit technology options. A variety of new technologies thatmore » may exhibit future potential are also described. Appendices include a glossary, background information on the Ontario soap/detergent industry, and description of the four major categories of ingredients used in the industry.« less
Valuing Human Leptospirosis Prevention Using the Opportunity Cost of Labor

PubMed Central

Arbiol, Joseph; Borja, Maridel; Yabe, Mitsuyasu; Nomura, Hisako; Gloriani, Nina; Yoshida, Shinichi

2013-01-01

Leptospirosis is a serious public health concern in the Philippines, not only because of its increasing incidence rate, but also because of its significant health and economic impacts. Despite its relatively high seroprevalence, knowledge on the economic burden of disease, particularly on the value that the society places on disease prevention remains limited. Obtaining such information is important within the context of public health policy. This study was conducted in Metro Manila to determine the economic burden of leptospirosis, by asking respondents about their willingness to contribute to labor (WTCL) for the prevention of leptospirosis. The respondents pledged an average labor contribution of 10.66 h/month. The average WTCL corresponded to a monetary value of US$4.01 per month when valued using the opportunity cost of labor (leisure rate of time). From the monetized labor contribution, the total economic value of preventing leptospirosis was estimated at US$124.97 million per annum, which represents 1.13% of Metro Manila’s gross domestic product (GDP). Estimates from a Tobit regression model identified the respondents’ knowledge regarding leptospirosis, the susceptibility of their homes to flooding, and the proximity of their homes to sewers as significant factors to consider when developing resource contribution programs for leptospirosis prevention. More efforts need to be made in developing community level preventive programs, and in improving public’s knowledge and awareness about leptospirosis. PMID:23644831
Time and travel costs incurred by women attending antenatal tests: A costing study.

PubMed

Verhoef, Talitha I; Daley, Rebecca; Vallejo-Torres, Laura; Chitty, Lyn S; Morris, Stephen

2016-09-01

to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. questionnaire-based costing study. eight maternity clinics across the UK. pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.
Diversity, College Costs, and Postsecondary Opportunity: An Examination of the Financial Nexus between College Choice and Persistence for African Americans and Whites

ERIC Educational Resources Information Center

St. John, Edward P.; Paulsen, Michael B.; Carter, Deborah Faye

2005-01-01

Questions about how student financial aid and the costs of attending college influence educational opportunity for diverse racial groups have lurked beneath the surface of the policy debates about higher education for decades. When the Higher Education Act (HEA) was passed in 1965, there was a general acceptance that the federal government had a…
Investment opportunity : the FPL low-cost solar dry kiln

Treesearch

George B. Harpole

1988-01-01

Two equations are presented that may be used to estimate a maximum investment limit and working capital requirements for the FPL low-cost solar dry kiln systems. The equations require data for drying cycle time, green lumber cost, and kiln-dried lumber costs. Results are intended to provide a preliminary estimate.
PV opportunities in India

NASA Astrophysics Data System (ADS)

Stone, Jack L.; Ullal, Harin S.

1996-01-01

The growing middle class in India, coupled with a need for electricity to provide basic services to the masses, provides an opportunity to deploy photovoltaic systems in cost-effective applications ranging from grid-connected to isolated location requirements. This need is being satisfied by aggressive government programs, the availability of funds from agencies such as the World Bank, and the desire of Indian industries to form joint ventures for in-country manufacturing. The relaxed restrictions on doing business in India makes today's opportunities timely indeed.
34 CFR 644.31 - What are unallowable costs?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false What are unallowable costs? 644.31 Section 644.31... EDUCATION, DEPARTMENT OF EDUCATION EDUCATIONAL OPPORTUNITY CENTERS What Conditions Must Be Met by a Grantee? § 644.31 What are unallowable costs? Costs that are unallowable under the Educational Opportunity...
Cutting medical transcription costs.

PubMed

Forsman, John A

2003-07-01

Home-based, production-based medical transcription represents a substantial cost-saving opportunity. Fewer employees are required. Office space is not needed. Outsourcing costs are eliminated. Turnaround time is reduced.
34 CFR 644.30 - What are allowable costs?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false What are allowable costs? 644.30 Section 644.30... EDUCATION, DEPARTMENT OF EDUCATION EDUCATIONAL OPPORTUNITY CENTERS What Conditions Must Be Met by a Grantee? § 644.30 What are allowable costs? The cost principles that apply to the Educational Opportunity Centers...
Local health care expenditure plans and their opportunity costs.

PubMed

Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

2015-09-01

In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Energy efficiency improvement and cost saving opportunities for the Corn Wet Milling Industry: An ENERGY STAR Guide for Energy and Plant Managers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Galitsky, Christina; Worrell, Ernst; Ruth, Michael

2003-07-01

Corn wet milling is the most energy intensive industry within the food and kindred products group (SIC 20), using 15 percent of the energy in the entire food industry. After corn, energy is the second largest operating cost for corn wet millers in the United States. A typical corn wet milling plant in the United States spends approximately $20 to $30 million per year on energy, making energy efficiency improvement an important way to reduce costs and increase predictable earnings, especially in times of high energy-price volatility. This report shows energy efficiency opportunities available for wet corn millers. It beginsmore » with descriptions of the trends, structure and production of the corn wet milling industry and the energy used in the milling and refining process. Specific primary energy savings for each energy efficiency measure based on case studies of plants and references to technical literature are provided. If available, typical payback periods are also listed. The report draws upon the experiences of corn, wheat and other starch processing plants worldwide for energy efficiency measures. The findings suggest that given available resources and technology, there are opportunities to reduce energy consumption cost-effectively in the corn wet milling industry while maintaining the quality of the products manufactured. Further research on the economics of the measures, as well as the applicability of these to different wet milling practices, is needed to assess the feasibility of implementation of selected technologies at individual plants.« less

Water Technology Innovation: 10 Market Opportunities

EPA Pesticide Factsheets

The Water Technology Innovation Blueprint offers an overview of market opportunities that include conserving and recovering energy, recovering nutrients, improving water infrastructure, reducing costs for water monitoring, and improving water quality.
Employment Opportunities for Family Members in Germany.

DTIC Science & Technology

1983-05-24

30 V . NEW INITIATIVES TO IMPROVE FAMILY MEMBER EMPLOYMENT OPPORTUNITIES ........ ...................... . 40 VI. OBSERVATIONS AND COMMENTS...I, II, V Local National Hire 9.94% 2.5% 6.52% 1.93% 12.07% NOTES 1. CONUS Hire Fringe Benefits include overseas unique estimated costs outlined in...from a survey of ODCSRM FY81 vouchers . 19 TABLE 3-4 FY83 GENERAL SCHEDULE CONUS HIRE CIVILIAN COST FACTORS This table provides cost factors for
Cooperative vehicle routing problem: an opportunity for cost saving

NASA Astrophysics Data System (ADS)

Zibaei, Sedighe; Hafezalkotob, Ashkan; Ghashami, Seyed Sajad

2016-09-01

In this paper, a novel methodology is proposed to solve a cooperative multi-depot vehicle routing problem. We establish a mathematical model for multi-owner VRP in which each owner (i.e. player) manages single or multiple depots. The basic idea consists of offering an option that owners cooperatively manage the VRP to save their costs. We present cooperative game theory techniques for cost saving allocations which are obtained from various coalitions of owners. The methodology is illustrated with a numerical example in which different coalitions of the players are evaluated along with the results of cooperation and cost saving allocation methods.
The opportunity cost of animal based diets exceeds all food losses

PubMed Central

Shepon, Alon

2018-01-01

Food loss is widely recognized as undermining food security and environmental sustainability. However, consumption of resource-intensive food items instead of more efficient, equally nutritious alternatives can also be considered as an effective food loss. Here we define and quantify these opportunity food losses as the food loss associated with consuming resource-intensive animal-based items instead of plant-based alternatives which are nutritionally comparable, e.g., in terms of protein content. We consider replacements that minimize cropland use for each of the main US animal-based food categories. We find that although the characteristic conventional retail-to-consumer food losses are ≈30% for plant and animal products, the opportunity food losses of beef, pork, dairy, poultry, and eggs are 96%, 90%, 75%, 50%, and 40%, respectively. This arises because plant-based replacement diets can produce 20-fold and twofold more nutritionally similar food per cropland than beef and eggs, the most and least resource-intensive animal categories, respectively. Although conventional and opportunity food losses are both targets for improvement, the high opportunity food losses highlight the large potential savings beyond conventionally defined food losses. Concurrently replacing all animal-based items in the US diet with plant-based alternatives will add enough food to feed, in full, 350 million additional people, well above the expected benefits of eliminating all supply chain food waste. These results highlight the importance of dietary shifts to improving food availability and security. PMID:29581251
The opportunity cost of animal based diets exceeds all food losses.

PubMed

Shepon, Alon; Eshel, Gidon; Noor, Elad; Milo, Ron

2018-04-10

Food loss is widely recognized as undermining food security and environmental sustainability. However, consumption of resource-intensive food items instead of more efficient, equally nutritious alternatives can also be considered as an effective food loss. Here we define and quantify these opportunity food losses as the food loss associated with consuming resource-intensive animal-based items instead of plant-based alternatives which are nutritionally comparable, e.g., in terms of protein content. We consider replacements that minimize cropland use for each of the main US animal-based food categories. We find that although the characteristic conventional retail-to-consumer food losses are ≈30% for plant and animal products, the opportunity food losses of beef, pork, dairy, poultry, and eggs are 96%, 90%, 75%, 50%, and 40%, respectively. This arises because plant-based replacement diets can produce 20-fold and twofold more nutritionally similar food per cropland than beef and eggs, the most and least resource-intensive animal categories, respectively. Although conventional and opportunity food losses are both targets for improvement, the high opportunity food losses highlight the large potential savings beyond conventionally defined food losses. Concurrently replacing all animal-based items in the US diet with plant-based alternatives will add enough food to feed, in full, 350 million additional people, well above the expected benefits of eliminating all supply chain food waste. These results highlight the importance of dietary shifts to improving food availability and security. Copyright © 2018 the Author(s). Published by PNAS.
Nikola Tesla Educational Opportunity School.

ERIC Educational Resources Information Center

Design Cost Data, 2001

2001-01-01

Describes the architectural design, costs, general description, and square footage data for the Nikola Tesla Educational Opportunity School in Colorado Springs, Colorado. A floor plan and photos are included along with a list of manufacturers and suppliers used for the project. (GR)
Energy efficiency opportunities in the brewery industry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Worrell, Ernst; Galitsky, Christina; Martin, Nathan

2002-06-28

Breweries in the United States spend annually over $200 Million on energy. Energy consumption is equal to 3-8% of the production costs of beer, making energy efficiency improvement an important way to reduce costs, especially in times of high energy price volatility. After a summary of the beer making process and energy use, we examine energy efficiency opportunities available for breweries. We provide specific primary energy savings for each energy efficiency measure based on case studies that have implemented the measures, as well as references to technical literature. If available, we have also listed typical payback periods. Our findings suggestmore » that there may still be opportunities to reduce energy consumption cost-effectively for breweries. Major brewing companies have and will continue to spend capital on cost effective measures that do not impact the quality of the beer. Further research on the economics of the measures, as well as their applicability to different brewing practices, is needed to assess implementation of selected technologies at individual breweries.« less
[Opportunity for the integration of the gender perspective in health research and innovation in Europe: COST Network genderSTE].

PubMed

Sánchez de Madariaga, Inés; Ruiz Cantero, María Teresa

2014-01-01

The European Commission supports several routes for incorporating the gender perspective. The Commission currently supports the new Horizon 2020 program, and also funds projects such as "gendered innovations", which show how gender innovations increase the quality of research and professional practice for health and welfare. One of the policy instruments is the Recommendation on Gender, Science and Innovation. Against this background, the international European Cooperation in Science and Technology (COST) network genderSTE (Gender, Science, Technology and Environment) was created, which seeks to: 1) promote structural changes in institutions to increase the number of women researchers; 2) identify the gender dimensions relevant to the environment; and 3) improve the integration of a gender perspective in research and technology. COST GenderSTE supports networking and the dissemination of knowledge with a gender perspective. All these tools provide an opportunity to incorporate a gender perspective in research in Europe. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Opportunity cost for early treatment of Chagas disease in Mexico.

PubMed

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

2014-04-01

Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.
Opportunity Cost for Early Treatment of Chagas Disease in Mexico

PubMed Central

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

2014-01-01

Background Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. Methodology/Principal Findings A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. Conclusions/Significance In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life. PMID:24743112
34 CFR 644.30 - What are allowable costs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION, DEPARTMENT OF EDUCATION EDUCATIONAL OPPORTUNITY CENTERS What Conditions Must Be Met by a Grantee? § 644.30 What are allowable costs? The cost principles that apply to the Educational Opportunity Centers... in various career fields in the target area and who can serve as role models for participants. (b...
Cutting costs in your own backyard: opportunities in financial services.

PubMed

van Londen, Jan; Zimmerman, Paul

2012-03-01

Hospitals looking to reduce cost and improve performance in financial services should focus on these areas: Treasury banking services costs and fees. The possibility of a revenue-generating vendor payment solution. The accounts payable process.
Evaluating Opportunities for Achieving Cost Efficiencies Through the Introduction of PrePex Device Male Circumcision in Adult VMMC Programs in Zambia and Zimbabwe.

PubMed

Vandament, Lyndsey; Chintu, Naminga; Yano, Nanako; Mugurungi, Owen; Tambatamba, Bushimbwa; Ncube, Gertrude; Xaba, Sinokuthemba; Mpasela, Felton; Muguza, Edward; Mangono, Tichakunda; Madidi, Ngonidzashe; Samona, Alick; Tagar, Elva; Hatzold, Karin

2016-06-01

Results from recent costing studies have put into question potential Voluntary Medical Male Circumcision (VMMC) cost savings with the introduction of the PrePex device. We evaluated the cost drivers and the overall unit cost of VMMC for a variety of service delivery models providing either surgical VMMC or both PrePex and surgery using current program data in Zimbabwe and Zambia. In Zimbabwe, 3 hypothetical PrePex only models were also included. For all models, clients aged 18 years and older were assumed to be medically eligible for PrePex and uptake was based on current program data from sites providing both methods. Direct costs included costs for consumables, including surgical VMMC kits for the forceps-guided method, device (US $12), human resources, demand creation, supply chain, waste management, training, and transport. Results for both countries suggest limited potential for PrePex to generate cost savings when adding the device to current surgical service delivery models. However, results for the hypothetical rural Integrated PrePex model in Zimbabwe suggest the potential for material unit cost savings (US $35 per VMMC vs. US $65-69 for existing surgical models). This analysis illustrates that models designed to leverage PrePex's advantages, namely the potential for integrating services in rural clinics and less stringent infrastructure requirements, may present opportunities for improved cost efficiency and service integration. Countries seeking to scale up VMMC in rural settings might consider integrating PrePex only MC services at the primary health care level to reduce costs while also increasing VMMC access and coverage.
Cutting power costs starts with basic analyses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paik, M.

1996-10-07

Oil and gas production departments should already be reducing their power costs. Regardless of how US deregulation of electricity finally shakes out, power costs are a large portion of total operating expense. Much has been written in recent months about the rosy days, ahead, when electric utilities will be fully deregulated. But this will only be an extension of the opportunities available today; although, after deregulation, many new options will add both opportunities along with complexities. There is no magic to reducing power costs. It is simply a matter of working at it. Recommended steps for lowering power costs ismore » shown. The paper discusses electricity basics, power bills, managing power cost, field equipment changes, electrical equipment changes and deregulation.« less
Energy Efficiency Improvement and Cost Saving Opportunities for the Baking Industry: An ENERGY STAR ® Guide for Plant and Energy Managers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Masanet, Eric; Therkelsen, Peter; Worrell, Ernst

The U.S. baking industry—defined in this Energy Guide as facilities engaged in the manufacture of commercial bakery products such as breads, rolls, frozen cakes, pies, pastries, and cookies and crackers—consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component,more » process, facility, and organizational levels. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in food processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. A summary of basic, proven measures for improving plant-level water efficiency is also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. baking industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.« less
The Economics of Higher Education: Focus on Cost.

ERIC Educational Resources Information Center

Brinkman, Paul T.

2000-01-01

Introduces this topical issue on costs in higher education with an overview of the economics of higher education. Considers various types of supplier costs (opportunity versus accounting costs), various ways of determining costs (cost accounting, statistical estimation, and modeling), and factors that influence supplier costs (environmental…
HIPAA brings new requirements, new opportunities.

PubMed

Moynihan, J J; McLure, M L

2000-03-01

The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) brought with it the need for Federal rules to implement the act's simplification and cost-reduction efforts. HHS has published proposed rules related to security for the electronic transmission of health information, privacy of individually identifiable health information, transactions and code sets, and national provider and employer identifiers. Additional proposed rules will be published this year for claims attachments and health plan identifiers. Although HIPAA does not require providers to conduct business electronically, the new standards give providers the opportunity to reduce healthcare administrative costs significantly and undertake electronic commerce efficiently and cost-effectively.
The costs of caring: medical costs of Alzheimer's disease and the managed care environment.

PubMed

Murman, D L

2001-01-01

This review summarizes the medical costs associated with Alzheimer's disease (AD) and related dementias, as well as the payers responsible for these medical costs in the US health care system. It is clear from this review that AD and related dementias are associated with substantial medical costs. The payers responsible for a majority of these costs are families of patients with AD and the US government through the Medicare and Medicaid programs. In an attempt to control expenditures, Medicare and Medicaid have turned to managed care principles and managed care organizations. The increase in "managed" dementia care gives rise to several potential problems for patients with AD, along with many opportunities for systematic improvement in the quality of dementia care. Evidence-based disease management programs provide the greatest opportunities for improving managed dementia care but will require the development of dementia-specific quality of care measures to evaluate and continually improve them.
Opportunity costs of implementing forest plans

NASA Astrophysics Data System (ADS)

Fox, Bruce; Keller, Mary Anne; Schlosberg, Andrew J.; Vlahovich, James E.

1989-01-01

Intellectual concern with the National Forest Management Act of 1976 has followed a course emphasizing the planning aspects of the legislation associated with the development of forest plans. Once approved, however, forest plans must be implemented. Due to the complex nature of the ecological systems of interest, and the multiple and often conflicting desires of user clientele groups, the feasibility and costs of implementing forest plans require immediate investigation. For one timber sale on the Coconino National Forest in Arizona, forest plan constraints were applied and resulting resource outputs predicted using the terrestrial ecosystem analysis and modeling system (TEAMS), a computer-based decision support system developed at the School of Forestry, Northern Arizona University, With forest plan constraints for wildlife habitat, visual diversity, riparian area protection, and soil and slope harvesting restrictions, the maximum timber harvest obtainable was reduced 58% from the maximum obtainable without plan constraints.
OSHA's bloodborne pathogens rule an opportunity/threat.

PubMed

Weller, S C

1992-02-01

If you supply healthcare linen, OSHA's new ruling comes with a price tag, but it may be a marketing boon as well. The costs of compliance are high--about $1.19 million annually. One of the most costly and important parts of the ruling is the required employer-paid hepatitis B vaccination of employees. But behind the costs, there's good news for the textile rental industry. The opportunity to serve small medical facilities and nursing homes as well as hospitals with reusable healthcare garments could create a revenue source estimated to be at least $177 million a year.

Opportunities to change timber demand through altered timber utilization [Chapter 10

Treesearch

K. E. Skog; D. P. Bradley; H. N. Spelter; I. Durbak; P. J. Ince; W. J. Lange; P. A. Araman; D. B. McKeever; J. I. Zerbe

1990-01-01

This paper discusses opportunities for timber utilization improvement that will 1) increase efficiency of wood use, 2) reduce the cost of wood products and the cost of using wood in applications, and 3) provide new or improved wood products or wood use applications. A key purpose here is to propose and explain technology-influenced projections of 1) costs for...
2011 Workplace and Equal Opportunity Survey of Reserve Component Members: Overview Report

DTIC Science & Technology

2014-02-06

2011 Workplace and Equal Opportunity Survey of Reserve Members Overview Report The estimated cost of report or study for the Department of...Ask for report by ADA602626 February 26, 2014 OVERVIEW REPORT Note No. 2013-003 1 2011 Workplace and Equal Opportunity Survey of Reserve...harassment and discrimination within the Reserve components. This overview report discusses findings from the 2011 Workplace and Equal Opportunity
Scientific Opportunities with ispace, a Lunar Exploration Company

NASA Astrophysics Data System (ADS)

Acierno, K. T.

2016-11-01

This presentation introduces ispace, a Tokyo-based lunar exploration company. Technology applied to the Team Hakuto Google Lunar XPRIZE mission will be described. Finally, it will discuss how developing low cost and mass efficient rovers can support scientific opportunities.
Existing School Buildings: Incremental Seismic Retrofit Opportunities.

ERIC Educational Resources Information Center

Federal Emergency Management Agency, Washington, DC.

The intent of this document is to provide technical guidance to school district facility managers for linking specific incremental seismic retrofit opportunities to specific maintenance and capital improvement projects. The linkages are based on logical affinities, such as technical fit, location of the work within the building, cost saving…
Opportunity Knocks! A Student Employment Preparation Program.

ERIC Educational Resources Information Center

Golden, Cynthia

2000-01-01

Describes the Opportunity Knocks student employment preparation program at Duquesne University (Pennsylvania) in which students receive one week of training prior to fall semester and then work to meet escalating demands for information technology support on campus. Notes special features of the program, program costs, and program impact. A…
Status and opportunities associated with product costing strategies in wood component manufacturing

Treesearch

Adrienn Andersch; Urs Buehlmann; Jan Wiedenbeck; Steve Lawser

2013-01-01

Product costing systems are critically important for businesses because they help reduce costs, price products at competitive prices, and enable strategic decisionmaking. This article reports the results of a survey designed to collect information about practices used by the North American hardwood dimension and components industry to calculate the cost of their...
"Poverty is the big thing": exploring financial, transportation, and opportunity costs associated with fistula management and repair in Nigeria and Uganda.

PubMed

Keya, Kaji Tamanna; Sripad, Pooja; Nwala, Emmanuel; Warren, Charlotte E

2018-06-01

Women living with obstetric fistula often live in poverty and in remote areas far from hospitals offering surgical repair. These women and their families face a range of costs while accessing fistula repair, some of which include: management of their condition, lost productivity and time, and transport to facilities. This study explores, through women's, communities', and providers' perspectives, the financial, transport, and opportunity cost barriers and enabling factors for seeking repair services. A qualitative approach was applied in Kano and Ebonyi in Nigeria and Hoima and Masaka in Uganda. Between June and December 2015, the study team conducted in-depth interviews (IDIs) with women affected by fistula (n = 52) - including those awaiting repair, living with fistula, and after repair, and their spouses and other family members (n = 17), along with health service providers involved in fistula repair and counseling (n = 38). Focus group discussions (FGDs) with male and female community stakeholders (n = 8) and post-repair clients (n = 6) were also conducted. Women's experiences indicate the obstetric fistula results in a combined set of costs associated with delivery, repair, transportation, lost income, and companion expenses that are often limiting. Medical and non-medical ancillary costs such as food, medications, and water are not borne evenly among all fistula care centers or camps due to funding shortages. In Uganda, experienced transport costs indicate that women spend Ugandan Shilling (UGX) 10,000 to 90,000 (US$3.00-US$25.00) for two people for a single trip to a camp (client and her caregiver), while Nigerian women (Kano) spent Naira 250 to 2000 (US$0.80-US$6.41) for transportation. Factors that influence women's and families' ability to cover costs of fistula care access include education and vocational skills, community savings mechanisms, available resources in repair centers, client counseling, and subsidized care and
Energy Efficiency Improvement and Cost Saving Opportunities for the Dairy Processing Industry: An ENERGY STAR? Guide for Energy and Plant Managers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brush, Adrian; Masanet, Eric; Worrell, Ernst

The U.S. dairy processing industry—defined in this Energy Guide as facilities engaged in the conversion of raw milk to consumable dairy products—consumes around $1.5 billion worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. dairy processing industry to reduce energy consumption and greenhouse gas emissions in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented atmore » the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. dairy processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to dairy processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in dairy processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in dairy processing, a summary of basic, proven measures for improving water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. dairy processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.« less
Vehicle Lightweighting: Challenges and Opportunities with Aluminum

NASA Astrophysics Data System (ADS)

Sachdev, Anil K.; Mishra, Raja K.; Mahato, Anirban; Alpas, Ahmet

Rising energy costs, consumer preferences and regulations drive requirements for fuel economy, performance, comfort, safety and cost of future automobiles. These conflicting situations offer challenges for vehicle lightweighting, for which aluminum applications are key. This paper describes product design needs and materials and process development opportunities driven by theoretical, experimental and modeling tools in the area of sheet and castings. Computational tools and novel experimental techniques used in their development are described. The paper concludes with challenges that lie ahead for pervasive use of aluminum and the necessary fundamental R&D that is still needed.
Portfolio Analysis of Renewable Energy Opportunities: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Richards, Allison; Deprizio, Jodi; Anderson, Kate

Time Warner Cable (TWC), now Charter Communications (CC), partnered with the National Renewable Energy Laboratory (NREL) to assess the technical and economic potential for solar photovoltaic (PV), wind, and ground-source heat-pump systems at 696 TWC facilities. NREL identified 306 sites where adding a renewable energy system would provide cost savings over the project life-cycle. In general, the top sites have some combination of high electricity rates ($0.16-$0.29/kWh), significant state incentives, and favorable net-metering policies. If all projects were implemented via third-party power purchase agreements, TWC/CC would save $37 million over 25 years and meet 10.5% of their energy consumption withmore » renewable energy. This paper describes the portfolio screening methodology used to identify and prioritize renewable energy opportunities across the TWC sites, as well as a summary of the potential cost savings that may be realized by implementing these projects. This may provide a template for other companies interested in identifying and prioritizing renewable energy opportunities across a large number of geographically dispersed sites. Following this initial portfolio analysis, NREL will be conducting in-depth analysis of project development opportunities at ten sites and evaluating off-grid solutions that may enable carbon emission reduction and grid independence at select facilities.« less
Cost-effective priorities for global mammal conservation.

PubMed

Carwardine, Josie; Wilson, Kerrie A; Ceballos, Gerardo; Ehrlich, Paul R; Naidoo, Robin; Iwamura, Takuya; Hajkowicz, Stefan A; Possingham, Hugh P

2008-08-12

Global biodiversity priority setting underpins the strategic allocation of conservation funds. In identifying the first comprehensive set of global priority areas for mammals, Ceballos et al. [Ceballos G, Ehrlich PR, Soberón J, Salazar I, Fay JP (2005) Science 309:603-607] found much potential for conflict between conservation and agricultural human activity. This is not surprising because, like other global priority-setting approaches, they set priorities without socioeconomic objectives. Here we present a priority-setting framework that seeks to minimize the conflicts and opportunity costs of meeting conservation goals. We use it to derive a new set of priority areas for investment in mammal conservation based on (i) agricultural opportunity cost and biodiversity importance, (ii) current levels of international funding, and (iii) degree of threat. Our approach achieves the same biodiversity outcomes as Ceballos et al.'s while reducing the opportunity costs and conflicts with agricultural human activity by up to 50%. We uncover shortfalls in the allocation of conservation funds in many threatened priority areas, highlighting a global conservation challenge.
Environmental Co-Benefit Opportunities of Solar Energy

NASA Astrophysics Data System (ADS)

Hernandez, R. R.; Armstrong, A.; Burney, J. A.; Easter, S. B.; Hoffacker, M. K.; Moore, K. A.

2015-12-01

Solar energy reduces greenhouse gas emissions by an order of magnitude when substituted for fossil fuels. Nonetheless, the strategic deployment of solar energy—from single, rooftop modules to utility-scale solar energy power plants—can confer additional environmental co-benefits beyond its immediate use as a low carbon energy source. In this study, we identify a diverse portfolio of environmental co-benefit opportunities of solar energy technologies resulting from synergistic innovations in land, food, energy, and water systems. For each opportunity, we provide a demonstrative, quantitative framework for environmental co-benefit valuation—including, equations, models, or case studies for estimating carbon dioxide equivalent (CO2-eq) and cost savings ($US) averted by environmental co-benefit opportunities of solar energy—and imminent research questions to improve certainty of valuations. As land-energy-food-water nexus issues are increasingly exigent in 21st century, we show that environmental co-benefit opportunities of solar energy are feasible in numerous environments and at a wide range of spatial scales thereby able to contribute to local and regional environmental goals and for the mitigation of climate change.
Low cost solar silicon production

NASA Astrophysics Data System (ADS)

Mede, Matt

2009-08-01

The worldwide demand for solar grade silicon reached an all time high between 2007 and 2008. Although growth in the solar industry is slowing due to the current economic downturn, demand is expected to rebound in 2011 based on current cost models. However, demand will increase even more than currently anticipated if costs are reduced. This situation creates an opportunity for new and innovative approaches to the production of photovoltaic grade silicon, especially methods which can demonstrate cost reductions over currently utilized processes.
Cost-benefit analysis of childhood asthma management through school-based clinic programs.

PubMed

Tai, Teresa; Bame, Sherry I

2011-04-01

Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.
Cost Evaluation of Evidence-Based Treatments

PubMed Central

Sindelar, Jody L.; Ball, Samuel A.

2010-01-01

Many treatment programs have adopted or are considering adopting evidence-based treatments (EBTs). When a program evaluates whether to adopt a new intervention, it must consider program objectives, operational goals, and costs. This article examines cost concepts, cost estimation, and use of cost information to make the final decision on whether to adopt an EBT. Cost categories, including variable and fixed, accounting and opportunity, and costs borne by patients and others, are defined and illustrated using the example of expenditures for contingency management. Ultimately, cost is one consideration in the overall determination of whether implementing an EBT is the best use of a program’s resources. PMID:22002453
Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II.

PubMed

Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

2010-01-01

Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The
Energy savings opportunity survey at Walter Reed Army Medical Center, Washington, DC. Final Submittal report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1987-10-22

This Energy Savings Opportunity Survey (ESOS) was performed for sixteen (16) buildings at Walter Reed Army Medical Center (WPAMC) in Washington, D.C. This survey was intended to reevaluate and update projects from a previous Energy Engineering Analysis Program (EEAP) survey performed at WRAMC. However, the previous EEAP survey was determined by the contracting officer to be incomplete and not worthy of further consideration. Therefore, this survey involved the complete reevaluation of the buildings to determine their potential energy cost savings. Six (6) projects and nine (9) low cost/no cost energy conservation opportunities (ECO`s) are recommended for implementation in the buildings.more » These projects and ECO`s are projected to annually save $448,263 at an implementation cost of $891,659. The simple payback (i.e., implementation cost divided by cost savings) for the recommendations in the survey is 1.99 years. The two (2) projects with the greatest cost savings are a stack heat recovery system (Project Number 5) and HVAC modifications (Project Number 1). These two (2) projects will provide 67% of the projected total savings for the survey. The sixteen (16) buildings in this survey represent only 22% of the total floor area of the Walter Reed Army Medical Center complex. It is believed that significant potential energy cost savings amounting to two (2) million dollars may be achieved in the remaining buildings in the complex not included in this survey. Specifically it is believed the main hospital building contains many opportunities for substantial cost savings.« less
Biorefinery opportunities for the forest products industries

Treesearch

Alan W. Rudie

2013-01-01

Wood residues offer biorefinery opportunities for new products in our industries including fuel and chemicals. But industry must have two capabilities to succeed with biorefineries. Most forest products companies already have the first capability: knowing where the resource is, how to get it, and how much it will cost. They will need to integrate the acquisition of...
Seizing Opportunity: "Opportunity as Transformation"

ERIC Educational Resources Information Center

Williams, Michael; Muller, Esther

2012-01-01

Opportunity creates conditions for achievement. We learn daily of the success of others that resulted from conditions they created through opportunity. Often these conditions of opportunity are the product of a compelling vision of a future steeped in possibility and rich in reward. These visions, however, must be operationalized in order to be…
The New Jersey Medicaid ACO Demonstration Project: seeking opportunities for better care and lower costs among complex low-income patients.

PubMed

Cantor, Joel C; Chakravarty, Sujoy; Tong, Jian; Yedidia, Michael J; Lontok, Oliver; DeLia, Derek

2014-12-01

A small but growing number of states are turning to accountable care concepts to improve their Medicaid programs. In 2011 New Jersey enacted the Medicaid Accountable Care Organization (ACO) Demonstration Project to offer local provider coalitions the opportunity to share any savings they generate. Impetus came from initiatives in Camden that aim to reduce costs through improved care coordination among hospital high users and that have received considerable media attention and substantial federal and private grant support. Though broadly similar to Medicare and commercial ACOs, the New Jersey demonstration addresses the unique concerns faced by Medicaid populations. Using hospital all-payer billing data, we estimate savings from care improvement efforts among inpatient and emergency department high users in thirteen communities that are candidates for participation in the New Jersey demonstration. We also examine their characteristics to inform Medicaid accountable care strategies. We find substantial variation in the share of high-user hospital patients across the study communities and high rates of avoidable use and costs among these patients. The potential savings among Medicaid enrollees are considerable, particularly if Medicaid ACOs can develop ways to successfully address the high burden of chronic illness and behavioral health conditions prevalent in the prospective demonstration communities. Copyright © 2014 by Duke University Press.

Solar Avoided Cost Solution SunShot 6 Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tucker, John; Danziger, Eric

2014-01-29

The core objectives of this project were two separate but integrated products, collectively providing game-changing Avoided Cost capabilities. The first was a kit of avoided cost tools and data that any solar provider can use a-lacarte or as a whole. It’s open and easily accessible nature allows the rapid and accurate calculation of avoided cost in whatever context and software that make sense (“Typical and Avoided Cost Tools”). This kit includes a dataset of typical energy rates, costs and usage that can be used for solar prospecting, lead generation and any situation where data about an opportunity is missing ormore » imperfect. The second is a web application and related APIs specifically built for solar providers to radically streamline their lead-to-sale process (“Solar Provider Module”). The typical and Avoided Cost tools are built directly into this, and allow for solar providers to track their opportunities, collaborate with their installers and financiers, and close more sales faster.« less
The cost of poor quality: an opportunity of enormous proportions.

PubMed

Hughes, J M

1998-01-01

In all organizations, the state of finance is routinely reported in sublime detail for study and action. And yet, anywhere from 20 to 50 percent of the monies involved in that report are never identified as unnecessary and nonproductive. These monies, referred to as the Cost of Waste (COW), are the result of actions that have been taken or must be taken because quality is not served--inappropriate actions are being performed or appropriate actions are not being performed right the first time, every time. Proactively determining, reporting, and monitoring the COW brings a degree of objectivity to the quality management process and provides a powerful internal driver for performance improvement. A 10 step Cost of Waste system is proposed.
2013 Cost of Wind Energy Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mone, C.; Smith, A.; Maples, B.

2015-02-01

This report uses representative project types to estimate the levelized cost of wind energy (LCOE) in the United States for 2013. Scheduled to be published on an annual basis, it relies on both market and modeled data to maintain a current understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed from this analysis are used to inform wind technology cost projections, goals, and improvement opportunities.
78 FR 68857 - Fiscal Year (FY) 2014 Funding Opportunity

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Fiscal Year (FY) 2014 Funding Opportunity AGENCY: Substance Abuse and Mental Health Services... Mental Health Services Administration (SAMHSA) intends to award $459,505 (total costs) for up to five...
78 FR 49276 - Fiscal Year (FY) 2013 Funding Opportunity

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Fiscal Year (FY) 2013 Funding Opportunity AGENCY: Substance Abuse and Mental Health Services... Mental Health Services Administration (SAMHSA) intends to award $1,895,388 (total costs) for up to five...
Overview of energy-conservation research opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hopp, W.J.; Hauser, S.G.; Hane, G.J.

1981-12-01

This document is a study of research opportunities that are important to developing advanced technologies for efficient energy use. The study's purpose is to describe a wide array of attractive technical areas from which specific research and development programs could be implemented. Research areas are presented for potential application in each of the major end-use sectors. The study develops and applies a systematic approach to identifying and screening applied energy conservation research opportunities. To broadly cover the energy end-use sectors, this study develops useful information relating to the areas where federally-funded applied research will most likely play an important rolemore » in promoting energy conservation. This study is not designed to produce a detailed agenda of specific recommended research activities. The general information presented allows uniform comparisons of disparate research areas and as such provides the basis for formulating a cost-effective, comprehensive federal-applied energy conservation research strategy. Chapter 2 discusses the various methodologies that have been used in the past to identify research opportunities and details the approach used here. In Chapters 3, 4, and 5 the methodology is applied to the buildings, transportation, and industrial end-use sectors and the opportunities for applied research in these sectors are discussed.Chapter 6 synthesizes the results of the previous three chapters to give a comprehensive picture of applied energy conservation research opportunities across all end-use sectors and presents the conclusions to the report.« less
Proportional costs in trauma and acute care surgery patients: dominant role of intensive care unit costs.

PubMed

Fakhry, Samir M; Martin, Brad; Al Harakeh, Hasan; Norcross, E Douglas; Ferguson, Pamela L

2013-04-01

Controlling inpatient costs is increasingly important. Identifying proportionately larger cost categories may help focus cost control efforts. The purpose of this study was to identify proportionate patient cost categories in trauma and acute care surgery (TACS) patients and determine subgroups in which the largest opportunities for cost savings might exist. Administrative data from our academic, urban, level I trauma center were used to identify all adult TACS patients from FY07 through FY11. We determined, on average, what proportion of the whole each cost category contributed to patients' total costs and examined the same proportions for subgroups of patients. We identified 6,008 TACS patients. Trauma patients (n = 3,904) made up 65% of the cohort (mean Injury Severity Score 13.2). Payers were: 22% government (Medicare, Medicaid, Champus), 27% private, 43% self-pay/indigent, 3% other, and 5% workers compensation. Nontrauma (general surgery) patients (n = 2,104) made up 35% of the cohort. Payers were: 44% government, 24% private, 29% self-pay/indigent, 2% other, and 1% workers compensation. Total inpatient costs were $141,304,993. Per patient costs rose from $17,245 in FY07 to $26,468 in FY11. In the aggregate, supplies, ICU stays, and ward stays represented the largest proportionate cost categories. On a per patient basis, however, ICU stays were by far the largest cost. Patients with ICU stay greater than 10 days were only 7% of all patients but accounted for 41% of total costs. Trauma and acute care surgery patients represent a significant and increasing institutional cost. Per patient ICU costs were the largest single category, suggesting that cost control efforts should focus heavily on critically ill patients. Nontrauma patients who require critical care have the highest per patient ICU costs and may represent a previously underappreciated opportunity for cost control. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights
Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center.

PubMed

Anzai, Yoshimi; Heilbrun, Marta E; Haas, Derek; Boi, Luca; Moshre, Kirk; Minoshima, Satoshi; Kaplan, Robert; Lee, Vivian S

2017-02-01

The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service. The study was exempt from an institutional review board approval. TDABC utilizes process mapping tools from industrial engineering and activity-based costing. The process map outlines every step of discrete activity and duration of use of clinical resources, personnel, and equipment. By multiplying the cost per unit of capacity by the required task time for each step, and summing each component cost, the overall costs of AP CT is determined for patients in three settings, inpatient (IP), outpatient (OP), and emergency departments (ED). The component costs to deliver an AP CT study were as follows: radiologist interpretation: 40.1%; other personnel (scheduler, technologist, nurse, pharmacist, and transporter): 39.6%; materials: 13.9%; and space and equipment: 6.4%. The cost of performing CT was 13% higher for ED patients and 31% higher for inpatients (IP), as compared to that for OP. The difference in cost was mostly due to non-radiologist personnel costs. Approximately 80% of the direct costs of AP CT to the academic medical center are related to labor. Potential opportunities to reduce the costs include increasing the efficiency of utilization of CT, substituting lower cost resources when appropriate, and streamlining the ordering system to clarify medical necessity and clinical indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
A bottom-up approach to estimating cost elements of REDD+ pilot projects in Tanzania

PubMed Central

2012-01-01

Background Several previous global REDD+ cost studies have been conducted, demonstrating that payments for maintaining forest carbon stocks have significant potential to be a cost-effective mechanism for climate change mitigation. These studies have mostly followed highly aggregated top-down approaches without estimating the full range of REDD+ costs elements, thus underestimating the actual costs of REDD+. Based on three REDD+ pilot projects in Tanzania, representing an area of 327,825 ha, this study explicitly adopts a bottom-up approach to data assessment. By estimating opportunity, implementation, transaction and institutional costs of REDD+ we develop a practical and replicable methodological framework to consistently assess REDD+ cost elements. Results Based on historical land use change patterns, current region-specific economic conditions and carbon stocks, project-specific opportunity costs ranged between US$ -7.8 and 28.8 tCOxxxx for deforestation and forest degradation drivers such as agriculture, fuel wood production, unsustainable timber extraction and pasture expansion. The mean opportunity costs for the three projects ranged between US$ 10.1 – 12.5 tCO2. Implementation costs comprised between 89% and 95% of total project costs (excluding opportunity costs) ranging between US$ 4.5 - 12.2 tCO2 for a period of 30 years. Transaction costs for measurement, reporting, verification (MRV), and other carbon market related compliance costs comprised a minor share, between US$ 0.21 - 1.46 tCO2. Similarly, the institutional costs comprised around 1% of total REDD+ costs in a range of US$ 0.06 – 0.11 tCO2. Conclusions The use of bottom-up approaches to estimate REDD+ economics by considering regional variations in economic conditions and carbon stocks has been shown to be an appropriate approach to provide policy and decision-makers robust economic information on REDD+. The assessment of opportunity costs is a crucial first step to provide information on the
Opportunities and costs for preventing vertebrate extinctions.

PubMed

Conde, Dalia A; Colchero, Fernando; Güneralp, Burak; Gusset, Markus; Skolnik, Ben; Parr, Michael; Byers, Onnie; Johnson, Kevin; Young, Glyn; Flesness, Nate; Possingham, Hugh; Fa, John E

2015-03-16

Despite an increase in policy and management responses to the global biodiversity crisis, implementation of the 20 Aichi Biodiversity Targets still shows insufficient progress [1]. These targets, strategic goals defined by the United Nations Convention on Biological Diversity (CBD), address major causes of biodiversity loss in part by establishing protected areas (Target 11) and preventing species extinctions (Target 12). To achieve this, increased interventions will be required for a large number of sites and species. The Alliance for Zero Extinction (AZE) [2], a consortium of conservation-oriented organisations that aims to protect Critically Endangered and Endangered species restricted to single sites, has identified 920 species of mammals, birds, amphibians, reptiles, conifers and reef-building corals in 588 'trigger' sites [3]. These are arguably the most irreplaceable category of important biodiversity conservation sites. Protected area coverage of AZE sites is a key indicator of progress towards Target 11 [1]. Moreover, effective conservation of AZE sites is essential to achieve Target 12, as the loss of any of these sites would certainly result in the global extinction of at least one species [2]. However, averting human-induced species extinctions within AZE sites requires enhanced planning tools to increase the chances of success [3]. Here, we assess the potential for ensuring the long-term conservation of AZE vertebrate species (157 mammals, 165 birds, 17 reptiles and 502 amphibians) by calculating a conservation opportunity index (COI) for each species. The COI encompasses a set of measurable indicators that quantify the possibility of achieving successful conservation of a species in its natural habitat (COIh) and by establishing insurance populations in zoos (COIc). Copyright © 2015 Elsevier Ltd. All rights reserved.
Nanomanufacturing and sustainability: opportunities and challenges

NASA Astrophysics Data System (ADS)

Busnaina, Ahmed A.; Mead, Joey; Isaacs, Jacqueline; Somu, Sivasubramanian

2013-10-01

New nanomanufacturing technologies, although still in research labs, present a great opportunity to drastically reduce the cost of making nanostructures on a large scale and at high-rates. Such new bottom-up directed assembly-based approaches involve adding materials selectively thereby both reducing waste and the number of required processes. Directed assembly-based processes are conducted at room pressure and temperatures which significantly reduces the cost of nanomanufacturing equipment and tools, ensuring long-term sustainability by reducing energy, consumables, and waste costs. This paradigm shift in nanomanufacturing will unleash not only a wave of creativity in sustainable nanomanufacturing but lessons learnt along the way can be used in various other sectors. Along with the exquisite technological promise that nanotechnology holds, nano-enabled products are heralded as a means for energy and resource reduction, resulting in potential manufacturing cost reductions and further, for potential improvements to environmental remediation. Sustainable nanomanufacturing will, by dramatically lowering current nanomanufacturing barriers, spur innovation, and the creation of entirely new industries by leveling the playing and ultimately leading to the democratization of nanomanufacturing.
Costly punishment prevails in intergroup conflict

PubMed Central

Sääksvuori, Lauri; Mappes, Tapio; Puurtinen, Mikael

2011-01-01

Understanding how societies resolve conflicts between individual and common interests remains one of the most fundamental issues across disciplines. The observation that humans readily incur costs to sanction uncooperative individuals without tangible individual benefits has attracted considerable attention as a proximate cause as to why cooperative behaviours might evolve. However, the proliferation of individually costly punishment has been difficult to explain. Several studies over the last decade employing experimental designs with isolated groups have found clear evidence that the costs of punishment often nullify the benefits of increased cooperation, rendering the strong human tendency to punish a thorny evolutionary puzzle. Here, we show that group competition enhances the effectiveness of punishment so that when groups are in direct competition, individuals belonging to a group with punishment opportunity prevail over individuals in a group without this opportunity. In addition to competitive superiority in between-group competition, punishment reduces within-group variation in success, creating circumstances that are highly favourable for the evolution of accompanying group-functional behaviours. We find that the individual willingness to engage in costly punishment increases with tightening competitive pressure between groups. Our results suggest the importance of intergroup conflict behind the emergence of costly punishment and human cooperation. PMID:21450740
Costly punishment prevails in intergroup conflict.

PubMed

Sääksvuori, Lauri; Mappes, Tapio; Puurtinen, Mikael

2011-11-22

Understanding how societies resolve conflicts between individual and common interests remains one of the most fundamental issues across disciplines. The observation that humans readily incur costs to sanction uncooperative individuals without tangible individual benefits has attracted considerable attention as a proximate cause as to why cooperative behaviours might evolve. However, the proliferation of individually costly punishment has been difficult to explain. Several studies over the last decade employing experimental designs with isolated groups have found clear evidence that the costs of punishment often nullify the benefits of increased cooperation, rendering the strong human tendency to punish a thorny evolutionary puzzle. Here, we show that group competition enhances the effectiveness of punishment so that when groups are in direct competition, individuals belonging to a group with punishment opportunity prevail over individuals in a group without this opportunity. In addition to competitive superiority in between-group competition, punishment reduces within-group variation in success, creating circumstances that are highly favourable for the evolution of accompanying group-functional behaviours. We find that the individual willingness to engage in costly punishment increases with tightening competitive pressure between groups. Our results suggest the importance of intergroup conflict behind the emergence of costly punishment and human cooperation.
Cost Analysis of Online Courses. AIR 2000 Annual Forum Paper.

ERIC Educational Resources Information Center

Milam, John H., Jr.

This paper presents a complex, hybrid, method of cost analysis of online courses, which incorporates data on expenditures; student/course enrollment; departmental consumption/contribution; space utilization/opportunity costs; direct non-personnel costs; computing support; faculty/staff workload; administrative overhead at the department, dean, and…
The value-added laboratory: an opportunity to merge research and service objectives.

PubMed

McDonald, J M

1997-01-01

The changing health-care environment is creating a new opportunities for laboratory medicine professionals that correspond with the new health services research agendas. Proving cost-effectiveness and conducting outcomes assessment are becoming vital functions of laboratories in this era of managed care. Laboratorians must take advantage of the resulting opportunities to show how they add value and medical relevance to the health-care delivery system.
The ability of land owners and their cooperatives to leverage payments greater than opportunity costs from conservation contracts.

PubMed

Lennox, Gareth D; Armsworth, Paul R

2013-06-01

In negotiations over land-right acquisitions, landowners have an informational advantage over conservation groups because they know more about the opportunity costs of conservation measures on their sites. This advantage creates the possibility that landowners will demand payments greater than the required minimum, where this minimum required payment is known as the landowner’s willingness to accept (WTA). However, in recent studies of conservation costs, researchers have assumed landowners will accept conservation with minimum payments. We investigated the ability of landowners to demand payments above their WTA when a conservation group has identified multiple sites for protection. First, we estimated the maximum payment landowners could potentially demand, which is set when groups of landowners act as a cooperative. Next, through the simulation of conservation auctions, we explored the amount of money above landowners’ WTA (i.e., surplus) that conservation groups could cede to secure conservation agreements, again investigating the influence of landowner cooperatives. The simulations showed the informational advantage landowners held could make conservation investments up to 42% more expensive than suggested by the site WTAs. Moreover, all auctions resulted in landowners obtaining payments greater than their WTA; thus, it may be unrealistic to assume landowners will accept conservation contracts with minimum payments. Of particular significance for species conservation, conservation objectives focused on overall species richness,which therefore recognize site complementarity, create an incentive for land owners to form cooperatives to capture surplus. To the contrary, objectives in which sites are substitutes, such as the maximization of species occurrences, create a disincentive for cooperative formation.
Chimpanzees do not take advantage of very low cost opportunities to deliver food to unrelated group members.

PubMed

Vonk, Jennifer; Brosnan, Sarah F; Silk, Joan B; Henrich, Joseph; Richardson, Amanda S; Lambeth, Susan P; Schapiro, Steven J; Povinelli, Daniel J

2008-05-01

We conducted experiments on two populations of chimpanzees, Pan troglodytes , to determine whether they would take advantage of opportunities to provide food rewards to familiar group members at little cost to themselves. In both of the experiments described here, chimpanzees were able to deliver identical rewards to themselves and to other members of their social groups. We compared the chimpanzees' behaviour when they were paired with another chimpanzee and when they were alone. If chimpanzees are motivated to provide benefits to others, they are expected to consistently deliver rewards to others and to distinguish between the partner-present and partner-absent conditions. Results from both experiments indicate that our subjects were largely indifferent to the benefits they could provide to others. They were less likely to provide rewards to potential recipients as the experiment progressed, and all but one of the 18 subjects were as likely to deliver rewards to an empty enclosure as to an enclosure housing another chimpanzee. These results, in conjunction with similar results obtained in previous experiments, suggest that chimpanzees are not motivated by prosocial sentiments to provide food rewards to other group members.
Chimpanzees do not take advantage of very low cost opportunities to deliver food to unrelated group members

PubMed Central

VONK, JENNIFER; BROSNAN, SARAH F.; SILK, JOAN B.; HENRICH, JOSEPH; RICHARDSON, AMANDA S.; LAMBETH, SUSAN P.; SCHAPIRO, STEVEN J.; POVINELLI, DANIEL J.

2015-01-01

We conducted experiments on two populations of chimpanzees, Pan troglodytes, to determine whether they would take advantage of opportunities to provide food rewards to familiar group members at little cost to themselves. In both of the experiments described here, chimpanzees were able to deliver identical rewards to themselves and to other members of their social groups. We compared the chimpanzees’ behaviour when they were paired with another chimpanzee and when they were alone. If chimpanzees are motivated to provide benefits to others, they are expected to consistently deliver rewards to others and to distinguish between the partner-present and partner-absent conditions. Results from both experiments indicate that our subjects were largely indifferent to the benefits they could provide to others. They were less likely to provide rewards to potential recipients as the experiment progressed, and all but one of the 18 subjects were as likely to deliver rewards to an empty enclosure as to an enclosure housing another chimpanzee. These results, in conjunction with similar results obtained in previous experiments, suggest that chimpanzees are not motivated by prosocial sentiments to provide food rewards to other group members. PMID:27011388
Vehicle Technologies Program Funding Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

The U.S. Department of Energy (DOE) Office of Energy Efficiency and Renewable Energy (EERE) provides funding opportunities for advanced vehicle technology projects that are aimed at removing technical and cost barriers. Much of the funding available to the Vehicle Technologies Program is distributed to private firms, educational institutions, nonprofit organizations, state and local governments, Native American organizations, and individuals, through competitive solicitations. DOE is strongly committed to partnerships to help ensure the eventual market acceptance of the technologies being developed. New solicitations are announced regularly.
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.

Research opportunities to advance solar energy utilization.

PubMed

Lewis, Nathan S

2016-01-22

Major developments, as well as remaining challenges and the associated research opportunities, are evaluated for three technologically distinct approaches to solar energy utilization: solar electricity, solar thermal, and solar fuels technologies. Much progress has been made, but research opportunities are still present for all approaches. Both evolutionary and revolutionary technology development, involving foundational research, applied research, learning by doing, demonstration projects, and deployment at scale will be needed to continue this technology-innovation ecosystem. Most of the approaches still offer the potential to provide much higher efficiencies, much lower costs, improved scalability, and new functionality, relative to the embodiments of solar energy-conversion systems that have been developed to date. Copyright © 2016, American Association for the Advancement of Science.
Job Opportunities Glitter for Librarians Who Surf the Net.

ERIC Educational Resources Information Center

Azar, A. Paula

1996-01-01

The Internet gives library professionals access to job opportunities that are not readily accessible in print. Employers can advertise at minimal cost and reach a broad, technically adept audience. This article lists Internet job resource sites and listservs for library and information professionals, providing Uniform Resource Locators (URLs),…
A method for quantifying and comparing the costs and benefits of alternative riparian zone buffer widths

Treesearch

Chris B. LeDoux; Ethel Wilkerson

2008-01-01

We developed a method that can be used to quantify the opportunity costs and ecological benefits of implementing alternative streamside management zones/buffer zone widths. The opportunity costs are computed based on the net value of the timber left behind in the buffer zone, the stump-to-mill logging costs for the logging technology that would have been used to...
A revolutionary approach to health care cost control: leveraging the power of Web-enabled employee "consumerism".

PubMed

Rozzi, M V

2001-09-01

The confluence of two trends--health care "consumerism" and employee self-service benefits programs--offers employers a promising opportunity for health care cost control. To take advantage of this opportunity, employers must take a fresh look at the health care cost dilemma and find ways to simultaneously offer employees a new kind of benefit and implement more effective cost-control measures.
Cost Analysis in Telemedicine: Empirical Evidence From Sites in Arizona

ERIC Educational Resources Information Center

de la Torre, Adela; Hernandez-Rodriguez, Clemente; Garcia, Lorena

2004-01-01

Support of telemedicine for largely rural and ethnically diverse populations is premised on expectations that it increases opportunities for appropriate and timely medical services, and that it improves cost-effective service delivery. To understand the cost-effectiveness of telemedicine in 8 small and/or rural sites in Arizona. A cost analysis…
Cost Recovery Through Depreciation.

ERIC Educational Resources Information Center

Forrester, Robert T.; Wesolowski, Leonard V.

1983-01-01

The approach of adopting depreciation rather than use allowance in order to recover more accurately the cost of college buildings and equipment used on federal projects is considered. It is suggested that depreciation will offer most colleges and universities a higher annual recovery rate, and an opportunity for better facilities planning. For…
Contextual variations in costs for a community health strategy implemented in rural, peri-urban and nomadic sites in Kenya.

PubMed

Wafula, Charles Ouma; Edwards, Nancy; Kaseje, Dan C O

2017-02-28

Many low and middle income countries have developed community health strategies involving lay health workers, to complement and strengthen public health services. This study explores variations in costing parameters pertinent to deployment of community health volunteers across different contexts outlining considerations for costing program scale-up. The study used quasi experimental study design and employed both quantitative and qualitative methods to explore community health unit implementation activities and costs and compare costs across purposively selected sites that differed socially, economically and ecologically. Data were collected from November 2010 to December 2013 through key informant interviews and focus group discussions. We interviewed 16 key informants (eight District community health strategy focal persons, eight frontline field officers), and eight focus group discussions (four with community health volunteers and four with community health committee) and 560 sets of monthly cost data. Cost data were tabulated using Microsoft Excel. Qualitative data were transcribed and coded using a content analysis framework. Four critical elements: attrition rates for community health volunteers, geography and population density, livelihood opportunity costs and benefits, and social opportunity benefits, drove cost variations across the three sites. Attrition rate was highest in peri-urban site where population is highly mobile and lowest in nomadic site. More households were covered by community health workers in the peri-urban area making per capita costs considerably less than in the nomadic settings where long distances had to be covered to reach sparsely distributed households. Livelihood opportunity costs for Community Health Volunteers were highest in nomadic setting, while peri-urban ones reported substantial employability benefits resulting from training. Social opportunity benefits were highest in rural site. Results show that costs of implementing
Cost and cost-effectiveness studies in urologic oncology using large administrative databases.

PubMed

Wang, Ye; Mossanen, Matthew; Chang, Steven L

2018-04-01

Urologic cancers are not only among the most common types of cancers, but also among the most expensive cancers to treat in the United States. This study aimed to review the use of CEAs and other cost analyses in urologic oncology using large databases to better understand the value of management strategies of these cancers. A literature review on CEAs and other cost analyses in urologic oncology using large databases. The options for and costs of diagnosing, treating, and following patients with urologic cancers can be expected to rise in the coming years. There are numerous opportunities in each urologic cancer to use CEAs to both lower costs and provide high-quality services. Improved cancer care must balance the integration of novelty with ensuring reasonable costs to patients and the health care system. With the increasing focus cost containment, appreciating the value of competing strategies in caring for our patients is pivotal. Leveraging methods such as CEAs and harnessing large databases may help evaluate the merit of established or emerging strategies. Copyright © 2018 Elsevier Inc. All rights reserved.
Estimating the capital recovery costs of alternative patch retention treatments in eastern hardwoods

Treesearch

Chris B. LeDoux; Andrew Whitman

2006-01-01

We used a simulation model to estimate the economic opportunity costs and the density of large stems retained for patch retention in two temperate oak stands representative of the oak/hickory forest type in the eastern United States. Opportunity/retention costs ranged from $321.0 to $760.7/ha [$129.9 to $307.8/acre] depending on the species mix in the stand, the...
Revolutionary opportunities for materials and structures study, addendum

NASA Technical Reports Server (NTRS)

Feig, P. D.

1987-01-01

This report is an addendum to the Revolutionary Opportunities for Materials and Structures Study (ROMS), modifying the original by the addition of two tasks. The primary purpose of these tasks was to conduct additional aircraft/engine sizing and mission analysis to obtain contributory aircraft performance data such as fuel burns and direct operating costs for both the subsonic and supersonic engines.
Large-scale conservation planning in a multinational marine environment: cost matters.

PubMed

Mazor, Tessa; Giakoumi, Sylvaine; Kark, Salit; Possingham, Hugh P

2014-07-01

Explicitly including cost in marine conservation planning is essential for achieving feasible and efficient conservation outcomes. Yet, spatial priorities for marine conservation are still often based solely on biodiversity hotspots, species richness, and/or cumulative threat maps. This study aims to provide an approach for including cost when planning large-scale Marine Protected Area (MPA) networks that span multiple countries. Here, we explore the incorporation of cost in the complex setting of the Mediterranean Sea. In order to include cost in conservation prioritization, we developed surrogates that account for revenue from multiple marine sectors: commercial fishing, noncommercial fishing, and aquaculture. Such revenue can translate into an opportunity cost for the implementation of an MPA network. Using the software Marxan, we set conservation targets to protect 10% of the distribution of 77 threatened marine species in the Mediterranean Sea. We compared nine scenarios of opportunity cost by calculating the area and cost required to meet our targets. We further compared our spatial priorities with those that are considered consensus areas by several proposed prioritization schemes in the Mediterranean Sea, none of which explicitly considers cost. We found that for less than 10% of the Sea's area, our conservation targets can be achieved while incurring opportunity costs of less than 1%. In marine systems, we reveal that area is a poor cost surrogate and that the most effective surrogates are those that account for multiple sectors or stakeholders. Furthermore, our results indicate that including cost can greatly influence the selection of spatial priorities for marine conservation of threatened species. Although there are known limitations in multinational large-scale planning, attempting to devise more systematic and rigorous planning methods is especially critical given that collaborative conservation action is on the rise and global financial crisis
Opportunities

ERIC Educational Resources Information Center

Estkowski, Terri

2008-01-01

In life, each person is offered opportunities, one after the other, until life ceases. For the author, one of those opportunities was to attend the Kalamazoo Area Mathematics and Science Center (KAMSC), an NCSSSMST school. While attending KAMSC as a member of its inaugural class required a bit of imagination regarding the opportunity at hand, and…
Mapping the economic costs and benefits of conservation.

PubMed

Naidoo, Robin; Ricketts, Taylor H

2006-10-01

Resources for biodiversity conservation are severely limited, requiring strategic investment. Understanding both the economic benefits and costs of conserving ecosystems will help to allocate scarce dollars most efficiently. However, although cost-benefit analyses are common in many areas of policy, they are not typically used in conservation planning. We conducted a spatial evaluation of the costs and benefits of conservation for a landscape in the Atlantic forests of Paraguay. We considered five ecosystem services (i.e., sustainable bushmeat harvest, sustainable timber harvest, bioprospecting for pharmaceutical products, existence value, and carbon storage in aboveground biomass) and compared them to estimates of the opportunity costs of conservation. We found a high degree of spatial variability in both costs and benefits over this relatively small (approximately 3,000 km(2)) landscape. Benefits exceeded costs in some areas, with carbon storage dominating the ecosystem service values and swamping opportunity costs. Other benefits associated with conservation were more modest and exceeded costs only in protected areas and indigenous reserves. We used this cost-benefit information to show that one potential corridor between two large forest patches had net benefits that were three times greater than two otherwise similar alternatives. Spatial cost-benefit analysis can powerfully inform conservation planning, even though the availability of relevant data may be limited, as was the case in our study area. It can help us understand the synergies between biodiversity conservation and economic development when the two are indeed aligned and to clearly understand the trade-offs when they are not.
Mapping the Economic Costs and Benefits of Conservation

PubMed Central

Naidoo, Robin; Ricketts, Taylor H

2006-01-01

Resources for biodiversity conservation are severely limited, requiring strategic investment. Understanding both the economic benefits and costs of conserving ecosystems will help to allocate scarce dollars most efficiently. However, although cost-benefit analyses are common in many areas of policy, they are not typically used in conservation planning. We conducted a spatial evaluation of the costs and benefits of conservation for a landscape in the Atlantic forests of Paraguay. We considered five ecosystem services (i.e., sustainable bushmeat harvest, sustainable timber harvest, bioprospecting for pharmaceutical products, existence value, and carbon storage in aboveground biomass) and compared them to estimates of the opportunity costs of conservation. We found a high degree of spatial variability in both costs and benefits over this relatively small (~3,000 km2) landscape. Benefits exceeded costs in some areas, with carbon storage dominating the ecosystem service values and swamping opportunity costs. Other benefits associated with conservation were more modest and exceeded costs only in protected areas and indigenous reserves. We used this cost-benefit information to show that one potential corridor between two large forest patches had net benefits that were three times greater than two otherwise similar alternatives. Spatial cost-benefit analysis can powerfully inform conservation planning, even though the availability of relevant data may be limited, as was the case in our study area. It can help us understand the synergies between biodiversity conservation and economic development when the two are indeed aligned and to clearly understand the trade-offs when they are not. PMID:17076583
32 CFR 37.550 - May I accept intellectual property as cost sharing?

Code of Federal Regulations, 2010 CFR

2010-07-01

... the same cost of lost opportunity to a recipient as contributions of cash or tangible assets. The... 32 National Defense 1 2010-07-01 2010-07-01 false May I accept intellectual property as cost... Cost Sharing § 37.550 May I accept intellectual property as cost sharing? (a) In most instances, you...
Opportunities for Energy Efficiency and Automated Demand Response in Industrial Refrigerated Warehouses in California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lekov, Alex; Thompson, Lisa; McKane, Aimee

2009-05-11

This report summarizes the Lawrence Berkeley National Laboratory's research to date in characterizing energy efficiency and open automated demand response opportunities for industrial refrigerated warehouses in California. The report describes refrigerated warehouses characteristics, energy use and demand, and control systems. It also discusses energy efficiency and open automated demand response opportunities and provides analysis results from three demand response studies. In addition, several energy efficiency, load management, and demand response case studies are provided for refrigerated warehouses. This study shows that refrigerated warehouses can be excellent candidates for open automated demand response and that facilities which have implemented energy efficiencymore » measures and have centralized control systems are well-suited to shift or shed electrical loads in response to financial incentives, utility bill savings, and/or opportunities to enhance reliability of service. Control technologies installed for energy efficiency and load management purposes can often be adapted for open automated demand response (OpenADR) at little additional cost. These improved controls may prepare facilities to be more receptive to OpenADR due to both increased confidence in the opportunities for controlling energy cost/use and access to the real-time data.« less
Administrative Claims Data for Economic Analyses in Hematopoietic Cell Transplantation: Challenges and Opportunities

PubMed Central

Preussler, Jaime M.; Mau, Lih-Wen; Majhail, Navneet S; Meyer, Christa L.; Denzen, Ellen; Edsall, Kristen C.; Farnia, Stephanie H.; Silver, Alicia; Saber, Wael; Burns, Linda J.; Vanness, David J.

2017-01-01

There is an increasing need for the development of approaches to measure quality, costs and resource utilization patterns among allogeneic hematopoietic cell transplant (HCT) patients. Administrative claims data provide an opportunity to examine service utilization and costs, particularly from the payer’s perspective. However, because administrative claims data are primarily designed for reimbursement purposes, challenges arise when using it for research. We use a case study with data derived from the 2007–2011 Truven Health MarketScan Research database to discuss opportunities and challenges for the use of administrative claims data to examine the costs and service utilization of allogeneic HCT and chemotherapy alone for patients with acute myeloid leukemia (AML). Starting with a cohort of 29,915 potentially eligible patients with a diagnosis of AML, we were able to identify 211 patients treated with HCT and 774 treated with chemotherapy only where we were sufficiently confident of the diagnosis and treatment path to allow analysis. Administrative claims data provide an avenue to meet the need for health care costs, resource utilization, and outcome information. However, when using these data, a balance between clinical knowledge and applied methods is critical to identifying a valid study cohort and accurate measures of costs and resource utilization. PMID:27184624
Marginal abatement cost curves for NOx incorporating both controls and alternative measures

EPA Science Inventory

A marginal abatement cost curve (MACC) traces out the efficient marginal abatement cost level for any aggregate emissions target when a least cost approach is implemented. In order for it to represent the efficient MAC level, all abatement opportunities across all sectors and loc...
Do Health Insurance and Pension Costs Reduce the Job Opportunities of Older Workers?

ERIC Educational Resources Information Center

Scott, Frank A.; And Others

1995-01-01

Current Population Survey data (1979, 1983, 1988, 1993) and a 1991 employer survey showed that the probability a newly hired worker was aged 55-65 was significantly lower in companies with health care plans and with relatively costly plans. Neither cost nor presence of pension plans significantly affected employment of older workers. (SK)
2015 Cost of Wind Energy Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mone, Christopher; Hand, Maureen; Bolinger, Mark

This report uses representative commercial projects to estimate the levelized cost of energy (LCOE) for both land-based and offshore wind plants in the United States for 2015. Scheduled to be published on an annual basis, the analysis relies on both market and modeled data to maintain an up-to-date understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed by the National Renewable Energy Laboratory (NREL) are used in this analysis to inform wind technology cost projections,more » goals, and improvement opportunities.« less

2014 Cost of Wind Energy Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mone, Christopher; Stehly, Tyler; Maples, Ben

2015-10-01

This report uses representative commercial projects to estimate the levelized cost of energy (LCOE) for both land-based and offshore wind plants in the United States for 2014. Scheduled to be published on an annual basis, the analysis relies on both market and modeled data to maintain an up-to-date understanding of wind generation cost trends and drivers. It is intended to provide insight into current component-level costs and a basis for understanding variability in the LCOE across the industry. Data and tools developed by the National Renewable Energy Laboratory (NREL) are used in this analysis to inform wind technology cost projections,more » goals, and improvement opportunities.« less
[Radiology in managed care environment: opportunities for cost savings in an HMO].

PubMed

Schmidt, C; Mohr, A; Möller, J; Levin-Scherz, J; Heller, M

2003-09-01

A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were docu-mented in Microsoft Excel(R) and analyzed by non-parametric tests using SPSS(R) 8.0 (Statistical Package for the Social Sciences) for Windows(R). The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. We identified initiatives with estimated potential savings of approximately $ 5.5 million. Some of these
Energy Efficiency Improvement and Cost Saving Opportunities for the Fruit and Vegetable Processing Industry. An ENERGY STAR Guide for Energy and Plant Managers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Masanet, Eric; Masanet, Eric; Worrell, Ernst

2008-01-01

The U.S. fruit and vegetable processing industry--defined in this Energy Guide as facilities engaged in the canning, freezing, and drying or dehydrating of fruits and vegetables--consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement isan important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. fruit and vegetable processing industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implementedmore » at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. fruit and vegetable processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to fruit and vegetable processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in fruit and vegetable processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in fruit and vegetable processing, a summary of basic, proven measures for improving plant-level water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. fruit and vegetable processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures--as well as on their applicability to different
Regulatory environment and claims - limits and opportunities.

PubMed

Martin, Ambroise

2010-01-01

During the past decade, the use of claims became more and more important in many countries in relation to the increased awareness of consumer about the link between foods and health, offering to industry a valuable opportunity to differentiate and valorize their products and to promote innovation. However, more and more stringent regulations are developed, all based on the general principles adopted by the Codex Alimentarius Commission. In addition to the different regulatory processes and administrative requirements according to the country, the high level (and cost) of scientific substantiation of claims, the constraints introduced by nutrient profiles and the poor knowledge of the impact on consumer depending on the cultural contexts may limit these opportunities or, at least complicate their use. All these issues are briefly analyzed, highlighting some striking convergences and differences between countries. Copyright © 2010 S. Karger AG, Basel.
Top 1% of Inpatients Administered Antimicrobial Agents Comprising 50% of Expenditures: A Descriptive Study and Opportunities for Stewardship Intervention.

PubMed

Dela-Pena, Jennifer; Kerstenetzky, Luiza; Schulz, Lucas; Kendall, Ron; Lepak, Alexander; Fox, Barry

2017-03-01

OBJECTIVE To characterize the top 1% of inpatients who contributed to the 6-month antimicrobial budget in a tertiary, academic medical center and identify cost-effective intervention opportunities targeting high-cost antimicrobial utilization. DESIGN Retrospective cohort study. PATIENTS Top 1% of the antimicrobial budget from July 1 through December 31, 2014. METHODS Patients were identified through a pharmacy billing database. Baseline characteristics were collected through a retrospective medical chart review. Patients were presented to the antimicrobial stewardship team to determine appropriate utilization of high-cost antimicrobials and potential intervention opportunities. Appropriate use was defined as antimicrobial therapy that was effective, safe, and most cost-effective compared with alternative agents. RESULTS A total of 10,460 patients received antimicrobials in 6 months; 106 patients accounted for $889,543 (47.2%) of the antimicrobial budget with an antimicrobial cost per day of $219±$192 and antimicrobial cost per admission of $4,733±$7,614. Most patients were immunocompromised (75%) and were followed by the infectious disease consult service (80%). The most commonly prescribed antimicrobials for treatment were daptomycin, micafungin, liposomal amphotericin B, and meropenem. Posaconazole and valganciclovir accounted for most of the prophylactic therapy. Cost-effective opportunities (n=71) were present in 57 (54%) of 106 patients, which included dose optimization, de-escalation, dosage form conversion, and improvement in transitions of care. CONCLUSION Antimicrobial stewardship oversight is important in implementing cost-effective strategies, especially in complex and immunocompromised patients who require the use of high-cost antimicrobials. Infect Control Hosp Epidemiol 2017;38:259-265.
[Direct and indirect costs of fractures due to osteoporosis in Austria].

PubMed

Dimai, H-P; Redlich, K; Schneider, H; Siebert, U; Viernstein, H; Mahlich, J

2012-10-01

We examined the financial burden of osteoporosis in Austria. We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. While there exist similar studies for other countries, this is the first comprehensive study for Austria. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria. Our estimation of the total annual costs in the year 2008 imposed by osteoporosis in Austria is 707.4 million €. The largest fraction of this amount is incurred by acute hospital treatment. Another significant figure, accounting for 29% of total costs, is the opportunity cost of informal care. The financial burden of osteoporosis in Austria is substantial. Economic evaluations of preventive and therapeutic interventions for the specific context of Austria are needed to inform health policy decision makers. © Georg Thieme Verlag KG Stuttgart · New York.
The Distributed Wind Cost Taxonomy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forsyth, Trudy; Jimenez, Tony; Preus, Robert

To date, there has been no standard method or tool to analyze the installed and operational costs for distributed wind turbine systems. This report describes the development of a classification system, or taxonomy, for distributed wind turbine project costs. The taxonomy establishes a framework to help collect, sort, and compare distributed wind cost data that mirrors how the industry categorizes information. The taxonomy organizes costs so they can be aggregated from installers, developers, vendors, and other sources without losing cost details. Developing a peer-reviewed taxonomy is valuable to industry stakeholders because a common understanding the details of distributed wind turbinemore » costs and balance of station costs is a first step to identifying potential high-value cost reduction opportunities. Addressing cost reduction potential can help increase distributed wind's competitiveness and propel the U.S. distributed wind industry forward. The taxonomy can also be used to perform cost comparisons between technologies and track trends for distributed wind industry costs in the future. As an initial application and piloting of the taxonomy, preliminary cost data were collected for projects of different sizes and from different regions across the contiguous United States. Following the methods described in this report, these data are placed into the established cost categories.« less
The indirect cost of Patient-Specific Instruments.

PubMed

Thienpont, Emmanuel; Paternostre, Frederic; Van Wymeersch, Charles

2015-09-01

To calculate the indirect costs of Patient Specific Instruments (PSI) based on an opportunity cost, cost of efforts and a supply chain cost model to compare PSI for value with conventional total knee arthroplasty (TKA). In 81 patients the total (direct+indirect) cost of PSI-assisted TKA was compared with conventional TKA. Surgical times and coronal mechanical alignment were measured to evaluate the effectiveness of the PSI system. Indirect costs (459 euro) make up 40% of the total cost that can run up to 1142 euro for a patient operated with PSI guides. No difference in surgical times or coronal alignment was observed in between both groups. Considering the total cost of PSI no value was found for the use of PSI in primary TKA as measured by surgical times or for obtaining a neutral mechanical axis in the coronal plane.
Streaming Audio and Video: New Challenges and Opportunities for Museums.

ERIC Educational Resources Information Center

Spadaccini, Jim

Streaming audio and video present new challenges and opportunities for museums. Streaming media is easier to author and deliver to Internet audiences than ever before; digital video editing is commonplace now that the tools--computers, digital video cameras, and hard drives--are so affordable; the cost of serving video files across the Internet…
Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures.

PubMed

Neumann, Peter J; Anderson, Jordan E; Panzer, Ari D; Pope, Elle F; D'Cruz, Brittany N; Kim, David D; Cohen, Joshua T

2018-01-18

Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life years (QALYs) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics including intervention type, sponsor, country, and primary disease, and also analysed the number of CEAs versus disease burden estimates for major diseases and conditions across three geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth in publication rates for both literatures. Cost-per-QALY studies were most likely to examine pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found discrepancies in the number of published CEAs for certain diseases and conditions in certain regions, suggesting "under-studied" areas (e.g., cardiovascular disease in Southeast Asia, East Asia, and Oceania and "overstudied" areas (e.g., HIV in Sub Saharan Africa) relative to disease burden in those regions. Conclusions : The number of cost-per QALY and cost-per-DALY analyses has grown rapidly with applications to diverse interventions and diseases. Discrepancies between the number of published studies and disease burden suggest funding opportunities for future cost-effectiveness research.
Industrial energy systems and assessment opportunities

NASA Astrophysics Data System (ADS)

Barringer, Frank Leonard, III

Industrial energy assessments are performed primarily to increase energy system efficiency and reduce energy costs in industrial facilities. The most common energy systems are lighting, compressed air, steam, process heating, HVAC, pumping, and fan systems, and these systems are described in this document. ASME has produced energy assessment standards for four energy systems, and these systems include compressed air, steam, process heating, and pumping systems. ASHRAE has produced an energy assessment standard for HVAC systems. Software tools for energy systems were developed for the DOE, and there are software tools for almost all of the most common energy systems. The software tools are AIRMaster+ and LogTool for compressed air systems, SSAT and 3E Plus for steam systems, PHAST and 3E Plus for process heating systems, eQUEST for HVAC systems, PSAT for pumping systems, and FSAT for fan systems. The recommended assessment procedures described in this thesis are used to set up an energy assessment for an industrial facility, collect energy system data, and analyze the energy system data. The assessment recommendations (ARs) are opportunities to increase efficiency and reduce energy consumption for energy systems. A set of recommended assessment procedures and recommended assessment opportunities are presented for each of the most common energy systems. There are many assessment opportunities for industrial facilities, and this thesis describes forty-three ARs for the seven different energy systems. There are seven ARs for lighting systems, ten ARs for compressed air systems, eight ARs for boiler and steam systems, four ARs for process heating systems, six ARs for HVAC systems, and four ARs for both pumping and fan systems. Based on a history of past assessments, average potential energy savings and typical implementation costs are shared in this thesis for most ARs. Implementing these ARs will increase efficiency and reduce energy consumption for energy systems in
Cost-Effective Fuel Treatment Planning

NASA Astrophysics Data System (ADS)

Kreitler, J.; Thompson, M.; Vaillant, N.

2014-12-01

that use only benefits. Variations across the heterogeneous surfaces of costs and benefits create opportunities for fuel treatments to maximize the expected averted loss of benefits. By targeting these opportunities we demonstrate how incorporating costs in fuel treatment prioritization can improve the outcome of fuel treatment planning.
The effects of patient cost sharing on inpatient utilization, cost, and outcome.

PubMed

Xu, Yuan; Li, Ning; Lu, Mingshan; Dixon, Elijah; Myers, Robert P; Jelley, Rachel J; Quan, Hude

2017-01-01

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stanton-Hoyle, D.R.

1998-07-01

Globally, governments and industries are implementing innovative voluntary programs to reduce greenhouse gas emissions. Often these programs encourage groups to use cost effective technologies that capture market-based forces. These programs are successful because they capitalize on existing opportunities where both the environment and the participants can benefit (i.e., win-win opportunities). This paper documents efforts to investigate these kinds of win-win opportunities in three developing countries: the Philippines, South Africa, and Mexico. Initial observations are provided as fresh information from the field, drawing on six missions during the last nine months. Utility costs, interest rates, and overall economic health appear tomore » critically affect opportunities in each country. By contrast, details of heating, ventilating and air-conditioning (HVAC) design and local climate were often important differences between countries. These affect opportunities, for example, to achieve significant savings from cooling systems or not. Looking at the success of ESCOs was somewhat surprising. One might expect to see the most successful ESCO activity where utility costs are high and upgrade opportunities are plentiful (such as in the Philippines). This was not the case, however, as research in the Philippines did not reveal even one active ESCO contract yet. Design practices for new construction were in need of the same thing that helps US design teams do a better job of energy-efficient design, better communications between design team members. Finally, industrial firms were doing a variety of EE upgrades in each country, but this level of activity was relatively small compared to what should be cost effective.« less
Estimating costs in the economic evaluation of medical technologies.

PubMed

Luce, B R; Elixhauser, A

1990-01-01

The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.
Cost consideration as a factor affecting recreation site decisions

Treesearch

Allan Marsinko; John Dwyer; Herb Schroeder

2001-01-01

Because they are charged with providing opportunities for all potential site users, it is important that managers at public sites understand the characteristics and behaviors of different user groups. Recreationists who are sensitive to cost may be more sensitive to certain changes in policies, such as fees and other charges, than those who are not sensitive to costs....
Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

PubMed

Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

2009-01-01

More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year.
Cost-effectiveness analysis: what it really means for transfusion medicine decision making.

PubMed

Custer, Brian; Hoch, Jeffrey S

2009-01-01

Some have suggested that "blood is different," and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning behind cost-effectiveness analysis, the authors point out how economic thinking is evident in some aspects of transfusion medicine. Some cost-effectiveness study results for blood safety are discussed to provide context, followed by consideration of prominent decisions that have been made in transfusion medicine field. In the last section, the authors conjecture as to why in some cases cost-effectiveness analysis appears to have greater impact than in others, noting the terrible price that is paid in mortality and morbidity when cost-effectiveness analysis is ignored. In this context, the implications of opportunity cost are discussed, and it is noted that opportunity cost should not be viewed as benefits forgone by concentrating on one aspect of blood safety and instead should be viewed as our societal willingness to misallocate resources to achieve less health for the same cost.
Opportunities for Small Satellites in NASA's Earth System Science Pathfinder (ESSP) Program

NASA Technical Reports Server (NTRS)

Peri, Frank; Law, Richard C.; Wells, James E.

2014-01-01

NASA's Earth Venture class (EV) of missions are competitively selected, Principal Investigator (PI) led, relatively low cost and narrowly focused in scientific scope. Investigations address a full spectrum of earth science objectives, including studies of the atmosphere, oceans, land surface, polar ice regions, and solid Earth. EV has three program elements: EV-Suborbital (EVS) are suborbital/airborne investigations; EV-Mission (EVM) element comprises small complete spaceborne missions; and EV-Instrument (EVI) element develops spaceborne instruments for flight as Missions-of-Opportunity (MoO). To ensure the success of EV, frequent opportunities for selecting missions has been established in NASA's Earth Science budget. This paper will describe those opportunities and how the management approach of each element is tailored according to the specific needs of the element.
Benchmarking U.S. Small Wind Costs with the Distributed Wind Taxonomy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Orrell, Alice C.; Poehlman, Eric A.

The objective of this report is to benchmark costs for small wind projects installed in the United States using a distributed wind taxonomy. Consequently, this report is a starting point to help expand the U.S. distributed wind market by informing potential areas for small wind cost-reduction opportunities and providing a benchmark to track future small wind cost-reduction progress.

Space shuttle solid rocket booster cost-per-flight analysis technique

NASA Technical Reports Server (NTRS)

Forney, J. A.

1979-01-01

A cost per flight computer model is described which considers: traffic model, component attrition, hardware useful life, turnaround time for refurbishment, manufacturing rates, learning curves on the time to perform tasks, cost improvement curves on quantity hardware buys, inflation, spares philosophy, long lead, hardware funding requirements, and other logistics and scheduling constraints. Additional uses of the model include assessing the cost per flight impact of changing major space shuttle program parameters and searching for opportunities to make cost effective management decisions.
Methane Recovery from Animal Manures The Current Opportunities Casebook

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lusk, P.

1998-09-22

Growth and concentration of the livestock industry create opportunities for the proper disposal of the large quantities of manures generated at dairy, swine, and poultry farms. Pollutants from unmanaged livestock wastes can degrade the environment, and methane emitted from decomposing manure may contribute to global climate change. One management system not only helps prevent pollution but can also convert a manure problem into a new profit center. Economic evaluations and case studies of operating systems indicate that the anaerobic digestion of livestock manures is a commercially viable conversion technology with considerable potential for providing profitable coproducts, including a cost-effective renewablemore » fuel for livestock production operations. This casebook examines some of the current opportunities for recovering methane from anaerobic digestion animal manures.« less
Health Careers Directory; Health Education and Training Opportunities in South Carolina.

ERIC Educational Resources Information Center

South Carolina Hospital Association, Columbia. Educational Services Program.

The stated goal of the directory is to provide high school guidance counselors with information on health education and training opportunities in one document. To achieve this, the following information is provided: definition of career, program, location, admissions policy, length of course, affiliation, costs, and other items for each career…
Opportunities for Cost-Sharing in Conservation: Variation in Volunteering Effort across Protected Areas

PubMed Central

Armsworth, Paul R.; Cantú-Salazar, Lisette; Parnell, Mark; Booth, Josephine E.; Stoneman, Rob; Davies, Zoe G.

2013-01-01

Efforts to expand protected area networks are limited by the costs of managing protected sites. Volunteers who donate labor to help manage protected areas can help defray these costs. However, volunteers may be willing to donate more labor to some protected areas than others. Understanding variation in volunteering effort would enable conservation organizations to account for volunteer labor in their strategic planning. We examined variation in volunteering effort across 59 small protected areas managed by Yorkshire Wildlife Trust, a regional conservation nonprofit in the United Kingdom. Three surveys of volunteering effort reveal consistent patterns of variation across protected areas. Using the most detailed of these sources, a survey of site managers, we estimate that volunteers provided 3200 days of labor per year across the 59 sites with a total value exceeding that of paid staff time spent managing the sites. The median percentage by which volunteer labor supplements management costs on the sites was 36%. Volunteering effort and paid management costs are positively correlated, after controlling for the effect of site area. We examined how well a range of characteristics of the protected areas and surrounding communities explain variation in volunteering effort. Protected areas that are larger have been protected for longer and that are located near to denser conurbations experience greater volunteering effort. Together these factors explain 38% of the observed variation in volunteering effort across protected areas. PMID:23383176
Opportunities for cost-sharing in conservation: variation in volunteering effort across protected areas.

PubMed

Armsworth, Paul R; Cantú-Salazar, Lisette; Parnell, Mark; Booth, Josephine E; Stoneman, Rob; Davies, Zoe G

2013-01-01

Efforts to expand protected area networks are limited by the costs of managing protected sites. Volunteers who donate labor to help manage protected areas can help defray these costs. However, volunteers may be willing to donate more labor to some protected areas than others. Understanding variation in volunteering effort would enable conservation organizations to account for volunteer labor in their strategic planning. We examined variation in volunteering effort across 59 small protected areas managed by Yorkshire Wildlife Trust, a regional conservation nonprofit in the United Kingdom. Three surveys of volunteering effort reveal consistent patterns of variation across protected areas. Using the most detailed of these sources, a survey of site managers, we estimate that volunteers provided 3200 days of labor per year across the 59 sites with a total value exceeding that of paid staff time spent managing the sites. The median percentage by which volunteer labor supplements management costs on the sites was 36%. Volunteering effort and paid management costs are positively correlated, after controlling for the effect of site area. We examined how well a range of characteristics of the protected areas and surrounding communities explain variation in volunteering effort. Protected areas that are larger have been protected for longer and that are located near to denser conurbations experience greater volunteering effort. Together these factors explain 38% of the observed variation in volunteering effort across protected areas.
Demand Response Advanced Controls Framework and Assessment of Enabling Technology Costs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Potter, Jennifer; Cappers, Peter

The Demand Response Advanced Controls Framework and Assessment of Enabling Technology Costs research describe a variety of DR opportunities and the various bulk power system services they can provide. The bulk power system services are mapped to a generalized taxonomy of DR “service types”, which allows us to discuss DR opportunities and bulk power system services in fewer yet broader categories that share similar technological requirements which mainly drive DR enablement costs. The research presents a framework for the costs to automate DR and provides descriptions of the various elements that drive enablement costs. The report introduces the various DRmore » enabling technologies and end-uses, identifies the various services that each can provide to the grid and provides the cost assessment for each enabling technology. In addition to a report, this research includes a Demand Response Advanced Controls Database and User Manual. They are intended to provide users with the data that underlies this research and instructions for how to use that database more effectively and efficiently.« less
The economic and environmental cost of delayed GM crop adoption: The case of Australia's GM canola moratorium.

PubMed

Biden, Scott; Smyth, Stuart J; Hudson, David

2018-01-02

Incorporating socio-economic considerations (SECs) into national biosafety regulations regarding genetically modified (GM) crops have opportunity costs. Australia approved the cultivation of GM canola through a science-based risk assessment in 2003, but allowed state moratoria to be instituted based on potential trade impacts over the period 2004 to 2008 and 2010 in the main canola growing states. This analysis constructs a counterfactual assessment using Canadian GM canola adoption data to create an S-Curve of adoption in Australia to measure the environmental and economic opportunity costs of Australia's SEC-based moratoria between 2004 and 2014. The environmental impacts are measured through the amount of chemical active ingredients applied during pest management, the Environmental Impact Quotient indicator, and greenhouse gas emissions. The economic impacts are measured through the variable costs of the weed control programs, yield and the contribution margin. The environmental opportunity costs from delaying the adoption of GM canola in Australia include an additional 6.5 million kilograms of active ingredients applied to canola land; a 14.3% increase in environmental impact to farmers, consumers and the ecology; 8.7 million litres of diesel fuel burned; and an additional 24.2 million kilograms of greenhouse gas (GHG) and compound emissions released. The economic opportunity costs of the SEC-based moratoria resulted in foregone output of 1.1 million metric tonnes of canola and a net economic loss to canola farmers' of AU$485.6 million. The paper provides some of the first quantified, post-adoption evidence on the opportunity cost and environmental impacts of incorporating SECs into GM crop regulation.
Using strategic foresight to assess conservation opportunity.

PubMed

Cook, Carly N; Wintle, Bonnie C; Aldrich, Stephen C; Wintle, Brendan A

2014-12-01

The nature of conservation challenges can foster a reactive, rather than proactive approach to decision making. Failure to anticipate problems before they escalate results in the need for more costly and time-consuming solutions. Proactive conservation requires forward-looking approaches to decision making that consider possible futures without being overly constrained by the past. Strategic foresight provides a structured process for considering the most desirable future and for mapping the most efficient and effective approaches to promoting that future with tools that facilitate creative thinking. The process involves 6 steps: setting the scope, collecting inputs, analyzing signals, interpreting the information, determining how to act, and implementing the outcomes. Strategic foresight is ideal for seeking, recognizing, and realizing conservation opportunities because it explicitly encourages a broad-minded, forward-looking perspective on an issue. Despite its potential value, the foresight process is rarely used to address conservation issues, and previous attempts have generally failed to influence policy. We present the strategic foresight process as it can be used for proactive conservation planning, describing some of the key tools in the foresight tool kit and how they can be used to identify and exploit different types of conservation opportunities. Scanning is an important tool for collecting and organizing diverse streams of information and can be used to recognize new opportunities and those that could be created. Scenario planning explores how current trends, drivers of change, and key uncertainties might influence the future and can be used to identify barriers to opportunities. Backcasting is used to map out a path to a goal and can determine how to remove barriers to opportunities. We highlight how the foresight process was used to identify conservation opportunities during the development of a strategic plan to address climate change in New York
Opportunity Road: The Promise and Challenge of America's Forgotten Youth

ERIC Educational Resources Information Center

Bridgeland, John M.; Milano, Jessica A.

2012-01-01

There are millions of youth ages 16 to 24 who are out of school and out of work. They cost the nation billions of dollars every year and over their lifetimes in lost productivity and increased social services. They also represent an opportunity for the nation to tap the talents of millions of potential leaders and productive workers at a time when…
Cost-benefit analysis of riparian protection in an eastern Canadian watershed.

PubMed

Trenholm, Ryan; Lantz, Van; Martínez-Espiñeira, Roberto; Little, Shawn

2013-02-15

Forested riparian buffers have proved to be an effective management practice that helps maintain ecological goods and services in watersheds. In this study, we assessed the non-market benefits and opportunity costs associated with implementing these buffers in an eastern Canadian watershed using contingent valuation and wood supply modeling methods, respectively. A number of buffer scenarios were considered, including 30 and 60 m buffers on woodlots and on all land (including woodlots, agricultural, and residential lands) in the watershed. Household annual WTP estimates ranged from -$6.80 to $42.85, and total present value benefits ranged from -$11.7 to $121.7 million (CDN 2007), depending on the buffer scenario, affected population, time horizon, and econometric modeling assumptions considered. Opportunity cost estimates range from $1.3 to $10.4 million in present value terms, depending on silvicultural and agriculture land rental rate assumptions. Overall, we found that the net present value of riparian buffers was positive for the majority of scenarios and assumptions. Some exceptions were found under more conservative benefit, and higher unit cost, assumptions. These results provide decision makers with data on stated benefits and opportunity costs of riparian buffers, as well as insight into the importance of modeling assumptions when using this framework of analysis. Copyright © 2012 Elsevier Ltd. All rights reserved.
Balancing the cost of leaving with the cost of living: drivers of long-term retention of health workers: an explorative study in three rural districts in Eastern Uganda

PubMed Central

Namusoke Kiwanuka, Suzanne; Akulume, Martha; Tetui, Moses; Muhumuza Kananura, Rornald; Bua, John; Ekirapa-Kiracho, Elizabeth

2017-01-01

ABSTRACT Background: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered. Objective: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda. Methods: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural districts of Uganda: Kamuli, Pallisa, and Kibuku. In-depth interviews conducted among health workers who have been retained for at least 10 years explored factors motivating the health workers to stay within the district, opportunities, and the benefits of staying. Results: Twenty-one health workers participated. Ten of them male and 11 female with the age range of 33–51 years. The mean duration of stay among the participants was 13, 15, and 26 years for Kamuli, Kibuku, and Pallisa respectively. Long-term retention was related to personal factors, such as having family ties, community ties, and opportunities to invest. The decentralization policy and pension benefits also kept workers in place. Opportunities for promotion or leadership motivated long stay only if they came with financial benefits. Workload reportedly increased over the years, but staffing and emoluments had not increased. Multiple job, family support, and community support helped health workers cope with the costs of living, and holding a secure pensionable government job was valued more highly than seeking uncertain job opportunities elsewhere. Conclusion: The interplay between the costs of leaving and the benefit of staying is demonstrated. Family proximity, community ties, job security, and pension enhance staying, while higher costs of living and an unpredictable employment market make leaving risky. Health workers should be able to access investment opportunities in order to cope with inadequate remuneration. Promotions and leadership
Analysis of MRSA-attributed costs of hospitalized patients in Germany.

PubMed

Hübner, C; Hübner, N-O; Hopert, K; Maletzki, S; Flessa, S

2014-10-01

Infections with methicillin-resistant Staphylococcus aureus (MRSA) are assumed to have a high economic impact due to increased hygienic measures and prolonged hospital length of stay. However, surveys on the real expenditure for the prevention and treatment of MRSA are scarce, in particular with regard to the German Diagnosis-Related Groups (G-DRG) payment system. The aim of our study is to empirically assess the additional cost for MRSA management measures and to identify the main cost drivers in the whole process from the hospital's point of view. We conducted a one-year retrospective analysis of MRSA-positive cases in a German university hospital and determined the cost of hygienic measures, laboratory costs, and opportunity costs due to isolation time and extended lengths of stay. A total of 182 cases were included in the analysis. The mean length of hospital stay was 22.75 days and the mean time in isolation was 17.08 days, respectively. Overall, the calculated MRSA-attributable costs were 8,673.04 per case, with opportunity costs making up, by far, the largest share (77.45 %). Our study provides a detailed up-to-date analysis of MRSA-attributed costs in a hospital. It allows a current comparison to previous studies worldwide. Moreover, it offers the prerequisites to investigate the adequate reimbursement of MRSA burden in the DRG payment system and to assess the efficiency of targeted hygienic measures in the prevention of MRSA.
Cost-effectiveness of MRI to assess for posttraumatic ligamentous cervical spine injury.

PubMed

Murphy, Joshua M; Park, Paul; Patel, Rakesh D

2014-02-01

Magnetic resonance imaging (MRI) has been shown to be sensitive in identifying ligamentous injury to the cervical spine. The major drawbacks to its routine use are cost and availability. The purpose of this study was to compare the cost of using MRI to rule out ligamentous injury of the cervical spine with the cost of immobilization in a cervical collar and outpatient follow-up. Neurologically intact and nonobtunded patients with neck pain and normal findings on radiographs evaluated for ligamentous injury of the cervical spine were studied. Patients were either evaluated with MRI or immobilized in a cervical collar and followed up for repeat clinical and radiographic evaluation as outpatients. The authors gathered year 2011 fees from their institution and 2011 Medicare reimbursement data and compared the costs of MRI with the costs of cervical collar and outpatient follow-up. In addition, the median income of the local community was used to estimate opportunity costs associated with cervical collar immobilization. After 7 days of lost wages at the median local income, MRI became a less costly option when comparing hospital fees. Alternatively, when considering Medicare reimbursement, MRI became less costly after only 2 days of lost wages at the median local income. On the basis of these findings, MRI of the cervical spine is less costly than other current management strategies when opportunity costs are considered. Copyright 2014, SLACK Incorporated.
A unique funding opportunity for public health in Texas.

PubMed

Schlenker, Thomas; Huber, Carol A

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.
Survey of Applicant Experience and Cost in the Urology Match: Opportunities for Reform.

PubMed

Nikonow, Tara N; Lyon, Timothy D; Jackman, Stephen V; Averch, Timothy D

2015-10-01

The urology match is highly competitive but there is a paucity of published data regarding the costs and barriers that applicants face. We gathered data on contributors to cost in the 2014 urology residency match. A survey was sent to all applicants offered an interview at each of 18 participating institutions. Information on demographics, interview related costs, access to financial aid, frequency of away rotations and second look invitations was collected. A total of 173 respondents spent a median of $7,000 on the urology match. Applicants attended a mean of 14 interviews with an average per interview cost of $500. Overall 95% of respondents did at least 1 away rotation and 79% reported being asked to return for a second look interview at least once. Of the respondents 66% did not receive any financial aid for interviews and only 28% believed their financial aid departments provided adequate financial planning. Of those surveyed 20% indicated that their financial situation limited the number of interviews they attended. We estimate that $3,122,000 was spent by applicants on the 2014 urology match. One in 5 applicants reported limiting the number of interviews they attended due to financial concerns. Adequate financial planning resources were not widely available. Nearly all applicants went on an away rotation and encouragement to return for second look interviews was common. These factors may contribute to financial and regional bias in the match process, and are potential targets for reform. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Opportunities to improve the value of outpatient surgical care.

PubMed

Erhun, Feryal; Malcolm, Elizabeth; Kalani, Maziyar; Brayton, Kimberly; Nguyen, Christine; Asch, Steven M; Platchek, Terry; Milstein, Arnold

2016-09-01

Nearly 57 million outpatient surgeries-invasive procedures performed on an outpatient basis in hospital outpatient departments (HOPDs) or ambulatory surgery centers (ASCs)-produced annually in the United States account for roughly 7% of healthcare expenditures. Although moving inpatient surgeries to outpatient settings has lowered the cost of care, substantial opportunities to improve the value of outpatient surgery remain. To exploit these remaining opportunities, we composed an evidence-based care delivery composite for national discussion and pilot testing. Evidence-based care delivery composite. We synthesized peer-reviewed publications describing efforts to improve the value of outpatient surgical care, interviewed patients and clinicians to understand their most deeply felt discontents, reviewed potentially relevant emerging science and technology, and observed surgeries at healthcare organizations nominated by researchers as exemplars of efficiency and effectiveness. Primed by this information, we iterated potential new designs utilizing criticism from practicing clinicians, health services researchers, and healthcare managers. We found that 3 opportunities are most likely to improve value: 1) maximizing the appropriate use of surgeries via decision aids, clinical decision support, and a remote surgical coach for physicians considering a surgical referral; 2) safely shifting surgeries from HOPDs to high-volume, multi-specialty ASCs where costs are much lower; and 3) standardizing processes in ASCs from referral to recovery. Extrapolation based on published studies of the effects of each component suggests that the proposed 3-part composite may lower annual national outpatient surgical spending by as much as one-fifth, while maintaining or improving outcomes and the care experience for patients and clinicians. Pilot testing and evaluation will allow refinement of this composite.
Future opportunities for advancing glucose test device electronics.

PubMed

Young, Brian R; Young, Teresa L; Joyce, Margaret K; Kennedy, Spencer I; Atashbar, Massood Z

2011-09-01

Advancements in the field of printed electronics can be applied to the field of diabetes testing. A brief history and some new developments in printed electronics components applicable to personal test devices, including circuitry, batteries, transmission devices, displays, and sensors, are presented. Low-cost, thin, and lightweight materials containing printed circuits with energy storage or harvest capability and reactive/display centers, made using new printing/imaging technologies, are ideal for incorporation into personal-use medical devices such as glucose test meters. Semicontinuous rotogravure printing, which utilizes flexible substrates and polymeric, metallic, and/or nano "ink" composite materials to effect rapidly produced, lower-cost printed electronics, is showing promise. Continuing research advancing substrate, "ink," and continuous processing development presents the opportunity for research collaboration with medical device designers. © 2011 Diabetes Technology Society.
Ethanol production from woody biomass: Silvicultural opportunities for suppressed western conifers

Treesearch

Andrew Youngblood; Junyong Zhu; C. Tim Scott

2010-01-01

The 2007 Energy Security and Independence Act (ESIA) requires 16 billion gallons of ethanol to be produced from lignocellulose biomass by 2022 in the United States. Forests can be a key source of renewable lignocellulose for ethanol production if cost and conversion efficiency barriers can be overcome. We explored opportunities for using woody biomass from thinning...
The Hidden Cost of Regulation: The Administrative Cost of Reporting Serious Reportable Events.

PubMed

Blanchfield, Bonnie B; Acharya, Bijay; Mort, Elizabeth

2018-04-01

More than half of the 50 states (27) and the District of Columbia require reporting of Serous Reportable Events (SREs). The goal is to hold providers accountable and improve patient safety, but there is little information about the administrative cost of this reporting requirement. This study was conducted to identify costs associated with investigating and reporting SREs. This qualitative study used case study methods that included interviewing staff and review of data and documents to investigate each SRE occurring at one academic medical center during fiscal year 2013. A framework of tasks and a model to categorize costs was created. Time was summarized and costs were estimated for each SRE. The administrative cost to process 44 SREs was estimated at $353,291, an average cost of $8,029 per SRE, ranging $6,653 for an environmental-related SRE to $21,276 for a device-related SRE. Care management SREs occurred most frequently, costing an average $7,201 per SRE. Surgical SREs, the most expensive on average, cost $9,123 per SRE. Investigation of events accounted for 64.5% of total cost; public reporting, 17.2%; internal reporting, 10.2%; finance and administration, 6.0%; and 2.1%, other. Even with 26 states mandating reporting, the 17.2% incremental cost of public reporting is substantial. Policy makers should consider the opportunity costs of these resources, averaging $8,029 per SRE, when mandating reporting. The benefits of public reporting should be collectively reviewed to ensure that the incremental costs in this resource-constrained environment continue to improve patient safety and that trade-offs are acknowledged. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.
Influencing and impacting the profession through governance opportunities.

PubMed

Drenkard, Karen N

2015-01-01

In addition to board leadership of health care organizations and corporations, there are strategic opportunities for nurses to participate in professional association boards and commissions and expert panels. These boards have specific and unique challenges and opportunities, and it is important for nurse leaders to serve in shaping the direction of the profession. Nursing as a profession has an opening to solve many of the care delivery issues that face the country. A strategic contribution to association boards and commissions can influence the health care delivery system changes needed to improve quality of care, access to care, and reducing costs. This article describes similarities and differences of service on association boards and commissions compared with organizational and corporate boards. Through these leadership roles, the larger community can observe influential nurses in an essential role. These leadership opportunities, including membership boards, commissions, and content expert panels, call for a special understanding of those governance structures and the contributions that nurse leaders can make to impact health care. Association and membership organizations have undergone many changes in the past 10 years, and new models of governance and leadership have been called into play. There are challenges and opportunities in serving on these boards and commissions. Maximizing the leadership and governance roles of this type of service is a critical contribution that nurses can make to impact the profession of nursing and the greater health care system.

Energy Efficiency Improvement and Cost Saving Oportunities for the Concrete Industry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kermeli, Katerina; Worrell, Ernst; Masanet, Eric

2011-12-01

The U.S. concrete industry is the main consumer of U.S.-produced cement. The manufacturing of ready mixed concrete accounts for more than 75% of the U.S. concrete production following the manufacturing of precast concrete and masonry units. The most significant expenditure is the cost of materials accounting for more than 50% of total concrete production costs - cement only accounts for nearly 24%. In 2009, energy costs of the U.S. concrete industry were over $610 million. Hence, energy efficiency improvements along with efficient use of materials without negatively affecting product quality and yield, especially in times of increased fuel and materialmore » costs, can significantly reduce production costs and increase competitiveness. The Energy Guide starts with an overview of the U.S. concrete industry’s structure and energy use, a description of the various manufacturing processes, and identification of the major energy consuming areas in the different industry segments. This is followed by a description of general and process related energy- and cost-efficiency measures applicable to the concrete industry. Specific energy and cost savings and a typical payback period are included based on literature and case studies, when available. The Energy Guide intends to provide information on cost reduction opportunities to energy and plant managers in the U.S. concrete industry. Every cost saving opportunity should be assessed carefully prior to implementation in individual plants, as the economics and the potential energy and material savings may differ.« less
The challenges and opportunities of supersonic transport propulsion technology

NASA Technical Reports Server (NTRS)

Strack, William C.; Morris, Shelby J., Jr.

1988-01-01

The major challenges confronting the propulsion community for civil supersonic transport applications are identified: high propulsion system efficiency at both supersonic and subsonic cruise conditions, low-cost fuel with adequate thermal stability at high temperatures, low noise cycles and exhaust systems, low emission combustion systems, and low drag installations. Both past progress and future opportunities are discussed in relation to perceived technology shortfalls for an economically successful airplane that satisfies environmental constraints.
The cost of medical education in an ambulatory neurology clinic.

PubMed Central

Abramovitch, Anna; Newman, William; Padaliya, Bimal; Gill, Chandler; Charles, P. David

2005-01-01

Decreased revenue from clinical services has required academic hospitals and physicians to improve productivity. Medical student education may be a significant hindrance to increased productivity and income. This study quantifies the amount of time spent by faculty members teaching medical students in an ambulatory neurology clinic as well as the amount of time students occupied rooms when seeing patients on their own. Over a three-week period in an ambulatory neurology clinic, an observer noted these quantities of time, and the opportunity costs of both amounts of time were determined. Attending physicians spent an average of 19.6 minutes per medical student per half-day teaching, which translates to an average cost of $20.78 per half-day clinic. Students spent an average of 49.9 minutes per half-day seeing patients in the absence of an attending physician, an opportunity cost to the clinic of $142.50 per student per half-day. PMID:16296220
Establishment of reference costs for occupational health services and implementation of cost management in Japanese manufacturing companies.

PubMed

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

2016-07-22

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

PubMed Central

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

2016-01-01

Objectives: We developed a standardized cost estimation method for occupational health (OH) services. The purpose of this study was to set reference OH services costs and to conduct OH services cost management assessments in two workplaces by comparing actual OH services costs with the reference costs. Methods: Data were obtained from retrospective analyses of OH services costs regarding 15 OH activities over a 1-year period in three manufacturing workplaces. We set the reference OH services costs in one of the three locations and compared OH services costs of each of the two other workplaces with the reference costs. Results: The total reference OH services cost was 176,654 Japanese yen (JPY) per employee. The personnel cost for OH staff to conduct OH services was JPY 47,993, and the personnel cost for non-OH staff was JPY 38,699. The personnel cost for receipt of OH services-opportunity cost-was JPY 19,747, expense was JPY 25,512, depreciation expense was 34,849, and outsourcing cost was JPY 9,854. We compared actual OH services costs from two workplaces (the total OH services costs were JPY 182,151 and JPY 238,023) with the reference costs according to OH activity. The actual costs were different from the reference costs, especially in the case of personnel cost for non-OH staff, expense, and depreciation expense. Conclusions: Using our cost estimation tool, it is helpful to compare actual OH services cost data with reference cost data. The outcomes help employers make informed decisions regarding investment in OH services. PMID:27170449
Strategies for net cost reductions with the expanded role and expertise of anesthesiologists in the perioperative surgical home.

PubMed

Dexter, Franklin; Wachtel, Ruth E

2014-05-01

The Perioperative Surgical Home is a model adopted by the American Society of Anesthesiologists to increase quality and patient safety and to decrease costs. This Special Article is about the latter topic. Using narrative review, we show that there are two principal opportunities for net cost reduction. One opportunity is to reduce unnecessary interventions that do not have potential to benefit patients (e.g., preoperative laboratory studies in healthy patients undergoing low-risk surgery and use of substantial fresh gas flows with volatile anesthetics). The other opportunity is to optimize staff scheduling, case scheduling, and staff assignment. These two are the same as the principal ways that a positive return on investment can be achieved from use of an anesthesia information management system. Three other opportunities are much less likely to achieve as large (if any) net cost reduction among all patients but may at some hospitals. These are to reduce cancellations, operating room times, and/or hospital postoperative lengths of stay.
Concepts for Cost-Effective Enhanced Cryosat Continuity: Opportunity in the Iridium PRIME Context

NASA Astrophysics Data System (ADS)

Le Roy, Y.; Caubet, E.; Silverstrin, P.; Legrand, C.

2016-08-01

The Iridium-PRIME offer, recently initiated by the Iridium company, consists in hosting payloads on customized low cost Iridium-NEXT platforms on which the main telecom mission antenna (L-band) is removed. This leaves significant resources in terms of mass, volume and power consumption to host up to three payloads on these customized platforms. The Iridium-PRIME satellites will be inserted in the Iridium-NEXT constellation to take benefit of the low cost operation service (command, control and data telemetry through the life time of the Iridium-PRIME mission). Given the synergy between schedules of the Iridium-PRIME program (launches starting around 2020) and of a possible CryoSat Follow-On (FO) mission (launch around 2022) and the adequacy of the available on-board resources for such a mission, ESA tasked Thales Alenia Space, as responsible for the SIRAL radar instrument of the currently in-orbit CryoSat mission, to study the feasibility of a concept for enhanced continuity of CryoSat on an Iridium- PRIME satellite as potential low-cost fast-track solution. The study aimed to define a cost-effective topographic payload including not only the SIRAL radar but also the necessary sub-systems to retrieve the SIRAL antenna baseline attitude (star trackers) with high accuracy and to perform a Precise Orbit Determination (POD). All these aspects are presented in this paper. In addition, possible evolutions/improvements of the Ku-band radar instrument were analysed and are presented: adding a Ka-band nadir measurement capability and a Ku-band or Ka-band wide swath mode measurement capability. The transmission issue for the SIRAL science data is also discussed in the paper.
Consideration of Cost of Care in Pediatric Emergency Transfer-An Opportunity for Improvement.

PubMed

Gattu, Rajender K; De Fee, Ann-Sophie; Lichenstein, Richard; Teshome, Getachew

2017-05-01

Pediatric interhospital transfers are an economic burden to the health care, especially when deemed unnecessary. Physicians may be unaware of the cost implications of pediatric emergency transfers. A cost analysis may be relevant to reduce cost. To characterize children transferred from outlying emergency departments (EDs) to pediatric ED (PED) with a specific focus on transfers who were discharged home in 12 hours or less after transfer without intervention in PED and analyze charges associated with them. Charts of 352 patients (age, 0-18 years) transferred from 31 outlying EDs to PED during July 2009 to June 2010 were reviewed. Data were collected on the range, unit charge and volume of services provided in PED, length of stay, and final disposition. The average charge per patient transfer is calculated based on unit charge times total service units per 1000 patients per year and divided by 1000. Hospital charges were divided into fixed and variable. Of 352 patients transferred, 108 (30.7%) were admitted to pediatric inpatient service, 42 (11.9%) to intensive care; 36 (10.2%) went to the operating room, and 166 (47.2%) were discharged home. The average hospital charge per transfer was US $4843. Most (89%) of the charges were fixed, and 11% were variable. One hundred one (28.7%) patients were discharged home from PED in 12 hours or less without intervention. The hospital charges for these transfers were US $489,143. Significant number of transfers was discharged 12 hours or less without any additional intervention in PED. Fixed charges contribute to majority of total charges. Cost saving can be achieved by preventing unnecessary transfer.
What an option is worth for an exploration opportunity

DOE Office of Scientific and Technical Information (OSTI.GOV)

MacKay, J.A.; Lerche, I.

1995-12-25

The reason that a corporation might want to take an option on an opportunity is to wait until more information becomes available before committing to the decision to drill. For instance, in a situation where an opportunity is one of the first prospects in a new play trend, there is often very little known (as opposed to surmised) about the potential gain, and the chances of success are also often poorly determined. Thus, until the estimates of costs, gains, and success chances are firmed up in the future by drilling information from other operators, the corporation would prefer to holdmore » off on the decision to drill a particular prospect. Recently Dixit and Pindyck have persuasively argued qualitatively that an options approach should be taken to capital investment in any business field because, opportunities are options--rights but not obligations to take some action in the future and, as soon as you begin thinking of investment opportunities as options, the premise (that investment decisions can be reversed if conditions change or, if they cannot be reversed, that they are now-or-never propositions) changes. Irreversibility, uncertainty, and the choice of timing alter the investment decision in critical ways. From an oil industry perspective Dixit and Pindyck eloquently provide the rationale for considering an option position rather than dealing only with net present value considerations. The ability to calculate the worth of an option to a hydrocarbon exploration opportunity is what this article is about.« less
US Clean Energy Sector and the Opportunity for Modeling and Simulation

NASA Technical Reports Server (NTRS)

Inge, Carole Cameron

2011-01-01

The following paper sets forth the current understanding of the US clean energy demand and opportunity. As clean energy systems come online and technology is developed, modeling and simulation of these complex energy programs provides an untapped business opportunity. The US Department of Defense provides a great venue for developing new technology in the energy sector because it is demanding lower fuel costs, more energy efficiencies in its buildings and bases, and overall improvements in its carbon footprint. These issues coupled with the security issues faced by foreign dependence on oil will soon bring more clean energy innovations to the forefront (lighter batteries for soldiers, alternative fuel for jets, energy storage systems for ships, etc).
Satellite servicing: A business opportunity?

NASA Technical Reports Server (NTRS)

Wong, R. E.; Medler, E. H.

1984-01-01

The possibilities of satellite servicing as a business opportunity are examined. The service rate which a user must be charged to yield a reasonable return is derived and then compared against the market's willingness to pay that rate. Steps taken to provide the basis from which the service rate could be derived include: (1) constructing a hypothetical on orbit servicing business offering both on orbit and associated ground services; (2) estimating the total on orbit service business potential by analyzing mission models to the year 2000; and (3) setting up ground rules to bound the conduct of the business. Using this basic information service demand (business volume) cost to set up the business, costs for operation and maintenance tax rates and desired rate of return are estimated to determine the user charge. Sensitivity of the service rate to various parameters are also assessed. The time span for the business venture runs from 1986 through 2000 with service to 1991 provided via the orbiter and by a space station beyond 1991. This point analysis shows about five years of negative cash flow, with steady profits thereafter.
Wildfire Risk Management: Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Thompson, M.; Calkin, D. E.; Hand, M. S.; Kreitler, J.

2014-12-01

In this presentation we address federal wildfire risk management largely through the lens of economics, targeting questions related to costs, effectiveness, efficiency, and tradeoffs. Beyond risks to resources and assets such as wildlife habitat, watersheds, and homes, wildfires present financial risk and budgetary instability for federal wildfire management agencies due to highly variable annual suppression costs. Despite its variability, the costs of wildfire management have continued to escalate and account for an ever-growing share of overall agency budgets, compromising abilities to attain other objectives related to forest health, recreation, timber management, etc. Trends associated with a changing climate and human expansion into fire-prone areas could lead to additional suppression costs in the future, only further highlighting the need for an ability to evaluate economic tradeoffs in investments across the wildfire management spectrum. Critically, these economic analyses need to accurately capture the complex spatial and stochastic aspects of wildfire, the inherent uncertainty associated with monetizing environmental impacts of wildfire, the costs and effectiveness of alternative management policies, and linkages between pre-fire investments and active incident management. Investing in hazardous fuels reduction and forest restoration in particular is a major policy lever for pre-fire risk mitigation, and will be a primary focus of our presentation. Evaluating alternative fuel management and suppression policies could provide opportunities for significant efficiency improvements in the development of risk-informed management fire management strategies. Better understanding tradeoffs of fire impacts and costs can help inform policy questions such as how much of the landscape to treat and how to balance investments in treating new areas versus maintaining previous investments. We will summarize current data needs, knowledge gaps, and other factors
A Unique Funding Opportunity for Public Health in Texas

PubMed Central

Schlenker, Thomas; Huber, Carol A.

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the “Triple Aim” goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation. PMID:25423061
The Rise of E-learning and Opportunities for Indian Family Physicians.

PubMed

Datta, Chayan

2012-01-01

The IT (information technology) revolution is sweeping across the globe. Distance, location and costs have become irrelevant. With availability of newer communication tools, medical education and practice are bound to be transformed. Rapid advancement of science requires medical professionals to update their knowledge constantly. Online interface for CME (Continued Medical Education) presents an exciting opportunity as an E learning tool.
City-scale analysis of water-related energy identifies more cost-effective solutions.

PubMed

Lam, Ka Leung; Kenway, Steven J; Lant, Paul A

2017-02-01

Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia. In the studied scenario, the cost-effective energy saving potential from a city perspective (292 GWh/year) is far more significant than that from a utility perspective (65 GWh/year). In some cases, for similar capital cost, if regional water planners invested in end use options instead of utility options, a greater energy saving potential at a greater cost-effectiveness could be achieved in urban water systems. For example, upgrading a wastewater treatment plant for biogas recovery at a capital cost of $27.2 million would save 31 GWh/year with a marginal cost saving of $63/MWh, while solar hot water system rebates at a cost of $28.6 million would save 67 GWh/year with a marginal cost saving of $111/MWh. Options related to hot water use such as water-efficient shower heads, water-efficient clothes washers and solar hot water system rebates are among the most cost-effective city-scale opportunities. This study demonstrates the use of cost curves to compare both utility and end use options in a consistent framework. It also illustrates that focusing solely on managing the energy use within the utility would miss substantial non-utility water-related energy saving opportunities. There is a need to broaden the conventional scope of cost curve analysis to include water-related energy and greenhouse gas at the water end use, and to value their management from a city perspective. This
Current trends in treatment of obesity in Karachi and possibilities of cost minimization.

PubMed

Hussain, Mirza Izhar; Naqvi, Baqir Shyum

2015-03-01

Our study finds out drug usage trends in over weight and obese patients without any compelling indications in Karachi, looks for deviations of current practices from evidence based antihypertensive therapeutic guidelines and identifies not only cost minimization opportunities but also communication strategies to improve patients' awareness and compliance to achieve therapeutic goal. In present study two sets were used. Randomized stratified independent surveys were conducted in hospital doctors and family physicians (general practitioners), using pretested questionnaires. Sample size was 100. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Opportunities of cost minimization were also analyzed. One the basis of doctors' feedback, preference is given to non-pharmacologic management of obesity. Mass media campaign and media usage were recommended to increase patients awareness and patients' education along with strengthening family support systems was recommended for better compliance of the patients to doctor's advice. Local therapeutic guidelines for weight reduction were not found. Feedbacks showed that global therapeutic guidelines were followed by the doctors practicing in the community and hospitals in Karachi. However, high price branded drugs were used instead of low priced generic therapeutic equivalents. Patient's education is required for better awareness and improving patients' compliance. The doctors found preferring brand leaders instead of low cost options. This trend increases cost of therapy by 0.59 to 4.17 times. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.
Principles and methods of managerial cost-accounting systems.

PubMed

Suver, J D; Cooper, J C

1988-01-01

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

NASA Astrophysics Data System (ADS)

Ho, S. Ping; Hsu, Yaowen

2015-04-01

In order to meet the requirements of the rapid economic growth, many countries demand an increasing number of power plants to meet the increasing electricity usage. Since high capital requirements of power plants present a big issue for these countries, PPPs have been considered an alternative to provide power plant infrastructure. In particular, in emerging or developing countries, PPPs may be the fastest way to provide the infrastructure needed. However, while PPPs are a promising alternative to providing various types of infrastructure, many failed power plant PPP projects have made it evident that PPPs, under certain situations, can be very costly or even a wrong choice of governance structure. While the higher efficiency due to better pooling of resources is greatly emphasized in Public-Private Partnerships (PPPs), the embedded transaction inefficiencies are often understated or even ignored. Through the lens of Transaction Cost Economics (TCE), this paper aims to answer why and when PPPs may become a costly governance structure for power plants. Specifically, we develop a TCE-based theory of PPPs as a governance structure. This theory suggests that three major opportunism problems embedded in infrastructure PPPs are possible to cause substantial transaction costs and render PPPs a costly governance structure. The three main opportunism problems are principal-principal problem, firm's hold-up problem, and government-led hold-up problem. Moreover, project and institutional characteristics that may lead to opportunism problems are identified. Based on these characteristics, an opportunism-focused transaction cost analysis (OTCA) for PPPs as a governance structure is proposed to supplement the current practice of PPP feasibility analysis. As a part of theory development, a case study of PPP power plants is performed to evaluate the proposed theory and to illustrate how the proposed OTCA can be applied in practice. Policies and administration strategies for power
Hospital-based glaucoma clinics: what are the costs to patients?

PubMed

Sharma, A; Jofre-Bonet, M; Panca, M; Lawrenson, J G; Murdoch, I

2010-06-01

To investigate the costs to patients attending hospital-based glaucoma clinics. A patient-based costs questionnaire was developed and completed for patients attending six ophthalmology units across London (Ealing General Hospital, St Georges Hospital, Mile End Hospital, Upney Centre Barking, St Ann's Hospital and the Royal London Hospital). The questionnaire considered age, sex, ethnicity as well as patient-based costs, opportunity costs, and companion costs. All patients visiting for review or appointments were approached non-selectively. A total of 100 patients were sampled from each unit. The mean age of the full sample was 69.6 years (SD 12.6), with little variation between sites (68.5-71.8 years). There was an almost equal sex distribution (male (298 (50.6%)). There was no major difference in occupational distribution between sites. The majority of people came to hospital by bus (40%) or car (26%). Female patients went slightly more by cab or car, whereas male patients went slightly more by foot or train. There was some variability in transport method by site. The data showed that the Royal London hospital had the highest mean cost per visit (pound16.20), whereas St Georges had the lowest (pound12.90). Upney had the second highest mean cost per visit (pound15.20), whereas Ealing and St Ann's had similar mean costs of (pound13.25) and (pound13), respectively. Travel costs accounted for about one-fifth of the total patient's costs. For all glaucoma clinics, total societal costs were higher than the sum of patients' costs because of the high frequency of companions. A surprising finding was that two-thirds of the population (392 or 66.6%) reported no qualification-considerably higher than the national census statistics for the same population. To our knowledge this paper presents direct and indirect patient costs in attending hospital glaucoma units for the first time. It highlights the significance of opportunity costs when considering health-care interventions
A Retrospective Study of Non-Ventilator-Associated Hospital Acquired Pneumonia Incidence and Missed Opportunities for Nursing Care.

PubMed

Tesoro, Mary; Peyser, Diane J; Villarente, Farley

2018-05-01

To determine non-ventilator-associated hospital-acquired pneumonia (NV-HAP) incidence, assess negative impacts on patient outcomes and cost, and identify missed preventive nursing care opportunities. NV-HAP is inadequately studied and underreported. Missed nursing care opportunities, particularly oral care, may aid NV-HAP prevention. This descriptive, observational, retrospective chart review identified adult NV-HAP cases and associated demographic and hospital care data. Two hundred five NV-HAP cases occurred in 1 year at Montefiore Medical Center, equating to an incidence of 0.47 per 1000 patient-days and an estimated excess cost of $8.2 million. ICU transfer following pneumonia occurred in 15.6% of cases. Care requirements from specialist nursing facilities increased at discharge (26.8%), as compared with care requirements on admission (17.6%). Complete nursing care documentation was missing for most patients, with oral care undocumented 60.5% of the time. Preventable NV-HAP cases and their negative impact on cost and patient outcomes may decrease through improved basic nursing care.

Total cost of ownership: the role of clinical engineering.

PubMed

Hockel, Dale; Kintner, Michael

2014-06-01

Hospitals often incur substantial hidden costs associated with service agreements that they enter into with original equipment manufacturers at the time of equipment purchase. Hospitals should perform an analysis of the total cost of ownership (TCO) of their organizations' medical equipment to identify opportunities for performance improvement and savings. The findings of the TCO analysis can point to areas where clinical engineering service management can be improved through investments in technology, training, and teamwork.
The hand surgery fellowship application process: expectations, logistics, and costs.

PubMed

Meals, Clifton; Osterman, Meredith

2015-04-01

To investigate expectations, logistics, and costs relevant to the hand surgery fellowship application process. We sought to discover (1) what both applicants and program directors are seeking, (2) what both parties have to offer, (3) how both parties collect information about each other, and (4) the costs incurred in arranging each match. We conducted on-line surveys of hand surgery fellowship applicants for appointment in 2015 and of current fellowship program directors. Sixty-two applicants and 41 program directors completed the survey. Results revealed applicants' demographic characteristics, qualifications, method of ranking hand fellowship programs, costs incurred (both monetary and opportunity) during the application process, ultimate match status, and suggestions for change. Results also revealed program directors' program demographics, rationale for offering interviews and favorably ranking applicants, application-related logistical details, costs incurred (both monetary and opportunity) during the application process, and suggestions for change. Applicants for hand surgery fellowship training are primarily interested in a potential program's academic reputation, emphasis on orthopedic surgery, and location. The typical, successfully matched applicant was a 30-year-old male orthopedic resident with 3 publications to his credit. Applicants rely on peers and Web sites for information about fellowships. Fellowship directors are primarily seeking applicants recommended by other experienced surgeons and with positive personality traits. The typical fellowship director offers a single year of orthopedic-based fellowship training to 2 fellows per year and relies on a common application and in-person interviews to collect information about applicants. Applicants appear to be more concerned than directors about the current state of the match process. Applicants and directors alike incur heavy costs, in both dollars and opportunity, to arrange each match. A nuanced
Surgeon-Directed Cost Variation in Isolated Rotator Cuff Repair.

PubMed

Terhune, E Bailey; Cannamela, Peter C; Johnson, Jared S; Saad, Charles D; Barnes, John; Silbernagel, Janette; Faciszewski, Thomas; Shea, Kevin G

2016-12-01

As value becomes a larger component of heath care decision making, cost data can be evaluated for regional and physician variation. Value is determined by outcome divided by cost, and reducing cost increases value for patients. "Third-party spend" items are individual selections by surgeons used to perform procedures. Cost data for third-party spend items provide surgeons and hospitals with important information regarding care value, potential cost-saving opportunities, and the total cost of ownership of specific clinical decisions. To perform a cost review of isolated rotator cuff repair within a regional 7-hospital system and to document procedure cost variation among operating surgeons. Economic and decision analysis; Level of evidence, 4. Current Procedural Terminology (CPT) codes were used to retrospectively identify subjects who received an isolated rotator cuff repair within a 7-hospital system. Cost data were collected for clinically sensitive third-party spend items and divided into 4 cost groups: (1) suture anchors, (2) suture-passing devices and needles, (3) sutures used for cuff repair, and (4) disposable tools or instruments. A total of 62 isolated rotator cuff repairs were performed by 17 surgeons over a 13-month period. The total cost per case for clinically sensitive third-party spend items (in 2015 US dollars) ranged from $293 to $3752 (mean, $1826). Four surgeons had a mean procedure cost that was higher than the data set mean procedure cost. The cost of an individual suture anchor ranged from $75 to $1775 (mean, $403). One disposable suture passer was used, which cost $140. The cost of passing needles ranged from $140 to $995 (mean, $468). The cost per repair suture (used to repair cuff tears) varied from $18 to $298 (mean, $61). The mean suture (used to close wounds) cost per case was $81 (range, $0-$454). A total of 316 tools or disposable instruments were used, costing $1 to $1573 per case (mean, $624). This study demonstrates significant cost
Modeling bladder cancer in mice: opportunities and challenges

PubMed Central

Kobayashi, Takashi; Owczarek, Tomasz B.; McKiernan, James M.; Abate-Shen, Cory

2015-01-01

The prognosis and treatment of bladder cancer have hardly improved in the last 20 years. Bladder cancer remains a debilitating and often fatal disease, and among the most costly cancers to treat. The generation of informative mouse models has the potential to improve our understanding of bladder cancer progression, as well as impact its diagnosis and treatment. However, relatively few mouse models of bladder cancer have been described and particularly few that develop invasive cancer phenotypes. This review focuses on opportunities for improving the landscape of mouse models of bladder cancer. PMID:25533675
Delivering an empowerment intervention to a remote Indigenous child safety workforce: Its economic cost from an agency perspective.

PubMed

Kinchin, Irina; Doran, Christopher M; McCalman, Janya; Jacups, Susan; Tsey, Komla; Lines, Katrina; Smith, Kieran; Searles, Andrew

2017-10-01

The Family Wellbeing (FWB) program applies culturally appropriate community led empowerment training to enhance the personal development of Aboriginal and Torres Strait Islander people in life skills. This study sought to estimate the economic cost required to deliver the FWB program to a child safety workforce in remote Australian communities. This study was designed as a retrospective cost description taken from the perspective of a non-government child safety agency. The target population were child protection residential care workers aged 24 or older, who worked in safe houses in five remote Indigenous communities and a regional office during the study year (2013). Resource utilization included direct costs (personnel and administrative) and indirect or opportunity costs of participants, regarded as absence from work. The total cost of delivering the FWB program for 66 participants was $182,588 ($2766 per participant), with 45% ($82,995) of costs classified as indirect (i.e., opportunity cost of participants time). Training cost could be further mitigated (∼30%) if offered on-site, in the community. The costs for offering the FWB program to a remotely located workforce were high, but not substantial when compared to the recruitment cost required to substitute a worker in remote settings. An investment of $2766 per participant created an opportunity to improve social and emotional wellbeing of remotely located workforce. This cost study provided policy relevant information by identifying the resources required to transfer the FWB program to other remote locations. It also can be used to support future comparative cost and outcome analyses and add to the evidence base around the cost-effectiveness of empowerment programs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Applications of cost-effectiveness methodologies in behavioral medicine.

PubMed

Kaplan, Robert M; Groessl, Erik J

2002-06-01

In 1996, the Panel on Cost-Effectiveness in Health and Medicine developed standards for cost-effectiveness analysis. The standards include the use of a societal perspective, that treatments be evaluated in comparison with the best available alternative (rather than with no care at all), and that health benefits be expressed in standardized units. Guidelines for cost accounting were also offered. Among 24,562 references on cost-effectiveness in Medline between 1995 and 2000, only a handful were relevant to behavioral medicine. Only 19 studies published between 1983 and 2000 met criteria for further evaluation. Among analyses that were reported, only 2 studies were found consistent with the Panel's criteria for high-quality analyses, although more recent studies were more likely to meet methodological standards. There are substantial opportunities to advance behavioral medicine by performing standardized cost-effectiveness analyses.
Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs.
Costs of food waste in South Africa: Incorporating inedible food waste.

PubMed

de Lange, Willem; Nahman, Anton

2015-06-01

The economic, social and environmental costs of food waste are being increasingly recognised. Food waste consists of both edible and inedible components. Whilst wastage of edible food is problematic for obvious reasons, there are also costs associated with the disposal of the inedible fraction to landfill. This is the third in a series of papers examining the costs of food waste throughout the value chain in South Africa. The previous papers focused on the edible portion of food waste. In this paper, costs associated with inedible food waste in South Africa are estimated, in terms of the value foregone by not recovering this waste for use in downstream applications, such as energy generation or composting; as well as costs associated with disposal to landfill. Opportunity costs are estimated at R6.4 (US$0.64) billion per annum, or R2668 (US$266) per tonne. Adding this to the previous estimate for edible food waste of R61.5 billion per annum (in 2012 prices; equivalent to R65 billion in 2013 prices) results in a total opportunity cost of food waste in South Africa (in terms of loss of a potentially valuable food source or resource) of R71.4 (US$7.14) billion per annum, or R5667 (US$567) per tonne. Thereafter, estimates of the costs associated with disposal of this food waste to landfill, including both financial costs and externalities (social and environmental costs), are taken into account. These costs amount to R255 (US$25) per tonne, giving rise to a total cost of food waste in South Africa of R75 billion (US$7.5 billion) per annum, or R5922 (US$592) per tonne. This is equivalent to 2.2% of South Africa's 2013 GDP. Copyright © 2015 Elsevier Ltd. All rights reserved.
Mixed-Mode Surveys: A Strategy to Reduce Costs and Enhance Response Rates

ERIC Educational Resources Information Center

Tobin, Daniel; Thomson, Joan; Radhakrishna, Rama; LaBorde, Luke

2012-01-01

Mixed-mode surveys present one opportunity for Extension to determine program outcomes at lower costs. In order to conduct a follow-up evaluation, we implemented a mixed-mode survey that relied on communication using the Web, postal mailings, and telephone calls. Using multiple modes conserved costs by reducing the number of postal mailings yet…
Asteroid/comet encounter opportunities for the Galileo VEEGA mission

NASA Technical Reports Server (NTRS)

Johannesen, Jennie R.; Nolan, Brian G.; Byrnes, Dennis V.; D'Amario, Louis A.

1988-01-01

The opportunity for the Galileo spacecraft to perform a close flyby of an asteroid or distant observation of a comet while on the Venus-Earth-Earth-Gravity-Assist (VEEGA) mission to Jupiter is discussed. More than 120 nominal trajectories were used in a scan program to identify asteroids passing within 30 million km of the spacecraft. A total of 47 asteroids were examined to determine the propellant cost of a close flyby. The possible flybys include a double asteroid flyby with No. 951 in October, 1991, with a flyby of No. 243 in August 1993. The factors considered in the selection of an asteroid include the propellant margin cost of modifying a nominal trajectory to include a close flyby, the size and type of asteroid, and the Jupiter arrival date.
36 CFR 1206.50 - What types of funding and cost sharing arrangements does the Commission make?

Code of Federal Regulations, 2010 CFR

2010-07-01

... opportunity announcements. (2) Cost sharing may include cash or in-kind contributions provided by the... cost sharing arrangements does the Commission make? 1206.50 Section 1206.50 Parks, Forests, and Public... RECORDS COMMISSION Applying for NHPRC Grants § 1206.50 What types of funding and cost sharing arrangements...
Drug involvement during and after college: Estimates of opportunity and use given opportunity

PubMed Central

Allen, Hannah K.; Caldeira, Kimberly M.; Bugbee, Brittany A.; Vincent, Kathryn B.; O’Grady, Kevin E.; Arria, Amelia M.

2017-01-01

Background College students perceive widespread availability of drugs and prescription medications for nonmedical use on campus, but less is known about the relationship between opportunity to use, use, and use given opportunity of these drugs during and after college. The current study describes annual trends in (1) opportunity to use, (2) use, and (3) use given opportunity of eight drugs and three prescription medications used nonmedically over seven years. Methods Data were derived from a longitudinal cohort study of 1,253 first-year college students (52% female, 72% non-Hispanic white) at one large, public university. Annually, past-year opportunity to use and use were assessed for marijuana, hallucinogens, inhalants, cocaine, ecstasy, amphetamines, methamphetamine, heroin, and nonmedical use of prescription stimulants, analgesics, and tranquilizers. Binary variables were created to represent opportunity to use, use, and use given opportunity for each drug. Results Participants had the greatest opportunity to use marijuana compared with other drugs during the study period, but there was a significant decline in the opportunity to use marijuana over time. Notably, opportunity for both drugs other than marijuana and prescription medications used nonmedically consistently declined, while use given opportunity remained relatively stable over time. Conclusions These findings suggest that changes in drug use are driven by changes in opportunity to use, even during the post-college years. Greater opportunity to use and use of all drugs during the college years in comparison with the post-college years confirms the high-risk nature of the college environment. PMID:28329719
Drug involvement during and after college: Estimates of opportunity and use given opportunity.

PubMed

Allen, Hannah K; Caldeira, Kimberly M; Bugbee, Brittany A; Vincent, Kathryn B; O'Grady, Kevin E; Arria, Amelia M

2017-05-01

College students perceive widespread availability of drugs and prescription medications for non-medical use on campus, but less is known about the relationship between opportunity to use, use, and use given opportunity of these drugs during and after college. The current study describes annual trends in (1) opportunity to use, (2) use, and (3) use given opportunity of eight drugs and three prescription medications used non-medically over seven years. Data were derived from a longitudinal cohort study of 1253 first-year college students (52% female, 72% non-Hispanic white) at one large, public university. Annually, past-year opportunity to use and use were assessed for marijuana, hallucinogens, inhalants, cocaine, ecstasy, amphetamines, methamphetamine, heroin, and non-medical use of prescription stimulants, analgesics, and tranquilizers. Binary variables were created to represent opportunity to use, use, and use given opportunity for each drug. Participants had the greatest opportunity to use marijuana compared with other drugs during the study period, but there was a significant decline in the opportunity to use marijuana over time. Notably, opportunity for both drugs other than marijuana and prescription medications used non-medically consistently declined, while use given opportunity remained relatively stable over time. These findings suggest that changes in drug use are driven by changes in opportunity to use, even during the post-college years. Greater opportunity to use and use of all drugs during the college years in comparison with the post-college years confirms the high-risk nature of the college environment. Copyright © 2017 Elsevier B.V. All rights reserved.
A review of the costs and cost effectiveness of interventions in chronic kidney disease: implications for policy.

PubMed

Menzin, Joseph; Lines, Lisa M; Weiner, Daniel E; Neumann, Peter J; Nichols, Christine; Rodriguez, Lauren; Agodoa, Irene; Mayne, Tracy

2011-10-01

Given rising healthcare costs and a growing population of patients with chronic kidney disease (CKD), there is an urgent need to identify health interventions that provide good value for money. For this review, the English-language literature was searched for studies of interventions in CKD reporting an original incremental cost-utility (cost per QALY) or cost-effectiveness (cost per life-year) ratio. Published cost studies that did not report cost-effectiveness or cost-utility ratios were also reviewed. League tables were then created for both cost-utility and cost-effectiveness ratios to assess interventions in patients with stage 1-4 CKD, waitlist and transplant patients and those with end-stage renal disease (ESRD). In addition, the percentage of cost-saving or dominant interventions (those that save money and improve health) was compared across these three disease categories. A total of 84 studies were included, contributing 72 cost-utility ratios, 20 cost-effectiveness ratios and 42 other cost measures. Many of the interventions were dominant over the comparator, indicating better health outcomes and lower costs. For the three disease categories, the greatest number of dominant or cost-saving interventions was reported for stage 1-4 CKD patients, followed by waitlist and transplant recipients and those with ESRD (91%, 87% and 55% of studies reporting a dominant or cost-saving intervention, respectively). There is evidence of opportunities to lower costs in the treatment of patients with CKD, while either improving or maintaining the quality of care. In order to realize these cost savings, efforts will be required to promote and effectively implement changes in treatment practices.
Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed Central

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs. PMID:511578
Transforming Learning through Technology: Educating More, Costing Less

ERIC Educational Resources Information Center

Twigg, Carol A.

2011-01-01

Face-to-face instruction has been held as the gold standard of a quality academic program. But using information technology to redesign traditional courses can actually improve the quality of teaching, cut costs, and improve access and success. A strong redesign often involves active learning opportunities; individualized, on-demand assistance; a…
Women, family medicine, and career choice: An opportunity cost analysis.

PubMed

Essary, Alison C; Coplan, Bettie H; Cawley, James F; Schneller, Eugene S; Ohsfeldt, Robert L

2016-09-01

This study compared the cost of physician versus physician assistant (PA) education for women practicing in family medicine. Using 2013 salary survey data from both the Medical Group Management Association and the American Academy of PAs as well as other publicly available data sources, the authors compared the current net present value (NPV) of physician and PA training for women practicing in family medicine. Considering a base case scenario involving a 24-year-old woman, the NPV to become a family medicine physician was $2,015,000 compared with an NPV of $1,751,000 to become a family medicine PA. Alternative projections produced an NPV for PA training that slightly exceeded the NPV for family medicine physician training. For a woman practicing in family medicine, becoming a physician or a PA offers similar financial rewards.
The Costs of Climate Change

NASA Astrophysics Data System (ADS)

Guo, Jason

2018-03-01

This research paper talks about the economic costs of climate change, as well as the costs involved in responding to climate change with alternative fuels. This paper seeks to show that climate change, although seemingly costly in the short run, will both save future generations trillions of dollars and serve as a good economic opportunity. Scientists have long argued that the fate of humanity depends on a shift towards renewable energy. However, this paper will make clear that there is also an economic struggle. By embracing alternative fuels, we will not only lessen the danger and the frequency of these natural disasters but also strengthen the world’s financial state. Although a common argument against responding to climate change is that it is too expensive to make the switch, this research shows that in the future, it will save millions of lives and trillions of dollars. The only question left for policymakers is whether they will grasp this energy source shift.
76 FR 26794 - Funding Opportunity Title: Notice of Funds Availability (NOFA) Inviting Applications for the FY...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

.... Reporting certain Financial Services: The CDFI Fund will value the administrative cost of providing certain... DEPARTMENT OF THE TREASURY Community Development Financial Institutions Fund Funding Opportunity... Development Financial Institutions (CDFI) Fund. The BEA Program encourages Insured Depository Institutions to...
Missing College Attendance Costs: Opportunity, Financing, and Risk. ACT Student Financial Aid Research Report Series 89-3.

ERIC Educational Resources Information Center

Mortenson, Thomas G.

The way in which costs enter the potential college student's calculation of the benefits of college attendance is examined. In particular, the paper considers how costs not considered in financial aid need analysis can increase college attendance costs and thereby decrease net benefits of college attendance for those who use financial aid. The…

Opportunities for Energy Efficiency and Open Automated Demand Response in Wastewater Treatment Facilities in California -- Phase I Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lekov, Alex; Thompson, Lisa; McKane, Aimee

This report summarizes the Lawrence Berkeley National Laboratory?s research to date in characterizing energy efficiency and automated demand response opportunities for wastewater treatment facilities in California. The report describes the characteristics of wastewater treatment facilities, the nature of the wastewater stream, energy use and demand, as well as details of the wastewater treatment process. It also discusses control systems and energy efficiency and automated demand response opportunities. In addition, several energy efficiency and load management case studies are provided for wastewater treatment facilities.This study shows that wastewater treatment facilities can be excellent candidates for open automated demand response and thatmore » facilities which have implemented energy efficiency measures and have centralized control systems are well-suited to shift or shed electrical loads in response to financial incentives, utility bill savings, and/or opportunities to enhance reliability of service. Control technologies installed for energy efficiency and load management purposes can often be adapted for automated demand response at little additional cost. These improved controls may prepare facilities to be more receptive to open automated demand response due to both increased confidence in the opportunities for controlling energy cost/use and access to the real-time data.« less
Millimeter-wave automotive radars: the markets, technologies, and production costs

NASA Astrophysics Data System (ADS)

Raffaelli, Lamberto; Stewart, Earle

1995-01-01

This paper examines markets, competing technologies, and required production costs of 77 GHz automotive radars. These products will be offered to the market a few years from now and represent the largest opportunity ever offered to the millimeter-wave (MMW) industry. To succeed in this business, an entire industry, primarily focused in the past on expensive small volume military applications, has to be re-engineered to successfully design and manufacture low cost, large volume parts.
Percutaneous Trigger Finger Release: A Cost-effectiveness Analysis.

PubMed

Gancarczyk, Stephanie M; Jang, Eugene S; Swart, Eric P; Makhni, Eric C; Kadiyala, Rajendra Kumar

2016-07-01

Percutaneous trigger finger releases (TFRs) performed in the office setting are becoming more prevalent. This study compares the costs of in-hospital open TFRs, open TFRs performed in ambulatory surgical centers (ASCs), and in-office percutaneous releases. An expected-value decision-analysis model was constructed from the payer perspective to estimate total costs of the three competing treatment strategies for TFR. Model parameters were estimated based on the best available literature and were tested using multiway sensitivity analysis. Percutaneous TFR performed in the office and then, if needed, revised open TFR performed in the ASC, was the most cost-effective strategy, with an attributed cost of $603. The cost associated with an initial open TFR performed in the ASC was approximately 7% higher. Initial open TFR performed in the hospital was the least cost-effective, with an attributed cost nearly twice that of primary percutaneous TFR. An initial attempt at percutaneous TFR is more cost-effective than an open TFR. Currently, only about 5% of TFRs are performed in the office; therefore, a substantial opportunity exists for cost savings in the future. Decision model level II.
Calculating Cost-Return for Investments in Student Success

ERIC Educational Resources Information Center

Lumina Foundation for Education, 2010

2010-01-01

In late 2007, Jobs for the Future (JFF), working with the Delta Project on Postsecondary Costs, Productivity and Accountability, launched "Investing in Student Success", a one-year pilot program. The pilot, conceived of as part of the "Making Opportunity Affordable" initiative and funded by Walmart Foundation and Lumina Foundation for Education,…
Mitigating climate change through small-scale forestry in the USA: opportunities and challenges

Treesearch

Susan Charnley; David Diaz; Hannah Gosnell

2010-01-01

Forest management for carbon sequestration is a low-cost, low-technology, relatively easy way to help mitigate global climate change that can be adopted now while additional long-term solutions are developed. Carbon-oriented management of forests also offers forest owners an opportunity to obtain a new source of income, and commonly has environmental co-benefits. The...
Business Opportunities Guide

DTIC Science & Technology

1987-01-01

Electronic Systems Division Business Opportunities Guide. We remain committed to providing industry the best information possible on pending ESD...Commander Justific ill,):, By_ D.is’ * . ’ . Dist, : :,. ELECTRONIC SYSTEMS DIVISION BUSINESS OPPORTUNITIES GUIDE The complex Command, Control...Communications (C) systems necessary for tomorrow’s Air Foice can only be developed by a stronq’ESD/industry team. Our first Business Opportunities Guide
Ecosystem Services in Conservation Planning: Targeted Benefits vs. Co-Benefits or Costs?

PubMed Central

Chan, Kai M. A.; Hoshizaki, Lara; Klinkenberg, Brian

2011-01-01

There is growing support for characterizing ecosystem services in order to link conservation and human well-being. However, few studies have explicitly included ecosystem services within systematic conservation planning, and those that have follow two fundamentally different approaches: ecosystem services as intrinsically-important targeted benefits vs. substitutable co-benefits. We present a first comparison of these two approaches in a case study in the Central Interior of British Columbia. We calculated and mapped economic values for carbon storage, timber production, and recreational angling using a geographical information system (GIS). These ‘marginal’ values represent the difference in service-provision between conservation and managed forestry as land uses. We compared two approaches to including ecosystem services in the site-selection software Marxan: as Targeted Benefits, and as Co-Benefits/Costs (in Marxan's cost function); we also compared these approaches with a Hybrid approach (carbon and angling as targeted benefits, timber as an opportunity cost). For this analysis, the Co-Benefit/Cost approach yielded a less costly reserve network than the Hybrid approach (1.6% cheaper). Including timber harvest as an opportunity cost in the cost function resulted in a reserve network that achieved targets equivalently, but at 15% lower total cost. We found counter-intuitive results for conservation: conservation-compatible services (carbon, angling) were positively correlated with each other and biodiversity, whereas the conservation-incompatible service (timber) was negatively correlated with all other networks. Our findings suggest that including ecosystem services within a conservation plan may be most cost-effective when they are represented as substitutable co-benefits/costs, rather than as targeted benefits. By explicitly valuing the costs and benefits associated with services, we may be able to achieve meaningful biodiversity conservation at lower cost
Opportunities for composites from recycled wastewood-based resources: A problem analysis and research plan

Treesearch

Roger M. Rowell; Henry Spelter; Rodger A. Arola; Phil Davis; Tom Friberg; Richard W. Hemingway; Tim Rials; David Luneke; Ramani Narayan; John Simonsen; Don White

1993-01-01

There are many opportunities to produce composites from recycled biobased fiber. The fiber can be used alone to make low-cost and high-performance composites, combined with inorganic materials, or combined with other recycled materials, such as plastics, to produce mixtures, compatibilized blends, and alloys. This report describes the resources available: problems...
NBIC Job Opportunities

Science.gov Websites

| NBIC Research & Development | NBIC News | Home Job Opportunities NBIC Home|NBIC Overview | Collaborators | Citation | Disclaimer | Credits | Job Opportunities Contact us: nbic@ballastreport.org
Relative costs of specialist services in a family practice population

PubMed Central

Norton, Peter G.; Nelson, Wendy; Rudner, Howard L.; Dunn, Earl V.

1985-01-01

The frequency and cost of referrals to specialists in March 1984 for 8980 rostered patients attending a family practice clinic located in a teaching hospital were analysed. The patients made 1891 visits to specialists. In all age groups and for all specialties female patients were more likely to be seen. The total direct provider costs were higher for female patients than for male patients. However, costs per patient seen were higher for male patients, except for psychiatry and medicine. Visits to surgeons had the highest total cost, while visits to psychiatrists had the highest cost per patient seen. Of the direct provider costs 61% was for specialist services. The family physician, in the “gatekeeper” role, has an opportunity to control some of the costs of the health care system by ensuring that the best and most efficient use is made of the referral network. PMID:4042059
Designing for psychological change: individuals' reward and cost valuations in weight management.

PubMed

Hsu, Anne; Blandford, Ann

2014-06-26

Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. We applied a decision theory-based analysis in the domain of weight management to understand the rewards and costs that surround individuals' weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and costs surrounding weight management offers a range
Designing for Psychological Change: Individuals’ Reward and Cost Valuations in Weight Management

PubMed Central

Blandford, Ann

2014-01-01

Background Knowledge of the psychological constructs that underlie behavior offers valuable design opportunities for persuasive systems. We use the decision theory, which describes how behavior is underpinned by reward-cost valuations, as a framework for investigating such psychological constructs to deliver design objectives for weight management technologies. Objective We applied a decision theory–based analysis in the domain of weight management to understand the rewards and costs that surround individuals’ weight management behaviors, with the aim of uncovering design opportunities for weight management technologies. Methods We conducted qualitative interviews with 15 participants who were or had been trying to lose weight. Thematic analysis was used to extract themes that covered the rewards and costs surrounding weight management behaviors. We supplemented our qualitative study with a quantitative survey of 100 respondents investigating the extent to which they agreed with statements reflecting themes from the qualitative study. Results The primary obstacles to weight management were the rewards associated with unhealthy choices, such as the pleasures of unhealthy foods and unrestricted consumption in social situations, and the significant efforts required to change habits, plan, and exercise. Psychological constructs that supported positive weight management included feeling good after making healthy choices, being good to oneself, experiencing healthy yet still delicious foods, and receiving social support and encouraging messages (although opinions about encouraging messages was mixed). Conclusions A rewards-costs driven enquiry revealed a wide range of psychological constructs that contribute to discouraging and supporting weight management. The constructs extracted from our qualitative study were verified by our quantitative survey, in which the majority of respondents also reported similar thoughts and feelings. This understanding of the rewards and
Current trends in treatment of hypertension in Karachi and cost minimization possibilities.

PubMed

Hussain, Izhar M; Naqvi, Baqir S; Qasim, Rao M; Ali, Nasir

2015-01-01

This study finds out drug usage trends in Stage I Hypertensive Patients without any compelling indications in Karachi, deviations of current practices from evidence based antihypertensive therapeutic guidelines and looks for cost minimization opportunities. In the present study conducted during June 2012 to August 2012, two sets were used. Randomized stratified independent surveys were conducted in doctors and general population - including patients, using pretested questionnaires. Sample sizes for doctors and general population were 100 and 400 respectively. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Financial impact was also analyzed. On the basis of patients' doctors' feedback, Beta Blockers, and Angiotensin Converting Enzyme Inhibitors were used more frequently than other drugs. Thiazides and low-priced generics were hardly prescribed. Beta blockers were prescribed widely and considered cost effective. This trend increases cost by two to ten times. Feedbacks showed that therapeutic guidelines were not followed by the doctors practicing in the community and hospitals in Karachi. Thiazide diuretics were hardly used. Beta blockers were widely prescribed. High priced market leaders or expensive branded generics were commonly prescribed. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.
Opportunity for peri-urban Perth groundwater trade

NASA Astrophysics Data System (ADS)

Gao, Lei; Connor, Jeff; Doble, Rebecca; Ali, Riasat; McFarlane, Don

2013-07-01

Groundwater trade is widely advocated for reallocating scarce groundwater resources between competing users, and managing over-allocated and declining aquifers. However, groundwater markets are still in their infancy, and the potential benefits and opportunities need investigation, particularly where there is a need to reduce the extraction from declining aquifers. This article evaluates economic impacts of reducing groundwater extraction for irrigation use in peri-urban Perth, Australia, where irrigation, a lake-based ecosystem, and public water supply are highly dependent on a declining groundwater resource. We present an assessment of market-based water trading approaches to reduce groundwater extraction with an economic model representing diversity in returns to groundwater use across a population of irrigators. The results indicate that potential economic costs of a proportional reduction in available groundwater for irrigation are 18-21% less if groundwater trade is possible. We also evaluate a water buyback from irrigation to provide public water supply as an alternative to new infrastructure. We find that buying back up to around 50% of current irrigation allocations could create new public water supply only at the cost of 0.32-0.39 million per GL, which is less than one fifth of the costs of new desalinisation or recycled water supply options (2-3 million per GL). We conclude that, with rapid development of computer and internet based trading platforms that allows fast, efficient and low cost multiple party trading, it is increasingly feasible to realise the economic potentials of market-based trade approaches for managing overexploited aquifers.
A primer on the cost of quality for improvement of laboratory and pathology specimen processes.

PubMed

Carlson, Richard O; Amirahmadi, Fazlollaah; Hernandez, James S

2012-09-01

In today's environment, many laboratories and pathology practices are challenged to maintain or increase their quality while simultaneously lowering their overall costs. The cost of improving specimen processes is related to quality, and we demonstrate that actual costs can be reduced by designing "quality at the source" into the processes. Various costs are hidden along the total testing process, and we suggest ways to identify opportunities to reduce cost by improving quality in laboratories and pathology practices through the use of Lean, Six Sigma, and industrial engineering.
Definitions and methods of cost assessment: an intensivist's guide. ESICM section on health research and outcome working group on cost effectiveness.

PubMed

Jegers, M; Edbrooke, D L; Hibbert, C L; Chalfin, D B; Burchardi, H

2002-06-01

To define the different types of costs incurred in the care of critically ill patients and to describe some of the most commonly used methods for measuring and allocating these costs. Literature review. Definitions for opportunity, direct and indirect, fixed, variable, marginal, and total costs are described and interpreted in the context of the critical care setting. Two main methods of costing are described: the 'top-down' and 'bottom-up' methods together with a number of cost proxies, such as the use of weighted hospital days, diagnosis-related groups, severity and activity scores, and effective costs per survivor. The assessment and allocation of costs to critically ill patients is complex and as a result of the different definitions and methods used, meaningful comparisons between studies are plagued with difficulty. When undertaking a study looking to measure costs, it is important to state: (a) the aim of the cost assessment study; (b) the perspective (point of view); (c) the type of costs that need to be measured; and (d) the time span of assessment. By being explicit about the rationale of the study and the methods used, it is hoped that the results of economic evaluations will be better understood, and hence implemented within the critical care setting.
No Cost – Low Cost Compressed Air System Optimization in Industry

NASA Astrophysics Data System (ADS)

Dharma, A.; Budiarsa, N.; Watiniasih, N.; Antara, N. G.

2018-04-01

Energy conservation is a systematic, integrated of effort, in order to preserve energy sources and improve energy utilization efficiency. Utilization of energy in efficient manner without reducing the energy usage it must. Energy conservation efforts are applied at all stages of utilization, from utilization of energy resources to final, using efficient technology, and cultivating an energy-efficient lifestyle. The most common way is to promote energy efficiency in the industry on end use and overcome barriers to achieve such efficiency by using system energy optimization programs. The facts show that energy saving efforts in the process usually only focus on replacing tools and not an overall system improvement effort. In this research, a framework of sustainable energy reduction work in companies that have or have not implemented energy management system (EnMS) will be conducted a systematic technical approach in evaluating accurately a compressed-air system and potential optimization through observation, measurement and verification environmental conditions and processes, then processing the physical quantities of systems such as air flow, pressure and electrical power energy at any given time measured using comparative analysis methods in this industry, to provide the potential savings of energy saving is greater than the component approach, with no cost to the lowest cost (no cost - low cost). The process of evaluating energy utilization and energy saving opportunities will provide recommendations for increasing efficiency in the industry and reducing CO2 emissions and improving environmental quality.
Killer whale depredation and associated costs to Alaskan sablefish, Pacific halibut and Greenland turbot longliners.

PubMed

Peterson, Megan J; Mueter, Franz; Criddle, Keith; Haynie, Alan C

2014-01-01

Killer whale (Orcinus orca) depredation (whales stealing or damaging fish caught on fishing gear) adversely impacts demersal longline fisheries for sablefish (Anoplopoma fimbria), Pacific halibut (Hippoglossus stenolepis) and Greenland turbot (Reinhardtius hippoglossoides) in the Bering Sea, Aleutian Islands and Western Gulf of Alaska. These interactions increase direct costs and opportunity costs associated with catching fish and reduce the profitability of longline fishing in western Alaska. This study synthesizes National Marine Fisheries Service observer data, National Marine Fisheries Service sablefish longline survey and fishermen-collected depredation data to: 1) estimate the frequency of killer whale depredation on longline fisheries in Alaska; 2) estimate depredation-related catch per unit effort reductions; and 3) assess direct costs and opportunity costs incurred by longliners in western Alaska as a result of killer whale interactions. The percentage of commercial fishery sets affected by killer whales was highest in the Bering Sea fisheries for: sablefish (21.4%), Greenland turbot (9.9%), and Pacific halibut (6.9%). Average catch per unit effort reductions on depredated sets ranged from 35.1-69.3% for the observed longline fleet in all three management areas from 1998-2012 (p<0.001). To compensate for depredation, fishermen set additional gear to catch the same amount of fish, and this increased fuel costs by an additional 82% per depredated set (average $433 additional fuel per depredated set). In a separate analysis with six longline vessels in 2011 and 2012, killer whale depredation avoidance measures resulted in an average additional cost of $494 per depredated vessel-day for fuel and crew food. Opportunity costs of time lost by fishermen averaged $522 per additional vessel-day on the grounds. This assessment of killer whale depredation costs represents the most extensive economic evaluation of this issue in Alaska to date and will help longline
Killer Whale Depredation and Associated Costs to Alaskan Sablefish, Pacific Halibut and Greenland Turbot Longliners

PubMed Central

Peterson, Megan J.; Mueter, Franz; Criddle, Keith; Haynie, Alan C.

2014-01-01

Killer whale (Orcinus orca) depredation (whales stealing or damaging fish caught on fishing gear) adversely impacts demersal longline fisheries for sablefish (Anoplopoma fimbria), Pacific halibut (Hippoglossus stenolepis) and Greenland turbot (Reinhardtius hippoglossoides) in the Bering Sea, Aleutian Islands and Western Gulf of Alaska. These interactions increase direct costs and opportunity costs associated with catching fish and reduce the profitability of longline fishing in western Alaska. This study synthesizes National Marine Fisheries Service observer data, National Marine Fisheries Service sablefish longline survey and fishermen-collected depredation data to: 1) estimate the frequency of killer whale depredation on longline fisheries in Alaska; 2) estimate depredation-related catch per unit effort reductions; and 3) assess direct costs and opportunity costs incurred by longliners in western Alaska as a result of killer whale interactions. The percentage of commercial fishery sets affected by killer whales was highest in the Bering Sea fisheries for: sablefish (21.4%), Greenland turbot (9.9%), and Pacific halibut (6.9%). Average catch per unit effort reductions on depredated sets ranged from 35.1–69.3% for the observed longline fleet in all three management areas from 1998–2012 (p<0.001). To compensate for depredation, fishermen set additional gear to catch the same amount of fish, and this increased fuel costs by an additional 82% per depredated set (average $433 additional fuel per depredated set). In a separate analysis with six longline vessels in 2011and 2012, killer whale depredation avoidance measures resulted in an average additional cost of $494 per depredated vessel-day for fuel and crew food. Opportunity costs of time lost by fishermen averaged $522 per additional vessel-day on the grounds. This assessment of killer whale depredation costs represents the most extensive economic evaluation of this issue in Alaska to date and will help longline
Biowaste biorefinery in Europe: opportunities and research & development needs.

PubMed

Fava, Fabio; Totaro, Grazia; Diels, Ludo; Reis, Maria; Duarte, Jose; Carioca, Osvaldo Beserra; Poggi-Varaldo, Héctor M; Ferreira, Bruno Sommer

2015-01-25

This review aims to explore the needs and opportunities of research & development in the field of biowaste biorefinery in Europe. Modern industry in recent years is giving its close attention on organic waste as a new precious bioresource. Specific biowaste valorisation pathways are focusing on food processing waste, being food sector the first manufacture in Europe. Anyway they need to be further tested and validated and then transferred at the larger scale. In particular, they also need to become integrated, combining biomass pretreatments and recovery of biogenic chemicals with bioconversion processes in order to obtain a large class of chemicals. This will help to (a) use the whole biowaste, by avoiding producing residues and providing to the approach the required environmental sustainability, and (b) producing different biobased products that enter different markets, to get the possible economical sustainability of the whole biorefinery. However, the costs of the developed integrated processes might be high, mostly for the fact that the industry dealing with such issues is still underdeveloped and therefore dominated by high processing costs. Such costs can be significantly reduced by intensifying research & development on process integration and intensification. The low or no cost of starting material along with the environmental benefits coming from the concomitant biowaste disposal would offset the high capital costs for initiating such a biorefinery. As long as the oil prices tend to increase (and they will) this strategy will become even more attractive. Copyright © 2013 Elsevier B.V. All rights reserved.

The economic cost of upland and gully erosion on subsistence agriculture for a watershed in the Ethiopian highlands

USDA-ARS?s Scientific Manuscript database

This paper quantifies the cost of erosion; it uses nutrient replacement cost to value topsoil nutrient depletion, daily wage rate to monetize the opportunity cost of labour due to gully erosion and local market price to quantify the lost animal and cash crop trees. Soil erosion rate is estimated fro...
Density as a Cost Driver in Naval Submarine Design and Procurement

DTIC Science & Technology

2008-06-01

RADM Steve Johnson, thank you for this opportunity to contribute to the continued preeminence of the United States Submarine Force. Mr. Chris Deegan ...craft and is used to respond to questions from higher echelon Navy/DoD on cost of historical ships ( Deegan , 2005). NAVSEA 05U provided SCN end-cost...Arlington, VA 6. Chris Deegan Director, NAVSEA 05C Washington Navy Yard, Washington, DC 7. RDML William Hilardes Program Executive Officer
A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance.

PubMed

Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik

2016-07-27

Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.
Managing U.S. Air Force Aircraft Operating and Support Costs: Insights from Recent RAND Analysis and Opportunities for the Future

DTIC Science & Technology

2016-01-01

operating and support (O&S) cost growth: Fuel costs drove 31 percent of overall O&S cost growth, unit-level personnel costs 30 percent, weapon system ...hours. • The root causes of weapon system sustainment costs are war-related effects and aging effects; while the former will diminish with the end of...the cost growth experienced for these large and costly fleets, with a particular focus on weapon system sustainment (WSS) costs.2 We focused on WSS
On the Estimation of the Cost-Effectiveness Threshold: Why, What, How?

PubMed

Vallejo-Torres, Laura; García-Lorenzo, Borja; Castilla, Iván; Valcárcel-Nazco, Cristina; García-Pérez, Lidia; Linertová, Renata; Polentinos-Castro, Elena; Serrano-Aguilar, Pedro

2016-01-01

Many health care systems claim to incorporate the cost-effectiveness criterion in their investment decisions. Information on the system's willingness to pay per effectiveness unit, normally measured as quality-adjusted life-years (QALYs), however, is not available in most countries. This is partly because of the controversy that remains around the use of a cost-effectiveness threshold, about what the threshold ought to represent, and about the appropriate methodology to arrive at a threshold value. The aim of this article was to identify and critically appraise the conceptual perspectives and methodologies used to date to estimate the cost-effectiveness threshold. We provided an in-depth discussion of different conceptual views and undertook a systematic review of empirical analyses. Identified studies were categorized into the two main conceptual perspectives that argue that the threshold should reflect 1) the value that society places on a QALY and 2) the opportunity cost of investment to the system given budget constraints. These studies showed different underpinning assumptions, strengths, and limitations, which are highlighted and discussed. Furthermore, this review allowed us to compare the cost-effectiveness threshold estimates derived from different types of studies. We found that thresholds based on society's valuation of a QALY are generally larger than thresholds resulting from estimating the opportunity cost to the health care system. This implies that some interventions with positive social net benefits, as informed by individuals' preferences, might not be an appropriate use of resources under fixed budget constraints. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Current and Future Opportunities for Wind Power in the Southeast

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tinnesand, Heidi; Roberts, Owen; Lantz, Eric

This presentation discusses future wind opportunities in the Southeast including factors such as changes in wind turbine technology, historical innovation trends, and forecast demand growth among regions. The presentation covers the current status of wind in the United States at 80-m hub height and the near-future outlook with a hub height at 110 to 140 meters. Future cost reductions in 2030 and beyond are also explored. Heidi Tinnesand presented this information to a utility advisory group meeting in Charlotte, North Carolina, on October 5, 2016.
Opportunities for oncology in the Patient Protection and Affordable Care Act.

PubMed

Patel, Kavita K; Tran, Lisa

2013-01-01

The Patient Protection and Affordable Care Act (ACA) contains within it three significant legislative constructs: to enhance access to health care, improve quality, and decrease cost. Also known as the Triple Aim, these three simple, yet monumental, goals have been the object of actions to date as well as future implementation efforts. This article will identify sections of the legislation that would directly provide areas of opportunity to improve health and achieve the triple aim for the oncology profession.
New Opportunities of Low-Cost Photogrammetry for Culture Heritage Preservation

NASA Astrophysics Data System (ADS)

Shults, R.

2017-05-01

In the paper, the questions of using the technologies of low-cost photogrammetry in combination with the additional capabilities of modern smartphones are considered. The research was carried out on the example of documenting the historical construction of the II World War - the Kiev Fortified Region. Brief historical information about the object of research is given. The possibilities of using modern smartphones as measuring instruments are considered. To get high-quality results, the camera of the smartphone was calibrated. The calibration results were used in the future to perform 3D modeling of defense facilities. Photographing of three defense structures in a different state: destroyed, partially destroyed and operating was carried out. Based on the results of photography using code targets, 3D object models were constructed. To verify the accuracy of the 3D modelling, control measurements of the lines between the code targets at the objects were performed. The obtained results are satisfying, and the technology considered in the paper can be recommended for use in performing archaeological and historical studies.
Application and opportunities of pulses in food system: a review.

PubMed

Asif, Muhammad; Rooney, Lloyd W; Ali, Rashida; Riaz, Mian N

2013-01-01

Pulses are highly nutritious seeds of pod-bearing leguminous plants, specifically dry peas, lentils, and chickpeas. US farmers harvest about 2.6 million pounds of pulses every year but 75% of this is being exported internationally because of its increased consumption in the developing countries. In the current scenario, increasing costs of production, bad economy, and fluctuating food commodity prices have made a strong case for US producers to seek opportunities to increase domestic consumption of pulses through value-added products. Pulses are the richest sources of plant proteins and provide approximately 10% of the total dietary requirements of the proteins world over. Pulses are also high in dietary fibers and complex carbohydrates leading to low GI (glycemic index) foods. Pulses help to lower cholesterol and triglycerides as leguminous fibers are hypoglycosuria because of consisting more amylose than amylopectin. Pulses provide tremendous opportunities to be utilized in the processed foods such as bakery products, bread, pasta, snack foods, soups, cereal bar filing, tortillas, meat, etc. These show excellent opportunities in frozen dough foods either as added flour or as fillings. Pulses in view of their nutrient profile, seem to be ideal for inclusion in designing snack foods, baby, and sports foods.
Contribution of education to cost-effective care of microcytic, hypochromic anemia.

PubMed

Mulligan, J L; Arnold, L; Sanders, R; Brumwell, M; Rupani, M; Stelle, R; Romang, L; Sinnett, M; Ryan, P; Sirridge, M S

1984-06-01

Through a handbook, a seminar, and multiple opportunities for reinforcement in clinical settings, faculty in family medicine conducted an educational program that presented cost-effective practice standards for the care of anemia patients to resident physicians. A comparison of the quality and cost of anemia care by the residents before and during the program ascertained its value. The quality of patient care by residents rose significantly during the program. In addition, the residents' utilization of tests, therapy, and clinic visits and attendant costs reached more appropriate levels. These results should encourage faculty to respond to the current national need for the development of educational materials on cost-effective care of patients with common health problems.
Opportunities Center. Concept Paper.

ERIC Educational Resources Information Center

Kimeldorf, Martin

The opportunities center is a new school service concept that can help students find opportunities related to their talents and interests in work, education, leisure, small business, or community service. The opportunities center model expands the career center model into an information search center offering multiple services that link academic…
Assessing the cost of contemporary pituitary care.

PubMed

McLaughlin, Nancy; Martin, Neil A; Upadhyaya, Pooja; Bari, Ausaf A; Buxey, Farzad; Wang, Marilene B; Heaney, Anthony P; Bergsneider, Marvin

2014-11-01

Knowledge of the costs incurred through the delivery of neurosurgical care has been lagging, making it challenging to design impactful cost-containment initiatives. In this report, the authors describe a detailed cost analysis for pituitary surgery episodes of care and demonstrate the importance of such analyses in helping to identify high-impact cost activities and drive value-based care. This was a retrospective study of consecutively treated patients undergoing an endoscopic endonasal procedure for the resection of a pituitary adenoma after implementation and maturation of quality-improvement initiatives and the implementation of cost-containment initiatives. The cost data pertaining to 27 patients were reviewed. The 2 most expensive cost activities during the index hospitalization were the total operating room (OR) and total bed-assignment costs. Together, these activities represented more than 60% of the cost of hospitalization. Although value-improvement initiatives contributed to the reduction of variation in the total cost of hospitalization, specific cost activities remained relatively variable, namely the following: 1) OR charged supplies, 2) postoperative imaging, and 3) use of intraoperative neuromonitoring. These activities, however, each contributed to less than 10% of the cost of hospitalization. Bed assignment was the fourth most variable cost activity. Cost related to readmission/reoperation represented less than 5% of the total cost of the surgical episode of care. After completing a detailed assessment of costs incurred throughout the management of patients undergoing pituitary surgery, high-yield opportunities for cost containment should be identified among the most expensive activities and/or those with the highest variation. Strategies for safely reducing the use of the targeted resources, and related costs incurred, should be developed by the multidisciplinary team providing care for this patient population.
Commercial opportunities utilizing the International Space Station

NASA Astrophysics Data System (ADS)

Kearney, Michael E.; Mongan, Phil; Overmyer, Carolyn M.; Jackson, Kenneth

1998-01-01

The International Space Station (ISS) has the unique capability of providing a low-g environment for both short- and long-duration experimentation. This environment can provide a unique and competitive research capability to industry; but until recently, utilization of this environment by the private sector has been limited if not totally unavailable. NASA has recently expressed an interest in the commercial development of space and this is now an integral part of the Agency's enabling legislation through the Space Act. NASA's objective is to foster the use of the space environment for the development of commercial products and processes. Through alliances and agreements with several commercial companies and universities, SPACEHAB, Inc., has built a comprehensive package of services designed to provide low-cost reliable access to space for experimenters. These services provide opportunities to support engineering test beds for materials exposure analysis, to mitigate structural failures as observed on the Hubble Space Telescope; materials processing, remote sensing; space environment definition; and electronic experiments. The intent of this paper is to identify commercial opportunities for utilizing the International Space Station and provide examples of several facilities currently being designed and manufactured by commercial companies with the purpose of providing access to the space environment for commercial users.
Florivory as an Opportunity Benefit of Aposematism.

PubMed

Higginson, Andrew D; Speed, Michael P; Ruxton, Graeme D

2015-12-01

Inconspicuous prey pay a cost of reduced feeding opportunities. Flowers are highly nutritious but are positioned where prey would be apparent to predators and often contain toxins to reduce consumption. However, many herbivores are specialized to subvert these defenses by retaining toxins for their own use. Here, we present a model of the growth and life history of a small herbivore that can feed on leaves or flowers during its development and can change its primary defense against visual predators between crypsis and warning coloration. When herbivores can retain plant toxins, their fitness is greatly increased when they are aposematic and can consume flowers. Thus, toxin sequestration leading to aposematism may enable a significant opportunity benefit for florivory. Florivory by cryptic herbivores is predicted when toxins are very potent but are at high concentration only in flowers and not in leaves. Herbivores should usually switch to eating flowers only when large and in most conditions should switch simultaneously from crypsis to aposematism. Our results suggest that florivory should be widespread in later instars of small aposematic herbivores and should be associated with ontogenic color change. Florivory is likely to play an underappreciated role in herbivorous insect life histories and host plant reproductive success.
Multiplying Mars Lander Opportunities with Marsdrop Microlanders

NASA Technical Reports Server (NTRS)

Staehle, Robert L.; Spangelo, Sara; Lane, Marc S.; Aaron, Kim M.; Bhartia, Rohit; Boland, Justin S.; Christensen, Lance E.; Forouhar, Siamak; de la Torre Juarez, Manuel; Trawny, Nikolas;

2015-01-01

From canyons to glaciers, from geology to astrobiology, the amount of exciting surface science awaiting us at Mars greatly outstrips available mission opportunities. Based on the thrice -flown Aerospace Corporation Earth Reentry Breakup Recorder (REBR), we present a method for accurate landing of small instrument payloads on Mars, utilizing excess cruise -stage mass on larger missions. One to a few such microlanders might add 1-5% to the cost of a primary mission with inconsequential risk. Using the REBR and JPL Deep Space 2 starting points for a passively stable entry vehicle provides a low mass and low ballistic coefficient, enabling subsonic d employment of a steerable parawing glider, capable of 10+ km of guided flight at a 3:1 glide ratio. Originally developed for the Gemini human space program, the parawing is attractive for a volume -limited microprobe, minimizing descent velocity, and providing sufficient remaining volume for a useful scientific payload. The ability to steer the parawing during descent opens unique opportunities, including terrain- relative navigation for landing within tens of meters of one of several specified targets within a given uncertainty ellipse. In addition to scientific value, some Mars human exploration Strategic Knowledge Gaps could be addressed with deployment of focused instruments at multiple locations.

Time-driven activity-based costing: a driver for provider engagement in costing activities and redesign initiatives.

PubMed

McLaughlin, Nancy; Burke, Michael A; Setlur, Nisheeta P; Niedzwiecki, Douglas R; Kaplan, Alan L; Saigal, Christopher; Mahajan, Aman; Martin, Neil A; Kaplan, Robert S

2014-11-01

To date, health care providers have devoted significant efforts to improve performance regarding patient safety and quality of care. To address the lagging involvement of health care providers in the cost component of the value equation, UCLA Health piloted the implementation of time-driven activity-based costing (TDABC). Here, the authors describe the implementation experiment, share lessons learned across the care continuum, and report how TDABC has actively engaged health care providers in costing activities and care redesign. After the selection of pilots in neurosurgery and urology and the creation of the TDABC team, multidisciplinary process mapping sessions, capacity-cost calculations, and model integration were coordinated and offered to engage care providers at each phase. Reviewing the maps for the entire episode of care, varying types of personnel involved in the delivery of care were noted: 63 for the neurosurgery pilot and 61 for the urology pilot. The average cost capacities for care coordinators, nurses, residents, and faculty were $0.70 (range $0.63-$0.75), $1.55 (range $1.28-$2.04), $0.58 (range $0.56-$0.62), and $3.54 (range $2.29-$4.52), across both pilots. After calculating the costs for material, equipment, and space, the TDABC model enabled the linking of a specific step of the care cycle (who performed the step and its duration) and its associated costs. Both pilots identified important opportunities to redesign care delivery in a costconscious fashion. The experimentation and implementation phases of the TDABC model have succeeded in engaging health care providers in process assessment and costing activities. The TDABC model proved to be a catalyzing agent for cost-conscious care redesign.
Low cost missions to explore the diversity of near Earth objects

NASA Technical Reports Server (NTRS)

Belton, Michael J. S.; Delamere, Alan

1992-01-01

We propose a series of low-cost flyby missions to perform a reconnaissance of near-Earth cometary nuclei and asteroids. The primary scientific goal is to study the physical and chemical diversity in these objects. The mission concept is based on the Pegasus launch vehicle. Mission costs, inclusive of launch, development, mission operations, and analysis are expected to be near $50 M per mission. Launch opportunities occur in all years. The benefits of this reconnaissance to society are stressed.
Toward a Cost/Benefit Analysis of Physical Fitness

PubMed Central

Shephard, Roy J.

1986-01-01

This article, which is based, in part, on a paper presented to the Canadian Association of Sport Sciences, Quebec City, in November 1985, evaluates the principles of cost/benefit and cost-effectiveness analysis in the specific context of fitness programming. Because of difficulties in valuing all aspects of fitness and health—particularly survival after retirement—cost-effectiveness analysis is generally preferred. Allowance must be made for inflation, the discount rate (except in a “steady state” analysis), marginal costs of program expansion, opportunity costs incurred by participants, the changing fabric of society, the economic multiplication of investment in fitness, and anticipated participation rates. Benefits may be observed by the individual (improved health), the corporation (reduced turnover and absenteeism, increased productivity, fewer injuries), and the state (reduced direct and indirect costs of illness, improved lifestyle, reduced demand for geriatric services). Program costs vary widely with the activity that is undertaken, but even daily walking involves the participant in some expense. Employee programs often cost $500-$750 per participant/year, while, depending on the sport and local speculation by land “developers”, community programs may cost $175-$1,000 per participant/year. Cost/effectiveness analyses allow governments to reach informed decisions, but they cannot always answer associated ethical problems such as determining the value of human life, and the rights of the individual as opposed to those of society. PMID:21267294
A facility monitoring system: The single most valuable and cost-effective tool available to an energy manager

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holmes, W.A.

Energy engineering and management combines engineering problem-solving and financial management techniques to reduce utility costs. At present, substantial amounts of time and money are being spent in order to attempt to quantify energy consumption and costs and define opportunities for savings. Unfortunately, accurate verification of results is often overlooked. Advances in technology during the last few years have made the installation of a permanent, PC-based monitoring system possible for any facility, often for no more than the cost of a detailed study. By investing initially in a monitoring system rather than audits or studies, the actual consumption and cost datamore » will be available on a continuing basis and can be used to produce immediate operational savings, more accurately analyze opportunities requiring capital investments, and to verify actual savings resulting from changes. A permanent monitoring system, installed as the first step in a utility cost reduction effort, to identify where and how energy is used in a facility on a dynamic and real-time basis, can provide the most valuable and cost-effective tool available to an energy manager. The resulting data allows energy consumption patterns and utility costs to be understood and managed in the same manner as all other costs within a facility.« less
Chemical engineering challenges and investment opportunities in sustainable energy.

PubMed

Heller, Adam

2008-01-01

The chemical and energy industries are transforming as they adjust to the new era of high-priced petroleum and severe global warming. As a result of the transformation, engineering challenges and investment opportunities abound. Rapid evolution and fast growth are expected in cathode and anode materials as well as polymeric electrolytes for vehicular batteries and in high-performance polymer-ceramic composites for wind turbines, fuel-efficient aircraft, and lighter and safer cars. Unique process-engineering opportunities exist in sand-oil, coal, and possibly also shale liquefaction to produce transportation fuel; and also in genetic engineering of photosynthesizing plants and other organisms for their processing into high-performance biodegradable polymers and high-value-added environmentally friendly chemicals. Also, research on the feasibility of mitigation of global warming through enhancement of CO(2) uptake by the southern oceans by fertilization with trace amounts of iron is progressing. Because chemical engineers are uniquely well trained in mathematical modeling of mass transport, flow, and mixing, and also in cost analysis, they are likely to join the oceanographers and marine biologists in this important endeavor.

Opportunities for Epidemiologists in Implementation Science: A Primer.

PubMed

Neta, Gila; Brownson, Ross C; Chambers, David A

2018-05-01

The field of epidemiology has been defined as the study of the spread and control of disease. However, epidemiology frequently focuses on studies of etiology and distribution of disease at the cost of understanding the best ways to control disease. Moreover, only a small fraction of scientific discoveries are translated into public health practice, and the process from discovery to translation is exceedingly slow. Given the importance of translational science, the future of epidemiologic training should include competency in implementation science, whose goal is to rapidly move evidence into practice. Our purpose in this paper is to provide epidemiologists with a primer in implementation science, which includes dissemination research and implementation research as defined by the National Institutes of Health. We describe the basic principles of implementation science, highlight key components for conducting research, provide examples of implementation studies that encompass epidemiology, and offer resources and opportunities for continued learning. There is a clear need for greater speed, relevance, and application of evidence into practice, programs, and policies and an opportunity to enable epidemiologists to conduct research that not only will inform practitioners and policy-makers of risk but also will enhance the likelihood that evidence will be implemented.
Variation in the Cost of Managing Actinic Keratosis

PubMed Central

Gregory, Tanner; Liu, Guodong; Leslie, Douglas L.; Miller, Jeffrey J.

2017-01-01

Importance Actinic keratosis (AK), a skin growth induced by ultraviolet light exposure, requires chronic management because a small proportion can progress into squamous cell skin cancer. Spending for AK management was more than $1 billion in 2004. Investigating geographic variation in AK spending presents an opportunity to decrease waste or recoup excess spending. Objective To evaluate geographic variation in health care cost for management of AKs and the association with patient-related and health-related factors. Design, Setting, and Participants This retrospective cohort study was performed using data from the MarketScan medical claims database of 488 324 continuously enrolled members with 2 or more claims for AK. Data from January 1, 2008, to December 31, 2012, was used. Main Outcomes and Measures Annual costs of care were calculated for outpatient visits, AK destruction, and medications for AKs, and the total of these components. Costs were adjusted for inflation to 2014 US dollars. To display cost variation, we calculated the ratio of mean cost in the highest quintile (Q5) relative to the mean in the lowest quintile (Q1), or the Q5:Q1 ratio; Q5:Q1 ratios were adjusted based on age, sex, history of nonmelanoma skin cancer, US geographic region, and population density (metropolitan statistical area). Results Overall, data from 488 324 continuously enrolled members (mean [SD] age, 53.1 [7.5] years; 243 662 women) with 2 or more claims for AK were included. Overall, patients had 1 085 985 claims related to AK, and dermatologists accounted for 71.0% of claims. The 2-year total cost was $111.5 million, with $52.4 million in 2011 and $59.1 million in 2012. The unadjusted Q5:Q1 ratios for total annual cost per patient ranged from 9.49 to 15.10. Adjusted ratios ranged from 1.72 to 1.80. Conclusions and Relevance There is variation in AK management cost within and between regions. This is not fully explained by differences in patient characteristics such as
Expert elicitation survey on future wind energy costs

DOE PAGES

Wiser, Ryan; Jenni, Karen; Seel, Joachim; ...

2016-09-12

Wind energy supply has grown rapidly over the last decade. However, the long-term contribution of wind to future energy supply, and the degree to which policy support is necessary to motivate higher levels of deployment, depends - in part - on the future costs of both onshore and offshore wind. In this paper, we summarize the results of an expert elicitation survey of 163 of the world's foremost wind experts, aimed at better understanding future costs and technology advancement possibilities. Results suggest significant opportunities for cost reductions, but also underlying uncertainties. Under the median scenario, experts anticipate 24-30% reductions bymore » 2030 and 35-41% reductions by 2050 across the three wind applications studied. Costs could be even lower: experts predict a 10% chance that reductions will be more than 40% by 2030 and more than 50% by 2050. Insights gained through expert elicitation complement other tools for evaluating cost-reduction potential, and help inform policy and planning, R & D and industry strategy.« less
Expert elicitation survey on future wind energy costs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiser, Ryan; Jenni, Karen; Seel, Joachim

Wind energy supply has grown rapidly over the last decade. However, the long-term contribution of wind to future energy supply, and the degree to which policy support is necessary to motivate higher levels of deployment, depends -- in part -- on the future costs of both onshore and offshore wind. Here, we summarize the results of an expert elicitation survey of 163 of the world's foremost wind experts, aimed at better understanding future costs and technology advancement possibilities. Results suggest significant opportunities for cost reductions, but also underlying uncertainties. Under the median scenario, experts anticipate 24-30% reductions by 2030 andmore » 35-41% reductions by 2050 across the three wind applications studied. Costs could be even lower: experts predict a 10% chance that reductions will be more than 40% by 2030 and more than 50% by 2050. Insights gained through expert elicitation complement other tools for evaluating cost-reduction potential, and help inform policy and planning, R&D and industry strategy.« less
Expert elicitation survey on future wind energy costs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiser, Ryan; Jenni, Karen; Seel, Joachim

Wind energy supply has grown rapidly over the last decade. However, the long-term contribution of wind to future energy supply, and the degree to which policy support is necessary to motivate higher levels of deployment, depends - in part - on the future costs of both onshore and offshore wind. In this paper, we summarize the results of an expert elicitation survey of 163 of the world's foremost wind experts, aimed at better understanding future costs and technology advancement possibilities. Results suggest significant opportunities for cost reductions, but also underlying uncertainties. Under the median scenario, experts anticipate 24-30% reductions bymore » 2030 and 35-41% reductions by 2050 across the three wind applications studied. Costs could be even lower: experts predict a 10% chance that reductions will be more than 40% by 2030 and more than 50% by 2050. Insights gained through expert elicitation complement other tools for evaluating cost-reduction potential, and help inform policy and planning, R & D and industry strategy.« less
Cost-effectiveness of vaccination against herpes zoster.

PubMed

de Boer, Pieter T; Wilschut, Jan C; Postma, Maarten J

2014-01-01

Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella zoster virus vaccine has been shown to be effective in reducing the incidence and burden of illness of HZ and PHN, providing the opportunity to prevent significant health-related and financial consequences of HZ. In this review, we summarize the available literature on cost-effectiveness of HZ vaccination and discuss critical parameters for cost-effectiveness results. A search in PubMed and EMBASE was performed to identify full cost-effectiveness studies published before April 2013. Fourteen cost-effectiveness studies were included, all performed in western countries. All studies evaluated cost-effectiveness among elderly above 50 years and used costs per quality-adjusted life year (QALY) gained as primary outcome. The vast majority of studies showed vaccination of 60- to 75-year-old individuals to be cost-effective, when duration of vaccine efficacy was longer than 10 years. Duration of vaccine efficacy, vaccine price, HZ incidence, HZ incidence and discount rates were influential to the incremental cost-effectiveness ratio (ICER). HZ vaccination may be a worthwhile intervention from a cost-effectiveness point of view. More extensive reporting on methodology and more detailed results of sensitivity analyses would be desirable to address uncertainty and to guarantee optimal comparability between studies, for example regarding model structure, discounting, vaccine characteristics and loss of quality of life due to HZ and PHN.
Cost-effectiveness of vaccination against herpes zoster

PubMed Central

de Boer, Pieter T; Wilschut, Jan C; Postma, Maarten J

2014-01-01

Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella zoster virus vaccine has been shown to be effective in reducing the incidence and burden of illness of HZ and PHN, providing the opportunity to prevent significant health-related and financial consequences of HZ. In this review, we summarize the available literature on cost-effectiveness of HZ vaccination and discuss critical parameters for cost-effectiveness results. A search in PubMed and EMBASE was performed to identify full cost-effectiveness studies published before April 2013. Fourteen cost-effectiveness studies were included, all performed in western countries. All studies evaluated cost-effectiveness among elderly above 50 years and used costs per quality-adjusted life year (QALY) gained as primary outcome. The vast majority of studies showed vaccination of 60- to 75-year-old individuals to be cost-effective, when duration of vaccine efficacy was longer than 10 years. Duration of vaccine efficacy, vaccine price, HZ incidence, HZ incidence and discount rates were influential to the incremental cost-effectiveness ratio (ICER). HZ vaccination may be a worthwhile intervention from a cost-effectiveness point of view. More extensive reporting on methodology and more detailed results of sensitivity analyses would be desirable to address uncertainty and to guarantee optimal comparability between studies, for example regarding model structure, discounting, vaccine characteristics and loss of quality of life due to HZ and PHN. PMID:25424815
Fuel ethanol production: process design trends and integration opportunities.

PubMed

Cardona, Carlos A; Sánchez, Oscar J

2007-09-01

Current fuel ethanol research and development deals with process engineering trends for improving biotechnological production of ethanol. In this work, the key role that process design plays during the development of cost-effective technologies is recognized through the analysis of major trends in process synthesis, modeling, simulation and optimization related to ethanol production. Main directions in techno-economical evaluation of fuel ethanol processes are described as well as some prospecting configurations. The most promising alternatives for compensating ethanol production costs by the generation of valuable co-products are analyzed. Opportunities for integration of fuel ethanol production processes and their implications are underlined. Main ways of process intensification through reaction-reaction, reaction-separation and separation-separation processes are analyzed in the case of bioethanol production. Some examples of energy integration during ethanol production are also highlighted. Finally, some concluding considerations on current and future research tendencies in fuel ethanol production regarding process design and integration are presented.
Estimation of optimal educational cost per medical student.

PubMed

Yang, Eunbae B; Lee, Seunghee

2009-09-01

This study aims to estimate the optimal educational cost per medical student. A private medical college in Seoul was targeted by the study, and its 2006 learning environment and data from the 2003~2006 budget and settlement were carefully analyzed. Through interviews with 3 medical professors and 2 experts in the economics of education, the study attempted to establish the educational cost estimation model, which yields an empirically computed estimate of the optimal cost per student in medical college. The estimation model was based primarily upon the educational cost which consisted of direct educational costs (47.25%), support costs (36.44%), fixed asset purchases (11.18%) and costs for student affairs (5.14%). These results indicate that the optimal cost per student is approximately 20,367,000 won each semester; thus, training a doctor costs 162,936,000 won over 4 years. Consequently, we inferred that the tuition levels of a local medical college or professional medical graduate school cover one quarter or one-half of the per- student cost. The findings of this study do not necessarily imply an increase in medical college tuition; the estimation of the per-student cost for training to be a doctor is one matter, and the issue of who should bear this burden is another. For further study, we should consider the college type and its location for general application of the estimation method, in addition to living expenses and opportunity costs.
Communication satellite technology: State of the art and development opportunities

NASA Technical Reports Server (NTRS)

Woodford, J. B. (Compiler)

1978-01-01

Opportunities in communication satellite technology are identified and defined. Factors that tend to limit the ready availability of satellite communication to an increasingly wide group of users are evaluated. Current primary limitations on this wide utilization are the availability of frequency and/or synchronous equatorial satellite positions and the cost of individual user Earth terminals. The former could be ameliorated through the reuse of frequencies, the use of higher frequency bands, and the reduction of antenna side lobes. The latter limitation requires innovative hardware, design, careful system design, and large scale production.
Cost allocation methodology applicable to the temporary assistance for needy families program. Final rule.

PubMed

2008-07-23

This final rule applies to the Temporary Assistance for Needy Families (TANF) program and requires States, the District of Columbia and the Territories (hereinafter referred to as the "States") to use the "benefiting program" cost allocation methodology in U.S. Office of Management and Budget (OMB) Circular A-87 (2 CFR part 225). It is the judgment and determination of HHS/ACF that the "benefiting program" cost allocation methodology is the appropriate methodology for the proper use of Federal TANF funds. The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 gave federally-recognized Tribes the opportunity to operate their own Tribal TANF programs. Federally-recognized Indian tribes operating approved Tribal TANF programs have always followed the "benefiting program" cost allocation methodology in accordance with OMB Circular A-87 (2 CFR part 225) and the applicable regulatory provisions at 45 CFR 286.45(c) and (d). This final rule contains no substantive changes to the proposed rule published on September 27, 2006.
Market opportunities in Canada for multimedia residential services in rural and small urban areas

NASA Technical Reports Server (NTRS)

Shariatmadar, Mehran; Narasimhan, Vasantha

1995-01-01

This paper reviews the studies which were undertaken jointly by Telesat and Industry Canada to provide an estimate of the market opportunities for residential multi-media services in the rural and small urban areas of Canada. This study is part of the Advanced Satcom program, a Ka-band satellite system proposal which is currently in the implementation proposal phase by the government and the Canadian space industry of which Telesat is an active member. Advanced Satcom extends the reach of terrestrial information highways to the remote and sparsely populated parts of the country in a cost-effective manner and thus provides a ubiquitous coverage of the information highways to all Canadians. Therefore, the rural and small urban markets are believed to be good opportunities for the Advanced Satcom. Although the results are primarily intended for fixed residential applications, they can also be used as input to market opportunity studies for wideband mobile applications.
Aging in the United States: Opportunities and Challenges for Otolaryngology-Head and Neck Surgery.

PubMed

Chiu, Brandon L; Pinto, Jayant M

2018-05-17

The number of Americans over the age of 65 has been growing much faster than the overall population's growth rate. These changes can be largely attributed to the improvement in life expectancy. This demographic shift yields a unique and exciting opportunity to provide both expedient and cost-efficient care to a growing patient population. Copyright © 2018 Elsevier Inc. All rights reserved.
Making the Most of Opportunities to Learn What Works: A School District's Guide. REL 2014-048

ERIC Educational Resources Information Center

Akers, Lauren; Resch, Alexandra; Berk, Jillian

2014-01-01

This guide for district and school leaders shows how to recognize opportunities to embed randomized controlled trials (RCTs) into planned policies or programs. Opportunistic RCTs can generate strong evidence for informing education decisions--with minimal added cost and disruption. The guide also outlines the key steps to conduct RCTs and responds…
E-Learning: opportunity or end of field classes?

NASA Astrophysics Data System (ADS)

Bloemertz, Lena; Kuhn, Brigitte; Kuhn, Nikolaus J.

2013-04-01

E-Learning is often seen as an opportunity to avoid the costs of field classes by using new digital media to communicate content to students that otherwise could only be seen in the field. However, feeling, tasting and smelling soil on a farm or in a forest cannot be substituted via the internet. To achieve some teaching efficiency, an course on e-learning introduced at the University of Basel therefore took an opposite approach: instead of compromising the field experience, the opportunities to broaden access and generate flexibility for the students and instructors during the lecture room section of a soil science and land use course were maximised. The course has six topics, each e-learning element is designed to take one week of the studentśself study time devoted to the course. Three one-day field classes spread over the term offer an opportunity to the students to become acquainted with common soil types in the region of Basel and typical land use. The latter emphasizes visits to farms to ensure that the perspective of the farmers on their and soils and business is communicated to the students. The field classes also ensure sufficient contact time between instructors and students. The informal time spend together during the days in the field also ensures to address individual questions of the students. Overall, the format of the course ensures that the field experience and instructor presence are offered where needed and that e-learning is used to replace formal contact time where self-study is possible.
New design opportunities with OVI

NASA Astrophysics Data System (ADS)

Bleikolm, Anton F.

1998-04-01

Optically Variable Ink (OVITM) chosen for its unique colour shifting properties is applied to the currencies of more than 50 countries. An significant colour difference at viewing angles of 90 degrees and 30 degrees respectively makes colour copying impossible. New manufacturing techniques for the interference pigment (OVP) provide ever better cost/performance ratios. Screen printing presses newly available on the market guarantee production speeds of 8000 sheets/hour or 130 meters/minute in the case of web printing, perfectly in line with the traditional equipment for manufacturing of currency. Specifically developed ink formulations allow UV-curing at high speed or oxidative drying to create highly mechanically and chemically resistant colour shifting prints. The unique colour shifting characteristics together with overprinting in intaglio give design opportunities providing the best protection against colour copying or commercial reprint. Specific designs of OVP together with high security ingredients allow the formulation of machine readable optically variable inks useful for the authentication and sorting of documents.
Cost-Control Mechanisms in Canadian Private Drug Plans

PubMed Central

Kratzer, Jillian; McGrail, Kimberlyn; Strumpf, Erin; Law, Michael R.

2013-01-01

Approximately 68% of Canadians receive prescription drug coverage through an employer-sponsored private plan. However, we have very limited data on the structure of these plans. This study aims to identify and describe the use of cost-control mechanisms in private drug plans in Canada and describe what private coverage looks like for the average Canadian. Using 2010 data from over 113,000 different private drug plans, provided by Applied Management Consultants, we determined the overall use of key cost-control measures, and the cost-control tools that appear to be gaining currency compared to a report on benefits coverage in 1998. We found that the use of common cost-control measures is relatively low among Canadian private benefits programs. Co-insurance is much more common in private coverage plans than co-payments. Deductibles are uncommon in Canada and, when in place, are very small. The use of annual and lifetime maximums is increasing. Canadian private benefits programs use few cost-control measures to respond to increasing costs, particularly in comparison to their public counterparts. These results suggest there are ample opportunities for greater efficiency in private sector drug coverage plans. PMID:23968672
Opportunities in biotechnology.

PubMed

Gartland, Kevan M A; Gartland, Jill S

2018-06-08

Strategies for biotechnology must take account of opportunities for research, innovation and business growth. At a regional level, public-private collaborations provide potential for such growth and the creation of centres of excellence. By considering recent progress in areas such as genomics, healthcare diagnostics, synthetic biology, gene editing and bio-digital technologies, opportunities for smart, strategic and specialised investment are discussed. These opportunities often involve convergent or disruptive technologies, combining for example elements of pharma-science, molecular biology, bioinformatics and novel device development to enhance biotechnology and the life sciences. Analytical applications use novel devices in mobile health, predictive diagnostics and stratified medicine. Synthetic biology provides opportunities for new product development and increased efficiency for existing processes. Successful centres of excellence should promote public-private business partnerships, clustering and global collaborations based on excellence, smart strategies and innovation if they are to remain sustainable in the longer term. Copyright © 2018. Published by Elsevier B.V.
What opportunities are available for resident involvement in national orthopedic and subspecialty societies?

PubMed

Dy, Christopher J; Cross, Michael B; Osbahr, Daryl C; Parks, Michael L; Green, Daniel W

2011-10-05

As physician involvement in health policy grows, there will be an increasing need for future leaders in orthopedics. Interested orthopedic residents may be unaware of opportunities for leadership involvement in professional and subspecialty organizations. This article investigates whether national and subspecialty organizations offer membership to residents, allow residents to participate in committees, and provide opportunities for scholarly activity and mentorship. The authors surveyed 20 national orthopedic professional and subspecialty societies to evaluate the availability and cost of resident membership, meeting attendance and participation, research funding, committee membership, and mentorship opportunities. Each society's Web site was reviewed, and societies were contacted by phone if further inquiry was needed. Of the 20 orthopedic societies surveyed, 11 allowed resident membership. Five of 20 societies allowed residents to serve on committees, with a total of 14 total positions for residents. Four organizations provided formalized mentorship programs to residents. Although opportunities for resident involvement in subspecialty and professional societies are available in the majority of groups surveyed, the Orthopaedic Trauma Association and American Society for Surgery of the Hand provided the most comprehensive collection of opportunities. Residents should also pursue involvement in other organizations that may be more readily accessible, such as local, state, and regional orthopedic and medical societies. Increased resident participation in these organizations may help in increasing the 14 nationally available committee positions for orthopedic residents. Our orthopedic profession and societies should encourage motivated residents to pursue involvement and leadership at the national level. Copyright 2011, SLACK Incorporated.
Using social media to enhance career development opportunities for health promotion professionals.

PubMed

Roman, Leah A

2014-07-01

For health promotion professionals, social media offers many ways to engage with a broader range of colleagues; participate in professional development events; promote expertise, products, or services; and learn about career-enhancing opportunities such as funding and fellowships. Previous work has recommended "building networking into what you are already doing." This article provides updated and new social media resources, as well as practical examples and strategies to promote effective use of social media. Social media offers health promotion professionals cost-effective opportunities to enhance their career by building communities of practice, participating in professional development events, and enriching classroom learning. Developing the skills necessary to use social media for networking is important in the public health workforce, especially as social media is increasingly used in academic and practice settings. © 2014 Society for Public Health Education.

The Kaiser Permanente implant registries: effect on patient safety, quality improvement, cost effectiveness, and research opportunities.

PubMed

Paxton, Elizabeth W; Inacio, Maria Cs; Kiley, Mary-Lou

2012-01-01

Considering the high cost, volume, and patient safety issues associated with medical devices, monitoring of medical device performance is critical to ensure patient safety and quality of care. The purpose of this article is to describe the Kaiser Permanente (KP) implant registries and to highlight the benefits of these implant registries on patient safety, quality, cost effectiveness, and research. Eight KP implant registries leverage the integrated health care system's administrative databases and electronic health records system. Registry data collected undergo quality control and validation as well as statistical analysis. Patient safety has been enhanced through identification of affected patients during major recalls, identification of risk factors associated with outcomes of interest, development of risk calculators, and surveillance programs for infections and adverse events. Effective quality improvement activities included medical center- and surgeon-specific profiles for use in benchmarking reports, and changes in practice related to registry information output. Among the cost-effectiveness strategies employed were collaborations with sourcing and contracting groups, and assistance in adherence to formulary device guidelines. Research studies using registry data included postoperative complications, resource utilization, infection risk factors, thromboembolic prophylaxis, effects of surgical delay on concurrent injuries, and sports injury patterns. The unique KP implant registries provide important information and affect several areas of our organization, including patient safety, quality improvement, cost-effectiveness, and research.
ELaNa - Educational Launch of Nanosatellite Providing Routine RideShare Opportunities

NASA Technical Reports Server (NTRS)

Skrobot, Garrett Lee; Coelho, Roland

2012-01-01

rideshare carrier system is not always cost effective. Sometimes a launch vehicle with an excellent performance record appears to be a great rideshare candidate however, after completing a feasibility study, LSP may determine that the cost of the rideshare carrier system is too great and, due to budget constraints, the development cannot go forward. With the current budget environment, one cost effective way to secure rideshare opportunities is to look for synergy with other government organizations that share the same interest.
A cost-efficient frequency-domain photoacoustic imaging system

PubMed Central

LeBoulluec, Peter; Liu, Hanli; Yuan, Baohong

2013-01-01

Photoacoustic (PA) imaging techniques have recently attracted much attention and can be used for noninvasive imaging of biological tissues. Most PA imaging systems in research laboratories use the time domain method with expensive nanosecond pulsed lasers that are not affordable for most educational laboratories. Using an intensity modulated light source to excite PA signals is an alternative technique, known as the frequency domain method, with a much lower cost. In this paper, we describe a simple frequency domain PA system and demonstrate its imaging capability. The system provides opportunities not only to observe PA signals in tissue phantoms, but also to acquire hands-on skills in PA signal detection. It also provides opportunities to explore the underlying mechanisms of the PA effect. PMID:24659823
A cost-efficient frequency-domain photoacoustic imaging system.

PubMed

Leboulluec, Peter; Liu, Hanli; Yuan, Baohong

2013-09-01

Photoacoustic (PA) imaging techniques have recently attracted much attention and can be used for noninvasive imaging of biological tissues. Most PA imaging systems in research laboratories use the time domain method with expensive nanosecond pulsed lasers that are not affordable for most educational laboratories. Using an intensity modulated light source to excite PA signals is an alternative technique, known as the frequency domain method, with a much lower cost. In this paper, we describe a simple frequency domain PA system and demonstrate its imaging capability. The system provides opportunities not only to observe PA signals in tissue phantoms, but also to acquire hands-on skills in PA signal detection. It also provides opportunities to explore the underlying mechanisms of the PA effect.
Variation in the cost of care for primary total knee arthroplasties.

PubMed

Haas, Derek A; Kaplan, Robert S

2017-03-01

The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.
Opportunities for Efficiency and Innovation: A Primer on How to Cut College Costs. Working Paper 2011-02

ERIC Educational Resources Information Center

Fried, Vance H.

2011-01-01

In this paper the author explores how colleges whose primary mission is undergraduate education can strategically allocate resources in a way that reduces costs and prioritizes teaching and learning. He starts from a provocative thought-experiment--what would it cost to educate undergraduates at a hypothetical college built from scratch?--and uses…
Cost effectiveness of recycling: A systems model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tonjes, David J., E-mail: david.tonjes@stonybrook.edu; Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000; Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044

Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have alsomore » found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.« less
29 CFR 1625.10 - Costs and benefits under employee benefit plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... discrimination on the basis of age. Section 4(a) in particular makes it unlawful for an employer to “discriminate... Section 1625.10 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION AGE DISCRIMINATION IN EMPLOYMENT ACT Interpretations § 1625.10 Costs and benefits under employee...
Costs and Benefits of Electronic Portfolios in Teacher Education: Student Voices

ERIC Educational Resources Information Center

Wetzel, Keith; Strudler, Neal

2006-01-01

This descriptive study investigated the benefits and costs of using electronic portfolios (EPs) in preservice teacher education by examining the voices of students in six programs thought to be mature in their implementation. Benefits included opportunities to reflect, better access to and organization of professional documents, increased…
On the Path to SunShot. The Role of Advancements in Solar Photovoltaic Efficiency, Reliability, and Costs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woodhouse, Michael; Jones-Albertus, Rebecca; Feldman, David

2016-05-01

This report examines the remaining challenges to achieving the competitive photovoltaic (PV) costs and large-scale deployment envisioned under the U.S. Department of Energy's SunShot Initiative. Solar-energy cost reductions can be realized through lower PV module and balance-of-system (BOS) costs as well as improved system efficiency and reliability. Numerous combinations of PV improvements could help achieve the levelized cost of electricity (LCOE) goals because of the tradeoffs among key metrics like module price, efficiency, and degradation rate as well as system price and lifetime. Using LCOE modeling based on bottom-up cost analysis, two specific pathways are mapped to exemplify the manymore » possible approaches to module cost reductions of 29%-38% between 2015 and 2020. BOS hardware and soft cost reductions, ranging from 54%-77% of total cost reductions, are also modeled. The residential sector's high supply-chain costs, labor requirements, and customer-acquisition costs give it the greatest BOS cost-reduction opportunities, followed by the commercial sector, although opportunities are available to the utility-scale sector as well. Finally, a future scenario is considered in which very high PV penetration requires additional costs to facilitate grid integration and increased power-system flexibility--which might necessitate even lower solar LCOEs. The analysis of a pathway to 3-5 cents/kWh PV systems underscores the importance of combining robust improvements in PV module and BOS costs as well as PV system efficiency and reliability if such aggressive long-term targets are to be achieved.« less
Cost analysis of a primary health centre in northern India.

PubMed

Anand, K; Kapoor, S K; Pandav, C S

1993-01-01

Cost data are useful in health planning, budgeting and for assessing the efficiency of services. However, such data are not easily available from developing countries. We therefore estimated the cost incurred for the year 1991-92 on a primary health centre in northern India, which is affiliated to an academic institution. The total costs incurred included the capital costs for land, building, furniture, vehicles and equipment as well as the recurrent costs for salaries, drugs and vaccines, diesel and maintenance. Except for land, where the 'opportunity cost' was calculated, the current market rates were considered for all other factors. A discount rate of 10% was used in the study. A total of Rs 777,015 (US $24,282) was incurred on the primary health centre in the study year, 80% being recurrent costs. Salaries constituted 62% of the total costs. A sum of Rs 30 (US $0.94) per head per year on primary health care was being incurred. Salaries constitute the bulk of the cost incurred on health. Approximately Rs 28 (40%) of the Rs 69 spent per head per year on health services by the Government of India is incurred on providing primary health care services.
Dairy farm cost efficiency in leading milk-producing regions in Poland.

PubMed

Sobczyński, T; Klepacka, A M; Revoredo-Giha, C; Florkowski, W J

2015-12-01

This paper examines the cost efficiency of dairy farms in 2 important regions of commercial milk production in Poland (i.e., Wielkopolskie and Podlaskie). Both regions gained importance following the market-driven resource allocation mechanism adopted after Poland's transition to the market economy in 1989 and accession to the European Union (EU) in 2004. The elimination of the dairy quota system in the EU in 2015 offers new expansion opportunities. The analysis of trends in cow numbers, milk production, and yield per cow shows different patterns of expansion of the dairy sector in the 2 regions. We selected dairy farm data from the Farm Accounts Data Network database for both regions and applied the cost frontier estimation model to calculate the relative cost-efficiency index for the period 2004 to 2009. The indexes compare each farm in the sample to the most efficient dairy farm in each region separately. Additionally, the top 5% of dairy farms with the highest relative cost efficiency index from each region were compared in terms of production costs with published results from a study using the representative farm approach. The comparison of results from 2 different studies permits a conclusion that Wielkopolskie and Podlaskie dairy farms are able to compete with farms from the 4 largest milk-producing countries in the EU. Although both regions can improve yields per cow, especially Podlaskie, both regions are likely to take advantage of the expansion opportunities offered by the 2015 termination of the milk quota system. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
The cost of implementing inpatient bar code medication administration.

PubMed

Sakowski, Julie Ann; Ketchel, Alan

2013-02-01

To calculate the costs associated with implementing and operating an inpatient bar-code medication administration (BCMA) system in the community hospital setting and to estimate the cost per harmful error prevented. This is a retrospective, observational study. Costs were calculated from the hospital perspective and a cost-consequence analysis was performed to estimate the cost per preventable adverse drug event averted. Costs were collected from financial records and key informant interviews at 4 not-for profit community hospitals. Costs included direct expenditures on capital, infrastructure, additional personnel, and the opportunity costs of time for existing personnel working on the project. The number of adverse drug events prevented using BCMA was estimated by multiplying the number of doses administered using BCMA by the rate of harmful errors prevented by interventions in response to system warnings. Our previous work found that BCMA identified and intercepted medication errors in 1.1% of doses administered, 9% of which potentially could have resulted in lasting harm. The cost of implementing and operating BCMA including electronic pharmacy management and drug repackaging over 5 years is $40,000 (range: $35,600 to $54,600) per BCMA-enabled bed and $2000 (range: $1800 to $2600) per harmful error prevented. BCMA can be an effective and potentially cost-saving tool for preventing the harm and costs associated with medication errors.
Bold Leadership, Real Reform 2.0: Improving Efficiency, Cutting Costs, and Expanding College Opportunity

ERIC Educational Resources Information Center

American Council of Trustees and Alumni, 2017

2017-01-01

Trustees face complex choices related to costs and efficiency as they navigate new accountability policies, financial headwinds, and a changing global marketplace for college education. The latest release in a series of trustee guides from the American Council of Trustees and Alumni's Institute for Effective Governance, "Bold Leadership, Real…
Opportunity Rocks!

NASA Technical Reports Server (NTRS)

2004-01-01

This high-resolution image captured by the Mars Exploration Rover Opportunity's panoramic camera shows in superb detail a portion of the puzzling rock outcropping that scientists are eagerly planning to investigate. Presently, Opportunity is on its lander facing northeast; the outcropping lies to the northwest. These layered rocks measure only 10 centimeters (4 inches) tall and are thought to be either volcanic ash deposits or sediments carried by water or wind. The small rock in the center is about the size of a golf ball.
Ares V: New Opportunities for Scientific Payloads

NASA Technical Reports Server (NTRS)

Creech, Steve

2009-01-01

What if scientists and payload planners had access to three to five times the volume and five to nine times the mass provided by today's launch vehicles? This simple question can lead to numerous exciting possibilities, all involving NASA's new Ares V cargo launch vehicle now on the drawing board. Multiple scientific fields and payload designers have that opportunity with the Ares V cargo launch vehicle, being developed at NASA as the heavy-lift component of the U.S. Space Exploration Policy. When the Ares V begins flying late next decade, its capabilities will significantly exceed the 1960s-era Saturn V or the current Space Shuttle, while it benefits from their engineering, manufacturing, and infrastructure heritage. It will send more crew and cargo to more places on the lunar surface than Apollo and provide ongoing support to a permanent lunar outpost. Moreover, it will restore a strategic heavy-lift U.S. asset, which can support human and robotic exploration and scientific ventures for decades to come. Assessment of astronomy payload requirements since Spring 2008 has indicated that Ares V has the potential to support a range of payloads and missions. Some of these missions were impossible in the absence of Ares V's capabilities. Collaborative design/architecture inputs, exchanges, and analyses have already begun between scientists and payload developers. A 2008 study by a National Research Council (NRC) panel, as well as analyses presented by astronomers and planetary scientists at two weekend conferences in 2008, support the position that Ares V has benefit to a broad range of planetary and astronomy missions. This early dialogue with Ares V engineers is permitting the greatest opportunity for payload/transportation/mission synergy and the least financial impact to Ares V development. In addition, independent analyses suggest that Ares V has the opportunity to enable more cost-effective mission design.
Cost minimization analysis of different growth hormone pen devices based on time-and-motion simulations.

PubMed

Nickman, Nancy A; Haak, Sandra W; Kim, Jaewhan

2010-04-08

Numerous pen devices are available to administer recombinant Human Growth Hormone (rhGH), and both patients and health plans have varying issues to consider when selecting a particular product and device for daily use. Therefore, the present study utilized multi-dimensional product analysis to assess potential time involvement, required weekly administration steps, and utilization costs relative to daily rhGH administration. Study objectives were to conduct 1) Time-and-Motion (TM) simulations in a randomized block design that allowed time and steps comparisons related to rhGH preparation, administration and storage, and 2) a Cost Minimization Analysis (CMA) relative to opportunity and supply costs. Nurses naïve to rhGH administration and devices were recruited to evaluate four rhGH pen devices (2 in liquid form, 2 requiring reconstitution) via TM simulations. Five videotaped and timed trials for each product were evaluated based on: 1) Learning (initial use instructions), 2) Preparation (arrange device for use), 3) Administration (actual simulation manikin injection), and 4) Storage (maintain product viability between doses), in addition to assessment of steps required for weekly use. The CMA applied micro-costing techniques related to opportunity costs for caregivers (categorized as wages), non-drug medical supplies, and drug product costs. Norditropin(R) NordiFlex and Norditropin(R) NordiPen (NNF and NNP, Novo Nordisk, Inc., Bagsvaerd, Denmark) took less weekly Total Time (p < 0.05) to use than either of the comparator products, Genotropin(R) Pen (GTP, Pfizer, Inc, New York, New York) or HumatroPen(R) (HTP, Eli Lilly and Company, Indianapolis, Indiana). Time savings were directly related to differences in new package Preparation times (NNF (1.35 minutes), NNP (2.48 minutes) GTP (4.11 minutes), HTP (8.64 minutes), p < 0.05)). Administration and Storage times were not statistically different. NNF (15.8 minutes) and NNP (16.2 minutes) also took less time to Learn
Research Opportunities in Space Propulsion

NASA Technical Reports Server (NTRS)

Rodgers, Stephen L.

2007-01-01

Rocket propulsion determines the primary characteristics of any space vehicle; how fast and far it can go, its lifetime, and its capabilities. It is the primary factor in safety and reliability and the biggest cost driver. The extremes of heat and pressure produced by propulsion systems push the limits of materials used for manufacturing. Space travel is very unforgiving with little room for errors, and so many things can go wrong with these very complex systems. So we have to plan for failure and that makes it costly. But what is more exciting than the roar of a rocket blasting into space? By its nature the propulsion world is conservative. The stakes are so high at every launch, in terms of payload value or in human life, that to introduce new components to a working, qualified system is extremely difficult and costly. Every launch counts and no risks are tolerated, which leads to the space world's version of Catch-22:"You can't fly till you flown." The last big 'game changer' in propulsion was the use of liquid hydrogen as a fuel. No new breakthrough, low cost access to space system will be developed without new efficient propulsion systems. Because there is no large commercial market driving investment in propulsion, what propulsion research is done is sponsored by government funding agencies. A further difficulty in propulsion technology development is that there are so few new systems flying. There is little opportunity to evolve propulsion technologies and to update existing systems with results coming out of research as there is in, for example, the auto industry. The biggest hurdle to space exploration is getting off the ground. The launch phase will consume most of the energy required for any foreseeable space exploration mission. The fundamental physical energy requirements of escaping earth's gravity make it difficult. It takes 60,000 kJ to put a kilogram into an escape orbit. The vast majority (-97%) of the energy produced by a launch vehicle is used
Measuring costs of data collection at village clinics by village doctors for a syndromic surveillance system-a cross sectional survey from China.

PubMed

Ding, Yan; Fei, Yang; Xu, Biao; Yang, Jun; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

2015-07-25

Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors expressed their willingness to join in the surveillance if a proper subsidy was provided. This study aims to measure the costs of data collection by village clinics to provide a reference regarding the subsidy level required for village clinics to participate in data collection. We conducted a cross-sectional survey with a village clinic questionnaire and a staff questionnaire using a purposive sampling strategy. We tracked reported events using the ISSC internal database. Cost data included staff time, and the annual depreciation and opportunity costs of computers. We measured the village doctors' time costs for data collection by multiplying the number of full time employment equivalents devoted to the surveillance by the village doctors' annual salaries and benefits, which equaled their net incomes. We estimated the depreciation and opportunity costs of computers by calculating the equivalent annual computer cost and then allocating this to the surveillance based on the percentage usage. The estimated total annual cost of collecting data was 1,423 Chinese Renminbi (RMB) in 2012 (P25 = 857, P75 = 3284), including 1,250 RMB (P25 = 656, P75 = 3000) staff time costs and 134 RMB (P25 = 101, P75 = 335) depreciation and opportunity costs of computers. The total costs of collecting data from the village clinics for the syndromic surveillance system was calculated to be low compared with the individual net income in County A.
Innovative approach for low-cost quick-access small payload missions

NASA Astrophysics Data System (ADS)

Friis, Jan W., Jr.

2000-11-01

A significant part of the burgeoning commercial space industry is placing an unprecedented number of satellites into low earth orbit for a variety of new applications and services. By some estimates the commercial space industry now exceeds that of government space activities. Yet the two markets remain largely separate, with each deploying dedicated satellites and infrastructure for their respective missions. One commercial space firm, Final Analysis, has created a new program wherein either government, scientific or new technology payloads can be integrated on a commercial spacecraft on commercial satellites for a variety of mission scenarios at a fraction of the cost of a dedicated mission. NASA has recognized the advantage of this approach, and has awarded the Quick Ride program to provide frequent, low cost flight opportunities for small independent payloads aboard the Final Analysis constellation, and investigators are rapidly developing science programs that conform to the proposed payload accommodations envelope. Missions that were not feasible using dedicated launches are now receiving approval under the lower cost Quick Ride approach. Final Analysis has dedicated ten out of its thirty-eight satellites in support of the Quick Ride efforts. The benefit of this type of space access extend beyond NASA science programs. Commercial space firms can now gain valuable flight heritage for new technology and satellite product offerings. Further, emerging international space programs can now place a payload in orbit enabling the country to allocate its resources against the payload and mission requirements rather htan increased launch costs of a dedicated spacecraft. Finally, the low cost nature provides University-based research educational opportunities previously out of the reach of most space-related budgets. This paper will describe the motivation, benefits, technical features, and program costs of the Final Analysis secondary payload program. Payloads can be

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

PubMed

Yildiz, M Said; Khan, M Mahmud

2016-08-12

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

PubMed

Lindstrom, D P

1996-08-01

I analyze the influence of the economic characteristics of origin area on trip duration for Mexican migrants in the United States. I argue that migrants from economically dynamic areas in Mexico with favorable opportunities for employment and small capital investment have a larger incentive to stay in the United States longer and to withstand the psychic costs of separation from family and friends than do migrants from economically stagnant areas in Mexico, where the productive uses of savings are severely limited. In line with this argument we should expect investment opportunities in migrants' origin areas to be associated positively with migrants' trip duration in the United States. To test this hypothesis I use individual- and household-level data on U.S. migration experience collected in 13 Mexican communities. Evidence from parametric hazards models supports the idea that economic characteristics of origin areas influence the motivations and strategies of Mexican migrants in the United States.
Costs of epilepsy in an intermediate care facility for persons with mental retardation.

PubMed

Burke, T A; McKee, J R; Pathak, D S; Donahue, R M; Parasuraman, T V; Batenhorst, A S

1999-03-01

Epilepsy is a significant comorbid condition in institutionalized persons with developmental disabilities and may contribute significant additional costs. This study was conducted to provide an estimate of the costs of epilepsy from the institutional perspective. Costs were measured retrospectively for 50 persons with epilepsy and 50 persons without epilepsy matched by severity of developmental disability. A time and motion study was employed to assign opportunity costs to documented nursing and physician activities. Two separate methods of attribution were used and incremental costs attributable to epilepsy were found to be approximately $825 and $918 per person over a 6-month period. The following categories accounted for costs: personnel (47.0%), drug (39.6%), hospitalization (9.4%), and laboratories/procedures (4.0%). Results are useful for describing the economic burden of epilepsy.
Cyberlearning for Climate Literacy: Challenges and Opportunities

NASA Astrophysics Data System (ADS)

McCaffrey, M. S.; Buhr, S. M.; Gold, A. U.; Ledley, T. S.; Mooney, M. E.; Niepold, F.

2010-12-01

Cyberlearning tools provide cost and carbon-efficient avenues for fostering a climate literate society through online engagement with learners. With climate change education becoming a Presidential Priority in 2009, funding for grants from NSF, NASA and NOAA is leading to a new generation of cyberlearning resources that supplement existing online resources. This paper provides an overview of challenges and opportunities relating to the online delivery of high quality, often complex climate science by examining several existing and emerging efforts, including the Climate Literacy and Energy Awareness Network (CLEAN,) a National Science Digital Library Pathway, the development by CIRES Education and Outreach of the Inspiring Climate Education Excellence (ICEE) online course, TERC’s Earth Exploration Toolbook (EET,) DataTools, and EarthLab modules, the NOAA Climate Stewards Education Program (CSEP) that utilizes the NSTA E-Learning Center, online efforts by members of the Federation of Earth Science Information Partners (ESIP), UCAR’s Climate Discovery program, and the Climate Adaptation, Mitigation e-Learning (CAMeL) project. In addition, we will summarize outcomes of the Cyberlearning for Climate Literacy workshop held in Washington DC in the Fall of 2009 and examine opportunities for teachers to develop and share their own lesson plans based on climate-related web resources that currently lack built-in learning activities, assessments or teaching tips.
Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD)

PubMed Central

Hübner, Claudia; Hübner, Nils-Olaf; Muhr, Michaela; Claus, Franziska; Leesch, Henning; Kramer, Axel; Flessa, Steffen

2015-01-01

Aim: Clostridium difficile-associated diarrhea (CDAD) causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted. Method: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated. Results: 19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98), pharmaceuticals (€ 22.88) and laboratory (€ 17.44) are quite low. Conclusion: CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results. PMID:26550553
Cost-Reduction Roadmap for Residential Solar Photovoltaics (PV), 2017-2030

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cook, Jeffrey J.; Ardani, Kristen B.; Margolis, Robert M.

The installed cost of solar photovoltaics (PV) has fallen rapidly in recent years and is expected to continue declining in the future. In this report, we focus on the potential for continued PV cost reductions in the residential market. From 2010 to 2017, the levelized cost of energy (LCOE) for residential PV declined from 52 cents per kilowatt-hour (cents/kWh) to 16 cents/kWh (Fu et al. 2017). The U.S. Department of Energy's (DOE's) Solar Energy Technologies Office (SETO) recently set new LCOE targets for 2030, including a target of 5 cents/kWh for residential PV. We present a roadmap for achieving themore » SETO 2030 residential PV target. Because the 2030 target likely will not be achieved under business-as-usual trends (NREL 2017), we examine two key market segments that demonstrate significant opportunities for cost savings and market growth: installing PV at the time of roof replacement and installing PV as part of the new home construction process. Within both market segments, we identify four key cost-reduction opportunities: market maturation, business model integration, product innovation, and economies of scale. To assess the potential impact of these cost reductions, we compare modeled residential PV system prices in 2030 to the National Renewable Energy Laboratory's (NREL's) quarter one 2017 (Q1 2017) residential PV system price benchmark (Fu et al. 2017). We use a bottom-up accounting framework to model all component and project-development costs incurred when installing a PV system. The result is a granular accounting for 11 direct and indirect costs associated with installing a residential PV system in 2030. All four modeled pathways demonstrate significant installed-system price savings over the Q1 2017 benchmark, with the visionary pathways yielding the greatest price benefits. The largest modeled cost savings are in the supply chain, sales and marketing, overhead, and installation labor cost categories. When we translate these installed
COTSAT Small Spacecraft Cost Optimization for Government and Commercial Use

NASA Technical Reports Server (NTRS)

Swank, Aaron J.; Bui, David; Dallara, Christopher; Ghassemieh, Shakib; Hanratty, James; Jackson, Evan; Klupar, Pete; Lindsay, Michael; Ling, Kuok; Mattei, Nicholas;

2009-01-01

Cost Optimized Test of Spacecraft Avionics and Technologies (COTSAT-1) is an ongoing spacecraft research and development project at NASA Ames Research Center (ARC). The prototype spacecraft, also known as CheapSat, is the first of what could potentially be a series of rapidly produced low-cost spacecraft. The COTSAT-1 team is committed to realizing the challenging goal of building a fully functional spacecraft for $500K parts and $2.0M labor. The project's efforts have resulted in significant accomplishments within the scope of a limited budget and schedule. Completion and delivery of the flight hardware to the Engineering Directorate at NASA Ames occurred in February 2009 and a cost effective qualification program is currently under study. The COTSAT-1 spacecraft is now located at NASA Ames Research Center and is awaiting a cost effective launch opportunity. This paper highlights the advancements of the COTSAT-1 spacecraft cost reduction techniques.

Career development. Opportunity 2000.

PubMed

Adams, J

Opportunity 2000 is an initiative designed to increase the role of women in the workforce and to promote equal opportunities in the workplace. The NHS Management Executive has set up a women's unit to put Opportunity 2000 into practice and to develop more 'women-friendly' working practices. The unit has produced a good practice handbook. The article discusses the eight goals produced by the NHSME to be achieved by health authorities and trusts by this year.
Cost savings through implementation of an integrated home-based record: a case study in Vietnam.

PubMed

Aiga, Hirotsugu; Pham Huy, Tuan Kiet; Nguyen, Vinh Duc

2018-03-01

In Vietnam, there are three major home-based records (HBRs) for maternal and child health (MCH) that have been already nationally scaled up, i.e., Maternal and Child Health Handbook (MCH Handbook), Child Vaccination Handbook, and Child Growth Monitoring Chart. The MCH Handbook covers all the essential recording items that are included in the other two. This overlapping of recording items between the HBRs is likely to result in inefficient use of both financial and human resources. This study is aimed at estimating the magnitude of cost savings that are expected to be realized through implementing exclusively the MCH Handbook by terminating the other two. Secondary data collection and analyses on HBR production and distribution costs and health workers' opportunity costs. Through multiplying the unit costs by their respective quantity multipliers, recurrent costs of operations of three HBRs were estimated. Moreover, magnitude of cost savings likely to be realized was estimated, by calculating recurrent costs overlapping between the three HBRs. It was estimated that implementing exclusively the MCH Handbook would lead to cost savings of United States dollar 3.01 million per annum. The amount estimated is minimum cost savings because only recurrent cost elements (HBR production and distribution costs and health workers' opportunity costs) were incorporated into the estimation. Further indirect cost savings could be expected through reductions in health expenditures, as the use of the MCH Handbook would contribute to prevention of maternal and child illnesses by increasing antenatal care visits and breastfeeding practices. To avoid wasting financial and human resources, the MCH Handbook should be exclusively implemented by abolishing the other two HBRs. This study is globally an initial attempt to estimate cost savings to be realized through avoiding overlapping operations between multiple HBRs for MCH. Copyright © 2017 The Royal Society for Public Health. Published
Launching Science: Science Opportunities Provided by NASA's Constellation System

NASA Technical Reports Server (NTRS)

2008-01-01

In 2004 NASA began implementation of the first phases of a new space exploration policy. This implementation effort included the development of a new human-carrying spacecraft, known as Orion; the Altair lunar lander; and two new launch vehicles, the Ares I and Ares V rockets.collectively called the Constellation System (described in Chapter 5 of this report). The Altair lunar lander, which is in the very preliminary concept stage, is not discussed in detail in the report. In 2007 NASA asked the National Research Council (NRC) to evaluate the science opportunities enabled by the Constellation System. To do so, the NRC established the Committee on Science Opportunities Enabled by NASA's Constellation System. In general, the committee interpreted "Constellation-enabled" broadly, to include not only mission concepts that required Constellation, but also those that could be significantly enhanced by Constellation. The committee intends this report to be a general overview of the topic of science missions that might be enabled by Constellation, a sort of textbook introduction to the subject. The mission concepts that are reviewed in this report should serve as general examples of kinds of missions, and the committee s evaluation should not be construed as an endorsement of the specific teams that developed the mission concepts or of their proposals. Additionally, NASA has a well-developed process for establishing scientific priorities by asking the NRC to conduct a "decadal survey" for a particular discipline. Any scientific mission that eventually uses the Constellation System will have to be properly evaluated by means of this decadal survey process. The committee was impressed with the scientific potential of many of the proposals that it evaluated. However, the committee notes that the Constellation System has been justified by NASA and selected in order to enable human exploration beyond low Earth orbit.not to enable science missions. Virtually all of the science
Mapping Malaria Risk in Low Transmission Settings: Challenges and Opportunities.

PubMed

Sturrock, Hugh J W; Bennett, Adam F; Midekisa, Alemayehu; Gosling, Roly D; Gething, Peter W; Greenhouse, Bryan

2016-08-01

As malaria transmission declines, it becomes increasingly focal and prone to outbreaks. Understanding and predicting patterns of transmission risk becomes an important component of an effective elimination campaign, allowing limited resources for control and elimination to be targeted cost-effectively. Malaria risk mapping in low transmission settings is associated with some unique challenges. This article reviews the main challenges and opportunities related to risk mapping in low transmission areas including recent advancements in risk mapping low transmission malaria, relevant metrics, and statistical approaches and risk mapping in post-elimination settings. Copyright © 2016. Published by Elsevier Ltd.
Mangrove and Freshwater Wetland Conservation Through Carbon Offsets: A Cost-Benefit Analysis for Establishing Environmental Policies

NASA Astrophysics Data System (ADS)

Vázquez-González, César; Moreno-Casasola, Patricia; Hernández, María Elizabeth; Campos, Adolfo; Espejel, Ileana; Fermán-Almada, José Luis

2017-02-01

Mexico has extensive coastal wetlands (4,243,137 ha), and one of its most important sites is the Alvarado Lagoon System, located in the Papaloapan River Basin on the Gulf of Mexico. The land cover dedicated to livestock and sugarcane has increased: by 25 % in 2005 and 50 % in 2010, with a loss of wetland vegetation and the carbon that it stores. We found that the Net Present Value of mangrove carbon offsets profit is equal to 5822.71, that of broad-leaved marshes is 7958.86, cattail marshes 5250.33, and forested wetlands 8369.41 per hectare, during a 30-year-carbonoffset contract. However, the opportunity cost from conserving wetland instead of growing sugarcane is positive according to REDD+ methodology, e.g., broad-leaved marsh conservation ranged from 6.73 to 20 USD/t CO2e, that of cattail marshes from 12.20 to 32.65 USD/t CO2e, and forested wetlands from 7.15 to 20.60 USD/t CO2e, whereas the opportunity cost between conservation and livestock was negative, it means that conservation is more profitable. The cost-benefit analysis for assessing investment projects from a governmental perspective is useful to determine the viability of conserving coastal wetlands through carbon offset credits. It also shows why in some areas it is not possible to conserve ecosystems due to the opportunity cost of changing from one economic activity (livestock and sugarcane) to carbon offsets for protecting wetlands. Furthermore, it allows for a comparison of carbon markets and assessment in terms of REDD+ and its methods for determining the social cost per ton of carbon avoided.
Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

PubMed

Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M

2009-02-01

The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.
A Cross-Cultural Multi-agent Model of Opportunism in Trade

NASA Astrophysics Data System (ADS)

Hofstede, Gert Jan; Jonker, Catholijn M.; Verwaart, Tim

According to transaction cost economics, contracts are always incomplete and offer opportunities to defect. Some level of trust is a sine qua non for trade. If the seller is better informed about product quality than the buyer, the buyer has to rely on information the seller provides or has to check the information by testing the product or tracing the supply chain processes, thus incurring extra transaction cost. An opportunistic seller who assumes the buyer to trust, may deliver a lower quality product than agreed upon. In human decisions to deceive and to show trust or distrust, issues like mutual expectations, shame, self-esteem, personality, and reputation are involved. These factors depend in part on traders' cultural background. This paper proposes an agent model of deceit and trust and describes a multi-agent simulation where trading agents are differentiated according to Hofstede's dimensions of national culture. Simulations of USA and Dutch trading situations are compared.
A Cost Comparison Framework for Use in Optimizing Ground Water Pump and Treat Systems

EPA Pesticide Factsheets

This fact sheet has been prepared to provide a framework for conducting cost comparisons to evaluate whether or not to pursue potential opportunities from an optimization evaluation for improving, replacing, or supplementing the P&T system.
The impact of BPO on cost reduction in mid-sized health care systems.

PubMed

Perry, Andy; Kocakülâh, Mehmet C

2010-01-01

At the convergence of two politico-economic "hot topics" of the day--outsourcing and the cost of health care-lie opportunities for mid-sized health systems to innovate, collaborate, and reduce overhead. Competition in the retail health care market can serve as both an impetus and an inhibitor to such measures, though. Here we are going to address the motivations, influences, opportunities, and limitations facing mid-sized, US non-profit health systems in business process outsourcing (BPO). Advocates cite numerous benefits to BPO, particularly in cost reduction and strategy optimization. BPO can elicit cost savings due to specialization among provider firms, returns to scale and technology, standardization and automation, and gains in resource arbitrage (off-shoring capabilities). BPO can also free an organization of non-critical tasks and focus resources on core competencies (treating patients). The surge in BPO utilization has rarely extended to the back-office functions of many mid-sized health systems. Health care providers, still a largely fragmented bunch with many rural, independent non-profit systems, have not experienced the consolidation and organizational scale growth to make BPO as attractive as other industries. Smaller firms, spurning merger and acquisition pressure from large, tertiary health systems, often wish to retain their autonomy and identity; hence, they face a competitive cost disadvantage compared to their larger competitors. This article examines the functional areas for these health systems in which BPO is not currently utilized and dissects the various methods available in which to practice BPO. We assess the ongoing adoption of BPO in these areas as well as the barriers to adoption, and identify the key processes that best represent opportunity for success. An emphasis is placed on a collaborative model with other health systems compared to a single system, unilateral BPO arrangement.
WHITE BOX: LOW COST BOX FOR LAPAROSCOPIC TRAINING

PubMed Central

MARTINS, João Maximiliano Pedron; RIBEIRO, Roberto Vanin Pinto; CAVAZZOLA, Leandro Totti

2015-01-01

Background: Laparoscopic surgery is a reality in almost all surgical centers. Although with initial greater technical difficulty for surgeons, the rapid return to activities, less postoperative pain and higher quality aesthetic stimulates surgeons to evolve technically in this area. However, unlike open surgery where learning opportunities are more accessible, the laparoscopic training represents a challenge in surgeon formation. Aim: To present a low cost model for laparoscopic training box. Methods: This model is based in easily accessible materials; the equipment can be easily found based on chrome mini jet and passes rubber thread and a webcam attached to an aluminum handle. Results: It can be finalized in two days costing R$ 280,00 (US$ 90). Conclusion: It is possible to stimulate a larger number of surgeons to have self training in laparoscopy at low cost seeking to improve their surgical skills outside the operating room. PMID:26537148
Commitment-Insurance: Compensating for the Autonomy Costs of Interdependence in Close Relationships

PubMed Central

Murray, Sandra L.; Holmes, John G.; Aloni, Maya; Pinkus, Rebecca T.; Derrick, Jaye L.; Leder, Sadie

2014-01-01

A model of the commitment-insurance system is proposed to examine how low and high self-esteem people cope with the costs interdependence imposes on autonomous goal pursuits. In this system, autonomy costs automatically activate compensatory cognitive processes that attach greater value to the partner. Greater partner-valuing compels greater responsiveness to the partner’s needs. Two experiments and a daily diary study of newlyweds supported the model. Autonomy costs automatically activate more positive implicit evaluations of the partner. On explicit measures of positive illusions, high self-esteem people continue to compensate for costs. However, cost-primed low self-esteem people correct and override their positive implicit sentiments when they have the opportunity to do so. Such corrections put the marriages of low self-esteem people at risk: Failing to compensate for costs predicted declines in satisfaction over a one year period. PMID:19634974
Opportunity's Travels

NASA Technical Reports Server (NTRS)

2004-01-01

This overview map made from Mars Orbiter camera images illustrates the path that the Mars Exploration Rover Opportunity has taken from its first sol on the red planet through its 87th sol. After thoroughly examining its 'Eagle Crater' landing-site, the rover moved onto the plains of Meridiani Planum, stopping to examine a curious trough and a target within it called 'Anatolia.' Following that, Opportunity approached and remotely studied the rocky dish called 'Fram Crater.' As of its 91st sol (April 26, 2004), the rover sits 160 meters (about 525 feet) from the rim of 'Endurance Crater.'
The personal cost of dementia care in Japan: A comparative analysis of residence types.

PubMed

Nakabe, Takayo; Sasaki, Noriko; Uematsu, Hironori; Kunisawa, Susumu; Wimo, Anders; Imanaka, Yuichi

2018-06-12

We aimed to quantify the personal economic burden of dementia care in Japan according to residence type. A cross-sectional online survey was conducted on 3841 caregivers of people with dementia. An opportunity cost approach was used to calculate informal care costs. All costs and the observed/expected (OE) ratio of costs were adjusted using patient sex, age, and care-needs levels, and compared among the residence types. The mean daily informal care time was 8.2 hours, and the mean monthly informal care costs for community-dwelling people with dementia were US$1559. The OE ratio for informal care costs in community-dwelling patients was higher than in institutionalized patients. The inclusion of informal care costs reduced the differences in total personal costs among the residence types. The economic burden of informal care should be considered when quantifying dementia care costs. Copyright © 2018 John Wiley & Sons, Ltd.

Bookending the Opportunity to Lower Wind’s LCOE by Reducing the Uncertainty Surrounding Annual Energy Production

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bolinger, Mark

Reducing the performance risk surrounding a wind project can potentially lead to a lower weighted-average cost of capital (WACC), and hence a lower levelized cost of energy (LCOE), through an advantageous shift in capital structure, and possibly also a reduction in the cost of capital. Specifically, a reduction in performance risk will move the 1-year P99 annual energy production (AEP) estimate closer to the P50 AEP estimate, which in turn reduces the minimum debt service coverage ratio (DSCR) required by lenders, thereby allowing the project to be financed with a greater proportion of low-cost debt. In addition, a reduction inmore » performance risk might also reduce the cost of one or more of the three sources of capital that are commonly used to finance wind projects: sponsor or cash equity, tax equity, and/or debt. Preliminary internal LBNL analysis of the maximum possible LCOE reduction attainable from reducing the performance risk of a wind project found a potentially significant opportunity for LCOE reduction of ~$10/MWh, by reducing the P50 DSCR to its theoretical minimum value of 1.0 (Bolinger 2015b, 2014) and by reducing the cost of sponsor equity and debt by one-third to one-half each (Bolinger 2015a, 2015b). However, with FY17 funding from the U.S. Department of Energy’s Atmosphere to Electrons (A2e) Performance Risk, Uncertainty, and Finance (PRUF) initiative, LBNL has been revisiting this “bookending” exercise in more depth, and now believes that its earlier preliminary assessment of the LCOE reduction opportunity was overstated. This reassessment is based on two new-found understandings: (1) Due to ever-present and largely irreducible inter-annual variability (IAV) in the wind resource, the minimum required DSCR cannot possibly fall to 1.0 (on a P50 basis), and (2) A reduction in AEP uncertainty will not necessarily lead to a reduction in the cost of capital, meaning that a shift in capital structure is perhaps the best that can be expected
Compile-time estimation of communication costs in multicomputers

NASA Technical Reports Server (NTRS)

Gupta, Manish; Banerjee, Prithviraj

1991-01-01

An important problem facing numerous research projects on parallelizing compilers for distributed memory machines is that of automatically determining a suitable data partitioning scheme for a program. Any strategy for automatic data partitioning needs a mechanism for estimating the performance of a program under a given partitioning scheme, the most crucial part of which involves determining the communication costs incurred by the program. A methodology is described for estimating the communication costs at compile-time as functions of the numbers of processors over which various arrays are distributed. A strategy is described along with its theoretical basis, for making program transformations that expose opportunities for combining of messages, leading to considerable savings in the communication costs. For certain loops with regular dependences, the compiler can detect the possibility of pipelining, and thus estimate communication costs more accurately than it could otherwise. These results are of great significance to any parallelization system supporting numeric applications on multicomputers. In particular, they lay down a framework for effective synthesis of communication on multicomputers from sequential program references.
Global report on preterm birth and stillbirth (5 of 7): advocacy barriers and opportunities.

PubMed

Sather, Megan; Fajon, Anne-Véronique; Zaentz, Rachel; Rubens, Craig E

2010-02-23

Efforts to achieve the Millennium Development Goals (MDGs) to improve maternal and child health can be accelerated by addressing preterm birth and stillbirth. However, most global health stakeholders are unaware of the inextricable connections of these adverse pregnancy outcomes to maternal, newborn and child health (MNCH). Improved visibility of preterm births and stillbirths will help fuel investments and strengthen commitments in the discovery, development and delivery of low-cost solutions globally. This article addresses potential barriers and opportunities to increasing global awareness and understanding. Qualitative research was conducted to analyze current knowledge, attitudes and commitments toward preterm birth and stillbirth; identify advocacy challenges; and learn more about examples of programs that successfully advocate for research and appropriate interventions. Forty-one individuals from 14 countries on six continents were interviewed. They included maternal, newborn, and child health advocates and implementers, United Nations agency representatives, policymakers, researchers, and private and government donors. A common recognition of three advocacy challenges with regard to preterm birth and stillbirth emerged from these interviews: (1) lack of data about the magnitude and impact; (2) lack of awareness and understanding; and (3) lack of low-cost, effective and scalable interventions. Participants also identified advocacy opportunities. The first of these opportunities involves linking preterm birth and stillbirth to the MDGs, adding these outcomes to broader global health discussions and advocacy efforts, and presenting a united voice among advocates in the context of broader MNCH issues when addressing preterm birth and stillbirth. Another key opportunity is putting a human face to these tragedies--such as a parent who can speak to the personal impact on the family. Lastly, several interviewees suggested identifying and engaging champions to
The Effect of Emissions Trading And Carbon Sequestration on The Cost Of CO2 Emissions Mitigation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahasenan, Natesan; Scott, Michael J.; Smith, Steven J.

2002-08-05

The deployment of carbon capture and sequestration (CC&S) technologies is greatly affected by the marginal cost of controlling carbon emissions (also the value of carbon, when emissions permits are traded). Emissions limits that are more stringent in the near term imply higher near-term carbon values and therefore encourage the local development and deployment of CC&S technologies. In addition, trade in emissions obligations lowers the cost of meeting any regional or global emissions limit and so affects the rate of penetration of CC&S technologies. We examine the effects of the availability of sequestration opportunities and emissions trading (either within select regionsmore » or globally) on the cost of emissions mitigation and compliance with different emissions reduction targets for the IPCC SRES scenarios. For each base scenario and emissions target, we examine the issues outlined above and present quantitative estimates for the impacts of trade and the availability of sequestration opportunities in meeting emissions limitation obligations.« less
Is the Juice Worth the Squeeze? A Benefit/Cost Analysis of the District of Columbia Opportunity Scholarship Program

ERIC Educational Resources Information Center

Wolf, Patrick J.; McShane, Michael

2013-01-01

School voucher programs have become a prominent aspect of the education policy landscape in the United States. The DC Opportunity Scholarship Program is the only federally funded voucher program in the United States. Since 2004 it has offered publicly funded private school vouchers to nearly four thousand students to attend any of seventy-three…
Costs and Benefits of Electronic Portfolios in Teacher Education: Faculty Perspectives

ERIC Educational Resources Information Center

Strudler, Neal; Wetzel, Keith

2008-01-01

This descriptive study investigated the benefits and costs of using electronic portfolios (EPs) in preservice teacher education. Grounded within change theory, the study examined the perspectives of faculty in six programs in which EPs have been used on a large scale for two or more years. Benefits identified include increased opportunities for…
The myth of managed care. Moving beyond managing costs to really managing care.

PubMed

Houck, S

1997-01-01

Today's managed care manages costs, not care. Care is lopsided with costly physician and provider control of the information, decision-making and treatment processes that are built on outdated fee-for-service incentives. Fast moving providers who exploit opportunities to redesign care, shifting more responsibility and control to non-physician providers and to patients will gain a major competitive advantage. These providers are much more likely to stand out from their peers, enabling them to attract patients and contracts.
Patient monitoring in mobile health: opportunities and challenges.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

In most countries chronic diseases lead to high health care costs and reduced productivity of people in society. The best way to reduce costs of health sector and increase the empowerment of people is prevention of chronic diseases and appropriate health activities management through monitoring of patients. To enjoy the full benefits of E-health, making use of methods and modern technologies is very important. This literature review articles were searched with keywords like Patient monitoring, Mobile Health, and Chronic Disease in Science Direct, Google Scholar and Pub Med databases without regard to the year of publications. Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly to reduce health care costs, correct performance management particularly in chronic disease management. Also some challenges are in patient monitoring in general and specific aspects like threats to confidentiality and privacy, technology acceptance in general and lack of system interoperability with electronic health records and other IT tools, decrease in face to face communication between doctor and patient, sudden interruptions of telecommunication networks, and device and sensor type in specific aspect. It is obvious identifying the opportunities and challenges of mobile technology and reducing barriers, strengthening the positive points will have a significant role in the appropriate planning and promoting the achievements of the health care systems based on mobile and helps to design a roadmap for improvement of mobile health.
Costs of unstructured investigation of unexplained syncope: insights from a micro-costing analysis of the observational PICTURE registry.

PubMed

Edvardsson, Nils; Wolff, Claudia; Tsintzos, Stelios; Rieger, Guido; Linker, Nicholas J

2015-07-01

The observational PICTURE (Place of Reveal In the Care pathway and Treatment of patients with Unexplained Recurrent Syncope) registry enrolled 570 patients with unexplained syncope, documented their care pathway and the various tests they underwent before the insertion of an implantable loop recorder (ILR). The aims were to describe the extent and cost of diagnostic tests performed before the implant. Actual costs of 17 predefined diagnostic tests were characterized based on a combination of data from PICTURE and a micro-costing study performed at a medium-sized UK university hospital in the UK. The median cost of diagnostic tests per patient was £1114 (95% CI £995-£1233). As many patients received more than the median number of tests, the mean expenditure per patient was higher with £1613 (95% CI £1494-£1732), and for 10% of the patients the cost exceeded £3539. Tests were frequently repeated, and early use of specific and expensive tests was common. In the 12% of patients with types of tests entirely within the recommendations for an initial evaluation before ILR implant, the mean cost was £710. Important opportunities to reduce test-related costs before an ILR implant were identified, e.g. by more appropriate use of tests recommended in the initial evaluation, by decreasing repetition of tests, and by avoiding early use of specialized and expensive tests. A structured multidisciplinary approach would be the best model to achieve an optimal outcome. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.
Costs of unstructured investigation of unexplained syncope: insights from a micro-costing analysis of the observational PICTURE registry

PubMed Central

Edvardsson, Nils; Wolff, Claudia; Tsintzos, Stelios; Rieger, Guido; Linker, Nicholas J.

2015-01-01

Aims The observational PICTURE (Place of Reveal In the Care pathway and Treatment of patients with Unexplained Recurrent Syncope) registry enrolled 570 patients with unexplained syncope, documented their care pathway and the various tests they underwent before the insertion of an implantable loop recorder (ILR). The aims were to describe the extent and cost of diagnostic tests performed before the implant. Methods and results Actual costs of 17 predefined diagnostic tests were characterized based on a combination of data from PICTURE and a micro-costing study performed at a medium-sized UK university hospital in the UK. The median cost of diagnostic tests per patient was £1114 (95% CI £995–£1233). As many patients received more than the median number of tests, the mean expenditure per patient was higher with £1613 (95% CI £1494–£1732), and for 10% of the patients the cost exceeded £3539. Tests were frequently repeated, and early use of specific and expensive tests was common. In the 12% of patients with types of tests entirely within the recommendations for an initial evaluation before ILR implant, the mean cost was £710. Conclusion Important opportunities to reduce test-related costs before an ILR implant were identified, e.g. by more appropriate use of tests recommended in the initial evaluation, by decreasing repetition of tests, and by avoiding early use of specialized and expensive tests. A structured multidisciplinary approach would be the best model to achieve an optimal outcome. PMID:25759408
The cost of care homes for people with dementia in England: a modelling approach.

PubMed

Romeo, Renee; Knapp, Martin; Salverda, Suzanne; Orrell, Martin; Fossey, Jane; Ballard, Clive

2017-12-01

To examine the cost of care for people with dementia in institutional care settings, to understand the major cost drivers and to highlight opportunities for service development. Data on 277 residents with dementia in 16 UK residential or nursing homes were collected. We estimated care and support costs and fitted models to the data. Sensitivity analyses were also conducted. Care home residents cost £792 weekly: 95% of the costs accounted for by direct fees. Hospital contacts contributed the largest proportion of the additional costs. Having an established diagnosis of dementia (b = 0.070; p < 0.05) was associated with higher costs. No association was found between cost and needs (b = -0.002; p = 0.818). The absence of an association between cost and needs emphasizes the importance of a more needs-based costing system which could result in clinical and economic advantages. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Final Technical Progress Report: Development of Low-Cost Suspension Heliostat; December 7, 2011 - December 6, 2012

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bender, W.

2013-01-01

Final technical progress report of SunShot Incubator Solaflect Energy. The project succeeded in demonstrating that the Solaflect Suspension Heliostat design is viable for large-scale CSP installations. Canting accuracy is acceptable and is continually improving as Solaflect improves its understanding of this design. Cost reduction initiatives were successful, and there are still many opportunities for further development and further cost reduction.
Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program’s focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs, what dollars are spent on, and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program’s longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occurs during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost
Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program's focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs--what dollars are spent on--and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program's longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occur during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost
New Skills for a New Economy: Adult Education's Key Role in Sustaining Economic Growth and Expanding Opportunity.

ERIC Educational Resources Information Center

Comings, John; Sum, Andrew; Uvin, Johan

The role of adult education in sustaining economic growth and expanding opportunity in Massachusetts was explored. The analysis focused on the new basic skills needed for a new economy, groups lacking the new basic skills, the demand for adult basic education (ABE), funding for ABE, building basic skills through adult education, ABE's costs and…
Opportunities for crash and injury reduction: A multiharm approach for crash data analysis.

PubMed

Mallory, Ann; Kender, Allison; Moorhouse, Kevin

2017-05-29

A multiharm approach for analyzing crash and injury data was developed for the ultimate purpose of getting a richer picture of motor vehicle crash outcomes for identifying research opportunities in crash safety. Methods were illustrated using a retrospective analysis of 69,597 occupant cases from NASS CDS from 2005 to 2015. Occupant cases were analyzed by frequency and severity of outcome: fatality, injury by Abbreviated Injury Scale (AIS), number of cases, attributable fatality, disability, and injury costs. Comparative analysis variables included precrash scenario, impact type, and injured body region. Crash and injury prevention opportunities vary depending on the search parameters. For example, occupants in rear-end crash scenarios were more frequent than in any other precrash configuration, yet there were significantly more fatalities and serious injury cases in control loss, road departure, and opposite direction crashes. Fatality is most frequently associated with head and thorax injury, and disability is primarily associated with extremity injury. Costs attributed to specific body regions are more evenly distributed, dominated by injuries to the head, thorax, and extremities but with contributions from all body regions. Though AIS 3+ can be used as a single measure of harm, an analysis based on multiple measures of harm gives a much more detailed picture of the risk presented by a particular injury or set of crash conditions. The developed methods represent a new approach to crash data mining that is expected to be useful for the identification of research priorities and opportunities for reduction of crashes and injuries. As the pace of crash safety improvement accelerates with innovations in both active and passive safety, these techniques for combining outcome measures for insights beyond fatality and serious injury will be increasingly valuable.
Hospital cost analysis of neuromuscular scoliosis surgery.

PubMed

Diefenbach, Christopher; Ialenti, Marc N; Lonner, Baron S; Kamerlink, Jonathan R; Verma, Kushagra; Errico, Thomas J

2013-01-01

A retrospective review of 74 consecutive, surgical patients with neuromuscular scoliosis (NMS). This study evaluates the distribution of hospital and operating room costs incurred during surgical correction of NMS. Recent studies have demonstrated that surgical treatment improves both medical outcomes and the quality of life in patients with progressive NMS. Characterization of the costs incurred at the time of surgery and hospitalization will facilitate the identification of opportunities for cost reduction. Demographic data collected included gender, age, preoperative height, weight, and BMI. Major coronal curvatures and T5-T12 kyphosis were assessed from radiographs. Construct type and number of screws, hooks, and wires implanted were recorded. Surgical costs were calculated based on cost of surgical correction, hospital stay, and postoperative care. Mean age was 15.8 ± 7.3 years; 57% were male. Comorbidities included cerebral palsy (28%) and familial dysautonomia (14%). The mean preoperative major curve magnitude was 60°; minor curve magnitude was 33°. Posterior approach (76%) and pedicle screws (75%) were predominantly utilized. The average length of hospitalization was 8 days (range: 3 to 47). There were six major complications (8%). The total surgical cost was $50,096 ± $23,998. The highest individual cost was for implants ($13,916; 24% of total costs). The second highest was inpatient room and ICU costs ($12,483; 22%); bone grafts were the third ($6,398; 11%). Increased major and minor structural curve, increased total (A/P) levels fused, and increased length of hospital stay predicted an increase in total cost. Major contributors to cost in NMS surgery are implants, inpatient room and ICU costs, and bone grafts. Independent predictors of higher cost are the degree of major and minor structural curve, total number of A/P levels fused, and length of hospital stay. These conclusions provide insight into costs associated with care for a medically fragile
A consumer register: an acceptable and cost-effective alternative for accessing patient populations.

PubMed

Bryant, Jamie; Sanson-Fisher, Rob; Fradgley, Elizabeth; Hobden, Breanne; Zucca, Alison; Henskens, Frans; Searles, Andrew; Webb, Brad; Oldmeadow, Christopher

2016-10-10

Population-based registries are increasingly used to recruit patient samples for research, however, they have several limitations including low consent and participation rates, and potential selection bias. To improve access to samples for research, the utility of a new model of recruitment termed the 'Consumer Register', that allows for direct patient recruitment from hospitals, was examined. This paper reports: (i) consent rates onto the register; (ii) preferred methods and frequency of contact; and (iii) the feasibility of establishing the register, including: (a) cost per person recruited to the register; (b) the differential cost and consent rates of volunteer versus paid data collectors; and (c) participant completion rates. A cross-sectional survey was conducted in five outpatient clinics in Australia. Patients were approached by volunteers or paid data collectors and asked to complete a touch-screen electronic survey. Consenting individuals were asked to indicate their willingness and preferences for enrolment onto a research register. Descriptive statistics were used to examine patient preferences and linear regression used to model the success of volunteer versus paid data collectors. The opportunity and financial costs of establishing the register were calculated. A total of 1947 patients (80.6 %) consented to complete the survey, of which, 1486 (76.3 %) completed the questionnaire. Of the completers, the majority (69.4 %, or 1032 participants) were willing to be listed on the register and preferred to be contacted by email (50.3 %). Almost 39 % of completers were willing to be contacted three or more times in a 12 month period. The annual opportunity cost of resources consumed by the register was valued at $37,187, giving an opportunity cost per person recruited to the register of $36. After amortising fixed costs, the annual financial outlay was $23,004 or $22 per person recruited to the register. Use of volunteer data collectors contributed to
Challenges and Opportunities of Big Data in Health Care: A Systematic Review

PubMed Central

Goswamy, Rishi; Raval, Yesha; Marawi, Sarah

2016-01-01

Background Big data analytics offers promise in many business sectors, and health care is looking at big data to provide answers to many age-related issues, particularly dementia and chronic disease management. Objective The purpose of this review was to summarize the challenges faced by big data analytics and the opportunities that big data opens in health care. Methods A total of 3 searches were performed for publications between January 1, 2010 and January 1, 2016 (PubMed/MEDLINE, CINAHL, and Google Scholar), and an assessment was made on content germane to big data in health care. From the results of the searches in research databases and Google Scholar (N=28), the authors summarized content and identified 9 and 14 themes under the categories Challenges and Opportunities, respectively. We rank-ordered and analyzed the themes based on the frequency of occurrence. Results The top challenges were issues of data structure, security, data standardization, storage and transfers, and managerial skills such as data governance. The top opportunities revealed were quality improvement, population management and health, early detection of disease, data quality, structure, and accessibility, improved decision making, and cost reduction. Conclusions Big data analytics has the potential for positive impact and global implications; however, it must overcome some legitimate obstacles. PMID:27872036
Cost minimization analysis of different growth hormone pen devices based on time-and-motion simulations

PubMed Central

2010-01-01

Background Numerous pen devices are available to administer recombinant Human Growth Hormone (rhGH), and both patients and health plans have varying issues to consider when selecting a particular product and device for daily use. Therefore, the present study utilized multi-dimensional product analysis to assess potential time involvement, required weekly administration steps, and utilization costs relative to daily rhGH administration. Methods Study objectives were to conduct 1) Time-and-Motion (TM) simulations in a randomized block design that allowed time and steps comparisons related to rhGH preparation, administration and storage, and 2) a Cost Minimization Analysis (CMA) relative to opportunity and supply costs. Nurses naïve to rhGH administration and devices were recruited to evaluate four rhGH pen devices (2 in liquid form, 2 requiring reconstitution) via TM simulations. Five videotaped and timed trials for each product were evaluated based on: 1) Learning (initial use instructions), 2) Preparation (arrange device for use), 3) Administration (actual simulation manikin injection), and 4) Storage (maintain product viability between doses), in addition to assessment of steps required for weekly use. The CMA applied micro-costing techniques related to opportunity costs for caregivers (categorized as wages), non-drug medical supplies, and drug product costs. Results Norditropin® NordiFlex and Norditropin® NordiPen (NNF and NNP, Novo Nordisk, Inc., Bagsværd, Denmark) took less weekly Total Time (p < 0.05) to use than either of the comparator products, Genotropin® Pen (GTP, Pfizer, Inc, New York, New York) or HumatroPen® (HTP, Eli Lilly and Company, Indianapolis, Indiana). Time savings were directly related to differences in new package Preparation times (NNF (1.35 minutes), NNP (2.48 minutes) GTP (4.11 minutes), HTP (8.64 minutes), p < 0.05)). Administration and Storage times were not statistically different. NNF (15.8 minutes) and NNP (16.2 minutes) also

Small, Low Cost, Launch Capability Development

NASA Technical Reports Server (NTRS)

Brown, Thomas

2014-01-01

A recent explosion in nano-sat, small-sat, and university class payloads has been driven by low cost electronics and sensors, wide component availability, as well as low cost, miniature computational capability and open source code. Increasing numbers of these very small spacecraft are being launched as secondary payloads, dramatically decreasing costs, and allowing greater access to operations and experimentation using actual space flight systems. While manifesting as a secondary payload provides inexpensive rides to orbit, these arrangements also have certain limitations. Small, secondary payloads are typically included with very limited payload accommodations, supported on a non interference basis (to the prime payload), and are delivered to orbital conditions driven by the primary launch customer. Integration of propulsion systems or other hazardous capabilities will further complicate secondary launch arrangements, and accommodation requirements. The National Aeronautics and Space Administration's Marshall Space Flight Center has begun work on the development of small, low cost launch system concepts that could provide dedicated, affordable launch alternatives to small, high risk university type payloads and spacecraft. These efforts include development of small propulsion systems and highly optimized structural efficiency, utilizing modern advanced manufacturing techniques. This paper outlines the plans and accomplishments of these efforts and investigates opportunities for truly revolutionary reductions in launch and operations costs. Both evolution of existing sounding rocket systems to orbital delivery, and the development of clean sheet, optimized small launch systems are addressed.
On the Efficiency Costs of De-Tracking Secondary Schools in Europe

ERIC Educational Resources Information Center

Brunello, Giorgio; Rocco, Lorenzo; Ariga, Kenn; Iwahashi, Roki

2012-01-01

Many European countries have delayed the time when school tracking starts in order to pursue equality of opportunity. What are the efficiency costs of de-tracking secondary schools? This paper builds a stylized model of the optimal time of tracking, estimates the relevant parameters using micro data for 11 European countries and computes the…
Information technology for the treatment of diabetes: improving outcomes and controlling costs.

PubMed

Wyne, Kathleen

2008-03-01

Diabetes in particular presents an ideal opportunity for the incorporation of information technology (IT) in the provision of care. The disease is highly prevalent in managed care populations, is frequently associated with comorbid conditions, and requires multiple medications in its management. Furthermore, effective diabetes care involves the monitoring of several measures of disease control, such as hemoglobin A1c (A1c) and lipid levels, by several different levels of providers, such as physicians, nurse practitioners, physician assistants, pharmacists, and dieticians. All of these factors combined make diabetes an opportune disease state for a case study of the implementation of health information technology (HIT) in managed care. To review practical applications of HIT for improving the delivery of care in diabetes management. Between 1990 and 2002, the incidence of type 2 diabetes increased by 61% in the United States. The total costs associated with diabetes have been increasing since the late 1970s as well, with a more dramatic rise over the last 10 years. In fact, the total cost of diabetes in the United States will approach $200 billion per year by the year 2020. In order to improve diabetes management efforts nation wide, the goal of glucose lowering therapy has been recommended to lower the hemoglobin A1c (A1c) to < 7% and keep it below that level long term. Other measures beyond A1c levels have also been identified as being important components to effective diabetes management and incorporated into national treatment recommendations, providing an ideal opportunity for the incorporation of HIT interventions. These interventions have been aimed at 3 different groups of stakeholders in managed care: payers, providers, and patients. While uncontrolled diabetes remains a major concern in managed care from both a health and a cost perspective, implementation of information technology enabled diabetes management (ITDM) has demonstrated significant potential
Process-Based Governance in Public Administrations Using Activity-Based Costing

NASA Astrophysics Data System (ADS)

Becker, Jörg; Bergener, Philipp; Räckers, Michael

Decision- and policy-makers in public administrations currently lack on missing relevant information for sufficient governance. In Germany the introduction of New Public Management and double-entry accounting enable public administrations to get the opportunity to use cost-centered accounting mechanisms to establish new governance mechanisms. Process modelling in this case can be a useful instrument to help the public administrations decision- and policy-makers to structure their activities and capture relevant information. In combination with approaches like Activity-Based Costing, higher management level can be supported with a reasonable data base for fruitful and reasonable governance approaches. Therefore, the aim of this article is combining the public sector domain specific process modelling method PICTURE and concept of activity-based costing for supporting Public Administrations in process-based Governance.
Cost-effectiveness of payments for ecosystem services with dual goals of environment and poverty alleviation.

PubMed

Gauvin, Crystal; Uchida, Emi; Rozelle, Scott; Xu, Jintao; Zhan, Jinyan

2010-03-01

The goal of this article is to understand strategies by which both the environmental and poverty alleviation objectives of PES programs can be achieved cost effectively. To meet this goal, we first create a conceptual framework to understand the implications of alternative targeting when policy makers have both environmental and poverty alleviation goals. We then use the Grain for Green program in China, the largest PES program in the developing world, as a case study. We also use a data set from a survey that we designed and implemented to evaluate the program. Using the data set we first evaluate what factors determined selection of program areas for the Grain for Green program. We then demonstrate the heterogeneity of parcels and households and examine the correlations across households and their parcels in terms of their potential environmental benefits, opportunity costs of participating, and the asset levels of households as an indicator of poverty. Finally, we compare five alternative targeting criteria and simulate their performance in terms of cost effectiveness in meeting both the environmental and poverty alleviation goals when given a fixed budget. Based on our simulations, we find that there is a substantial gain in the cost effectiveness of the program by targeting parcels based on the "gold standard," i.e., targeting parcels with low opportunity cost and high environmental benefit managed by poorer households.
Cost-Effectiveness of Payments for Ecosystem Services with Dual Goals of Environment and Poverty Alleviation

NASA Astrophysics Data System (ADS)

Gauvin, Crystal; Uchida, Emi; Rozelle, Scott; Xu, Jintao; Zhan, Jinyan

2010-03-01

The goal of this article is to understand strategies by which both the environmental and poverty alleviation objectives of PES programs can be achieved cost effectively. To meet this goal, we first create a conceptual framework to understand the implications of alternative targeting when policy makers have both environmental and poverty alleviation goals. We then use the Grain for Green program in China, the largest PES program in the developing world, as a case study. We also use a data set from a survey that we designed and implemented to evaluate the program. Using the data set we first evaluate what factors determined selection of program areas for the Grain for Green program. We then demonstrate the heterogeneity of parcels and households and examine the correlations across households and their parcels in terms of their potential environmental benefits, opportunity costs of participating, and the asset levels of households as an indicator of poverty. Finally, we compare five alternative targeting criteria and simulate their performance in terms of cost effectiveness in meeting both the environmental and poverty alleviation goals when given a fixed budget. Based on our simulations, we find that there is a substantial gain in the cost effectiveness of the program by targeting parcels based on the “gold standard,” i.e., targeting parcels with low opportunity cost and high environmental benefit managed by poorer households.
Private and social costs of surface mine reforestation performance criteria.

PubMed

Sullivan, Jay; Amacher, Gregory S

2010-02-01

We study the potentially unnecessary costs imposed by strict performance standards for forest restoration of surface coal mines in the Appalachian region under the Surface Mining Control and Reclamation Act of 1977 (SMCRA) that can vary widely across states. Both the unnecessary private costs to the mine operator and costs to society (social costs) are reported for two performance standards, a ground cover requirement, and a seedling survival target. These standards are examined using numerical analyses under a range of site productivity class and market conditions. We show that a strict (90%) ground cover standard may produce an unnecessary private cost of more than $700/ha and a social cost ranging from $428/ha to $710/ha, as compared with a 70% standard. A strict tree survival standard of 1235 trees/ha, as compared with the more typical 1087 trees/ha standard, may produce an unnecessary private cost of approximately $200/ha, and a social cost in the range of $120 to $208/ha. We conclude that strict performance standards may impose substantial unnecessary private costs and social costs, that strict performance standards may be discouraging the choice of forestry as a post-mining land use, and that opportunities exist for reform of reforestation performance standards. Our study provides a basis for evaluating tradeoffs between regulatory efficiency and optimal reforestation effort.
Towards measuring the transaction costs of co-management in Mkambati Nature Reserve, Eastern Cape, South Africa.

PubMed

Blore, M L; Cundill, G; Mkhulisi, M

2013-11-15

During the last three decades, there has been an increased pursuit of participatory approaches to managing natural resources. In South Africa, this has been evident in the management of protected areas. In particular, land claims, which affect much of the conservation estate in South Africa, frequently result in co-management of protected areas by claimant communities and conservation agencies. This is occurring against a backdrop of declining state subsidies and growing expectations that South African conservation agencies will finance themselves while simultaneously stimulating local economic opportunities. In this context, it is important for co-management partners to understand and monitor the cost-effectiveness of management processes in achieving both the socio-economic and ecological targets of conservation management. Transaction costs are useful in gauging the cost-effectiveness of policies and institutions; however there is little methodological guidance for measuring transaction costs empirically. This study develops and tests a transaction costs model for a co-managed nature reserve in the Eastern Cape province of South Africa. Transaction costs were quantified by taking into account the total time spent in meetings annually, the daily opportunity cost of participants' time and the travel costs associated with attending such meetings. A key limitation in the development of this model was a lack of record keeping by the conservation agency. The model developed in this study offers a practical means for co-management partners in similar contexts to monitor how transaction costs change over time. Copyright © 2013 Elsevier Ltd. All rights reserved.
Low-cost, light-switched, forward-osmosis desalination system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warner, John C.

The looming water crisis is the second largest issue facing humanity after energy. In order to meet the increasing demand for clean water, new efficient and low-cost methods of water purification must be developed. A promising method for dry regions with sea borders is the desalination of seawater. While there remain many disadvantages to current desalination techniques, such as environmental pollution and high cost, there is a strong opportunity for new technology development in this area. In this Phase I program, the development of a light-switchable, low-cost desalination system was explored. The system requires photoselective switching of water solubility. Ninemore » new light-switchable spiropyran-based small molecule and polymeric materials were synthesized, and methods to evaluate their desalination potential were developed and utilized. Severable promising spiropyran analogues proved to be photoswitchable, but so far sufficient photoswitchablity of solubility for a commercial desalination system was not achieved. More development is required.« less
Science Opportunity Analyzer (SOA) Version 8

NASA Technical Reports Server (NTRS)

Witoff, Robert J.; Polanskey, Carol A.; Aguinaldo, Anna Marie A.; Liu, Ning; Hofstadter, Mark D.

2013-01-01

SOA allows scientists to plan spacecraft observations. It facilitates the identification of geometrically interesting times in a spacecraft s orbit that a user can use to plan observations or instrument-driven spacecraft maneuvers. These observations can then be visualized multiple ways in both two- and three-dimensional views. When observations have been optimized within a spacecraft's flight rules, the resulting plans can be output for use by other JPL uplink tools. Now in its eighth major version, SOA improves on these capabilities in a modern and integrated fashion. SOA consists of five major functions: Opportunity Search, Visualization, Observation Design, Constraint Checking, and Data Output. Opportunity Search is a GUI-driven interface to existing search engines that can be used to identify times when a spacecraft is in a specific geometrical relationship with other bodies in the solar system. This function can be used for advanced mission planning as well as for making last-minute adjustments to mission sequences in response to trajectory modifications. Visualization is a key aspect of SOA. The user can view observation opportunities in either a 3D representation or as a 2D map projection. Observation Design allows the user to orient the spacecraft and visualize the projection of the instrument field of view for that orientation using the same views as Opportunity Search. Constraint Checking is provided to validate various geometrical and physical aspects of an observation design. The user has the ability to easily create custom rules or to use official project-generated flight rules. This capability may also allow scientists to easily assess the cost to science if flight rule changes occur. Data Output allows the user to compute ancillary data related to an observation or to a given position of the spacecraft along its trajectory. The data can be saved as a tab-delimited text file or viewed as a graph. SOA combines science planning functionality unique to
Research and Development Opportunities for Joining Technologies in HVAC&R

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goetzler, William; Guernsey, Matt; Young, Jim

The Building Technologies Office (BTO) works with researchers and industry partners to develop and deploy technologies that can substantially reduce energy consumption and greenhouse gas (GHG) emissions in residential and commercial buildings. This opportunity assessment aims to advance BTO’s energy savings, GHG reduction, and other program goals by identifying research and development (R&D) initiatives for joining technologies in heating, ventilation, air-conditioning, and refrigeration (HVAC&R) systems. Improving joining technologies for HVAC&R equipment has the potential to increase lifetime equipment operating efficiency, decrease equipment and project cost, and most importantly reduce hydroflourocarbon (HFC) refrigerant leakage to support HFC phasedown and GHG reductionmore » goals.« less
On the Path to SunShot. Emerging Opportunities and Challenges in U.S. Solar Manufacturing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, Donald; Horowitz, Kelsey; Kurup, Parthiv

This report provides insights into photovoltaic (PV) and concentrating solar power (CSP) manufacturing in the context of the U.S. Department of Energy's SunShot Initiative. Although global PV price reductions and deployment have been strong recently, PV manufacturing faces challenges. Slowing rates of manufacturing cost reductions, combined with the relatively low price of incumbent electricity generating sources in most large global PV markets, may constrain profit opportunities for firms and poses a potential challenge to the sustainable operation and growth of the global PV manufacturing base. In the United States, manufacturers also face a factors-of-production cost disadvantage compared with competing nations.more » However, the United States is one of the world's most competitive and innovative countries as well as one of the best locations for PV manufacturing. In conjunction with strong projected PV demand in the United States and across the Americas, these advantages could increase the share of PV technologies produced by U.S. manufacturers as the importance of innovation-driven PV cost reductions increases. Compared with PV, CSP systems are much more complex and require a much larger minimum effective scale, resulting in much higher total CAPEX requirements for system construction, lengthier development cycles, and ultimately higher costs of energy produced. The global lack of consistent CSP project development creates challenges for companies that manufacture specialty CSP components, and the potential lack of a near-term U.S. market could hinder domestic CSP manufacturers. However, global and U.S. CSP deployment is expected to expand beyond 2020, and U.S. CSP manufacturers could benefit from U.S. innovation advantages similar to those associated with PV. Expansion of PV and CSP manufacturing also presents U.S. job-growth opportunities.« less
Cost-Sharing of General and Specific Training with Depreciation of Human Capital.

ERIC Educational Resources Information Center

Pichler, Eva

1993-01-01

Investigates why employers (particularly those valuing technical progress as important for performance) share general training costs and returns. Workers stay with a firm paying a wage below their opportunity wage if it continually provides additional training so that the prospect of future wages outweighs the short-run gain from quitting and…
On the transition to sustainability: an analysis of the costs of school feeding compared with the costs of primary education.

PubMed

Bundy, Donald; Burbano, Carmen; Gelli, Aulo; Risley, Claire; Neeser, Kristie

2011-09-01

The current food, fuel, and financial crises have highlighted the importance of school feeding programs both as a social safety net for children living in poverty and food insecurity, and as part of national educational policies and plans. To examine the costs of school feeding, in terms of both the absolute cost per child and the cost per child relative to overall education expenditure and gross domestic product (GDP) in low-, middle-, and high-income countries. Data on the costs of school feeding in different countries were collected from multiple sources, including World Food Programme project data, reports from government ministries, and, where such searches failed, newspaper articles and other literature obtained from internet searches. Regression models were then used to analyze the relationships between school feeding costs, the per capita costs of primary education and GDP per capita. School feeding programs in low-income countries exhibit large variations in cost, with concomitant opportunities for cost containment. As countries get richer, however, school feeding costs become a much smaller proportion of the investment in education. The per capita costs of feeding relative to education decline nonlinearly with increasing GDP. These analyses suggest that the main reason for this decline in the relative cost of school feeding versus primary education is a greatly increased investment per child in primary education as GDP rises, but a fairly flat investment in food. The analyses also show that there appears to be a transitional discontinuity at the interface between the lower- and middle-income countries, which tends to coincide with changes in the capacity of governments to take over the management and funding of programs. Further analysis is required to define these relationships, but an initial conclusion is that supporting countries to maintain an investment in school feeding through this transition may emerge as a key role for development partners.
Capability and Cost of COTS Networking Components

NASA Astrophysics Data System (ADS)

Hinteregger, Hans

In this talk we will emphasize first the ease with which dedicated 'dark' fiber can today be 'lit' at one or more gigE-bandwidth wavelengths with low-cost switches, optical transceivers with up to 100 Km reach, and passive mux/demux's. The chief expense for dedicated links today is that of leasing a fiber pair, especially in a city like Wash. DC. But, at least in the US, the intercity cable overbuild of the telecom boom has now, in the bust, made in-the-ground dark fiber pairs buyable for <$1000/km. Hence there are now business interests in COTS networking components,with corresponding opportunities for e-VLBI. We will outline the fairly clear and certain road from gigE in SFP to 10gigE in XFP commodity pluggable packages. The timing of cost/bandwidth crossover is less so - due to current uncertainty in the telecom business climate. A 2006 budget for LOFAR networking requirements, assumed here to be built from scratch in the WA desert where the dominant cable laying costs are minimized, is considered in some detail. The cost of fibers and the cost lighting them (one-way) to 200 Gb/s per station is judged to be affordable. A further projection to SKA's COFON in 2009 will be made. Denser CWDM and/or cheaper DWDM may be developed and mature by that time.
Lean principles to optimize instrument utilization for spine surgery in an academic medical center: an opportunity to standardize, cut costs, and build a culture of improvement.

PubMed

Lunardini, David; Arington, Richard; Canacari, Elena G; Gamboa, Kelly; Wagner, Katiri; McGuire, Kevin J

2014-09-15

Case study OBJECTIVE.: To optimize the utilization of operating room instruments for orthopedic and neurosurgical spine cases in an urban level 1 academic medical center through application of Lean principles. Process improvement systems such as Lean have been adapted to health care and offer an opportunity for frank assessment of surgical routines to increase efficiency and enhance value. The goal has been to safely reduce the financial burden to the health care system without compromising care and if possible reallocate these resources or gains in efficiency to further improve the value to the patient. The investigators identified instruments as a source of waste in the operating room and proposed a Lean process assessment. The instruments and the instrument processing workflow were described. An audit documented the utilization of each instrument by orthopedic surgeons and neurosurgeons through observation of spine cases. The data were then presented to the stakeholders, including surgeons, the perioperative director, and representatives from nursing, central processing, and the surgical technicians. Of the 38 cases audited, only 89 (58%) of the instruments were used at least once. On the basis of the data and stakeholder consensus, 63 (41%) of the instruments were removed, resulting in a weight reduction of 17.5 lb and consolidation of 2 instrument sets into 1. Projected cost savings were approximately $41,000 annually. Although new instruments were purchased to standardize sets, the return on investment was estimated to be 2 years. Inefficient surgical routines may comprise significant resource waste in an institution. Process assessment is an important tool in decreasing health care costs, with objectivity provided by Lean or similar principles, and essential impetus to change provided by stakeholders. 4.
Economic credentialing: the propriety of managing physician costs through privileging.

PubMed

Dahl, B A

1999-01-01

Hospital executives face the unique task of managing the costs of an institution in which they have no direct managerial authority over the primary cost drivers, namely, the physicians who practice in the hospital. Perhaps the most controversial method of controlling physician costs consists of the application of economic factors to the credentialing process. Using the credentialing process as a technique to exert fiscal control over physicians affords hospital executives and their governing boards a tremendous cost-management opportunity. The legal propriety of economic credentialing remains unsettled. Many commentators, relying on limited case law, conclude that hospitals can engage in economic credentialing. Nevertheless, hospitals should exercise care when employing an economic rationale to restrict privileges lest they stir up legal challenges. Moreover, if hospitals use economic credentialing to limit medicaid patients' access to hospitals by excluding these patients' physicians from the hospital, the federal government may have the last word on the propriety of the practice.
Onset Of Opportunity To Use Cannabis And Progression From Opportunity To Dependence: Are Influences Consistent Across Transitions?

PubMed Central

Hines, Lindsey A.; Morley, Katherine I.; Strang, John; Agrawal, Arpana; Nelson, Elliot C.; Statham, Dixie; Martin, Nicholas G.; Lynskey, Michael T.

2016-01-01

Background There is a developing body of research looking at cannabis use opportunity, but little research examining timing of opportunity to use cannabis. Aims Identify factors associated with 1) earlier opportunity to use cannabis and 2) faster progression from opportunity to cannabis dependence. Method Cross-sectional study of 3824 Australian twins and siblings, measuring age of onset of cannabis use opportunity and DSM-IV cannabis dependence. Survival analysis identified factors associated with faster progression to opportunity or dependence. Results Factors associated with both speed of progression to opportunity and dependence were conduct disorder (opportunity HR 5.57, 95%CI 1.52–20.47; dependence HR 2.49, 95%CI 1.91–3.25), parental drug problems (opportunity HR 7.29, 95%CI 1.74–30.62; dependence HR 3.30, 95%CI 1.63–6.69), weekly tobacco use (opportunity HR 8.57, 95%CI 3.93–18.68; dependence HR 2.76, 95% CI 2.10–3.64), and female gender (opportunity HR 0.69, 95%CI 0.64–0.75; dependence HR 0.44, 95%CI 0.34–0.55). Frequent childhood religious attendance (HR 0.74, 95%CI 0.68–0.80), parental conflict (HR 1.09, 95%CI 1.00–1.18), parental alcohol problems (HR 1.19, 95%CI 1.08–1.30) and childhood sexual abuse (HR 1.17, 95%CI 1.01–1.34) were uniquely associated with transition to opportunity. Depressive episode (HR 1.44, 95%CI 1.12–1.85), tobacco dependence (HR 1.36, 95%CI 1.04 – 1.78), alcohol dependence (HR 2.64, 95%CI 1.53–4.58), other drug use (HR 2.10, 95%CI 1.64–2.69) and other drug dependence (HR 2.75, 95%CI 1.70–4.43) were uniquely associated with progression to dependence. Conclusion The profile of factors associated with opportunity to use cannabis and dependence only partially overlaps, suggesting targeting of interventions may benefit from being tailored to the stages of drug use. PMID:26811121
Space Station needs, attributes and architectural options, volume 2, book 3: Cost and programmatics

NASA Technical Reports Server (NTRS)

1983-01-01

The cost and programmatic considerations which integrate mission requirements and architectural options into a cohesive system for exploitation of space opportunities within affordable limits are discussed. The mission requirements, baseline architecture, a top level baseline schedule, and acquisition costs are summarized. The work breakdown structure (WBS) used to structure the program, and the WBS dictionary are included. The costing approach used, including the operation of the primary costing tool, the SPACE cost model are described. The rationale for the choice of cost estimating relationships is given and costs at the module level are shown. Detailed costs at the subsystem level are shown. The baseline schedule and annual funding profiles are provided. Alternate schedules are developed to provide different funding profiles. Alternate funding sources are discussed and foreign and contractor participation is outlined. The results of the benefit analysis are given and the accrued benefits deriving from an implemented space station program are outlined.
Postsecondary Education Opportunity, 1999.

ERIC Educational Resources Information Center

Postsecondary Education Opportunity, 1999

1999-01-01

Each of the 12 issues of this 1999 publication contains 1 or more analyses of postsecondary educational opportunities. Titles of the individual analyses are: (1) Parental Educational Attainment and Higher Educational Opportunity (number 79); (2) Refinancing Higher Education, 1952 to 1997 (number 79); (3) State Outreach Efforts to Students from Low…

76 FR 76815 - Business Opportunity Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

...The Commission is adopting final amendments to its Trade Regulation Rule entitled ``Disclosure Requirements and Prohibitions Concerning Business Opportunities'' (``Business Opportunity Rule'' or ``Rule''). Among other things, the Business Opportunity Rule has been amended to broaden its scope to cover business opportunity sellers not covered by the interim Business Opportunity Rule, such as sellers of work-at-home opportunities, and to streamline and simplify the disclosures that sellers must provide to prospective purchasers. The final Rule is based upon the comments received in response to an Advance Notice of Proposed Rulemaking (``ANPR''), an Initial Notice of Proposed Rulemaking (``INPR''), a Revised Notice of Proposed Rulemaking (``RNPR''), a public workshop, a Staff Report, and other information discussed herein. This document also contains the text of the final Rule and the Rule's Statement of Basis and Purpose (``SBP''), including a Regulatory Analysis.
Cost implications of PSA screening differ by age.

PubMed

Rao, Karthik; Liang, Stella; Cardamone, Michael; Joshu, Corinne E; Marmen, Kyle; Bhavsar, Nrupen; Nelson, William G; Ballentine Carter, H; Albert, Michael C; Platz, Elizabeth A; Pollack, Craig E

2018-05-09

Multiple guidelines seek to alter rates of prostate-specific antigen (PSA)-based prostate cancer screening. The costs borne by payers associated with PSA-based screening for men of different age groups-including the costs of screening and subsequent diagnosis, treatment, and adverse events-remain uncertain. We sought to develop a model of PSA costs that could be used by payers and health care systems to inform cost considerations under a range of different scenarios. We determined the prevalence of PSA screening among men aged 50 and higher using 2013-2014 data from a large, multispecialty group, obtained reimbursed costs associated with screening, diagnosis, and treatment from a commercial health plan, and identified transition probabilities for biopsy, diagnosis, treatment, and complications from the literature to generate a cost model. We estimated annual total costs for groups of men ages 50-54, 55-69, and 70+ years, and varied annual prostate cancer screening prevalence in each group from 5 to 50% and tested hypothetical examples of different test characteristics (e.g., true/false positive rate). Under the baseline screening patterns, costs of the PSA screening represented 10.1% of the total costs; costs of biopsies and associated complications were 23.3% of total costs; and, although only 0.3% of all screen eligible patients were treated, they accounted for 66.7% of total costs. For each 5-percentage point decrease in PSA screening among men aged 70 and older for a single calendar year, total costs associated with prostate cancer screening decreased by 13.8%. For each 5-percentage point decrease in PSA screening among men 50-54 and 55-69 years old, costs were 2.3% and 7.3% lower respectively. With constrained financial resources and with national pressure to decrease use of clinically unnecessary PSA-based prostate cancer screening, there is an opportunity for cost savings, especially by focusing on the downstream costs disproportionately associated with
Opportunity's Path

NASA Technical Reports Server (NTRS)

2004-01-01

This Long Term Planning graphic was created from a mosaic of navigation camera images overlain by a polar coordinate grid with the center point as Opportunity's original landing site. The blue dots represent the rover position at various locations.
The red dots represent the center points of the target areas for the instruments on the rover mast (the panoramic camera and miniature thermal emission spectrometer). Opportunity visited Stone Mountain on Feb. 5. Stone Mountain was named after the southernmost point of the Appalachian Mountains outside of Atlanta, Ga. On Earth, Stone Mountain is the last big mountain before the Piedmont flatlands, and on Mars, Stone Mountain is at one end of Opportunity Ledge. El Capitan is a target of interest on Mars named after the second highest peak in Texas in Guadaloupe National Park, which is one of the most visited outcrops in the United States by geologists. It has been a training ground for students and professional geologists to understand what the layering means in relation to the formation of Earth, and scientists will study this prominent point of Opportunity Ledge to understand what the layering means on Mars.
The yellow lines show the midpoint where the panoramic camera has swept and will sweep a 120-degree area from the three waypoints on the tour of the outcrop. Imagine a fan-shaped wedge from left to right of the yellow line.
The white contour lines are one meter apart, and each drive has been roughly about 2-3 meters in length over the last few sols. The large white blocks are dropouts in the navigation camera data.
Opportunity is driving along and taking a photographic panorama of the entire outcrop. Scientists will stitch together these images and use the new mosaic as a 'base map' to decide on geology targets of interest for a more detailed study of the outcrop using the instruments on the robotic arm. Once scientists choose their targets of interest, they plan to study the outcrop for roughly five to
Modeling fuel treatment leverage: Encounter rates, risk reduction, and suppression cost impacts

Treesearch

Matthew P. Thompson; Karin L. Riley; Dan Loeffler; Jessica R. Haas

2017-01-01

The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the...
The Future Train Wreck: Paying for Medical Costs for Higher Education's Retirees

ERIC Educational Resources Information Center

Biggs, John H.

2006-01-01

Trustees and administrators today confront one of two problems with post-retirement medical care. First, if institutions provide no support for their retirees' medical care, they implicitly offer a powerful incentive for senior faculty to stay on. The compensation and opportunity costs of this effect are obviously very high. But, second, if they…
Informal caregivers in hospitals: Opportunities and threats.

PubMed

Amiresmaili, Mohammadreza; Emrani, Zahra

2018-05-20

High hospital costs are a challenge that health system face. Additionally, studies identified manpower deficiency as a problem in health system. Hospital is a place where patients with different physical and mental conditions come to. Their families and friends' companionship can facilitate this situation for them. This study illustrates the roles of informal caregivers in hospital. This is a phenomenological qualitative study. Data were gathered through semistructured interviews. We interviewed 22 informal caregivers and 9 nurse staffs from different departments of hospital. They were selected through purposeful and snowball sampling approach. The framework method was used for data analysis. We found 3 main themes including (a) roles of informal caregivers, (b) opportunities of presence of the informal caregivers in the hospital, and (c) threats of presence of informal caregivers. This study shows some roles for informal caregivers including mental supports, consultation, decision-making, and care roles. Concerning the shortage of manpower in Iran's hospitals, nurses have less time to take care of each patient; therefore, using informal caregivers as an implicit strategy to overcome nursing shortage and to reduce hospital costs seems to be beneficial. We suggest that an appropriate plan is necessary to make use of them for filling this gap to some extent, as well as providing training sessions and facilities for companions acting as informal caregivers. Copyright © 2018 John Wiley & Sons, Ltd.
Big Data in Designing Clinical Trials: Opportunities and Challenges

PubMed Central

Mayo, Charles S.; Matuszak, Martha M.; Schipper, Matthew J.; Jolly, Shruti; Hayman, James A.; Ten Haken, Randall K.

2017-01-01

Emergence of big data analytics resource systems (BDARSs) as a part of routine practice in Radiation Oncology is on the horizon. Gradually, individual researchers, vendors, and professional societies are leading initiatives to create and demonstrate use of automated systems. What are the implications for design of clinical trials, as these systems emerge? Gold standard, randomized controlled trials (RCTs) have high internal validity for the patients and settings fitting constraints of the trial, but also have limitations including: reproducibility, generalizability to routine practice, infrequent external validation, selection bias, characterization of confounding factors, ethics, and use for rare events. BDARS present opportunities to augment and extend RCTs. Preliminary modeling using single- and muti-institutional BDARS may lead to better design and less cost. Standardizations in data elements, clinical processes, and nomenclatures used to decrease variability and increase veracity needed for automation and multi-institutional data pooling in BDARS also support ability to add clinical validation phases to clinical trial design and increase participation. However, volume and variety in BDARS present other technical, policy, and conceptual challenges including applicable statistical concepts, cloud-based technologies. In this summary, we will examine both the opportunities and the challenges for use of big data in design of clinical trials. PMID:28913177
Big Data in Designing Clinical Trials: Opportunities and Challenges.

PubMed

Mayo, Charles S; Matuszak, Martha M; Schipper, Matthew J; Jolly, Shruti; Hayman, James A; Ten Haken, Randall K

2017-01-01

Emergence of big data analytics resource systems (BDARSs) as a part of routine practice in Radiation Oncology is on the horizon. Gradually, individual researchers, vendors, and professional societies are leading initiatives to create and demonstrate use of automated systems. What are the implications for design of clinical trials, as these systems emerge? Gold standard, randomized controlled trials (RCTs) have high internal validity for the patients and settings fitting constraints of the trial, but also have limitations including: reproducibility, generalizability to routine practice, infrequent external validation, selection bias, characterization of confounding factors, ethics, and use for rare events. BDARS present opportunities to augment and extend RCTs. Preliminary modeling using single- and muti-institutional BDARS may lead to better design and less cost. Standardizations in data elements, clinical processes, and nomenclatures used to decrease variability and increase veracity needed for automation and multi-institutional data pooling in BDARS also support ability to add clinical validation phases to clinical trial design and increase participation. However, volume and variety in BDARS present other technical, policy, and conceptual challenges including applicable statistical concepts, cloud-based technologies. In this summary, we will examine both the opportunities and the challenges for use of big data in design of clinical trials.
Quality improvement initiatives: the missed opportunity for health plans.

PubMed

Fernandez-Lopez, Sara; Lennert, Barbara

2009-11-01

The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.
Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

PubMed

Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright Â© 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
A comparative assessment of the financial costs and carbon benefits of REDD+ strategies in Southeast Asia

NASA Astrophysics Data System (ADS)

Graham, Victoria; Laurance, Susan G.; Grech, Alana; McGregor, Andrew; Venter, Oscar

2016-11-01

REDD+ holds potential for mitigating emissions from tropical forest loss by providing financial incentives for carbon stored in forests, but its economic viability is under scrutiny. The primary narrative raised in the literature is that REDD+ will be of limited utility for reducing forest carbon loss in Southeast Asia, while the level of finance committed falls short of profits from alternative land-use activities in the region, including large-scale timber and oil palm operations. Here we assess the financial costs and carbon benefits of various REDD+ strategies deployed in the region. We find the cost of reducing emissions ranges from 9 to 75 per tonne of avoided carbon emissions. The strategies focused on reducing forest degradation and promoting forest regrowth are the most cost-effective ways of reducing emissions and used in over 60% of REDD+ projects. By comparing the financial costs and carbon benefits of a broader range of strategies than previously assessed, we highlight the variation between different strategies and draw attention to opportunities where REDD+ can achieve maximum carbon benefits cost-effectively. These findings have broad policy implications for Southeast Asia. Until carbon finance escalates, emissions reductions can be maximized from reforestation, reduced-impact logging and investing in improved management of protected areas. Targeting cost-efficient opportunities for REDD+ is important to improve the efficiency of national REDD+ policy, which in-turn fosters greater financial and political support for the scheme.
Media and Equal Opportunities.

ERIC Educational Resources Information Center

Lefranc, Robert

1994-01-01

Considers the proposition that media are vehicles for equality of opportunity in education. How to harness the "parallel school," i.e. where students learn outside the school, to improve learning in the schools is discussed. The effect of social groupings on the equality of opportunity via media is also considered. (Author/KRN)
Cost-effectiveness of Human Papilloma Virus (HPV) vaccination in Nigeria: a decision analysis using pragmatic parameter estimates for cost and programme coverage.

PubMed

Ekwunife, Obinna I; Lhachimi, Stefan K

2017-12-08

World Health Organisation recommends routine Human Papilloma Virus (HPV) vaccination for girls when its cost-effectiveness in the country or region has been duly considered. We therefore aimed to evaluate cost-effectiveness of HPV vaccination in Nigeria using pragmatic parameter estimates for cost and programme coverage, i.e. realistically achievable in the studied context. A microsimulation frame-work was used. The natural history for cervical cancer disease was remodelled from a previous Nigerian model-based study. Costing was based on health providers' perspective. Disability adjusted life years attributable to cervical cancer mortality served as benefit estimate. Suitable policy option was obtained by calculating the incremental costs-effectiveness ratio. Probabilistic sensitivity analysis was used to assess parameter uncertainty. One-way sensitivity analysis was used to explore the robustness of the policy recommendation to key parameters alteration. Expected value of perfect information (EVPI) was calculated to determine the expected opportunity cost associated with choosing the optimal scenario or strategy at the maximum cost-effectiveness threshold. Combination of the current scenario of opportunistic screening and national HPV vaccination programme (CS + NV) was the only cost-effective and robust policy option. However, CS + NV scenario was only cost-effective so far the unit cost of HPV vaccine did not exceed $5. EVPI analysis showed that it may be worthwhile to conduct additional research to inform the decision to adopt CS + NV. National HPV vaccination combined with opportunist cervical cancer screening is cost-effective in Nigeria. However, adoption of this strategy should depend on its relative efficiency when compared to other competing new vaccines and health interventions.
Pediatric Price Transparency: Still Opaque With Opportunities for Improvement.

PubMed

Faherty, Laura J; Wong, Charlene A; Feingold, Jordyn; Li, Joan; Town, Robert; Fieldston, Evan; Werner, Rachel M

2017-10-01

Price transparency is gaining importance as families' portion of health care costs rise. We describe (1) online price transparency data for pediatric care on children's hospital Web sites and state-based price transparency Web sites, and (2) the consumer experience of obtaining an out-of-pocket estimate from children's hospitals for a common procedure. From 2015 to 2016, we audited 45 children's hospital Web sites and 38 state-based price transparency Web sites, describing availability and characteristics of health care prices and personalized cost estimate tools. Using secret shopper methodology, we called children's hospitals and submitted online estimate requests posing as a self-paying family requesting an out-of-pocket estimate for a tonsillectomy-adenoidectomy. Eight children's hospital Web sites (18%) listed prices. Twelve (27%) provided personalized cost estimate tool (online form n = 5 and/or phone number n = 9). All 9 hospitals with a phone number for estimates provided the estimated patient liability for a tonsillectomy-adenoidectomy (mean $6008, range $2622-$9840). Of the remaining 36 hospitals without a dedicated price estimate phone number, 21 (58%) provided estimates (mean $7144, range $1200-$15 360). Two of 4 hospitals with online forms provided estimates. Fifteen (39%) state-based Web sites distinguished between prices for pediatric and adult care. One had a personalized cost estimate tool. Meaningful prices for pediatric care were not widely available online through children's hospital or state-based price transparency Web sites. A phone line or online form for price estimates were effective strategies for hospitals to provide out-of-pocket price information. Opportunities exist to improve pediatric price transparency. Copyright © 2017 by the American Academy of Pediatrics.
Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

PubMed Central

Abdullah, Mohammad M. H.; Marinangeli, Christopher P. F.; Jones, Peter J. H.; Carlberg, Jared G.

2017-01-01

Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1) estimate the proportions of individuals who are likely to consume pulses; (2) evaluate the reductions in established risk factors for T2D and CVD; (3) assess the percent reduction in incidences or complications of the diseases of interest; and (4) calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9) to Can$62.4 (95% CI $26–$98.8) and Can$31.6 (95% CI $11.1–$52) to Can$315.5 (95% CI $110.6–$520.4) million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term. PMID:28737688
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. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Hydropower Baseline Cost Modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Connor, Patrick W.; Zhang, Qin Fen; DeNeale, Scott T.

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

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

Malignancy-associated mortality, decreased productivity, and spiritual, social and physical burden in cancer patients and their families impose heavy costs on communities. Therefore cancer prevention, early detection, rapid diagnosis and timely treatment are very important. Use of modern methods based on information technology in cancer can improve patient survival and increase patient and health care provider satisfaction. Robot technology is used in different areas of health care and applications in surgery have emerged affecting the cancer treatment domain. Computerized and robotic devices can offer enhanced dexterity by tremor abolition, motion scaling, high quality 3D vision for surgeons and decreased blood loss, significant reduction in narcotic use, and reduced hospital stay for patients. However, there are many challenges like lack of surgical community support, large size, high costs and absence of tactile and haptic feedback. A comprehensive view to identify all factors in different aspects such as technical, legal and ethical items that prevent robotic surgery adoption is thus very necessary. Also evidence must be presented to surgeons to achieve appropriate support from physicians. The aim of this review article is to survey applications, opportunities and barriers to this advanced technology in patients and surgeons as an approach to improve cancer care.
Funding Opportunity: Genomic Data Centers

Cancer.gov

Funding Opportunity CCG, Funding Opportunity Center for Cancer Genomics, CCG, Center for Cancer Genomics, CCG RFA, Center for cancer genomics rfa, genomic data analysis network, genomic data analysis network centers,
Formation of costs of high-rise objects of housing and civil purpose based on enlarged norms

NASA Astrophysics Data System (ADS)

Vorotyntseva, Anna; Ovsiannikov, Andrei; Bolgov, Vladimir

2018-03-01

When determining the cost of capital construction objects, for purposes of pre-design workings out and purposes of initial maximum initial price determination on tenders, construction price norms are used (CPNs). Modern CPNs are not designed to determine the value of high-rise buildings. It is necessary to adapt modern CPNs to get opportunity for the possibility to take into account special cost factors in determining the cost of high-rise buildings. The main ways can be: selection of new representative objects or application of additional correction factors.

Effect of prospective reimbursement on nursing home costs.

PubMed

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.
Social Entrepreneurship for Obesity Prevention: What Are the Opportunities?

PubMed

Smith, Tosha Woods; Calancie, Larissa; Ammerman, Alice

2015-09-01

In recent years, social entrepreneurship has emerged as a new field to address social and public health challenges. Social entrepreneurship, which harnesses traditional business practices and market forces to address social challenges, may produce solutions that are more cost-effective and sustainable than those produced by governmental and nonprofit sectors. In this paper, we discuss whether and how social entrepreneurship can be harnessed for obesity prevention by defining and briefly reviewing the rise of social entrepreneurship in the USA, outlining the threat that obesity poses to US society and offering some examples of how social ventures are addressing the problem of obesity. Additional untapped opportunities are also discussed and recommendations given for how social entrepreneurship might impact obesity prevention in the future.
The Electrification of Energy: Long-Term Trends and Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsao, Jeffrey Y.; Fouquet, Roger; Schubert, E. Fred

Here, we present and analyze three powerful long-term historical trends in energy, particularly electrical energy, as well as the opportunities and challenges associated with these trends. The first trend is from a world containing a diversity of energy currencies to one whose predominant currency is electricity, driven by electricity’s transportability, exchangeability, and steadily decreasing cost. The second trend is from electricity generated from a diversity of sources to electricity generated predominantly by free-fuel sources, driven by their steadily decreasing cost and long-term abundance. These trends necessitate a just-emerging third trend: from a grid in which electricity is transported uni-directionally, tradedmore » at near-static prices, and consumed under direct human control; to a grid in which electricity is transported bi-directionally, traded at dynamic prices, and consumed under human-tailored agential control. Early acceptance and appreciation of these trends will accelerate their remaking of humanity’s energy landscape into one in which energy is much more affordable, abundant and efficiently deployed than it is today; with major economic, geo-political, and environmental benefits to human society.« less
10 CFR 600.8 - Funding Opportunity Announcement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Funding Opportunity Announcement. 600.8 Section 600.8... Funding Opportunity Announcement. (a) General. Funding Opportunity Announcements (FOA) include any issuance used to announce funding opportunities that would result in the award of a discretionary grant...
10 CFR 600.8 - Funding Opportunity Announcement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Funding Opportunity Announcement. 600.8 Section 600.8... Funding Opportunity Announcement. (a) General. Funding Opportunity Announcements (FOA) include any issuance used to announce funding opportunities that would result in the award of a discretionary grant...
Cost-effective analysis of conventional and nurse-led clinics for common otological procedures.

PubMed

Uppal, S; Jose, J; Banks, P; Mackay, E; Coatesworth, A P

2004-03-01

The need to reduce costs while providing a first-class service has led to the expansion in the role of nurses in recent years. We present results of a comparison of the cost-effectiveness of conventional and nurse-led out-patient ear clinics. Our results indicate that cost-effective health care is a distinct competitive advantage for nurses taking up some roles conventionally performed by doctors. The difference in mean cost of out-patient visit per patient between the two groups is 75.28 pounds. This is equivalent to a reduction in cost to the hospital of more than 47,000 pounds for the 626 patients seen in a nurse-led ear clinic in a year. The nurse-led service is thus more cost-effective and presents an opportunity by freeing up otolaryngologists' time to see more complex patients and has the potential for reducing out-patient access time in the NHS.
Cost considerations in implementing a screening and surveillance strategy for Barrett's oesophagus.

PubMed

Inadomi, John M

2015-02-01

There is increasing concern over the rising costs of healthcare leading to debate regarding the use of resources to implement preventive strategies. Oesophageal adenocarcinoma and its precursor, Barrett's oesophagus provides an excellent opportunity to highlight this issue since cancer is uncommon even among individuals with documented Barrett's oesophagus. This review provides a brief introduction to economic analysis in healthcare and summarizes published studies of the cost-effectiveness of strategies to reduce mortality from cancer. Current best estimates highlight the cost-effectiveness of endoscopic ablation among patients with Barrett's oesophagus and high-grade dysplasia and the low cost-effectiveness of ablation among patients without dysplasia. The cost-effectiveness of ablation among patients with Barrett's and low-grade dysplasia is poorly defined due to the ambiguity of diagnosing dysplasia, the unknown risk of cancer among patients with low-grade dysplasia, and the uncertain durability of ablation to maintain remission from metaplasia and dysplasia and prevent cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.
Wastewater Treatment Costs and Outlays in Organic Petrochemicals: Standards Versus Taxes With Methodology Suggestions for Marginal Cost Pricing and Analysis

NASA Astrophysics Data System (ADS)

Thompson, Russell G.; Singleton, F. D., Jr.

1986-04-01

With the methodology recommended by Baumol and Oates, comparable estimates of wastewater treatment costs and industry outlays are developed for effluent standard and effluent tax instruments for pollution abatement in five hypothetical organic petrochemicals (olefins) plants. The computational method uses a nonlinear simulation model for wastewater treatment to estimate the system state inputs for linear programming cost estimation, following a practice developed in a National Science Foundation (Research Applied to National Needs) study at the University of Houston and used to estimate Houston Ship Channel pollution abatement costs for the National Commission on Water Quality. Focusing on best practical and best available technology standards, with effluent taxes adjusted to give nearly equal pollution discharges, shows that average daily treatment costs (and the confidence intervals for treatment cost) would always be less for the effluent tax than for the effluent standard approach. However, industry's total outlay for these treatment costs, plus effluent taxes, would always be greater for the effluent tax approach than the total treatment costs would be for the effluent standard approach. Thus the practical necessity of showing smaller outlays as a prerequisite for a policy change toward efficiency dictates the need to link the economics at the microlevel with that at the macrolevel. Aggregation of the plants into a programming modeling basis for individual sectors and for the economy would provide a sound basis for effective policy reform, because the opportunity costs of the salient regulatory policies would be captured. Then, the government's policymakers would have the informational insights necessary to legislate more efficient environmental policies in light of the wealth distribution effects.
Challenges and Opportunities of Big Data in Health Care: A Systematic Review.

PubMed

Kruse, Clemens Scott; Goswamy, Rishi; Raval, Yesha; Marawi, Sarah

2016-11-21

Big data analytics offers promise in many business sectors, and health care is looking at big data to provide answers to many age-related issues, particularly dementia and chronic disease management. The purpose of this review was to summarize the challenges faced by big data analytics and the opportunities that big data opens in health care. A total of 3 searches were performed for publications between January 1, 2010 and January 1, 2016 (PubMed/MEDLINE, CINAHL, and Google Scholar), and an assessment was made on content germane to big data in health care. From the results of the searches in research databases and Google Scholar (N=28), the authors summarized content and identified 9 and 14 themes under the categories Challenges and Opportunities, respectively. We rank-ordered and analyzed the themes based on the frequency of occurrence. The top challenges were issues of data structure, security, data standardization, storage and transfers, and managerial skills such as data governance. The top opportunities revealed were quality improvement, population management and health, early detection of disease, data quality, structure, and accessibility, improved decision making, and cost reduction. Big data analytics has the potential for positive impact and global implications; however, it must overcome some legitimate obstacles. ©Clemens Scott Kruse, Rishi Goswamy, Yesha Raval, Sarah Marawi. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 21.11.2016.
[The challenges and opportunities of implementing outsourcing in private and public hospitals in Israel].

PubMed

Rahimi, Benny; Mizrahi, Ronit; Magnezi, Racheli

2011-01-01

Outsourcing is a method that enables an organization to focus on its expertise by transferring its other services to professionals who can fulfill them. In recent years, research has repeatedly shown that health services use a variety of outsourcing companies. To describe the experience acquired using outsourcing in public and private hospitals in Israel, and to present the factors, budgetary parameters, opportunities and problems affecting outsourcing. The questionnaire was sent to 36 hospitals in Israel, constituting 88.2% of all hospitals in Israel--private, public, H.M.O ("Clalit") and governmental. The response to the questionnaire reached 97.2% and revealed the following: 94% of the hospitals use outsourcing services in the following fields: security, cleaning, Laundry service, cafeterias, and I.T.; 42% of the hospitals assign 0-5% of their annual budget for outsourcing contracts. Private hospitals use more outsourcing services than public hospitals. The factors driving outsourcing are: cost restrictions (82.8%), operational flexibility (77%), and focus on the core business (74.2%). The potential advantages of outsourcing are: improvement in services 180.5%), customer satisfaction (72.2%), and cost reduction (69.4%). Difficulties affecting outsourcing are: dependence on external resources (83.3%] and internal organizational resistance (69.4%). The results of the outsourcing are lower costs, reduced number of personnel by 1-10% and high level of satisfaction. It seems that in recent years outsourcing is being used in hospitals and is central to the areas of infrastructure and logistics, as well as legal and medical services. Using outsourcing in hospitals provides opportunities for improved customer satisfaction, better focus for the hospital on its core activities and cost reduction. HospitaLs that succeed in synergetically integrating the external and the internal service providers will flourish. INNOVATION/VALUE: This research exposes, for the first time
Gendered Opportunity? School-Based Adolescent Victimization

ERIC Educational Resources Information Center

Wilcox, Pamela; Tillyer, Marie Skubak; Fisher, Bonnie S.

2009-01-01

Researchers have shown that criminal opportunity significantly predicts school-based adolescent victimization. However, little is known about the extent to which opportunity for school-based victimization might be gendered. In this study, the authors drew from criminal opportunity and feminist research and extended the principle of homogamy to…
The Cost-Quality Debate in School Finance Legislation: Do Dollars Make a Difference?

ERIC Educational Resources Information Center

McDermott, John E.; Klein, Stephen P.

1974-01-01

The appropriateness of using the judicial process as a forum for resolving the cost-quality debate in educational finance is discussed in an attempt to discover some intermediate ground, which would permit the judicial machinery to operate but avoids settling the scientific dispute. Existing judicial standards of educational opportunity are…
Science opportunity analyzer - a multi-mission tool for planning

NASA Technical Reports Server (NTRS)

Streiffert, B. A.; Polanskey, C. A.; O'Reilly, T.; Colwell, J.

2002-01-01

For many years the diverse scientific community that supports JPL's wide variety ofinterplanetary space missions has needed a tool in order to plan and develop their experiments. The tool needs to be easily adapted to various mission types and portable to the user community. The Science Opportunity Analyzer, SOA, now in its third year of development, is intended to meet this need. SOA is a java-based application that is designed to enable scientists to identify and analyze opportunities for science observations from spacecraft. It differs from other planning tools in that it does not require an in-depth knowledge of the spacecraft command system or operation modes to begin high level planning. Users can, however, develop increasingly detailed levels of design. SOA consists of six major functions: Opportunity Search, Visualization, Observation Design, Constraint Checking, Data Output and Communications. Opportunity Search is a GUI driven interface to existing search engines that can be used to identify times when a spacecraft is in a specific geometrical relationship with other bodies in the solar system. This function can be used for advanced mission planning as well as for making last minute adjustments to mission sequences in response to trajectory modifications. Visualization is a key aspect of SOA. The user can view observation opportunities in either a 3D representation or as a 2D map projection. The user is given extensive flexibility to customize what is displayed in the view. Observation Design allows the user to orient the spacecraft and visualize the projection of the instrument field of view for that orientation using the same views as Opportunity Search. Constraint Checking is provided to validate various geometrical and physical aspects of an observation design. The user has the ability to easily create custom rules or to use official project-generated flight rules. This capability may also allow scientists to easily impact the cost to science if
Biogas Opportunities Roadmap Progress Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

In support of the Obama Administration's Climate Action Plan, the U.S. Department of Energy, the U.S. Environmental Protection Agency, and U.S. Department of Agriculture jointly released the Biogas Opportunities Roadmap Progress Report, updating the federal government's progress to reduce methane emissions through biogas systems since the Biogas Opportunities Roadmap was completed by the three agencies in July 2014. The report highlights actions taken, outlines challenges and opportunities, and identifies next steps to the growth of a robust biogas industry.
How to solve the cost crisis in health care.

PubMed

Kaplan, Robert S; Porter, Michael E

2011-09-01

U.S. health care costs currently exceed 17% of GDP and continue to rise. One fundamental reason that providers are unable to reverse the trend is that they don't understand what it costs to deliver patient care or how those costs compare with outcomes. To put it bluntly, few health care providers measure the actual costs for treating a given patient with a given medical condition over a full cycle of care, or compare the costs they incur with the outcomes they achieve. What isn't measured cannot be managed or improved, and this is all too true in health care, where poor costing systems mean that effective and efficient providers go unrewarded, and inefficient ones have little incentive to improve. But all this can be remedied by exploring the concept of value in health care and carefully measuring costs. This article describes a new way to analyze costs that uses patients and their conditions--not organizational units or narrow diagnostic treatment groups--as the fundamental unit of analysis for measuring costs and outcomes. The new approach, called time-driven activity-cased costing, is currently being implemented in pilots at the Head and Neck Center at MD Anderson, the Cleft Lip and Palate Program at Children's Hospital in Boston, and units performing knee replacements at Schön Klinik in Germany and Brigham & Women's Hospital in Boston. As providers and payors better understand costs, they will be positioned to achieve a true "bending of the cost curve" from within the system, not in response to top-down mandates. Accurate costing also unlocks a whole cascade of opportunities, such as process improvement, better organization of care, and new reimbursement approaches that will accelerate the pace of innovation and value creation.
Remote-site power generation opportunities for Alaska

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jones, M.L.

1997-03-01

The Energy and Environmental Research Center (EERC) has been working with the Federal Energy Technology Center in Morgantown, West Virginia, to assess options for small, low-cost, environmental acceptable power generation for application in remote areas of Alaska. The goal of this activity was to reduce the use of fuel in Alaskan villages by developing small, low-cost power generation applications. Because of the abundance of high-quality coal throughout Alaska, emphasis was placed on clean coal applications, but other energy sources, including geothermal, wind, hydro, and coalbed methane, were also considered. The use of indigenous energy sources would provide cheaper cleaner power,more » reduce the need for PCE (Power Cost Equalization program) subsidies, increase self-sufficiency, and retain hard currency in the state while at the same time creating jobs in the region. The introduction of economical, small power generation systems into Alaska by US equipment suppliers and technology developers aided by the EERC would create the opportunities for these companies to learn how to engineer, package, transport, finance, and operate small systems in remote locations. All of this experience would put the US developers and equipment supply companies in an excellent position to export similar types of small power systems to rural areas or developing countries. Thus activities in this task that relate to determining the generic suitability of these technologies for other countries can increase US competitiveness and help US companies sell these technologies in foreign countries, increasing the number of US jobs. The bulk of this report is contained in the two appendices: Small alternative power workshop, topical report and Global market assessment of coalbed methane, fluidized-bed combustion, and coal-fired diesel technologies in remote applications.« less
Federal incentives for industrial modernization: Historical review and future opportunities

NASA Technical Reports Server (NTRS)

Coleman, Sandra C.; Batson, Robert G.

1987-01-01

Concerns over the aging of the U.S. aerospace industrial base led DOD to introduce first its Technology Modernization (Tech Mod) Program, and more recently the Industrial Modernization Incentive Program (IMIP). These incentives include productivity shared savings rewards, contractor investment protection to allow for amortization of plant and equipment, and subcontractor/vendor participation. The purpose here is to review DOD IMIP and to evaluate whether a similar program is feasible for NASA and other non-DOD agencies. The IMIP methodology is of interest to industrial engineers because it provides a structured, disciplined approach to identifying productivity improvement opportunities and documenting their expected benefit. However, it is shown that more research on predicting and validating cost avoidance is needed.
Strengths, challenges, and opportunities for hydrothermal pretreatment in lignocellulosic biorefineries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Bin; Tao, Ling; Wyman, Charles E.

Pretreatment prior to or during biological conversion is required to achieve high sugar yields essential to economic production of fuels and chemicals from low cost, abundant lignocellulosic biomass. Aqueous thermochemical pretreatments achieve this performance objective from pretreatment coupled with subsequent enzymatic hydrolysis, but chemical pretreatment can also suffer from additional costs for exotic materials of construction, the need to recover or neutralize the chemicals, introduction of compounds that inhibit downstream operations, and waste disposal, as well as for the chemicals themselves. The simplicity of hydrothermal pretreatment with just hot water offers the potential to greatly improve the cost of themore » entire conversion process if sugar degradation during pretreatment, production of un-fermentable oligomers, and the amount of expensive enzymes needed to obtain satisfactory yields from hydrothermally pretreated solids can be reduced. Biorefinery economics would also benefit if value could be generated from lignin and other components that are currently fated to be burned for power. However, achieving these goals will no doubt require development of advanced hydrothermal pretreatment configurations. For example, passing water through a stationary bed of lignocellulosic biomass in a flowthrough configuration achieves very high yields of hemicellulose sugars, removes more than 75% of the lignin for potential valorization, and improves sugar release from the pretreated solids with lower enzyme loadings. Unfortunately, the large quantities of water needed to achieve this performance result in very dilute sugars, high energy costs for pretreatment and product recover, and large amounts of oligomers. Furthermore, improving our understanding of hydrothermal pretreatment fundamentals is needed to gain insights into R&D opportunities to improve performance, and help identify novel configurations that lower capital and operating costs and achieve
Strengths, challenges, and opportunities for hydrothermal pretreatment in lignocellulosic biorefineries

DOE PAGES

Yang, Bin; Tao, Ling; Wyman, Charles E.

2017-10-11

Pretreatment prior to or during biological conversion is required to achieve high sugar yields essential to economic production of fuels and chemicals from low cost, abundant lignocellulosic biomass. Aqueous thermochemical pretreatments achieve this performance objective from pretreatment coupled with subsequent enzymatic hydrolysis, but chemical pretreatment can also suffer from additional costs for exotic materials of construction, the need to recover or neutralize the chemicals, introduction of compounds that inhibit downstream operations, and waste disposal, as well as for the chemicals themselves. The simplicity of hydrothermal pretreatment with just hot water offers the potential to greatly improve the cost of themore » entire conversion process if sugar degradation during pretreatment, production of un-fermentable oligomers, and the amount of expensive enzymes needed to obtain satisfactory yields from hydrothermally pretreated solids can be reduced. Biorefinery economics would also benefit if value could be generated from lignin and other components that are currently fated to be burned for power. However, achieving these goals will no doubt require development of advanced hydrothermal pretreatment configurations. For example, passing water through a stationary bed of lignocellulosic biomass in a flowthrough configuration achieves very high yields of hemicellulose sugars, removes more than 75% of the lignin for potential valorization, and improves sugar release from the pretreated solids with lower enzyme loadings. Unfortunately, the large quantities of water needed to achieve this performance result in very dilute sugars, high energy costs for pretreatment and product recover, and large amounts of oligomers. Furthermore, improving our understanding of hydrothermal pretreatment fundamentals is needed to gain insights into R&D opportunities to improve performance, and help identify novel configurations that lower capital and operating costs and achieve
Cost-Effective, Equitable and Flexible Higher Education through Open and Distance Learning in Bangladesh

ERIC Educational Resources Information Center

Islam, Tofazzal

2011-01-01

This paper examines how this mega-university offers increasing access to cost-effective, equitable and flexible higher education by analyzing data from primary and secondary sources, identifies challenges impacting the continued growth of enrollment in distance education, and outlines opportunities for increasing access to higher education through…

Paved Path for Opportunity

NASA Technical Reports Server (NTRS)

2006-01-01

As NASA's Mars Exploration Rover Opportunity continues a southward trek from 'Erebus Crater' toward 'Victoria Crater,' the terrain consists of large sand ripples and patches of flat-lying rock outcrops, as shown in this image. Whenever possible, rover planners keep Opportunity on the 'pavement' for best mobility.
This false-color image mosaic was assembled using images acquired by the panoramic camera on Opportunity's 784th sol (April 8, 2006) at about 11:45 a.m. local solar time. The camera used its 753-nanometer, 535-nanometer and 432-nanometer filters. This view shows a portion of the outcrop named 'Bosque,' including rover wheel tracks, fractured and finely-layered outcrop rocks and smaller, dark cobbles littered across the surface.
Socio-economic and Engineering Assessments of Renewable Energy Cost Reduction Potential

NASA Astrophysics Data System (ADS)

Seel, Joachim

This dissertation combines three perspectives on the potential of cost reductions of renewable energy--a relevant topic, as high energy costs have traditionally been cited as major reason to vindicate developments of fossil fuel and nuclear power plants, and to justify financial support mechanisms and special incentives for renewable energy generators. First, I highlight the role of market and policy drivers in an international comparison of upfront capital expenses of residential photovoltaic systems in Germany and the United States that result in price differences of a factor of two and suggest cost reduction opportunities. In a second article I examine engineering approaches and siting considerations of large-scale photovoltaic projects in the United States that enable substantial system performance increases and allow thus for lower energy costs on a levelized basis. Finally, I investigate future cost reduction options of wind energy, ranging from capital expenses, operating expenses, and performance over a project's lifetime to financing costs. The assessment shows both substantial further cost decline potential for mature technologies like land-based turbines, nascent technologies like fixed-bottom offshore turbines, and experimental technologies like floating offshore turbines. The following paragraphs summarize each analysis: International upfront capital cost comparison of residential solar systems: Residential photovoltaic (PV) systems were twice as expensive in the United States as in Germany in 2012. This price discrepancy stems primarily from differences in non-hardware or "soft" costs between the two countries, of which only 35% be explained by differences in cumulative market size and associated learning. A survey of German PV installers was deployed to collect granular data on PV soft costs in Germany, and the results are compared to those of a similar survey of U.S. PV installers. Non-module hardware costs and all analyzed soft costs are lower in
Physical activity opportunities in afterschool programs

PubMed Central

Weaver, R. Glenn; Beets, Michael W.; Huberty, Jennifer; Freedman, Darcy; Turner-Mcgrievy, Gabrielle; Ward, Diane

2015-01-01

Afterschool programs (ASPs) have potential to provide children moderate-to-vigorous physical activity (MVPA). The availability and types (e.g., free play or organized activities) of physical activity opportunities, their structure (e.g., presence of lines, elimination games), and staff behaviors (e.g., encouragement, engaged) can influence children’s MVPA. This study explored these factors in 20 ASPs serving over 1,700 elementary-age children. The occurrence, types and structure of physical activity opportunities, and staff behaviors were collected via the System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN). A total of 4,660 SOSPAN scans were completed across 63 complete program days (1733 during physical activity opportunities). Physical activity opportunities were observed on 60 program days across all 20 sites, with 73% of those opportunities classified as free play. ASPs scheduled an average of 66.3 minutes (range 15-150min) of physical activity opportunities daily. Games played included basketball, tag, soccer and football. Staff rarely engaged in physical activity promotion behaviors, and the structure of organized games discouraged MVPA. For example, staff verbally promoted physical activity in just 6.1% of scans, while organized games were more likely to involve lines and elimination. Professional development training may enhance staffs’ physical activity promotion and the structure of activity opportunities. PMID:25586132
Opportunities, Rational Choice, and Self-Control: On the Interaction of Person and Situation in a General Theory of Crime

ERIC Educational Resources Information Center

Seipel, Christian; Eifler, Stefanie

2010-01-01

In this article, deviant action is analyzed on the basis of ideas derived from Gottfredson and Hirschi's self-control theory. Presumedly, self-control in interaction with opportunities can explain deviant action. This assumption is elaborated using the concept of high- and low-cost situations from rational choice theory. From this point of view,…
Cognitive cost as dynamic allocation of energetic resources

PubMed Central

Christie, S. Thomas; Schrater, Paul

2015-01-01

While it is widely recognized that thinking is somehow costly, involving cognitive effort and producing mental fatigue, these costs have alternatively been assumed to exist, treated as the brain's assessment of lost opportunities, or suggested to be metabolic but with implausible biological bases. We present a model of cognitive cost based on the novel idea that the brain senses and plans for longer-term allocation of metabolic resources by purposively conserving brain activity. We identify several distinct ways the brain might control its metabolic output, and show how a control-theoretic model that models decision-making with an energy budget can explain cognitive effort avoidance in terms of an optimal allocation of limited energetic resources. The model accounts for both subject responsiveness to reward and the detrimental effects of hypoglycemia on cognitive function. A critical component of the model is using astrocytic glycogen as a plausible basis for limited energetic reserves. Glycogen acts as an energy buffer that can temporarily support high neural activity beyond the rate supported by blood glucose supply. The published dynamics of glycogen depletion and repletion are consonant with a broad array of phenomena associated with cognitive cost. Our model thus subsumes both the “cost/benefit” and “limited resource” models of cognitive cost while retaining valuable contributions of each. We discuss how the rational control of metabolic resources could underpin the control of attention, working memory, cognitive look ahead, and model-free vs. model-based policy learning. PMID:26379482
Cognitive cost as dynamic allocation of energetic resources.

PubMed

Christie, S Thomas; Schrater, Paul

2015-01-01

While it is widely recognized that thinking is somehow costly, involving cognitive effort and producing mental fatigue, these costs have alternatively been assumed to exist, treated as the brain's assessment of lost opportunities, or suggested to be metabolic but with implausible biological bases. We present a model of cognitive cost based on the novel idea that the brain senses and plans for longer-term allocation of metabolic resources by purposively conserving brain activity. We identify several distinct ways the brain might control its metabolic output, and show how a control-theoretic model that models decision-making with an energy budget can explain cognitive effort avoidance in terms of an optimal allocation of limited energetic resources. The model accounts for both subject responsiveness to reward and the detrimental effects of hypoglycemia on cognitive function. A critical component of the model is using astrocytic glycogen as a plausible basis for limited energetic reserves. Glycogen acts as an energy buffer that can temporarily support high neural activity beyond the rate supported by blood glucose supply. The published dynamics of glycogen depletion and repletion are consonant with a broad array of phenomena associated with cognitive cost. Our model thus subsumes both the "cost/benefit" and "limited resource" models of cognitive cost while retaining valuable contributions of each. We discuss how the rational control of metabolic resources could underpin the control of attention, working memory, cognitive look ahead, and model-free vs. model-based policy learning.
Human Reliability and the Cost of Doing Business

NASA Technical Reports Server (NTRS)

DeMott, Diana

2014-01-01

Most businesses recognize that people will make mistakes and assume errors are just part of the cost of doing business, but does it need to be? Companies with high risk, or major consequences, should consider the effect of human error. In a variety of industries, Human Errors have caused costly failures and workplace injuries. These have included: airline mishaps, medical malpractice, administration of medication and major oil spills have all been blamed on human error. A technique to mitigate or even eliminate some of these costly human errors is the use of Human Reliability Analysis (HRA). Various methodologies are available to perform Human Reliability Assessments that range from identifying the most likely areas for concern to detailed assessments with human error failure probabilities calculated. Which methodology to use would be based on a variety of factors that would include: 1) how people react and act in different industries, and differing expectations based on industries standards, 2) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 3) type and availability of data and 4) how the industry views risk & reliability influences ( types of emergencies, contingencies and routine tasks versus cost based concerns). The Human Reliability Assessments should be the first step to reduce, mitigate or eliminate the costly mistakes or catastrophic failures. Using Human Reliability techniques to identify and classify human error risks allows a company more opportunities to mitigate or eliminate these risks and prevent costly failures.
Competition, regulation, and energy efficiency options in the electricity sector: Opportunities and challenges in developing countries

NASA Astrophysics Data System (ADS)

Phadke, Amol Anant

This dissertation explores issues related to competition in and regulation of electricity sectors in developing countries on the backdrop of fundamental reforms in their electricity sectors. In most cases, electricity sector reforms promoted privatization based on the rationale that it will lower prices and improve quality. In Chapter 2, I analyze this rationale by examining the stated capital cost of independent (private) power producer's (IPPs) power projects in eight developing countries and find that the stated capital cost of projects selected via competitive bidding is on an average about 40% to 60% lower than that of the projects selected via negotiations, which, I argue, represents the extent to which the costs of negotiated projects are overstated. My results indicate that the policy of promoting private sector without an adequate focus on improving competition or regulation has not worked in most cases in terms of getting competitively priced private sector projects. Given the importance of facilitating effective competition or regulation, In Chapter 3, I examine the challenges and opportunities of establishing a competitive wholesale electricity market in a developing country context. I model a potential wholesale electricity market in Maharashtra (MH) state, India and find that it would be robustly competitive even in a situation of up-to five percent of supply shortage, when opportunities for demand response are combined with policies such as divestiture and requiring long-term contracts. My results indicate that with appropriate policies, some developing countries could establish competitive wholesale electricity markets. In Chapter 4, I focus on the demand side and analyze the cost effectiveness of improving end-use efficiency in an electricity sector with subsidized tariffs and electricity shortages and show that they offer the least expensive way of reducing shortages in Maharashtra State, India. In Chapter 5, I examine the costs of reducing carbon
28 CFR 42.303 - Evaluation of employment opportunities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... opportunities for minorities and women. (b) In many cases an effective equal employment opportunity program may... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Evaluation of employment opportunities... EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Equal Employment Opportunity Program Guidelines § 42.303...
28 CFR 42.303 - Evaluation of employment opportunities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... opportunities for minorities and women. (b) In many cases an effective equal employment opportunity program may... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Evaluation of employment opportunities... EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Equal Employment Opportunity Program Guidelines § 42.303...
Capital intensity of photovoltaics manufacturing: Barrier to scale and opportunity for innovation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Powell, Douglas M.; Fu, Ran; Horowitz, Kelsey

In this study, using a bottom-up cost model, we assess the impact of initial factory capital expenditure (capex) on photovoltaic (PV) module minimum sustainable price (MSP) and industry-wide trends. We find capex to have two important impacts on PV manufacturing. First, capex strongly influences the per-unit MSP of a c-Si module: we calculate that the capex-related elements sum to 22% of MSP for an integrated wafer, cell, and module manufacturer. This fraction provides a significant opportunity to reduce MSP toward the U.S. DOE SunShot module price target through capex innovation.
Capital intensity of photovoltaics manufacturing: Barrier to scale and opportunity for innovation

DOE PAGES

Powell, Douglas M.; Fu, Ran; Horowitz, Kelsey; ...

2015-09-07

In this study, using a bottom-up cost model, we assess the impact of initial factory capital expenditure (capex) on photovoltaic (PV) module minimum sustainable price (MSP) and industry-wide trends. We find capex to have two important impacts on PV manufacturing. First, capex strongly influences the per-unit MSP of a c-Si module: we calculate that the capex-related elements sum to 22% of MSP for an integrated wafer, cell, and module manufacturer. This fraction provides a significant opportunity to reduce MSP toward the U.S. DOE SunShot module price target through capex innovation.
Lifetime indirect cost of childhood overweight and obesity: A decision analytic model.

PubMed

Sonntag, Diana; Ali, Shehzad; De Bock, Freia

2016-01-01

To estimate the indirect lifetime cost of childhood overweight and obesity for Germany. The lifetime cohort model consisted of two parts: (a) Model I used data from the German Interview and Examination Survey for Children on prevalence of BMI categories during childhood to evaluate BMI trajectories before the age of 18; and (b) Model II estimated lifetime excess indirect cost based on the history of childhood BMI. Indirect costs were defined as the opportunity cost of lost productivity due to mortality and morbidity and were identified through a systematic literature review. Our analysis showed that the majority of children with overweight and obesity remained in the same BMI category during their adult life, resulting in significant indirect lifetime costs. We estimated that overweight and obesity during childhood resulted in an excess lifetime cost per person of €4,209 (men) and €2,445 (women). For the current prevalent German population, the excess lifetime cost was €145 billion. Our study showed that childhood obesity results in significant economic burden on the society. Therefore, cost-effective strategies targeted at reducing the prevalence of obesity during the early years of life can significantly reduce both healthcare and nonhealthcare costs over the lifetime. © 2015 The Obesity Society.
Opportunity Journey Exceeds 25 Miles

NASA Image and Video Library

2014-07-28

NASA Opportunity rover, working on Mars since January 2004, passed 25 miles of total driving on the July 27, 2014. The gold line on this map shows Opportunity route from the landing site inside Eagle Crater, in upper left.
Societal economic costs and benefits from death: another look.

PubMed

Stack, Steven

2007-04-01

B. Yang and D. Lester (2007) have produced an innovative contribution to the relevant literature. Unlike previous studies, they incorporate estimates of cost savings from suicide. Their argument could be strengthened in 3 ways. First, they may have underestimated some of the cost savings by relying on inflated estimates of mental health usage by suicidal persons. The present analysis shows that only 20% of suicidal individuals see a mental health professional during the last year of life, much lower than previous estimates. Further, persons dying of cancer are 4 times more likely than suicides to report high usage of medical services. Second, our economy relies heavily on the health care sector for job creation, so that we need to exercise caution in interpreting savings in medical care; such savings may also represent costs in employment opportunities for nurses, doctors, and other medical personnel. Third, an anticipated criticism, the costs of the grieving of significant others, needs to be considered. Suicidal persons are shown to have less dense social networks, a sign of fewer potential grievers than in the case of natural deaths. Future work is needed to adjust lost earnings for the lower occupational status of suicides; this is another reason why Yang and Lester may be underestimating cost savings from suicide.
Vaccination and treatment as control interventions in an infectious disease model with their cost optimization

NASA Astrophysics Data System (ADS)

Kumar, Anuj; Srivastava, Prashant K.

2017-03-01

In this work, an optimal control problem with vaccination and treatment as control policies is proposed and analysed for an SVIR model. We choose vaccination and treatment as control policies because both these interventions have their own practical advantage and ease in implementation. Also, they are widely applied to control or curtail a disease. The corresponding total cost incurred is considered as weighted combination of costs because of opportunity loss due to infected individuals and costs incurred in providing vaccination and treatment. The existence of optimal control paths for the problem is established and guaranteed. Further, these optimal paths are obtained analytically using Pontryagin's Maximum Principle. We analyse our results numerically to compare three important strategies of proposed controls, viz.: vaccination only; with both treatment and vaccination; and treatment only. We note that first strategy (vaccination only) is less effective as well as expensive. Though, for a highly effective vaccine, vaccination alone may also work well in comparison with treatment only strategy. Among all the strategies, we observe that implementation of both treatment and vaccination is most effective and less expensive. Moreover, in this case the infective population is found to be relatively very low. Thus, we conclude that the comprehensive effect of vaccination and treatment not only minimizes cost burden due to opportunity loss and applied control policies but also keeps a tab on infective population.
Space development and space science together, an historic opportunity

NASA Astrophysics Data System (ADS)

Metzger, P. T.

2016-11-01

The national space programs have an historic opportunity to help solve the global-scale economic and environmental problems of Earth while becoming more effective at science through the use of space resources. Space programs will be more cost-effective when they work to establish a supply chain in space, mining and manufacturing then replicating the assets of the supply chain so it grows to larger capacity. This has become achievable because of advances in robotics and artificial intelligence. It is roughly estimated that developing a lunar outpost that relies upon and also develops the supply chain will cost about 1/3 or less of the existing annual budgets of the national space programs. It will require a sustained commitment of several decades to complete, during which time science and exploration become increasingly effective. At the end, this space industry will capable of addressing global-scale challenges including limited resources, clean energy, economic development, and preservation of the environment. Other potential solutions, including nuclear fusion and terrestrial renewable energy sources, do not address the root problem of our limited globe and there are real questions whether they will be inadequate or too late. While industry in space likewise cannot provide perfect assurance, it is uniquely able to solve the root problem, and it gives us an important chance that we should grasp. What makes this such an historic opportunity is that the space-based solution is obtainable as a side-benefit of doing space science and exploration within their existing budgets. Thinking pragmatically, it may take some time for policymakers to agree that setting up a complete supply chain is an achievable goal, so this paper describes a strategy of incremental progress. The most crucial part of this strategy is establishing a water economy by mining on the Moon and asteroids to manufacture rocket propellant. Technologies that support a water economy will play an
Mathematics and biology: The interface, challenges and opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levin, S.A.

1992-06-01

The interface between mathematics and biology has long been a rich area of research, with mutual benefit to each supporting discipline. Traditional areas of investigation, such as population genetics, ecology, neurobiology, and 3-D reconstructions, have flourished, despite a rather meager environment for the funding of such work. In the past twenty years, the kind and scope of such interactions between mathematicians and biologists have changed dramatically, reaching out to encompass areas of both biology and mathematics that previously had not benefited. At the same time, with the closer integration of theory and experiment, and the increased reliance on high-speed computation,more » the costs of such research grew, though not the opportunities for funding. The perception became reinforced, both within the research community and at funding agencies, that although these interactions were expanding, they were not doing so at the rate necessary to meet the opportunities and needs. A workshop was held in Washington, DC, between April 28 and May 3, 1990 which drew together a broadly based group of researchers to synthesize conclusions from a group of working papers and extended discussions. The result is the report presented here, which we hope will provide a guide and stimulus to research in mathematical and computational biology for at least the next decade. The report identifies a number of grand challenges, representing a broad consensus among the participants.« less
Effect of prospective reimbursement on nursing home costs.

PubMed Central

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-01-01

OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. STUDY DESIGN. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. PRINCIPAL FINDINGS. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. CONCLUSIONS. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems. PMID:8463109
Algae Production from Wastewater Resources: An Engineering and Cost Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schoenung, Susan; Efroymson, Rebecca Ann

Co-locating algae cultivation ponds near municipal wastewater (MWW) facilities provides the opportunity to make use of the nitrogen and phosphorus compounds in the wastewater as nutrient sources for the algae. This use benefits MWW facilities, the algae biomass and biofuel or bioproduct industry, and the users of streams where treated or untreated waste would be discharged. Nutrient compounds can lead to eutrophication, hypoxia, and adverse effects to some organisms if released downstream. This analysis presents an estimate of the cost savings made possible to cultivation facilities by using the nutrients from wastewater for algae growth rather than purchase of themore » nutrients. The analysis takes into consideration the cost of pipe transport from the wastewater facility to the algae ponds, a cost factor that has not been publicly documented in the past. The results show that the savings in nutrient costs can support a wastewater transport distance up to 10 miles for a 1000-acre-pond facility, with potential adjustments for different operating assumptions.« less

Cost analysis of different cervical cancer screening strategies in Mexico.

PubMed

Beal, Christyn M; Salmerón, Jorge; Flores, Yvonne N; Torres, Leticia; Granados-García, Víctor; Dugan, Ellen; Lazcano-Ponce, Eduardo

2014-01-01

To compare the costs and number of undetected cases of four cervical cancer screening strategies (CCSS) in Mexico. We estimated the costs and outcomes of the following CCSS: a) conventional Papanicolaou smear (Pap) alone; b) high-risk human papilloma virus testing (HR-HPV) as primary screening with Pap as reflex triage; c) HR-HPV as primary screening with HPV-16/18 typing, liquid-based cytology (LBC) and immunostaining for p16/Ki67 testing as reflex triage, and d) co-testing with HR-HPV and LBC with HPV-16/18 typing and immunostaining for p16/Ki67 as reflex triage. The outcome of interest was high-grade cervical lesions or cervical cancer. HR-HPV testing, HPV typing, LBC testing and immunostaining is the best alternative because it is the least expensive option with an acceptable number of missed cases. The opportunity costs of a poor quality CCSS is many false negatives. Combining multiple tests may be a more cost-effective way to screen for cervical cancer in Mexico.
The Costs and Benefits of Employing an Adult with Autism Spectrum Disorder: A Systematic Review

PubMed Central

2015-01-01

Background Despite an ambition from adults with Autism Spectrum Disorder (ASD) to be employed, there are limited opportunities for competitive employment for this group. Employment is not only an entitlement enjoyed by others in society, but employing adults with ASD also has economic benefits by decreasing lost productivity and resource costs for this group. Few studies have explored the cost-benefit ratio for employing adults with ASD and even fewer have taken the viewpoint of the employer, particularly applying this situation to ASD. Until such study occurs, employers may continue to be reluctant to employ adults from this group. Objective This review aimed to examine the costs, benefits and the cost-benefit ratio of employing adults with ASD, from a societal perspective and from the perspective of employers. Methods Eight databases were searched for scientific studies within defined inclusion criteria. These databases included CINAHL Plus, Cochrane Library, Emerald, Ovid Medline, ProQuest, PsycINFO, Scopus and Web of Science. Results and Conclusion Enhancing the opportunities for adults with ASD to join the workforce is beneficial from a societal perspective, not only from an inclusiveness viewpoint, but also from a strict economic standpoint. Providing supported employment services for adults with ASD does not only cut the cost compared with providing standard care, it also results in better outcomes for adults with ASD. Despite the fact that ASD was the most expensive group to provide vocational rehabilitation services for, adults with ASD have a strong chance of becoming employed once appropriate measures are in place. Hence, rehabilitation services could be considered as a worthwhile investment. The current systematic review uncovered the fact that very few studies have examined the benefits, the costs and the cost-benefit ratio of employing an adult with ASD from the perspective of employers indicating a need for this topic to be further explored. PMID
The Costs and Benefits of Employing an Adult with Autism Spectrum Disorder: A Systematic Review.

PubMed

Jacob, Andrew; Scott, Melissa; Falkmer, Marita; Falkmer, Torbjörn

2015-01-01

Despite an ambition from adults with Autism Spectrum Disorder (ASD) to be employed, there are limited opportunities for competitive employment for this group. Employment is not only an entitlement enjoyed by others in society, but employing adults with ASD also has economic benefits by decreasing lost productivity and resource costs for this group. Few studies have explored the cost-benefit ratio for employing adults with ASD and even fewer have taken the viewpoint of the employer, particularly applying this situation to ASD. Until such study occurs, employers may continue to be reluctant to employ adults from this group. This review aimed to examine the costs, benefits and the cost-benefit ratio of employing adults with ASD, from a societal perspective and from the perspective of employers. Eight databases were searched for scientific studies within defined inclusion criteria. These databases included CINAHL Plus, Cochrane Library, Emerald, Ovid Medline, ProQuest, PsycINFO, Scopus and Web of Science. Enhancing the opportunities for adults with ASD to join the workforce is beneficial from a societal perspective, not only from an inclusiveness viewpoint, but also from a strict economic standpoint. Providing supported employment services for adults with ASD does not only cut the cost compared with providing standard care, it also results in better outcomes for adults with ASD. Despite the fact that ASD was the most expensive group to provide vocational rehabilitation services for, adults with ASD have a strong chance of becoming employed once appropriate measures are in place. Hence, rehabilitation services could be considered as a worthwhile investment. The current systematic review uncovered the fact that very few studies have examined the benefits, the costs and the cost-benefit ratio of employing an adult with ASD from the perspective of employers indicating a need for this topic to be further explored.
Physical activity opportunities in afterschool programs.

PubMed

Weaver, R Glenn; Beets, Michael W; Huberty, Jennifer; Freedman, Darcy; Turner-Mcgrievy, Gabrielle; Ward, Diane

2015-05-01

Afterschool programs (ASPs) have potential to provide children moderate to vigorous physical activity (MVPA). The availability and types (e.g., free play or organized activities) of physical activity opportunities, their structure (e.g., presence of lines, elimination games), and staff behaviors (e.g., encouragement, engaged) can influence children's MVPA. This study explored these factors in 20 ASPs serving over 1,700 elementary-age children. The occurrence, types, and structure of physical activity opportunities, and staff behaviors were collected via the SOSPAN (System for Observing Staff Promotion of Physical Activity and Nutrition). A total of 4,660 SOSPAN scans were completed across 63 complete program days (1,733 during physical activity opportunities). Physical activity opportunities were observed on 60 program days across all 20 sites, with 73% of those opportunities classified as free play. ASPs scheduled an average of 66.3 minutes (range 15-150 minutes) of physical activity opportunities daily. Games played included basketball, tag, soccer, and football. Staff rarely engaged in physical activity promotion behaviors, and the structure of organized games discouraged MVPA. For example, staff verbally promoted physical activity in just 6.1% of scans, while organized games were more likely to involve lines and elimination. Professional development training may enhance staffs' physical activity promotion and the structure of activity opportunities. © 2015 Society for Public Health Education.
Kiovig for primary immunodeficiency: reduced infusion and decreased costs per infusion.

PubMed

Connolly, Mark; Simoens, Steven

2011-09-01

Kiovig is a ready-to-use 10% liquid immunoglobulin preparation that is medically indicated for the treatment of primary immunodeficiency. This study aims to conduct an economic evaluation which compares the intravenous immunoglobulin (IVIg) preparations Kiovig, Multigam, and Sandoglobulin from the Belgian societal perspective. As three prospective studies have observed no difference in outcomes, a cost-minimization analysis is considered appropriate to evaluate differences in treatment costs that can arise from IVIgs. A decision-analytic model simulated treatment costs attributed to one infusion. Resource use data were derived from a Dutch costing study. Cost items included immunoglobulin costs, pharmacy administration and nursing costs, mini-forfait for hospital infusion, costs of adverse events, and lost productivity with 2009 as base year. Cost data were identified from published sources and Belgian hospital administrators. A probabilistic sensitivity analysis explored the impact of parameter uncertainty on cost results. Costs per infusion cycle in adult primary immunodeficiency patients were €1,046 (95% confidence interval: €1,006-1,093) with Kiovig; €1,102 (€1,064-1,147) with Multigam; and €1,147 (€1,108-1,193) with Sandoglobulin. The average cost savings per infusion with Kiovig as compared to Multigam and Sandoglobulin amounted to €56 and €101 per infusion. In conclusion, treatment costs with Kiovig were shown to be lower as compared to other IVIgs in Belgium. Reduced costs per infusion were attributed to lower costs associated with treating adverse events and the opportunity cost of nursing time and time off work for working adults. Copyright © 2011 Elsevier B.V. All rights reserved.
Opportunity costs of carbon sequestration in a forest concession in central Africa.

PubMed

Ndjondo, Michel; Gourlet-Fleury, Sylvie; Manlay, Raphaël J; Engone Obiang, Nestor Laurier; Ngomanda, Alfred; Romero, Claudia; Claeys, Florian; Picard, Nicolas

2014-12-01

A large proportion of the tropical rain forests of central Africa undergo periodic selective logging for timber harvesting. The REDD+ mechanism could promote less intensive logging if revenue from the additional carbon stored in the forest compensates financially for the reduced timber yield. Carbon stocks, and timber yields, and their associated values, were predicted at the scale of a forest concession in Gabon over a project scenario of 40 yr with reduced logging intensity. Considering that the timber contribution margin (i.e. the selling price of timber minus its production costs) varies between 10 and US$40 m -3 , the minimum price of carbon that enables carbon revenues to compensate forgone timber benefits ranges between US$4.4 and US$25.9/tCO 2 depending on the management scenario implemented. Where multiple suppliers of emission reductions compete in a REDD+ carbon market, tropical timber companies are likely to change their management practices only if very favourable conditions are met, namely if the timber contribution margin remains low enough and if alternative management practices and associated incentives are appropriately chosen.
Quality Improvement Initiatives: The Missed Opportunity for Health Plans

PubMed Central

Fernandez-Lopez, Sara; Lennert, Barbara

2009-01-01

Background The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. Objectives To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. Methods We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. Results The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Conclusion Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations. PMID:25126303
Social inequalities and pharmaceutical cost sharing in Italian regions.

PubMed

Terraneo, Marco; Sarti, Simone; Tognetti Bordogna, Mara

2014-01-01

In recent years, Italian citizens have increasingly been asked to share pharmaceutical costs, but at the same time, households' medicines expenditure has decreased. Cost-sharing policies have to be assessed not just in terms of limitation of moral hazard and revenue to the state, but also for equal opportunities for citizen users accessing health services. The aim of this article is to analyze how Italian co-payment policies ("ticket") on medicines may affect pharmaceutical expenditure of households, considering territorial and social groups variation. We reviewed the per capita private spending on medicines of Italian regions, separating pharmaceutical outlay and "ticket." Across the period 2001-2010 we found that the overall per capita private spending on medicines remained substantially stable, although medicine expenditure decreases while the "ticket" increases. When cost sharing rises, out-of-pocket spending on medicines by poorer families seems to remain unchanged; however, poorer families seem to reduce their pharmaceutical expenditure. Our analysis suggests that applying co-payment in Italy is partly successful, in terms of greater revenue to the health system, but in the last few years, cost-sharing increases would seem to have rebounded negatively on more vulnerable families, due to the economic crisis.
Forestry mitigation potential and costs in developing countries - Preface

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sathaye, Jayant A.; Makundi, Willy; Andrasko, Kenneth

2001-01-01

The forest sector in Tanzania offers ample opportunities to reduce greenhouse gas emissions (GHG) and sequestered carbon (C) in terrestrial ecosystems. More than 90% of the country's demand for primary energy is obtained from biomass mostly procured unsustainably from natural forests. This study examines the potential to sequester C through expansion of forest plantations aimed at reducing the dependence on natural forest for wood fuel production, as well as increase the country's output of industrial wood from plantations. These were compared ton conservation options in the tropical and miombo ecosystems. Three sequestration options were analyzed, involving the establishment of shortmore » rotation and long rotation plantations on about 1.7 x 106 hectares. The short rotation community forest option has a potential to sequester an equilibrium amount of 197.4 x 106 Mg C by 2024 at a net benefit of $79.5 x 106, while yielding a NPV of $0.46 Mg-1 C. The long rotation options for softwood and hardwood plantations will reach an equilibrium sequestration of 5.6 and 11.8 x 106 Mg C at a negative NPV of $0.60 Mg-1 C and $0.32 Mg-1 C. The three options provide cost competitive opportunities for sequestering about 7.5 x 106 Mg C yr -1 while providing desired forest products and easing the pressure on the natural forests in Tanzania. The endowment costs of the sequestration options were all found to be cheaper than the emission avoidance cost for conservation options which had an average cost of $1.27 Mg-1 C, rising to $7.5 Mg-1 C under some assumptions on vulnerability to encroachment. The estimates shown here may represent the upper bound, because the actual potential will be influenced by market prices for inputs and forest products, land use policy constraints and the structure of global C transactions.« less
Professional Development Opportunities for Two-Year College Geoscience Faculty: Issues, Opportunities, and Successes

NASA Astrophysics Data System (ADS)

Baer, E. M.; Macdonald, H.; McDaris, J. R.; Granshaw, F. D.; Wenner, J. M.; Hodder, J.; van der Hoeven Kraft, K.; Filson, R. H.; Guertin, L. A.; Wiese, K.

2011-12-01

Two-year colleges (2YCs) play a critical role in geoscience education in the United States. Nearly half of the undergraduate students who take introductory geoscience do so at a 2YC. With awide reach and diverse student populations, 2YCs may be key to producing a well-trained, diverse and sufficiently large geoscience workforce. However, faculty at 2YCs often face many barriers to professional development including lack of financial resources, heavy and inflexible teaching loads, lack of awareness of opportunities, and few professional development resources/events targeted at their needs. As an example, at the 2009 GSA meeting in Portland, fewer than 80 of the 6500 attendees were from community colleges, although this was more than twice the 2YC faculty attendance the previous year. Other issues include the isolation described by many 2YC geoscience faculty who may be the only full time geoscientist on a campus and challenges faced by adjunct faculty who may have even fewer opportunities for professional development and networking with other geoscience faculty. Over the past three years we have convened several workshops and events for 2YC geoscience faculty including technical sessions and a workshop on funding opportunities for 2YC faculty at GSA annual meetings, a field trip and networking event at the fall AGU meeting, a planning workshop that examined the role of 2YCs in geoscience education and in broadening participation in the geosciences, two workshops supporting use of the 'Math You Need, When You Need It' educational materials that included a majority of 2YC faculty, and marine science summer institutes offered by COSEE-Pacific Partnerships for 2YC faculty. Our experience indicates that 2YC faculty desire professional development opportunities when the experience is tailored to the needs and character of their students, programs, and institutions. The content of the professional development opportunity must be useful to 2YC faculty -workshops and
Analysis of strengths, weaknesses, opportunities, and threats in the development of a health technology assessment program in Turkey.

PubMed

Kahveci, Rabia; Meads, Catherine

2008-01-01

The Turkish healthcare system is currently undergoing reform, and efficient use of resources has become a key factor in determining the allocation of resources. The objective of this study was to analyze strengths, weaknesses, opportunities, and threats (SWOT) in the development of a health technology assessment (HTA) program in Turkey. A SWOT analysis was performed using a literature review and interviews with key people in the Turkish Ministry of Health and Ministry of Labor and Social Security. Regarding recent reforms in health care, investments for information network and databank are the strengths, but the traditional "expert-based" decision making, poor availability of data, and poor quality of data could be seen as some of the weaknesses. Another major weakness is lack of general awareness of HTA. Increasing demand for transparency in decision making, demand for evidence, and demand for credibility by decision makers are some of the opportunities, and current healthcare reforms, i.e., restructuring of healthcare and general health insurance, could also be seen as major opportunities. These opportunities unfortunately could be threatened by lack of funding, and resources are challenged by large, recent national investments. There is a good opportunity for Turkey to use the skills in HTA currently being developed through activities in Europe and the Americas to assist in the development of a much more cost-effective and transparent healthcare system in Turkey.
Big data in health care: using analytics to identify and manage high-risk and high-cost patients.

PubMed

Bates, David W; Saria, Suchi; Ohno-Machado, Lucila; Shah, Anand; Escobar, Gabriel

2014-07-01

The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid progress has been made in clinical analytics--techniques for analyzing large quantities of data and gleaning new insights from that analysis--which is part of what is known as big data. As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States. We present six use cases--that is, key examples--where some of the clearest opportunities exist to reduce costs through the use of big data: high-cost patients, readmissions, triage, decompensation (when a patient's condition worsens), adverse events, and treatment optimization for diseases affecting multiple organ systems. We discuss the types of insights that are likely to emerge from clinical analytics, the types of data needed to obtain such insights, and the infrastructure--analytics, algorithms, registries, assessment scores, monitoring devices, and so forth--that organizations will need to perform the necessary analyses and to implement changes that will improve care while reducing costs. Our findings have policy implications for regulatory oversight, ways to address privacy concerns, and the support of research on analytics. Project HOPE—The People-to-People Health Foundation, Inc.
Black Carbon and Kerosene Lighting: An Opportunity for Rapid Action on Climate Change and Clean Energy for Development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jacobson, Arne; Bond, Tami C.; Lam, Nicholoas L.

2013-04-15

Replacing inefficient kerosene lighting with electric lighting or other clean alternatives can rapidly achieve development and energy access goals, save money and reduce climate warming. Many of the 250 million households that lack reliable access to electricity rely on inefficient and dangerous simple wick lamps and other kerosene-fueled light sources, using 4 to 25 billion liters of kerosene annually to meet basic lighting needs. Kerosene costs can be a significant household expense and subsidies are expensive. New information on kerosene lamp emissions reveals that their climate impacts are substantial. Eliminating current annual black carbon emissions would provide a climate benefitmore » equivalent to 5 gigatons of carbon dioxide reductions over the next 20 years. Robust and low-cost technologies for supplanting simple wick and other kerosene-fueled lamps exist and are easily distributed and scalable. Improving household lighting offers a low-cost opportunity to improve development, cool the climate and reduce costs.« less
Work, Health, And Worker Well-Being: Roles And Opportunities For Employers.

PubMed

McLellan, Robert K

2017-02-01

Work holds the promise of supporting and promoting health. It also carries the risk of injury, illness, and death. In addition to harms posed by traditional occupational health hazards, such as physically dangerous workplaces, work contributes to health problems with multifactorial origins such as unhealthy lifestyles, psychological distress, and chronic disease. Not only does work affect health, but the obverse is true: Unhealthy workers are more frequently disabled, absent, and less productive, and they use more health care resources, compared to their healthy colleagues. The costs of poor workforce health are collectively borne by workers, employers, and society. For business as well as altruistic reasons, employers may strive to cost-effectively achieve the safest, healthiest, and most productive workforce possible. Narrowly focused health goals are giving way to a broader concept of employee well-being. This article explores the relationship between health and work, outlines opportunities for employers to make this relationship health promoting, and identifies areas needing further exploration. Project HOPE—The People-to-People Health Foundation, Inc.
Costs of a work-family intervention: evidence from the work, family, and health network.

PubMed

Barbosa, Carolina; Bray, Jeremy W; Brockwood, Krista; Reeves, Daniel

2014-01-01

To estimate the cost to the workplace of implementing initiatives to reduce work-family conflict. Prospective cost analysis conducted alongside a group-randomized multisite controlled experimental study, using a microcosting approach. An information technology firm. Employees (n = 1004) and managers (n = 141) randomized to the intervention arm. STAR (Start. Transform. Achieve. Results.) to enhance employees' control over their work time, increase supervisor support for employees to manage work and family responsibilities, and reorient the culture toward results. A taxonomy of activities related to customization, start-up, and implementation was developed. Resource use and unit costs were estimated for each activity, excluding research-related activities. Economic costing approach (accounting and opportunity costs). Sensitivity analyses on intervention costs. The total cost of STAR was $709,654, of which $389,717 was labor costs and $319,937 nonlabor costs (including $313,877 for intervention contract). The cost per employee participation in the intervention was $340 (95% confidence interval: $330-$351); $597 ($561-$634) for managers and $300 ($292-$308) for other employees (2011 prices). A detailed activity costing approach allows for more accurate cost estimates and identifies key drivers of cost. The key cost driver was employees' time spent on receiving the intervention. Ignoring this cost, which is usual in studies that cost workplace interventions, would seriously underestimate the cost of a workplace initiative.
Potential impact of pharmacist interventions to reduce cost for Medicare Part D beneficiaries.

PubMed

Thatcher, Erin E; Vanwert, Elizabeth M; Erickson, Steven R

2013-06-01

The objective was to determine the impact of simulated pharmacist interventions on out-of-pocket cost, time to coverage gap, and cost per patient to the Medicare Part D program using actual patient cases from an adult general medicine clinic. Medication profiles of 100 randomly selected Medicare-eligible patients from a university-affiliated general internal medicine clinic were reviewed by a pharmacist to identify opportunities to cost-maximize the patients' therapies based on the plan. An online Part-D calculator, Aetna Medicare Rx Essentials, was used as the standard plan to determine medication cost and time to gap. The primary analysis was comparison of the patients' pre-review and post-review out-of-pocket cost, time to coverage gap, and cost to Medicare. A total of 65 patients had at least 1 simulated pharmacist cost intervention. The most common intervention was substituting for a less costly generic, followed by substituting a generic for a brand name. Projected patient cost savings was $476 per year. The average time to coverage gap was increased by 0.7 ±1.2 months. This study illustrates that the pharmacists may be able to reduce cost to some patients as well as to the Medicare Part D program.
Opportunities and challenges for optical wireless: the competitive advantage of free space telecommunications links in today's crowded marketplace

NASA Astrophysics Data System (ADS)

Carbonneau, Theresa H.; Wisely, David R.

1998-01-01

Never before has the opportunity for terrestrial optical wireless communications links been so great. The high data rates attainable, up to OC-24, make it a very attractive and cost effective alternative to traditional fiber optic and microwave links. With today's demand for interactive multimedia-based applications, such as video conferencing and telemedicine, optical wireless products are the only ones that can provide the needed bandwidth in situations when it is too costly or impossible to install fiber optic cable. Recent developments in laser and optics technologies, in addition to auto beam tracking, permit transmission units to achieve excellent performance rates in all weather conditions.
An Opportunity to Learn US History: What NAEP Data Suggest Regarding the Opportunity Gap

ERIC Educational Resources Information Center

Heafner, Tina L.; Fitchett, Paul G.

2015-01-01

The purpose of this study is to determine the degree to which Opportunity to Learn (OTL), is associated with students' achievement in US History. Opportunity to Learn stems from the basic premise that there is an important relationship between the quality and frequency of classroom instruction and students' levels of academic success. The authors…
75 FR 27984 - Broadband Technology Opportunities Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

....: 0907141137-0222-10] RIN 0660-ZA28 Broadband Technology Opportunities Program AGENCY: National...; Reopening of Application Filing Window for Broadband Technology Opportunities Program Comprehensive... filing window for the Broadband Technology Opportunities Program (BTOP) that the agency established...
75 FR 3791 - Broadband Technology Opportunities Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... Department of Agriculture Rural Utilities Service Broadband Technology Opportunities Program; Notices #0;#0... 0660-ZA28 Broadband Technology Opportunities Program AGENCY: National Telecommunications and... for the Broadband Technology Opportunities Program (BTOP or Program) that the agency established...

Mating opportunities in Sangalopsis veliterna females: Costs and benefits

PubMed Central

Hernández Duran, Linda C.; Fajardo Medina, Gonzalo E.; Fuentes Quinter, Luz S.; Martin, Oliver

2014-01-01

Abstract In nature, females of several animal taxa exhibit considerable variation in their mating system, and this variation involves different balances of costs (e.g., energetic, reproductive) and benefits (e.g., increased net reproductive rate of the female, increased longevity). Many studies have focused on discovering the potential advantages and disadvantages that females could have when increasing their mating rate and the possible evolutionary consequences that may result. Butterflies and moths are an ideal study system because it is easy to determine and to manipulate experimentally their mating frequency. In this study, the effect of continuous availability of different numbers of males (1, 2, 4, 8) on female mating rate and fitness components was estimated by comparing the number of spermatophores in the corpus bursa (an estimate of the number of copulations, but not of the number males involved in these copulations), female longevity, lifetime number of laid eggs (fecundity), and proportion of hatching eggs (fertility) in the moth Sangalopsis veliterna Druce (Lepidoptera: Geometridae). The results showed that there were no significant differences in either fertility or fecundity when treatments were compared, but longevity and in some cases fecundity increased when females had several matings. Resumen En la naturaleza, hembras de varios taxa animal muestran una variación considerable en su sistema de apareamiento, esta variación involucra diferentes costos (energéticos, reproductivos, etc) y beneficios (aumento de la tasa reproductiva neta de la hembra, mayor longevidad, entre otros). En años recientes, muchos estudios se han enfocado en descubrir las potenciales ventajas y desventajas que las hembras podrían tener al aumentar su número de cópulas y las posibles consecuencias evolutivas que podrían resultar. Las mariposas y polillas son un sistema de estudio ideal, dada la facilidad para determinar y manipular experimentalmente su frecuencia de
Curriculum reform for residency training: competence, change, and opportunities for leadership.

PubMed

Fraser, Amy B; Stodel, Emma J; Chaput, Alan J

2016-07-01

Certain pressures stemming from within the medical community and from society in general, such as the need for increased accountability in resident training and restricted resident duty hours, have prompted a re-examination of methods for training physicians. Leaders in medical education in North America and around the world champion competency-based medical education (CBME) as a solution. The Department of Anesthesiology at the University of Ottawa launched Canada's first CBME program for anesthesiology residents on July 1, 2015. In this paper, we discuss the opportunities and challenges associated with CBME and delineate the elements of the new CBME program at the University of Ottawa. Review of the current literature. Competency-based medical education addresses some of the challenges associated with physician training, such as ensuring that specialists are competent in all key areas and reducing training costs. In principle, competency-based medical education can better meet the needs of patients, providers, and other stakeholders in the healthcare system, but its success will depend on support from all involved. As CBME is implemented, anesthesiologists have the opportunity to become leaders in innovation and medical education. The University of Ottawa has implemented a CBME program with a twofold purpose, namely, to focus learning opportunities on the development of the specific competencies required of practicing anesthesiologists and to test the effectiveness of a reduction in the length of training. Canadian anesthesia residency programs will soon transition to CBME in order to promote better transparency, accountability, fairness, fiscal responsibility, and patient safety. Competency-based medical education offers significant potential advantages for healthcare stakeholders.
The cost to successfully apply for level 3 medical home recognition

PubMed Central

Mottus, Kathleen; Reiter, Kristin; Mitchell, C. Madeline; Donahue, Katrina E.; Gabbard, Wilson M.; Gush, Kimberly

2016-01-01

BACKGROUND The NCQA Patient Centered Medical Home (PCMH) recognition program provides practices an opportunity to implement Medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. METHODS Practice coaches identified 5 exemplar practices that received level 3 recognition (3 pediatric and 2 family medicine practices). This analysis focuses on 4 that received 2011 recognition. Clinical, informatics and administrative staff participated in 2–3 hour interviews. We collected the time required to develop, implement and maintain required activities. We categorized costs as: 1) non-personnel, 2) developmental 3) those to implement activities 4) those to maintain activities, 5) those to document the work and 6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent provider (pFTE) RESULTS Practice size ranged from 2.5 – 10.5 pFTE’s, payer mixes from 7–43 % Medicaid. There was variation in the distribution of costs by activity by practice; but the costs to apply were remarkably similar ($11,453–$15,977 pFTE). CONCLUSION The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low value activities could benefit practices. PMID:26769879
The Cost to Successfully Apply for Level 3 Medical Home Recognition.

PubMed

Halladay, Jacqueline R; Mottus, Kathleen; Reiter, Kristin; Mitchell, C Madeline; Donahue, Katrina E; Gabbard, Wilson M; Gush, Kimberly

2016-01-01

The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. Practice coaches identified 5 exemplar practices (3 pediatric and 2 family medicine practices) that received level 3 recognition. This analysis focuses on 4 that received recognition in 2011. Clinical, informatics, and administrative staff participated in 2- to 3-hour interviews. We determined the time required to develop, implement, and maintain required activities. We categorized costs as (1) nonpersonnel, (2) developmental, (3) those used to implement activities, (4) those used to maintain activities, (5) those to document the work, and (6) consultant costs. Only incremental costs were included and are presented as costs per full-time equivalent (pFTE) provider. Practice size ranged from 2.5 to 10.5 pFTE providers, and payer mixes ranged from 7% to 43% Medicaid. There was variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar ($11,453-15,977 pFTE provider). The costs to apply for 2011 recognition were noteworthy. Work to enhance care coordination and close loops were highly valued. Financial incentives were key motivators. Future efforts to minimize the burden of low-value activities could benefit practices. © Copyright 2016 by the American Board of Family Medicine.
Opportunities in Training & Development Careers. VGM Opportunities Series.

ERIC Educational Resources Information Center

Gordon, Edward E.; Petrini, Catherine M.; Campagna, Ann P.

This volume is a resource for those who want to explore opportunities in training and development careers. Chapter 1 covers the evolution of training and the future of education at work. Chapter 2 considers trainers' roles; program design and development; needs assessment; development of program objectives; program content, training methods,…
Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

PubMed

Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

2016-01-01

Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a
New meters open new business opportunities for Blue Earth

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mashaw, R.

1996-07-01

Competition in the electric utility industry isn`t a concern only for the big boys. Small utilities, too, are giving increasing attention to measures that will improve their competitiveness through paring costs and improving service. Blue Earth, Minn., Light and Water Department, with approximately 2,200 electric meters, is a prime example of a small utility that thinks big. {open_quotes}We conducted a customer survey to determine what our customers want from us in terms of service,{close_quotes} said General Manager Jeffrey Jansen. {open_quotes}To meet those needs we`ve begun to sell a new fiberglass, high-efficiency electric water heater; offer rent or purchase of uninterruptiblemore » power systems to provide back-up for sensitive electronics if an outage occurs; and we`re even selling bottled water. We`re also going to offer budget billing as of August 1, because our customers wanted that option.{close_quotes} Recognizing that providing excellent customer service is only part of the competitiveness equation, Blue Earth has also looked for ways to cut costs. Its latest effort has been the implementation of a new hand-held meter reading system, which Jansen expects to provide substantial savings, and offer opportunities for adding new services in the future.« less
A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

Foreman, Veronica; Le Moigne, Jacqueline; de Weck, Oliver

2016-01-01

Satellite constellations present unique capabilities and opportunities to Earth orbiting and near-Earth scientific and communications missions, but also present new challenges to cost estimators. An effective and adaptive cost model is essential to successful mission design and implementation, and as Distributed Spacecraft Missions (DSM) become more common, cost estimating tools must become more representative of these types of designs. Existing cost models often focus on a single spacecraft and require extensive design knowledge to produce high fidelity estimates. Previous research has examined the shortcomings of existing cost practices as they pertain to the early stages of mission formulation, for both individual satellites and small satellite constellations. Recommendations have been made for how to improve the cost models for individual satellites one-at-a-time, but much of the complexity in constellation and DSM cost modeling arises from constellation systems level considerations that have not yet been examined. This paper constitutes a survey of the current state-of-the-art in cost estimating techniques with recommendations for improvements to increase the fidelity of future constellation cost estimates. To enable our investigation, we have developed a cost estimating tool for constellation missions. The development of this tool has revealed three high-priority weaknesses within existing parametric cost estimating capabilities as they pertain to DSM architectures: design iteration, integration and test, and mission operations. Within this paper we offer illustrative examples of these discrepancies and make preliminary recommendations for addressing them. DSM and satellite constellation missions are shifting the paradigm of space-based remote sensing, showing promise in the realms of Earth science, planetary observation, and various heliophysical applications. To fully reap the benefits of DSM technology, accurate and relevant cost estimating capabilities
A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

Foreman, Veronica L.; Le Moigne, Jacqueline; de Weck, Oliver

2016-01-01

Satellite constellations present unique capabilities and opportunities to Earth orbiting and near-Earth scientific and communications missions, but also present new challenges to cost estimators. An effective and adaptive cost model is essential to successful mission design and implementation, and as Distributed Spacecraft Missions (DSM) become more common, cost estimating tools must become more representative of these types of designs. Existing cost models often focus on a single spacecraft and require extensive design knowledge to produce high fidelity estimates. Previous research has examined the limitations of existing cost practices as they pertain to the early stages of mission formulation, for both individual satellites and small satellite constellations. Recommendations have been made for how to improve the cost models for individual satellites one-at-a-time, but much of the complexity in constellation and DSM cost modeling arises from constellation systems level considerations that have not yet been examined. This paper constitutes a survey of the current state-of-theart in cost estimating techniques with recommendations for improvements to increase the fidelity of future constellation cost estimates. To enable our investigation, we have developed a cost estimating tool for constellation missions. The development of this tool has revealed three high-priority shortcomings within existing parametric cost estimating capabilities as they pertain to DSM architectures: design iteration, integration and test, and mission operations. Within this paper we offer illustrative examples of these discrepancies and make preliminary recommendations for addressing them. DSM and satellite constellation missions are shifting the paradigm of space-based remote sensing, showing promise in the realms of Earth science, planetary observation, and various heliophysical applications. To fully reap the benefits of DSM technology, accurate and relevant cost estimating capabilities
NUL Research History: Opportunity Magazine

ERIC Educational Resources Information Center

Urban League Review, 1976

1976-01-01

Discusses an official publication of the National Urban League, "Opportunity: Journal of Negro Life," first published in 1923. The purpose of "Opportunity" was to objectively present facts of Negro life through an analysis of social questions, to provide a basis of understanding and to encourage interracial cooperation in the…
Cost of schizophrenia in the Medicare program.

PubMed

Feldman, Rachel; Bailey, Robert A; Muller, James; Le, Jennifer; Dirani, Riad

2014-06-01

Medicare beneficiaries diagnosed with non-schizoaffective schizophrenia (MBS) in a 5% national Medicare fee-for-service sample from 2003-2007 were followed for 1-6 years. Medicare population and cost estimates also were made from 2001-2009. Service utilization and Medicare (and beneficiary share) payments for all services except prescription drugs were analyzed. Although adults with schizophrenia make up approximately 1% of the US adult population, they represent about 1.5% of Medicare beneficiaries. MBSs are disproportionately male and minority compared to national data describing the overall schizophrenia population. They also are younger than the general Medicare population (GMB): males are 9 years younger than females on average, and most enter Medicare long before age 65 through eligibility for social security disability, remaining in the program until death. The cost of care for MBSs in 2009 was, on average, 80% higher than for the average GMB per patient year (2010 dollars), and more than 50% of these costs are attributable to a combination of psychiatric and medical hospitalizations, concentrated in about 30% of MBSs with 1 or more hospitalizations per year. From 2004-2009, total estimated Medicare fee-for-service payments for MBSs increased from $9.4 billion to $11.5 billion, excluding Part D prescription drugs and payments for services to MBSs in Medicare for less than 1 year. Study results characterize utilization and costs for other services and suggest opportunities for further study to inform policy to improve access and continuity of care and decrease costs to the Medicare program associated with this population.
The cost of not breastfeeding in Southeast Asia

PubMed Central

Walters, Dylan; Horton, Susan; Siregar, Adiatma Yudistira Manogar; Pitriyan, Pipit; Hajeebhoy, Nemat; Mathisen, Roger; Phan, Linh Thi Hong; Rudert, Christiane

2016-01-01

Rates of exclusive breastfeeding are slowly increasing, but remain suboptimal globally despite the health and economic benefits. This study estimates the costs of not breastfeeding across seven countries in Southeast Asia and presents a cost-benefit analysis of a modeled comprehensive breastfeeding strategy in Viet Nam, based on a large programme. There have been very few such studies previously for low- and middle-income countries. The estimates used published data on disease prevalence and breastfeeding patterns for the seven countries, supplemented by information on healthcare costs from representative institutions. Modelling of costs of not breastfeeding used estimated effects obtained from systematic reviews and meta-analyses. Modelling of cost-benefit for Viet Nam used programme data on costs combined with effects from a large-scale cluster randomized breastfeeding promotion intervention with controls. This study found that over 12 400 preventable child and maternal deaths per year in the seven countries could be attributed to inadequate breastfeeding. The economic benefits associated with potential improvements in cognition alone, through higher IQ and earnings, total $1.6 billion annually. The loss exceeds 0.5% of Gross National Income in the country with the lowest exclusive breastfeeding rate (Thailand). The potential savings in health care treatment costs ($0.3 billion annually) from reducing the incidence of diarrhoea and pneumonia could help offset the cost of breastfeeding promotion. Based on the data available and authors’ assumptions, investing in a national breastfeeding promotion strategy in Viet Nam could result in preventing 200 child deaths per year and generate monetary benefits of US$2.39 for every US$1, or a 139% return on investment. These encouraging results suggest that there are feasible and affordable opportunities to accelerate progress towards achieving the Global Nutrition Target for exclusive breastfeeding by 2025. PMID:27107295
Weighing the cost of educational inflation in undergraduate medical education.

PubMed

Cusano, Ronald; Busche, Kevin; Coderre, Sylvain; Woloschuk, Wayne; Chadbolt, Karen; McLaughlin, Kevin

2017-08-01

Despite the fact that the length of medical school training has remained stable for many years, the expectations of graduating medical students (and the schools that train them) continue to increase. In this Reflection, the authors discuss motives for educational inflation and suggest that these are likely innocent, well-intentioned, and subconscious-and include both a propensity to increase expectations of ourselves and others over time, and a reluctance to reduce training content and expectations. They then discuss potential risks of educational inflation, including reduced emphasis on core knowledge and clinical skills, and adverse effects on the emotional, psychological, and financial wellbeing of students. While acknowledging the need to change curricula to improve learning and clinical outcomes, the authors proffer that it is naïve to assume that we can inflate educational expectations at no additional cost. They suggest that before implementing and/or mandating change, we should consider of all the costs that medical schools and students might incur, including opportunity costs and the impact on the emotional and financial wellbeing of students. They propose a cost-effectiveness framework for medical education and advocate prioritization of interventions that improve learning outcomes with no additional costs or are cost-saving without adversely impacting learning outcomes. When there is an additional cost for improved learning outcomes or a decline in learning outcomes as a result of cost saving interventions, they suggest careful consideration and justification of this trade-off. And when there are neither improved learning outcomes nor cost savings they recommend resisting the urge to change.
Economic cost and epidemiological characteristics of patients with fibromyalgia claims.

PubMed

Robinson, Rebecca L; Birnbaum, Howard G; Morley, Melissa A; Sisitsky, Tamar; Greenberg, Paul E; Claxton, Ami J

2003-06-01

Fibromyalgia (FM) is characterized by widespread pain that can lead to significant patient disability, complex management decisions for physicians, and economic burden on society. We investigated the total costs of FM in an employer population. Administrative claims data of a Fortune 100 manufacturer were used to quantify direct (i.e., medical and pharmaceutical claims) and indirect (i.e., disability claims and imputed absenteeism) costs associated with FM. A total of 4699 patients with at least one FM claim between 1996 and 1998 were contrasted with a 10% random sample of the overall beneficiary population. Employee-only subsets of both samples also were drawn. Medical utilization, receipt of prescription drugs, and annual total costs were proportionately similar yet significantly greater among FM claimants than the overall sample (all p < 0.0001). Total annual costs for FM claimants were $5945 versus $2486 for the typical beneficiary (p < 0.0001). Six percent of these costs were attributable to FM-specific claims. The prevalence of disability was twice as high among FM employees than overall employees (p < 0.0001). For every dollar spent on FM-specific claims, the employer spent another $57 to $143 on additional direct and indirect costs. Hidden costs of disability and comorbidities greatly increase the true burden of FM. Regardless of the clinical understanding of FM, when a claim for FM is present, considerable costs are involved. Findings suggest that within the management of FM there may be large cost-offset opportunities for reductions in patient, physician, and employer burdens.
Temporal view of the costs and benefits of self-deception

PubMed Central

Chance, Zoë; Norton, Michael I.; Gino, Francesca; Ariely, Dan

2011-01-01

Researchers have documented many cases in which individuals rationalize their regrettable actions. Four experiments examine situations in which people go beyond merely explaining away their misconduct to actively deceiving themselves. We find that those who exploit opportunities to cheat on tests are likely to engage in self-deception, inferring that their elevated performance is a sign of intelligence. This short-term psychological benefit of self-deception, however, can come with longer-term costs: when predicting future performance, participants expect to perform equally well—a lack of awareness that persists even when these inflated expectations prove costly. We show that although people expect to cheat, they do not foresee self-deception, and that factors that reinforce the benefits of cheating enhance self-deception. More broadly, the findings of these experiments offer evidence that debates about the relative costs and benefits of self-deception are informed by adopting a temporal view that assesses the cumulative impact of self-deception over time. PMID:21383150
New Opportunities for Cabled Ocean Observatories

NASA Astrophysics Data System (ADS)

Duennebier, F. K.; Butler, R.; Karl, D. M.; Roger, L. B.

2002-12-01

With the decommissioning of transoceanic telecommunications cables as they become obsolete or uneconomical, there is an opportunity to use these systems for ocean observatories. Two coaxial cables, TPC-1 and HAW-2 are currently in use for observatories, and another, ANZCAN, is scheduled to be used beginning in 2004 to provide a cabled observatory at Station ALOHA, north of Oahu. The ALOHA observatory will provide several Mb/s data rates and about 1 kW of power to experiments installed at Station ALOHA. Sensors can be installed either by wet mateable connection to a junction box on the ocean floor using an ROV, or by acoustic data link to the system. In either case real-time data will be provided to users over the Internet. A Small Experiment Module, to be first installed at the Hawaii-2 Observatory, and later at Station ALOHA, will provide relatively cheap and uncomplicated access to the observatories for relatively simple sensors. Within the next few years, the first electro-optical cables installed in the 1980's will be decommissioned and could be available for scientific use. These cables could provide long "extension cords" (thousands of km) with very high bandwidth and reasonable power to several observatories in remote locations in the ocean. While they could be used in-place, a more exciting scenario is to use cable ships to pick up sections of cable and move them to locations of higher scientific interest. While such moves would not be cheap, the costs would rival the cost of installation and maintenance of a buoyed observatory, with far more bandwidth and power available for science use.
De facto Privatization and Inequalities in Educational Opportunity in the Transition to Secondary School in Rural Malawi.

PubMed

Grant, Monica J

2017-09-01

There has been a recent, rapid de facto privatization of education in many African countries, as the number of private secondary schools operating in the region grew. The majority of these schools are "low-cost" private schools where tuition and fees are set as low as possible to cover operating costs and still generate profit. Proponents of low-cost private schools argue that these schools have proliferated in impoverished areas to meet unmet demand for access to education and where private schools may offer better quality than locally available public schools. Theories of inequality of educational opportunity suggest that if private schools offer better quality education, students from more advantaged families will be more likely to enroll at these institutions, potentially exacerbating educational inequality in the region. This analysis uses data from a school-based longitudinal survey, the Malawi Schooling and Adolescent Study, to examine socio-economic inequalities in the transition to secondary school and on-time enrollment in upper secondary. My findings indicate that youth from non-poor households are not only more likely to enroll in secondary school than poor youth, but they are also more likely to substitute enrollment in private schools for enrollment in second-tier government schools. Enrollment at private schools, however, does not yield schooling advantages; relative to both tiers of government secondary schooling, students who initially enrolled at private schools were the least likely to enroll on time in upper secondary school. These patterns suggest that these schooling circumstances may yield less segregation of opportunity than might otherwise be assumed.
Fiber in access technologies and network convergence: an opportunity for optical integration

NASA Astrophysics Data System (ADS)

Ghiggino, Pierpaolo C.

2008-11-01

Broadband networks are among the fastest growing segment in telecom. The initial and still very significant push originated with xDSL technologies and indeed a significant amount of research and development is still occurring in this field with impressive results and allowing for a remarkable use of the installed copper infrastructure way beyond its originally planned bandwidth capabilities. However it is clear that ultimately a more suitable fiber based infrastructure will be needed in order to reduce both operational and network technology costs. Such cost reduction in inevitable as the added value to end users is only related to services and these cannot be priced outside a sensible window, whilst the related bandwidth increase is much more dramatic and its huge variability must be met with little or no cost impact by the network and its operation. Fiber in access has indeed the potential to cope with a huge bandwidth demand for many years to come as its inherent bandwidth capabilities are only just tapped by current service requirements. However the whole technology supply chain must follow in line. In particular optical technology must brace itself to cope with the required much larger deployment and greater cost effectiveness, whilst at the same time deliver performance suitable to the bandwidth increase offered in the longer term by the fiber medium. This paper looks at this issues and debates the opportunities for a new class of optical devices making use of the progress in optical integration
Career Opportunities for Theatre Practitioners.

PubMed

Cadman, Victoria

2017-11-01

'What's the point in doing that?' This is often the response given to those saying they are undertaking education outside of work hours. Many do not see their role in theatre as just a job, but now want a career which means extra studying. Ideally this needs to be in advance so they are one step ahead for when an opportunity arises. Career opportunities and education go hand in hand together, and so it is difficult to discuss one without mentioning the other to some degree. We need education to access career opportunities, but we also need career routes to help drive education forward.
Economic cost of primary prevention of cardiovascular diseases in Tanzania

PubMed Central

Ngalesoni, Frida; Ruhago, George; Norheim, Ole F; Robberstad, Bjarne

2015-01-01

Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)’s CVD medical preventive guidelines are implemented in Tanzania. In addition, we estimate and explore the cost to patients of receiving these services. Cost data were collected in four health facilities located in both urban and rural settings. Providers’ costs were identified and measured using ingredients approach to costing and resource valuation followed the opportunity cost method. Unit costs were estimated using activity-based and step-down costing methodologies. The patient costs were obtained through a structured questionnaire. The unit cost of providing CVD medical primary prevention services ranged from US$30–41 to US$52–71 per patient per year at the health centre and hospital levels, respectively. Employing the WHO’s absolute risk approach guidelines will substantially increase these costs. The annual patient cost of receiving these services as currently practised was estimated to be US$118 and US$127 for urban and rural patients, respectively. Providers’ costs were estimated from two main viewpoints: ‘what is’, that is the current practice, and ‘what if’, reflecting a WHO guidelines scenario. The higher cost of implementing the WHO guidelines suggests the need for further evaluation of whether these added costs are reasonable relative to the added benefits. We also found considerably higher patient costs, implying that distributive and equity implications of access to care require more consideration. Facility location surfaced as the main explanatory variable for both direct and indirect patient costs in

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