Science.gov

Sample records for actual unit costs

  1. 50 CFR 253.16 - Actual cost.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Actual cost. 253.16 Section 253.16 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE AID TO FISHERIES FISHERIES ASSISTANCE PROGRAMS Fisheries Finance Program §...

  2. 50 CFR 253.16 - Actual cost.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 11 2013-10-01 2013-10-01 false Actual cost. 253.16 Section 253.16 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE AID TO FISHERIES FISHERIES ASSISTANCE PROGRAMS Fisheries Finance Program §...

  3. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., and water damage risks incurred when property is actually located in the United States and marine... 26 Internal Revenue 10 2014-04-01 2013-04-01 true Actual United States risks. 1.953-2 Section 1... coverage as “.825% plus .3% fire, etc. risks plus .12% water risks = 1.245%”, a reasonable basis exists...

  4. A comparison of NEAR actual spacecraft costs with three parametric cost models

    NASA Astrophysics Data System (ADS)

    Mosher, Todd J.; Lao, Norman Y.; Davalos, Evelyn T.; Bearden, David A.

    1999-11-01

    Costs for modern (post-1990) U.S.-built small planetary spacecraft have been shown to exhibit significantly different trends from those of larger spacecraft. These differences cannot be accounted for simply by the change in size alone. Some have attributed this departure to NASA's "faster, better, cheaper" design approach embodied by the efficiency of smaller teams, reduced government oversight, increased focus on cost, and short development periods. With the Discovery, Mars Surveyor and New Millennium programs representing the new approach to planetary exploration, it is important to understand these current cost trends and to be able to estimate costs of future proposed missions. To address this issue, The Aerospace Corporation (hereafter referred to as Aerospace) performed a study to compare the actual costs of the Near Earth Asteroid Rendezvous (NEAR) spacecraft bus (instruments were not estimated) using three different cost models; the U.S. Air Force Unmanned Spacecraft Cost Model, Version 7 (USCM-7), the Science Applications International Corporation (SAIC) NASA/Air Force Cost Model 1996 (NAFCOM96) and The Aerospace Corporation's Small Satellite Cost Model 1998 (SSCM98). The NEAR spacecraft was chosen for comparison because it was the first Discovery mission launched, and recently recognized with a Laurel award by Aviation Week and Space Technology as a benchmark for NASA's Discovery program [North, 1997]. It was also selected because the cost data has been released into the public domain [Hemmings, 1996]which makes it easy to discuss in a public forum. This paper summarizes the NEAR program, provides a short synopsis of each of the three cost models, and demonstrates how they were applied for this study.

  5. Processor Units Reduce Satellite Construction Costs

    NASA Technical Reports Server (NTRS)

    2014-01-01

    As part of the effort to build the Fast Affordable Science and Technology Satellite (FASTSAT), Marshall Space Flight Center developed a low-cost telemetry unit which is used to facilitate communication between a satellite and its receiving station. Huntsville, Alabama-based Orbital Telemetry Inc. has licensed the NASA technology and is offering to install the cost-cutting units on commercial satellites.

  6. Rocky Flats Closure Unit Cost Data

    SciTech Connect

    Sanford, P.C.; Skokan, B.

    2007-07-01

    The Rocky Flats Closure Project has completed the process of stabilizing residual nuclear materials, decommissioning nuclear facilities, remediating environmental media and closing the Rocky Flats Site (Site). The project cost approximately $4.1 B and included the decommissioning of over 700 structures including 5 major plutonium facilities and 5 major uranium facilities, shipping over 14,600 cubic meters of transuranic and 565,000 cubic meters of low level radioactive waste, and remediating a 385-acre industrial area and the surrounding land. Actual costs were collected for a large variety of closure activities. These costs can be correlated with metrics associated with the facilities and environmental media to capture cost factors from the project that could be applicable to a variety of other closure projects both within and outside of the Department of Energy's weapons complex. The paper covers four general topics: the process to correlate the actual costs and metrics, an example of the correlated data for one large sub-project, a discussion of the results, and the additional activities that are planned to correlate and make this data available to the public. The process to collect and arrange the project control data of the Closure Project relied on the actual Closure Project cost information. It was used to correlate these actual costs with the metrics for the physical work, such as building area or waste generated, to support the development of parametric cost factors. The example provides cost factors for the Industrial Sites Project. The discussion addresses the strengths and weaknesses of the data, followed by a section identifying future activities to improve and extend the analyses and integrate it within the Department's Environmental Cost Analysis System. (authors)

  7. 45 CFR 149.335 - Documentation of costs of actual claims involved.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Documentation of costs of actual claims involved. 149.335 Section 149.335 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement...

  8. 45 CFR 149.335 - Documentation of costs of actual claims involved.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Documentation of costs of actual claims involved. 149.335 Section 149.335 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement...

  9. California Charter Oversight: Key Elements and Actual Costs. CRB 12-001

    ERIC Educational Resources Information Center

    Blanton, Rebecca E.

    2012-01-01

    This study was mandated by SB537 (Simitian, Chapter 650, Stats. of 2007, codified at Ed. Code Section 47613), which requires the California Research Bureau (CRB) to prepare and submit to the Legislature a report on the key elements and actual costs of charter school oversight. Charter schools are public schools that are operated by entities other…

  10. 45 CFR 149.335 - Documentation of costs of actual claims involved.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... 149.335 Section 149.335 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods... list of early retirees for whom claims are being submitted, and documentation of the actual costs...

  11. 45 CFR 149.335 - Documentation of costs of actual claims involved.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... 149.335 Section 149.335 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods... list of early retirees for whom claims are being submitted, and documentation of the actual costs...

  12. 45 CFR 149.335 - Documentation of costs of actual claims involved.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... 149.335 Section 149.335 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods... list of early retirees for whom claims are being submitted, and documentation of the actual costs...

  13. Urban rail transit projects: Forecast versus actual ridership and costs. Final report

    SciTech Connect

    Pickrell, D.H.

    1989-10-01

    Substantial errors in forecasting ridership and costs for the ten rail transit projects reviewed in the report put forth the possibility that more accurate forecasts would have led decision-makers to select projects other than those reviewed. The study examines the accuracy of forecasts prepared for ten major capital improvement projects in nine urban areas during 1971-1987. Each project includes construction of a fixed transit guideway: Rapid Rail or Metrorail (Washington DC, Atlanta, Baltimore, Miami); Light Rail Transit (Buffalo, Pittsburgh, Portland, Sacramento); and Downtown Peoplemover (Miami and Detroit). The study examines why actual costs and ridership differed so markedly from their forecast values. It focuses on the accuracy of projections made available to local decision-makers at the time when the choice among alternative projects was actually made. The study compares forecast and actual values for four types of measures: ridership, capital costs and financing, operating and maintenance costs, and cost-effectiveness. The report is organized into 6 chapters, numerous tables, and an appendix that documents the sources of all data appearing in the tables presented in the report.

  14. Low cost inertial measuring unit

    NASA Astrophysics Data System (ADS)

    Karnick, Drew A.

    A concept being explored is the use of an inexpensive IMU (inertial measuring unit) with the GPS (Global Positioning System). An inexpensive IMU can meet many of the same functional requirements as the high-accuracy system, with the exception of long-term position. For example, some applications for instrumenting a reference frame are antenna stability, satellite acquisition (including GPS), platform stability, flight stabilization, and heading information. The acceleration data could still be integrated to find velocity and position; however, this position information would only be used for a period of minutes. For example, to provide continuous navigation during a GPS blockage due to buildings, wing blockage during a maneuver, etc. The author presents the capabilities of a unit of this type which was developed for the US Army.

  15. Low-cost inertial measurement unit.

    SciTech Connect

    Deyle, Travis Jay

    2005-03-01

    Sandia National Laboratories performs many expensive tests using inertial measurement units (IMUs)--systems that use accelerometers, gyroscopes, and other sensors to measure flight dynamics in three dimensions. For the purpose of this report, the metrics used to evaluate an IMU are cost, size, performance, resolution, upgradeability and testing. The cost of a precision IMU is very high and can cost hundreds of thousands of dollars. Thus the goals and results of this project are as follows: (1) Examine the data flow in an IMU and determine a generic IMU design. (2) Discuss a high cost IMU implementation and its theoretically achievable results. (3) Discuss design modifications that would save money for suited applications. (4) Design and implement a low cost IMU and discuss its theoretically achievable results. (5) Test the low cost IMU and compare theoretical results with empirical results. (6) Construct a more streamlined printed circuit board design reducing noise, increasing capabilities, and constructing a self-contained unit. Using these results, we can compare a high cost IMU versus a low cost IMU using the metrics from above. Further, we can examine and suggest situations where a low cost IMU could be used instead of a high cost IMU for saving cost, size, or both.

  16. Wind farm production cost: Optimum turbine size and farm capacity in the actual market

    SciTech Connect

    Laali, A.R.; Meyer, J.L.; Bellot, C.; Louche, A.

    1996-12-31

    Several studies are undertaken in R&D Division of EDF in collaboration with ERASME association in order to have a good knowledge of the wind energy production costs. These studies are performed in the framework of a wind energy monitoring project and concern the influence of a few parameters like wind farm capacity, turbine size and wind speed on production costs, through an analysis of the actual market trend. Some 50 manufacturers and 140 different kind of wind turbines are considered for this study. The minimum production cost is situated at 800/900 kW wind turbine rated power. This point will probably move to more important powers in the future. This study is valid only for average conditions and some special parameters like particular climate conditions or lack of infrastructure for a special site the could modify the results shown on the curves. The variety of wind turbines (rated power as a function of rotor diameter, height and specific rated power) in the actual market is analyzed. A brief analysis of the market trend is also performed. 7 refs., 7 figs.

  17. Costing of consumables: use in an intensive care unit.

    PubMed

    Mann, S A

    1999-08-01

    In 1991, the Intensive Care Unit (ICU) at Middlemore Hospital manually costed the treatment and care of asthmatic patients. This was long-winded and labour-intensive, but provided hard data to support anecdotal beliefs that intensive care patients are more expensive than was currently believed or accepted. It is a known problem that funder and provider organizations see a huge disparity on the funding issue. With additional accurate information on the actual cost of individual patients, which can be grouped into disease categories, funding applications can be backed with accurate, up-to-date quantitative data. After a long preparation time, we are now costing individual patient stays in the ICU. Each individual resource was established, costed and entered into an MS ACCESS computerized database. Schedules have been prepared for updating prices, as these change. The final report available gives a detailed list of resource use within certain categories. Some items proved to be impractical to cost on an individual patient basis, and these have been grouped together, costed, and divided by the number of patient days for the last year, and assigned to each individual patient as an hourly unit cost. Believed to be a world-first, this information now forms the basis for variance reporting and pricing. PMID:10786509

  18. Estimating the costs of landslide damage in the United States

    USGS Publications Warehouse

    Fleming, Robert W.; Taylor, Fred A.

    1980-01-01

    Landslide damages are one of the most costly natural disasters in the United States. A recent estimate of the total annual cost of landslide damage is in excess of $1 billion {Schuster, 1978}. The damages can be significantly reduced, however, through the combined action of technical experts, government, and the public. Before they can be expected to take action, local governments need to have an appreciation of costs of damage in their areas of responsibility and of the reductions in losses that can be achieved. Where studies of cost of landslide damages have been conducted, it is apparent that {1} costs to the public and private sectors of our economy due to landslide damage are much larger than anticipated; {2} taxpayers and public officials generally are unaware of the magnitude of the cost, owing perhaps to the lack of any centralization of data; and {3} incomplete records and unavailability of records result in lower reported costs than actually were incurred. The U.S. Geological Survey has developed a method to estimate the cost of landslide damages in regional and local areas and has applied the method in three urban areas and one rural area. Costs are for different periods and are unadjusted for inflation; therefore, strict comparisons of data from different years should be avoided. Estimates of the average annual cost of landslide damage for the urban areas studied are $5,900,000 in the San Francisco Bay area; $4,000,000 in Allegheny County, Pa.; and $5,170,000 in Hamilton County, Ohio. Adjusting these figures for the population of each area, the annual cost of damages per capita are $1.30 in the nine-county San Francisco Bay region; $2.50 in Allegheny County, Pa.; and $5.80 in Hamilton County, Ohio. On the basis of data from other sources, the estimated annual damages on a per capita basis for the City of Los Angeles, Calif., are about $1.60. If the costs were available for the damages from landslides in Los Angeles in 1977-78 and 1979-80, the annual per

  19. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false How do we define actual cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY...

  20. Making appropriate comparisons of estimated and actual costs of reducing SO{sub 2} emissions under Title IV

    SciTech Connect

    Smith, A.E.

    1998-12-31

    A current sentiment within some parts of the environmental policy community is that market-based regulatory approaches such as emissions trading have proven so effective that actual costs will be only a small fraction of what ex ante cost estimation procedures would project. With this line of reasoning, some have dismissed available cost estimates for major proposed new regulations, such as the new PM and ozone NAAQS, as not meaningful for policy decisions. The most commonly used evidence in support of this position is the experience with SO{sub 2} reductions under Title IV of the 1990 Clean Air Act Amendments. In Title IV, a market for emissions allowances has been used to achieve reductions in sulfur dioxides (SO{sub 2}) to ameliorate acid rain. It is commonly asserted today that the cost of achieving the SO{sub 2} emissions reductions has been only one-tenth or less of what Title IV was originally expected to cost. This paper demonstrates that, to the contrary, actual costs for SO{sub 2} reductions remain roughly in line with original estimates associated with Title IV. Erroneous conclusions about Title IV`s costs are due to inappropriate comparisons of a variety of different measures that appear to be comparable only because they are all stated in dollars per ton. Program cost estimates include the total costs of a fully-implemented regulatory program. The very low costs of Title IV that are commonly cited today are neither directly reflective of a fully implemented Title IV, (which is still many years away) nor reflective of all the costs already incurred. Further, a careful review of history finds that the initial cost estimates that many cite were never associated with Title IV. Technically speaking, people are comparing the estimated control costs for the most-costly power plant associated with earlier acid rain regulatory proposals with prices from a market that do not directly reflect total costs.

  1. Using Work Breakdown Structure Models to Develop Unit Treatment Costs

    EPA Science Inventory

    This article presents a new cost modeling approach called work breakdown structure (WBS), designed to develop unit costs for drinking water technologies. WBS involves breaking the technology into its discrete components for the purposes of estimating unit costs. The article dem...

  2. Manual for Reducing Educational Unit Costs in Latin American Countries.

    ERIC Educational Resources Information Center

    Centro Multinacional de Investigacion Educativa, San Jose (Costa Rica).

    Designed for educational administrators, this manual provides suggestions for reducing educational unit costs in Latin America without reducing the quality of the education. Chapter one defines unit cost concepts and compares the costs of the Latin American countries. Chapter two deals with the different policies which could affect the principal…

  3. [Work process and workers' health in a food and nutrition unit: prescribed versus actual work].

    PubMed

    Colares, Luciléia Granhen Tavares; Freitas, Carlos Machado de

    2007-12-01

    This study focuses on the relationship between the work process in a food and nutrition unit and workers' health, in the words of the participants themselves. Direct observation, a semi-structured interview, and focus groups were used to collect the data. The reference was the dialogue between human ergonomics and work psychodynamics. The results showed that work organization in the study unit represents a routine activity, the requirements of which in terms of the work situation are based on criteria set by the institution. Variability in the activities is influenced mainly by the available equipment, instruments, and materials, thereby generating improvisation in meal production that produces both a physical and psychological cost for workers. Dissatisfaction during the performance of tasks results mainly from the supervisory style and relationship to immediate superiors. Workers themselves proposed changes in the work organization, based on greater dialogue and trust between supervisors and the workforce. Finally, the study identifies the need for an intervention that encourages workers' participation as agents of change. PMID:18157343

  4. Unit costs of waste management operations

    SciTech Connect

    Kisieleski, W.E.; Folga, S.M.; Gillette, J.L.; Buehring, W.A.

    1994-04-01

    This report provides estimates of generic costs for the management, disposal, and surveillance of various waste types, from the time they are generated to the end of their institutional control. Costs include monitoring and surveillance costs required after waste disposal. Available data on costs for the treatment, storage, disposal, and transportation of spent nuclear fuel and high-level radioactive, low-level radioactive, transuranic radioactive, hazardous, mixed (low-level radioactive plus hazardous), and sanitary wastes are presented. The costs cover all major elements that contribute to the total system life-cycle (i.e., ``cradle to grave``) cost for each waste type. This total cost is the sum of fixed and variable cost components. Variable costs are affected by operating rates and throughput capacities and vary in direct proportion to changes in the level of activity. Fixed costs remain constant regardless of changes in the amount of waste, operating rates, or throughput capacities. Key factors that influence cost, such as the size and throughput capacity of facilities, are identified. In many cases, ranges of values for the key variables are presented. For some waste types, the planned or estimated costs for storage and disposal, projected to the year 2000, are presented as graphics.

  5. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel... PROCEDURE REQUIREMENTS Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury... assignment because of an incapacitating illness or injury? (a) Actual cost of travel will be...

  6. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel... PROCEDURE REQUIREMENTS Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury... assignment because of an incapacitating illness or injury? (a) Actual cost of travel will be...

  7. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal Travel... PROCEDURE REQUIREMENTS Policies and Procedures for Emergency Travel of Employee Due to Illness or Injury... assignment because of an incapacitating illness or injury? (a) Actual cost of travel will be...

  8. Fuzzy case based reasoning in sports facilities unit cost estimating

    NASA Astrophysics Data System (ADS)

    Zima, Krzysztof

    2016-06-01

    This article presents an example of estimating costs in the early phase of the project using fuzzy case-based reasoning. The fragment of database containing descriptions and unit cost of sports facilities was shown. The formulas used in Case Based Reasoning method were presented, too. The article presents similarity measurement using a few formulas, including fuzzy similarity. The outcome of cost calculations based on CBR method was presented as a fuzzy number of unit cost of construction work.

  9. California Charter Oversight: Key Elements and Actual Costs. CRB Briefly Stated

    ERIC Educational Resources Information Center

    Blanton, Rebecca E.

    2012-01-01

    The Legislature mandated the California Research Bureau (CRB) explore known best practices for charter school authorizers and survey California authorizers about their practices and costs. Additionally, the Legislature mandated CRB provide an analysis of current reimbursement for charter school oversight and include suggestions for improving…

  10. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

    PubMed Central

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2016-01-01

    Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

  11. Unit Cost of Medical Services at Different Hospitals in India

    PubMed Central

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

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

  12. Costs of Alcohol-Involved Crashes, United States, 2010

    PubMed Central

    Zaloshnja, Eduard; Miller, Ted R.; Blincoe, Lawrence J.

    2013-01-01

    This paper estimates total and unit costs of alcohol-involved crashes in the U.S. in 2010. With methods from earlier studies, we estimated costs per crash survivor by MAIS, body part, and fracture/dislocation involvement. We multiplied them times 2010 crash incidence estimates from NHTSA data sets, with adjustments for underreporting of crashes and their alcohol involvement. The unit costs are lifetime costs discounted at 3%. To develop medical costs, we combined 2008 Health Care Utilization Program national data for hospitalizations and ED visits of crash survivors with prior estimates of post-discharge costs. Productivity losses drew on Current Population Survey and American Time Use Survey data. Quality of life losses came from a 2011 AAAM paper and property damage from insurance data. We built a hybrid incidence file comprised of 2008–2010 and 1984–86 NHTSA crash surveillance data, weighted with 2010 General Estimates System weights. Fatality data came from the 2010 FARS. An estimated 12% of 2010 crashes but only 0.9% of miles driven were alcohol-involved (BAC > .05). Alcohol-involved crashes cost an estimated $125 billion. That is 22.5% of the societal cost of all crashes. Alcohol-attributable crashes accounted for an estimated 22.5% of US auto liability insurance payments. Alcohol-involved crashes cost $0.86 per drink. Above the US BAC limit of .08, crash costs were $8.37 per mile driven; 1 in 788 trips resulted in a crash and 1 in 1,016 trips in an arrest. Unit costs for crash survivors by severity are higher for impaired driving than for other crashes. That suggests national aggregate impaired driving cost estimates in other countries are substantial underestimates if they are based on all-crash unit costs. PMID:24406941

  13. The unit cost factors and calculation methods for decommissioning - Cost estimation of nuclear research facilities

    SciTech Connect

    Kwan-Seong Jeong; Dong-Gyu Lee; Chong-Hun Jung; Kune-Woo Lee

    2007-07-01

    Available in abstract form only. Full text of publication follows: The uncertainties of decommissioning costs increase high due to several conditions. Decommissioning cost estimation depends on the complexity of nuclear installations, its site-specific physical and radiological inventories. Therefore, the decommissioning costs of nuclear research facilities must be estimated in accordance with the detailed sub-tasks and resources by the tasks of decommissioning activities. By selecting the classified activities and resources, costs are calculated by the items and then the total costs of all decommissioning activities are reshuffled to match with its usage and objectives. And the decommissioning cost of nuclear research facilities is calculated by applying a unit cost factor method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning costs of nuclear research facilities are composed of labor cost, equipment and materials cost. Of these three categorical costs, the calculation of labor costs are very important because decommissioning activities mainly depend on labor force. Labor costs in decommissioning activities are calculated on the basis of working time consumed in decommissioning objects and works. The working times are figured out of unit cost factors and work difficulty factors. Finally, labor costs are figured out by using these factors as parameters of calculation. The accuracy of decommissioning cost estimation results is much higher compared to the real decommissioning works. (authors)

  14. COST ESTIMATION MODELS FOR DRINKING WATER TREATMENT UNIT PROCESSES

    EPA Science Inventory

    Cost models for unit processes typically utilized in a conventional water treatment plant and in package treatment plant technology are compiled in this paper. The cost curves are represented as a function of specified design parameters and are categorized into four major catego...

  15. The economic costs of heroin addiction in the United States.

    PubMed

    Mark, T L; Woody, G E; Juday, T; Kleber, H D

    2001-01-01

    This study documents the costs of heroin addiction in the United States, both to the addict and society at large. Using a cost-of-illness approach, costs were estimated in four broad areas: medical care, lost productivity, crime, and social welfare. We estimate that the cost of heroin addiction in the United States was US$21.9 billion in 1996. Of these costs, productivity losses accounted for approximately US$11.5 billion (53%), criminal activities US$5.2 billion (24%), medical care US$5.0 billion (23%), and social welfare US$0.1 billion (0.5%). The large economic burden resulting from heroin addiction highlights the importance of investment in prevention and treatment. PMID:11137285

  16. Applying activity-based costing to the nuclear medicine unit.

    PubMed

    Suthummanon, Sakesun; Omachonu, Vincent K; Akcin, Mehmet

    2005-08-01

    Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. The finding indicates that the current cost averages 236.11 US dollars for all procedures, which is quite different from the costs computed by using ABC. The difference is most significant with positron emission tomography scan, 463 US dollars (an increase of 96%), as well as bone scan and thyroid scan, 114 US dollars (a decrease of 52%). The result of ABC analysis demonstrates that the operational time (machine time and direct labour time) and the cost of drugs have the most influence on cost per procedure. Clearly, to reduce the cost per procedure for the NMU, the reduction in operational time and cost of drugs should be analysed. The result also indicates that ABC can be used to improve resource allocation and management. It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better. PMID:16102243

  17. Current pediatric rheumatology fellowship training in the United States: what fellows actually do

    PubMed Central

    2014-01-01

    Background Pediatric Rheumatology (PR) training in the US has existed since the 1970’s. In the early 1990’s, the training was formalized into a three year training program by the American College of Graduate Medical Education (ACGME) and American Board of Pediatrics (ABP). Programs have been evaluated every 5 years by the ACGME to remain credentialed and graduates had to pass a written exam to be certified. There has been no report yet that details not just what training fellows should receive in the 32 US PR training programs but what training the trainees are actually receiving. Methods After a literature search, a survey was constructed by the authors, then reviewed and revised with the help members of the Executive Committee of the Rheumatology Section of the American Academy of Pediatrics (AAP) using the Delphi technique. IRB approval was obtained from the AAP and Nationwide Children’s Hospital. The list of fellows was obtained from the ABP and the survey sent out to 81 current fellows or fellows just having finished. One repeat e-mail was sent out. Results Forty-seven fellows returned the survey by e-mail (58%) with the majority being 3rd year fellows or fellows who had completed their training. The demographics were as expected with females > males and Caucasians> > non-Caucasians. Training appeared quite appropriate in the number of ½ day continuity clinics per week (1–2, 71%), number of patients per clinic (4–5, 60%), inpatient exposure (2–4 inpatients per week, 40%; 5 or greater, 33%), and weekday/weekend call. Fellows attended more didactic activities than required, had ample time for research (54% 21-60/hours per week), and had multiple teaching opportunities. Seventy-seven percent of the trainees presented abstracts at national meetings, 41% had publication. Disease exposure was excellent and joint injection experience sufficient. Conclusions Most US PR training programs as a whole provide an appropriate training by current

  18. Unit Time/Cost Study of the Acquisitions Unit, Technical Services Division, Tucson Public Library.

    ERIC Educational Resources Information Center

    Bierman, Kenneth J.; And Others

    In the third and final report of a series designed to develop unit time and costs for the major operations of the Technical Services Division of the Tucson Public Library, the Acquisitions Unit's activities are analyzed by means of self-recorded daily logs. Ordering, accounting, and receiving are performed in this area, and those functions are…

  19. Actual and Perceived Units of Alcohol in a Self-Defined “Usual Glass” of Alcoholic Drinks in England

    PubMed Central

    Boniface, Sadie; Kneale, James; Shelton, Nicola

    2013-01-01

    Background Several studies have found participants pour more than 1 standard drink or unit as their usual glass. This is the first study to measure actual and perceived amounts of alcohol in a self-defined usual glass of wines and spirits in the general population. Methods Participants were a convenience sample of adults who drink alcohol or who pour drinks for other people (n = 283, 54% women) at 6 sites in South East England. The survey was face to face and comprised a self-completion questionnaire and pouring task. Estimation accuracy, categorised as correct (±0.5 units), underestimate (>0.5 units), or overestimate (>0.5 units) was the main outcome. Results The mean number of units poured was 1.90 (SD 0.80; n = 264) for wine and 1.93 (SD 0.78; n = 201) for spirits. The amount of alcohol in a self-defined usual glass was estimated in 440 glasses (248 wine and 192 spirits). Overestimation took place in 42% glasses of spirit poured and 29% glasses of wine poured, and underestimation in 17 and 19%, respectively. Multinomial logistic regression found volume poured to be significantly associated with underestimating both wines and spirits, and additionally for wine only, belonging to a non-white ethnic group and being unemployed or retired. Not having a university degree was significantly associated with overestimating both drink types. Conclusions This study is the first in the general population and did not identify systematic underestimation of the amount of alcohol in a self-defined usual glass. Underestimation is significantly associated with volume poured for both drink types; therefore, advocating pouring smaller glasses could reduce underestimation of alcohol consumption. PMID:23278164

  20. Fiscal Year 2000 Unit Cost Report for the Illinois Public Community Colleges.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    This report shows net instructional unit costs from fiscal year 1995 through fiscal year 2000. The five sections are: (1) Comparison of Fiscal Year 2000 Net Instructional Unit Cost with Previous Years; (2) Net Instructional Unit Cost in Illinois Public Community Colleges Since Fiscal Year 1995; (3) Fiscal Year 2000 Net Instructional Unit Cost,…

  1. 24 CFR 81.17 - Affordability-Income level definitions-family size and income known (owner-occupied units, actual...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... definitions-family size and income known (owner-occupied units, actual tenants, and prospective tenants). 81... prospective tenants). In determining whether a dwelling unit is affordable to very-low-, low-, or moderate... prospective tenants is available, income not in excess of the following percentages of area median...

  2. 47 CFR 51.511 - Forward-looking economic cost per unit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Forward-looking economic cost per unit. 51.511... (CONTINUED) INTERCONNECTION Pricing of Elements § 51.511 Forward-looking economic cost per unit. (a) The forward-looking economic cost per unit of an element equals the forward-looking economic cost of...

  3. 47 CFR 51.511 - Forward-looking economic cost per unit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Forward-looking economic cost per unit. 51.511... (CONTINUED) INTERCONNECTION Pricing of Elements § 51.511 Forward-looking economic cost per unit. (a) The forward-looking economic cost per unit of an element equals the forward-looking economic cost of...

  4. 47 CFR 51.511 - Forward-looking economic cost per unit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Forward-looking economic cost per unit. 51.511... (CONTINUED) INTERCONNECTION Pricing of Elements § 51.511 Forward-looking economic cost per unit. (a) The forward-looking economic cost per unit of an element equals the forward-looking economic cost of...

  5. 47 CFR 51.511 - Forward-looking economic cost per unit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Forward-looking economic cost per unit. 51.511... (CONTINUED) INTERCONNECTION Pricing of Elements § 51.511 Forward-looking economic cost per unit. (a) The forward-looking economic cost per unit of an element equals the forward-looking economic cost of...

  6. 47 CFR 51.511 - Forward-looking economic cost per unit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Forward-looking economic cost per unit. 51.511... (CONTINUED) INTERCONNECTION Pricing of Elements § 51.511 Forward-looking economic cost per unit. (a) The forward-looking economic cost per unit of an element equals the forward-looking economic cost of...

  7. Kawasaki syndrome hospitalizations and associated costs in the United States.

    PubMed Central

    Belay, Ermias D.; Holman, Robert C.; Maddox, Ryan A.; Foster, David A.; Schonberger, Lawrence B.

    2003-01-01

    OBJECTIVES: To describe the epidemiologic characteristics of patients hospitalized with Kawasaki syndrome (KS) and estimate associated costs in the United States, using a large national hospital discharge dataset. METHODS: Hospitalization discharge records with KS for 1997 through 1999 for U.S. residents <18 years of age were selected from Solucient's hospital discharge records. These records are collected from most of the self-governing children's hospitals and approximately one-third of short-term, non-federal general hospitals in the United States. RESULTS: A total of 7,431 hospital discharges with a KS diagnosis were identified; 2,270 of the discharges were in 1997, 2,700 in 1998, and 2,461 in 1999. Boys comprised 60.0% of the discharges, and 76.4% of discharges were among children ages <5 years. For the 44 states and the District of Columbia with at least one hospital reporting KS, the average annual KS hospitalization rate was 10.2 per 100,000 children ages <5 years. The KS hospitalization rate for boys (12.0 per 100,000) was higher than that for girls (8.3 per 100,000) (risk ratio 1.45; 95% confidence interval 1.37, 1.52). Extrapolation to the U.S. population showed an estimated average annual KS hospitalization rate of 21.6. The median KS hospitalization cost for children <5 years of age during the study period was $6,169 US dollars. CONCLUSIONS: The KS hospitalization rate was consistent with that of previous U.S. studies, although the extrapolated rate may be an overestimation. The median hospitalization cost for KS was higher than that for respiratory syncytial virus-associated bronchiolitis and diarrheal diseases. Large hospitalization datasets can be used to monitor the occurrence of KS in the United States. PMID:12941859

  8. 41 CFR 301-70.506 - How do we define actual cost and constructive cost when an employee interrupts a travel...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... appropriate en route travel time. ... cost and constructive cost when an employee interrupts a travel assignment because of an incapacitating illness or injury? 301-70.506 Section 301-70.506 Public Contracts and Property Management Federal...

  9. A Master Plan for Unit Cost Studies Among Community Junior Colleges.

    ERIC Educational Resources Information Center

    Sims, Howard D.

    The need for higher education programs is being challenged, and unit cost studies may become an integral part of the funding process for junior colleges. This paper describes the major tasks in a cost study and reviews the problems encountered in the unit costing efforts. The main tasks are: (1) identifying units of measurement (the language used…

  10. A low-cost evolutionary algorithm for the unit commitment problem considering probabilistic unit outages

    NASA Astrophysics Data System (ADS)

    Asouti, V. G.; Giannakoglou, K. C.

    2012-07-01

    This article presents a solution method to the unit commitment problem with probabilistic unit failures and repairs, which is based on evolutionary algorithms and Monte Carlo simulations. Regarding the latter, thousands of availability-unavailability trial time patterns along the scheduling horizon are generated. The objective function to be minimised is the expected total operating cost, computed after adapting any candidate solution, i.e. any series of generating/non-generating (ON/OFF) unit states, to the availability-unavailability patterns and performing evaluations by considering fuel, start-up and shutdown costs as well as the cost for buying electricity from external resources, if necessary. The proposed method introduces a new efficient chromosome representation: the decision variables are integer IDs corresponding to the binary-to-decimal converted ON/OFF (1/0) scenarios that cover the demand in each hour. In contrast to previous methods using binary strings as chromosomes, the new chromosome must be penalised only if any of the constraints regarding start-up, shutdown and ramp times cannot be met, chromosome repair is avoided and, consequently, the dispatch problems are solved once in the preparatory phase instead of during the evolution. For all these reasons, with or without probabilistic outages, the proposed algorithm has much lower CPU cost. In addition, if probabilistic outages are taken into account, a hierarchical evaluation scheme offers extra noticeable gain in CPU cost: the population members are approximately pre-evaluated using a small 'representative' set of the Monte Carlo simulations and only a few top population members undergo evaluations through the full Monte Carlo simulations. The hierarchical scheme makes the proposed method about one order of magnitude faster than its conventional counterpart.

  11. 77 FR 24940 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-26

    ...: Representative Average Unit Costs of Energy'', dated March 10, 2011, 76 FR 13168. May 29, 2012, the cost figures... pursuant to the Energy Policy and Conservation Act. The five sources are electricity, natural gas, No. 2... after-tax costs found in this notice. The representative average unit after-tax costs for...

  12. 12 CFR 1282.17 - Affordability-Income level definitions-family size and income known (owner-occupied units, actual...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Affordability-Income level definitions-family size and income known (owner-occupied units, actual tenants, and prospective tenants). 1282.17 Section 1282.17 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals §...

  13. Energy Savings and Breakeven Costs for Residential Heat Pump Water Heaters in the United States

    SciTech Connect

    Maguire, Jeff; Burch, Jay; Merrigan, Tim; Ong, Sean

    2013-07-01

    Heat pump water heaters (HPWHs) have recently re-emerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, NREL performed simulations of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern United States. When replacing an electric water heater, the HPWH is likely to break even in California, the southern United States, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  14. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... acquisition cost is under $100,000, it shall be reported as under $100,000. (g) Software acquisition costs include software costs incurred up through acceptance testing and material internal costs incurred to implement the software and otherwise make the software ready for use. Costs incurred after...

  15. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... acquisition cost is under $100,000, it shall be reported as under $100,000. (g) Software acquisition costs include software costs incurred up through acceptance testing and material internal costs incurred to implement the software and otherwise make the software ready for use. Costs incurred after...

  16. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... production costs (for assets produced or constructed). (5) Engineering, architectural, and other outside... acquisition cost is under $100,000, it shall be reported as under $100,000. (g) Software acquisition costs include software costs incurred up through acceptance testing and material internal costs incurred...

  17. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... production costs (for assets produced or constructed). (5) Engineering, architectural, and other outside... acquisition cost is under $100,000, it shall be reported as under $100,000. (g) Software acquisition costs include software costs incurred up through acceptance testing and material internal costs incurred...

  18. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... production costs (for assets produced or constructed). (5) Engineering, architectural, and other outside... acquisition cost is under $100,000, it shall be reported as under $100,000. (g) Software acquisition costs include software costs incurred up through acceptance testing and material internal costs incurred...

  19. Oversight overload: harried hospitals say the growing number of billing audits they face could actually increase costs.

    PubMed

    Daly, Rich

    2011-11-21

    Providers say the administration's growing emphasis on billing audits is pushing them to the limit and threatens to increase their costs. Many billing problems stem from simple errors, not fraud, they say. "When you get into the nuts and bolts of some of these programs you realize it's not as easy as taking the overpayment line out of the budget," says Michael Regier, of VHA. PMID:22175206

  20. Fiscal Year 1989 Unit Cost Report for the Public Community Colleges of Illinois.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    Fiscal year (FY) 1989 results of the annual unit cost study of the Illinois public community colleges are presented in this report, based on data on course offerings, enrollments, and costs provided by the colleges. After an initial summary overview, data and analyses are presented showing net instructional unit costs for FY 1989 compared with…

  1. 75 FR 13123 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ...: Representative Average Unit Costs of Energy'', dated June 3, 2009, 74 FR 26675. Effective April 19, 2010, the... pursuant to the Energy Policy and Conservation Act. The five sources are electricity, natural gas, No. 2...-tax costs found in this notice. The representative average unit after-tax costs for...

  2. 76 FR 13168 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ...: Representative Average Unit Costs of Energy'', dated March 18, 2010, 75 FR 13123. Effective April 11, 2011, the... pursuant to the Energy Policy and Conservation Act. The five sources are electricity, natural gas, No. 2... after-tax costs found in this notice. The representative average unit after-tax costs for...

  3. FY 1979 Unit Cost Analysis for the Public Community Colleges of Illinois.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    A unit cost analysis for fiscal year (FY) 1979 was conducted by the Illinois Community College Board using mid-term enrollment data and uniform accounting information from each of the state's 51 community colleges. Unit costs for instructional areas were determined at three incremental levels: (1) net instructional cost (NIC), which includes…

  4. Is DNA Barcoding Actually Cheaper and Faster than Traditional Morphological Methods: Results from a Survey of Freshwater Bioassessment Efforts in the United States?

    PubMed Central

    Stein, Eric D.; Martinez, Maria C.; Stiles, Sara; Miller, Peter E.; Zakharov, Evgeny V.

    2014-01-01

    Taxonomic identification accounts for a substantial portion of cost associated with bioassessment programs across the United States. New analytical approaches, such as DNA barcoding have been promoted as a way to reduce monitoring costs and improve efficiency, yet this assumption has not been thoroughly evaluated. We address this question by comparing costs for traditional morphology-based bioassessment, the standard Sanger sequencing-based DNA barcoding approach, and emerging next-generation (NGS) molecular methods. Market demand for molecular approaches is also assessed through a survey of the level of freshwater bioassessment effort in the United States across multiple habitat types (lakes, streams, wetlands) and indicators (benthic invertebrates, fish, algae). All state and regional level programs administered by public agencies and reported via agency web sites were included in the survey. Costs were based on surveys of labs and programs willing to provide such information. More than 19,500 sites are sampled annually across the United States, with the majority of effort occurring in streams. Benthic invertebrates are the most commonly used indicator, but algae and fish comprise between 35% and 21% of total sampling effort, respectively. We estimate that between $104 and $193 million is spent annually on routine freshwater bioassessment in the United States. Approximately 30% of the bioassessment costs are comprised of the cost to conduct traditional morphology-based taxonomy. Current barcoding costs using Sanger sequencing are between 1.7 and 3.4 times as expensive as traditional taxonomic approaches, excluding the cost of field sampling (which is common to both approaches). However, the cost of NGS methods are comparable (or slightly less expensive) than traditional methods depending on the indicator. The promise of barcoding as a cheaper alternative to current practices is not yet realized, although molecular methods may provide other benefits, such as a

  5. ABC estimation of unit costs for emergency department services.

    PubMed

    Holmes, R L; Schroeder, R E

    1996-04-01

    Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC. PMID:10156656

  6. 78 FR 17648 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ...: Representative Average Unit Costs of Energy'', dated April 26, 2012, 77 FR 24940. On April 22, 2013, the cost... pursuant to the Energy Policy and Conservation Act. The five sources are electricity, natural gas, No. 2...-tax residential costs found in this notice. These costs for electricity, natural gas, No. 2...

  7. Energy Savings and Breakeven Cost for Residential Heat Pump Water Heaters in the United States

    SciTech Connect

    Maguire, J.; Burch, J.; Merrigan, T.; Ong, S.

    2013-07-01

    Heat pump water heaters (HPWHs) have recently reemerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, simulations were performed of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern US. When replacing an electric water heater, the HPWH is likely to break even in California, the southern US, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  8. Cost-effective ceramics program in the United States

    SciTech Connect

    Schulz, R.B.; Johnson, D.R.

    1994-10-01

    The 5-year Cost-Effective Ceramics for Heat Engines program began in 1993. This effort reflects the realization that the problems with reliability of structural ceramics have been largely overcome, but the high cost of structural ceramics is limited their use in commercial applications. The technical causes of high cost were identified, and a technical plan developed. The work elements in the program include the following: economic cost modeling, ceramic machining, powder synthesis, alternative forming and densification processes, yield improvement, standards development, and low-expansion ceramics.

  9. Cost-Effectiveness and Cost-Reduction in United States Colleges and Universities.

    ERIC Educational Resources Information Center

    Miller, Richard I.; Miller, Peggy M.

    1991-01-01

    The relationship in college administration between cost effectiveness/cost reduction and planning, management, and evaluation is explored, and approaches to cost accounting and financial ratio analysis are discussed. It is concluded that it is important to emphasize institutional mission and people rather than cost containment and productivity.…

  10. Cost of crashes related to road conditions, United States, 2006.

    PubMed

    Zaloshnja, Eduard; Miller, Ted R

    2009-10-01

    This is the first study to estimate the cost of crashes related to road conditions in the U.S. To model the probability that road conditions contributed to the involvement of a vehicle in the crash, we used 2000-03 Large Truck Crash Causation Study (LTCCS) data, the only dataset that provides detailed information whether road conditions contributed to crash occurrence. We applied the logistic regression results to a costed national crash dataset in order to calculate the probability that road conditions contributed to the involvement of a vehicle in each crash. In crashes where someone was moderately to seriously injured (AIS-2-6) in a vehicle that harmfully impacted a large tree or medium or large non-breakaway pole, or if the first harmful event was collision with a bridge, we changed the calculated probability of being road-related to 1. We used the state distribution of costs of fatal crashes where road conditions contributed to crash occurrence or severity to estimate the respective state distribution of non-fatal crash costs. The estimated comprehensive cost of traffic crashes where road conditions contributed to crash occurrence or severity was $217.5 billion in 2006. This represented 43.6% of the total comprehensive crash cost. The large share of crash costs related to road design and conditions underlines the importance of these factors in highway safety. Road conditions are largely controllable. Road maintenance and upgrading can prevent crashes and reduce injury severity. PMID:20184840

  11. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false United States share of project costs. 151.43 Section 151.43 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.43 United States share of project costs....

  12. Drug Prohibition in the United States: Costs, Consequences, and Alternatives

    NASA Astrophysics Data System (ADS)

    Nadelmann, Ethan A.

    1989-09-01

    ``Drug legalization'' increasingly merits serious consideration as both an analytical model and a policy option for addressing the ``drug problem.'' Criminal justice approaches to the drug problem have proven limited in their capacity to curtail drug abuse. They also have proven increasingly costly and counterproductive. Drug legalization policies that are wisely implemented can minimize the risks of legalization, dramatically reduce the costs of current policies, and directly address the problems of drug abuse.

  13. Clinical observation units help manage costs and care.

    PubMed

    Lenox, A C; New, H

    1997-04-01

    Clinical observation units were created to avoid questionable admissions and short inpatient stays that were likely to result in Medicare payment denials. With the rise of managed care, these units also can contribute to ensuring optimal reimbursement by helping manage patient flow. Hermann Hospital, a facility affiliated with the University of Texas, Houston, initially opened an improved observation unit in 1992, but recorded a 13 percent Medicare payment denial rate and operating losses of as much as $20,000 per month during the first five months of the unit's operation. A multidisciplinary team was formed to address the observation unit's low utilization and payment denial problems. The problems identified included missed opportunities for admissions, inappropriate admissions, and extended stays. The facility took corrective measures based on the quality team's assessment and corrective measures developed by the utilization management committee and quality teams. The clinical observation unit now sustains a zero denial rate and steady revenue increases resulting from improved utilization of the unit. PMID:10166283

  14. Unit Costs Provide Basis for Meaningful Evaluation of Efficiency of TV Courses.

    ERIC Educational Resources Information Center

    Jones, Gardner; And Others

    1969-01-01

    Efficient use of television for teaching cannot be achieved without meaningful cost comparisons with conventional classroom methods. Considerable effort has been spent at the University of Michigan in developing a unit cost basis for televised filmed lectures to include not only salaries, but administrative costs, supplies, amortization of…

  15. Cost unit accounting based on a clinical pathway: a practical tool for DRG implementation.

    PubMed

    Feyrer, R; Rösch, J; Weyand, M; Kunzmann, U

    2005-10-01

    Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity for economic survival, given the current general conditions in the healthcare system. Definition of a suitable cost unit is a crucial factor for success. We present here the development and use of a clinical pathway as a cost unit as an alternative to the DRG. Elective coronary artery bypass grafting was selected as an example. Development of the clinical pathway was conducted according to a modular concept that mirrored all the treatment processes across various levels and modules. Using service records and analyses the process algorithms of the clinical pathway were developed and visualized with CorelTM iGrafix Process 2003. A detailed process cost record constituted the basis of the pathway costing, in which financial evaluation of the treatment processes was performed. The result of this study was a structured clinical pathway for coronary artery bypass grafting together with a cost calculation in the form of cost unit accounting. The use of a clinical pathway as a cost unit offers considerable advantages compared to the DRG or clinical case. The variance in the diagnoses and procedures within a pathway is minimal, so the consumption of resources is homogeneous. This leads to a considerable improvement in the value of cost unit accounting as a strategic control instrument in hospitals. PMID:16208610

  16. Water balance-based actual evapotranspiration reconstruction from ground and satellite observations over the conterminous United States

    NASA Astrophysics Data System (ADS)

    Wan, Zhanming; Zhang, Ke; Xue, Xianwu; Hong, Zhen; Hong, Yang; Gourley, Jonathan J.

    2015-08-01

    The objective of this study is to produce an observationally based monthly evapotranspiration (ET) product using the simple water balance equation across the conterminous United States (CONUS). We adopted the best quality ground and satellite-based observations of the water budget components, i.e., precipitation, runoff, and water storage change, while ET is computed as the residual. Precipitation data are provided by the bias-corrected PRISM observation-based precipitation data set, while runoff comes from observed monthly streamflow values at 592 USGS stream gauging stations that have been screened by strict quality controls. We developed a land surface model-based downscaling approach to disaggregate the monthly GRACE equivalent water thickness data to daily, 0.125° values. The derived ET computed as the residual from the water balance equation is evaluated against three sets of existing ET products. The similar spatial patterns and small differences between the reconstructed ET in this study and the other three products show the reliability of the observationally based approach. The new ET product and the disaggregated GRACE data provide a unique, important hydro-meteorological data set that can be used to evaluate the other ET products as a benchmark data set, assess recent hydrological and climatological changes, and terrestrial water and energy cycle dynamics across the CONUS. These products will also be valuable for studies and applications in drought assessment, water resources management, and climate change evaluation.

  17. Renewable Energy Cost Modeling. A Toolkit for Establishing Cost-Based Incentives in the United States

    SciTech Connect

    Gifford, Jason S.; Grace, Robert C.; Rickerson, Wilson H.

    2011-05-01

    This report serves as a resource for policymakers who wish to learn more about levelized cost of energy (LCOE) calculations, including cost-based incentives. The report identifies key renewable energy cost modeling options, highlights the policy implications of choosing one approach over the other, and presents recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, FITs, or similar policies. These recommendations shaped the design of NREL's Cost of Renewable Energy Spreadsheet Tool (CREST), which is used by state policymakers, regulators, utilities, developers, and other stakeholders to assist with analyses of policy and renewable energy incentive payment structures. Authored by Jason S. Gifford and Robert C. Grace of Sustainable Energy Advantage LLC and Wilson H. Rickerson of Meister Consultants Group, Inc.

  18. Improvements in and actual performance of the Plant Experiment Unit onboard Kibo, the Japanese experiment module on the international space station

    NASA Astrophysics Data System (ADS)

    Yano, Sachiko; Kasahara, Haruo; Masuda, Daisuke; Tanigaki, Fumiaki; Shimazu, Toru; Suzuki, Hiromi; Karahara, Ichirou; Soga, Kouichi; Hoson, Takayuki; Tayama, Ichiro; Tsuchiya, Yoshikazu; Kamisaka, Seiichiro

    2013-03-01

    In 2004, Japan Aerospace Exploration Agency developed the engineered model of the Plant Experiment Unit and the Cell Biology Experiment Facility. The Plant Experiment Unit was designed to be installed in the Cell Biology Experiment Facility and to support the seed-to-seed life cycle experiment of Arabidopsis plants in space in the project named Space Seed. Ground-based experiments to test the Plant Experiment Unit showed that the unit needed further improvement of a system to control the water content of a seedbed using an infrared moisture analyzer and that it was difficult to keep the relative humidity inside the Plant Experiment Unit between 70 and 80% because the Cell Biology Experiment Facility had neither a ventilation system nor a dehumidifying system. Therefore, excess moisture inside the Cell Biology Experiment Facility was removed with desiccant bags containing calcium chloride. Eight flight models of the Plant Experiment Unit in which dry Arabidopsis seeds were fixed to the seedbed with gum arabic were launched to the International Space Station in the space shuttle STS-128 (17A) on August 28, 2009. Plant Experiment Unit were installed in the Cell Biology Experiment Facility with desiccant boxes, and then the Space Seed experiment was started in the Japanese Experiment Module, named Kibo, which was part of the International Space Station, on September 10, 2009 by watering the seedbed and terminated 2 months later on November 11, 2009. On April 19, 2010, the Arabidopsis plants harvested in Kibo were retrieved and brought back to Earth by the space shuttle mission STS-131 (19A). The present paper describes the Space Seed experiment with particular reference to the development of the Plant Experiment Unit and its actual performance in Kibo onboard the International Space Station. Downlinked images from Kibo showed that the seeds had started germinating 3 days after the initial watering. The plants continued growing, producing rosette leaves, inflorescence

  19. Treatment of an actual slaughterhouse wastewater by integration of biological and advanced oxidation processes: Modeling, optimization, and cost-effectiveness analysis.

    PubMed

    Bustillo-Lecompte, Ciro Fernando; Mehrvar, Mehrab

    2016-11-01

    Biological and advanced oxidation processes are combined to treat an actual slaughterhouse wastewater (SWW) by a sequence of an anaerobic baffled reactor, an aerobic activated sludge reactor, and a UV/H2O2 photoreactor with recycle in continuous mode at laboratory scale. In the first part of this study, quadratic modeling along with response surface methodology are used for the statistical analysis and optimization of the combined process. The effects of the influent total organic carbon (TOC) concentration, the flow rate, the pH, the inlet H2O2 concentration, and their interaction on the overall treatment efficiency, CH4 yield, and H2O2 residual in the effluent of the photoreactor are investigated. The models are validated at different operating conditions using experimental data. Maximum TOC and total nitrogen (TN) removals of 91.29 and 86.05%, respectively, maximum CH4 yield of 55.72%, and minimum H2O2 residual of 1.45% in the photoreactor effluent were found at optimal operating conditions. In the second part of this study, continuous distribution kinetics is applied to establish a mathematical model for the degradation of SWW as a function of time. The agreement between model predictions and experimental values indicates that the proposed model could describe the performance of the combined anaerobic-aerobic-UV/H2O2 processes for the treatment of SWW. In the final part of the study, the optimized combined anaerobic-aerobic-UV/H2O2 processes with recycle were evaluated using a cost-effectiveness analysis to minimize the retention time, the electrical energy consumption, and the overall incurred treatment costs required for the efficient treatment of slaughterhouse wastewater effluents. PMID:27568982

  20. Breakeven Cost for Residential Photovoltaics in the United States: Key Drivers and Sensitivities (Report Summary) (Presentation)

    SciTech Connect

    Denholm, P.; Margolis, R. M.; Ong, S.; Roberts, B.

    2009-12-01

    "Break-even cost" for photovoltaic (PV) technology is defined as the point where the cost of PV-generated electricity equals the cost of electricity purchased from the grid. Break-even cost is expressed in $/W of an installed system. Achieving break-even cost is a function of many variables. Consequently, break-even costs vary by location and time for a country, such as the United States, with a diverse set of resources, electricity prices, and other variables. In this presentation, we introduce an analysis of PV break-even costs for residential customers in the United States, including an evaluation of some of the key drivers of PV breakeven both regionally and over time. This presentation includes our methodology and presents results for both near-term residential breakeven costs(2009) and future market sensitivities of break-even costs (2015). See also the the report "Break-Even Cost for Residential Photovoltaics in the United States: Key Drivers and Sensitivities". Presentation for NREL/TP-6A2-45991.

  1. ATP cost of muscle contraction is associated with motor unit discharge rate in humans.

    PubMed

    Christie, Anita D; Foulis, Stephen A; Kent, Jane A

    2016-08-26

    Although a neural component has been suggested to contribute to the energetic cost of muscle contraction in vivo, the association between neural and energetic factors has not been determined during voluntary contractions in humans. Twenty young (24±1years, 10 women) healthy individuals performed isometric ankle dorsiflexion contractions at 20%, 50% and 100% of maximal voluntary contraction torque on two occasions during which measures of either motor unit discharge rates (MUDR, by indwelling electromyography) or ATP cost of contraction (by (31)P magnetic resonance spectroscopy) were obtained. Both MUDR and ATP cost increased with increasing contraction intensity (p≤0.02). A strong, positive relationship (r(2)=0.70; p<0.001) was observed between MUDR and ATP cost. These results suggest that a substantial portion of the variability in ATP cost can be explained by MUDR, and thus demonstrate that motor unit rate coding is likely an important neural factor contributing to energetic cost in vivo. PMID:27397010

  2. Fiscal Year 2001 Unit Cost Report for the Illinois Public Community Colleges.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    This unit cost study of the Illinois Community College Board is an annual project involving the direct participation of all community colleges in Illinois. Each college submits data based on course offerings, enrollments, and costs to the Board staff, who in turn check the data for consistency with credit hour claims and financial reports, and…

  3. Fiscal Year 2004 Unit Cost Report for the Illinois Public Community Colleges

    ERIC Educational Resources Information Center

    Illinois Community College Board, 2005

    2005-01-01

    The Unit Cost Study is an annual project involving the direct participation of all public community colleges in Illinois. Each college submits basic data on course offerings, enrollments, and costs to the Illinois Community College Board staff, who in turn check the data for consistency with credit hour claims and financial reports and then…

  4. FY 1980 Unit Cost Analysis for the Public Community Colleges of Illinois.

    ERIC Educational Resources Information Center

    Lach, Ivan J.

    An analysis is presented of the Illinois Public Community College Unit Cost Study for Fiscal Year (FY) 1980, an annual study using basic enrollment and cost data supplied by college for each instructional area offered. After introductory material, including study highlights and a glossary of terms, district and school data are provided on net…

  5. 16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Representative Average Unit Energy Costs K... CONGRESS ENERGY AND WATER USE LABELING FOR CONSUMER PRODUCTS UNDER THE ENERGY POLICY AND CONSERVATION ACT (âENERGY LABELING RULEâ) Pt. 305, App. K Appendix K to Part 305—Representative Average Unit...

  6. Six climate change-related events in the United States accounted for about $14 billion in lost lives and health costs.

    PubMed

    Knowlton, Kim; Rotkin-Ellman, Miriam; Geballe, Linda; Max, Wendy; Solomon, Gina M

    2011-11-01

    The future health costs associated with predicted climate change-related events such as hurricanes, heat waves, and floods are projected to be enormous. This article estimates the health costs associated with six climate change-related events that struck the United States between 2000 and 2009. The six case studies came from categories of climate change-related events projected to worsen with continued global warming-ozone pollution, heat waves, hurricanes, infectious disease outbreaks, river flooding, and wildfires. We estimate that the health costs exceeded $14 billion, with 95 percent due to the value of lives lost prematurely. Actual health care costs were an estimated $740 million. This reflects more than 760,000 encounters with the health care system. Our analysis provides scientists and policy makers with a methodology to use in estimating future health costs related to climate change and highlights the growing need for public health preparedness. PMID:22068410

  7. Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States

    PubMed Central

    2009-01-01

    Background The aim of this study was to estimate both the direct and indirect annual costs of treating bacterial conjunctivitis (BC) in the United States. This was a cost of illness study performed from a U.S. healthcare payer perspective. Methods A comprehensive review of the medical literature was supplemented by data on the annual incidence of BC which was obtained from an analysis of the National Ambulatory Medical Care Survey (NAMCS) database for the year 2005. Cost estimates for medical visits and laboratory or diagnostic tests were derived from published Medicare CPT fee codes. The cost of prescription drugs was obtained from standard reference sources. Indirect costs were calculated as those due to lost productivity. Due to the acute nature of BC, no cost discounting was performed. All costs are expressed in 2007 U.S. dollars. Results The number of BC cases in the U.S. for 2005 was estimated at approximately 4 million yielding an estimated annual incidence rate of 135 per 10,000. Base-case analysis estimated the total direct and indirect cost of treating patients with BC in the United States at $ 589 million. One- way sensitivity analysis, assuming either a 20% variation in the annual incidence of BC or treatment costs, generated a cost range of $ 469 million to $ 705 million. Two-way sensitivity analysis, assuming a 20% variation in both the annual incidence of BC and treatment costs occurring simultaneously, resulted in an estimated cost range of $ 377 million to $ 857 million. Conclusion The economic burden posed by BC is significant. The findings may prove useful to decision makers regarding the allocation of healthcare resources necessary to address the economic burden of BC in the United States. PMID:19939250

  8. A new Markov model for base-loaded units for use in production costing

    SciTech Connect

    Ansari, S.H.; Patton, A.D. )

    1990-08-01

    This paper describes a new Markov model for base-loaded units henceforth to be called the LLM (load linked Markov) model for use in a probabilistic production costing algorithm. This new LLM model recognizes the relationship between the need for operating a base-loaded unit and the system load cycle. A comparison of the results obtained by using a traditional production costing method, the Opcost method with explicit consideration of unit duty cycle effects and the new method using the LLM model for base-loaded units to be called Procop method show significant differences in the energies produced by the base-loaded units and consequently the other units. The linkage of a base-loaded unit's need for operation to the load cycle avoids the assumption of the traditional model that the base-loaded units are equally needed all times. It also avoids the ad hoc treatment of outage postponability of base-loaded units. Hence the Procop method is more physically based and is likely to be more accurately responsive to changes in the load cycle and other system parameters.

  9. The Economic Cost of Methamphetamine Use in the United States, 2005

    ERIC Educational Resources Information Center

    Nicosia, Nancy; Pacula, Rosalie Liccardo; Kilmer, Beau; Lundberg, Russell; Chiesa, James

    2009-01-01

    This first national estimate suggests that the economic cost of methamphetamine (meth) use in the United States reached $23.4 billion in 2005. Given the uncertainty in estimating the costs of meth use, this book provides a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion. The analysis considers a wide range of…

  10. Evaluation of syngas production unit cost of bio-gasification facility using regression analysis techniques

    SciTech Connect

    Deng, Yangyang; Parajuli, Prem B.

    2011-08-10

    Evaluation of economic feasibility of a bio-gasification facility needs understanding of its unit cost under different production capacities. The objective of this study was to evaluate the unit cost of syngas production at capacities from 60 through 1800Nm 3/h using an economic model with three regression analysis techniques (simple regression, reciprocal regression, and log-log regression). The preliminary result of this study showed that reciprocal regression analysis technique had the best fit curve between per unit cost and production capacity, with sum of error squares (SES) lower than 0.001 and coefficient of determination of (R 2) 0.996. The regression analysis techniques determined the minimum unit cost of syngas production for micro-scale bio-gasification facilities of $0.052/Nm 3, under the capacity of 2,880 Nm 3/h. The results of this study suggest that to reduce cost, facilities should run at a high production capacity. In addition, the contribution of this technique could be the new categorical criterion to evaluate micro-scale bio-gasification facility from the perspective of economic analysis.

  11. A cost-effective methodology for the design of massively-parallel VLSI functional units

    NASA Technical Reports Server (NTRS)

    Venkateswaran, N.; Sriram, G.; Desouza, J.

    1993-01-01

    In this paper we propose a generalized methodology for the design of cost-effective massively-parallel VLSI Functional Units. This methodology is based on a technique of generating and reducing a massive bit-array on the mask-programmable PAcube VLSI array. This methodology unifies (maintains identical data flow and control) the execution of complex arithmetic functions on PAcube arrays. It is highly regular, expandable and uniform with respect to problem-size and wordlength, thereby reducing the communication complexity. The memory-functional unit interface is regular and expandable. Using this technique functional units of dedicated processors can be mask-programmed on the naked PAcube arrays, reducing the turn-around time. The production cost of such dedicated processors can be drastically reduced since the naked PAcube arrays can be mass-produced. Analysis of the the performance of functional units designed by our method yields promising results.

  12. Break-Even Cost for Residential Photovoltaics in the United States: Key Drivers and Sensitivities

    SciTech Connect

    Denholm, P.; Margolis, R. M.; Ong, S.; Roberts, B.

    2009-12-01

    Grid parity--or break-even cost--for photovoltaic (PV) technology is defined as the point where the cost of PV-generated electricity equals the cost of electricity purchased from the grid. Break-even cost is expressed in $/W of an installed system. Achieving break-even cost is a function of many variables. Consequently, break-even costs vary by location and time for a country, such as the United States, with a diverse set of resources, electricity prices, and other variables. In this report, we analyze PV break-even costs for U.S. residential customers. We evaluate some key drivers of grid parity both regionally and over time. We also examine the impact of moving from flat to time-of-use (TOU) rates, and we evaluate individual components of the break-even cost, including effect of rate structure and various incentives. Finally, we examine how PV markets might evolve on a regional basis considering the sensitivity of the break-even cost to four major drivers: technical performance, financing parameters, electricity prices and rates, and policies. We find that local incentives rather than ?technical? parameters are in general the key drivers of the break-even cost of PV. Additionally, this analysis provides insight about the potential viability of PV markets.

  13. A Time Study of Physicians’ Work in a German University Eye Hospital to Estimate Unit Costs

    PubMed Central

    Wolff, Jan; McCrone, Paul; Patel, Anita; Auber, Gerd; Reinhard, Thomas

    2015-01-01

    Background Technical efficiency of hospital services is debated since performance has been heterogeneous. Staff time represents the main resource in patient care and its inappropriate allocation has been identified as a key factor of inefficiency. The aim of this study was to analyse the utilisation of physicians’ work time stratified by staff groups, tasks and places of work. A further aim was to use these data to estimate resource use per unit of output. Methods A self-reporting work-sampling study was carried during 14-days at a University Eye Hospital. Staff costs of physicians per unit of output were calculated at the wards, the operating rooms and the outpatient unit. Results Forty per cent of total work time was spent in contact with the patient. Thirty per cent was spent with documentation tasks. Time spent with documentation tasks declined monotonically with increasing seniority of staff. Unit costs were 56 € per patient day at the wards, 77 € and 20 € per intervention at the operating rooms for inpatients and outpatients, respectively, and 33 € per contact at the outpatient unit. Substantial differences in resources directly dedicated to the patient were found between these locations. Conclusion The presented data provide unprecedented units costs in inpatient Ophthalmology. Future research should focus on analysing factors that influence differences in time allocation, such as types of patients, organisation of care processes and composition of staff. PMID:25803022

  14. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

    PubMed

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto

    2016-01-01

    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs. PMID:27111688

  15. Pedestrian and Pedalcyclist Injury Costs in the United States by Age and Injury Severity

    PubMed Central

    Miller, Ted R.; Zaloshnja, Eduard; Lawrence, Bruce A.; Crandall, Jeff; Ivarsson, Johan; Finkelstein, A. Eric

    2004-01-01

    This paper estimates the incidence, unit costs, and annual costs of pedestrian and pedalcycle crash injuries in the United States. It includes medical care costs, household and wage work losses, and the value of pain, suffering, and lost quality of life. The estimates are broken down by body region and severity. They rely heavily on data from the health care system. Costs of pedestrian and pedalcycle injuries in 2000 will total $40 billion over the lifetimes of the injured. Most pedalcyclist injury costs and half of pedestrian injury costs do not involve motor vehicles. Youth ages 5–14 face greater annual risks when walking or driving their own pedaled vehicles than when being driven. Children under age 5 experience higher costs than their elders when injured as pedestrians. Our results suggest European and Japanese component tests used to design pedestrian injury countermeasures for motor vehicles are too narrow. Separate lower limb testing is needed for younger children. Testing for torso/vertebral column injury of adults also seems desirable. PMID:15319130

  16. Suicide and Suicidal Attempts in the United States: Costs and Policy Implications.

    PubMed

    Shepard, Donald S; Gurewich, Deborah; Lwin, Aung K; Reed, Gerald A; Silverman, Morton M

    2016-06-01

    The national cost of suicides and suicide attempts in the United States in 2013 was $58.4 billion based on reported numbers alone. Lost productivity (termed indirect costs) represents most (97.1%) of this cost. Adjustment for under-reporting increased the total cost to $93.5 billion or $298 per capita, 2.1-2.8 times that of previous studies. Previous research suggests that improved continuity of care would likely reduce the number of subsequent suicidal attempts following a previous nonfatal attempt. We estimate a highly favorable benefit-cost ratio of 6 to 1 for investments in additional medical, counseling, and linkage services for such patients. PMID:26511788

  17. Cost Effectiveness of Home Energy Retrofits in Pre-Code Vintage Homes in the United States

    SciTech Connect

    Fairey, Philip

    2012-11-01

    This analytical study examines the opportunities for cost-effective energy efficiency and renewable energy retrofits in residential archetypes constructed prior to 1980 (Pre-Code) in fourteen U.S. cities. These fourteen cities are representative of each of the International Energy Conservation Code (IECC) climate zones in the contiguous United States. The analysis is conducted using an in-house version of EnergyGauge USA v.2.8.05 named CostOpt that has been programmed to perform iterative, incremental economic optimization on a large list of residential energy efficiency and renewable energy retrofit measures. The principle objectives of the study are to determine the opportunities for cost effective source energy reductions in this large cohort of existing residential building stock as a function of local climate and energy costs; and to examine how retrofit financing alternatives impact the source energy reductions that are cost effectively achievable.

  18. Cost-effectiveness of pazopanib in advanced soft tissue sarcoma in the United kingdom.

    PubMed

    Amdahl, Jordan; Manson, Stephanie C; Isbell, Robert; Chit, Ayman; Diaz, Jose; Lewis, Lily; Delea, Thomas E

    2014-01-01

    In the phase III PALETTE trial, pazopanib improved progression-free survival (PFS) compared with placebo in patients with advanced/metastatic soft tissue sarcomas (mSTS) who had received prior chemotherapy. We used a multistate model to estimate expected PFS, overall survival (OS), lifetime STS treatment costs, and quality-adjusted life-years (QALYs) for patients receiving pazopanib, placebo, trabectedin, ifosfamide, or gemcitabine plus docetaxel as second-line mSTS therapies. The cost-effectiveness of pazopanib was expressed as the incremental costs per QALY gained. Estimates of PFS/OS, adverse events, and utilities for pazopanib and placebo were from the PALETTE trial. Estimates of relative effectiveness of the other comparators were from an unadjusted indirect comparison versus pazopanib. Costs were from published sources. Pazopanib is estimated to increase QALYs by 0.128 and costs by £7,976 versus placebo; cost per QALY gained with pazopanib versus placebo is estimated to be £62,000. Compared with the other chemotherapies, pazopanib provides similar QALYs at a lower cost. Pazopanib may not be cost-effective versus placebo but may be cost-effective versus the most commonly used active treatments, although this conclusion is uncertain. Given the unmet need for effective treatments for mSTS, pazopanib may be an appropriate alternative to some currently used medications in the United Kingdom. PMID:25024640

  19. Cost of Wind Energy in the United States: Trends from 2007 to 2012 (Presentation)

    SciTech Connect

    Hand, M.

    2015-01-01

    This presentation provides an overview of recent technology trends observed in the United States including project size, turbine size, rotor diameter, hub height, annual average wind speed, and annual energy production. It also highlights area where system analysis is required to fully understand how these technology trends relate to the cost of wind energy.

  20. The Cost-Effectiveness of Supported Employment for Adults with Autism in the United Kingdom

    ERIC Educational Resources Information Center

    Mavranezouli, Ifigeneia; Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

    2014-01-01

    Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom.…

  1. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.43... Airport Act. (b) Except as provided in paragraphs (c) and (d) of this section and in subpart C of this part, the United States share of the costs of an approved project for airport development...

  2. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.43... Airport Act. (b) Except as provided in paragraphs (c) and (d) of this section and in subpart C of this part, the United States share of the costs of an approved project for airport development...

  3. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.43... Airport Act. (b) Except as provided in paragraphs (c) and (d) of this section and in subpart C of this part, the United States share of the costs of an approved project for airport development...

  4. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... (CONTINUED) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.43... Airport Act. (b) Except as provided in paragraphs (c) and (d) of this section and in subpart C of this part, the United States share of the costs of an approved project for airport development...

  5. 76 FR 77528 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California,......

  6. 76 FR 79678 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California,......

  7. 16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Representative Average Unit Energy Costs K... CONGRESS RULE CONCERNING DISCLOSURES REGARDING ENERGY CONSUMPTION AND WATER USE OF CERTAIN HOME APPLIANCES AND OTHER PRODUCTS REQUIRED UNDER THE ENERGY POLICY AND CONSERVATION ACT (âAPPLIANCE LABELING...

  8. 16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Representative Average Unit Energy Costs K... CONGRESS RULE CONCERNING DISCLOSURES REGARDING ENERGY CONSUMPTION AND WATER USE OF CERTAIN HOME APPLIANCES AND OTHER PRODUCTS REQUIRED UNDER THE ENERGY POLICY AND CONSERVATION ACT (âAPPLIANCE LABELING...

  9. 16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Representative Average Unit Energy Costs K... CONGRESS RULE CONCERNING DISCLOSURES REGARDING ENERGY CONSUMPTION AND WATER USE OF CERTAIN HOME APPLIANCES AND OTHER PRODUCTS REQUIRED UNDER THE ENERGY POLICY AND CONSERVATION ACT (âAPPLIANCE LABELING...

  10. 16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Representative Average Unit Energy Costs K... CONGRESS RULE CONCERNING DISCLOSURES REGARDING ENERGY CONSUMPTION AND WATER USE OF CERTAIN HOME APPLIANCES AND OTHER PRODUCTS REQUIRED UNDER THE ENERGY POLICY AND CONSERVATION ACT (âAPPLIANCE LABELING...

  11. The Lifetime Medical Cost Savings from Preventing HIV in the United States

    PubMed Central

    Schackman, Bruce R.; Fleishman, John A.; Su, Amanda E.; Berkowitz, Bethany K.; Moore, Richard D.; Walensky, Rochelle P.; Becker, Jessica E.; Voss, Cindy; Paltiel, A. David; Weinstein, Milton C.; Freedberg, Kenneth A.; Gebo, Kelly A.; Losina, Elena

    2015-01-01

    Objective Enhanced HIV prevention interventions, such as pre-exposure prophylaxis for high-risk individuals, require substantial investments. We sought to estimate the medical cost saved by averting one HIV infection in the United States. Methods We estimated lifetime medical costs in persons with and without HIV to determine the cost saved by preventing one HIV infection. We used a computer simulation model of HIV disease and treatment (CEPAC) to project CD4 cell count, antiretroviral treatment status, and mortality after HIV infection. Annual medical cost estimates for HIV-infected persons, adjusted for age, sex, race/ethnicity, and transmission risk group, were from the HIV Research Network (range $1,854–$4,545/month) and for HIV-uninfected persons were from the Medical Expenditure Panel Survey (range $73–$628/month). Results are reported as lifetime medical costs from the US health system perspective discounted at 3% (2012 US dollars). Results The estimated discounted lifetime cost for persons who become HIV infected at age 35 is $326,500 (60% for antiretroviral medications, 15% for other medications, 25% non-drug costs). For individuals who remain uninfected but at high risk for infection, the discounted lifetime cost estimate is $96,700. The medical cost saved by avoiding one HIV infection is $229,800. The cost saved would reach $338,400 if all HIV-infected individuals presented early and remained in care. Cost savings are higher taking into account secondary infections avoided and lower if HIV infections are temporarily delayed rather than permanently avoided. Conclusions The economic value of HIV prevention in the US is substantial given the high cost of HIV disease treatment. PMID:25710311

  12. Inventory of Data Sources for Estimating Health Care Costs in the United States

    PubMed Central

    Lund, Jennifer L.; Yabroff, K. Robin; Ibuka, Yoko; Russell, Louise B.; Barnett, Paul G.; Lipscomb, Joseph; Lawrence, William F.; Brown, Martin L.

    2011-01-01

    Objective To develop an inventory of data sources for estimating health care costs in the United States and provide information to aid researchers in identifying appropriate data sources for their specific research questions. Methods We identified data sources for estimating health care costs using 3 approaches: (1) a review of the 18 articles included in this supplement, (2) an evaluation of websites of federal government agencies, non profit foundations, and related societies that support health care research or provide health care services, and (3) a systematic review of the recently published literature. Descriptive information was abstracted from each data source, including sponsor, website, lowest level of data aggregation, type of data source, population included, cross-sectional or longitudinal data capture, source of diagnosis information, and cost of obtaining the data source. Details about the cost elements available in each data source were also abstracted. Results We identified 88 data sources that can be used to estimate health care costs in the United States. Most data sources were sponsored by government agencies, national or nationally representative, and cross-sectional. About 40% were surveys, followed by administrative or linked administrative data, fee or cost schedules, discharges, and other types of data. Diagnosis information was available in most data sources through procedure or diagnosis codes, self-report, registry, or chart review. Cost elements included inpatient hospitalizations (42.0%), physician and other outpatient services (45.5%), outpatient pharmacy or laboratory (28.4%), out-of-pocket (22.7%), patient time and other direct nonmedical costs (35.2%), and wages (13.6%). About half were freely available for downloading or available for a nominal fee, and the cost of obtaining the remaining data sources varied by the scope of the project. Conclusions Available data sources vary in population included, type of data source, scope, and

  13. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  14. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  15. A tale of 2 countries: the cost of my mother's cardiac care in the United States and India.

    PubMed

    Rao, Sowmya R

    2014-01-01

    When my mother fell ill while visiting me in the United States, I had the opportunity to compare costs of surgical cardiac care in the United States and India. I faced challenges in making well-informed decisions in the United States due to the lack of cost transparency and the minimal flexibility offered in choice of care, whereas in India costs are readily available and allow most people to freely choose their preferred type of care. PMID:25354412

  16. Economic Cost of Campylobacter, Norovirus and Rotavirus Disease in the United Kingdom

    PubMed Central

    Tam, Clarence C; O’Brien, Sarah J

    2016-01-01

    Objectives To estimate the annual cost to patients, the health service and society of infectious intestinal disease (IID) from Campylobacter, norovirus and rotavirus. Design Secondary data analysis. Setting The United Kingdom population, 2008–9. Main outcome measures Cases and frequency of health services usage due to these three pathogens; associated healthcare costs; direct, out-of-pocket expenses; indirect costs to patients and caregivers. Results The median estimated costs to patients and the health service at 2008–9 prices were: Campylobacter £50 million (95% CI: £33m–£75m), norovirus £81 million (95% CI: £63m–£106m), rotavirus £25m (95% CI: £18m–£35m). The costs per case were approximately £30 for norovirus and rotavirus, and £85 for Campylobacter. This was mostly borne by patients and caregivers through lost income or out-of-pocket expenditure. The cost of Campylobacter-related Guillain-Barré syndrome hospitalisation was £1.26 million (95% CI: £0.4m–£4.2m). Conclusions Norovirus causes greater economic burden than Campylobacter and rotavirus combined. Efforts to control IID must prioritise norovirus. For Campylobacter, estimated costs should be considered in the context of expenditure to control this pathogen in agriculture, food production and retail. Our estimates, prior to routine rotavirus immunisation in the UK, provide a baseline vaccine cost-effectiveness analyses. PMID:26828435

  17. Estimated Lifetime Medical and Work-Loss Costs of Fatal Injuries--United States, 2013.

    PubMed

    Florence, Curtis; Simon, Thomas; Haegerich, Tamara; Luo, Feijun; Zhou, Chao

    2015-10-01

    Injury-associated deaths have substantial economic consequences. In 2013, unintentional injury was the fourth leading cause of death, suicide was the tenth, and homicide was the sixteenth; these three causes accounted for approximately 187,000 deaths in the United States. To assess the economic impact of fatal injuries, CDC analyzed death data from the National Vital Statistics System for 2013, along with cost of injury data using the Web-Based Injury Statistics Query and Reporting System. This report updates a previous study that analyzed death data from the year 2000, and employs recently revised methodology for determining the costs of injury outcomes, which uses the most current economic data and incorporates improvements for estimating medical costs associated with injury. Number of deaths, crude and age-specific death rates, and total lifetime work-loss costs and medical costs were calculated for fatal injuries by sex, age group, intent (intentional versus unintentional), and mechanism of injury. During 2013, the rate of fatal injury was 61.0 per 100,000 population, with combined medical and work-loss costs exceeding $214 billion. Costs from fatal injuries represent approximately one third of the total $671 billion medical and work-loss costs associated with all injuries in 2013. The magnitude of the economic burden associated with injury-associated deaths underscores the need for effective prevention. PMID:26421530

  18. Optimal number of minimal repairs with cumulative repair cost limit for a two-unit system with failure rate interactions

    NASA Astrophysics Data System (ADS)

    Lai, Min-Tsai; Yan, Huey

    2016-01-01

    A discrete replacement model is presented that includes a cumulative repair cost limit for a two-unit system with failure rate interactions between the units. We assume a failure in unit 1 causes the failure rate in unit 2 to increase, whereas a failure in unit 2 causes a failure in unit 1, resulting in a total system failure. If unit 1 fails and the cumulative repair cost till to this failure is less than a limit L, then unit 1 is repaired. If there is a failure in unit 1 and the cumulative repair cost exceeds L or the number of failures equals n, the entire system is preventively replaced. The system is also replaced at a total failure, and such replacement cost is higher than the preventive replacement cost. The long-term expected cost per unit time is derived using the expected costs as the optimality criterion. The minimum-cost policy is derived, and existence and uniqueness are proved.

  19. Cost of wind energy: comparing distant wind resources to local resources in the midwestern United States.

    PubMed

    Hoppock, David C; Patiño-Echeverri, Dalia

    2010-11-15

    The best wind sites in the United States are often located far from electricity demand centers and lack transmission access. Local sites that have lower quality wind resources but do not require as much power transmission capacity are an alternative to distant wind resources. In this paper, we explore the trade-offs between developing new wind generation at local sites and installing wind farms at remote sites. We first examine the general relationship between the high capital costs required for local wind development and the relatively lower capital costs required to install a wind farm capable of generating the same electrical output at a remote site,with the results representing the maximum amount an investor should be willing to pay for transmission access. We suggest that this analysis can be used as a first step in comparing potential wind resources to meet a state renewable portfolio standard (RPS). To illustrate, we compare the cost of local wind (∼50 km from the load) to the cost of distant wind requiring new transmission (∼550-750 km from the load) to meet the Illinois RPS. We find that local, lower capacity factor wind sites are the lowest cost option for meeting the Illinois RPS if new long distance transmission is required to access distant, higher capacity factor wind resources. If higher capacity wind sites can be connected to the existing grid at minimal cost, in many cases they will have lower costs. PMID:20931984

  20. Effectiveness and Cost-Effectiveness of Blood Pressure Screening in Adolescents in the United States

    PubMed Central

    Wang, Y. Claire; Cheung, Angela M.; Bibbins-Domingo, Kirsten; Prosser, Lisa A.; Cook, Nancy R.; Goldman, Lee; Gillman, Matthew W.

    2014-01-01

    Objective To compare the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood pressure (BP) in adolescents in the United States: no intervention, “screen-and-treat,” and population-wide strategies to lower the entire BP distribution. Study design We used a simulation model to combine several data sources to project the lifetime costs and cardiovascular outcomes for a cohort of 15-year-old U.S. adolescents under different BP approaches and conducted cost-effectiveness analysis. We obtained BP distributions from the National Health and Nutrition Examination Survey 1999–2004 and used childhood-to-adult longitudinal correlation analyses to simulate the tracking of BP. We then used the coronary heart disease policy model to estimate lifetime coronary heart disease events, costs, and quality-adjusted life years (QALY). Results Among screen-and-treat strategies, finding and treating the adolescents at highest risk (eg, left ventricular hypertrophy) was most cost-effective ($18 000/QALY [boys] and $47 000/QALY [girls]). However, all screen-and-treat strategies were dominated by population-wide strategies such as salt reduction (cost-saving [boys] and $650/ QALY [girls]) and increasing physical education ($11 000/QALY [boys] and $35 000/QALY [girls]). Conclusions Routine adolescents BP screening is moderately effective, but population-based BP interventions with broader reach could potentially be less costly and more effective for early cardiovascular disease prevention and should be implemented in parallel. PMID:20850759

  1. Cost-effectiveness analysis of universal influenza vaccination with quadrivalent inactivated vaccine in the United States

    PubMed Central

    Clements, Karen M; Meier, Genevieve; McGarry, Lisa J; Pruttivarasin, Narin; Misurski, Derek A

    2014-01-01

    To address influenza B lineage mismatch and co-circulation, several quadrivalent inactivated influenza vaccines (IIV4s) containing two type A strains and both type B lineages have recently been approved in the United States. Currently available trivalent inactivated vaccines (IIV3s) or trivalent live attenuated influenza vaccines (LAIV3s) comprise two influenza A strains and one of the two influenza B lineages that have co-circulated in the United States since 2001. The objective of this analysis was to evaluate the cost-effectiveness of a policy of universal vaccination with IIV4 vs. IIV3/LAIV3 during 1 year in the United States. On average per influenza season, IIV4 was predicted to result in 30 251 fewer influenza cases, 3512 fewer hospitalizations, 722 fewer deaths, 4812 fewer life-years lost, and 3596 fewer quality-adjusted life-years (QALYs) lost vs. IIV3/LAIV3. Using the Fluarix QuadrivalentTM (GlaxoSmithKline) prices and the weighted average IIV3/LAIV3 prices, the model predicts that the vaccination program costs would increase by $452.2 million, while direct medical and indirect costs would decrease by $111.6 million and $218.7 million, respectively, with IIV4. The incremental cost-effectiveness ratio (ICER) comparing IIV4 to IIV3/LAIV3 is predicted to be $90 301/QALY gained. Deterministic sensitivity analyses found that influenza B vaccine-matched and mismatched efficacies among adults aged ≥65 years had the greatest impact on the ICER. Probabilistic sensitivity analysis showed that the cost per QALY remained below $100 000 for 61% of iterations. In conclusion, vaccination with IIV4 in the US is predicted to reduce morbidity and mortality. This strategy is also predicted to be cost-effective vs. IIV3/LAIV3 at conventional willingness-to-pay thresholds. PMID:24609063

  2. Thermal analysis of Malaysian double storey housing - low/medium cost unit

    NASA Astrophysics Data System (ADS)

    Normah, M. G.; Lau, K. Y.; Yusoff, S. Mohd.

    2012-06-01

    Almost half of the total energy used today is consumed in buildings. In the tropical climate, air-conditioning a housing unit takes much of the energy bill. Malaysia is no exception. Malaysian double storey terrace housing is popular among developers and buyers. Surveys have shown that housing occupants are much dissatisfied with the thermal comfort and artificial cooling is often sought. The objective of this study is to assess the thermal comfort of the low and medium-cost double storey housing in the area surrounding Universiti Teknologi Malaysia. A simulation program using the Weighting Factor Method calculates the heat transfer interaction, temperature distribution, and PMV level in three types of housing units in relation to the size. Fanger's PMV model based on ISO Standard 7730 is used here because it accounts for all parameters that affect the thermal sensation of a human within its equation. Results showed that both the low and medium-cost housing units studied are out of the comfortable range described by ASHRAE Standard 55 with the units all complied with the local bylaws. In view of the uncertainties in energy supply, future housing units should consider natural ventilation as part of the passive energy management.

  3. Critical Care Medicine Beds, Use, Occupancy, and Costs in the United States: A Methodological Review.

    PubMed

    Halpern, Neil A; Pastores, Stephen M

    2015-11-01

    This article is a methodological review to help the intensivist gain insights into the classic and sometimes arcane maze of national databases and methodologies used to determine and analyze the ICU bed supply, use, occupancy, and costs in the United States. Data for total ICU beds, use, and occupancy can be derived from two large national healthcare databases: the Healthcare Cost Report Information System maintained by the federal Centers for Medicare and Medicaid Services and the proprietary Hospital Statistics of the American Hospital Association. Two costing methodologies can be used to calculate U.S. ICU costs: the Russell equation and national projections. Both methods are based on cost and use data from the national hospital datasets or from defined groups of hospitals or patients. At the national level, an understanding of U.S. ICU bed supply, use, occupancy, and costs helps provide clarity to the width and scope of the critical care medicine enterprise within the U.S. healthcare system. This review will also help the intensivist better understand published studies on administrative topics related to critical care medicine and be better prepared to participate in their own local hospital organizations or regional critical care medicine programs. PMID:26308432

  4. Development of Low Cost, High Energy-Per-Unit-Area Solar Cell Modules

    NASA Technical Reports Server (NTRS)

    Jones, G. T.; Chitre, S.

    1977-01-01

    Work on the development of low cost, high energy per unit area solar cell modules was conducted. Hexagonal solar cell and module efficiencies, module packing ratio, and solar cell design calculations were made. The cell grid structure and interconnection pattern was designed and the module substrates were fabricated for the three modules to be used. It was demonstrated that surface macrostructures significantly improve cell power output and photovoltaic energy conversion efficiency.

  5. Efficiency-optimized low-cost TDPAC spectrometer using a versatile routing/coincidence unit

    NASA Astrophysics Data System (ADS)

    Rentería, M.; Bibiloni, A. G.; Darriba, G. N.; Errico, L. A.; Muñoz, E. L.; Richard, D.; Runco, J.

    2008-01-01

    A highly efficient, reliable, and low-cost γ γ TDPAC spectrometer, PACAr, optimized for 181Hf-implanted low-activity samples, is presented. A versatile EPROM-based routing/coincidence unit was developed and implemented to be use with the memory-card-based multichannel analyzer hosted in a personal computer. The excellent energy resolution and very good overall resolution and efficiency of PACAr are analyzed and compare with advanced and already tested fast fast and slow fast PAC spectrometers.

  6. Estimated parameters as independent variables - with an application to the costs of electric-generating units

    SciTech Connect

    Schmalensee, R.; Joskow, P.L.

    1984-01-01

    The cost of a piece of capital equipment, like an electric-generating unit, is a function of a variety of unit-specific attributes. Some of these attributes can be observed directly without error (such as size), but others (such as the reliability or efficiency of the equipment), cannot be. However, estimates of the unobservable quality attributes can often be obtained from time-series data on expost performance, and these estimates can in turn be used as data on the unobservable attributes that appear as exogenous variables in a cost equation. The authors consider estimation of linear models in which observation-specific (firm, plant, household, individual) attributes appear as exogenous variables, but these attributes cannot be observed directly. Rather, they assume that estimates of the relevant observation-specific attributes, along with the associated covariance matrix, can be computed using data on variables (such as ex post performance) that do not appear directly in the primary model of interest. A maximum-likelihood technique for using such estimates as independent variables in cross-section regression analysis is derived. The solution to the measurement-error problem is interpretable as nonlinear (Theil-Goldberger) mixed estimation. The method is applied to the estimation of a construction cost relationship for electric-generating units.

  7. Mortality and Economic Costs From Regular Cigar Use in the United States, 2010

    PubMed Central

    Rostron, Brian; Hall, Patricia; MacMonegle, Anna; Apelberg, Benjamin

    2014-01-01

    Objectives. We estimated annual mortality, years of potential life lost, and associated economic costs attributable to regular cigar smoking among US adults aged 35 years or older. Methods. We estimated cigar-attributable mortality for the United States in 2010 using the Centers for Disease Control and Prevention’s Smoking-Attributable Mortality, Morbidity, and Economic Costs methodology for smoking-related causes of death. We obtained cigar prevalence from the National Adult Tobacco Survey, relative risks from the Cancer Prevention Studies I and II, and annual US deaths from the National Vital Statistics System. We also estimated the economic cost of this premature mortality using the value of a statistical life-year. Results. Regular cigar smoking was responsible for approximately 9000 premature deaths and more than 140 000 years of potential life lost among US adults aged 35 years or older in 2010. These years of life had an economic value of approximately $23 billion. Conclusions. The health and economic burden of cigar smoking in the United States is large and may increase over time because of the increasing consumption of cigars in the United States. PMID:25033140

  8. Cost-Effectiveness of Pertussis Vaccination During Pregnancy in the United States.

    PubMed

    Atkins, Katherine E; Fitzpatrick, Meagan C; Galvani, Alison P; Townsend, Jeffrey P

    2016-06-15

    Vaccination against pertussis has reduced the disease burden dramatically, but the most severe cases and almost all fatalities occur in infants too young to be vaccinated. Recent epidemiologic evidence suggests that targeted vaccination of mothers during pregnancy can reduce pertussis incidence in their infants. To evaluate the cost-effectiveness of antepartum maternal vaccination in the United States, we created an age-stratified transmission model, incorporating empirical data on US contact patterns and explicitly modeling parent-infant exposure. Antepartum maternal vaccination incurs costs of $114,000 (95% prediction interval: 82,000, 183,000) per quality-adjusted life-year, in comparison with the strategy of no adult vaccination, and is cost-effective in the United States according to World Health Organization criteria. By contrast, vaccinating a second parent is not cost-effective, and vaccination of either parent postpartum is strongly dominated by antepartum maternal vaccination. Nonetheless, postpartum vaccination of mothers who were not vaccinated antepartum improves upon the current recommendation of untargeted adult vaccination. Additionally, the temporary direct protection of the infant due to maternal antibody transfer has efficacy for infants comparable to that conferred to toddlers by the full primary vaccination series. Efficient protection against pertussis for infants begins before birth. We highly recommend antepartum vaccination for as many US mothers as possible. PMID:27188951

  9. Cost-Effectiveness of Screening and Treating Foreign-Born Students for Tuberculosis before Entering the United States

    PubMed Central

    Wingate, La’Marcus T.; Posey, Drew L.; Zhou, Weigong; Olson, Christine K.; Maskery, Brian

    2015-01-01

    Introduction The Centers for Disease Control and Prevention is considering implementation of overseas medical screening of student-visa applicants to reduce the numbers of active tuberculosis cases entering the United States. Objective To evaluate the costs, cases averted, and cost-effectiveness of screening for, and treating, tuberculosis in United States-bound students from countries with varying tuberculosis prevalence. Methods Costs and benefits were evaluated from two perspectives, combined and United States only. The combined perspective totaled overseas and United States costs and benefits from a societal perspective. The United States only perspective was a domestic measure of costs and benefits. A decision tree was developed to determine the cost-effectiveness of tuberculosis screening and treatment from the combined perspective. Results From the United States only perspective, overseas screening programs of Chinese and Indian students would prevent the importation of 157 tuberculosis cases annually, and result in $2.7 million in savings. From the combined perspective, screening programs for Chinese students would cost more than $2.8 million annually and screening programs for Indian students nearly $440,000 annually. From the combined perspective, the incremental cost for each tuberculosis case averted by screening Chinese and Indian students was $22,187 and $15,063, respectively. Implementing screening programs for German students would prevent no cases in most years, and would result in increased costs both overseas and in the United States. The domestic costs would occur because public health departments would need to follow up on students identified overseas as having an elevated risk of tuberculosis. Conclusions Tuberculosis screening and treatment programs for students seeking long term visas to attend United States schools would reduce the number of tuberculosis cases imported. Implementing screening in high-incidence countries could save the

  10. Cost Resulting from Anti-Tuberculosis Drug Shortages in the United States: A Hypothetical Cohort Study

    PubMed Central

    Scott, James C.; Shah, Neha; Porco, Travis; Flood, Jennifer

    2015-01-01

    Background From 2012 through 2014, the United States experienced acute shortages and price escalations of several first-line anti-tuberculosis (TB) medications. Because secondary TB drug regimens are longer and adverse events occur more frequently with them, we sought to conservatively estimate the cost, to patients and the health care system, of TB treatment and medication adverse events from alternative regimens during drug shortages. Methods We assessed the cost of treatment for TB disease in the absence of isoniazid (INH), rifampin (RIF), or pyrazinamide (PZA), or both INH and RIF. We simulated adverse events based on published probabilities using a monthly discrete-time stochastic model. For total costs, we summed costs of medications, routine testing, and treatment of adverse events using procedural terminology codes. We report average cost ratios of TB treatment during drug shortages to standard TB treatment. Results The cost ratio of TB treatment without INH, RIF, or PZA to standard treatment was 1.7 (Range: 1.2, 2.3), 4.9 (Range: 3.2, 7.3), and 1.1 (Range: 0.7, 1.7) times higher, respectively. Without both INH and RIF, the cost ratio was 18.6 (Range: 10.0, 39.0) times higher. When the prices for INH, RIF and PZA were increased, the cost for standard treatment increased by a factor of 2.7 (Range: 1.9, 3.0). The percentage of patients experiencing at least one adverse event while taking standard therapy was 3.9% (Range: 1.3%, 11.8%). This percentage increased to 51.5% (Range: 20.1%, 83.8%) when RIF was unavailable, and increased to 82.5% (Range: 41.2%, 98.5%) when both INH and RIF were unavailable. Conclusions Our conservative model illustrates that an interruption in first-line anti-TB medications leads to appreciable additional costs and adverse events for patients. The availability of these drugs in the United States should be ensured. Models that incorporate the effectiveness of alternative regimens, delays in treatment initiation, and TB transmission

  11. Methods of Calculating Unit Activity and Output Costs in French Universities. Technical Report. Programme on Institutional Management in Higher Education.

    ERIC Educational Resources Information Center

    Babeau, Andre; And Others

    Proposals for calculating unit costs are advocated that are based on a body of methods common to the member universities. Production inputs and cost components in French universities are studied in terms of resources at the disposal of the university, and staffing, capital, operating, and transfer costs. Identification of activities and…

  12. Retrospective cost-effectiveness analyses for polio vaccination in the United States.

    PubMed

    Thompson, Kimberly M; Tebbens, Radboud J Duintjer

    2006-12-01

    The history of polio vaccination in the United States spans 50 years and includes different phases of the disease, multiple vaccines, and a sustained significant commitment of resources. We estimated cost-effectiveness ratios and assessed the net benefits of polio vaccination applicable at various points in time from the societal perspective and we discounted these back to appropriate points in time. We reconstructed vaccine price data from available sources and used these to retrospectively estimate the total costs of the U.S. historical polio vaccination strategies (all costs reported in year 2002 dollars). We estimate that the United States invested approximately US dollars 35 billion (1955 net present value, discount rate of 3%) in polio vaccines between 1955 and 2005 and will invest approximately US dollars 1.4 billion (1955 net present value, or US dollars 6.3 billion in 2006 net present value) between 2006 and 2015 assuming a policy of continued use of inactivated poliovirus vaccine (IPV) for routine vaccination. The historical and future investments translate into over 1.7 billion vaccinations that prevent approximately 1.1 million cases of paralytic polio and over 160,000 deaths (1955 net present values of approximately 480,000 cases and 73,000 deaths). Due to treatment cost savings, the investment implies net benefits of approximately US dollars 180 billion (1955 net present value), even without incorporating the intangible costs of suffering and death and of averted fear. Retrospectively, the U.S. investment in polio vaccination represents a highly valuable, cost-saving public health program. Observed changes in the cost-effectiveness ratio estimates over time suggest the need for living economic models for interventions that appropriately change with time. This article also demonstrates that estimates of cost-effectiveness ratios at any single time point may fail to adequately consider the context of the investment made to date and the importance of

  13. Cost of reactive nitrogen release from human activities to the environment in the United States

    NASA Astrophysics Data System (ADS)

    Sobota, Daniel J.; Compton, Jana E.; McCrackin, Michelle L.; Singh, Shweta

    2015-02-01

    Leakage of reactive nitrogen (N) from human activities to the environment can cause human health and ecological problems. Often these harmful effects are not reflected in the costs of food, fuel, and fiber that derive from N use. Spatial analyses of damage costs attributable to source at management-relevant scales could inform decisions in areas where anthropogenic N leakage causes harm. We used recently compiled data describing N inputs in the conterminous United States (US) to assess potential damage costs associated with anthropogenic N. We estimated fates of N leaked to the environment (air/deposition, surface freshwater, groundwater, and coastal zones) in the early 2000s by multiplying watershed-level N inputs (8-digit US Geologic Survey Hydrologic Unit Codes; HUC8s) with published coefficients describing nutrient uptake efficiency, leaching losses, and gaseous emissions. We scaled these N leakage estimates with mitigation, remediation, direct damage, and substitution costs associated with human health, agriculture, ecosystems, and climate (per kg of N) to calculate annual damage cost (US dollars in 2008 or as reported) of anthropogenic N per HUC8. Estimates of N leakage by HUC8 ranged from <1 to 125 kg N ha-1 yr-1, with most N leaked to freshwater ecosystems. Estimates of potential damages (based on median estimates) ranged from 1.94 to 2255 ha-1 yr-1 across watersheds, with a median of 252 ha-1 yr-1. Eutrophication of freshwater ecosystems and respiratory effects of atmospheric N pollution were important across HUC8s. However, significant data gaps remain in our ability to fully assess N damages, such as damage costs from harmful algal blooms and drinking water contamination. Nationally, potential health and environmental damages of anthropogenic N in the early 2000s totaled 210 billion yr-1 USD (range: 81-441 billion yr-1). While a number of gaps and uncertainties remain in these estimates, overall this work represents a starting point to inform decisions

  14. Cost of Herpes Zoster in Patients With Selected Immune-Compromised Conditions in the United States.

    PubMed

    Li, Qian; Chen, Shih-Yin; Burstin, Stuart J; Levin, Myron J; Suaya, Jose A

    2016-04-01

    Background.  This retrospective study investigates the healthcare costs of herpes zoster (HZ) in patients with selected immune-compromised (IC) conditions in the United States (US). Methods.  Patients with incident HZ diagnosis (index date) were selected from nationwide administrative claims databases from 2005 to 2009. Baseline IC groups, analyzed separately, included adults aged 18-64 years with the following: human immunodeficiency virus infection (HIV), solid organ transplant (SOT), bone marrow or stem cell transplant (BMSCT), or cancer; and older adults (aged ≥65 years) with cancer. Herpes zoster patients (n = 2020, n = 1053, n = 286, n = 13 178, and n = 9089, respectively) were 1-to-1 matched to controls without HZ (with randomly selected index date) in the same baseline group. The healthcare resource utilization and costs (2014 US dollars) during the first 2 postindex quarters were compared between matched cohorts with continuous enrollment during the quarter. Results.  Herpes zoster patients generally had greater use of inpatient, emergency room and outpatient services, and pain medications than matched controls (P < .05). The incremental costs of HZ during the first postindex quarter were $3056, $2649, $13 332, $2549, and $3108 for HIV, SOT, BMSCT, cancer in adults aged 18-64 years, and cancer in older adults, respectively (each P < .05). The incremental costs of HZ during the second quarter were only significant for adults aged 18-64 years with cancer ($1748, P < .05). The national incremental costs of HZ were projected to be $298 million annually across the 5 IC groups. Conclusions.  The healthcare cost associated with HZ among patients with studied IC conditions was sizable and occurred mainly during the first 90 days after diagnosis. PMID:27419151

  15. Cost of Herpes Zoster in Patients With Selected Immune-Compromised Conditions in the United States

    PubMed Central

    Li, Qian; Chen, Shih-Yin; Burstin, Stuart J.; Levin, Myron J.; Suaya, Jose A.

    2016-01-01

    Background. This retrospective study investigates the healthcare costs of herpes zoster (HZ) in patients with selected immune-compromised (IC) conditions in the United States (US). Methods. Patients with incident HZ diagnosis (index date) were selected from nationwide administrative claims databases from 2005 to 2009. Baseline IC groups, analyzed separately, included adults aged 18–64 years with the following: human immunodeficiency virus infection (HIV), solid organ transplant (SOT), bone marrow or stem cell transplant (BMSCT), or cancer; and older adults (aged ≥65 years) with cancer. Herpes zoster patients (n = 2020, n = 1053, n = 286, n = 13 178, and n = 9089, respectively) were 1-to-1 matched to controls without HZ (with randomly selected index date) in the same baseline group. The healthcare resource utilization and costs (2014 US dollars) during the first 2 postindex quarters were compared between matched cohorts with continuous enrollment during the quarter. Results. Herpes zoster patients generally had greater use of inpatient, emergency room and outpatient services, and pain medications than matched controls (P < .05). The incremental costs of HZ during the first postindex quarter were $3056, $2649, $13 332, $2549, and $3108 for HIV, SOT, BMSCT, cancer in adults aged 18–64 years, and cancer in older adults, respectively (each P < .05). The incremental costs of HZ during the second quarter were only significant for adults aged 18–64 years with cancer ($1748, P < .05). The national incremental costs of HZ were projected to be $298 million annually across the 5 IC groups. Conclusions. The healthcare cost associated with HZ among patients with studied IC conditions was sizable and occurred mainly during the first 90 days after diagnosis. PMID:27419151

  16. Total Elbow Arthroplasty in the United States: Evaluation of Cost, Patient Demographics, and Complication Rates

    PubMed Central

    Zhou, Hanbing; Orvets, Nathan D.; Merlin, Gabriel; Shaw, Joshua; Dines, Joshua S.; Price, Mark D.; Eichinger, Josef K.; Li, Xinning

    2016-01-01

    Total elbow arthroplasty (TEA) is utilized in the treatment of rheumatoid and post-traumatic elbow arthritis. TEA is a relatively low volume surgery in comparison to other types of arthroplasty and therefore little is known about current surgical utilization, patient demographics and complication rates in the United States. The purpose of our study is to evaluate the current practice trends and associated in-patient complications of TEA at academic centers in the United States. We queried the University Health Systems Consortium administrative database from 2007 to 2011 for patients who underwent an elective TEA. A descriptive analysis of demographics was performed which included patient age, sex, race, and insurance status. We also evaluated the following patient clinical benchmarks: hospital length of stay (LOS), hospital direct cost, in-hospital mortality, complications, and 30-day readmission rates. Our cohort consisted of 3146 adult patients (36.5% male and 63.5% female) with an average age of 58 years who underwent a total elbow arthroplasty (159 academic medical centers) in the United States. The racial demographics included 2334 (74%) Caucasian, 285 (9%) black, 236 (7.5%) Hispanic, 16 (0.5%) Asian, and 283 (9%) other patients. The mean LOS was 4.2±5 days and the mean total direct cost for the hospital was 16,300±4000 US Dollars per case. The overall inpatient complication rate was 3.1% and included mortality <1%, DVT (0.8%), re-operation (0.5%), and infection (0.4%). The 30-day readmission rate was 4.4%. TEA is a relatively uncommon surgery in comparison to other forms of arthroplasty but is associated with low in-patient and 30-day perioperative complication rate. Additionally, the 30-day readmission rate and overall hospital costs are comparable to the traditional total hip and knee arthroplasty surgeries. PMID:27114806

  17. Efficiency-optimized low-cost TDPAC spectrometer using a versatile routing/coincidence unit

    NASA Astrophysics Data System (ADS)

    Rentería, M.; Bibiloni, A. G.; Darriba, G. N.; Errico, L. A.; Muñoz, E. L.; Richard, D.; Runco, J.

    A highly efficient, reliable, and low-cost μ-μ TDPAC spectrometer, PACAr, optimized for 181Hf-implanted low-activity samples, is presented. A versatile EPROM-based routing/coincidence unit was developed and implemented to be use with the memory-card-based multichannel analyzer hosted in a personal computer. The excellent energy resolution and very good overall resolution and efficiency of PACAr are analyzed and compare with advanced and already tested fast-fast and slow-fast PAC spectrometers.

  18. A preliminary design and BOP cost analysis of M-C Power`s MCFC commerical unit

    SciTech Connect

    Chen, T.P.

    1996-12-31

    M-C Power Corporation plans to introduce its molten carbonate fuel cell (MCFC) market entry unit in the year 2000 for distributed and on-site power generation. Extensive efforts have been made to analyze the cell stack manufacturing costs. The major objective of this study is to conduct a detailed analysis of BOP costs based on an initial design of the market entry unit.

  19. The cost-effectiveness of a modestly effective HIV vaccine in the United States

    PubMed Central

    Long, Elisa F.; Owens, Douglas K.

    2011-01-01

    Background The recent RV144 clinical trial showed that an ALVAC/AIDSVAX prime-boost HIV vaccine regimen may confer partial immunity in recipients and reduce transmission by 31%. Trial data suggest that efficacy may initially exceed 70% but decline over the following 3.5 years. Estimating the potential health benefits associated with a one-time vaccination campaign, as well as the projected benefits of repeat booster vaccination, may inform future HIV vaccine research and licensing decisions. Methods We developed a mathematical model to project the future course of the HIV epidemic in the United States under varying HIV vaccine scenarios. The model accounts for disease progression, infection transmission, antiretroviral therapy, and HIV-related morbidity and mortality. We projected HIV prevalence and incidence over time in multiple risk groups, and we estimated quality-adjusted life years (QALYs) and costs over a 10-year time horizon. We used an exponentially declining efficacy curve fit to trial data, and we assumed subsequent vaccine boosters confer similar immunity. Variations in vaccine parameters were examined in sensitivity analysis. Results Under existing HIV prevention and treatment efforts, an estimated 590,000 HIV infections occur over 10 years. One-time vaccination achieving 60% coverage of adults could prevent 9.8% of projected new infections over 10 years (and prevent 34% of new infections in the first year) and cost approximately $91,000/QALY gained relative to the status quo, assuming a vaccination price of $500. Targeted vaccination of high-risk groups results in net cost savings for vaccines costing less than $750. One-time vaccination of 60% of all adults coupled with three-year boosters only for men who have sex with men and injection drug users could prevent 21% of infections for $81,000/QALY gained relative to vaccination of high-risk groups only. A program attaining 90% vaccination coverage prevents 15% of new HIV cases over 10 years (and

  20. Cost and threshold analysis of positive charge, a multi-site linkage to HIV care program in the United States.

    PubMed

    Kim, Jeeyon Janet; Maulsby, Cathy; Zulliger, Rose; Jain, Kriti; Charles, Vignetta; Riordan, Maura; Davey-Rothwell, Melissa; Holtgrave, David R

    2015-10-01

    Positive Charge (PC) is a linkage to HIV care initiative implemented by AIDS United with sites in New York, Chicago, Louisiana, North Carolina, and the San Francisco/Bay Area. This study employed standard methods of cost and threshold analyses, as recommended by the US Panel on Cost-effectiveness in Health and Medicine, to calculate cost-saving and cost effective thresholds of the initiative. The overall societal cost of the linkage to care programs ranged from $48,490 to $370,525. The study found that PC's five unique evidence-based linkage to care programs have relatively low costs per client served and highly achievable cost-saving and cost-effectiveness thresholds. The findings from this study suggest that HIV linkage to care programs have the potential to be a highly productive use of public health resources. PMID:26139421

  1. The Cost of Public and Community Residential Care for Mentally Retarded People in the United States. Project Report No. 9.

    ERIC Educational Resources Information Center

    Wieck, Colleen A.; Bruininks, Robert H.

    The direction and scope of deinstitutionalization in 75 public and 161 community residential programs for mentally retarded people in the Unites States were examined by analysis of current levels of expenditures, projected costs, efficacy of existing funding mechanisms, and identification of critical factors affecting cost variation. Results of a…

  2. Analysis of Unit Costs in a University. The Fribourg Example. Program on Institutional Management in Higher Education.

    ERIC Educational Resources Information Center

    Pasquier, Jacques; Sachse, Matthias

    Costing principles are applied to a university by estimating unit costs and their component factors for the university's different inputs, activities, and outputs. The information system used is designed for Fribourg University but could be applicable to other Swiss universities and could serve Switzerland's universities policy. In general, it…

  3. Feasibility and Costs of Natural Gas as a Bridge to Deep Decarbonization in the United States

    NASA Astrophysics Data System (ADS)

    Jones, A. D.; McJeon, H. C.; Muratori, M.; Shi, W.

    2015-12-01

    Achieving emissions reductions consistent with a 2 degree Celsius global warming target requires nearly complete replacement of traditional fossil fuel combustion with near-zero carbon energy technologies in the United States by 2050. There are multiple technological change pathways consistent with this deep decarbonization, including strategies that rely on renewable energy, nuclear, and carbon capture and storage (CCS) technologies. The replacement of coal-fired power plants with natural gas-fired power plants has also been suggested as a bridge strategy to achieve near-term emissions reduction targets. These gas plants, however, would need to be replaced by near-zero energy technologies or retrofitted with CCS by 2050 in order to achieve longer-term targets. Here we examine the costs and feasibility of a natural gas bridge strategy. Using the Global Change Assessment (GCAM) model, we develop multiple scenarios that each meet the recent US Intended Nationally Determined Contribution (INDC) to reduce GHG emissions by 26%-28% below its 2005 levels in 2025, as well as a deep decarbonization target of 80% emissions reductions below 1990 levels by 2050. We find that the gas bridge strategy requires that gas plants be retired on average 20 years earlier than their designed lifetime of 45 years, a potentially challenging outcome to achieve from a policy perspective. Using a more idealized model, we examine the net energy system costs of this gas bridge strategy compared to one in which near-zero energy technologies are deployed in the near tem. We explore the sensitivity of these cost results to four factors: the discount rate applied to future costs, the length (or start year) of the gas bridge, the relative capital cost of natural gas vs. near-zero energy technology, and the fuel price of natural gas. The discount rate and cost factors are found to be more important than the length of the bridge. However, we find an important interaction as well. At low discount rates

  4. Renewable Energy Cost Modeling: A Toolkit for Establishing Cost-Based Incentives in the United States; March 2010 -- March 2011

    SciTech Connect

    Gifford, J. S.; Grace, R. C.; Rickerson, W. H.

    2011-05-01

    This report is intended to serve as a resource for policymakers who wish to learn more about establishing cost-based incentives. The report will identify key renewable energy cost modeling options, highlight the policy implications of choosing one approach over the other, and present recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, feed-in tariffs (FITs), or similar policies. These recommendations will be utilized in designing the Cost of Renewable Energy Spreadsheet Tool (CREST). Three CREST models will be publicly available and capable of analyzing the cost of energy associated with solar, wind, and geothermal electricity generators. The CREST models will be developed for use by state policymakers, regulators, utilities, developers, and other stakeholders to assist them in current and future rate-setting processes for both FIT and other renewable energy incentive payment structures and policy analyses.

  5. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities. [Task 1, Final report

    SciTech Connect

    Not Available

    1993-10-15

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco`s refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R&D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ``unit cost`` portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible` to estimate the likely future impacts, costs, and sources of oil spills.

  6. Cost-Efficiency of Indigenously Fabricated Mobile-Portable Dental Unit in Delivery of Primary Healthcare in Rural India

    PubMed Central

    Goel, Ashok; Torwane, Nilesh Arjun

    2014-01-01

    Aim: Innovation in primary oral healthcare delivery is a potential yet relatively unexplored area in Dental literature. Aim of the present study was to assess the economic gains that can be made by designing and operating an indigenously fabricated portable dental unit in rural areas. Materials and Methods: Cost-efficiency was determined by comparing total revenue (number of patients treated) with total costs (direct – capital cost of fabrication; and indirect – dental materials, disposables, transport, miscellaneous) over a period of seven years (2005 to 2012). Operational efficiency of portable dental units was also compared with dental vans on various categories of performance indicators. Data analysis was based on institutional records of Rajasthan Dental College (RDC), Jaipur, India. Results: Results show that a total of 52,900 patients who attended 223 camps during this period were provided various primary oral healthcare services using four such portable dental units that were developed @ Rs. 24,000 ($ 417) per unit. Based on a cost-efficiency of Rs 35.53 ($ 0.65) per person, which is among the lowest reported from any part of the world, the authors conclude that indigenously fabricated portable dental units provide a cost-efficient service. The other aspects most relevant to portable equipment were ease of transportation and feasibility in domiciliary care provision. Conclusion: The Limitations of productivity due to time spent in setting up the unit and need for additional space/equipment was their main drawbacks vis-à-vis dental vans. PMID:25177627

  7. Direct stroke unit admission of intravenous tissue plasminogen activator: safety, clinical outcome, and hospital cost savings

    PubMed Central

    Alexandrov, Anne W.; Coleman, Kisha C.; Palazzo, Paola; Shahripour, Reza Bavarsad; Alexandrov, Andrei V.

    2016-01-01

    Background: In the USA, stable intravenous tissue plasminogen activator (IV tPA) patients have traditionally been cared for in an intensive care unit (ICU). We examined the safety of using an acuity-adaptable stroke unit (SU) to manage IV tPA patients. Methods: We conducted an observational study of consecutive patients admitted to our acuity-adaptable SU over the first 3 years of operation. Safety was assessed by symptomatic intracerebral hemorrhage (sICH) rates, systemic hemorrhage (SH) rates, tPA-related deaths, and transfers from SU to ICU; cost savings and length of stay (LOS) were determined. Results: We admitted 333 IV tPA patients, of which 302 were admitted directly to the SU. A total of 31 (10%) patients had concurrent systemic hemodynamic or pulmonary compromise warranting direct ICU admission. There were no differences in admission National Institutes of Health Stroke Scale scores between SU and ICU patients (9.0 versus 9.5, respectively). Overall sICH rate was 3.3% (n = 10) and SH rate was 2.9 (n = 9), with no difference between SU and ICU patients. No tPA-related deaths occurred, and no SU patients required transfer to the ICU. Estimated hospital cost savings were US$362,400 for ‘avoided’ ICU days, and hospital LOS decreased significantly (p = 0.001) from 9.8 ± 15.6 days (median 5) in year 1, to 5.2 ± 4.8 days (median 3) by year 3. Conclusions: IV tPA patients may be safely cared for in a SU when nurses undergo extensive education to ensure clinical competence. Use of the ICU solely for monitoring may constitute significant overuse of system resources at an expense that is not associated with additional safety benefit. PMID:27366237

  8. Cost, correlates and effects of malpractice litigation in family practice residency programmes in the United States.

    PubMed

    Bowman, M A; Murray, J L

    1989-06-01

    A survey of family practice residency programme directors in the United States was undertaken to look at the impact of malpractice and malpractice insurance on residency education. Of 385 programmes 276 (71.7%) responded to the 20 question survey. The results indicated a mean rate of 0.043 claims per resident or faculty member in the previous year. One-fifth of the respondents did not report the type of malpractice insurance retained for residents and over half did not report the cost of insurance for residents. Current problems with liability were most often related to the region of the country, number of visits to the family practice centre, the number of residents, the number of faculty, the type of faculty employer and the type of resident employer. Programmes which anticipated future problems with liability were most likely to be those with current problems. The areas identified as most concerning to residents included: obstetrics, cost of malpractice insurance, difficulty obtaining coverage, and the general anxiety created by malpractice litigation. PMID:2744300

  9. Access, quality, and costs of care at physician owned hospitals in the United States: observational study

    PubMed Central

    Orav, E John; Jena, Anupam B; Dudzinski, David M; Le, Sidney T; Jha, Ashish K

    2015-01-01

    Objective To compare physician owned hospitals (POHs) with non-POHs on metrics around patient populations, quality of care, costs, and payments. Design Observational study. Setting Acute care hospitals in 95 hospital referral regions in the United States, 2010. Participants 2186 US acute care hospitals (219 POHs and 1967 non-POHs). Main outcome measures Proportions of patients using Medicaid and those from ethnic and racial minority groups; hospital performance on patient experience metrics, care processes, risk adjusted 30 day mortality, and readmission rates; costs of care; care payments; and Medicare market share. Results The 219 POHs were more often small (<100 beds), for profit, and in urban areas. 120 of these POHs were general (non-specialty) hospitals. Compared with patients from non-POHs, those from POHs were younger (77.4 v 78.4 years, P<0.001), less likely to be admitted through an emergency department (23.2% v. 29.0%, P<0.001), equally likely to be black (5.1% v 5.5%, P=0.85) or to use Medicaid (14.9% v 15.4%, P=0.75), and had similar numbers of chronic diseases and predicted mortality scores. POHs and non-POHs performed similarly on patient experience scores, processes of care, risk adjusted 30 day mortality, 30 day readmission rates, costs, and payments for acute myocardial infarction, congestive heart failure, and pneumonia. Conclusion Although POHs may treat slightly healthier patients, they do not seem to systematically select more profitable or less disadvantaged patients or to provide lower value care. PMID:26333819

  10. A low-cost off-the-shelf FGPA-based smart wireless sensing unit

    NASA Astrophysics Data System (ADS)

    Kapoor, Chetan; Graves-Abe, Troy L.; Pei, Jin-Song

    2006-03-01

    To continue with the development of a wireless sensing unit built upon an off-the-shelf FPGA development board presented by the authors at SPIE 2005, this paper outlines a further effort consisting of embedding onboard computations, simulation and validation of the FPGA-based wireless sensing unit that is able to collect, process and transmit data. This research supports the concepts of decentralized wireless sensor networks and local-based damage detection, where individual wireless sensor nodes are capable of performing intricate tasks and can eventually transmit the processed results. An FPGA-based hardware platform is thus looked upon as a major contender for performing this function in a proficient manner. Throughout this research, the principal design complexities, in terms of both hardware and software development, are kept to a minimum. Development cycle and monetary cost of the hardware are other major considerations for this research. Data processing functions including windowing, Fast Fourier Transform (FFT), peak detection, are implemented into the selected FPGA, when limitations of different design options are explored to yield a solution that optimizes the resources of the selected FPGA. Numerical simulations and laboratory validations are carried out to scrutinize the operations and flexibility of the design.

  11. Australia's 'fourth hurdle' drug review comparing costs and benefits holds lessons for the United States.

    PubMed

    Lopert, Ruth; Elshaug, Adam G

    2013-04-01

    Two decades ago Australia introduced an assessment of value as a prerequisite for adding new medicines to its national drug formulary. Australia's program--a "fourth hurdle" process after a drug is assessed for safety, efficacy, and quality--stands in stark contrast to the situation in the United States, where comparing the clinical and economic value of a proposed new drug to those of existing ones only rarely plays a role in the drug coverage determination process. This article describes the role that Australia's Pharmaceutical Benefits Advisory Committee, a statutory independent expert committee, plays in determining which new drugs the government will help pay for in the nation's pharmaceutical benefit program. The program does not directly control drug prices or ration prescription drugs-policy options that are widely opposed in the United States. Australia's program supports patients' access to important, innovative medications deemed to be cost-effective. The US system could benefit if policy makers examined Australia's experience and adopted a comparative clinical and value review suited to the US political and economic landscape. PMID:23569059

  12. Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study

    PubMed Central

    Meng, Yang; Holmes, John; Hill-McManus, Daniel; Meier, Petra S

    2014-01-01

    Objective To evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. Design Modelling study using the Sheffield Alcohol Policy Model version 2.5. Setting England 2014-15. Population Adults and young people aged 16 or more, including subgroups of moderate, hazardous, and harmful drinkers. Interventions Policy to ban below cost selling, which means that the selling price to consumers could not be lower than tax payable on the product, compared with policies of minimum unit pricing at £0.40 (€0.57; $0.75), 45p, and 50p per unit (7.9 g/10 mL) of pure alcohol. Main outcome measures Changes in mean consumption in terms of units of alcohol, drinkers’ expenditure, and reductions in deaths, illnesses, admissions to hospital, and quality adjusted life years. Results The proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45p minimum unit price. Below cost selling is estimated to reduce harmful drinkers’ mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health—saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45p minimum unit price is estimated to save 624 deaths and 23 700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers. Conclusions The ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at

  13. Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

    PubMed Central

    Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

    2015-01-01

    Context: Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher's two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed. PMID:25829909

  14. Break-Even Cost for Residential Solar Water Heating in the United States: Key Drivers and Sensitivities

    SciTech Connect

    Cassard, H.; Denholm, P.; Ong, S.

    2011-02-01

    This paper examines the break-even cost for residential rooftop solar water heating (SWH) technology, defined as the point where the cost of the energy saved with a SWH system equals the cost of a conventional heating fuel purchased from the grid (either electricity or natural gas). We examine the break-even cost for the largest 1,000 electric and natural gas utilities serving residential customers in the United States as of 2008. Currently, the break-even cost of SWH in the United States varies by more than a factor of five for both electricity and natural gas, despite a much smaller variation in the amount of energy saved by the systems (a factor of approximately one and a half). The break-even price for natural gas is lower than that for electricity due to a lower fuel cost. We also consider the relationship between SWH price and solar fraction and examine the key drivers behind break-even costs. Overall, the key drivers of the break-even cost of SWH are a combination of fuel price, local incentives, and technical factors including the solar resource location, system size, and hot water draw.

  15. DUCKS: Low cost thermal monitoring units for near-vent deployment

    NASA Astrophysics Data System (ADS)

    Harris, Andrew; Pirie, Dawn; Horton, Keith; Garbeil, Harold; Pilger, Eric; Ramm, Hans; Hoblitt, Rick; Thornber, Carl; Ripepe, Maurizio; Marchetti, Emanuele; Poggi, Pasquale

    2005-05-01

    During 1999 we designed and tested a thermal monitoring system to provide a cheap, robust, modular, real-time system capable of surviving the hostile conditions encountered proximal to active volcanic vents. In November 2000 the first system was deployed at Pu'u 'O'o (Kilauea, Hawai'i) to target persistently active vents. Aside from some minor problems, such as sensor damage due to tampering, this system remained operational until January 2004. The success of the prototype system led us to use the blueprint for a second installation at Stromboli (Aeolian Islands, Italy). This was deployed, dug into a bomb-proof bunker, during May 2002 and survived the April 2003 paroxysmal eruption despite being located just 250 m from the vent. In both cases, careful waterproofing of connectors and selection of suitable protection has prevented water damage and corrosion in the harsh atmosphere encountered at the crater rim. The Pu'u 'O'o system cost ˜US10,000 and comprises four modules: sensors, transmission and power hub, repeater station and reception site. The sensor component consists of three thermal infrared thermometers housed in Pelican™ cases fitted with Germanium-Arsenide-Selenium windows. Two 1° field of view (FOV) sensors allow specific vents to be targeted and a 60° FOV sensor provides a crater floor overview. A hard wire connection links to a Pelican™-case-housed microprocessor, modem and power module. From here data are transmitted, via a repeater site, to a dedicated PC at the Hawaiian Volcano Observatory. Here data are displayed with a delay of ˜3 s between acquisition and display. The modular design allows for great flexibility. At Stromboli, 1° and 15° FOV sensor modules can be switched depending changes in activity style and crater geometry. In addition a direct line of site to the Stromboli reception center negates the repeater site requirement, reducing the cost to US5500 for a single sensor system. We have also constructed self-contained units

  16. Health Care Costs for Adults With Congenital Heart Disease in the United States 2002 to 2012.

    PubMed

    Briston, David A; Bradley, Elisa A; Sabanayagam, Aarthi; Zaidi, Ali N

    2016-08-15

    More adults than children with congenital heart disease (CHD) are alive today. Few studies have evaluated adult congenital heart disease (ACHD) health care utilization in the United States. Data from the National Inpatient Sample from 2002 to 2012, using International Classification of Diseases, Ninth Revision, codes for moderate and complex CHD were analyzed. Hospital discharges, total billed and reimbursed amounts, length of stay, and gender/age disparities were evaluated. There was an increase in CHD discharges (moderate CHD: 4,742 vs 6,545; severe CHD: 807 vs 1,115) and total billed and reimbursed dollar amounts across all CHD (billed: $2.7 vs $7.0 billion, 155% increase; reimbursed: $1.3 vs $2.3 billion, 99% increase) and in the ACHD subgroup (billed: $543 million vs $1.5 billion, 178% increase; reimbursed: $221 vs $433 million, 95% increase). Women comprised more discharges in 2002 but not in 2012 (men:women, 2002: 6,503 vs 7,805; 2012: 7,715 vs 7,200, p = 0.39). Gender-based billed amounts followed similar trends (2002: $263 vs $280 million; 2012: $845 vs $662 million, p = 0.006) as did reimbursements (2002: $108 vs $114 million; 2012: $243 vs $190 million, p = 0.008). All age subgroups demonstrated increased health care expenditures, including the >44 versus 18- to 44-year-old age subgroup (billed: $618 vs $347 million, p <0.001; reimbursed: $136 vs $75 million, p <0.001). Our results reveal increased ACHD billed and reimbursed amounts and hospital discharges with a shift in gender-based ACHD hospitalizations: men now account for more hospitalizations in the United States. In conclusion, increased health care expenditure in older patients with ACHD is likely to increase further as health care system use and costs continue to grow. PMID:27476099

  17. Estimating the Cost of Standardized Student Testing in the United States.

    ERIC Educational Resources Information Center

    Phelps, Richard P.

    2000-01-01

    Describes and contrasts different methods of estimating costs of standardized testing. Using a cost-accounting approach, compares gross and marginal costs and considers testing objects (test materials and services, personnel and student time, and administrative/building overhead). Social marginal costs of replacing existing tests with a national…

  18. Managing Information On Costs

    NASA Technical Reports Server (NTRS)

    Taulbee, Zoe A.

    1990-01-01

    Cost Management Model, CMM, software tool for planning, tracking, and reporting costs and information related to costs. Capable of estimating costs, comparing estimated to actual costs, performing "what-if" analyses on estimates of costs, and providing mechanism to maintain data on costs in format oriented to management. Number of supportive cost methods built in: escalation rates, production-learning curves, activity/event schedules, unit production schedules, set of spread distributions, tables of rates and factors defined by user, and full arithmetic capability. Import/export capability possible with 20/20 Spreadsheet available on Data General equipment. Program requires AOS/VS operating system available on Data General MV series computers. Written mainly in FORTRAN 77 but uses SGU (Screen Generation Utility).

  19. Cost comparison of selected coal mines from Australia, Canada, Colombia, South Africa, and the United States. Special pub

    SciTech Connect

    Not Available

    1993-08-01

    The report presents production and delivered costs for coal exports from the five major Western coal-exporting countries: Australia, Canada, Colombia, South Africa, and the United States. Cost data were compiled from visits to 43 mines by U.S. Bureau of Mines engineers between 1985 and 1990. All report costs are in January 1989 U.S. dollars per short ton. In the report, the Bureau updates and combines information from four earlier reports. These studies provide basic insights into the competitiveness of the U.S. coal industry with those of major coal-exporting countries.

  20. A comparative cost analysis of polytrauma and neurosurgery Intensive Care Units at an apex trauma care facility in India

    PubMed Central

    Kumar, Parmeshwar; Jithesh, V.; Gupta, Shakti Kumar

    2016-01-01

    Context: Although Intensive Care Units (ICUs) only account for 10% of the hospital beds, they consume nearly 22% of the hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: The aim of this study was to evaluate and compare the cost of intensive care delivery between multispecialty and neurosurgery ICUs at an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203-bedded Level IV trauma care facility in New Delhi, India, from May 1, 2012 to June 30, 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in the study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Statistical analysis was performed by Fisher's two tailed t-test. Results: Total cost/bed/day for the multispecialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU, it was Rs. 14,306.7/-, workforce constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist health-care decision makers in better allocation of resources. Although multispecialty ICUs are more cost-effective, other factors will also play a role in defining the kind of ICU that needs to be designed. PMID:27555693

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

    PubMed Central

    2013-01-01

    Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. Method A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. Results The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Conclusions Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation. PMID:23421756

  2. Screening, isolation, and decolonisation strategies in the control of meticillin resistant Staphylococcus aureus in intensive care units: cost effectiveness evaluation

    PubMed Central

    Graves, Nicholas; Cookson, Barry D; Barnett, Adrian G; Wilson, Jennie A; Edgeworth, Jonathan D; Batra, Rahul; Cuthbertson, Brian H; Cooper, Ben S

    2011-01-01

    Objective To assess the cost effectiveness of screening, isolation, and decolonisation strategies in the control of meticillin resistant Staphylococcus aureus (MRSA) in intensive care units. Design Economic evaluation based on a dynamic transmission model. Setting England and Wales. Population Theoretical population of patients on an intensive care unit. Main outcome measures Infections, deaths, costs, quality adjusted life years (QALYs), incremental cost effectiveness ratios for alternative strategies, and net monetary benefits. Results All decolonisation strategies improved health outcomes and reduced costs. Although universal decolonisation (regardless of MRSA status) was the most cost effective in the short term, strategies using screening to target MRSA carriers may be preferred owing to the reduced risk of selecting for resistance. Among such targeted strategies, universal admission and weekly screening with polymerase chain reaction coupled with decolonisation using nasal mupirocin was the most cost effective. This finding was robust to the size of intensive care units, prevalence of MRSA on admission, proportion of patients classified as high risk, and precise value of willingness to pay for health benefits. All strategies using isolation but not decolonisation improved health outcomes but costs were increased. When the prevalence of MRSA on admission to the intensive care unit was 5% and the willingness to pay per QALY gained was between £20 000 (€23 000; $32 000) and £30 000, the best such strategy was to isolate only those patients at high risk of carrying MRSA (either pre-emptively or after identification by admission and weekly screening for MRSA using chromogenic agar). Universal admission and weekly screening using polymerase chain reaction based detection of MRSA coupled with isolation was unlikely to be cost effective unless prevalence was high (10% of patients colonised with MRSA on admission). Conclusions MRSA control strategies that

  3. 75 FR 9102 - Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United States...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... purposes of the reporting requirement of 5 U.S.C. 801. List of Subjects in 28 CFR Part 43 Claims, Health... Department of Justice. * * * * * Dated: February 23, 2010. Eric H. Holder, Jr., Attorney General. BILLING... Part 43 Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United...

  4. Low cost solar array project production process and equipment task. A Module Experimental Process System Development Unit (MEPSDU)

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Technical readiness for the production of photovoltaic modules using single crystal silicon dendritic web sheet material is demonstrated by: (1) selection, design and implementation of solar cell and photovoltaic module process sequence in a Module Experimental Process System Development Unit; (2) demonstration runs; (3) passing of acceptance and qualification tests; and (4) achievement of a cost effective module.

  5. 45 CFR 1309.34 - Costs of installation of modular unit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... in 45 CFR part 74 and 45 CFR part 92, all reasonable costs necessary to the installation of a modular... funds. Such costs include, but are not limited to, payments for public utility hook-ups, site...

  6. 45 CFR 1309.34 - Costs of installation of modular unit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... in 45 CFR part 74 and 45 CFR part 92, all reasonable costs necessary to the installation of a modular... funds. Such costs include, but are not limited to, payments for public utility hook-ups, site...

  7. 45 CFR 1309.34 - Costs of installation of modular unit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... in 45 CFR part 74 and 45 CFR part 92, all reasonable costs necessary to the installation of a modular... funds. Such costs include, but are not limited to, payments for public utility hook-ups, site...

  8. 45 CFR 1309.34 - Costs of installation of modular unit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... in 45 CFR part 74 and 45 CFR part 92, all reasonable costs necessary to the installation of a modular... funds. Such costs include, but are not limited to, payments for public utility hook-ups, site...

  9. 45 CFR 1309.34 - Costs of installation of modular unit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... in 45 CFR part 74 and 45 CFR part 92, all reasonable costs necessary to the installation of a modular... funds. Such costs include, but are not limited to, payments for public utility hook-ups, site...

  10. Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania.

    PubMed Central

    Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian

    2003-01-01

    OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. PMID:12764493

  11. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  12. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  13. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  14. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  15. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  16. Geothermal Energy Development in the Eastern United States, Sensitivity analysis-cost of geothermal energy

    SciTech Connect

    Kane, S.M.; Kroll, P.; Nilo, B.

    1982-12-01

    The Geothermal Resources Interactive Temporal Simulation (GRITS) model is a computer code designed to estimate the costs of geothermal energy systems. The interactive program allows the user to vary resource, demand, and financial parameters to observe their effects on delivered costs of direct-use geothermal energy. Due to the large number and interdependent nature of the variables that influence these costs, the variables can be handled practically only through computer modeling. This report documents a sensitivity analysis of the cost of direct-use geothermal energy where each major element is varied to measure the responsiveness of cost to changes in that element. It is hoped that this analysis will assist those persons interested in geothermal energy to understand the most significant cost element as well as those individuals interested in using the GRITS program in the future.

  17. Benchmarking Soft Costs for PV Systems in the United States (Presentation)

    SciTech Connect

    Ardani, K.

    2012-06-01

    This paper presents results from the first U.S. based data collection effort to quantify non-hardware, business process costs for PV systems at the residential and commercial scales, using a bottom-up approach. Annual expenditure and labor hour productivity data are analyzed to benchmark business process costs in the specific areas of: (1) customer acquisition; (2) permitting, inspection, and interconnection; (3) labor costs of third party financing; and (4) installation labor.

  18. Cost-Effectiveness of Frequent HIV Testing of High-Risk Populations in the United States

    PubMed Central

    Farnham, Paul G.; Sansom, Stephanie L.; Yaylali, Emine; Mermin, Jonathan H.

    2016-01-01

    Purpose: Data showing a high incidence of HIV infection among men who have sex with men (MSM) who had annual testing suggest that more frequent HIV testing may be warranted. Testing technology is also a consideration given the availability of sensitive testing modalities and the increased use of less-sensitive rapid, point-of-care antibody tests. We assessed the cost-effectiveness of HIV testing of MSM and injection drug users (IDUs) at 3- and 6-month intervals using fourth-generation and rapid tests. Methods: We used a published mathematical model of HIV transmission to evaluate testing intervals for each population using cohorts of 10,000 MSM and IDU. We incorporated HIV transmissions averted due to serostatus awareness and viral suppression. We included costs for HIV testing and treatment initiation, and also treatment costs saved from averted transmissions. Results: For MSM, HIV testing was cost saving or cost effective over a 1-year period for both 6-month compared with annual testing and quarterly compared with 6-month testing using either test. Testing IDU every 6 months compared with annually was moderately cost effective over a 1-year period with a fourth-generation test, while testing with rapid, point-of-care tests or quarterly was not cost effective. MSM results remained robust in sensitivity analysis, whereas IDU results were sensitive to changes in HIV incidence and continuum-of-care parameters. Threshold analyses on costs suggested that additional implementation costs could be incurred for more frequent testing for MSM while remaining cost effective. Conclusions: HIV testing of MSM as frequently as quarterly is cost effective compared with annual testing, but testing IDU more frequently than annually is generally not cost effective. PMID:26361172

  19. Design, construction and testing of a low-cost automated 68Gallium-labeling synthesis unit for clinical use

    PubMed Central

    Heidari, Pedram; Szretter, Alicia; Rushford, Laura E; Stevens, Maria; Collier, Lee; Sore, Judit; Hooker, Jacob; Mahmood, Umar

    2016-01-01

    The interest in 68Gallium labeled PET probes continues to increase around the world. Widespread use in Europe and Asia has led to great interest for use at numerous sites in the US. One barrier to entry is the cost of the automated synthesis units for relatively simple labeling procedures. We describe the construction and testing of a relatively low-cost automated 68Ga-labeling unit for human-use. We provide a guide for construction, including part lists and synthesis timelists to facilitate local implementation. Such inexpensive systems could help increase use around the globe and in the US in particular by removing one of the barriers to greater widespread availability. The developed automated synthesis unit reproducibly synthesized 68Ga-DOTATOC with average yield of 71 ± 8% and a radiochemical purity ≥ 95% in a synthesis time of 25 ± 1 minutes. Automated product yields are comparable to that of manual synthesis. We demonstrate in-house construction and use of a low-cost automated synthesis unit for labeling of DOTATOC and similar peptides with 68Gallium. PMID:27508104

  20. Design, construction and testing of a low-cost automated (68)Gallium-labeling synthesis unit for clinical use.

    PubMed

    Heidari, Pedram; Szretter, Alicia; Rushford, Laura E; Stevens, Maria; Collier, Lee; Sore, Judit; Hooker, Jacob; Mahmood, Umar

    2016-01-01

    The interest in (68)Gallium labeled PET probes continues to increase around the world. Widespread use in Europe and Asia has led to great interest for use at numerous sites in the US. One barrier to entry is the cost of the automated synthesis units for relatively simple labeling procedures. We describe the construction and testing of a relatively low-cost automated (68)Ga-labeling unit for human-use. We provide a guide for construction, including part lists and synthesis timelists to facilitate local implementation. Such inexpensive systems could help increase use around the globe and in the US in particular by removing one of the barriers to greater widespread availability. The developed automated synthesis unit reproducibly synthesized (68)Ga-DOTATOC with average yield of 71 ± 8% and a radiochemical purity ≥ 95% in a synthesis time of 25 ± 1 minutes. Automated product yields are comparable to that of manual synthesis. We demonstrate in-house construction and use of a low-cost automated synthesis unit for labeling of DOTATOC and similar peptides with (68)Gallium. PMID:27508104

  1. Stress Cardiac Magnetic Resonance Imaging With Observation Unit Care Reduces Cost for Patients With Emergent Chest Pain: A Randomized Trial

    PubMed Central

    Miller, Chadwick D.; Hwang, Wenke; Hoekstra, James W.; Case, Doug; Lefebvre, Cedric; Blumstein, Howard; Hiestand, Brian; Diercks, Deborah B.; Hamilton, Craig A.; Harper, Erin N.; Hundley, W. Gregory

    2013-01-01

    Study objective We determine whether imaging with cardiac magnetic resonance imaging (MRI) in an observation unit would reduce medical costs among patients with emergent non-low-risk chest pain who otherwise would be managed with an inpatient care strategy. Methods Emergency department patients (n=110) at intermediate or high probability for acute coronary syndrome without electrocardiographic or biomarker evidence of a myocardial infarction provided consent and were randomized to stress cardiac MRI in an observation unit versus standard inpatient care. The primary outcome was direct hospital cost calculated as the sum of hospital and provider costs. Estimated median cost differences (Hodges-Lehmann) and distribution-free 95% confidence intervals (Moses) were used to compare groups. Results There were 110 participants with 53 randomized to cardiac MRI and 57 to inpatient care; 8 of 110 (7%) experienced acute coronary syndrome. In the MRI pathway, 49 of 53 underwent stress cardiac MRI, 11 of 53 were admitted, 1 left against medical advice, 41 were discharged, and 2 had acute coronary syndrome. In the inpatient care pathway, 39 of 57 patients initially received stress testing, 54 of 57 were admitted, 3 left against medical advice, and 6 had acute coronary syndrome. At 30 days, no subjects in either group experienced acute coronary syndrome after discharge. The cardiac MRI group had a reduced median hospitalization cost (Hodges-Lehmann estimate $588; 95% confidence interval $336 to $811); 79% were managed without hospital admission. Conclusion Compared with inpatient care, an observation unit strategy involving stress cardiac MRI reduced incident cost without any cases of missed acute coronary syndrome in patients with emergent chest pain. PMID:20554078

  2. Cost-Effectiveness Analysis of a Transparent Antimicrobial Dressing for Managing Central Venous and Arterial Catheters in Intensive Care Units

    PubMed Central

    Bernatchez, Stéphanie F.; Ruckly, Stéphane; Timsit, Jean-François

    2015-01-01

    Objective To model the cost-effectiveness impact of routine use of an antimicrobial chlorhexidine gluconate-containing securement dressing compared to non-antimicrobial transparent dressings for the protection of central vascular lines in intensive care unit patients. Design This study uses a novel health economic model to estimate the cost-effectiveness of using the chlorhexidine gluconate dressing versus transparent dressings in a French intensive care unit scenario. The 30-day time non-homogeneous markovian model comprises eight health states. The probabilities of events derive from a multicentre (12 French intensive care units) randomized controlled trial. 1,000 Monte Carlo simulations of 1,000 patients per dressing strategy are used for probabilistic sensitivity analysis and 95% confidence intervals calculations. The outcome is the number of catheter-related bloodstream infections avoided. Costs of intensive care unit stay are based on a recent French multicentre study and the cost-effectiveness criterion is the cost per catheter-related bloodstream infections avoided. The incremental net monetary benefit per patient is also estimated. Patients 1000 patients per group simulated based on the source randomized controlled trial involving 1,879 adults expected to require intravascular catheterization for 48 hours. Intervention Chlorhexidine Gluconate-containing securement dressing compared to non-antimicrobial transparent dressings. Results The chlorhexidine gluconate dressing prevents 11.8 infections /1,000 patients (95% confidence interval: [3.85; 19.64]) with a number needed to treat of 85 patients. The mean cost difference per patient of €141 is not statistically significant (95% confidence interval: [€-975; €1,258]). The incremental cost-effectiveness ratio is of €12,046 per catheter-related bloodstream infection prevented, and the incremental net monetary benefit per patient is of €344.88. Conclusions According to the base case scenario, the

  3. 42 CFR 447.206 - Cost limit for providers operated by units of government.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Medicare cost reporting principles, and audited financial statements that will be used in conjunction with... are organized and operating in accordance with the provisions of 42 CFR 438; (3) Federally Qualified... 1905 of the Act, as well as 45 CFR 92.22 and Medicare cost principles when applicable....

  4. Public School Teacher Cost Differences across the United States. Analysis/Methodology Report.

    ERIC Educational Resources Information Center

    Chambers, Jay; Fowler, William J., Jr.

    This document presents findings of a study that used a hedonic wage model to develop a national, geographical teacher cost index (TCI). The research sought to extend the analysis of teacher compensation to include not only variables that reflect the geographic cost-of-living, but also the amenities of the labor markets in which the public school…

  5. Cost of reactive nitrogen release from human activities to the environment in the United States

    EPA Science Inventory

    The leakage of reactive nitrogen (N) from human activities to the environment can cause human health and ecological problems. Often these harmful effects are not reflected in the costs of food, fuel, and fiber that derive from N use. Spatial analyses of economic costs and benef...

  6. Excess costs associated with common healthcare-associated infections in an Iranian cardiac surgical unit.

    PubMed

    Nosrati, M; Boroumand, M; Tahmasebi, S; Sotoudeh, M; Sheikhfathollahi, M; Goodarzynejad, H

    2010-12-01

    Healthcare-associated infection (HCAI) following open heart surgery is not only a major cause of mortality and morbidity, but also carries higher costs. There are limited data on the additional costs due to HCAI in non-western countries. To estimate the direct cost of the four most common HCAIs in an Iranian sample, we studied 1191 patients admitted for elective open heart surgery. HCAIs were defined using the National Nosocomial Infections Surveillance criteria (Centers for Disease Control and Prevention, Atlanta, GA, USA). The financial costs of length of stay per day in hospital, paraclinical services, medications, instruments, and operating room were provided by the hospital's finance department. The contribution of HCAI to excess direct medical costs in patients with HCAI was assessed by multivariable linear regression. In the study population, the mean age was 57.3±11.9 years, 857 (72.0%) were men, and 64 (5.4%) developed HCAI. In total there were 73 infections of which the most common was surgical site infection (49.3%), followed by urinary tract infection (20.5%), bloodstream infection (16.5%), and pneumonia (13.7%). After adjustment for other confounders HCAI remained associated with excess direct medical costs (β=1707.06, SE=90.84; P < 0.001). The medical costs in patients with HCAI were almost twice those in patients without HCAI. More than half of the excess cost was attributable to prolonged hospitalisation. PMID:20833445

  7. Exploring the cost effectiveness of an immunization programme for rotavirus gastroenteritis in the United Kingdom.

    PubMed

    Lorgelly, P K; Joshi, D; Iturriza Gómara, M; Gray, J; Mugford, M

    2008-01-01

    Rotavirus is the most common cause of gastroenteritis in children aged <5 years old, two new vaccines have recently been developed which can prevent associated morbidity and mortality. While apparently safe and efficacious, it is also important to establish whether rotavirus immunization is cost effective. A decision analytical model which employs data from a review of published evidence is used to determine the cost effectiveness of a rotavirus vaccine. The results suggest that some of the health sector costs, and all of the societal costs, of rotavirus gastroenteritis in children can be avoided by an immunization programme. The additional cost to the health sector may be considered worthwhile if there is a sufficient improvement in the quality-of-life of children and parents affected by gastroenteritis; this study did not find any evidence of research which has measured the utility gains from vaccination. PMID:17335631

  8. Exploring the cost effectiveness of an immunization programme for rotavirus gastroenteritis in the United Kingdom

    PubMed Central

    LORGELLY, P. K.; JOSHI, D.; ITURRIZA GÓMARA, M.; GRAY, J.; MUGFORD, M.

    2008-01-01

    SUMMARY Rotavirus is the most common cause of gastroenteritis in children aged <5 years old, two new vaccines have recently been developed which can prevent associated morbidity and mortality. While apparently safe and efficacious, it is also important to establish whether rotavirus immunization is cost effective. A decision analytical model which employs data from a review of published evidence is used to determine the cost effectiveness of a rotavirus vaccine. The results suggest that some of the health sector costs, and all of the societal costs, of rotavirus gastroenteritis in children can be avoided by an immunization programme. The additional cost to the health sector may be considered worthwhile if there is a sufficient improvement in the quality-of-life of children and parents affected by gastroenteritis; this study did not find any evidence of research which has measured the utility gains from vaccination. PMID:17335631

  9. The Self Actualized Reader.

    ERIC Educational Resources Information Center

    Marino, Michael; Moylan, Mary Elizabeth

    A study examined the commonalities that "voracious" readers share, and how their experiences can guide parents, teachers, and librarians in assisting children to become self-actualized readers. Subjects, 25 adults ranging in age from 20 to 67 years, completed a questionnaire concerning their reading histories and habits. Respondents varied in…

  10. Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs

    PubMed Central

    Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D.K.; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

    2016-01-01

    Background & objectives: Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. Methods: This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. Results: The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were 2,04,787 (US$ 3,413) and 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was 1,48,200 (95% CI 55,716 to 2,40,685, P<0.01). Interpretation & conclusions: This study highlights the effect of HAI on costs for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care. PMID:27377508

  11. Hospitalization cost after spine surgery in the United States of America.

    PubMed

    Missios, Symeon; Bekelis, Kimon

    2015-10-01

    The objective of this study was to develop and validate a predictive model of hospitalization costs after spine surgery. Several initiatives have been put in place to minimize healthcare expenditures but there are limited data on the magnitude of the contribution of procedure-specific drivers of cost. We performed a retrospective cohort study involving 672,591 patients who underwent spine surgery and were registered in the National Inpatient Sample from 2005-2010. The cohort underwent 1:1 randomization to create derivation and validation subsamples. Regression techniques were used for the creation of a parsimonious predictive model of total hospitalization cost after spine surgery. Included were 356,783 patients (53.1%) who underwent fusions, and 315,808 (46.9%) non-fusion surgeries. The median hospitalization cost was $14,202 (interquartile range $4772-23,632). Common drivers of cost identified in the multivariate analysis included the length of stay, number of admission diagnoses and procedures, hospital size and region, patient income, fusion surgery, acute renal failure, sex, and coagulopathy. The model was validated in an independent cohort and demonstrated a final coefficient of determination that was very similar to the initial model. The predicted and observed values in the validation cohort demonstrated good correlations. This national study quantified the magnitude of significant drivers of hospitalization cost after spine surgery. We developed a predictive model that can be utilized as an adjunct in the cost containment debate and the creation of data driven policies. PMID:26183305

  12. Costs of gunshot and cut/stab wounds in the United States, with some Canadian comparisons.

    PubMed

    Miller, T R; Cohen, M A

    1997-05-01

    This article estimates the costs of U.S. gunshot and cut/stab wound by intent. It also compares U.S. to Canadian gunshot experience. Incidence data are from published sources, the National Hospital Ambulatory Medical Care Survey (NHAMCS), and cause-coded emergency department discharge and hospital discharge data systems. Medical care payments and lost earnings per case come from National Crime Survey data, a literature review, and weighting of costs by diagnosis from Databook on Nonfatal Injury-Incidence. Costs, and Consequences by Miller et al. (The Urban Institute Press, Washington, DC. 1995) with the diagnosis distribution of penetrating injuries from the discharge data systems. Quality of life losses are estimated primarily from jury awards to penetrating injury victims. In 1992, gunshots killed 37,776 Americans; cut/stab wounds killed 4095. Another 134,000 gunshot survivors and 3,100,000 cut/stab wound survivors received medical treatment. Annually, gunshot wounds cost an estimated U.S. $126 billion. Cut/stab wounds cost another U.S. $51 billion. The gunshot and cut/stab totals include U.S. $40 billion and U.S. $13 billion respectively in medical, public services, and work-loss costs. Across medically treated cases, costs average U.S. $154,000 per gunshot survivor and U.S. $12,000 per cut/stab survivor. Gunshot wounds are more than three times as common in the U.S. than in Canada, which has strict handgun control. With the same quality of life loss per victim, gunshot costs per capita are an estimated U.S. $495 in the U.S. vs U.S. $180 in Canada. Per gun, however, the costs are higher in Canada, Gunshot wound rates rise linearly with gun ownership. PMID:9183471

  13. Formulas for estimating the costs averted by sexually transmitted infection (STI) prevention programs in the United States

    PubMed Central

    Chesson, Harrell W; Collins, Dayne; Koski, Kathryn

    2008-01-01

    Background Sexually transmitted infection (STI) prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. Methods We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity) averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies. Results We present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars), using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw)(0.16)(0.925)(0.70)($1,995), where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID) as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources. Conclusion The formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities. PMID:18500996

  14. Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series.

    PubMed

    Culme-Seymour, Emily J; Mason, Katrina; Vallejo-Torres, Laura; Carvalho, Carla; Partington, Leanne; Crowley, Claire; Hamilton, Nick J; Toll, Ed C; Butler, Colin R; Elliott, Martin J; Birchall, Martin A; Lowdell, Mark W; Mason, Chris

    2016-02-01

    Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations. PMID:26559535

  15. Taxes, divorce-transactions costs, economic conditions, and divorce rates: an exploratory empirical inquiry for the United States.

    PubMed

    Cebula, R J; Belton, W J

    1995-01-01

    "This study argues that, given the tax deductibility of alimony payments in the United States, higher marginal federal income tax rates may reduce the expected transactions costs of divorce and act thereby to increase the divorce rate. After allowing for a variety of other factors, including inflation, female labor force participation, AIDS, the Vietnam War, age, the availability of legal assistance, and transfer payments, both first-differences estimates and Granger-causality tests strongly support the hypothesis." PMID:12178368

  16. Tracking the Sun III; The Installed Cost of Photovoltaics in the United States from 1998-2009

    SciTech Connect

    Barbose, Galen; Darghouth, Naim; Wiser, Ryan

    2010-12-13

    Installations of solar photovoltaic (PV) systems have been growing at a rapid pace in recent years. In 2009, approximately 7,500 megawatts (MW) of PV were installed globally, up from approximately 6,000 MW in 2008, consisting primarily of grid-connected applications. With 335 MW of grid-connected PV capacity added in 2009, the United States was the world's fourth largest PV market in 2009, behind Germany, Italy, and Japan. The market for PV in the United States is driven by national, state, and local government incentives, including up-front cash rebates, production-based incentives, requirements that electricity suppliers purchase a certain amount of solar energy, and federal and state tax benefits. These programs are, in part, motivated by the popular appeal of solar energy, and by the positive attributes of PV - modest environmental impacts, avoidance of fuel price risks, coincidence with peak electrical demand, and the possible deployment of PV at the point of use. Given the relatively high cost of PV, however, a key goal of these policies is to encourage cost reductions over time. Therefore, as policy incentives have become more significant and as PV deployment has accelerated, so too has the desire to track the installed cost of PV systems over time, by system characteristics, by system location, and by component. Despite the significant year-on-year growth, however, the share of global and U.S. electricity supply met with PV remains small, and annual PV additions are currently modest in the context of the overall electric system. To address this need, Lawrence Berkeley National Laboratory initiated a report series focused on describing trends in the installed cost of grid-connected PV systems in the United States. The present report, the third in the series, describes installed cost trends from 1998 through 2009, and provides preliminary cost data for systems installed in 2010. The analysis is based on project-level cost data from approximately 78

  17. A synthesis of regional inputs and damage costs of reactive nitrogen in the United States

    EPA Science Inventory

    We estimated the fate of N in crops and in the environment (air, land, freshwater, groundwater, and coastal zones) with published coefficients describing nutrient uptake efficiency, gaseous emissions, and leaching losses. Benefits and damage costs of anthropogenic N inputs were ...

  18. Cost-Effectiveness of Complementary Therapies in the United Kingdom—A Systematic Review†

    PubMed Central

    Canter, Peter H.; Coon, Joanna Thompson; Ernst, Edzard

    2006-01-01

    Objectives: The aim of this review is to systematically summarize and assess all prospective, controlled, cost-effectiveness studies of complementary therapies carried out in the UK. Data sources: Medline (via PubMed), Embase, CINAHL, Amed (Alternative and Allied Medicine Database, British Library Medical Information Centre), The Cochrane Library, National Health Service Economic Evaluation Database (via Cochrane) and Health Technology Assessments up to October 2005. Review methods: Articles describing prospective, controlled, cost-effectiveness studies of any type of complementary therapy for any medical condition carried out in the UK were included. Data extracted included the main outcomes for health benefit and cost. These data were extracted independently by two authors, described narratively and also presented as a table. Results: Six cost-effectiveness studies of complementary medicine in the UK were identified: four different types of spinal manipulation for back pain, one type of acupuncture for chronic headache and one type of acupuncture for chronic back pain. Four of the six studies compared the complementary therapy with usual conventional treatment in pragmatic, randomized clinical trials without sham or placebo arms. Main outcome measures of effectiveness favored the complementary therapies but in the case of spinal manipulation (four studies) and acupuncture (one study) for back pain, effect sizes were small and of uncertain clinical relevance. The same four studies included a cost-utility analyses in which the incremental cost per quality adjusted life year (QALY) was less than £10 000. The complementary therapy represented an additional health care cost in five of the six studies. Conclusions: Prospective, controlled, cost-effectiveness studies of complementary therapies have been carried out in the UK only for spinal manipulation (four studies) and acupuncture (two studies). The limited data available indicate that the use of these therapies

  19. Examining Health Care Costs: Opportunities to Provide Value in the Intensive Care Unit.

    PubMed

    Chang, Beverly; Lorenzo, Javier; Macario, Alex

    2015-12-01

    As health care costs threaten the economic stability of American society, increasing pressures to focus on value-based health care have led to the development of protocols for fast-track cardiac surgery and for delirium management. Critical care services can be led by anesthesiologists with the goal of improving ICU outcomes and at the same time decreasing the rising cost of ICU medicine. PMID:26610628

  20. Net Costs Due to Seasonal Influenza Vaccination — United States, 2005–2009

    PubMed Central

    Carias, Cristina; Reed, Carrie; Kim, Inkyu K.; Foppa, Ivo M.; Biggerstaff, Matthew; Meltzer, Martin I.; Finelli, Lyn; Swerdlow, David L.

    2015-01-01

    Background Seasonal influenza causes considerable morbidity and mortality across all age groups, and influenza vaccination was recommended in 2010 for all persons aged 6 months and above. We estimated the averted costs due to influenza vaccination, taking into account the seasonal economic burden of the disease. Methods We used recently published values for averted outcomes due to influenza vaccination for influenza seasons 2005-06, 2006-07, 2007-08, and 2008-09, and age cohorts 6 months-4 years, 5-19 years, 20-64 years, and 65 years and above. Costs were calculated according to a payer and societal perspective (in 2009 US$), and took into account medical costs and productivity losses. Results When taking into account direct medical costs (payer perspective), influenza vaccination was cost saving only for the older age group (65≥) in seasons 2005-06 and 2007-08. Using the same perspective, influenza vaccination resulted in total costs of $US 1.7 billion (95%CI: $US 0.3–4.0 billion) in 2006-07 and $US 1.8 billion (95%CI: $US 0.1–4.1 billion) in 2008-09. When taking into account a societal perspective (and including the averted lost earnings due to premature death) averted deaths in the older age group influenced the results, resulting in cost savings for all ages combined in season 07-08. Discussion Influenza vaccination was cost saving in the older age group (65≥) when taking into account productivity losses and, in some seasons, when taking into account medical costs only. Averted costs vary significantly per season; however, in seasons where the averted burden of deaths is high in the older age group, averted productivity losses due to premature death tilt overall seasonal results towards savings. Indirect vaccination effects and the possibility of diminished case severity due to influenza vaccination were not considered, thus the averted burden due to influenza vaccine may be even greater than reported. PMID:26230271

  1. Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England.

    PubMed

    Shetty, S; Kennea, N; Desai, P; Giuliani, S; Richards, J

    2016-01-01

    Introduction There is a lack of knowledge on the average length of stay (LOS) in neonatal units after surgical repair of common congenital anomalies. There are few if any publications reporting the activity performed by units undertaking neonatal surgery. Such activity is important for contracting arrangements, commissioning specialist services and counselling parents. The aim of this study was to describe postnatal LOS for infants admitted to a single tertiary referral neonatal unit with congenital malformations requiring surgery. Methods Data on nine conditions were collected prospectively for babies on the neonatal unit over a five-year period (2006-2011). For those transferred back to their local unit following surgery, the local unit was contacted to determine the total LOS. Only those babies who had surgery during their first admission to our unit and who survived to discharge were included in the study. Cost estimates were based on the tariffs agreed for neonatal care between our trust and the London specialised commissioning group in 2011-2012. Results The median LOS for the conditions studied was: gastroschisis 35 days (range: 19-154 days), oesophageal atresia 33 days (range: 9-133 days), congenital diaphragmatic hernia 28 days (range: 7-99 days), intestinal atresia 24 days (range: 6-168 days), Hirschsprung's disease 21 days (range: 15-36 days), sacrococcygeal teratoma 17 days (range: 12-55 days), myelomeningocoele 15.5 days (range: 8-24 days), anorectal malformation 15 days (range: 6-90 days) and exomphalos 12 days (range: 3-228 days). The total neonatal bed day costs for the median LOS ranged from £8,701 (myelomeningocoele) to £23,874 (gastroschisis). The cost of surgery was not included. Conclusions There is wide variation in LOS for the same conditions in a single neonatal unit. This can be explained by different types and severity within the same congenital anomalies, different surgeons and other clinical confounders (eg sepsis, surgical

  2. Cost-benefit analysis: patient care at neurological intensive care unit.

    PubMed

    Kopacević, Lenka; Strapac, Marija; Mihelcić, Vesna Bozan

    2013-09-01

    Modern quality definition relies on patient centeredness and on patient needs for particular services, continuous control of the service provided, complete service quality management, and setting quality indicators as the health service endpoints. The health service provided to the patient has certain costs. Thus, one can ask the following: "To what extent does the increasing cost of patient care with changes in elimination improve the quality of health care and what costs are justifiable?" As stroke is the third leading cause of morbidity and mortality in Europe and worldwide, attention has been increasingly focused on stroke prevention and providing quality care for stroke patients. One of the most common medical/nursing problems in these patients is change in elimination, which additionally affects their mental health. PMID:24558761

  3. Cost implications of African swine fever in smallholder farrow-to-finish units: economic benefits of disease prevention through biosecurity.

    PubMed

    Fasina, F O; Lazarus, D D; Spencer, B T; Makinde, A A; Bastos, A D S

    2012-06-01

    African swine fever remains the greatest limitation to the development of the pig industry in Africa, and parts of Asia and Europe. It is especially important in West and Central African countries where the disease has become endemic. Biosecurity is the implementation of a set of measures that reduce the risk of infection through segregation, cleaning and disinfection. Using a 122-sow piggery unit, a financial model and costing were used to estimate the economic benefits of effective biosecurity against African swine fever. The outcomes suggest that pig production is a profitable venture that can generate a profit of approximately US$109,637.40 per annum and that an outbreak of African swine fever (ASF) has the potential to cause losses of up to US$910,836.70 in a single year. The implementation of biosecurity and its effective monitoring can prevent losses owing to ASF and is calculated to give a benefit-cost ratio of 29. A full implementation of biosecurity will result in a 9.70% reduction in total annual profit, but is justified in view of the substantial costs incurred in the event of an ASF outbreak. Biosecurity implementation is robust and capable of withstanding changes in input costs including moderate feed price increases, higher management costs and marginal reductions in total outputs. It is concluded that biosecurity is a key to successful pig production in an endemic situation. PMID:21929615

  4. Cost-effectiveness of strategies to prevent MRSA transmission and infection in an intensive care unit

    PubMed Central

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

    2014-01-01

    Objective We created a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent MRSA transmission and infection. Design Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. Patients and setting Hypothetical cohort of 10,000 adult patients admitted to a U.S. ICU. Methods We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures (ASC); (2) ASC plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate (CHG) baths; (5) universal decolonization; (6) UCP + CHG baths; and (7) UCP + decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. Results 1,989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared to all strategies except UCP + decolonization and UCP + CHG. UCP + decolonization was more effective than universal decolonization, but would cost $2,469 per colonization averted and $9,007 per infection averted. If MRSA colonization prevalence drops from 12% to 5%, ASC plus selective decolonization becomes the least expensive strategy. Conclusions Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission. PMID:25627757

  5. Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania.

    PubMed Central

    Rommelmann, Vanessa; Setel, Philip W.; Hemed, Yusuf; Angeles, Gustavo; Mponezya, Hamisi; Whiting, David; Boerma, Ties

    2005-01-01

    OBJECTIVE: To examine the costs of complementary information generation activities in a resource-constrained setting and compare the costs and outputs of information subsystems that generate the statistics on poverty, health and survival required for monitoring, evaluation and reporting on health programmes in the United Republic of Tanzania. METHODS: Nine systems used by four government agencies or ministries were assessed. Costs were calculated from budgets and expenditure data made available by information system managers. System coverage, quality assurance and information production were reviewed using questionnaires and interviews. Information production was characterized in terms of 38 key sociodemographic indicators required for national programme monitoring. FINDINGS: In 2002-03 approximately US$ 0.53 was spent per Tanzanian citizen on the nine information subsystems that generated information on 37 of the 38 selected indicators. The census and reporting system for routine health service statistics had the largest participating populations and highest total costs. Nationally representative household surveys and demographic surveillance systems (which are not based on nationally representative samples) produced more than half the indicators and used the most rigorous quality assurance. Five systems produced fewer than 13 indicators and had comparatively high costs per participant. CONCLUSION: Policy-makers and programme planners should be aware of the many trade-offs with respect to system costs, coverage, production, representativeness and quality control when making investment choices for monitoring and evaluation. In future, formal cost-effectiveness studies of complementary information systems would help guide investments in the monitoring, evaluation and planning needed to demonstrate the impact of poverty-reduction and health programmes. PMID:16184275

  6. The cost-effectiveness and population outcomes of expanded HIV screening and antiretroviral treatment in the United States

    PubMed Central

    Long, Elisa F.; Brandeau, Margaret L.; Owens, Douglas K.

    2011-01-01

    Background Although recent guidelines call for expanded routine screening for HIV, resources for antiretroviral treatment (ART) are limited and all eligible people are not currently being treated. Objective To evaluate the effects on the U.S. HIV epidemic of expanded ART, HIV screening, or interventions to reduce risk behavior. Design Dynamic mathematical model of HIV transmission and disease progression, and cost-effectiveness analysis. Data Sources Published literature. Target Population High-risk (injection drug users, men who have sex with men) and low-risk individuals aged 15 to 64 in the U.S. Time Horizon 20 years and lifetime (costs and QALYs). Perspective Societal. Interventions Expanded HIV screening and counseling, treatment with ART, or both. Outcome Measures New HIV infections, discounted costs and quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios. Results Base-Case Analysis One-time HIV screening of low-risk individuals coupled with annual screening of high-risk individuals could prevent 6.7% of a projected 1.23 million new infections and cost $22,382/QALY gained, assuming a 20% reduction in sexual activity post-screening. Expanding ART utilization to 75% of eligible individuals prevents 10.3% of infections and costs $20,300/QALY gained. A combination strategy prevents 17.3% of infections and costs $21,580/QALY gained. Results Sensitivity Analysis With no reduction in sexual activity, expanded screening prevents 3.7% of infections. Earlier ART initiation when CD4>350 cells/mL prevents 20–28% of infections. Additional efforts to halve high-risk behavior could reduce infections by 65%. Limitations Simplified model of disease progression and treatment; exclusion of acute HIV screening. Conclusions Expanding HIV screening and treatment simultaneously offers the greatest health benefit and is cost-effective. However, even substantial expansion of HIV screening and treatment programs is not sufficient to markedly reduce the U

  7. A cost-effectiveness analysis of respiratory syncytial virus (RSV) prophylaxis in infants in the United Kingdom

    PubMed Central

    2013-01-01

    Background Respiratory syncytial virus (RSV) is a common cause of respiratory infection that is highly prevalent in infants. Severe cases of RSV infection require hospitalisation; this is most likely to occur in infant populations at high risk. The study assesses the cost-effectiveness of palivizumab versus no prophylaxis in infants at high risk of hospitalisation with RSV in the United Kingdom (UK). Methods A decision tree model was developed to reflect the clinical pathway of infants at high risk of severe RSV infection who receive either prophylaxis with palivizumab or no prophylaxis. The main outcome was the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to assess the degree of uncertainty surrounding the results. A threshold analysis considered the impact of clinical and environmental risk factors on the cost-effectiveness in the subgroup of preterm infants 33–35 weeks gestational age (wGA). Results Prophylaxis with palivizumab compared with no prophylaxis is associated with the following ICERs; £33,216 for infants with congenital heart disease; £19,168 for infants with chronic lung disease; £3,845 for preterm infants < 29 wGA; £30,205 for preterm infants 29–32 wGA; and £99,056 for preterm infants 33–35 wGA. One-way sensitivity analysis suggests that these results are highly sensitive to the input data. Threshold analysis in the preterm 33–35 wGA subgroup demonstrates that an adjusted RSV-hospitalisation baseline risk of 17.94% or higher would result in an ICER below the £30,000 per quality-adjusted life-year threshold. Discussion Palivizumab is cost-effective compared to no prophylaxis in the United Kingdom in many of the subgroups considered, showing that palivizumab would be a cost-effective use of National Health Service resources. PMID:23919494

  8. The Per Case and Total Annual Costs of Foodborne Illness in the United States.

    PubMed

    Minor, Travis; Lasher, Angela; Klontz, Karl; Brown, Bradley; Nardinelli, Clark; Zorn, David

    2015-06-01

    We present an economic welfare-based method to estimate the health costs associated with foodborne illness caused by known viruses, bacteria, parasites, allergens, two marine biotoxins, and unspecified agents. The method generates health costs measured in both quality-adjusted life years and in dollars. We calculate the reduction in quality-adjusted life days caused by the illness and add reductions in quality-adjusted life years from any secondary effects that are estimated to occur. For fatal cases, we calculate the life years lost due to premature death. We add direct medical expenses to the monetary costs as derived from estimates of willingness to pay to reduce health risks. In total, we estimate that foodborne illness represents an annual burden to society of approximately $36 billion, with an average identified illness estimated to reduce quality-adjusted life days by 0.84, which is monetized and included in the average cost burden per illness of $3,630. PMID:25557397

  9. The costs and financing of perinatal care in the United States.

    PubMed Central

    Long, S H; Marquis, M S; Harrison, E R

    1994-01-01

    OBJECTIVES. The purpose of this study was to estimate the aggregate annual costs of maternal and infant health care and to describe the flow of funds that finance that care. METHODS. Estimates of costs and financing based on household and provider surveys, third-party claims data, and hospital discharge data were combined into a single, best estimate. RESULTS. The total cost of perinatal care in 1989 was $27.8 billion, or $6850 per mother-infant pair. Payments made directly by patients or third parties for this care totaled $25.4 billion, or about 7% of personal health care spending by the nonaged population. Payments were less than costs because they did not include a value for direct delivery care or for bad debt and charity care, which accounted for $2.4 billion. Private insurance accounted for about 63% of total payments, and Medicaid accounted for 17% of the total. CONCLUSIONS. National health reform would provide windfall receipts to hospitals, which would receive payment for the considerable bad debt and charity care they provide. Reform might also provide short-term gains to providers as private payment rates are substituted for those of Medicaid. PMID:8092374

  10. Plant breeding with genomic selection: potential gain per unit time and cost

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Advancements in genotyping are rapidly decreasing marker costs and increasing genome coverage. This is facilitating the use of marker-assisted selection (MAS) in plant breeding. Commonly employed MAS strategies, however, are not well suited for complex traits, requiring extra time for field-based ph...

  11. Consumption and Response Output as a Function of Unit Price: Manipulation of Cost and Benefit Components

    ERIC Educational Resources Information Center

    Delmendo, Xeres; Borrero, John C.; Beauchamp, Kenneth L.; Francisco, Monica T.

    2009-01-01

    We conducted preference assessments with 4 typically developing children to identify potential reinforcers and assessed the reinforcing efficacy of those stimuli. Next, we tested two predictions of economic theory: that overall consumption (reinforcers obtained) would decrease as the unit price (response requirement per reinforcer) increased and…

  12. A MORE COST-EFFECTIVE EMAP-W BENTHIC MACROFAUNAL SAMPLE UNIT

    EPA Science Inventory

    The standard EPA West Coast Environmental Monitoring and Assessment Program (EMAP-W) benthic macrofaunal sampling protocol is to collect 30-50 random benthic samples per reporting unit (e.g., estuary, region) using a 0.1 m2 grab and to sort out macrofauna using a 1.0 mm mesh scre...

  13. Pharmaceutical costs for inflammatory bowel disease units - An issue for department heads? The GESTIONAEII survey.

    PubMed

    Argüelles Arias, Federico; Barreiro-de Acosta, Manuel; Hinojosa, Joaquín

    2016-06-01

    Inflammatory bowel disease (IBD) units have a relevant weight within gastroenterology departments. In order to gain insight into the managerial aspects of IBD diagnosis and treatment, SEPD submitted a survey (GESTIONAEII) to department heads, IBD specialists, and other gastroenterologists. In this letter, we discuss the results obtained from gastroenterology department heads. PMID:26937746

  14. Cost of Power Interruptions to Electricity Consumers in the UnitedStates (U.S.)

    SciTech Connect

    Hamachi LaCommare, Kristina; Eto, Joseph H.

    2006-02-16

    The massive electric power blackout in the northeastern U.S.and Canada on August 14-15, 2003 catalyzed discussions about modernizingthe U.S. electricity grid. Industry sources suggested that investments of$50 to $100 billion would be needed. This work seeks to better understandan important piece of information that has been missing from thesediscussions: What do power interruptions and fluctuations in powerquality (power-quality events) cost electricity consumers? We developed abottom-up approach for assessing the cost to U.S. electricity consumersof power interruptions and power-quality events (referred to collectivelyas "reliability events"). The approach can be used to help assess thepotential benefits of investments in improving the reliability of thegrid. We developed a new estimate based on publicly availableinformation, and assessed how uncertainties in these data affect thisestimate using sensitivity analysis.

  15. Cost-Effectiveness of Pazopanib Versus Sunitinib for Renal Cancer in the United States.

    PubMed

    Benedict, Agnes; Ramaswamy, Krishnan; Sandin, Rickard

    2015-09-01

    We write to comment on a recently published study by Delea et al. in the January 2015 issue of JMCP that evaluated the cost-effectiveness (CE) of sunitinib (SU) versus pazopanib (PAZ) as first-line treatment for metastatic renal cell carcinoma (mRCC) from a U.S. third-party payer perspective.1 This analysis was based on COMPARZ and PISCES, clinical trials that compared SU and PAZ2,3 and led the authors to conclude that PAZ is cost-effective (in fact, dominant, according to the base-case results) compared with SU. Such assessment of economic value is clearly important for deciding between therapies to ensure fair access; therefore, we welcome a comparative evaluation of SU and PAZ. However, we believe that some of the key assumptions and inputs used in the model by Delea et al. render their results and conclusions invalid.  Best practice requires that results from a health economic model should reflect the most likely outcomes based on sound methodology and robust evidence for its inputs, as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR).4 Here, we focus on 2 key areas (utilities and survival modeling) where, in our view, the analysis by Delea et al. falls short of this standard, and a third area (treatment costs) where the basis for the data derived is unclear. PMID:26308230

  16. Quality and Cost of Diabetes Mellitus Care in Community Health Centers in the United States

    PubMed Central

    Richard, Patrick; Shin, Peter; Beeson, Tishra; Burke, Laura S.; Wood, Susan F.; Rosenbaum, Sara

    2015-01-01

    Objective To examine variations in the quality and cost of care provided to patients with diabetes mellitus by Community Health Centers (CHCs) compared to other primary care settings. Research Design and Methods We used data from the 2005–2008 Medical Expenditure Panel Survey (N = 2,108). We used two dependent variables: quality of care and ambulatory care expenditures. Our primary independent variable was whether the respondent received care in a Community Health Centers (CHCs) or not. We estimated logistic regression models to determine the probability of quality of care, and used generalized linear models with log link and gamma distribution to predict expenditures for CHC users compared to non-users of CHCs, conditional on patients with positive expenditures. Results Results showed that variations of quality between CHC users and non-CHC users were not statistically significant. Patients with diabetes mellitus who used CHCs saved payers and individuals approximately $1,656 in ambulatory care costs compared to non-users of CHCs. Conclusions These findings suggest an opportunity for policymakers to control costs for diabetes mellitus patients without having a negative impact on quality of care. PMID:26636324

  17. Expanded HIV Testing in Low-Prevalence, High-Income Countries: A Cost-Effectiveness Analysis for the United Kingdom

    PubMed Central

    Long, Elisa F.; Mandalia, Roshni; Mandalia, Sundhiya; Alistar, Sabina S.

    2014-01-01

    Objective In many high-income countries with low HIV prevalence, significant numbers of persons living with HIV (PLHIV) remain undiagnosed. Identification of PLHIV via HIV testing offers timely access to lifesaving antiretroviral therapy (ART) and decreases HIV transmission. We estimated the effectiveness and cost-effectiveness of HIV testing in the United Kingdom (UK), where 25% of PLHIV are estimated to be undiagnosed. Design We developed a dynamic compartmental model to analyze strategies to expand HIV testing and treatment in the UK, with particular focus on men who have sex with men (MSM), people who inject drugs (PWID), and individuals from HIV-endemic countries. Methods We estimated HIV prevalence, incidence, quality-adjusted life years (QALYs), and health care costs over 10 years, and cost-effectiveness. Results Annual HIV testing of all adults could avert 5% of new infections, even with no behavior change following HIV diagnosis because of earlier ART initiation, or up to 18% if risky behavior is halved. This strategy costs £67,000–£106,000/QALY gained. Providing annual testing only to MSM, PWID, and people from HIV-endemic countries, and one-time testing for all other adults, prevents 4–15% of infections, requires one-fourth as many tests to diagnose each PLHIV, and costs £17,500/QALY gained. Augmenting this program with increased ART access could add 145,000 QALYs to the population over 10 years, at £26,800/QALY gained. Conclusions Annual HIV testing of key populations in the UK is very cost-effective. Additional one-time testing of all other adults could identify the majority of undiagnosed PLHIV. These findings are potentially relevant to other low-prevalence, high-income countries. PMID:24763373

  18. How People Actually Use Thermostats

    SciTech Connect

    Meier, Alan; Aragon, Cecilia; Hurwitz, Becky; Mujumdar, Dhawal; Peffer, Therese; Perry, Daniel; Pritoni, Marco

    2010-08-15

    Residential thermostats have been a key element in controlling heating and cooling systems for over sixty years. However, today's modern programmable thermostats (PTs) are complicated and difficult for users to understand, leading to errors in operation and wasted energy. Four separate tests of usability were conducted in preparation for a larger study. These tests included personal interviews, an on-line survey, photographing actual thermostat settings, and measurements of ability to accomplish four tasks related to effective use of a PT. The interviews revealed that many occupants used the PT as an on-off switch and most demonstrated little knowledge of how to operate it. The on-line survey found that 89% of the respondents rarely or never used the PT to set a weekday or weekend program. The photographic survey (in low income homes) found that only 30% of the PTs were actually programmed. In the usability test, we found that we could quantify the difference in usability of two PTs as measured in time to accomplish tasks. Users accomplished the tasks in consistently shorter times with the touchscreen unit than with buttons. None of these studies are representative of the entire population of users but, together, they illustrate the importance of improving user interfaces in PTs.

  19. The benefits and costs of new fuels and engines for light-duty vehicles in the United States.

    PubMed

    Keefe, Ryan; Griffin, James P; Graham, John D

    2008-10-01

    Rising oil prices and concerns about energy security and climate change are spurring reconsideration of both automobile propulsion systems and the fuels that supply energy to them. In addition to the gasoline internal combustion engine, recent years have seen alternatives develop in the automotive marketplace. Currently, hybrid-electric vehicles, advanced diesels, and flex-fuel vehicles running on a high percentage mixture of ethanol and gasoline (E85) are appearing at auto shows and in driveways. We conduct a rigorous benefit-cost analysis from both the private and societal perspective of the marginal benefits and costs of each technology--using the conventional gasoline engine as a baseline. The private perspective considers only those factors that influence the decisions of individual consumers, while the societal perspective accounts for environmental, energy, and congestion externalities as well. Our analysis illustrates that both hybrids and diesels show promise for particular light-duty applications (sport utility vehicles and pickup trucks), but that vehicles running continuously on E85 consistently have greater costs than benefits. The results for diesels were particularly robust over a wide range of sensitivity analyses. The results from the societal analysis are qualitatively similar to the private analysis, demonstrating that the most relevant factors to the benefit-cost calculations are the factors that drive the individual consumer's decision. We conclude with a brief discussion of marketplace and public policy trends that will both illustrate and influence the relative adoption of these alternative technologies in the United States in the coming decade. PMID:18684162

  20. Evaluation of plug-in electric vehicles impact on cost-based unit commitment

    NASA Astrophysics Data System (ADS)

    Talebizadeh, Ehsan; Rashidinejad, Masoud; Abdollahi, Amir

    2014-02-01

    Incorporating plug in electric vehicles (PEVs) to power systems may address both additional demand as well as mobile storage to support electric grid spatially. Better utilization of such potential depends on the optimal scheduling of charging and discharging PEVs. Charging management malfunction of PEVs may increase the peak load which leads to additional generation. Therefore, charging and discharging of PEVs must be scheduled intelligently to prevent overloading of the network at peak hours, take advantages of off peak charging benefits and delaying any load shedding. A charging and discharging schedule of PEVs with respect to load curve variations is proposed in this paper. The proposed methodology incorporates integrated PEVs; the so-called parking lots; into the unit commitment problem. An IEEE 10-unit test system is employed to investigate the impacts of PEVs on generation scheduling. The results obtained from simulation analysis show a significant techno-economic saving.

  1. 42 CFR 137.336 - What is the difference between fixed-price and cost-reimbursement agreements?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... establish budgets based upon the actual costs of the project and are not allowed to include profit; (4... lump sums, unit cost pricing, or a combination thereof; (4) For unit cost pricing, savings may occur if... 42 Public Health 1 2010-10-01 2010-10-01 false What is the difference between fixed-price and...

  2. Effect of PACS/CR on cost of care and length of stay in a medical intensive care unit

    NASA Astrophysics Data System (ADS)

    Langlotz, Curtis P.; Kundel, Harold L.; Brikman, Inna; Pratt, Hugh M.; Redfern, Regina O.; Horii, Steven C.; Schwartz, J. Sanford

    1996-05-01

    Our purpose was to determine the economic effects associated with the introduction of PACS and computed radiology (CR) in a medical intensive care unit (MICU). Clinical and financial data were collected over a period of 6 months, both before and after the introduction of PACS/CR in our medical intensive care unit. Administrative claims data resulting from the MICU stay of each patient enrolled in our study were transferred online to our research database from the administrative databases of our hospital and its affiliated clinical practices. These data included all charge entries, sociodemographic data, admissions/discharge/transfer chronologies, ICD9 diagnostic and procedure codes, and diagnostic related groups. APACHE III scores and other case mix adjusters were computed from the diagnostic codes, and from the contemporaneous medical record. Departmental charge to cost ratios and the Medicare Resource-Based Relative Value Scale fee schedule were used to estimate costs from hospital and professional charges. Data were analyzed using both the patient and the exam as the unit of analysis. Univariate analyses by patient show that patients enrolled during the PACS periods were similar to those enrolled during the Film periods in age, sex, APACHE III score, and other measures of case mix. No significant differences in unadjusted median length of stay between the two Film and two PACS periods were detected. Likewise, no significant differences in unadjusted total hospital and professional costs were found between the Film and PACS periods. In our univariate analyses by exam, we focused on the subgroup of exams that had triggered primary clinical actions in any period. Those action-triggering exams were divided into two groups according to whether the referring clinician elected to obtain imaging results from the workstation or from the usual channels. Patients whose imaging results were obtain from the workstation had significantly lower professional costs in the 7 days

  3. Utility-Scale Solar 2014. An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    SciTech Connect

    Bolinger, Mark; Seel, Joachim

    2015-09-01

    Other than the nine Solar Energy Generation Systems (“SEGS”) parabolic trough projects built in the 1980s, virtually no large-scale or “utility-scale” solar projects – defined here to include any groundmounted photovoltaic (“PV”), concentrating photovoltaic (“CPV”), or concentrating solar thermal power (“CSP”) project larger than 5 MWAC – existed in the United States prior to 2007. By 2012 – just five years later – utility-scale had become the largest sector of the overall PV market in the United States, a distinction that was repeated in both 2013 and 2014 and that is expected to continue for at least the next few years. Over this same short period, CSP also experienced a bit of a renaissance in the United States, with a number of large new parabolic trough and power tower systems – some including thermal storage – achieving commercial operation. With this critical mass of new utility-scale projects now online and in some cases having operated for a number of years (generating not only electricity, but also empirical data that can be mined), the rapidly growing utility-scale sector is ripe for analysis. This report, the third edition in an ongoing annual series, meets this need through in-depth, annually updated, data-driven analysis of not just installed project costs or prices – i.e., the traditional realm of solar economics analyses – but also operating costs, capacity factors, and power purchase agreement (“PPA”) prices from a large sample of utility-scale solar projects in the United States. Given its current dominance in the market, utility-scale PV also dominates much of this report, though data from CPV and CSP projects are presented where appropriate.

  4. Trends in Outcome and Hospitalization Cost among Adult Patients with Acute Ischemic Stroke in the United States

    PubMed Central

    Yacoub, Hussam A.; Al-Qudah, Zaid A.; Khan, Hafiz M. R.; Farhad, Khosro; Ji, Andrew Bo-Hua; Souayah, Nizar

    2015-01-01

    Introduction New treatments for acute ischemic stroke (AIS) have been introduced and are expected to improve patients’ overall outcomes. We assessed the impact of new therapeutic strategies on outcome and cost of hospitalization among adult patients with AIS in the United States. Methods Patients with AIS admitted in the United States in 1993–1994 and 2006–2007 were listed using the Nationwide Inpatient Survey database. We determined the rates of occurrence, hospitalization outcomes, and mean hospital charges for all patients. We further analyzed these variables in the ventilated and nonventilated patients. Results We identified 386,043 patients with AIS admitted in the United States in 1993–1994 and 749,766 patients in 2006–2007. The length of hospitalization was significantly higher in 1993–1994 compared with 2006–2007: 6.9 ± 4.2 days versus 4.66 ± 3 days, respectively. In-hospital mortality rate was 8.9% in 1993–1994 and 5.6% in 2006–2007 (P < 0.0001). There was a significant increase in mean hospital charges in 2006–2007 compared with 1993–1994 ($21,916 ± $14,117 versus $9,646 ± $5,727). The length of hospitalization was significantly shorter in 2006–2007 in nonventilated patients. There was a significant increase in mean hospital charges in 2006–2007 compared with 1993–1994 in both ventilated ($81,528 ± $64,526 versus $25,143 ± $17,172, P<0.0001) and nonventilated patients ($21,085 ± $13,042 versus $10,000 ± $6,300, P<0.0001). The mortality rate was significantly lower in 2006–2007 in both subgroups: 46.5% versus 59.8% in ventilated patients and 4.2% versus 8.2% in nonventilated patients (P < 0.0001). Conclusion Our study suggests that new therapeutic strategies have improved outcomes and increased cost of hospitalization among adult patients with AIS in the United States over a period of 13 years. The hospitalization cost was significantly higher in the ventilated and nonventilated patients in 2006–2007, which may

  5. A Module Experimental Process System Development Unit (MEPSDU). [development of low cost solar arrays

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The technical readiness of a cost effective process sequence that has the potential for the production of flat plate photovoltaic modules which met the price goal in 1986 of $.70 or less per Watt peak was demonstrated. The proposed process sequence was reviewed and laboratory verification experiments were conducted. The preliminary process includes the following features: semicrystalline silicon (10 cm by 10 cm) as the silicon input material; spray on dopant diffusion source; Al paste BSF formation; spray on AR coating; electroless Ni plate solder dip metallization; laser scribe edges; K & S tabbing and stringing machine; and laminated EVA modules.

  6. Mapping water availability, projected use and cost in the western United States

    SciTech Connect

    Vincent C. Tidwell; Barbara D. Moreland; Katie M. Zemlick; Barry L. Roberts; Howard D. Passell; Daniel Jensen; Christopher Forsgren; Gerald Sehlke; Margaret A. Cook; Carey W. King

    2014-06-01

    New demands for water can be satisfied through a variety of source options. In some basins surface and/or groundwater may be available through permitting with the state water management agency (termed unappropriated water), alternatively water might be purchased and transferred out of its current use to another (termed appropriated water), or non-traditional water sources can be captured and treated (e.g., wastewater). The relative availability and cost of each source are key factors in the development decision. Unfortunately, these measures are location dependent with no consistent or comparable set of data available for evaluating competing water sources. With the help of western water managers, water availability was mapped for over 1200 watersheds throughout the western US. Five water sources were individually examined, including unappropriated surface water, unappropriated groundwater, appropriated water, municipal wastewater and brackish groundwater. Also mapped was projected change in consumptive water use from 2010 to 2030. Associated costs to acquire, convey and treat the water, as necessary, for each of the five sources were estimated. These metrics were developed to support regional water planning and policy analysis with initial application to electric transmission planning in the western US.

  7. Mapping water availability, projected use and cost in the western United States

    NASA Astrophysics Data System (ADS)

    Tidwell, Vincent C.; Moreland, Barbara D.; Zemlick, Katie M.; Roberts, Barry L.; Passell, Howard D.; Jensen, Daniel; Forsgren, Christopher; Sehlke, Gerald; Cook, Margaret A.; King, Carey W.; Larsen, Sara

    2014-05-01

    New demands for water can be satisfied through a variety of source options. In some basins surface and/or groundwater may be available through permitting with the state water management agency (termed unappropriated water), alternatively water might be purchased and transferred out of its current use to another (termed appropriated water), or non-traditional water sources can be captured and treated (e.g., wastewater). The relative availability and cost of each source are key factors in the development decision. Unfortunately, these measures are location dependent with no consistent or comparable set of data available for evaluating competing water sources. With the help of western water managers, water availability was mapped for over 1200 watersheds throughout the western US. Five water sources were individually examined, including unappropriated surface water, unappropriated groundwater, appropriated water, municipal wastewater and brackish groundwater. Also mapped was projected change in consumptive water use from 2010 to 2030. Associated costs to acquire, convey and treat the water, as necessary, for each of the five sources were estimated. These metrics were developed to support regional water planning and policy analysis with initial application to electric transmission planning in the western US.

  8. Antimicrobial agents’ utilization and cost pattern in an Intensive Care Unit of a Teaching Hospital in South India

    PubMed Central

    Anand, Nikhilesh; Nagendra Nayak, I. M.; Advaitha, M. V.; Thaikattil, Noble J.; Kantanavar, Kiran A.; Anand, Sanjit

    2016-01-01

    Background and Aims: High utilization and inappropriate usage of antimicrobial agents (AMAs) in an Intensive Care Unit (ICU) increases resistant organisms, morbidity, mortality, and treatment cost. Prescription audit and active feedback are a proven method to check the irrational prescription. Measuring drug utilization in DDD/100 bed-days is proposed by the WHO to analyze and compare the utilization of drugs. Data of AMAs utilization are required for planning an antibiotic policy and for follow-up of intervention strategies. Hence, in this study, we proposed to evaluate the utilization pattern and cost analysis of AMA used in the ICU. Methodology: A prospective observational study was conducted for 1 year from January 1, 2014, to December 31, 2014, and the data were obtained from the ICU of a tertiary care hospital. The demographic data, disease data, relevant investigation, the utilization of different classes of AMAs (WHO-ATC classification) as well as individual drugs and their costs were recorded. Results: One thousand eight hundred and sixty-two prescriptions of AMAs were recorded during the study period with an average of 1.73 ± 0.04 prescriptions/patient. About 80.4% patients were prescribed AMAs during admission. Ceftriaxone (22.77%) was the most commonly prescribed AMA followed by piperacillin/tazobactam (15.79%), metronidazole (12%), amoxicillin/clavulanic acid (6.44%), and azithromycin (4.34%). Ceftriaxone, piperacillin/tazobactam, metronidazole, and linezolid were the five maximally utilized AMAs with 38.52, 19.22, 14.34, 8.76, and 8.16 DDD/100 bed-days respectively. An average cost of AMAs used per patient was 2213 Indian rupees (INR). Conclusion: A high utilization of AMAs and a high cost of treatment were noticed which was comparable to other published data, though an increased use of newer AMAs such as linezolid, clindamycin, meropenem, colistin was noticed. PMID:27275075

  9. Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007 - 2012; NREL (National Renewable Energy Laboratory)

    SciTech Connect

    Hand, Maureen

    2015-06-15

    This presentation provides a summary of IEA Wind Task 26 report on Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007-2012

  10. A Low-Cost Energy-Efficient Cableless Geophone Unit for Passive Surface Wave Surveys

    PubMed Central

    Dai, Kaoshan; Li, Xiaofeng; Lu, Chuan; You, Qingyu; Huang, Zhenhua; Wu, H. Felix

    2015-01-01

    The passive surface wave survey is a practical, non-invasive seismic exploration method that has increasingly been used in geotechnical engineering. However, in situ deployment of traditional wired geophones is labor intensive for a dense sensor array. Alternatively, stand-alone seismometers can be used, but they are bulky, heavy, and expensive because they are usually designed for long-term monitoring. To better facilitate field applications of the passive surface wave survey, a low-cost energy-efficient geophone system was developed in this study. The hardware design is presented in this paper. To validate the system’s functionality, both laboratory and field experiments were conducted. The unique feature of this newly-developed cableless geophone system allows for rapid field applications of the passive surface wave survey with dense array measurements. PMID:26404270

  11. A Low-Cost Energy-Efficient Cableless Geophone Unit for Passive Surface Wave Surveys.

    PubMed

    Dai, Kaoshan; Li, Xiaofeng; Lu, Chuan; You, Qingyu; Huang, Zhenhua; Wu, H Felix

    2015-01-01

    The passive surface wave survey is a practical, non-invasive seismic exploration method that has increasingly been used in geotechnical engineering. However, in situ deployment of traditional wired geophones is labor intensive for a dense sensor array. Alternatively, stand-alone seismometers can be used, but they are bulky, heavy, and expensive because they are usually designed for long-term monitoring. To better facilitate field applications of the passive surface wave survey, a low-cost energy-efficient geophone system was developed in this study. The hardware design is presented in this paper. To validate the system's functionality, both laboratory and field experiments were conducted. The unique feature of this newly-developed cableless geophone system allows for rapid field applications of the passive surface wave survey with dense array measurements. PMID:26404270

  12. National- and state-level impact and cost-effectiveness of nonavalent HPV vaccination in the United States.

    PubMed

    Durham, David P; Ndeffo-Mbah, Martial L; Skrip, Laura A; Jones, Forrest K; Bauch, Chris T; Galvani, Alison P

    2016-05-01

    Every year in the United States more than 12,000 women are diagnosed with cervical cancer, a disease principally caused by human papillomavirus (HPV). Bivalent and quadrivalent HPV vaccines protect against 66% of HPV-associated cervical cancers, and a new nonavalent vaccine protects against an additional 15% of cervical cancers. However, vaccination policy varies across states, and migration between states interdependently dilutes state-specific vaccination policies. To quantify the economic and epidemiological impacts of switching to the nonavalent vaccine both for individual states and for the nation as a whole, we developed a model of HPV transmission and cervical cancer incidence that incorporates state-specific demographic dynamics, sexual behavior, and migratory patterns. At the national level, the nonavalent vaccine was shown to be cost-effective compared with the bivalent and quadrivalent vaccines at any coverage despite the greater per-dose cost of the new vaccine. Furthermore, the nonavalent vaccine remains cost-effective with up to an additional 40% coverage of the adolescent population, representing 80% of girls and 62% of boys. We find that expansion of coverage would have the greatest health impact in states with the lowest coverage because of the decreasing marginal returns of herd immunity. Our results show that if policies promoting nonavalent vaccine implementation and expansion of coverage are coordinated across multiple states, all states benefit both in health and in economic terms. PMID:27091978

  13. Building a market for small wind: The break-even turnkey cost of residential wind systems in the United States

    SciTech Connect

    Edwards, Jennifer L.; Wiser, Ryan; Bolinger, Mark; Forsyth, Trudy

    2004-03-01

    Although small wind turbine technology and economics have improved in recent years, the small wind market in the United States continues to be driven in large part by state incentives, such as cash rebates, favorable loan programs, and tax credits. This paper examines the state-by-state economic attractiveness of small residential wind systems. Economic attractiveness is evaluated primarily using the break-even turnkey cost (BTC) of a residential wind system as the figure of merit. The BTC is defined here as the aggregate installed cost of a small wind system that could be supported such that the system owner would break even (and receive a specified return on investment) over the life of the turbine, taking into account current available incentives, the wind resource, and the retail electricity rate offset by on-site generation. Based on the analysis presented in this paper, we conclude that: (1) the economics of residential, grid-connected small wind systems is highly variable by state and wind resource class, (2) significant cost reductions will be necessary to stimulate widespread market acceptance absent significant changes in the level of policy support, and (3) a number of policies could help stimulate the market, but state cash incentives currently have the most significant impact, and will be a critical element of continued growth in this market.

  14. Fuel miles and the blend wall: costs and emissions from ethanol distribution in the United States.

    PubMed

    Strogen, Bret; Horvath, Arpad; McKone, Thomas E

    2012-05-15

    From 1991 to 2009, U.S. production of ethanol increased 10-fold, largely due to government programs motivated by climate change, energy security, and economic development goals. As low-level ethanol-gasoline blends have not consistently outperformed ethanol-free gasoline in vehicle performance or tailpipe emissions, national-level economic and environmental goals could be accomplished more efficiently by concentrating consumption of gasoline containing 10% ethanol (i.e., E10) near producers to minimize freight activity. As the domestic transportation of ethanol increased 10-fold in metric ton-kilometers (t-km) from 2000 to 2009, the portion of t-km potentially justified by the E10 blend wall increased from less than 40% to 80%. However, we estimate 10 billion t-km took place annually from 2004 to 2009 for reasons other than the blend wall. This "unnecessary" transportation resulted in more than $240 million in freight costs, 90 million L of diesel consumption, 300,000 metric tons of CO(2)-e emissions, and 440 g of human intake of PM(2.5). By 2009, the marginal savings from enabling Iowa to surpass E10 would have exceeded 2.5 g CO(2)-e/MJ and $0.12/gallon of ethanol, as the next-closest customer was 1600 km away. The use of a national network model enables estimation of marginal transportation impacts from subnational policies, and benefits from policies encouraging concentrated consumption of renewable fuels. PMID:22506875

  15. Development of a cost-effective torsional unit for rodent long bone assessment.

    PubMed

    Saunders, M M; Burger, R B; Kalantari, B; Nichols, A D; Witman, C

    2010-09-01

    Thorough mechanical testing of rodent bones requires an understanding of bone behavior in a variety of loading modes including tension, compression, bending and shear. While these tests are easily conducted with single axis mechanical testing machines, it may also be desirable to determine torsional properties of bone. Although higher-end materials testing machines will enable torsional and/or rotational testing, simpler, less expensive systems rarely offer these capabilities. In this work, we illustrate the development of a torsional system that uses a simple rack and pinion concept to deliver a rotary motion to bones given the linear motion of a testing machine. As the bone field becomes increasingly interdisciplinary, more biologists and non-test engineers need cost-effective mechanical testing capabilities and the torsional system described here has proven to be more than adequate for standard biomechanical testing requirements. Furthermore, given the small-scale size of rodent long bones, a series of potting/testing fixtures were developed that enabled preparation and handling of the specimens without incurring damage to the bone shafts. Once fabricated the system was used to destructively load mice humeri and femurs and quantify torsional properties. PMID:20554468

  16. Food costs, diet quality and energy balance in the United States.

    PubMed

    Carlson, Andrea; Frazão, Elizabeth

    2014-07-01

    The high obesity rates and poor diet quality in the United States, particularly among low income populations, are often attributed to low income, low food access, and high food prices of healthy foods. This paper discusses these associations and questions some of the metrics used to measure food prices. The paper argues that 1. On average, Americans consume diets that need improvement and there is only a very limited relationship between income and diet quality; 2. The way the food price is measured makes a difference in the perception of how expensive healthy and less healthy food is; 3. The way Americans allocate their food budgets between healthy and less healthy foods is not in line with healthy diets; and 4. At any food spending level there are households that purchase healthy (and unhealthy) diets, including budgets at or below the maximum allotment for the Supplemental Nutrition Assistance Program (SNAP) which provides a means for low-income households to purchase food. Our key finding is that healthy foods and diets are affordable, but policy makers, nutrition educators, researchers and the media need to focus on promoting this message, and providing additional guidance on making the changes for Americans to switch to a healthy and affordable diet. PMID:24631301

  17. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  18. Value-based cost sharing in the United States and elsewhere can increase patients' use of high-value goods and services.

    PubMed

    Thomson, Sarah; Schang, Laura; Chernew, Michael E

    2013-04-01

    This article reviews efforts in the United States and several other member countries of the Organization for Economic Cooperation and Development to encourage patients, through cost sharing, to use goods such as medications, services, and providers that offer better value than other options--an approach known as value-based cost sharing. Among the countries we reviewed, we found that value-based approaches were most commonly applied to drug cost sharing. A few countries, including the United States, employed financial incentives, such as lower copayments, to encourage use of preferred providers or preventive services. Evidence suggests that these efforts can increase patients' use of high-value services--although they may also be associated with high administrative costs and could exacerbate health inequalities among various groups. With careful design, implementation, and evaluation, value-based cost sharing can be an important tool for aligning patient and provider incentives to pursue high-value care. PMID:23569050

  19. Vaccination benefits and cost-sharing policy for non-institutionalized adult Medicaid enrollees in the United States

    PubMed Central

    Stewart, Alexandra M.; Lindley, Megan C.; Chang, Kristen H.M.; Cox, Marisa A.

    2015-01-01

    Medicaid is the largest funding source of health services for the poorest people in the United States. Medicaid enrollees have greater health care, needs, and higher health risks than other individuals in the country and, experience disproportionately low rates of preventive care. Without, Medicaid coverage, poor uninsured adults may not be vaccinated or would, rely on publicly-funded programs that provide vaccinations. We examined each programs’ policies related to benefit coverage and, copayments for adult enrollees. Our study was completed between October 2011 and September 2012 using a document review and a survey of Medicaid administrators that assessed coverage and cost-sharing policy for fee-for-service programs. Results were compared to a similar review, conducted in 2003. Over the past 10 years, Medicaid programs have typically maintained or expanded vaccination coverage benefits for adults and nearly half have explicitly prohibited copayments. The 17 programs that cover all recommended vaccines while prohibiting, copayments demonstrate a commitment to providing increased access to vaccinations for adult enrollees. When developing responses to fiscal and political challenges, the programs that do not cover all ACIP recommended adult vaccines or those that permit copayments for vaccinations, should consider all strategies to increase vaccinations and reduce costs to enrollees. PMID:24291539

  20. Cost and appropriateness of treating asthma with fixed-combination drugs in local health care units in Italy

    PubMed Central

    Ruggeri, Isabella; Bragato, Donatello; Colombo, Giorgio L; Valla, Emanuela; Di Matteo, Sergio

    2012-01-01

    Background Bronchial asthma is a chronic airways disease and is considered to be one of the major health problems in the Western world. During the last decade, a significant increase in the use of β2-agonists in combination with inhaled corticosteroids has been observed. The aim of this study was to assess the appropriateness of expenditure on these agents in an asthmatic population treated in a real practice setting. Methods This study used data for a resident population of 635,906 citizens in the integrated patient database (Banca Dati Assistito) of a local health care unit (Milano 2 Azienda Sanitaria Locale) in the Lombardy region over 3 years (2007–2009). The sample included 3787–4808 patients selected from all citizens aged ≥ 18 years entitled to social security benefits, having a prescription for a corticosteroid + β2-agonist combination, and an ATC code corresponding to R03AK, divided into three groups, ie, pressurized (spray) drugs, inhaled powders, and extrafine formulations. Patients with chronic obstructive lung disease were excluded. Indicators of appropriateness were 1–3 packs per year (underdosed, inappropriate), 4–12 packs per year (presumably appropriate), and ≥13 packs per year (overtreatment, inappropriate). Results The corticosteroid + β2-agonist combination per treated asthmatic patient increased from 37% in 2007 to 45% in 2009 for the total of prescribed antiasthma drugs, and 28%–32% of patients used the drugs in an appropriate manner (4–12 packs per years). The cost of inappropriately used packs increased combination drug expenditure by about 40%, leading to inefficient use of health care resources. This trend improved during the 3-year observation period. The mean annual cost per patient was higher for powders (€223.95) and sprays (€224.83) than for extrafine formulation (€142.71). Conclusion Based on this analysis, we suggest implementation of better health care planning and more appropriate prescription practices

  1. Educational Costs.

    ERIC Educational Resources Information Center

    Arnold, Robert

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

  2. A population dynamic approach to evaluating the impact of school attendance on the unit cost and effectiveness of school-based schistosomiasis chemotherapy programmes.

    PubMed

    Carabin, H; Chan, M S; Guyatt, H L

    2000-08-01

    This paper presents a first attempt at modelling the possible cost and effectiveness of reaching non-enrolled children through school-based programmes using empirical data from Egypt. A sex/school-attendance/age-structured population dynamic model was used to predict trends in infection and early disease. Four treatment delivery strategies were compared: school-based (coverage of 85 %) and school-aged targeted (coverage of 25, 50 and 85 %). The school-aged targeted strategies also included the school-based programme. For each alternative strategy, the maximum unit cost was calculated to obtain a cost-effectiveness ratio equal or smaller to the one obtained with the school-based programme (unit cost of US$ 0.60). The analysis showed that, for S. mansoni in Lower Egypt, a programme where only 85% of children attending school were treated would still prevent 77 % of the early disease cases prevented with a programme where 85 % of all school-age children were treated. However, using the school-aged targeted strategy, from US $ 0.06 to US $ 1.03 extra unit costs could be spent to reach non-enrolled children and still be more cost-effective. Treating non-enrolled children is an important consideration in maximizing the effectiveness of treatment programmes while maintaining a cost-effectiveness comparable to school-based delivery. PMID:11085237

  3. Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

    PubMed Central

    Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

    2014-01-01

    Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

  4. Joint U.S./Russian Study on the Development of a Preliminary Cost Estimate of the SAFSTOR Decommissioning Alternative for the Leningrad Nuclear Power Plant Unit #1

    SciTech Connect

    SM Garrett

    1998-09-28

    The objectives of the two joint Russian/U.S. Leningrad Nuclear Power Plant (NPP) Unit #1 studies were the development of a safe, technically feasible, economically acceptable decom missioning strategy, and the preliminary cost evaluation of the developed strategy. The first study, resulting in the decommissioning strategy, was performed in 1996 and 1997. The preliminary cost estimation study, described in this report, was performed in 1997 and 1998. The decommissioning strategy study included the analyses of three basic RBM.K decommission- ing alternatives, refined for the Leningrad NPP Unit #1. The analyses included analysis of the requirements for the planning and preparation as well as the decommissioning phases.

  5. Costs and prices of single dental fillings in Europe: a micro-costing study.

    PubMed

    Tan, Siok Swan; Ken Redekop, W; Rutten, Frans F H

    2008-01-01

    Dental fillings represent an established procedure to treat tooth decay. The present paper provides a cost comparison of dental filling procedures across nine European countries. More specifically, the paper aims to estimate the costs and prices (i.e. reimbursement fees) of a single dental filling procedure in an approximately 12-year-old child with a toothache in a lower molar who presents at a dental practice, as described in a case vignette. Both amalgam and composite fillings were examined. Total costs were determined by identifying resource use and unit costs for the following cost components: diagnostic procedures, labour, materials, drugs, and overheads. Altogether, 49 practices provided data for the cost calculations. Mean total costs per country varied considerably, ranging from 8 euros to 156 euros. Labour costs were the most important cost driver in all practices, comprising 58% of total costs. Overhead costs were the second-most important cost component in the majority of countries. Actual cost differences across practices within countries were relatively small. Cost variations between countries were primarily due to differences in unit costs, especially for labour and overheads, and only to a lesser extent to differences in resource use. Finally, cost estimates for a single dental filling procedure based on reimbursement fees led to an underestimation of the total costs by approximately 50%. PMID:18186032

  6. Tracking the Sun IV: An Historical Summary of the Installed Cost of Photovoltaics in the United States from 1998 to 2010

    SciTech Connect

    Darghouth, Naim; Wiser, Ryan

    2011-09-07

    The present report describes installed cost trends for grid-connected PV projects installed from 1998 through 2010 (with some limited and preliminary results presented for projects installed in the first six months of 2011). The analysis is based on project-level cost data from approximately 116,500 residential, non-residential, and utility-sector PV systems in the United States. The inclusion of utility-sector PV is a new element in this year’s report. The combined capacity of all systems in the data sample totals 1,685 MW, equal to 79% of all grid-connected PV capacity installed in the United States through 2010 and representing one of the most comprehensive sources of installed PV cost data for the U.S. Based on this dataset, the report describes historical installed cost trends over time, and by location, market segment, technology type, and component. The report also briefly compares recent PV installed costs in the United States to those in Germany and Japan, and describes trends in customer incentives for PV installations and net installed costs after receipt of such incentives. The analysis presented here focuses on descriptive trends in the underlying data, serving primarily to summarize the data in tabular and graphical form.

  7. Operating cost model for local service airlines

    NASA Technical Reports Server (NTRS)

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

    1976-01-01

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

  8. IEA Wind Task 26. Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007–2012

    SciTech Connect

    Vitina, Aisma; Lüers, Silke; Wallasch, Anna-Kathrin; Berkhout, Volker; Duffy, Aidan; Cleary, Brendan; Husabø, Lief I.; Weir, David E.; Lacal-Arántegui, Roberto; Hand, Maureen; Lantz, Eric; Belyeu, Kathy; Wiser, Ryan H; Bolinger, Mark; Hoen, Ben

    2015-06-01

    The International Energy Agency Implementing Agreement for cooperation in Research, Development, and Deployment of Wind Energy Systems (IEA Wind) Task 26—The Cost of Wind Energy represents an international collaboration dedicated to exploring past, present and future cost of wind energy. This report provides an overview of recent trends in wind plant technology, cost, and performance in those countries that are currently represented by participating organizations in IEA Wind Task 26: Denmark, Germany, Ireland, Norway, and the United States as well as the European Union.

  9. Gebrauchstexte im Fremdsprachenunterricht ("Actual" Texts in Foreign Language Teaching)

    ERIC Educational Resources Information Center

    Ziegesar, Detlef von

    1976-01-01

    Presents for analysis actual texts and texts specially written for teaching, arriving at a basis for a typology of actual texts. Defines teaching aims using such texts, and develops, from a TV program, a teaching unit used in a Karlsruhe school. (Text is in German.) (IFS/WGA)

  10. Cost-effectiveness of levonorgestrel subdermal implants. Comparison with other contraceptive methods available in the United States.

    PubMed

    Ashraf, T; Arnold, S B; Maxfield, M

    1994-10-01

    The objective of this analysis was to evaluate and compare the cost-effectiveness of eight contraceptive methods: condoms, diaphragms, oral contraceptives, intrauterine devices, medroxyprogesterone acetate suspension, levonorgestrel subdermal implants, tubal ligation and vasectomy. Based on a comprehensive review of the literature and various additional data sources, this analysis identified, measured and compared direct costs of the methods, physician visits, treatment of adverse effects and cost of failure (i.e., mean cost for all types of deliveries or first-trimester abortion). Medical benefits (if any) resulting from each contraceptive method were calculated and considered in the analysis as cost savings. The cost of method failure proved to be the greatest influence on cost-effectiveness. Sterilization was identified as the most cost-effective method overall. Of the reversible methods, the intrauterine device was found to be the most cost-effective, followed by levonorgestrel implants. PMID:7837126

  11. Further Validation of the Psychosocial Costs of Racism to Whites Scale on a Sample of University Students in the Southeastern United States

    ERIC Educational Resources Information Center

    Sifford, Amy; Ng, Kok-Mun; Wang, Chuang

    2009-01-01

    We examined the factor structure of the Psychosocial Costs of Racism to Whites Scale (PCRW; Spanierman & Heppner, 2004) on 766 White American university students from the southeastern United States. Results from confirmatory factor analyses supported the 3-factor model proposed by Spanierman and Heppner (2004). The construct validity of the PCRW…

  12. United States Air Force 611th Civil Engineer Squadron, Elmendorf, AFB, Alaska. Final engineering evaluation/cost analysis, million gallon hill source area of the West Unit, Galena Airport, Alaska

    SciTech Connect

    1996-02-05

    This decision document presents the selected removal action for the Million Gallon Hill source area of the Installation Restoration Program (IRP) site ST009, otherwise known as the West Unit at Galena Airport, Alaska. The information from the RI Report is summarized, along with an analysis of potential removal action alternatives in the Engineering Evaluation/Cost Analysis (EE/CA).

  13. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  14. The Economic Costs of Progressive Supranuclear Palsy and Multiple System Atrophy in France, Germany and the United Kingdom

    PubMed Central

    McCrone, Paul; Payan, Christine Anne Mary; Knapp, Martin; Ludolph, Albert; Agid, Yves; Leigh, P. Nigel; Bensimon, Gilbert

    2011-01-01

    Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are progressive disabling neurological conditions usually fatal within 10 years of onset. Little is known about the economic costs of these conditions. This paper reports service use and costs from France, Germany and the UK and identifies patient characteristics that are associated with cost. 767 patients were recruited, and 760 included in the study, from 44 centres as part of the NNIPPS trial. Service use during the previous six months was measured at entry to the study and costs calculated. Mean six-month costs were calculated for 742 patients. Data on patient sociodemographic and clinical characteristics were recorded and used in regression models to identify predictors of service costs and unpaid care costs (i.e., care from family and friends). The mean six-month service costs of PSP were €24,491 in France, €30,643 in Germany and €25,655 in the UK. The costs for MSA were €28,924, €25,645 and €19,103 respectively. Unpaid care accounted for 68–76%. Formal and unpaid costs were significantly higher the more severe the illness, as indicated by the Parkinson's Plus Symptom scale. There was a significant inverse relationship between service and unpaid care costs. PMID:21931694

  15. The economic costs of progressive supranuclear palsy and multiple system atrophy in France, Germany and the United Kingdom.

    PubMed

    McCrone, Paul; Payan, Christine Anne Mary; Knapp, Martin; Ludolph, Albert; Agid, Yves; Leigh, P Nigel; Bensimon, Gilbert

    2011-01-01

    Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are progressive disabling neurological conditions usually fatal within 10 years of onset. Little is known about the economic costs of these conditions. This paper reports service use and costs from France, Germany and the UK and identifies patient characteristics that are associated with cost. 767 patients were recruited, and 760 included in the study, from 44 centres as part of the NNIPPS trial. Service use during the previous six months was measured at entry to the study and costs calculated. Mean six-month costs were calculated for 742 patients. Data on patient sociodemographic and clinical characteristics were recorded and used in regression models to identify predictors of service costs and unpaid care costs (i.e., care from family and friends). The mean six-month service costs of PSP were €24,491 in France, €30,643 in Germany and €25,655 in the UK. The costs for MSA were €28,924, €25,645 and €19,103 respectively. Unpaid care accounted for 68-76%. Formal and unpaid costs were significantly higher the more severe the illness, as indicated by the Parkinson's Plus Symptom scale. There was a significant inverse relationship between service and unpaid care costs. PMID:21931694

  16. Hospital costs associated with atrial fibrillation for ischemic stroke patients aged 18-64 years in the United States

    PubMed Central

    Wang, Guijing; Joo, Heesoo; Tong, Xin; George, Mary G.

    2015-01-01

    Background and purpose Hospital costs associated with atrial fibrillation (AFib) among stroke patients have not been well-studied, especially among people younger than 65 years. We estimated the AFib-associated hospital costs in U.S. patients aged 18-64 years. Methods We identified hospital admissions with a primary diagnosis of ischemic stroke from the 2010-2012 MarketScan Commercial Claims and Encounters inpatient datasets, excluding those with capitated health insurance plans, aged <18 or >64, missing geographic region, hospital costs below the 1st or above 99th percentile, and having carotid intervention (N=40,082). We searched the data for AFib and analyzed the costs for non-repeat and repeat stroke admissions separately. We estimated the AFib-associated costs using multivariate regression models controlling for age, sex, geographic region, and Charlson comorbidity index. Results Of the 33,500 non-repeat stroke admissions, 2,407 (7.2%) had AFib. Admissions with AFib cost $4,991 more than those without AFib ($23,770 vs. $18,779). For the 6,582 repeat stroke admissions, 397 (6.0%) had AFib. The costs were $3,260 more for those with AFib than those without ($24,119 vs. $20,929). After controlling for potential confounders, AFib-associated costs for non-repeat stroke admissions were $4,905, representing 20.6% of the total costs for the admissions. Both the hospital costs and the AFib-associated costs were associated with age, but not sex. AFib-associated costs for repeat stroke admissions were not significantly higher than for non-AFib patients, except for those aged 55-64 ($3,537). Conclusions AFib increased the hospital cost of ischemic stroke substantially. Further investigation on AFib-associated costs for repeat stroke admissions is needed. PMID:25851767

  17. Whiteheadian Actual Entitities and String Theory

    NASA Astrophysics Data System (ADS)

    Bracken, Joseph A.

    2012-06-01

    In the philosophy of Alfred North Whitehead, the ultimate units of reality are actual entities, momentary self-constituting subjects of experience which are too small to be sensibly perceived. Their combination into "societies" with a "common element of form" produces the organisms and inanimate things of ordinary sense experience. According to the proponents of string theory, tiny vibrating strings are the ultimate constituents of physical reality which in harmonious combination yield perceptible entities at the macroscopic level of physical reality. Given that the number of Whiteheadian actual entities and of individual strings within string theory are beyond reckoning at any given moment, could they be two ways to describe the same non-verifiable foundational reality? For example, if one could establish that the "superject" or objective pattern of self- constitution of an actual entity vibrates at a specific frequency, its affinity with the individual strings of string theory would be striking. Likewise, if one were to claim that the size and complexity of Whiteheadian 'societies" require different space-time parameters for the dynamic interrelationship of constituent actual entities, would that at least partially account for the assumption of 10 or even 26 instead of just 3 dimensions within string theory? The overall conclusion of this article is that, if a suitably revised understanding of Whiteheadian metaphysics were seen as compatible with the philosophical implications of string theory, their combination into a single world view would strengthen the plausibility of both schemes taken separately. Key words: actual entities, subject/superjects, vibrating strings, structured fields of activity, multi-dimensional physical reality.

  18. IEA Wind Task 26. Wind Technology, Cost and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States. 2007 - 2012

    SciTech Connect

    Vitina, Aisma; Luers, Silke; Wallasch, Anna-Kathrin; Berkhout, Volker; Duffy, Aidan; Cleary, Brendan; Husabo, Leif I.; Weir, David E.; Lacal-Arantegui, Roberto; Hand, M. Maureen; Lantz, Eric; Belyeu, Kathy; Wiser, Ryan; Bolinger, Mark; Hoen, Ben

    2015-06-12

    This report builds from a similar previous analysis (Schwabe et al., 2011) exploring the differences in cost of wind energy in 2008 among countries participating in IEA Wind Task 26 at that time. The levelized cost of energy (LCOE) is a widely recognized metric for understanding how technology, capital investment, operations, and financing impact the life-cycle cost of building and operating a wind plant. Schwabe et al. (2011) apply a spreadsheet-based cash flow model developed by the Energy Research Centre of the Netherlands (ECN) to estimate LCOE. This model is a detailed, discounted cash flow model used to represent the various cost structures in each of the participating countries from the perspective of a financial investor in a domestic wind energy project. This model is used for the present analysis as well, and comparisons are made for those countries who contributed to both reports, Denmark, Germany, and the United States.

  19. An economic model demonstrating the long-term cost benefits of incorporating fertility control into wild horse (Equus caballus) management programs on public lands in the United States.

    PubMed

    de Seve, Charles W; Griffin, Stephanie L Boyles

    2013-12-01

    In recent years, the Bureau of Land Management's (BLM) Wild Horse and Burro Management program costs have increased dramatically due to a rise in the number of animals removed from public lands coupled with significantly decreased adoption rates. To assist with development and implementation of effective, cost-containing management programs, a robust economic model to project the costs and optimize outcomes of various management scenarios was created. For example, preliminary demonstration model runs show that by gradually replacing "removal-only" programs with contraception-and-removal programs on one hypothetical Herd Management Area (HMA), the BLM could save about US$8 million over 12 years while maintaining an area target population of 874 horses. Because the BLM estimates that more than 38,000 wild horses roam on 179 HMAs in the United States, the use of this economic model could result in a cost-savings of tens of millions of dollars if applied broadly across all HMAs. PMID:24437083

  20. Residential, Commercial, and Utility-Scale Photovoltaic (PV) System Prices in the United States: Current Drivers and Cost-Reduction Opportunities

    SciTech Connect

    Goodrich, A.; James, T.; Woodhouse, M.

    2012-02-01

    The price of photovoltaic (PV) systems in the United States (i.e., the cost to the system owner) has dropped precipitously in recent years, led by substantial reductions in global PV module prices. However, system cost reductions are not necessarily realized or realized in a timely manner by many customers. Many reasons exist for the apparent disconnects between installation costs, component prices, and system prices; most notable is the impact of fair market value considerations on system prices. To guide policy and research and development strategy decisions, it is necessary to develop a granular perspective on the factors that underlie PV system prices and to eliminate subjective pricing parameters. This report's analysis of the overnight capital costs (cash purchase) paid for PV systems attempts to establish an objective methodology that most closely approximates the book value of PV system assets.

  1. Light-rail-transit capital-cost study

    SciTech Connect

    Schneck, D.C.; Amodei, R.M.; Ferreri, M.G.

    1991-04-05

    The Fixed Guideway Capital Cost Study is an attempt to develop a capital cost data base of actual unit costs to construct and procure the various assets necessary to operate mass transit busway and rail systems. The report documents the initial effort at the overall objective by concentrating on the light rail mode of passenger rail systems. The term light rail refers more to the mode's relative simplicity and operational flexibility rather than actual vehicle weight or cost. With an overhead power supply source, light rail systems can operate in mixed traffic and various alignment configurations. Service can be operated in single or multi-unit trains of standards and articulated vehicle fleets that permit close service level design in line with passenger demand. Seven light rail systems that were developed over the past ten years, were the focus of the project. However, only five of the system operating agencies responded with pertinent capital cost information that formed the basis of the study.

  2. Cost-Benefit Analysis of Nanoparticle Albumin-Bound Paclitaxel versus Solvent-Based Paclitaxel for the Treatment of Metastatic Breast Cancer in the United States

    NASA Astrophysics Data System (ADS)

    Vichansavakul, Kittaya

    had some limitations because they were conducted from a narrow perspective such as payer and provider point of views. The studies also considered only direct costs in their analysis. In fact, conducting economic evaluations from a narrow perspective and leaving out indirect costs might undermine the true benefit of the interventions for society. A cost-benefit analysis measures all costs and benefits in monetary units. It incorporates both health outcomes gained from individuals and the value gained to society in order to maximize the usage of resources effectively. This thesis conducted a cost-benefit analysis to compare nab-paclitaxel and generic paclitaxel in treating metastatic breast cancer from a societal perspective in the United States. The results showed that nab-paclitaxel is a cost-benefit strategy regardless of the different costs and benefits due to the extra 3 years of living it provides. In all models, when nab-paclitaxel was compared to generic paclitaxel, nab-paclitaxel showed cost-benefit to society. However, the results of generic paclitaxel were dependent on the total medical costs. Performing a cost-benefit analysis of nab-paclitaxel from a societal perspective is important to understand the true benefit of interventions. Furthermore, considering both direct and indirect costs, as well as benefits, of this drug is vital because the economic profile of nab-paclitaxel would be improved.

  3. NREL Analysis: Cost-Effective and Reliable Integration of High-Penetration Solar in the Western United States (Poster)

    SciTech Connect

    Lew, D.; Brinkman, G.; Ibanez, E.; Hodge, B.; Lefton, S.; Kumar, N.; Agan, D.; Jordan, G.; Venkatataman, S.

    2012-07-01

    SunShot Initiative awardee posters describing the different technologies within the four subprograms of the DOE Solar Program (Photovoltaics, Concentrating Solar Power, Soft Costs, and Systems Integration).

  4. First- and Second-Line Bevacizumab in Addition to Chemotherapy for Metastatic Colorectal Cancer: A United States–Based Cost-Effectiveness Analysis

    PubMed Central

    Goldstein, Daniel A.; Chen, Qiushi; Ayer, Turgay; Howard, David H.; Lipscomb, Joseph; El-Rayes, Bassel F.; Flowers, Christopher R.

    2015-01-01

    Purpose The addition of bevacizumab to fluorouracil-based chemotherapy is a standard of care for previously untreated metastatic colorectal cancer. Continuation of bevacizumab beyond progression is an accepted standard of care based on a 1.4-month increase in median overall survival observed in a randomized trial. No United States–based cost-effectiveness modeling analyses are currently available addressing the use of bevacizumab in metastatic colorectal cancer. Our objective was to determine the cost effectiveness of bevacizumab in the first-line setting and when continued beyond progression from the perspective of US payers. Methods We developed two Markov models to compare the cost and effectiveness of fluorouracil, leucovorin, and oxaliplatin with or without bevacizumab in the first-line treatment and subsequent fluorouracil, leucovorin, and irinotecan with or without bevacizumab in the second-line treatment of metastatic colorectal cancer. Model robustness was addressed by univariable and probabilistic sensitivity analyses. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Results Using bevacizumab in first-line therapy provided an additional 0.10 QALYs (0.14 life-years) at a cost of $59,361. The incremental cost-effectiveness ratio was $571,240 per QALY. Continuing bevacizumab beyond progression provided an additional 0.11 QALYs (0.16 life-years) at a cost of $39,209. The incremental cost-effectiveness ratio was $364,083 per QALY. In univariable sensitivity analyses, the variables with the greatest influence on the incremental cost-effectiveness ratio were bevacizumab cost, overall survival, and utility. Conclusion Bevacizumab provides minimal incremental benefit at high incremental cost per QALY in both the first- and second-line settings of metastatic colorectal cancer treatment. PMID:25691669

  5. Using lysimeters to test the Penman Monteith actual evapotranspiration.

    NASA Astrophysics Data System (ADS)

    Ben Asher, Jiftah; Volinski, Roman; Zilberman, Arkadi; Bar Yosef, Beni; Silber, Avner

    2015-04-01

    Differences in actual transpiration (ETa) of banana plants were quantified in a lysimeter experiment. ETA was computed using instantaneous data from two weighing lysimeters and compared to PM (Penman-Monteith) model for ETa. Two critical problems were faced in this test. A) Estimating canopy and aerodynamic resistances ("rc" and "ra" respectively ) and B) converting the lysimeter changes in water volume ( LYv cm3 ) to ETa length units ( cm ). The two unknowns " rc" and "ra" were obtained from continuous measurements of the differences between canopy and air temperature (Tc - Ta). This difference was established by means of the infrared thermometry which was followed by numerical and analytical calculation of ETa using the modification suggested by R. Jackson to the PM model. The conversion of lysimeter volumetric units (LYv) to ETa length units was derived from the slope of cumulative LYv/ETa. This relationship was significantly linear (r2=0.97and 0.98.). Its slope was interpreted as "evaporating leaf area" which accounted for 1.8E4 cm2 in lysimeter 1 and 2.3E4 cm2.in lysimeter 2 . The comparison between LYv and PM model was acceptable even under very low ETa. The average of two lysimeters was 1.1mm/day (1.4 mm/day , LYv 1 and 0.8 LYv 2) while ETa calculated on the basis of PM model was 1.2 mm/day. It was concluded that although lysimeters are most accurate systems to measure ETa one of its disadvantages ( beside the high cost) is the volumetric output that in many cases should be supported by a one dimensional energy balance system. The PM model was found to be a reliable complementary tool to convert lysimeters volumetric output into conventional length units of ETa.

  6. A Cost-Effectiveness Analysis of First Trimester Non-Invasive Prenatal Screening for Fetal Trisomies in the United States

    PubMed Central

    Walker, Brandon S.; Nelson, Richard E.; Jackson, Brian R.; Grenache, David G.; Ashwood, Edward R.; Schmidt, Robert L.

    2015-01-01

    Background Non-invasive prenatal testing (NIPT) is a relatively new technology for diagnosis of fetal aneuploidies. NIPT is more accurate than conventional maternal serum screening (MSS) but is also more costly. Contingent NIPT may provide a cost-effective alternative to universal NIPT screening. Contingent screening used a two-stage process in which risk is assessed by MSS in the first stage and, based on a risk cutoff, high-risk pregnancies are referred for NIPT. The objective of this study was to (1) determine the optimum MSS risk cutoff for contingent NIPT and (2) compare the cost effectiveness of optimized contingent NIPT to universal NIPT and conventional MSS. Study Design Decision-analytic model using micro-simulation and probabilistic sensitivity analysis. We evaluated cost effectiveness from three perspectives: societal, governmental, and payer. Results From a societal perspective, universal NIPT dominated both contingent NIPT and MSS. From a government and payer perspective, contingent NIPT dominated MSS. Compared to contingent NIPT, adopting a universal NIPT would cost $203,088 for each additional case detected from a government perspective and $263,922 for each additional case detected from a payer perspective. Conclusions From a societal perspective, universal NIPT is a cost-effective alternative to MSS and contingent NIPT. When viewed from narrower perspectives, contingent NIPT is less costly than universal NIPT and provides a cost-effective alternative to MSS. PMID:26133556

  7. Highway crash costs in the United States by driver age, blood alcohol level, victim age, and restraint use.

    PubMed

    Miller, T R; Lestina, D C; Spicer, R S

    1998-03-01

    This paper estimates 1993 U.S. highway crash incidence and costs by driver age, alcohol use, victim age, occupant status, and restraint use. Notable findings are: (1) crash costs of novice drivers are high enough to yield preliminary benefit-cost ratios around 4-8 for a provisional licensing system that restricts driving after midnight and 11 for zero alcohol tolerance for young drivers with violators receiving a 6-month suspension; (2) the costs to people other than the intoxicated driver per mile driven at BACs of 0.08-0.099% exceed the value of driver mobility; (3) the safety costs of drunk driving appear to exceed $5.80 per mile, compared with $2.50 per mile driven at BACs of 0.08-0.099%, and $0.11 per mile driven sober; (4) highway crashes cause an estimated 3.2% of U.S. medical spending, including more than 14% of medical spending for ages 15-24; (5) ignoring crash-involved occupants whose restraint use is unknown, the 13% of occupants who police reported were traveling unrestrained accounted for an estimated 42% of the crash costs; and (6) if these unrestrained occupants buckled up, the medical costs of crashes would decline by an estimated 18% (almost $4 billion annually) and the comprehensive costs by 24%. PMID:9450118

  8. School-to-Work Programs in the United States: A Multi-Firm Case Study of Training, Benefits, and Costs.

    ERIC Educational Resources Information Center

    Bassi, Laurie J.; Ludwig, Jens

    2000-01-01

    Case studies of seven school-to-work programs sponsored by diverse businesses showed that firms paid at least some training costs, only partially recouped by hiring former apprentices. Although the imperfections of the U.S. labor market motivate company participation and financing of training, long-term benefits do not seem to outweigh costs. (SK)

  9. Relation between diet cost and Healthy Eating Index 2010 scores among adults in the United States 2007-2010

    PubMed Central

    Rehm, Colin D.; Monsivais, Pablo; Drewnowski, Adam

    2016-01-01

    Background Food prices may be one reason for the growing socioeconomic disparities in diet quality. Objective To evaluate the association between diet costs and the Healthy Eating Index-2010 (HEI-2010). Methods Cross-sectional study based on 11,181 adults from the 2007-2010 National Health and Nutrition Examination Survey, analyzed in spring 2014. Diet cost was estimated by linking dietary data with a national food price database. The HEI-2010, a measure of adherence to the Dietary Guidelines, was the outcome. The population ratio method was used to estimate the average HEI-2010 scores by quintile of energy-adjusted diet cost. Additional analyses evaluated the association between cost and HEI-2010 components. Results There was a strong positive association between lower energy-adjusted diet costs and lower HEI-2010 scores. The association was stronger among women (p-interaction=0.003). Lower diet costs were associated with lower consumption of vegetables, fruit, whole grains, and seafood, and higher consumption of refined grains and solid fat, alcohol and added sugars. Conclusions Lower energy-adjusted diet costs were associated with lower-quality diets. Future efforts to improve the nutritional status of the US public should take food prices and diet costs into account. PMID:25625693

  10. Coal unit trains: operations, maintenance, and technology. Volume 4. Costs and benefits of aluminum coal cars. Final report

    SciTech Connect

    Boghani, A.B.

    1984-11-01

    This report examines the costs and benefits to a utility of acquiring aluminum coal cars. After discussing the history of aluminum car production, the report describes in detail the characteristics of several aluminum cars now in use, and the experience of railroads and utilities with them. The effects of acquiring aluminum cars instead of steel cars on the fuel cost, crew cost, maintenance-of-way cost, and car costs (capital and maintenance) are discussed. An illustrative example is given, in which the internal rate of return (IRR) and payback period of the extra investment made to acquire aluminum cars are calculated. A parametric analysis is performed to determine the sensitivity of IRR and payback period to the freight-rate discount for the aluminum car, the inflation rate, the purchase price of aluminum and steel cars, their maintenance costs, bad order ratios, car lives, salvage values, trip length, and car utilization. The study concludes that the aluminum cars can be an excellent investment, provided a reasonable freight-rate discount is obtained. The first cost of an aluminum car compared to that of a steel car, its estimated downtime, its estimated maintenance cost, and the anticipated degree of its utilization are also shown to significantly affect the attractiveness of the extra investment. In addition, the study reveals that some aluminum cars have proved more durable in service than others. Thus, the importance of a thorough evaluation of the design of the aluminum cars being offered is demonstrated. 11 references, 15 figures, 8 tables.

  11. The Social Cost of Trading: Measuring the Increased Damages from Sulfur Dioxide Trading in the United States

    ERIC Educational Resources Information Center

    Henry, David D., III; Muller, Nicholas Z.; Mendelsohn, Robert O.

    2011-01-01

    The sulfur dioxide (SO[subscript 2]) cap and trade program established in the 1990 Clean Air Act Amendments is celebrated for reducing abatement costs ($0.7 to $2.1 billion per year) by allowing emissions allowances to be traded. Unfortunately, places with high marginal costs also tend to have high marginal damages. Ton-for-ton trading reduces…

  12. The Cost-Effectiveness of Preexposure Prophylaxis for HIV Prevention in Men Who Have Sex with Men in the United States

    PubMed Central

    Juusola, Jessie L.; Brandeau, Margaret L.; Owens, Douglas K.; Bendavid, Eran

    2013-01-01

    Background In a recent randomized controlled trial, daily oral preexposure chemoprophylaxis (PrEP) was shown to be effective for HIV prevention in men who have sex with men (MSM). The United States Centers for Disease Control and Prevention (CDC) recently provided interim guidance for PrEP use among MSM who are at high risk for acquiring HIV. Previous studies failed to reach a consistent estimate of its cost-effectiveness. Objective To estimate the effectiveness and cost-effectiveness of PrEP in MSM in the United States. Design Dynamic model of HIV transmission and progression combined with a detailed economic analysis. Data Sources Published literature. Target Population MSM aged 13–64 in the United States. Time Horizon Lifetime. Perspective Societal. Interventions We evaluated PrEP for the general MSM population and for high-risk MSM. We assumed that PrEP reduces infection risk by 44%, based on clinical trial results. Outcome Measures New HIV infections, discounted quality-adjusted life-years (QALYs) and costs, and incremental cost-effectiveness ratios. Results of Base-Case Analysis If PrEP is initiated in 20% of MSM in the United States, we estimate a 13% reduction in new HIV infections and a gain of 550,166 QALYs over 20 years at a cost of $172,091/QALY gained. Initiating PrEP in a larger proportion of MSM averts more infections but at increasing cost per QALY gained ($216,480/QALY gained when 100% of MSM receive PrEP). Using PrEP only in high-risk MSM can improve its cost-effectiveness. PrEP costs approximately $50,000/QALY gained for MSM with 5 annual partners on average. PrEP for all high-risk MSM for 20 years leads to $75 billion in healthcare-related costs incremental to the status quo and costs $600,000 per HIV infection averted, compared with incremental costs of $95 billion and $2 million per infection averted for 20% coverage of all MSM. Results of Sensitivity Analysis PrEP use in the general MSM population costs less than $100,000/QALY gained if the

  13. Cost-Effectiveness of Home Energy Retrofits in Pre-Code Vintage Homes in the United States

    SciTech Connect

    Fairey, P.; Parker, D.

    2012-11-01

    This analytical study examines the opportunities for cost-effective energy efficiency and renewable energy retrofits in residential archetypes constructed prior to 1980 (Pre-Code) in fourteen U.S. cities. These fourteen cities are representative of each of the International Energy Conservation Code (IECC) climate zones in the contiguous U.S. The analysis is conducted using an in-house version of EnergyGauge USA v.2.8.05 named CostOpt that has been programmed to perform iterative, incremental economic optimization on a large list of residential energy efficiency and renewable energy retrofit measures. The principle objectives of the study are as follows: to determine the opportunities for cost effective source energy reductions in this large cohort of existing residential building stock as a function of local climate and energy costs; and to examine how retrofit financing alternatives impact the source energy reductions that are cost effectively achievable.

  14. 26 CFR 513.8 - Addressee not actual owner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CONVENTIONS IRELAND Withholding of Tax § 513.8 Addressee not actual owner. (a) If any person with an address in Ireland who receives a dividend from a United States corporation with respect to which United... such reduced rate of 15 percent, such recipient in Ireland will withhold an additional amount of...

  15. Linguistic Theory and Actual Language.

    ERIC Educational Resources Information Center

    Segerdahl, Par

    1995-01-01

    Examines Noam Chomsky's (1957) discussion of "grammaticalness" and the role of linguistics in the "correct" way of speaking and writing. It is argued that the concern of linguistics with the tools of grammar has resulted in confusion, with the tools becoming mixed up with the actual language, thereby becoming the central element in a metaphysical…

  16. HIV Screening via Fourth-Generation Immunoassay or Nucleic Acid Amplification Test in the United States: A Cost-Effectiveness Analysis

    PubMed Central

    Long, Elisa F.

    2011-01-01

    Background At least 10% of the 56,000 annual new HIV infections in the United States are caused by individuals with acute HIV infection (AHI). It unknown whether the health benefits and costs of routine nucleic acid amplification testing (NAAT) are justified, given the availability of newer fourth-generation immunoassay tests. Methods Using a dynamic HIV transmission model instantiated with U.S. epidemiologic, demographic, and behavioral data, I estimated the number of acute infections identified, HIV infections prevented, quality-adjusted life years (QALYs) gained, and the cost-effectiveness of alternative screening strategies. I varied the target population (everyone aged 15-64, injection drug users [IDUs] and men who have sex with men [MSM], or MSM only), screening frequency (annually, or every six months), and test(s) utilized (fourth-generation immunoassay only, or immunoassay followed by pooled NAAT). Results Annual immunoassay testing of MSM reduces incidence by 9.5% and costs <$10,000 per QALY gained. Adding pooled NAAT identifies 410 AHI per year, prevents 9.6% of new cases, costs $92,000 per QALY gained, and remains <$100,000 per QALY gained in settings where undiagnosed HIV prevalence exceeds 4%. Screening IDUs and MSM annually with fourth-generation immunoassay reduces incidence by 13% with cost-effectiveness <$10,000 per QALY gained. Increasing the screening frequency to every six months reduces incidence by 11% (MSM only) or 16% (MSM and IDUs) and costs <$20,000 per QALY gained. Conclusions Pooled NAAT testing every 12 months of MSM and IDUs in the United States prevents a modest number of infections, but may be cost-effective given sufficiently high HIV prevalence levels. However, testing via fourth-generation immunoassay every six months prevents a greater number of infections, is more economically efficient, and may obviate the benefits of acute HIV screening via NAAT. PMID:22110698

  17. The economic burden of lung cancer and the associated costs of treatment failure in the United States.

    PubMed

    Kutikova, Lucie; Bowman, Lee; Chang, Stella; Long, Stacey R; Obasaju, Coleman; Crown, William H

    2005-11-01

    The economic burden of lung cancer was examined with a retrospective case-control cohort study on a database containing inpatient, outpatient and drug claims for employees, dependents and retirees of multiple large US employers with wide geographic distribution. Patients were followed for maximum of 2 years from first cancer diagnosis until death, health benefits dis-enrollment or study end (31 December 2000). Compared with controls (subjects without any cancer), patients with lung cancer (n = 2040) had greater health care service utilization and costs for hospitalization, emergency room visits, outpatient office visits, radiology procedures, laboratory procedures and pharmacy-dispensed drugs (all P < 0.05). Regression-adjusted mean monthly total costs were US dollar 6520 for patients versus US dollar 339 for controls (P < 0.0001), and overall costs across the study period (from diagnosis to death or maximum of 2 years) were US dollar 45,897 for patients and US dollar 2907 for controls (P < 0.0001). The main cost drivers were hospitalization (49.0% of costs) and outpatient office visits (35.2% of costs). Monthly initial treatment phase costs (US dollar 11,496 per patient) were higher than costs during the secondary treatment phase (US dollar 3733) or terminal care phase (US dollar 9399). Failure of initial treatment was associated with markedly increased costs. Compared with patients requiring only initial treatment, patients experiencing treatment failure accrued an additional US dollar 10,370 per month in initial treatment phase costs and US dollar 8779 more per month after starting the secondary and/or terminal care phase. Over the course of the study period, these patients had total costs of US dollar 120,650, compared with US dollar 45,953 for those receiving initial treatment only. Thus, the incremental costs associated with treatment failure were US dollar 19,149 per month and US dollar 74,697 across the study period. Other types of clinical and

  18. Cost analysis of carbon dioxide concentrators

    NASA Technical Reports Server (NTRS)

    Yakut, M. M.

    1973-01-01

    Methodology and cost estimating relationships, for flight-type and prototype CO2 concentrators, have been developed and presented. A validity check was made by comparing the molecular sieves system considered here and that developed for Skylab. The system evaluated here is twice the size of the Skylab system and is also more complex as it desorbs CO2 thermally and stores it in an accumulator. The cost estimates developed were found to be approximately 50 to 70% higher than the actual cost of the Skylab unit.

  19. 33 CFR 116.50 - Apportionment of costs under the Truman-Hobbs Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... traffic, and actual capital costs of the used service life. The United States will bear the balance of the... under the Truman-Hobbs Act. (a) In determining the apportionment of costs, the bridge owner must bear... service life of old bridge ____ $____ Subtotal ____ $____ Share to be borne by the bridge...

  20. Impacts assessment and trade-offs of fuel cell-based auxiliary power units. Part I: System performance and cost modeling

    NASA Astrophysics Data System (ADS)

    Baratto, Francesco; Diwekar, Urmila M.; Manca, Davide

    Auxiliary power units (APUs) are devices that can provide all or part of the non-propulsion power of a vehicle. They do not replace the main internal combustion engine, but they complement it offering low consumption, high comfort and low emissions during the idling periods of the vehicle. This work presents an integrated framework to evaluate the trade-offs between cost effectiveness, efficiency and health and environmental impacts of fuel cell power systems considering various stages of the life cycle of the device. The integrated framework has six main components, namely system level modeling, cost modeling, environmental impact assessment, health impact assessment, life cycle assessment and multi-objective optimization. In part I of these two papers, concerning the integrated framework, the first two components are described and applied to a solid oxide fuel cell-based auxiliary power unit. All the results are validated with experimental data or other published models.

  1. Cost-Effectiveness Osteoporosis Treatment Thresholds: The United States Perspective from the National Osteoporosis Foundation Guide Committee

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Introduction: Rapid growth of the elderly United States population will result in so many at risk of osteoporosis that economically efficient approaches to osteoporosis care warrant consideration.Methods: A Markov-cohort model of annual United States age-specific incidence of hip, wrist, clinical s...

  2. Cost-Effectiveness of Helicopter Versus Ground Emergency Medical Services for Trauma Scene Transport in the United States

    PubMed Central

    Delgado, M. Kit; Staudenmayer, Kristan L.; Wang, N. Ewen; Spain, David A.; Weir, Sharada; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

    2014-01-01

    Objective We determined the minimum mortality reduction that helicopter emergency medical services (HEMS) should provide relative to ground EMS for the scene transport of trauma victims to offset higher costs, inherent transport risks, and inevitable overtriage of minor injury patients. Methods We developed a decision-analytic model to compare the costs and outcomes of helicopter versus ground EMS transport to a trauma center from a societal perspective over a patient's lifetime. We determined the mortality reduction needed to make helicopter transport cost less than $100,000 and $50,000 per quality adjusted life year (QALY) gained compared to ground EMS. Model inputs were derived from the National Study on the Costs and Outcomes of Trauma (NSCOT), National Trauma Data Bank, Medicare reimbursements, and literature. We assessed robustness with probabilistic sensitivity analyses. Results HEMS must provide a minimum of a 17% relative risk reduction in mortality (1.6 lives saved/100 patients with the mean characteristics of the NSCOT cohort) to cost less than $100,000 per QALY gained and a reduction of at least 33% (3.7 lives saved/100 patients) to cost less than $50,000 per QALY. HEMS becomes more cost-effective with significant reductions in minor injury patients triaged to air transport or if long-term disability outcomes are improved. Conclusions HEMS needs to provide at least a 17% mortality reduction or a measurable improvement in long-term disability to compare favorably to other interventions considered cost-effective. Given current evidence, it is not clear that HEMS achieves this mortality or disability reduction. Reducing overtriage of minor injury patients to HEMS would improve its cost-effectiveness. PMID:23582619

  3. Cost-Effectiveness of Alternative Blood-Screening Strategies for West Nile Virus in the United States

    PubMed Central

    Korves, Caroline T; Goldie, Sue J; Murray, Megan B

    2006-01-01

    Background West Nile virus (WNV) is endemic in the US, varying seasonally and by geographic region. WNV can be transmitted by blood transfusion, and mandatory screening of blood for WNV was recently introduced throughout the US. Guidelines for selecting cost-effective strategies for screening blood for WNV do not exist. Methods and Findings We conducted a cost-effectiveness analysis for screening blood for WNV using a computer-based mathematical model, and using data from prospective studies, retrospective studies, and published literature. For three geographic areas with varying WNV-transmission intensity and length of transmission season, the model was used to estimate lifetime costs, quality-adjusted life expectancy, and incremental cost-effectiveness ratios associated with alternative screening strategies in a target population of blood-transfusion recipients. We compared the status quo (baseline screening using a donor questionnaire) to several strategies which differed by nucleic acid testing of either pooled or individual samples, universal versus targeted screening of donations designated for immunocompromised patients, and seasonal versus year-long screening. In low-transmission areas with short WNV seasons, screening by questionnaire alone was the most cost-effective strategy. In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for immunocompromised recipients was the most cost-effective strategy. Seasonal screening of the entire recipient pool added minimal clinical benefit, with incremental cost-effectiveness ratios exceeding US$1.7 million per quality-adjusted life-year gained. Year-round screening offered no additional benefit compared to seasonal screening in any of the transmission settings. Conclusions In areas with high levels of WNV transmission, seasonal screening of individual samples and restricting screening to blood donations designated for

  4. Low cost solar array project: Experimental process system development unit for producing semiconductor-grade silicon using silane-to-silicon process

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The design, fabrication, and installation of an experimental process system development unit (EPSDU) were analyzed. Supporting research and development were performed to provide an information data base usable for the EPSDU and for technological design and economical analysis for potential scale-up of the process. Iterative economic analyses were conducted for the estimated product cost for the production of semiconductor grade silicon in a facility capable of producing 1000-MT/Yr.

  5. [Cost analysis of twenty-nine nuclear medicine procedures].

    PubMed

    Kastanioti, Catherine K; Alphalbouharali, Gihand; Fotopoulos, Andreas

    2004-01-01

    The aim of this study was to compare actual cost estimates for diagnostic procedures as applied in the nuclear medicine department of our University Hospital, with cost estimates obtained through an analytical activity-based costing methodology. Activity data on the use of twenty-nine nuclear medicine procedures were collected. The actual hospital prices for the fiscal years of 2003-2004 were obtained from the Accounting Department of the Hospital. Cost estimates were calculated per patient. Activity-based data were compared with hospital prices and also with unit costs from the activity-based costing methodology. Our results showed a significant statistical difference between unit cost estimates per patient based on hospital prices, as compared with those based on unit costs. This study shows that in our university hospital, reliance on generic hospital prices for nuclear medicine procedures, considerable underestimates their real cost by a mean value of 40% as derived through the activity-based costing methodology and can lead to substantial financial hospital deficits. PMID:15841290

  6. Generalisability and Cost-Impact of Antibiotic-Impregnated Central Venous Catheters for Reducing Risk of Bloodstream Infection in Paediatric Intensive Care Units in England

    PubMed Central

    Harron, Katie; Mok, Quen; Hughes, Dyfrig; Muller-Pebody, Berit; Parslow, Roger; Ramnarayan, Padmanabhan; Gilbert, Ruth

    2016-01-01

    Background We determined the generalisability and cost-impact of adopting antibiotic-impregnated CVCs in all paediatric intensive care units (PICUs) in England, based on results from a large randomised controlled trial (the CATCH trial; ISRCTN34884569). Methods BSI rates using standard CVCs were estimated through linkage of national PICU audit data (PICANet) with laboratory surveillance data. We estimated the number of BSI averted if PICUs switched from standard to antibiotic-impregnated CVCs by applying the CATCH trial rate-ratio (0.40; 95% CI 0.17,0.97) to the BSI rate using standard CVCs. The value of healthcare resources made available by averting one BSI as estimated from the trial economic analysis was £10,975; 95% CI -£2,801,£24,751. Results The BSI rate using standard CVCs was 4.58 (95% CI 4.42,4.74) per 1000 CVC-days in 2012. Applying the rate-ratio gave 232 BSI averted using antibiotic CVCs. The additional cost of purchasing antibiotic-impregnated compared with standard CVCs was £36 for each child, corresponding to additional costs of £317,916 for an estimated 8831 CVCs required in PICUs in 2012. Based on 2012 BSI rates, management of BSI in PICUs cost £2.5 million annually (95% uncertainty interval: -£160,986, £5,603,005). The additional cost of antibiotic CVCs would be less than the value of resources associated with managing BSI in PICUs with standard BSI rates >1.2 per 1000 CVC-days. Conclusions The cost of introducing antibiotic-impregnated CVCs is less than the cost associated with managing BSIs occurring with standard CVCs. The long-term benefits of preventing BSI could mean that antibiotic CVCs are cost-effective even in PICUs with extremely low BSI rates. PMID:26999045

  7. Factory Cost Model

    1996-12-17

    The Factory Cost Model (FCM) is an economic analysis tool intended to provide flat panel display (FPD) and other similar discrete component manufacturers with the ability to make first-order estimates of the cost of unit production. This software has several intended uses. Primary among these is the ability to provide first-order economic analysis for future factories. Consequently, the model requires a minimal level of input detail, and accomodates situations where actual production data are notmore » available. This software is designed to be activity based such that most of the calculated direct costs are associated with the steps of a manufacturibg process. The FCM architecture has the ability to accomodate the analysis of existing manufacturing facilities. The FCM can provide assistance with strategic economic decisions surrounding production related matters. For instance, the program can project the effect on costs and resources of a new product''s introduction, or it can assess the potential cost reduction produced by step yield improvements in the manufacturing process.« less

  8. Accurate charge capture and cost allocation: cost justification for bedside computing.

    PubMed Central

    Grewal, R.; Reed, R. L.

    1993-01-01

    This paper shows that cost justification for bedside clinical computing can be made by recouping charges with accurate charge capture. Twelve months worth of professional charges for a sixteen bed surgical intensive care unit are computed from charted data in a bedside clinical database and are compared to the professional charges actually billed by the unit. A substantial difference in predicted charges and billed charges was found. This paper also discusses the concept of appropriate cost allocation in the inpatient environment and the feasibility of appropriate allocation as a by-product of bedside computing. PMID:8130444

  9. Costs of Rapid HIV Screening in an Urban Emergency Department and a Nearby County Jail in the Southeastern United States

    PubMed Central

    Spaulding, Anne C.; MacGowan, Robin J.; Copeland, Brittney; Shrestha, Ram K.; Bowden, Chava J.; Kim, Min J.; Margolis, Andrew; Mustaafaa, Genetha; Reid, Laurie C.; Heilpern, Katherine L.; Shah, Bijal B.

    2015-01-01

    Emergency departments and jails provide medical services to persons at risk for HIV infection and are recommended venues for HIV screening. Our main objective in this study was to analyze the cost per new HIV diagnosis associated with the HIV screening program in these two venues. The emergency department’s parallel testing program was conducted at Grady Memorial Hospital in Atlanta, Georgia starting in 2008; the jail’s integrated testing program began at the Fulton County (GA) Jail in 2011. The two sites, four miles apart from one another, employed the same rapid HIV test. Ascertainment that cases were new differed by site; only the jail systematically checked identities against health department HIV registries. The program in the emergency department used dedicated HIV test counselors and made 242 diagnoses over a 40-month period at a cost of $2,981 per diagnosis. The jail program used staff nurses, and found 41 new HIV cases over 10.5 months at a cost of $6,688 per new diagnosis. Differences in methods for ascertainment of new diagnoses, previously undiagnosed HIV sero-positivity, and methodologies used for assessing program costs prevent concluding that one program was more economical than the other. Nonetheless, our findings show that testing in both venues yielded many new diagnoses, with the costs within the range reported in the literature. PMID:26053140

  10. United States biomass energy: An assessment of costs and infrastructure for alternative uses of biomass energy crops as an energy feedstock

    NASA Astrophysics Data System (ADS)

    Morrow, William Russell, III

    Reduction of the negative environmental and human health externalities resulting from both the electricity and transportation sectors can be achieved through technologies such as clean coal, natural gas, nuclear, hydro, wind, and solar photovoltaic technologies for electricity; reformulated gasoline and other fossil fuels, hydrogen, and electrical options for transportation. Negative externalities can also be reduced through demand reductions and efficiency improvements in both sectors. However, most of these options come with cost increases for two primary reasons: (1) most environmental and human health consequences have historically been excluded from energy prices; (2) fossil energy markets have been optimizing costs for over 100 years and thus have achieved dramatic cost savings over time. Comparing the benefits and costs of alternatives requires understanding of the tradeoffs associated with competing technology and lifestyle choices. As bioenergy is proposed as a large-scale feedstock within the United States, a question of "best use" of bioenergy becomes important. Bioenergy advocates propose its use as an alternative energy resource for electricity generation and transportation fuel production, primarily focusing on ethanol. These advocates argue that bioenergy offers environmental and economic benefits over current fossil energy use in each of these two sectors as well as in the U.S. agriculture sector. Unfortunately, bioenergy research has offered very few comparisons of these two alternative uses. This thesis helps fill this gap. This thesis compares the economics of bioenergy utilization by a method for estimating total financial costs for each proposed bioenergy use. Locations for potential feedstocks and bio-processing facilities (co-firing switchgrass and coal in existing coal fired power plants and new ethanol refineries) are estimated and linear programs are developed to estimate large-scale transportation infrastructure costs for each sector

  11. The hospital cost (fiscal year 1991/1992) of a simple perioperative allogeneic red blood cell transfusion during elective surgery at Duke University.

    PubMed

    Lubarsky, D A; Hahn, C; Bennett, D H; Smith, L R; Bredehoeft, S J; Klein, H G; Reves, J G

    1994-10-01

    We sought to determine the actual cost to Duke University Medical Center of a perioperative red blood cell transfusion. A recent audit at Duke University Medical Center determined the base average direct and indirect hospital costs for providing a unit of red blood cells. The Transfusion Service's base cost for providing an allogeneic unit of red blood cells was $113.58. To obtain the actual hospital cost of transfusing a unit of red blood cells in the perioperative period, associated costs were calculated and added to the Transfusion Service's base cost. These associated costs included compatibility tests on multiple units per each unit transfused in the perioperative period, performing ABO and Rh typing and antibody screening on samples from patients who were not subsequently transfused, compatibility tests on units not issued, handling costs of units issued but not used, physically administering the blood, and the cost of the recipient contracting an infectious disease or developing a transfusion reaction. These associated costs increased the cost of transfusing an allogeneic unit of red blood cells in the perioperative period to $151.20. Perhaps the techniques described in the study can be used to quantify cost/benefit ratios associated with future changes in transfusion practice. PMID:7943767

  12. How much does care in palliative care wards cost in Poland?

    PubMed Central

    Pokropska, Wieslawa; Łuczak, Jacek; Kaptacz, Anna; Stachowiak, Andrzej; Hurich, Krystyna; Koszela, Monika

    2016-01-01

    Introduction The main task of palliative care units is to provide a dignified life for people with advanced progressive chronic disease through appropriate symptom management, communication between medical specialists and the patient and his family, as well as the coordination of care. Many palliative care units struggle with low incomes from the National Health Fund (NHF), which causes serious economic problems. The aim of the study was to estimate of direct and administrative costs of care and the actual cost per patient per day in selected palliative care units and comparison of the results to the valuation of the NHF. Material and methods The study of the costs of hospitalization of 175 patients was conducted prospectively in five palliative care units (PCUs). The costs directly associated with care were recorded on the specially prepared forms in each unit and also personnel and administrative costs provided by the accounting departments. Results The total costs of analyzed units amounted to 209 002 EUR (898 712 PLN), while the payment for palliative care services from the NHF amounted to 126 010 EUR (541 844 PLN), which accounted for only 60% of the costs incurred by the units. The average cost per person per day of hospitalization, calculated according to the actual duration of hospitalization in the unit, was 83 EUR (357 PLN), and the average payment from the NHF was 52.8 EUR (227 PLN). Underpayment per person per day was approximately 29.2 EUR (125 PLN). Conclusions The study showed a significant difference between the actual cost of palliative care units and the level of refund from the NHF. Based on the analysis of costs, the application has been submitted to the NHF to change the reimbursement amount of palliative care services in 2013. PMID:27186194

  13. Catastrophic Health Care Costs. Hearing before the Special Committee on Aging. United States Senate, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    This document provides witnesses' testimonies and prepared statements from the Senate hearing called to examine the problems of catastrophic health care costs. Statements are included from Senators John Melcher, Quentin Burdick, Larry Pressler, John Heinz, and Pete Wilson. Prepared statements are included from Senators David Pryor and Charles…

  14. Budget Control Procedures and Methods for Evaluating the Unit Costs of Activities and Outputs of Higher Educational Institutions. Interim Report.

    ERIC Educational Resources Information Center

    Phase 2 Bulletin, 1974

    1974-01-01

    In 1972, a group of French universities began a joint project under the aegis of the Centre for Educational Research and Innovation. Common concerns of the universities - specifically, the rising cost of education, the need for assessing effectiveness and efficiency of programs, and a 1968 law giving increased autonomy to French universities - led…

  15. A Cost-Effectiveness Analysis of Individual Learning Units in a Junior High School Basic Mathematics Program.

    ERIC Educational Resources Information Center

    LaPlaca, Nicholas Anthony

    This study compares the cost-effectiveness of an individualized basic mathematics program with a traditional program at the junior high school level. Eighth-grade basic mathematics students (N=118) were identified in two schools. The racial and ethnic makeup, socioeconomic level of residents and school size differed between schools. Teachers were…

  16. Food Assistance: Financial Information on WIC Nutrition Services and Administrative Costs. United States General Accounting Office Report to Congressional Committees.

    ERIC Educational Resources Information Center

    Robertson, Robert E.

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally funded nutrition assistance program administered by the Department of Agriculture's (USDA) Food and Nutrition Service (FNS). Responding to Congressional requests for information regarding program costs, this report provides information on: (1) funding…

  17. Cost-Effectiveness of LDL-C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States.

    PubMed

    Gandra, Shravanthi R; Villa, Guillermo; Fonarow, Gregg C; Lothgren, Mickael; Lindgren, Peter; Somaratne, Ransi; van Hout, Ben

    2016-06-01

    Randomized trials have shown marked reductions in low-density lipoprotein cholesterol (LDL-C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost-effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL-C >100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population-specific trial-based mean risk factors and calibrated against observed rates in the real world. The LDL-C-lowering effect from population-specific phase 3 randomized studies for evolocumab was used together with estimated LDL-C-lowering effect on CVD event rates per 38.67-mg/dL LDL-C lowering from a statin-trial meta-analysis. Costs and utilities were included from published sources. Evolocumab treatment was associated with both increased cost and improved quality-adjusted life-years (QALY): HeFH (incremental cost: US$153 289, incremental QALY: 2.02, incremental cost-effectiveness ratio: US$75 863/QALY); ASCVD (US$158 307, 1.12, US$141 699/QALY); and ASCVD with statin intolerance (US$136 903, 1.36, US$100 309/QALY). Evolocumab met both the American College of Cardiology/American Heart Association (ACC/AHA) and World Health Organization (WHO) thresholds in each population evaluated. Sensitivity and scenario analyses confirmed that model results were robust to changes in model parameters. Among patients with HeFH and ASCVD with or without statin intolerance, evolocumab added to SOC may provide a cost-effective treatment option for lowering LDL-C using ACC/AHA intermediate/high value and WHO cost-effectiveness thresholds. More definitive information on the clinical and economic value of evolocumab will be available from the forthcoming CVD outcomes study. PMID:27092712

  18. Estimated Lifetime Medical and Work-Loss Costs of Emergency Department-Treated Nonfatal Injuries--United States, 2013.

    PubMed

    Florence, Curtis; Haegerich, Tamara; Simon, Thomas; Zhou, Chao; Luo, Feijun

    2015-10-01

    A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies. PMID:26421663

  19. 42 CFR 412.130 - Retroactive adjustments for incorrectly excluded hospitals and units.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the inpatient population the hospital planned to treat during that cost reporting period, if the inpatient population actually treated in the hospital during that cost reporting period did not meet the... under § 412.29(c) regarding the inpatient population the hospital planned to treat in that unit...

  20. The Japanese Labor Market in a Comparative Perspective with the United States. A Transaction-Cost Interpretation.

    ERIC Educational Resources Information Center

    Hashimoto, Masanori

    A comparison is made of some of the notable features of the Japanese and U.S. labor markets. In Japan, as compared to the United States, for example, levels of employment tenure are higher, employer-employee attachment stronger, earnings-tenure profiles more steeply sloped, layoffs and dismissals much less frequent, and joint consultation and…

  1. Increased Mechanical Cost of Walking in Children with Diplegia: The Role of the Passenger Unit Cannot Be Neglected

    ERIC Educational Resources Information Center

    Van de Walle, P.; Hallemans, A.; Truijen, S.; Gosselink, R.; Heyrman, L.; Molenaers, G.; Desloovere, K.

    2012-01-01

    Gait efficiency in children with cerebral palsy is decreased. To date, most research did not include the upper body as a separate functional unit when exploring these changes in gait efficiency. Since children with spastic diplegia often experience problems with trunk control, they could benefit from separate evaluation of the so-called "passenger…

  2. 75 FR 73972 - Medicaid Program; Cost Limit for Providers Operated by Units of Government and Provisions To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... of Federal-State Financial Partnership'' in the Federal Register (72 FR 29747 through 29836). That... Integrity of Federal-State Financial Partnership AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... Units of Government and Provisions To Ensure the Integrity of Federal-State Financial Partnership''...

  3. Impact of Age and Sex on Outcomes and Hospital Cost of Acute Asthma in the United States, 2011-2012

    PubMed Central

    Teague, W. Gerald; Koroukian, Siran M.; Schlitz, Nicholas K.; Bleecker, Eugene R.; Busse, William B.; Calhoun, William J.; Castro, Mario; Comhair, Suzy A.; Fitzpatrick, Anne M.; Israel, Elliot; Wenzel, Sally E.; Holguin, Fernando; Gaston, Benjamin M.

    2016-01-01

    Background Worldwide, asthma is a leading cause of morbidity, mortality and economic burden, with significant gender and racial disparities. However, little attention has been given to the independent role of age on lifetime asthma severity and hospitalization. We aimed to assess the effect of age, gender, race and ethnicity on indicators of asthma severity including asthma related hospitalization, mortality, hospital cost, and the rate of respiratory failure. Methods We analyzed the 2011 and 2012 Healthcare Cost and Utilization Project- National Inpatient Sample (NIS). We validated and extended those results using the National Heart, Lung, and Blood Institute-Severe Asthma Research Program (SARP; 2002–2011) database. Severe asthma was prospectively defined using the stringent American Thoracic Society (ATS) definition. Results Hospitalization for asthma was reported in 372,685 encounters in 2012 and 368,528 in 2011. The yearly aggregate cost exceeded $2 billion. There were distinct bimodal distributions for hospitalization age, with an initial peak at 5 years and a second at 50 years. Likewise, this bimodal age distribution of patients with severe asthma was identified using SARP. Males comprised the majority of individuals in the first peak, but women in the second. Aggregate hospital cost mirrored the bimodal peak distribution. The probability of respiratory failure increased with age until the age of 60, after which it continued to increase in men, but not in women. Conclusions Severe asthma is primarily a disease of young boys and middle age women. Greater understanding of the biology of lung aging and influence of sex hormones will allow us to plan for targeted interventions during these times in order to reduce the personal and societal burdens of asthma. PMID:27294365

  4. Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women over Age 30 in the United States

    PubMed Central

    Kim, Jane J.; Ortendahl, Jesse; Goldie, Sue J.

    2009-01-01

    Background Women over the age of 30 are the main beneficiaries of improved cervical cancer screening with human papillomavirus (HPV) DNA testing. The role of vaccination against HPV types 16 and 18, recommended routinely in pre-adolescent girls, is unclear in this age group. Objective To assess the health and economic outcomes of HPV vaccination in older women participating in the U.S. screening program. Design Cost-effectiveness analysis with an empirically-calibrated model. Data Sources Published literature. Target Population U.S. women, ages 35–45. Time Horizon Lifetime. Perspective Societal. Interventions HPV vaccination added to screening strategies that differ by test (cytology, HPV DNA testing), frequency, and start age, versus screening alone. Outcome Measures Incremental cost-effectiveness ratios (2006 U.S. dollars per quality-adjusted life year (QALY) gained). Results of Base-Case Analysis In the context of annual or biennial screening, HPV vaccination of women ages 35–45 ranged from $116,950 to $272,350 per QALY using cytology with HPV DNA testing for triage of equivocal results, and from $193,690 to $381,590 per QALY using combination cytology and HPV DNA testing, depending on age and screening frequency. Results of Sensitivity Analysis Probabilistic sensitivity analysis revealed that the probability of HPV vaccination being cost-effective for women ages 35–45 was 0% when screening occurred annually or biennially, and <5% when screening occurred triennially, at thresholds considered good value for money. Limitations Uncertainty in the natural history of disease and vaccine efficacy in older women. Conclusions Given currently available information, the effectiveness of HPV vaccination of screened women over age 30 appears, on average, to be small. Compared with current screening that uses sensitive HPV DNA testing, HPV vaccination in this older population is associated with cost-effectiveness ratios that are less attractive than well

  5. Role of lignin in reducing life-cycle carbon emissions, water use, and cost for United States cellulosic biofuels.

    PubMed

    Scown, Corinne D; Gokhale, Amit A; Willems, Paul A; Horvath, Arpad; McKone, Thomas E

    2014-01-01

    Cellulosic ethanol can achieve estimated greenhouse gas (GHG) emission reductions greater than 80% relative to gasoline, largely as a result of the combustion of lignin for process heat and electricity in biorefineries. Most studies assume lignin is combusted onsite, but exporting lignin to be cofired at coal power plants has the potential to substantially reduce biorefinery capital costs. We assess the life-cycle GHG emissions, water use, and capital costs associated with four representative biorefinery test cases. Each case is evaluated in the context of a U.S. national scenario in which corn stover, wheat straw, and Miscanthus are converted to 1.4 EJ (60 billion liters) of ethanol annually. Life-cycle GHG emissions range from 4.7 to 61 g CO2e/MJ of ethanol (compared with ∼ 95 g CO2e/MJ of gasoline), depending on biorefinery configurations and marginal electricity sources. Exporting lignin can achieve GHG emission reductions comparable to onsite combustion in some cases, reduce life-cycle water consumption by up to 40%, and reduce combined heat and power-related capital costs by up to 63%. However, nearly 50% of current U.S. coal-fired power generating capacity is expected to be retired by 2050, which will limit the capacity for lignin cofiring and may double transportation distances between biorefineries and coal power plants. PMID:24988448

  6. Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States

    PubMed Central

    Padula, William V.; Larson, Richard A.; Dusetzina, Stacie B.; Apperley, Jane F.; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C.; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A.; Silver, Richard T.; Simonsson, Bengt

    2016-01-01

    Background: We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib’s price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness (“imatinib-first”) would be cost-effective compared with the current standard of care: “physicians’ choice” of initiating treatment with any one of the three TKIs. Methods: We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician’s choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models’ clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven’s MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study’s conduct. Results: Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician’s choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. Conclusion: When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP. PMID:26944912

  7. Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States

    PubMed Central

    Padula, William V.; Larson, Richard A.; Dusetzina, Stacie B.; Apperley, Jane F.; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C.; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A.; Silver, Richard T.; Simonsson, Bengt

    2016-01-01

    Background: We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib’s price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness (“imatinib-first”) would be cost-effective compared with the current standard of care: “physicians’ choice” of initiating treatment with any one of the three TKIs. Methods: We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician’s choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models’ clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven’s MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study’s conduct. Results: Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician’s choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. Conclusion: When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP.

  8. Comparison of 2-Dose and 3-Dose 9-Valent Human Papillomavirus Vaccine Schedules in the United States: A Cost-effectiveness Analysis.

    PubMed

    Laprise, Jean-François; Markowitz, Lauri E; Chesson, Harrell W; Drolet, Mélanie; Brisson, Marc

    2016-09-01

    A recent clinical trial using the 9-valent human papillomavirus virus (HPV) vaccine has shown that antibody responses after 2 doses are noninferior to those after 3 doses, suggesting that 2 and 3 doses may have comparable vaccine efficacy. We used an individual-based transmission-dynamic model to compare the population-level effectiveness and cost-effectiveness of 2- and 3-dose schedules of 9-valent HPV vaccine in the United States. Our model predicts that if 2 doses of 9-valent vaccine protect for ≥20 years, the additional benefits of a 3-dose schedule are small as compared to those of 2-dose schedules, and 2-dose schedules are likely much more cost-efficient than 3-dose schedules. PMID:27234416

  9. A value-based, no-cost-to-patient health model in the developing world: Critical appraisal of a unique patient-centric neurosurgery unit

    PubMed Central

    Thakar, Sumit; Dadlani, Ravi; Sivaraju, Laxminadh; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Rajarathnam, Ravikiran; Shyam, Maya; Sadanand, Venkatraman; Hegde, Alangar S.

    2015-01-01

    Background: It is well-accepted that the current healthcare scenario worldwide is due for a radical change, given that it is fraught with mounting costs and varying quality. Various modifications in health policies have been instituted toward this end. An alternative model, the low-cost, value-based health model, focuses on maximizing value for patients by moving away from a physician-centered, supply-driven system to a patient-centered system. Methods: The authors discuss the successful inception, functioning, sustainability, and replicability of a novel health model in neurosurgery built and sustained by inspired humanitarianism and that provides all treatment at no cost to the patients irrespective of their socioeconomic strata, color or creed. Results: The Sri Sathya Sai Institute of Higher Medical Sciences (SSSIHMS) at Whitefield, Bengaluru, India, a private charitable hospital established in 2001, functions on the ideals of providing free state-of-the-art healthcare to all in a compassionate and holistic manner. With modern equipment and respectable outcome benchmarks, its neurosurgery unit has operated on around 18,000 patients since its inception, and as such, has contributed INR 5310 million (USD 88.5 million) to society from an economic standpoint. Conclusions: The inception and sustainability of the SSSIHMS model are based on self-perpetuating philanthropy, a cost-conscious culture and the dissemination of human values. Replicated worldwide, at least in the developing nations, this unique healthcare model may well change the face of healthcare economics. PMID:26322241

  10. Estimating the Population Benefits and Costs of Rituximab Therapy in the United States from 1998 to 2013 Using Real-World Data

    PubMed Central

    Reyes, Carolina M.; Gleeson, Michelle L.; Halperin, Marc; Skettino, Sandra L.; Mikhael, Joseph

    2016-01-01

    Background: Rituximab was approved in 1997 and is regularly one of the largest drug expenditures for Medicare; however, its benefits and costs have not been estimated from a population perspective. Objectives: To estimate both the clinical and the economic outcomes of rituximab for its approved hematological uses at the population level. Research Design: Analyses using cancer registry incidence data from the Surveillance, Epidemiology, and End Results (SEER) program, and outcomes data from SEER data linked with Medicare administrative claims (SEER-Medicare data). These results were incorporated into an epidemiological simulation model of the population over time. Subjects: We modeled all United States patients from 1998 to 2013 diagnosed with diffuse large B-cell lymphoma, follicular lymphoma, or chronic lymphocytic leukemia. Measures: Using this model, we estimated the life-years saved, as well as their economic benefit, in the United States population. We also estimated the incremental cost of adding rituximab to chemotherapy. All economic inputs were based on Medicare reimbursed amounts inflated to 2013 dollars. Results: There were 279,704 cumulative life-years saved which were valued at $25.44 billion. The incremental direct medical cost of rituximab was estimated to be $8.92 billion, resulting in an incremental economic gain of $16.52 billion. Conclusions: These analyses, based on real-world evidence, show that the introduction of rituximab into clinical practice has produced a substantial number of incremental life-years. Importantly, the economic benefit of the life-years gained greatly exceeds the added costs of treatment. PMID:26759977

  11. Differential Time Trends of Outcomes and Costs of Care for Acute Myocardial Infarction Hospitalizations by ST Elevation and Type of Intervention in the United States, 2001–2011

    PubMed Central

    Sugiyama, Takehiro; Hasegawa, Kohei; Kobayashi, Yasuki; Takahashi, Osamu; Fukui, Tsuguya; Tsugawa, Yusuke

    2015-01-01

    Background Little is known whether time trends of in‐hospital mortality and costs of care for acute myocardial infarction (AMI) differ by type of AMI (ST‐elevation myocardial infarction [STEMI] vs. non‐ST‐elevation [NSTEMI]) and by the intervention received (percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], or no intervention) in the United States. Methods and Results We conducted a serial cross‐sectional study of all hospitalizations for AMI aged 30 years or older using the Nationwide Inpatient Sample, 2001–2011 (1 456 154 discharges; a weighted estimate of 7 135 592 discharges). Hospitalizations were stratified by type of AMI and intervention, and the time trends of in‐hospital mortality and hospital costs were examined for each combination of the AMI type and intervention, after adjusting for both patient‐ and hospital‐level characteristics. Compared with 2001, adjusted in‐hospital mortality improved significantly for NSTEMI patients in 2011, regardless of the intervention received (PCI odds ratio [OR] 0.68, 95% CI 0.56 to 0.83; CABG OR 0.57, 0.45 to 0.72; without intervention OR 0.61, 0.57 to 0.65). As for STEMI, a decline in adjusted in‐hospital mortality was significant for those who underwent PCI (OR 0.83; 0.73 to 0.94); however, no significant improvement was observed for those who received CABG or without intervention. Hospital costs per hospitalization increased significantly for patients who underwent intervention, but not for those without intervention. Conclusions In the United States, the decrease in in‐hospital mortality and the increase in costs differed by the AMI type and the intervention received. These non‐uniform trends may be informative for designing effective health policies to reduce the health and economic burdens of AMI. PMID:25801759

  12. CRADA with United Solar Technologies and Pacific Northwest Laboratory (PNL-021): Thin film materialsfor low-cost high performance solar concentrators

    NASA Astrophysics Data System (ADS)

    Martin, P. M.; Affinito, J. D.; Gross, M. E.; Bennett, W. D.

    1995-03-01

    The objectives of this project were to develop and evaluate promising low-cost dielectric and polymer-protected thin-film reflective metal coatings to be applied to preformed continuously-curved solar reflector panels to enhance their solar reflectance, and to demonstrate protected solar reflective coatings on preformed solar concentrator panels. The opportunity for this project arose from a search by United Solar Technologies (UST) for organizations and facilities capable of applying reflective coatings to large preformed panels. PNL was identified as being uniquely qualified to participate in this collaborative project.

  13. Nursing: a major hospital cost component.

    PubMed Central

    Wilson, L; Prescott, P A; Aleksandrowicz, L

    1988-01-01

    Selected studies of nursing costs demonstrate a wide variation per patient-day and per patient stay within the same DRG. These differences could reflect either actual differences in nursing practice or methodological differences in calculating practice costs. We examined several alternative methods to find hospital nursing costs of the same group of patients. Measures of patient illness--AS-SCORE severity of illness, Relative Intensity (RIMs), MacLeod nursing intensity, and a per diem measure--were compared for variations in nursing cost. Various definitions of nursing cost itself also were compared using the same patients. Two approaches to defining nursing cost elements--by nursing unit and by hands-on patient care-are discussed. Several nursing cost studies reporting data for DRG 121 (myocardial infarction with complications and/or comorbidity) were compared with our data. The nursing care costs in several studies of these same patients varied from $706 to $1,778 per stay (a 60 percent difference); reasons for these cost differences are discussed. It is suggested that at least part of this variability reflects methodological differences. Cost data should be reported carefully to facilitate comparisons with the results of other studies. Efforts should begin toward designing nursing cost studies using comparable measures and cost-finding methodologies. PMID:3126163

  14. Low cost solar array project production process and equipment task: A Module Experimental Process System Development Unit (MEPSDU)

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Several major modifications were made to the design presented at the PDR. The frame was deleted in favor of a "frameless" design which will provide a substantially improved cell packing factor. Potential shaded cell damage resulting from operation into a short circuit can be eliminated by a change in the cell series/parallel electrical interconnect configuration. The baseline process sequence defined for the MEPSON was refined and equipment design and specification work was completed. SAMICS cost analysis work accelerated, format A's were prepared and computer simulations completed. Design work on the automated cell interconnect station was focused on bond technique selection experiments.

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

    PubMed Central

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

    1980-01-01

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

  16. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... each risk covered, the period of coverage of each risk, the special warranties for each risk, the premium for each risk (or the basis for determining such premium), and the conditions of paying the premium for each risk. For purposes of this subdivision, it shall be unnecessary formally to make...

  17. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... each risk covered, the period of coverage of each risk, the special warranties for each risk, the premium for each risk (or the basis for determining such premium), and the conditions of paying the premium for each risk. For purposes of this subdivision, it shall be unnecessary formally to make...

  18. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... each risk covered, the period of coverage of each risk, the special warranties for each risk, the premium for each risk (or the basis for determining such premium), and the conditions of paying the premium for each risk. For purposes of this subdivision, it shall be unnecessary formally to make...

  19. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... each risk covered, the period of coverage of each risk, the special warranties for each risk, the premium for each risk (or the basis for determining such premium), and the conditions of paying the premium for each risk. For purposes of this subdivision, it shall be unnecessary formally to make...

  20. Dietary Diversity, Diet Cost, and Incidence of Type 2 Diabetes in the United Kingdom: A Prospective Cohort Study

    PubMed Central

    Conklin, Annalijn I.; Monsivais, Pablo; Khaw, Kay-Tee; Forouhi, Nita G.

    2016-01-01

    Background Diet is a key modifiable risk factor for multiple chronic conditions, including type 2 diabetes (T2D). Consuming a range of foods from the five major food groups is advocated as critical to healthy eating, but the association of diversity across major food groups with T2D is not clear and the relationship of within-food-group diversity is unknown. In addition, there is a growing price gap between more and less healthy foods, which may limit the uptake of varied diets. The current study had two aims: first, to examine the association of reported diversity of intake of food groups as well as their subtypes with risk of developing T2D, and second, to estimate the monetary cost associated with dietary diversity. Methods and Findings A prospective study of 23,238 participants in the population-based EPIC-Norfolk cohort completed a baseline Food Frequency Questionnaire in 1993–1997 and were followed up for a median of 10 y. We derived a total diet diversity score and additional scores for diversity within each food group (dairy products, fruits, vegetables, meat and alternatives, and grains). We used multivariable Cox regression analyses for incident diabetes (892 new cases), and multivariable linear regression for diet cost. Greater total diet diversity was associated with 30% lower risk of developing T2D (Hazard ratio [HR] 0.70 [95% CI 0.51 to 0.95]) comparing diets comprising all five food groups to those with three or fewer, adjusting for confounders including obesity and socioeconomic status. In analyses of diversity within each food group, greater diversity in dairy products (HR 0.61 [0.45 to 0.81]), fruits (HR 0.69 [0.52 to 0.90]), and vegetables (HR 0.67 [0.52 to 0.87]) were each associated with lower incident diabetes. The cost of consuming a diet covering all 5 food groups was 18% higher (£4.15/day [4.14 to 4.16]) than one comprising three or fewer groups. Key limitations are the self-reported dietary data and the binary scoring approach whereby

  1. CHARACTERIZING COSTS, SAVINGS AND BENEFITS OF A SELECTION OF ENERGY EFFICIENT EMERGING TECHNOLOGIES IN THE UNITED STATES

    SciTech Connect

    Xu, T.; Slaa, J.W.; Sathaye, J.

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing CO2 emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world. Successful implementation of emerging technologies not only can help advance productivities and competitiveness but also can play a significant role in mitigation efforts by saving energy. Providing evaluation and estimation of the costs and energy savings potential of emerging technologies is the focus of our work in this project. The overall goal of the project is to identify and select emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. This report contains the results from performing Task 2"Technology evaluation" for the project titled"Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies," which was sponsored by California Energy Commission and managed by CIEE. The project purpose is to analyze market status, market potential, and economic viability of selected technologies applicable to the U.S. In this report, LBNL first performed re-assessments of all of the 33 emerging energy-efficient industrial technologies, including re-evaluation of the 26 technologies that were previously identified by Martin et al. (2000) and

  2. Reforming Cardiovascular Care in the United States towards High-Quality Care at Lower Cost with Examples from Model Programs in the State of Michigan

    PubMed Central

    Alyeshmerni, Daniel; Froehlich, James B.; Lewin, Jack; Eagle, Kim A.

    2014-01-01

    Despite its status as a world leader in treatment innovation and medical education, a quality chasm exists in American health care. Care fragmentation and poor coordination contribute to expensive care with highly variable quality in the United States. The rising costs of health care since 1990 have had a huge impact on individuals, families, businesses, the federal and state governments, and the national budget deficit. The passage of the Affordable Care Act represents a large shift in how health care is financed and delivered in the United States. The objective of this review is to describe some of the economic and social forces driving health care reform, provide an overview of the Patient Protection and Affordable Care Act (ACA), and review model cardiovascular quality improvement programs underway in the state of Michigan. As health care reorganization occurs at the federal level, local and regional efforts can serve as models to accelerate improvement toward achieving better population health and better care at lower cost. Model programs in Michigan have achieved this goal in cardiovascular care through the systematic application of evidence-based care, the utilization of regional quality improvement collaboratives, community-based childhood wellness promotion, and medical device-based competitive bidding strategies. These efforts are examples of the direction cardiovascular care delivery will need to move in this era of the Affordable Care Act. PMID:25120917

  3. Conceptual Cost Estimating

    NASA Technical Reports Server (NTRS)

    Brown, J. A.

    1983-01-01

    Kennedy Space Center data aid in efficient construction-cost managment. Report discusses development and use of NASA TR-1508, Kennedy Space Center Aerospace Construction price book for preparing conceptual budget, funding cost estimating, and preliminary cost engineering reports. Report based on actual bid prices and Government estimates.

  4. Conceptual design and cost analysis of hydraulic output unit for 15 kW free-piston Stirling engine

    NASA Technical Reports Server (NTRS)

    White, M. A.

    1982-01-01

    A long-life hydraulic converter with unique features was conceptually designed to interface with a specified 15 kW(e) free-piston Stirling engine in a solar thermal dish application. Hydraulic fluid at 34.5 MPa (5000 psi) is produced to drive a conventional hydraulic motor and rotary alternator. Efficiency of the low-maintenance converter design was calculated at 93.5% for a counterbalanced version and 97.0% without the counterbalance feature. If the converter were coupled to a Stirling engine with design parameters more typcial of high-technology Stirling engines, counterbalanced converter efficiency could be increased to 99.6%. Dynamic computer simulation studies were conducted to evaluate performance and system sensitivities. Production costs of the complete Stirling hydraulic/electric power system were evaluated at $6506 which compared with $8746 for an alternative Stirling engine/linear alternator system.

  5. Public Health Impact and Economic Costs of Volkswagen's Lack of Compliance with the United States' Emission Standards.

    PubMed

    Hou, Lifang; Zhang, Kai; Luthin, Moira A; Baccarelli, Andrea A

    2016-01-01

    The U.S. Environmental Protection Agency (EPA) recently issued a notice of violation against Volkswagen (VW) for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx). We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA's Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles' lack of compliance on the health and well-being of the U.S. PMID:27618076

  6. The actual goals of geoethics

    NASA Astrophysics Data System (ADS)

    Nemec, Vaclav

    2014-05-01

    The most actual goals of geoethics have been formulated as results of the International Conference on Geoethics (October 2013) held at the geoethics birth-place Pribram (Czech Republic): In the sphere of education and public enlightenment an appropriate needed minimum know how of Earth sciences should be intensively promoted together with cultivating ethical way of thinking and acting for the sustainable well-being of the society. The actual activities of the Intergovernmental Panel of Climate Changes are not sustainable with the existing knowledge of the Earth sciences (as presented in the results of the 33rd and 34th International Geological Congresses). This knowledge should be incorporated into any further work of the IPCC. In the sphere of legislation in a large international co-operation following steps are needed: - to re-formulate the term of a "false alarm" and its legal consequences, - to demand very consequently the needed evaluation of existing risks, - to solve problems of rights of individuals and minorities in cases of the optimum use of mineral resources and of the optimum protection of the local population against emergency dangers and disasters; common good (well-being) must be considered as the priority when solving ethical dilemmas. The precaution principle should be applied in any decision making process. Earth scientists presenting their expert opinions are not exempted from civil, administrative or even criminal liabilities. Details must be established by national law and jurisprudence. The well known case of the L'Aquila earthquake (2009) should serve as a serious warning because of the proven misuse of geoethics for protecting top Italian seismologists responsible and sentenced for their inadequate superficial behaviour causing lot of human victims. Another recent scandal with the Himalayan fossil fraud will be also documented. A support is needed for any effort to analyze and to disclose the problems of the deformation of the contemporary

  7. Hydrologic Change during the Colonial Era of the United States: Beavers and the Energy Cost of Impoundments (Invited)

    NASA Astrophysics Data System (ADS)

    Green, M. B.; Bain, D. J.; Arrigo, J. S.; Duncan, J. M.; Kumar, S.; Parolari, A.; Salant, N.; Vorosmarty, C. J.; Aloysius, N. R.; Bray, E. N.; Ruffing, C. M.; Witherell, B. B.

    2009-12-01

    Europeans colonized North America in the early 17th century with intentions ranging between long-term inhabitation and quick extraction of resources for economic gain in Europe. Whatever the intentions, the colonists relied on the landscape for resources resulting in dramatic change to the forest and fur-bearing mammal population. We demonstrate that initial exploitation of North American forest and furs caused a substantial decrease in mean water residence time (τ) between 1600 and 1800 A.D. That loss, which regionally changed from 51 to 41 days, contrasts with conventional wisdom that humans tend to diminish variability in water resources by increasing storage capacity and thus increasing τ. The loss of τ resulted from over-hunted beaver for the hat market in Europe. Analysis suggests that colonial era demographics and economics did not allow human resource allocation to impoundment construction on a level matching the historic beaver effort. However, the τ appears to have regionally increased during the 19th century, suggesting that humans eventually began replacing the water storage lost with the beaver. The analysis highlights the energy cost of impounding water, which is likely to continue to be an important factor given the increasing need for stable water resources and finite energy resources.

  8. The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case–Control Analysis in the Southwestern United States

    PubMed Central

    Mapel, Douglas; Roberts, Melissa; Overhiser, Andrew; Mason, Andrew

    2013-01-01

    Background Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States. Methods We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori-related condition in years 2006 through 2010 using utilization data. Medical record abstraction of 400 cases was conducted to obtain additional clinical information. Results A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p < .001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18–29. Hispanic persons had a significantly higher risk of dyspepsia and positive H. pylori testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the “test and treat” approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55. Conclusions Women and older adults have a higher incidence of dyspepsia than previously appreciated, and Hispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed. PMID:23067108

  9. A GIS cost model to assess the availability of freshwater, seawater, and saline groundwater for algal biofuel production in the United States.

    PubMed

    Venteris, Erik R; Skaggs, Richard L; Coleman, Andre M; Wigmosta, Mark S

    2013-05-01

    A key advantage of using microalgae for biofuel production is the ability of some algal strains to thrive in waters unsuitable for conventional crop irrigation such as saline groundwater or seawater. Nonetheless, the availability of sustainable water supplies will provide significant challenges for scale-up and development of algal biofuels. We conduct a partial techno-economic assessment based on the availability of freshwater, saline groundwater, and seawater for use in open pond algae cultivation systems. We explore water issues through GIS-based models of algae biofuel production, freshwater supply (constrained to less than 5% of mean annual flow per watershed) and costs, and cost-distance models for supplying seawater and saline groundwater. We estimate that, combined, these resources can support 9.46 × 10(7) m(3) yr(-1) (25 billion gallons yr(-1)) of renewable biodiesel production in the coterminous United States. Achievement of larger targets requires the utilization of less water efficient sites and relatively expensive saline waters. Despite the addition of freshwater supply constraints and saline water resources, the geographic conclusions are similar to our previous results. Freshwater availability and saline water delivery costs are most favorable for the coast of the Gulf of Mexico and Florida peninsula, where evaporation relative to precipitation is moderate. As a whole, the barren and scrub lands of the southwestern U.S. have limited freshwater supplies, and large net evaporation rates greatly increase the cost of saline alternatives due to the added makeup water required to maintain pond salinity. However, this and similar analyses are particularly sensitive to knowledge gaps in algae growth/lipid production performance and the proportion of freshwater resources available, key topics for future investigation. PMID:23495893

  10. Sensor fusion system to estimate the trajectory of a low cost mobile robotic platform using an Inertial Measurement Unit

    NASA Astrophysics Data System (ADS)

    Botero V., J.-S.; M. Rico, G.; Villegas C, J.-P.

    2016-07-01

    In this paper, the development and implementation of an algorithm is presented to identify the trajectory of a mobile robot based on data from an Inertial Measurement Unit with nine degrees of freedom consisting of a 3-axis accelerometers, an 3-axis gyroscopes, an 3- axis magnetometers, and an additional temperature sensor to compensate for temperature errors. The combined information from this set of sensors allows determining the trajectory and orientation of the robot at any moment to complement the information from its navigation system. Initially, it was necessary to build controlled test environments that allow observing and getting to know the trajectory and the dimensions thereof for capturing the raw data of the mobile robotic platform. Then, the data obtained form the sensor was processed off-line applying a Kalman filter with the aim to remove Gaussian noise; to estimating the trajectory and the absolute orientation of the mobile robotic platform the proposed algorithm was implemented. This implementation used the hardware elements are inexpensive, thus allowing the necessary testing, the data analysis and the interpretation of the outcome to be replicable and to be used as an educational tool within courses of undergraduate and master level. The elements of hardware used in this implementation are cheap, allowing its reproduction for the analysis and interpretation of data and can be used as an educational tool in courses of undergraduate and master level.

  11. The cost of muscle power production: muscle oxygen consumption per unit work increases at low temperatures in Xenopus laevis.

    PubMed

    Seebacher, Frank; Tallis, Jason A; James, Rob S

    2014-06-01

    Metabolic energy (ATP) supply to muscle is essential to support activity and behaviour. It is expected, therefore, that there is strong selection to maximise muscle power output for a given rate of ATP use. However, the viscosity and stiffness of muscle increases with a decrease in temperature, which means that more ATP may be required to achieve a given work output. Here, we tested the hypothesis that ATP use increases at lower temperatures for a given power output in Xenopus laevis. To account for temperature variation at different time scales, we considered the interaction between acclimation for 4 weeks (to 15 or 25°C) and acute exposure to these temperatures. Cold-acclimated frogs had greater sprint speed at 15°C than warm-acclimated animals. However, acclimation temperature did not affect isolated gastrocnemius muscle biomechanics. Isolated muscle produced greater tetanus force, and faster isometric force generation and relaxation, and generated more work loop power at 25°C than at 15°C acute test temperature. Oxygen consumption of isolated muscle at rest did not change with test temperature, but oxygen consumption while muscle was performing work was significantly higher at 15°C than at 25°C, regardless of acclimation conditions. Muscle therefore consumed significantly more oxygen at 15°C for a given work output than at 25°C, and plastic responses did not modify this thermodynamic effect. The metabolic cost of muscle performance and activity therefore increased with a decrease in temperature. To maintain activity across a range of temperature, animals must increase ATP production or face an allocation trade-off at lower temperatures. Our data demonstrate the potential energetic benefits of warming up muscle before activity, which is seen in diverse groups of animals such as bees, which warm flight muscle before take-off, and humans performing warm ups before exercise. PMID:24625645

  12. COST DIGEST: COST SUMMARIES OF SELECTED ENVIRONMENTAL CONTROL TECHNOLOGIES

    EPA Science Inventory

    The report summarizes cost data on over 20 environmental control technologies. The cost parameters presented include total capital investment, net annual operating expenses, and unit annualized costs. These cost estimates are given over an appropriate range of system capacities f...

  13. Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down’s syndrome into NHS maternity care: prospective cohort study in eight diverse maternity units

    PubMed Central

    Wright, David; Hill, Melissa; Verhoef, Talitha I; Daley, Rebecca; Lewis, Celine; Mason, Sarah; McKay, Fiona; Jenkins, Lucy; Howarth, Abigail; Cameron, Louise; McEwan, Alec; Fisher, Jane; Kroese, Mark; Morris, Stephen

    2016-01-01

    Objective To investigate the benefits and costs of implementing non-invasive prenatal testing (NIPT) for Down’s syndrome into the NHS maternity care pathway. Design Prospective cohort study. Setting Eight maternity units across the United Kingdom between 1 November 2013 and 28 February 2015. Participants All pregnant women with a current Down’s syndrome risk on screening of at least 1/1000. Main outcome measures Outcomes were uptake of NIPT, number of cases of Down’s syndrome detected, invasive tests performed, and miscarriages avoided. Pregnancy outcomes and costs associated with implementation of NIPT, compared with current screening, were determined using study data on NIPT uptake and invasive testing in combination with national datasets. Results NIPT was prospectively offered to 3175 pregnant women. In 934 women with a Down’s syndrome risk greater than 1/150, 695 (74.4%) chose NIPT, 166 (17.8%) chose invasive testing, and 73 (7.8%) declined further testing. Of 2241 women with risks between 1/151 and 1/1000, 1799 (80.3%) chose NIPT. Of 71 pregnancies with a confirmed diagnosis of Down’s syndrome, 13/42 (31%) with the diagnosis after NIPT and 2/29 (7%) after direct invasive testing continued, resulting in 12 live births. In an annual screening population of 698 500, offering NIPT as a contingent test to women with a Down’s syndrome screening risk of at least 1/150 would increase detection by 195 (95% uncertainty interval −34 to 480) cases with 3368 (2279 to 4027) fewer invasive tests and 17 (7 to 30) fewer procedure related miscarriages, for a non-significant difference in total costs (£−46 000, £−1 802 000 to £2 661 000). The marginal cost of NIPT testing strategies versus current screening is very sensitive to NIPT costs; at a screening threshold of 1/150, NIPT would be cheaper than current screening if it cost less than £256. Lowering the risk threshold increases the number of Down’s syndrome cases detected and

  14. Tunable optical frequency comb enabled scalable and cost-effective multiuser orthogonal frequency-division multiple access passive optical network with source-free optical network units.

    PubMed

    Chen, Chen; Zhang, Chongfu; Liu, Deming; Qiu, Kun; Liu, Shuang

    2012-10-01

    We propose and experimentally demonstrate a multiuser orthogonal frequency-division multiple access passive optical network (OFDMA-PON) with source-free optical network units (ONUs), enabled by tunable optical frequency comb generation technology. By cascading a phase modulator (PM) and an intensity modulator and dynamically controlling the peak-to-peak voltage of a PM driven signal, a tunable optical frequency comb source can be generated. It is utilized to assist the configuration of a multiple source-free ONUs enhanced OFDMA-PON where simultaneous and interference-free multiuser upstream transmission over a single wavelength can be efficiently supported. The proposed multiuser OFDMA-PON is scalable and cost effective, and its feasibility is successfully verified by experiment. PMID:23027243

  15. Reducing coal transportation costs

    SciTech Connect

    Rosenberg, R.D. )

    1990-10-11

    Ten years ago, the Staggers Rail Act of 1980 became law. This act significantly altered the landscape against which the freight rates paid by electric utilities and other shippers for transporting coal and other goods by rail are determined. Among the most significant changes was the creation of the Rail Cost Adjustment Factor (RCAF), a special mechanism to enable railroads to recoup increases in their costs through expedited rate increases. The RCAF has generated much controversy between shippers and railroads, especially over the treatment of changes in rail productivity, that is, whether the RCAF should track only changes in the prices paid by railroads for raw inputs or should instead measure changes in the actual cost of rail production by reflecting increases in the amount of output achieved per unit of input. Shippers last year won a major battle when the Interstate Commerce Commission (ICC) added a productivity adjustment to the RCAF, although that decision is still subject to judicial review and possible modification by the ICC. The railroads have responded to the productivity adjustment by pursuing other means of raising their rates, thus creating new issues and choices for utilities. This article reviews the role and significance of the RCAF, explains the nature and impact of the new productivity adjustment, and analyzes the implications of the productivity adjustment for the pricing of rail transportation services in the future. These matters are of major importance for coal-burning utilities and their ratepayers, especially as the cost of coal transportation in many areas exceeds the cost of the coal itself.

  16. Troubleshooting Costs

    NASA Astrophysics Data System (ADS)

    Kornacki, Jeffrey L.

    Seventy-six million cases of foodborne disease occur each year in the United States alone. Medical and lost productivity costs of the most common pathogens are estimated to be 5.6-9.4 billion. Product recalls, whether from foodborne illness or spoilage, result in added costs to manufacturers in a variety of ways. These may include expenses associated with lawsuits from real or allegedly stricken individuals and lawsuits from shorted customers. Other costs include those associated with efforts involved in finding the source of the contamination and eliminating it and include time when lines are shut down and therefore non-productive, additional non-routine testing, consultant fees, time and personnel required to overhaul the entire food safety system, lost market share to competitors, and the cost associated with redesign of the factory and redesign or acquisition of more hygienic equipment. The cost associated with an effective quality assurance plan is well worth the effort to prevent the situations described.

  17. 50 CFR 37.46 - Cost reimbursement.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... actual costs incurred, including, but not limited to, its direct costs and indirect costs as established... costs shall include, but are not limited to, those direct costs and indirect costs, as established by the indirect costs rate of the charging bureau or office, incurred in reviewing and acting...

  18. A Critical Assessment of Sea-Level Rise Projections for the Northeast United States in the 21st Century: Discrepancies and Their Cost

    NASA Astrophysics Data System (ADS)

    Zhang, M.

    2015-12-01

    Several studies have projected the magnitudes of sea-level rise (SLR) in the Northeast United States for the 21th Century as a result of anthropogenic climate change. Among them are those by NOAA, the New York City Panel on Climate Change (NPCC), and the US Army Corps of Engineers (COE). The projected magnitudes of SLR from some of these sources are being used by policymakers to make difficult choices of investments on infrastructure that can be resilient against anticipated SLR. While there is no question that SLR will happen and resilience measures against SLR is very necessary, this presentation questions the rigor of science behind some of these projections that can have significant costs to the society. A critical assessment of available SLR projections for the northeast US and their discrepancies is presented. It is concluded from the current understanding of science that the mean values and upper bounds of SLR from NOAA, NPCC and COE are likely exaggerated for the region. It is also argued that scientists should treat the SLR projection as a separate problem from policies so that the best cost-benefit analysis can be performed in the decision process.

  19. Public Health Costs of Primary PM2.5 and Inorganic PM2.5 Precursor Emissions in the United States.

    PubMed

    Heo, Jinhyok; Adams, Peter J; Gao, H Oliver

    2016-06-01

    Current methods of estimating the public health effects of emissions are computationally too expensive or do not fully address complex atmospheric processes, frequently limiting their applications to policy research. Using a reduced-form model derived from tagged chemical transport model (CTM) simulations, we present PM2.5 mortality costs per tonne of inorganic air pollutants with the 36 km × 36 km spatial resolution of source location in the United States, providing the most comprehensive set of such estimates comparable to CTM-based estimates. Our estimates vary by 2 orders of magnitude. Emission-weighted seasonal averages were estimated at $88,000-130,000/t PM2.5 (inert primary), $14,000-24,000/t SO2, $3,800-14,000/t NOx, and $23,000-66,000/t NH3. The aggregate social costs for year 2005 emissions were estimated at $1.0 trillion dollars. Compared to other studies, our estimates have similar magnitudes and spatial distributions for primary PM2.5 but substantially different spatial patterns for precursor species where secondary chemistry is important. For example, differences of more than a factor of 10 were found in many areas of Texas, New Mexico, and New England states for NOx and of California, Texas, and Maine for NH3. Our method allows for updates as emissions inventories and CTMs improve, enhancing the potential to link policy research to up-to-date atmospheric science. PMID:27153150

  20. 23 CFR 140.906 - Labor costs.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... engineering, construction engineering, right-of-way, and force account construction. (2) Salaries and expenses... for the benefit of its employees. The cost of labor surcharges will be reimbursed at actual cost to... of actual costs provided that (i) the rate is based on historical cost data of the company, (ii)...

  1. 23 CFR 140.906 - Labor costs.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... engineering, construction engineering, right-of-way, and force account construction. (2) Salaries and expenses... for the benefit of its employees. The cost of labor surcharges will be reimbursed at actual cost to... of actual costs provided that (i) the rate is based on historical cost data of the company, (ii)...

  2. 23 CFR 140.906 - Labor costs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... engineering, construction engineering, right-of-way, and force account construction. (2) Salaries and expenses... for the benefit of its employees. The cost of labor surcharges will be reimbursed at actual cost to... of actual costs provided that (i) the rate is based on historical cost data of the company, (ii)...

  3. Economic cost of primary prevention of cardiovascular diseases in Tanzania.

    PubMed

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

    2015-09-01

    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 the regression

  4. 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

  5. 63. VIEW OF AUTOTRANSFERS. THE ACTUAL AUTOTRANSFERS ARE ENCLOSED IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    63. VIEW OF AUTOTRANSFERS. THE ACTUAL AUTOTRANSFERS ARE ENCLOSED IN THE OIL FILLED CYLINDERS ON THE RIGHT OF THE PHOTOGRAPH. THESE ELECTRICAL DEVICES BOOSTED THE GENERATOR OUTPUT OF 11,000 VOLTS TO 22,000 VOLTS PRIOR TO TRANSMISSION OUT TO THE MAIN FEEDER LINES. A SPARE INNER UNIT IS CONTAINED IN THE METAL BOX AT THE LEFT OF THE PHOTOGRAPH. - New York, New Haven & Hartford Railroad, Cos Cob Power Plant, Sound Shore Drive, Greenwich, Fairfield County, CT

  6. Consequences of Predicted or Actual Asteroid Impacts

    NASA Astrophysics Data System (ADS)

    Chapman, C. R.

    2003-12-01

    Earth impact by an asteroid could have enormous physical and environmental consequences. Impactors larger than 2 km diameter could be so destructive as to threaten civilization. Since such events greatly exceed any other natural or man-made catastrophe, much extrapolation is necessary just to understand environmental implications (e.g. sudden global cooling, tsunami magnitude, toxic effects). Responses of vital elements of the ecosystem (e.g. agriculture) and of human society to such an impact are conjectural. For instance, response to the Blackout of 2003 was restrained, but response to 9/11 terrorism was arguably exaggerated and dysfunctional; would society be fragile or robust in the face of global catastrophe? Even small impacts, or predictions of impacts (accurate or faulty), could generate disproportionate responses, especially if news media reports are hyped or inaccurate or if responsible entities (e.g. military organizations in regions of conflict) are inadequately aware of the phenomenology of small impacts. Asteroid impact is the one geophysical hazard of high potential consequence with which we, fortunately, have essentially no historical experience. It is thus important that decision makers familiarize themselves with the hazard and that society (perhaps using a formal procedure, like a National Academy of Sciences study) evaluate the priority of addressing the hazard by (a) further telescopic searches for dangerous but still-undiscovered asteroids and (b) development of mitigation strategies (including deflection of an oncoming asteroid and on- Earth civil defense). I exemplify these issues by discussing several representative cases that span the range of parameters. Many of the specific physical consequences of impact involve effects like those of other geophysical disasters (flood, fire, earthquake, etc.), but the psychological and sociological aspects of predicted and actual impacts are distinctive. Standard economic cost/benefit analyses may not

  7. Moral Reasoning in Hypothetical and Actual Situations.

    ERIC Educational Resources Information Center

    Sumprer, Gerard F.; Butter, Eliot J.

    1978-01-01

    Results of this investigation suggest that moral reasoning of college students, when assessed using the DIT format, is the same whether the dilemmas involve hypothetical or actual situations. Subjects, when presented with hypothetical situations, become deeply immersed in them and respond as if they were actual participants. (Author/BEF)

  8. Factors Related to Self-Actualization.

    ERIC Educational Resources Information Center

    Hogan, H. Wayne; McWilliams, Jettie M.

    1978-01-01

    Provides data to further support the notions that females score higher in self-actualization measures and that self-actualization scores correlate inversely to the degree of undesirability individuals assign to their heights and weights. Finds that, contrary to predictions, greater androgyny was related to lower, not higher, self-actualization…

  9. 75 FR 28059 - Actual Effects of the Free Trade Agreements With Chile, Australia, and Singapore

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-19

    ... COMMISSION Actual Effects of the Free Trade Agreements With Chile, Australia, and Singapore AGENCY: United...) instituted investigation No. 332-515, Actual Effects of the Free Trade Agreements with Chile, Australia, and...) concluded with Chile, Singapore, and Australia. In its report the Commission will-- (1) With respect to...

  10. General methodology: Costing, budgeting, and techniques for benefit-cost and cost-effectiveness analysis

    NASA Technical Reports Server (NTRS)

    Stretchberry, D. M.; Hein, G. F.

    1972-01-01

    The general concepts of costing, budgeting, and benefit-cost ratio and cost-effectiveness analysis are discussed. The three common methods of costing are presented. Budgeting distributions are discussed. The use of discounting procedures is outlined. The benefit-cost ratio and cost-effectiveness analysis is defined and their current application to NASA planning is pointed out. Specific practices and techniques are discussed, and actual costing and budgeting procedures are outlined. The recommended method of calculating benefit-cost ratios is described. A standardized method of cost-effectiveness analysis and long-range planning are also discussed.

  11. 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. PMID:19092521

  12. Indirect Costs of Health Research--How They are Computed, What Actions are Needed. Report by the Comptroller General of the United States.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    A review by the General Accounting Office of various aspects of indirect costs associated with federal health research grants is presented. After an introduction detailing the scope of the review and defining indirect costs and federal participation, the report focuses on the causes of the rapid increase of indirect costs. Among findings was that…

  13. Perceived and actual environmental benefits of the Los Angeles urban forest

    NASA Astrophysics Data System (ADS)

    Pataki, D. E.; McCarthy, H. R.

    2011-12-01

    There has been a widespread movement to plant more trees and increase canopy cover in cities throughout the United States, in order to enhance ecosystem services provided by urban forests. The city of Los Angeles has been engaged in a widespread tree planting program with the goal of increasing tree cover, particularly in low income neighborhoods. However, the Los Angeles urban forest is almost entirely non-native, located predominately in former semi-arid shrublands and grasslands. We used multiple approaches to evaluate environmental costs and benefits of urban trees in Los Angeles, both as they are perceived by local residents, as well as actual physical impacts of urban tree processes on the environment. We conducted an internet survey of attitudes and preferences for specific tree functional types, ecosystem services, and potential costs. We also directly measured urban forest structure and function including species and functional biodiversity, transpiration, basal area increments, hydraulic architecture, and leaf gas exchange. We translated these processes into categories of ecosystem services and costs such as water use, latent heat fluxes, water use efficiency, growth rates, sensitivity to drought stress, and aesthetic traits (flowering, fruiting, etc.). We found that provision of shade by urban trees is highly valued by local residents, and in fact, the urban forest has a significant impact on surface temperatures. Aesthetics benefits are also commonly cited as desirable traits. Although aesthetic and other cultural ecosystem services are difficult to quantify, we found spatial patterns in aesthetic traits influenced by neighborhood socioeconomic variables. Local residents seemed less concerned about the water use of irrigated urban trees, but we found significant rates of transpiration in urban trees and forest plots depending on species that may be important in the local hydrologic budget, which is increasingly constrained by water shortages. There was

  14. Prevention--a cost-effective way to fight the non-communicable disease epidemic: an academic perspective of the United Nations High-level NCD Meeting.

    PubMed

    Probst-Hensch, Nicole; Tanner, Marcel; Kessler, Claudia; Burri, Christian; Künzli, Nino

    2011-01-01

    The United Nations General Assembly has convened a Summit on non-communicable diseases (NCDs), an historic moment in the global combat of these disorders. Lifestyles in increasingly urban and globalised environments have led to a steep surge in NCD incidence in low and middle income countries, where two thirds of all NCD deaths occur (most importantly from cancer, cardiovascular and respiratory disease as well as diabetes). Treatment of NCDs is usually long term and expensive, thus threatening patients' and nations' budgets and putting them at high risk for poverty. The NCD Summit offers an opportunity for strengthening and shaping primary prevention, the most cost-effective instrument to fight major risk factors such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy diet. From a Swiss perspective, we also emphasised the efforts for new laws on prevention and diagnosis registration, in accordance with the recommendations of the NCD summit in order to strengthen primary prevention and disease monitoring. In addition, the need for structural prevention across all policy sectors with leadership in environmental policy making to prevent NCDs as well as the need to adapt and strengthen primary health care are equally relevant for Switzerland. To compliment efforts in primary prevention, the field of NCDs requires special R&D platforms for affordable NCD drugs and diagnostics for neglected population segments in both Switzerland and low and middle income countries. Switzerland has a track record in research and development against diseases of poverty on a global scale that now needs to be applied to NCDs. PMID:21901650

  15. 16 CFR 1105.13 - Noncompensable costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the participant's actual cost; and (c) Costs determined not to be allowable under generally accepted accounting principles and practices or part 1-15, Federal Procurement Regulations (41 CFR part 1-15). ... Noncompensable costs. The items of cost toward which the Commission will not contribute include: (a) Costs...

  16. 50 CFR 37.46 - Cost reimbursement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Cost reimbursement. 37.46 Section 37.46... NATIONAL WILDLIFE REFUGE, ALASKA General Administration § 37.46 Cost reimbursement. (a) Each applicant for... actual costs incurred, including, but not limited to, its direct costs and indirect costs as...

  17. Realizing actual feedback control of complex network

    NASA Astrophysics Data System (ADS)

    Tu, Chengyi; Cheng, Yuhua

    2014-06-01

    In this paper, we present the concept of feedbackability and how to identify the Minimum Feedbackability Set of an arbitrary complex directed network. Furthermore, we design an estimator and a feedback controller accessing one MFS to realize actual feedback control, i.e. control the system to our desired state according to the estimated system internal state from the output of estimator. Last but not least, we perform numerical simulations of a small linear time-invariant dynamics network and a real simple food network to verify the theoretical results. The framework presented here could make an arbitrary complex directed network realize actual feedback control and deepen our understanding of complex systems.

  18. Updated Conceptual Cost Estimating

    NASA Technical Reports Server (NTRS)

    Brown, J. A.

    1987-01-01

    16-page report discusses development and use of NASA TR-1508, the Kennedy Space Center Aerospace Construction Price Book for preparing conceptual, budget, funding, cost-estimating, and preliminary cost-engineering reports. Updated annually from 1974 through 1985 with actual bid prices and government estimates. Includes labor and material quantities and prices with contractor and subcontractor markups for buildings, facilities, and systems at Kennedy Space Center. While data pertains to aerospace facilities, format and cost-estimating techniques guide estimation of costs in other construction applications.

  19. The Frictional Force with Respect to the Actual Contact Surface

    NASA Technical Reports Server (NTRS)

    Holm, Ragnar

    1944-01-01

    Hardy's statement that the frictional force is largely adhesion, and to a lesser extent, deformation energy is proved by a simple experiment. The actual contact surface of sliding contacts and hence the friction per unit of contact surface was determined in several cases. It was found for contacts in normal atmosphere to be about one-third t-one-half as high as the macroscopic tearing strength of the softest contact link, while contacts annealed in vacuum and then tested, disclosed frictional forces which are greater than the macroscopic strength.

  20. Unit billed services for HANDI 2000 business management system

    SciTech Connect

    Wilson, D.

    1998-08-24

    Unit billed services are those services provided internally by project to other projects, except for those services furnished by Lockheed Martin Services,Inc., an Enterprise Company. These services are billed when the actual work is performed, based on a published rate for the service. Examples of this would be crane and rigging, duplicating, or lab analysis. The providers of these services collect their costs in a pool. The pool is then liquidated by the billings.

  1. Costs of RCRA corrective action: Interim report

    SciTech Connect

    Tonn, B.; Russell, M.; Hwang Ho-Ling; Goeltz, R. ); Warren, J. )

    1991-09-01

    This report estimates the cost of the corrective action provisions of the Resource Conservation and Recovery Act (RCRA) for all non-federal facilities in the United States. RCRA is the federal law which regulates the treatment, storage, disposal, and recovery of hazardous waste. The 1984 amendment to RCRA, known as the Hazardous and Solid Waste Amendments, stipulates that facilities that treat, store or dispose of hazardous wastes (TSDs) must remediate situations where hazardous wastes have escaped into the environment from their solid waste management units (SWMUs). The US Environmental Protection Agency (USEPA 1990a), among others, believes that the costs of RCRA corrective action could rival the costs of SUPERFUND. Evaluated herein are costs associated with actual remedial actions. The remedial action cost estimating program developed by CH2M Hill is known as the Cost of Remedial Action Model (CORA). It provides cost estimates, in 1987 dollars, by technology used to remediate hazardous waste sites. Rules were developed to categorize each SWMU in the RTI databases by the kinds of technologies that would be used to remediate them. Results were then run through CORA using various assumptions for variable values that could not be drawn from the RTI databases and that did not have CORA supplied default values. Cost estimates were developed under several scenarios. The base case assumes a TSD and SWMU universe equal to that captured in the RTI databases, a point of compliance at the SWMU boundary with no ability to shift wastes from SWMU to SWMU, and a best-as-practical clean-up to health-based standards. 11 refs., 12 figs., 12 tabs.

  2. Regional Comparative Unit Cost Studies for Maintenance and Operation of Physical Plants in Universities and Colleges in Central States Region and Rocky Mountain Region.

    ERIC Educational Resources Information Center

    Association of Physical Plant Administrators, Corvallis, OR.

    Presented in this document are data pertaining to maintenance and operations costs at colleges and universities in the central states region and the Rocky Mountain region. The major accounts included in the cost analysis are: (1) physical plant administration, (2) building maintenance, (3) custodial services, (4) utilities, (5) landscape and…

  3. Humanistic Education and Self-Actualization Theory.

    ERIC Educational Resources Information Center

    Farmer, Rod

    1984-01-01

    Stresses the need for theoretical justification for the development of humanistic education programs in today's schools. Explores Abraham Maslow's hierarchy of needs and theory of self-actualization. Argues that Maslow's theory may be the best available for educators concerned with educating the whole child. (JHZ)

  4. Children's Rights and Self-Actualization Theory.

    ERIC Educational Resources Information Center

    Farmer, Rod

    1982-01-01

    Educators need to seriously reflect upon the concept of children's rights. Though the idea of children's rights has been debated numerous times, the idea remains vague and shapeless; however, Maslow's theory of self-actualization can provide the children's rights idea with a needed theoretical framework. (Author)

  5. Culture Studies and Self-Actualization Theory.

    ERIC Educational Resources Information Center

    Farmer, Rod

    1983-01-01

    True citizenship education is impossible unless students develop the habit of intelligently evaluating cultures. Abraham Maslow's theory of self-actualization, a theory of innate human needs and of human motivation, is a nonethnocentric tool which can be used by teachers and students to help them understand other cultures. (SR)

  6. Group Counseling for Self-Actualization.

    ERIC Educational Resources Information Center

    Streich, William H.; Keeler, Douglas J.

    Self-concept, creativity, growth orientation, an integrated value system, and receptiveness to new experiences are considered to be crucial variables to the self-actualization process. A regular, year-long group counseling program was conducted with 85 randomly selected gifted secondary students in the Farmington, Connecticut Public Schools. A…

  7. Racial Discrimination in Occupations: Perceived and Actual.

    ERIC Educational Resources Information Center

    Turner, Castellano B.; Turner, Barbara F.

    The relationship between the actual representation of Blacks in certain occupations and individual perceptions of the occupational opportunity structure were examined. A scale which rated the degree of perceived discrimination against Blacks in 21 occupations was administered to 75 black male, 70 black female, 1,429 white male and 1,457 white…

  8. Developing Human Resources through Actualizing Human Potential

    ERIC Educational Resources Information Center

    Clarken, Rodney H.

    2012-01-01

    The key to human resource development is in actualizing individual and collective thinking, feeling and choosing potentials related to our minds, hearts and wills respectively. These capacities and faculties must be balanced and regulated according to the standards of truth, love and justice for individual, community and institutional development,…

  9. Impact of patient adherence on the cost-effectiveness of noninvasive tests for the initial diagnosis of Helicobacter pylori infection in the United States

    PubMed Central

    Boklage, Susan H; Mangel, Allen W; Ramamohan, Varun; Mladsi, Deirdre; Wang, Tao

    2016-01-01

    Objective Previous US-based economic models of noninvasive tests for diagnosis of Helicobacter pylori infection did not consider patient adherence or downstream costs of continuing infection. This analysis evaluated the long-term cost-effectiveness of the urea breath test (UBT), fecal antigen test (FAT), and serology for diagnosis of H. pylori infection after incorporating information regarding test adherence. Materials and methods A decision-analytic model incorporating adherence information evaluated the cost-effectiveness of the UBT, FAT, and serology for diagnosis of H. pylori infection. Positive test results led to first-line triple therapy; no further action was taken for nonadherence or negative results. Excess lifetime costs and reduced quality-adjusted life-years (QALYs) were estimated for patients with continuing H. pylori infection. Results In the base-case scenario with estimated adherence rates of 86%, 48%, and 86% for the UBT, monoclonal FAT, and serology, respectively, corresponding expected total costs were US$424.99, $466.41, and $404.98/patient. Test costs were higher for the UBT, but were fully or partially offset by higher excess lifetime costs for the monoclonal FAT and serology. The QALYs gained/patient with the UBT vs monoclonal FAT and serology were 0.86 and 0.27, respectively. The UBT was dominant vs the monoclonal FAT, leading to lower costs and higher QALYs; the UBT was cost-effective vs serology (incremental cost/QALY gained $74). Conclusion Based on a comprehensive modeled analysis that included consideration of patient test adherence and long-term consequences resulting from continuing H. pylori infection, the UBT provided the greatest economic value among noninvasive tests for diagnosis of H. pylori infection, because of high patient adherence and excellent test performance. PMID:26855566

  10. Measuring costs of child abuse and neglect: a mathematic model of specific cost estimations.

    PubMed

    Conrad, Cynthia

    2006-01-01

    Few empirical facts exist regarding the actual costs of child abuse in the United States. Consistent data is not available for national or even statewide analysis. Clearly there is a need for such accounting in order to fully understand the damage created by child abuse and neglect. Policy makers and social welfare planners should take child abuse costs into consideration when determining expenditures for prevention and intervention programs. The real savings may far outweigh the costs of such programs when both direct and indirect costs of child abuse and neglect enter into the analysis. This paper offers a model in which the actual costs of child abuse and neglect, based on direct, indirect, and opportunity costs associated with each case. Direct costs are those associated with the treatment of abused and neglected children as well as the costs of family intervention programs or foster care. Indirect costs are costs to society created by the negative effects of child abuse and neglect evinced by individuals who suffer such abuse and then as teens or adults engage in criminal behavior. Indirect costs also derive from the long term and ongoing health care needs required by victims of abuse, for both physical and mental health disorders. With the existence of this model, the author hopes to stimulate the discussion and desire for better data collection and analysis. In order to demonstrate the utility of the model, the author has included some cost estimates from the Connecticut State Department of Children and Families and the works of other scholars looking into the question of costs for child abuse and neglect. This data represents the best available at this time. As a result, the model appearing here is specific to Connecticut. Even so, once more valid data becomes available, the model's structure and theoretical framework should adapt to the needs of other states to facilitate better measurement of relevant costs and provide a clearer picture of the utility of

  11. Indirect costs in chronic obstructive pulmonary disease: A review of the economic burden on employers and individuals in the United States

    PubMed Central

    Patel, Jeetvan G; Nagar, Saurabh P; Dalal, Anand A

    2014-01-01

    Objective To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD) in the US. Methods Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality. Results Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987–2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%–18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27–63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3–19.4 days. Estimates of bed confinement range from 13–32 days per year. Estimated mean annual indirect costs were $893–$2,234/person (US dollars) with COPD ($1,521–$3,348 in 2010 [US dollars]) and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect) costs, indirect costs accounted for 27%–61% of total costs, depending on the population studied. Conclusions COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability. Consideration of indirect as well as direct costs is necessary to gain a more complete view of the societal burden of COPD. PMID:24672234

  12. United States Air Force 611th Civil Engineer Squadron, Elmendorf AFB, Alaska. Final engineering evaluation/cost analysis potential tce impact to the drinking water supply, Galena Airport, Alaska

    SciTech Connect

    1996-02-05

    This decision document presents the selected removal action to address potential trichloroethene (TCE) impact to drinking water supply wells, located in the Installation Restoration Program (IRP) site ST009, otherwise known as the West Unit, at Galena Airport, Alaska. The information fron the RI Report is summarized, along with an analysis of potential removal action alternatives, in the Engineering Evaluation/Cost Analysis (EE/CA).

  13. Societal costs of exposure to toxic substances: economic and health costs of four case studies that are candidates for environmental causation.

    PubMed Central

    Muir, T; Zegarac, M

    2001-01-01

    Four outcomes that evidence suggests are candidates for "environmental causation" were chosen for analysis: diabetes, Parkinson's disease (PD), neurodevelopmental effects and hypothyroidism, and deficits in intelligence quotient (IQ). These are an enormous burden in the United States, Canada, and other industrial countries. We review findings on actual social and economic costs, construct estimates of some of the costs from pertinent sources, and provide several hypothetical examples consistent with published evidence. Many detailed costs are estimated, but these are fragmented and missing in coverage and jurisdiction. Nonetheless, the cumulative costs identified are very large, totaling $568 billion to $793 billion per year for Canada and the United States combined. Partial Canadian costs alone are $46 billion to $52 billion per year. Specifics include diabetes (United States and Canada), $128 billion per year; PD in the United States, $13 billion to $28.5 billion per year; neurodevelopmental deficits and hypothryoidism are endemic and, including estimates of costs of childhood disorders that evidence suggests are linked, amount to $81.5 billion to $167 billion per year for the United States and $2 billion per year in Ontario; loss of 5 IQ points cost $30 billion per year in Canada and $275 billion to $326 billion per year in the United States; and hypothetical dynamic economic impacts cost another $19 billion to $92 billion per year for the United States and Canada combined. Reasoned arguments based on the weight of evidence can support the hypothesis that at least 10%, up to 50% of these costs are environmentally induced--between $57 billion and $397 billion per year. PMID:11744507

  14. Cost Is Not Everything.

    ERIC Educational Resources Information Center

    Clement, Russell T.

    1985-01-01

    Reports results of survey of 21 smaller to medium-sized (50,000-200,000 volumes) libraries which was conducted to determine factors used to make selection decisions in purchase of automated turnkey systems from established vendors. Factors examined include costs, software, hardware, and vendors for parts A (actual experience) and B (hypothetical…

  15. Cost-Effectiveness Analysis of Brief and Expanded Evidence-Based Risk Reduction Interventions for HIV-Infected People Who Inject Drugs in the United States

    PubMed Central

    Song, Dahye L.; Altice, Frederick L.; Copenhaver, Michael M.; Long, Elisa F.

    2015-01-01

    Aims Two behavioral HIV prevention interventions for people who inject drugs (PWID) infected with HIV include the Holistic Health Recovery Program for HIV+ (HHRP+), a comprehensive evidence-based CDC-supported program, and an abbreviated Holistic Health for HIV (3H+) Program, an adapted HHRP+ version in treatment settings. We compared the projected health benefits and cost-effectiveness of both programs, in addition to opioid substitution therapy (OST), to the status quo in the U.S. Methods A dynamic HIV transmission model calibrated to epidemic data of current US populations was created. Projected outcomes include future HIV incidence, HIV prevalence, and quality-adjusted life years (QALYs) gained under alternative strategies. Total medical costs were estimated to compare the cost-effectiveness of each strategy. Results Over 10 years, expanding HHRP+ access to 80% of PWID could avert up to 29,000 HIV infections, or 6% of the projected total, at a cost of $7,777/QALY gained. Alternatively, 3H+ could avert 19,000 infections, but is slightly more cost-effective ($7,707/QALY), and remains so under widely varying effectiveness and cost assumptions. Nearly two-thirds of infections averted with either program are among non-PWIDs, due to reduced sexual transmission from PWID to their partners. Expanding these programs with broader OST coverage could avert up to 74,000 HIV infections over 10 years and reduce HIV prevalence from 16.5% to 14.1%, but is substantially more expensive than HHRP+ or 3H+ alone. Conclusions Both behavioral interventions were effective and cost-effective at reducing HIV incidence among both PWID and the general adult population; however, 3H+, the economical HHRP+ version, was slightly more cost-effective than HHRP+. PMID:25658949

  16. Treatment of paediatric burns with a nanocrystalline silver dressing compared with standard wound care in a burns unit: a cost analysis.

    PubMed

    Cox, S G; Cullingworth, L; Rode, H

    2011-10-01

    Burns are a leading cause of non-natural death in South African infants and children. Conventional care of partial-thickness burns often requires painful, time consuming and costly twice-daily dressing changes to clean the wound and apply antimicrobial topical agents. A new topical nanocrystalline silver-coated NS dressing (Acticoat; Smith & Nephew) has been developed and is the first-line treatment of choice in many burn centres. However, because of its cost the Department of Health has been reluctant to introduce it as a standard of care. We retrospectively studied 4 randomly selected paediatric burn patients, calculating the cost associated with the use of NS dressings and comparing this with the projected costs of three previously standard burn wound treatment regimens. NS dressings were changed every 3 days based on their sustained and slow release of silver ions over 72 hours. Using NS clearly saved costs compared with the three other regimens. The demonstrated cost savings resulted primarily from the decreased number of dressings, and the presumed shorter hospital stay. PMID:22272852

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

    SciTech Connect

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

    2008-01-07

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

  18. The Actual Apollo 13 Prime Crew

    NASA Technical Reports Server (NTRS)

    1970-01-01

    The actual Apollo 13 lunar landing mission prime crew from left to right are: Commander, James A. Lovell Jr., Command Module pilot, John L. Swigert Jr.and Lunar Module pilot, Fred W. Haise Jr. The original Command Module pilot for this mission was Thomas 'Ken' Mattingly Jr. but due to exposure to German measles he was replaced by his backup, Command Module pilot, John L. 'Jack' Swigert Jr.

  19. Effects of Losartan-based therapy on the incidence of end-stage renal disease and associated costs in type 2 diabetes mellitus: A retrospective cost-effectiveness analysis in the United Kingdom

    PubMed Central

    Vora, Jiten; Carides, George; Robinson, Paul

    2005-01-01

    Background: In the Reduction of Endpoints in Non-Insulin-Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan (RENAAL) study, the primary composite end point was the 2-fold increase in baseline serum creatinine concentration, the development of end-stage renal disease (ESRD), or death. The effects of losartan used for the prevention or delay of progression of diabetic nephropathy to ESRD were compared with those of conventional anti-hypertensive treatment (control) (calcium channel blockers, diuretics, α-blockers, β-blockers, and centrally acting agents), but not angiotensin-converting enzyme (ACE) inhibitors or angiotensin II antagonists (AIIAs), in 1513 adults with type 2 diabetes mellitus (DM-2) and nephropathy. Both treatment groups received conventional antihypertensive therapy (calcium channel blockers, diuretics, α-blockers, β-blockers, and/or centrally acting agents). ACE inhibitors and AIIAs were not allowed during the study period. The relative risk (RR) for composite outcome was 25% less, and the RR for ESRD was 28% less, in the losartantreated group compared with the control group. Objective: The aim of this retrospective cost-effectiveness analysis was to use data from the RENAAL study to determine the survival benefits and lifetime direct medical costs of a losartan-based regimen for the prevention of ESRD in patients with DM-2 and nephropathy in the setting of the UK National Health Service (NHS). Methods: This analysis used life-years saved as the effectiveness measure. The effect of losartan-based treatment on ESRD risk was confined to the trial period (3.5 years). However, survival and the lifetime direct medical costs of managing ESRD were projected beyond the trial period to incorporate the full effects of ESRD on survival and resource use. The effect of altering key variables was examined using 1-way sensitivity analyses. Results: ESRD-related costs were significantly lower in patients receiving losartan-based treatment

  20. Specific Space Transportation Costs to GEO - Past, Present and Future

    NASA Astrophysics Data System (ADS)

    Koelle, Dietrich E.

    2002-01-01

    The largest share of space missions is going to the Geosynchronous Orbit (GEO); they have the highest commercial importance. The paper first shows the historic trend of specific transportation costs to GEO from 1963 to 2002. It started out with more than 500 000 /kg(2002-value) and has come down to 36 000 /kg. This reduction looks impressive, however, the reason is NOT improved technology or new techniques but solely the growth of GEO payloads`unit mass. The first GEO satellite in 1963 did have a mass of 36 kg mass (BoL) . This has grown to a weight of 1600 kg (average of all GEO satellites) in the year 2000. Mass in GEO after injection is used here instead of GTO mass since the GTO mass depends on the launch site latitude. The specific cost reduction is only due to the "law-of-scale", valid in the whole transportation business: the larger the payload, the lower the specific transportation cost. The paper shows the actual prices of launch services to GTO by the major launch vehicles. Finally the potential GEO transportation costs of future launch systems are evaluated. What is the potential reduction of specific transportation costs if reusable elements are introduced in future systems ? Examples show that cost reductions up to 75 % seem achievable - compared to actual costs - but only with launch systems optimized according to modern principles of cost engineering. 1. 53rd International Astronautical Congress, World Space Congress Houston 2. First Submission 3. Specific Space Transportation Costs to GEO - Past, Present and Future 4. KOELLE, D.E. 5. IAA.1.1 Launch Vehicles' Cost Engineering and Economic Competitiveness 6. D.E. Koelle; A.E. Goldstein 7. One overhead projector and screen 8. Word file attached 9. KOELLE I have approval to attend the Congress. I am not willing to present this paper at the IAC Public Outreach Program.

  1. Cost-Effectiveness of Single- Versus Generic Multiple-Tablet Regimens for Treatment of HIV-1 Infection in the United States

    PubMed Central

    E. Sweet, Donna; L. Altice, Frederick; J. Cohen, Calvin; Vandewalle, Björn

    2016-01-01

    Background The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs), may result in less efficacious medications and/or more complex regimens with the expectation of marked monetary savings. A modeling approach that assesses the merits of such policies in terms of lifelong costs and health outcomes using adherence and effectiveness data from real-world U.S. settings. Methods A comprehensive computer-based microsimulation model was developed to assess the lifetime health (life expectancy and quality adjusted life-years—QALYs) and economic outcomes in HIV-1 infected patients initiating STRs compared with multiple-table regimens including generic medications where possible (gMTRs). The STRs considered included tenofovir disoproxil fumarate/emtricitabine and efavirenz or rilpivirine or elvitegravir/cobicistat. gMTRs substitutions included each counterpart to STRs, including generic lamivudine for emtricitabine and generic versus branded efavirenz. Results Life expectancy is estimated to be 1.301 years higher (discounted 0.619 QALY gain) in HIV-1 patients initiating a single-tablet regimen in comparison to a generic-based multiple-table regimen. STRs were associated with an average increment of $26,547.43 per patient in medication and $1,824.09 in other medical costs due to longer survival which were partially offset by higher inpatients costs ($12,035.61) with gMTRs treatment. Overall, STRs presented incremental lifetime costs of $16,335.91 compared with gMTRs, resulting in an incremental cost-effectiveness ratio of $26,383.82 per QALY gained. Conclusions STRs continue to represent good value for money under contemporary cost-effectiveness thresholds despite substantial price reductions of generic medications in the U. S. PMID:26808503

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

    PubMed

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

    2015-12-01

    Operating room services are one of the major cost and revenue-generating centres of a hospital. The cost associated with the provisioning of operating department services depends on the resources consumed and the unit costs of those resources. The objective of this study was to calculate the cost of operation theatre services at Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi. The study was carried out at the operation theatre department of Jai Prakash Narayan Apex Trauma Centre (JPNATC), AIIMS from April 2010 to March 2011 after obtaining approval from concerned authorities. This study was observational and descriptive in nature. Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of operation theatre (OT) services. Cost was calculated under two heads; as capital and operating cost. Annualised cost of capital assets was calculated according to the methodology prescribed by the World Health Organization and operating costs were taken on actual basis; thereafter, per day cost of OT services was obtained. The average number of surgeries performed in the trauma centre per day is 13. The annual cost of providing operating room services at JPNATC, New Delhi was calculated to be 197,298,704 Indian rupees (INR) (US$ 3,653,679), while the per hour cost was calculated to be INR 22,626.92 (US$ 419). Majority of the expenditures were for human resource (33.63 %) followed by OT capital cost (31.90 %), consumables (29.97 %), engineering maintenance cost (2.55 %), support services operating cost (1.22 %) and support services capital cost (0.73 %). Of the total cost towards the provisioning of OT services, 32.63 % was capital cost while 67.37 % is operating cost. The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 54). PMID:26730059

  3. Costs of groundwater contamination

    SciTech Connect

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

    1990-01-01

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

  4. Area-Specific Marginal Costing for Electric Utilities: a Case Study of Transmission and Distribution Costs

    NASA Astrophysics Data System (ADS)

    Orans, Ren

    1990-10-01

    Existing procedures used to develop marginal costs for electric utilities were not designed for applications in an increasingly competitive market for electric power. The utility's value of receiving power, or the costs of selling power, however, depend on the exact location of the buyer or seller, the magnitude of the power and the period of time over which the power is used. Yet no electric utility in the United States has disaggregate marginal costs that reflect differences in costs due to the time, size or location of the load associated with their power or energy transactions. The existing marginal costing methods used by electric utilities were developed in response to the Public Utilities Regulatory Policy Act (PURPA) in 1978. The "ratemaking standards" (Title 1) established by PURPA were primarily concerned with the appropriate segmentation of total revenues to various classes-of-service, designing time-of-use rating periods, and the promotion of efficient long-term resource planning. By design, the methods were very simple and inexpensive to implement. Now, more than a decade later, the costing issues facing electric utilities are becoming increasingly complex, and the benefits of developing more specific marginal costs will outweigh the costs of developing this information in many cases. This research develops a framework for estimating total marginal costs that vary by the size, timing, and the location of changes in loads within an electric distribution system. To complement the existing work at the Electric Power Research Institute (EPRI) and Pacific Gas and Electric Company (PGandE) on estimating disaggregate generation and transmission capacity costs, this dissertation focuses on the estimation of distribution capacity costs. While the costing procedure is suitable for the estimation of total (generation, transmission and distribution) marginal costs, the empirical work focuses on the geographic disaggregation of marginal costs related to electric

  5. Air resistance measurements on actual airplane parts

    NASA Technical Reports Server (NTRS)

    Weiselsberger, C

    1923-01-01

    For the calculation of the parasite resistance of an airplane, a knowledge of the resistance of the individual structural and accessory parts is necessary. The most reliable basis for this is given by tests with actual airplane parts at airspeeds which occur in practice. The data given here relate to the landing gear of a Siemanms-Schuckert DI airplane; the landing gear of a 'Luftfahrzeug-Gesellschaft' airplane (type Roland Dlla); landing gear of a 'Flugzeugbau Friedrichshafen' G airplane; a machine gun, and the exhaust manifold of a 269 HP engine.

  6. The Economic Costs of Poverty in the United States: Subsequent Effects of Children Growing Up Poor. Discussion Paper No. 1327-07

    ERIC Educational Resources Information Center

    Holzer, Harry J.; Schanzenbach, Diane Whitmore; Duncan, Greg J.; Ludwig, Jens

    2007-01-01

    In this paper, we review a range of rigorous research studies that estimate the average statistical relationships between children growing up in poverty and their earnings, propensity to commit crime, and quality of health later in life. We also review estimates of the costs that crime and poor health per person impose on the economy. Then we…

  7. Better Cash Management Can Reduce the Cost of the National Direct Student Loan Program. Report to the Congress by the Comptroller General of the United States.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    The Office of Education has allowed schools participating in the National Direct Student Loan Program to hold more than an annual average of $63 million in federal funds in excess of their 30-day needs. The General Accounting Office estimates that if the Treasury had this money it could save the government interest costs of as much as $4 million,…

  8. Pell Grant Validation Imposes Some Costs and Does Not Greatly Reduce Award Errors: New Strategies Are Needed. Report to the Honorable Paul Simon, United States Senate.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    Efforts of the U.S. Department of Education to verify data submitted by applicants to the Pell Grant program were analyzed by the General Accounting Office. The effects of carrying out the Department's policy or methodology, called "validation," on financial aid applicants and colleges were assessed. Costs of 1982-1983 validation on schools were…

  9. The Benefits and Costs of Accreditation of Undergraduate Medical Education Programs Leading to the MD Degree in the United States and Its Territories

    ERIC Educational Resources Information Center

    Muhtadi, Dalal J.

    2013-01-01

    This study assessed the value of accreditation of all 126 fully-accredited four-year undergraduate medical education programs leading to the MD degree in the US through two lenses, "perceived benefits and costs" from the perspective of the leadership of internal stakeholders of the aforementioned programs. The online survey was sent to a…

  10. Continued urbanization of the United States is causing the deterioration of the central city; costly suburban developments; and increases in congestion, pollution, crime, violence and alienation

    NASA Technical Reports Server (NTRS)

    1975-01-01

    It is shown that urban sprawl and the abuses of technological industries result in substantial environmental and economic costs at the expense of center city locations and populations. Socioeconomic deterioration and modification of the biosphere triggers climatic and environmental changes leading to ecosystem damage and destruction, health consequences and international conflict.

  11. The Costs to the Nation of Inadequate Education. A Report Prepared for the Select Committee on Equal Educational Opportunity of the United States Senate.

    ERIC Educational Resources Information Center

    Levin, Henry M.; And Others

    The purpose of this study was to estimate the costs to the nation of the inadequate education of a substantial portion of the population, where an inadequate education for the latter third of the twentieth century was defined as an attainment of less than high school graduation. Using data from the Department of Commerce and other sources in…

  12. Program Tracks Cost Of Travel

    NASA Technical Reports Server (NTRS)

    Mauldin, Lemuel E., III

    1993-01-01

    Travel Forecaster is menu-driven, easy-to-use computer program that plans, forecasts cost, and tracks actual vs. planned cost of business-related travel of division or branch of organization and compiles information into data base to aid travel planner. Ability of program to handle multiple trip entries makes it valuable time-saving device.

  13. Continued investigation of solid propulsion economics. Task 1B: Large solid rocket motor case fabrication methods - Supplement process complexity factor cost technique

    NASA Technical Reports Server (NTRS)

    Baird, J.

    1967-01-01

    This supplement to Task lB-Large Solid Rocket Motor Case Fabrication Methods supplies additional supporting cost data and discusses in detail the methodology that was applied to the task. For the case elements studied, the cost was found to be directly proportional to the Process Complexity Factor (PCF). The PCF was obtained for each element by identifying unit processes that are common to the elements and their alternative manufacturing routes, by assigning a weight to each unit process, and by summing the weighted counts. In three instances of actual manufacture, the actual cost per pound equaled the cost estimate based on PCF per pound, but this supplement, recognizes that the methodology is of limited, rather than general, application.

  14. Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom12

    PubMed Central

    Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

    2015-01-01

    Background: The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). Objective: The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. Design: In this cross-sectional study of adults aged 39–79 y from the European Prospective Investigation into Cancer and Nutrition–Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom–based supermarket comparison website. Results: Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P < 0.0001). Among the DASH food groups, GHGs were most strongly and positively associated with meat consumption and negatively with whole-grain consumption. In addition, higher accordance with the DASH diet was associated with higher dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Conclusions: Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet

  15. Ion propulsion cost effectivity

    NASA Technical Reports Server (NTRS)

    Zafran, S.; Biess, J. J.

    1978-01-01

    Ion propulsion modules employing 8-cm thrusters and 30-cm thrusters were studied for Multimission Modular Spacecraft (MMS) applications. Recurring and nonrecurring cost elements were generated for these modules. As a result, ion propulsion cost drivers were identified to be Shuttle charges, solar array, power processing, and thruster costs. Cost effective design approaches included short length module configurations, array power sharing, operation at reduced thruster input power, simplified power processing units, and power processor output switching. The MMS mission model employed indicated that nonrecurring costs have to be shared with other programs unless the mission model grows. Extended performance missions exhibited the greatest benefits when compared with monopropellant hydrazine propulsion.

  16. Low cost solar array project: Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The results of the free space reactor experimental work are summarized. Overall, the objectives were achieved and the unit can be confidently scaled to the EPSDU size based on the experimental work and supporting theoretical analyses. The piping and instrumentation of the fluidized bed reactor was completed.

  17. Predicted Versus Actual Savings for a Low-Rise Multifamily Retrofit in Boulder, Colorado

    SciTech Connect

    Arena, L.; Williamson, J.

    2013-11-01

    To determine the most cost-effective methods of improving buildings, accurate analysis and prediction of the energy use of existing buildings is essential. However, multiple studies confirm that analysis methods tend to over-predict energy use in poorly insulated, leaky homes and thus, the savings associated with improving those homes. In this project, the Building America CARB team evaluated the retrofit of a multifamily building in Boulder, CO. The updated property is a 37 unit, 2 story apartment complex built in 1950, which underwent renovations in early 2009 to bring it into compliance with Boulder, CO's SmartRegs ordinance. Goals of the study were to: 1) evaluate predicted versus actual savings due to the improvements, 2) identify areas where the modeling assumptions may need to be changed, and 3) determine common changes made by renters that would negatively impact energy savings. Other issues that were investigated include the effects of improving building efficiency on tenant comfort, the impact on tenant turnover rates, and the potential market barriers for this type of community scale project.

  18. Predicted Versus Actual Savings for a Low-Rise Multifamily Retrofit in Boulder, Colorado

    SciTech Connect

    Arena, L.; Williamson, J.

    2013-11-01

    To determine the most cost-effective methods of improving buildings, accurate analysis and prediction of the energy use of existing buildings is essential. However, multiple studies confirm that analysis methods tend to over-predict energy use in poorly insulated, leaky homes and thus, the savings associated with improving those homes. In NREL's report titled 'Assessing and Improving the Accuracy of Energy Analysis of Residential Buildings,' researchers propose a method for improving the accuracy of residential energy analysis methods. A key step in this process involves the comparisons of predicted versus metered energy use and savings. In support of this research need, CARB evaluated the retrofit of a multifamily building in Boulder, CO. The updated property is a 37 unit, 2 story apartment complex built in 1950, which underwent renovations in early 2009 to bring it into compliance with Boulder, CO's SmartRegs ordinance. Goals of the study were to: 1) evaluate predicted versus actual savings due to the improvements, 2) identify areas where the modeling assumptions may need to be changed, and 3) determine common changes made by renters that would negatively impact energy savings. In this study, CARB seeks to improve the accuracy of modeling software while assessing retrofit measures to specifically determine which are most effective for large multifamily complexes in the cold climate region. Other issues that were investigated include the effects of improving building efficiency on tenant comfort, the impact on tenant turnover rates, and the potential market barriers for this type of community scale project.

  19. Effectiveness and Cost-Effectiveness of Sequential Treatment of Patients with Chronic Myeloid Leukemia in the United States: A Decision Analysis

    PubMed Central

    Rochau, Ursula; Kluibenschaedl, Martina; Stenehjem, David; Kuan-Ling, Kuo; Radich, Jerald; Oderda, Gary; Brixner, Diana; Siebert, Uwe

    2015-01-01

    Currently several tyrosine kinase inhibitors (TKIs) are approved for treatment of chronic myeloid leukemia (CML). Our goal was to identify the optimal sequential treatment strategy in terms of effectiveness and cost-effectiveness for CML patients within the US health care context. We evaluated 18 treatment strategies regarding survival, quality-adjusted survival, and costs. For model parameters, the literature data, expert surveys, registry data, and economic databases were used. Evaluated strategies included imatinib, dasatinib, nilotinib, bosutinib, ponatinib, stem-cell transplantation (SCT), and chemotherapy. We developed a Markov state-transition model, which was analyzed as a cohort simulation over a lifelong time horizon with a third-party payer perspective and discount rate of 3%. Remaining life expectancies ranged from 5.4 years (3.9 quality-adjusted life years (QALYs)) for chemotherapy treatment without TKI to 14.4 years (11.1 QALYs) for nilotinib→dasatinib→chemotherapy/SCT. In the economic evaluation, imatinib→chemotherapy/SCT resulted in an incremental cost-utility ratio (ICUR) of $171,700/QALY compared to chemotherapy without TKI. Imatinib→nilotinib→chemotherapy/SCT yielded an ICUR of $253,500/QALY compared to imatinib→chemotherapy/SCT. Nilotinib→dasatinib→chemotherapy/SCT yielded an ICUR of $445,100/QALY compared to imatinib→nilotinib→chemotherapy/SCT. All remaining strategies were excluded due to dominance of the clinically superior strategies. Based on our analysis and current treatment guidelines, imatinib→nilotinib→chemotherapy/SCT and nilotinib→dasatinib→chemotherapy/SCT can be considered cost-effective for patients with CML, depending on willingness-to-pay. PMID:26783469

  20. Low cost solar array project. Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

    NASA Astrophysics Data System (ADS)

    1980-03-01

    Technical activities are reported in the design of process, facilities, and equipment for producing silicon at a rate and price comensurate with production goals for low cost solar cell modules. The silane-silicone process has potential for providing high purity poly-silicon on a commercial scale at a price of fourteen dollars per kilogram by 1986, (1980 dollars). Commercial process, economic analysis, process support research and development, and quality control are discussed.

  1. Low cost solar array project. Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Technical activities are reported in the design of process, facilities, and equipment for producing silicon at a rate and price comensurate with production goals for low cost solar cell modules. The silane-silicone process has potential for providing high purity poly-silicon on a commercial scale at a price of fourteen dollars per kilogram by 1986, (1980 dollars). Commercial process, economic analysis, process support research and development, and quality control are discussed.

  2. The Feto-Maternal Health Cost of Intimate Partner Violence Among Delivery-Related Discharges in the United States, 2002-2009.

    PubMed

    Mogos, Mulubrhan F; Araya, Winta N; Masho, Saba W; Salemi, Jason L; Shieh, Carol; Salihu, Hamisu M

    2016-02-01

    Our purpose was to estimate the national prevalence of intimate partner violence (IPV) among delivery-related discharges and to investigate its association with adverse feto-maternal birth outcomes and delivery-related cost. A retrospective cross-sectional analysis of delivery-related hospital discharges from 2002 to 2009 was conducted using the Nationwide Inpatient Sample (NIS). We used ICD-9-CM codes to identify IPV, covariates, and outcomes. Multivariable logistic regression modeling was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the associations between IPV and each outcome. Joinpoint regression was used for trend analysis. During the study period, 3,649 delivery-related discharges were diagnosed with IPV (11.2 per 100,000; 95% CI = [10.0, 12.4]). IPV diagnosis during delivery is associated with stillbirth (AOR = 4.12, 95% CI = [2.75, 6.17]), preterm birth (AOR = 1.97, 95% CI = [1.59, 2.44]), fetal death (AOR = 3.34, 95% CI = [1.99, 5.61]), infant with poor intrauterine growth (AOR = 1.55, 95% CI = [1.01, 2.40]), and increased inpatient hospital care cost (US$5,438.2 vs. US$4,080.1) per each discharge, incurring an additional cost of US$4,955,707 during the study period. IPV occurring during pregnancy has a significant health burden to both the mother and infant. Education about IPV; screening at periodic intervals, including during obstetric visits; and ongoing clinical care could help to reduce or eliminate adverse effects of pregnancy-related IPV. Preventing the lifelong consequences associated with IPV can have a positive effect on the overall health of all women and delivery-related health care cost. PMID:25392375

  3. Comparative Analysis of Thermoeconomic Evaluation Criteria for an Actual Heat Engine

    NASA Astrophysics Data System (ADS)

    Özel, Gülcan; Açıkkalp, Emin; Savaş, Ahmet Fevzi; Yamık, Hasan

    2016-07-01

    In the present study, an actual heat engine is investigated by using different thermoeconomic evaluation criteria in the literature. A criteria that has not been investigated in detail is considered and it is called as ecologico-economical criteria (F_{EC}). It is the difference of power cost and exergy destruction rate cost of the system. All four criteria are applied to an irreversible Carnot heat engine, results are presented numerically and some suggestions are made.

  4. Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

    PubMed Central

    Othman, Diaa

    2012-01-01

    This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country. PMID:22701169

  5. 24 CFR 81.18 - Affordability-Income level definitions-family size not known (actual or prospective tenants).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... definitions-family size not known (actual or prospective tenants). 81.18 Section 81.18 Housing and Urban... (actual or prospective tenants). In determining whether a rental unit is affordable to very-low, low-, or..., and affordability determined as follows: (a) For moderate-income, the income of prospective...

  6. ESTIMATION OF SMALL SYSTEM WATER TREATMENT COSTS

    EPA Science Inventory

    This report presents cost data for unit processes that are capable of removing contaminants included in the National Interim Primary Drinking Water Regulations. Construction and operation and maintenance cost data are presented for 45 centralized treatment unit processes that are...

  7. The Population Impact and Cost-Effectiveness of Statins for Primary Prevention in Adults 75 and Older in the United States

    PubMed Central

    Odden, Michelle C.; Pletcher, Mark J.; Coxson, Pamela G.; Thekkethala, Divya; Guzman, David; Heller, David; Goldman, Lee; Bibbins-Domingo, Kirsten

    2015-01-01

    BACKGROUND Over 40% of adults 75 and older are taking statins, yet there is little evidence to guide primary prevention in this population. OBJECTIVE To project the population impact and cost-effectiveness of statin therapy in adults aged 75 years and older. DESIGN Forecasting study using the Cardiovascular Disease Policy Model, a Markov model. DATA SOURCE Trial, cohort, and nationally-representative data sources. TARGET POPULATION U.S. adults aged 75–94 years. TIME HORIZON 10 years. PERSPECTIVE Health care system. INTERVENTION Statins for primary prevention based on: 1) Low density lipoprotein cholesterol ≥4.91 mmol/L (190 mg/dL), 2) ≥4.14 mmol/L (160 mg/dL), 3) ≥3.36 mmol/L (130 mg/dL), 4) diabetes, 5) 10-year risk score ≥7.5% (treat all). OUTCOME MEASURES Myocardial infarction (MI), coronary heart disease (CHD) death, disability adjusted life years, costs RESULT OF BASE-CASE ANALYSIS All adults aged 75 and older in NHANES have a 10-year risk score >7.5%. If statins have no effect on functional limitation or cognitive impairment, all primary prevention strategies would prevent MIs and CHD deaths and be cost effective. The broadest strategy, treatment of all adults aged 75–94 years would result in 8 million additional users, and prevent 105,000 (4.3%) incident MIs and 68,000 (2.3%) CHD deaths at an incremental cost per disability adjusted life year of $25,200. RESULT OF SENSITIVITY ANALYSIS An increased relative risk of functional limitation or mild cognitive impairment in the range of 1.10 to 1.30 could offset the cardiovascular benefits. LIMITATIONS Limited trial evidence targeting primary prevention in adults 75 and older. CONCLUSIONS At effectiveness similar to trial findings, statins are projected to be cost-effective for primary prevention in adults age 75–94 years; however, even a small increase in geriatric specific side effects could offset the cardiovascular benefit. Improved data on the potential benefits and harms of statins are needed to

  8. The actual status of Astronomy in Moldova

    NASA Astrophysics Data System (ADS)

    Gaina, A.

    The astronomical research in the Republic of Moldova after Nicolae Donitch (Donici)(1874-1956(?)) were renewed in 1957, when a satellites observations station was open in Chisinau. Fotometric observations and rotations of first Soviet artificial satellites were investigated under a program SPIN put in action by the Academy of Sciences of former Socialist Countries. The works were conducted by Assoc. prof. Dr. V. Grigorevskij, which conducted also research in variable stars. Later, at the beginning of 60-th, an astronomical Observatory at the Chisinau State University named after Lenin (actually: the State University of Moldova), placed in Lozovo-Ciuciuleni villages was open, which were coordinated by Odessa State University (Prof. V.P. Tsesevich) and the Astrosovet of the USSR. Two main groups worked in this area: first conducted by V. Grigorevskij (till 1971) and second conducted by L.I. Shakun (till 1988), both graduated from Odessa State University. Besides this research areas another astronomical observations were made: Comets observations, astroclimate and atmospheric optics in collaboration with the Institute of the Atmospheric optics of the Siberian branch of the USSR (V. Chernobai, I. Nacu, C. Usov and A.F. Poiata). Comets observations were also made since 1988 by D. I. Gorodetskij which came to Chisinau from Alma-Ata and collaborated with Ukrainean astronomers conducted by K.I. Churyumov. Another part of space research was made at the State University of Tiraspol since the beggining of 70-th by a group of teaching staff of the Tiraspol State Pedagogical University: M.D. Polanuer, V.S. Sholokhov. No a collaboration between Moldovan astronomers and Transdniestrian ones actually exist due to War in Transdniestria in 1992. An important area of research concerned the Radiophysics of the Ionosphere, which was conducted in Beltsy at the Beltsy State Pedagogical Institute by a group of teaching staff of the University since the beginning of 70-th: N. D. Filip, E

  9. What Galvanic Vestibular Stimulation Actually Activates

    PubMed Central

    Curthoys, Ian S.; MacDougall, Hamish Gavin

    2012-01-01

    In a recent paper in Frontiers Cohen et al. (2012) asked “What does galvanic vestibular stimulation actually activate?” and concluded that galvanic vestibular stimulation (GVS) causes predominantly otolithic behavioral responses. In this Perspective paper we show that such a conclusion does not follow from the evidence. The evidence from neurophysiology is very clear: galvanic stimulation activates primary otolithic neurons as well as primary semicircular canal neurons (Kim and Curthoys, 2004). Irregular neurons are activated at lower currents. The answer to what behavior is activated depends on what is measured and how it is measured, including not just technical details, such as the frame rate of video, but the exact experimental context in which the measurement took place (visual fixation vs total darkness). Both canal and otolith dependent responses are activated by GVS. PMID:22833733

  10. MODIS Solar Diffuser: Modelled and Actual Performance

    NASA Technical Reports Server (NTRS)

    Waluschka, Eugene; Xiong, Xiao-Xiong; Esposito, Joe; Wang, Xin-Dong; Krebs, Carolyn (Technical Monitor)

    2001-01-01

    The Moderate Resolution Imaging Spectroradiometer (MODIS) instrument's solar diffuser is used in its radiometric calibration for the reflective solar bands (VIS, NTR, and SWIR) ranging from 0.41 to 2.1 micron. The sun illuminates the solar diffuser either directly or through a attenuation screen. The attenuation screen consists of a regular array of pin holes. The attenuated illumination pattern on the solar diffuser is not uniform, but consists of a multitude of pin-hole images of the sun. This non-uniform illumination produces small, but noticeable radiometric effects. A description of the computer model used to simulate the effects of the attenuation screen is given and the predictions of the model are compared with actual, on-orbit, calibration measurements.

  11. Removal of waterborne pathogens from liver transplant unit water taps in prevention of healthcare-associated infections: a proposal for a cost-effective, proactive infection control strategy.

    PubMed

    Zhou, Z Y; Hu, B J; Qin, L; Lin, Y E; Watanabe, H; Zhou, Q; Gao, X D

    2014-04-01

    Hospital water supplies often contain waterborne pathogens, which can become a reservoir for healthcare-associated infections (HAIs). We surveyed the extent of waterborne pathogen contamination in the water supply of a Liver Transplant Unit. The efficacy of point-of-use (POU) water filters was evaluated by comparative analysis in routine clinical use. Our baseline environmental surveillance showed that Legionella spp. (28%, 38/136), Pseudomonas aeruginosa (8%, 11/136), Mycobacterium spp. (87%, 118/136) and filamentous fungi (50%, 68/136) were isolated from the tap water of the Liver Transplant Unit. 28.9% of Legionella spp.-positive water samples (n = 38) showed high-level Legionella contamination (≥10(3) CFU/L). After installation of the POU water filter, none of these pathogens were found in the POU filtered water samples. Furthermore, colonizations/infections with Gram-negative bacteria determined from patient specimens were reduced by 47% during this period, even if only 27% (3/11) of the distal sites were installed with POU water filters. In conclusion, the presence of waterborne pathogens was common in the water supply of our Liver Transplant Unit. POU water filters effectively eradicated these pathogens from the water supply. Concomitantly, healthcare-associated colonization/infections declined after the POU filters were installed, indicating their potential benefit in reducing waterborne HAIs. PMID:23879308

  12. First-Grade Retention: Effects on Children's Actual and Perceived Performance throughout Elementary Education

    ERIC Educational Resources Information Center

    Goos, Mieke; Van Damme, Jan; Onghena, Patrick; Petry, Katja

    2011-01-01

    This study investigates the effects of repeating first grade on children's further academic growth, by tracking the actual performance and the teacher-rated performance of a cohort of Flemish first-graders until the end of elementary school. Two research questions are raised: (1) How do first-grade repeaters, at the cost of one extra year of…

  13. United States Air Force 611th Civil Engineer Squadron, Elmendorf AFB, Alaska. Final engineering evaluation/cost analysis: Petroleum, oil, and lubricants area, Galena Airport, Alaska

    SciTech Connect

    1996-02-05

    This decision document presents the selected removal action for the Installation Restoration Program (IRP) site ST005, otherwise known as the POL Tank Farm, at Galena Airport, Alaska. This decision is based on the administrative record for this site, specifically the draft Remedial Investigation Report (March 1995) and the Treatability Study Report (January 1995) (PB95-225314). The information from these documents is summarized, along with an analysis of potential removal action alternatives in the Engineering Evaluation/Cost Analysis (EE/CA).

  14. Acute Infections, Cost per Infection and Turnaround Time in Three United States Hospital Laboratories Using Fourth-Generation Antigen-Antibody Human Immunodeficiency Virus Immunoassays.

    PubMed

    Wesolowski, Laura G; Nasrullah, Muazzam; Coombs, Robert W; Rosenberg, Eric; Ethridge, Steven F; Hutchinson, Angela B; Dragavon, Joan; Rychert, Jennifer; Nolte, Frederick S; Madory, James E; Werner, Barbara G

    2016-01-01

    Background.  To improve clinical and public health outcomes through early human immunodeficiency virus (HIV) detection, fourth-generation antigen/antibody immunoassay (4IA) and supplemental testing results must be returned rapidly. Methods.  We examined HIV testing data at Harborview Medical Center (HMC), Massachusetts General Hospital (MGH), and the Medical University of South Carolina (MUSC), which used 4IA and supplemental antibody and nucleic acid tests (NATs). At MGH and MUSC, HIV-1 Western blot (WB) and HIV-2 testing were conducted at a reference laboratory. We compared time from specimen collection to laboratory result for established (positive WB) and acute infections (reactive 4IA, negative/indeterminate WB, detectable NAT), and we calculated testing cost per positive-test result. Results.  From 3731 (MUSC) to 19 774 (MGH) tests were conducted; 0.01% (MGH) to 0.05% (HMC) were acute infections. Each laboratory had reactive 4IA, WB-negative, or indeterminate specimens without NAT (ie, potential acute infections). Time to result was 1.5 (HMC) to 5.2 days (MGH) for acute and 1.0 (HMC) to 5.2 days (MGH) for established infections. Costs were $1054 (MGH) to $1521 (MUSC). Conclusions.  Conducting supplemental testing in-house lowered turnaround times, which may be further reduced with rapid HIV-1/HIV-2 differentiation tests. Hospitals may benefit from quantitative NATs not requiring physician orders, so all potential acute infections receive NAT. PMID:26798766

  15. Cost-benefit analysis of implementing an aluminum and tin recycling program onboard United States Naval Combatants. Master`s thesis

    SciTech Connect

    Devinney, E.W.

    1995-12-01

    This thesis analyzes the financial feasibility of implementing a recycling program onboard U.S. Naval Combatants. This study focuses primarily on revenues generated from the sale of aluminum and tin, as they compose the most significant portions of a ship`s recyclable waste stream. Specific factors investigated include storage limitations, sanitation concerns, manpower issues, cost constraints, lack of training, lack of incentives, tangible benefits, and perceived benefits. Usage data for both tin and aluminum were gathered from each ship type to determine required storage volumes and potential revenues from the sale of the recyclables. A thorough space inspection was conducted of each ship type to ascertain potential storage spaces and their suitability for temporary storage while underway. Specific findings are that there is adequate storage room aboard these ships, that crews` quality of life will not be sacrificed, and that there exists potential for significant revenues by selling the recyclable cans, all of which are retained by the ship. More generally, it is shown that it is cost-effective to implement an aluminum and tin recycling program onboard U.S. Naval Combatants.

  16. Acute Infections, Cost per Infection and Turnaround Time in Three United States Hospital Laboratories Using Fourth-Generation Antigen-Antibody Human Immunodeficiency Virus Immunoassays

    PubMed Central

    Wesolowski, Laura G.; Nasrullah, Muazzam; Coombs, Robert W.; Rosenberg, Eric; Ethridge, Steven F.; Hutchinson, Angela B.; Dragavon, Joan; Rychert, Jennifer; Nolte, Frederick S.; Madory, James E.; Werner, Barbara G.

    2016-01-01

    Background. To improve clinical and public health outcomes through early human immunodeficiency virus (HIV) detection, fourth-generation antigen/antibody immunoassay (4IA) and supplemental testing results must be returned rapidly. Methods. We examined HIV testing data at Harborview Medical Center (HMC), Massachusetts General Hospital (MGH), and the Medical University of South Carolina (MUSC), which used 4IA and supplemental antibody and nucleic acid tests (NATs). At MGH and MUSC, HIV-1 Western blot (WB) and HIV-2 testing were conducted at a reference laboratory. We compared time from specimen collection to laboratory result for established (positive WB) and acute infections (reactive 4IA, negative/indeterminate WB, detectable NAT), and we calculated testing cost per positive-test result. Results. From 3731 (MUSC) to 19 774 (MGH) tests were conducted; 0.01% (MGH) to 0.05% (HMC) were acute infections. Each laboratory had reactive 4IA, WB-negative, or indeterminate specimens without NAT (ie, potential acute infections). Time to result was 1.5 (HMC) to 5.2 days (MGH) for acute and 1.0 (HMC) to 5.2 days (MGH) for established infections. Costs were $1054 (MGH) to $1521 (MUSC). Conclusions. Conducting supplemental testing in-house lowered turnaround times, which may be further reduced with rapid HIV-1/HIV-2 differentiation tests. Hospitals may benefit from quantitative NATs not requiring physician orders, so all potential acute infections receive NAT. PMID:26798766

  17. Analysis of nuclear power plant construction costs

    SciTech Connect

    Not Available

    1986-01-01

    The objective of this report is to present the results of a statistical analysis of nuclear power plant construction costs and lead-times (where lead-time is defined as the duration of the construction period), using a sample of units that entered construction during the 1966-1977 period. For more than a decade, analysts have been attempting to understand the reasons for the divergence between predicted and actual construction costs and lead-times. More importantly, it is rapidly being recognized that the future of the nuclear power industry rests precariously on an improvement in the cost and lead-time situation. Thus, it is important to study the historical information on completed plants, not only to understand what has occurred to also to improve the ability to evaluate the economics of future plants. This requires an examination of the factors that have affected both the realized costs and lead-times and the expectations about these factors that have been formed during the construction process. 5 figs., 22 tabs.

  18. Caustic-Side Solvent Extraction: Prediction of Cesium Extraction for Actual Wastes and Actual Waste Simulants

    SciTech Connect

    Delmau, L.H.; Haverlock, T.J.; Sloop, F.V., Jr.; Moyer, B.A.

    2003-02-01

    This report presents the work that followed the CSSX model development completed in FY2002. The developed cesium and potassium extraction model was based on extraction data obtained from simple aqueous media. It was tested to ensure the validity of the prediction for the cesium extraction from actual waste. Compositions of the actual tank waste were obtained from the Savannah River Site personnel and were used to prepare defined simulants and to predict cesium distribution ratios using the model. It was therefore possible to compare the cesium distribution ratios obtained from the actual waste, the simulant, and the predicted values. It was determined that the predicted values agree with the measured values for the simulants. Predicted values also agreed, with three exceptions, with measured values for the tank wastes. Discrepancies were attributed in part to the uncertainty in the cation/anion balance in the actual waste composition, but likely more so to the uncertainty in the potassium concentration in the waste, given the demonstrated large competing effect of this metal on cesium extraction. It was demonstrated that the upper limit for the potassium concentration in the feed ought to not exceed 0.05 M in order to maintain suitable cesium distribution ratios.

  19. Clinical and cost burden of rotavirus infection before and after introduction of rotavirus vaccines among commercially and Medicaid insured children in the United States

    PubMed Central

    Krishnarajah, Girishanthy; Demissie, Kitaw; Lefebvre, Patrick; Gaur, Sunanda; Sheng Duh, Mei

    2014-01-01

    This study aims to quantify clinical and economic burden of rotavirus (RV) infection pre- and post-vaccine introduction in commercially insured and Medicaid populations. Beneficiaries with continuous enrollment for ≥6 months while <5 years of age were identified separately in commercial (2000–2010) and Medicaid (2002–2009) claims databases. Commercial and Medicaid databases included 3 998 708 and 1 034 440 eligible children, respectively, observed from enrollment start date(s) to end of eligibility or 5-years-old. Rates of RV-coded and diarrhea-coded encounters and first RV episodes, and incremental cost of first RV episodes were calculated. In the post-vaccine period, rates per 10 000 person-years for RV-coded hospitalizations, outpatient visits and ER visits were 5.58 (95% CI, 5.37–5.80), 6.96 (95% CI, 6.75–7.20), and 4.85 (95% CI, 4.66–5.06), respectively (pre-vaccine, 16.67 [95% CI, 16.19–17.15], 13.20 [95% CI, 12.78–13.63], 11.26 [95% CI, 10.87–11.66], respectively), for commercially insured. In Medicaid the corresponding rates were 10.53 (95% CI, 9.60–11.56), 11.72 (95% CI, 10.73–12.80), and 9.11 (95% CI, 8.24–10.07) (pre-vaccine, 19.78 [95% CI, 19.14–20.45], 19.39 [95% CI, 18.75–20.05], 27.61 [95% CI, 26.84–28.40]). Incidence rate per 10 000 person-years for first RV episode pre- vs. post-vaccine were 27.03 (95% CI, 26.42–27.65) vs. 10.14 (95% CI, 9.86–10.44) in the commercially insured population and 37.71 (95% CI, 36.81–38.63) vs. 18.64 (95% CI, 17.37–19.99) in Medicaid. Incremental per-patient per-month cost of first RV episode was $3363 (95% CI, $3308-$3418) among commercially insured and $1831 (95% CI, $1768-$1887) in Medicaid. Since vaccine introduction clinical burden of RV disease decreased among children; costs associated with RV episodes remained significant across insured populations. PMID:25424930

  20. Sexualization of Awareness: Catchy, but Does It Actually Increase Knowledge of Breast Cancer?

    ERIC Educational Resources Information Center

    Burgess, Melinda C. R.; Murray, Ashley B.

    2014-01-01

    Currently, in the United States, there exist numerous public awareness campaigns about breast cancer. Many of these campaigns are highly sexualized, focusing on the breasts as an object of fun, as opposed to focusing on information about prevention/diagnosis/treatment. In spite of their popularity, it is unknown what effect they actually have on…

  1. 12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will:...

  2. 12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Ensuring environmental documents are actually considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES PROCEDURES FOR COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT Eximbank Implementing Procedures § 408.5 Ensuring...

  3. 12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will:...

  4. 12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will:...

  5. 12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will:...

  6. Systematic Review of Programs Treating High-Need and High-Cost People With Multiple Chronic Diseases or Disabilities in the United States, 2008–2014

    PubMed Central

    Bleich, Sara N.; Sherrod, Cheryl; Chiang, Anne; Boyd, Cynthia; Wolff, Jennifer; DuGoff, Eva; Salzberg, Claudia; Anderson, Keely; Leff, Bruce

    2015-01-01

    Introduction Finding ways to provide better and less expensive health care for people with multiple chronic conditions or disability is a pressing concern. The purpose of this systematic review was to evaluate different approaches for caring for this high-need and high-cost population. Methods We searched Medline for articles published from May 31, 2008, through June 10, 2014, for relevant studies. Articles were considered eligible for this review if they met the following criteria: included people with multiple chronic conditions (behavioral or mental health) or disabilities (2 or more); addressed 1 or more of clinical outcomes, health care use and spending, or patient satisfaction; and compared results from an intervention group with a comparison group or baseline measurements. We extracted information on program characteristics, participant characteristics, and significant (positive and negative) clinical findings, patient satisfaction, and health care use outcomes. For each outcome, the number of significant and positive results was tabulated. Results Twenty-seven studies were included across 5 models of care. Of the 3 studies reporting patient satisfaction outcomes, 2 reported significant improvements; both were randomized controlled trials (RCTs). Of the 14 studies reporting clinical outcomes, 12 reported improvements (8 were RCTs). Of the 13 studies reporting health care use and spending outcomes, 12 reported significant improvements (2 were RCTs). Two models of care — care and case management and disease management — reported improvements in all 3 outcomes. For care and case management models, most improvements were related to health care use. For the disease management models, most improvements were related to clinical outcomes. Conclusions Care and case management as well as disease management may be promising models of care for people with multiple chronic conditions or disabilities. More research and consistent methods are needed to understand the

  7. Using activity-based costing in surgery.

    PubMed

    Grandlich, Cheryl

    2004-01-01

    ACTIVITY-BASED COSTING is an accounting technique that allows organizations to determine actual costs associated with their services based on the resources they consume. THIS TECHNIQUE can be used in a variety of ways, including targeting high-cost activities, forecasting financial baselines, and supporting resource allocation. FOUR STEPS should be followed when applying activity-based costing to surgical procedures. THIS ARTICLE explores how Froedtert Memorial Lutheran Hospital, Milwaukee, used activity-based costing. PMID:14763586

  8. Correlation of Spacecraft Mission and Project Costs

    NASA Technical Reports Server (NTRS)

    Swan, Christopher; Jarrett, Shawn

    2007-01-01

    A key component of any cost risk analysis is the level of correlation between individual elements of cost. This analysis supplements the available historical records with the cost estimates from the JPL Advanced Design Team. The costs from actual JPL flight projects are then used to validate the results, clearly indicating that, on average, the correlation between elements of cost is between 0.4 and 0.7.

  9. Chronic hepatitis B and C infection in the United States: a review of current guidelines, disease burden and cost effectiveness of screening.

    PubMed

    Sarpel, Dost; Baichoo, Esha; Dieterich, Douglas T

    2016-05-01

    Chronic hepatitis B and C infection are the leading causes of hepatocellular carcinoma and liver related death in the world and in the United States respectively. Screening guidelines have been developed based on estimated prevalence determined by NHANES data. However, individuals with the most risk of chronic infection (incarcerated, homeless, immigrants, nursing home residents, and hospitalized persons) are underrepresented in this cohort leading to an underestimation of the true prevalence of chronic hepatitis B and C infection. This has led to recent updates in the screening guidelines. This review examines the change in the guidelines, the likely true seroprevalence of hepatitis B and C virus, as well as the burden of chronic infection in this population. PMID:27043049

  10. On the cost of approximating and recognizing a noise perturbed straight line or a quadratic curve segment in the plane. [central processing units

    NASA Technical Reports Server (NTRS)

    Cooper, D. B.; Yalabik, N.

    1975-01-01

    Approximation of noisy data in the plane by straight lines or elliptic or single-branch hyperbolic curve segments arises in pattern recognition, data compaction, and other problems. The efficient search for and approximation of data by such curves were examined. Recursive least-squares linear curve-fitting was used, and ellipses and hyperbolas are parameterized as quadratic functions in x and y. The error minimized by the algorithm is interpreted, and central processing unit (CPU) times for estimating parameters for fitting straight lines and quadratic curves were determined and compared. CPU time for data search was also determined for the case of straight line fitting. Quadratic curve fitting is shown to require about six times as much CPU time as does straight line fitting, and curves relating CPU time and fitting error were determined for straight line fitting. Results are derived on early sequential determination of whether or not the underlying curve is a straight line.

  11. 23 CFR 140.906 - Labor costs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  12. A GIS COST MODEL TO ASSESS THE AVAILABILITY OF FRESHWATER, SEAWATER, AND SALINE GROUNDWATER FOR ALGAL BIOFUEL PRODUCTION IN THE UNITED STATES

    SciTech Connect

    Venteris, Erik R.; Skaggs, Richard; Coleman, Andre M.; Wigmosta, Mark S.

    2013-03-15

    A key advantage of using microalgae for biofuel production is the ability of some algal strains to thrive in waters unsuitable for conventional crop irrigation such as saline groundwater or seawater. Nonetheless, the availability of sustainable water supplies will provide significant challenges for scale-up and development of algal biofuels. We conduct a limited techno-economic assessment based on the availability of freshwater, saline groundwater, and seawater for use in open pond algae cultivation systems. We explore water issues through GIS-based models of algae biofuel production, freshwater supply, and cost models for supplying seawater and saline groundwater. We estimate that combined, within the coterminous US these resources can support production on the order of 9.46E+7 m3 yr-1 (25 billion gallons yr-1) of renewable biodiesel. Achievement of larger targets requires the utilization of less water efficient sites and relatively expensive saline waters. Geographically, water availability is most favorable for the coast of the Gulf of Mexico and Florida peninsula, where evaporation relative to precipitation is moderate and various saline waters are economically available. As a whole, barren and scrub lands of the southwestern US have limited freshwater supplies so accurate assessment of alternative waters is critical.

  13. Radioactive Doses - Predicted and Actual - and Likely Health Effects.

    PubMed

    Nagataki, S; Takamura, N

    2016-04-01

    Five years have passed since the nuclear accident at Fukushima Daiichi Nuclear Power Stations on 11 March 2011. Here we refer to reports from international organisations as sources of predicted values obtained from environmental monitoring and dose estimation models, and reports from various institutes in Japan are used as sources of individual actual values. The World Health Organization, based on information available up to 11 September 2011 (and published in 2012), reported that characteristic effective doses in the first year after the accident, to all age groups, were estimated to be in the 10-50 mSv dose band in example locations in evacuation areas. Estimated characteristic thyroid doses to infants in Namie Town were within the 100-200 mSv dose band. A report from the United Nations Scientific Committee on the Effects of Atomic Radiation published in 2014 shows that the effective dose received by adults in evacuation areas during the first year after the accident was 1.1-13 mSv. The absorbed dose to the thyroid in evacuated settlements was 7.2-35 mSv in adults and 15-83 mSv in 1-year-old infants. Individual external radiation exposure in the initial 4 months after the accident, estimated by superimposing individual behaviour data on to a daily dose rate map, was less than 3 mSv in 93.9% of residents (maximum 15 mSv) in evacuation areas. Actual individual thyroid equivalent doses were less than 15 mSv in 98.8% of children (maximum 25 mSv) in evacuation areas. When uncertainty exists in dose estimation models, it may be sensible to err on the side of caution, and final estimated doses are often much greater than actual radiation doses. However, overestimation of the dose at the time of an accident has a great influence on the psychology of residents. More than 100 000 residents have not returned to the evacuation areas 5 years after the Fukushima accident because of the social and mental effects during the initial period of the disaster. Estimates of

  14. Elements of Designing for Cost

    NASA Technical Reports Server (NTRS)

    Dean, Edwin B.; Unal, Resit

    1992-01-01

    During recent history in the United States, government systems development has been performance driven. As a result, systems within a class have experienced exponentially increasing cost over time in fixed year dollars. Moreover, little emphasis has been placed on reducing cost. This paper defines designing for cost and presents several tools which, if used in the engineering process, offer the promise of reducing cost. Although other potential tools exist for designing for cost, this paper focuses on rules of thumb, quality function deployment, Taguchi methods, concurrent engineering, and activity based costing. Each of these tools has been demonstrated to reduce cost if used within the engineering process.

  15. Elements of designing for cost

    NASA Technical Reports Server (NTRS)

    Dean, Edwin B.; Unal, Resit

    1992-01-01

    During recent history in the United States, government systems development has been performance driven. As a result, systems within a class have experienced exponentially increasing cost over time in fixed year dollars. Moreover, little emphasis has been placed on reducing cost. This paper defines designing for cost and presents several tools which, if used in the engineering process, offer the promise of reducing cost. Although other potential tools exist for designing for cost, this paper focuses on rules of thumb, quality function deployment, Taguchi methods, concurrent engineering, and activity-based costing. Each of these tools has been demonstrated to reduce cost if used within the engineering process.

  16. Low cost solar aray project: Experimental process system development unit for producing semiconductor-grade silicon using the silane-to-silicon process

    NASA Technical Reports Server (NTRS)

    1981-01-01

    This phase consists of the engineering design, fabrication, assembly, operation, economic analysis, and process support R&D for an Experimental Process System Development Unit (EPSDU). The mechanical bid package was issued and the bid responses are under evaluation. Similarly, the electrical bid package was issued, however, responses are not yet due. The majority of all equipment is on order or has been received at the EPSDU site. The pyrolysis/consolidation process design package was issued. Preparation of process and instrumentation diagram for the free-space reactor was started. In the area of melting/consolidation, Kayex successfully melted chunk silicon and have produced silicon shot. The free-space reactor powder was successfully transported pneumatically from a storage bin to the auger feeder twenty-five feet up and was melted. The fluid-bed PDU has successfully operated at silane feed concentrations up to 21%. The writing of the operating manual has started. Overall, the design phase is nearing completion.

  17. Electric propulsion cost estimation

    NASA Technical Reports Server (NTRS)

    Palaszewski, B. A.

    1985-01-01

    A parametric cost model for mercury ion propulsion modules is presented. A detailed work breakdown structure is included. Cost estimating relationships were developed for the individual subsystems and the nonhardware items (systems engineering, software, etc.). Solar array and power processor unit (PPU) costs are the significant cost drivers. Simplification of both of these subsystems through applications of advanced technology (lightweight solar arrays and high-efficiency, self-radiating PPUs) can reduce costs. Comparison of the performance and cost of several chemical propulsion systems with the Hg ion module are also presented. For outer-planet missions, advanced solar electric propulsion (ASEP) trip times and O2/H2 propulsion trip times are comparable. A three-year trip time savings over the baselined NTO/MMH propulsion system is possible with ASEP.

  18. Aid Effectiveness, Transaction Costs and Conditionality in the Education Sector

    ERIC Educational Resources Information Center

    Ashford, Richard; Biswas, Shampa

    2010-01-01

    The reduction of transaction costs is a commonly mentioned yet rarely elaborated goal for aid effectiveness in educational development. The casual use of the concept of transaction costs conceals which costs may be reduced, which costs are required and, indeed, what transaction costs actually are. Examining issues related to harmonizing the…

  19. 40 CFR 35.940-4 - Indirect costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Indirect costs. Indirect costs shall be allowable in accordance with an indirect cost agreement negotiated... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Indirect costs. 35.940-4 Section 35.940... the same as the actual indirect costs....

  20. 40 CFR 35.940-4 - Indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Indirect costs. Indirect costs shall be allowable in accordance with an indirect cost agreement negotiated... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Indirect costs. 35.940-4 Section 35.940... the same as the actual indirect costs....

  1. 40 CFR 35.940-4 - Indirect costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Indirect costs. Indirect costs shall be allowable in accordance with an indirect cost agreement negotiated... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Indirect costs. 35.940-4 Section 35.940... the same as the actual indirect costs....

  2. 40 CFR 35.940-4 - Indirect costs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Indirect costs. Indirect costs shall be allowable in accordance with an indirect cost agreement negotiated... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Indirect costs. 35.940-4 Section 35.940... the same as the actual indirect costs....

  3. 40 CFR 35.940-4 - Indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Indirect costs. Indirect costs shall be allowable in accordance with an indirect cost agreement negotiated... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Indirect costs. 35.940-4 Section 35.940... the same as the actual indirect costs....

  4. Tele-ICU: Efficacy and Cost-Effectiveness Approach of Remotely Managing the Critical Care

    PubMed Central

    Kumar, Sajeesh; Merchant, Shezana; Reynolds, Rebecca

    2013-01-01

    Tele-ICU has an off-site command center in which a critical care team (intensivists and critical care nurses) is connected with patients in distance intensive care units (ICUs) through a real-time audio, visual and electronic means and health information is exchanged. The aim of this paper is to review literature to explore the available studies related to efficacy and cost effectiveness of Tele-ICU applications and to study the possible barriers to broader adoption. While studies draw conclusions on cost based on the mortality and Length of Stay (LOS), actual cost was not reported. Another problem in the studies was the lack of consistent measurement, reporting and adjustment for patient severity. From the data available, Tele-ICU seems to be a promising path, especially in the United States where there is a limited number of board-certified intensivists. PMID:24078857

  5. LIFE Cost of Electricity, Capital and Operating Costs

    SciTech Connect

    Anklam, T

    2011-04-14

    Successful commercialization of fusion energy requires economic viability as well as technical and scientific feasibility. To assess economic viability, we have conducted a pre-conceptual level evaluation of LIFE economics. Unit costs are estimated from a combination of bottom-up costs estimates, working with representative vendors, and scaled results from previous studies of fission and fusion plants. An integrated process model of a LIFE power plant was developed to integrate and optimize unit costs and calculate top level metrics such as cost of electricity and power plant capital cost. The scope of this activity was the entire power plant site. Separately, a development program to deliver the required specialized equipment has been assembled. Results show that LIFE power plant cost of electricity and plant capital cost compare favorably to estimates for new-build LWR's, coal and gas - particularly if indicative costs of carbon capture and sequestration are accounted for.

  6. Direct and Indirect Effects of Completion versus Accuracy Contingencies on Practice-Exam and Actual-Exam Performance

    ERIC Educational Resources Information Center

    Oliver, Renee; Williams, Robert L.

    2005-01-01

    Students in four sections of an undergraduate educational course (two large and two small sections) took out-of-class practice exams prior to actual exams for each of five course units. Each course unit consisted of five class sessions focusing on a specific developmental theme. Some sections received practice-exam credit based on the number of…

  7. Estimating the Deep Space Network modification costs to prepare for future space missions by using major cost drivers

    NASA Technical Reports Server (NTRS)

    Remer, Donald S.; Sherif, Josef; Buchanan, Harry R.

    1993-01-01

    This paper develops a cost model to do long range planning cost estimates for Deep Space Network (DSN) support of future space missions. The paper focuses on the costs required to modify and/or enhance the DSN to prepare for future space missions. The model is a function of eight major mission cost drivers and estimates both the total cost and the annual costs of a similar future space mission. The model is derived from actual cost data from three space missions: Voyager (Uranus), Voyager (Neptune), and Magellan. Estimates derived from the model are tested against actual cost data for two independent missions, Viking and Mariner Jupiter/Saturn (MJS).

  8. STEAM REFORMING TECHNOLOGY DEMONSTRATION FOR THE DESTRUCTION OF ORGANICS ON ACTUAL DOE SAVANNAH RIVER SITE TANK 48H WASTE 9138

    SciTech Connect

    Burket, P

    2009-02-24

    This paper describes the design of the Bench-scale Steam Reformer (BSR); a processing unit for demonstrating steam reforming technology on actual radioactive waste [1]. It describes the operating conditions of the unit used for processing a sample of Savannah River Site (SRS) Tank 48H waste. Finally, it compares the results from processing the actual waste in the BSR to processing simulant waste in the BSR to processing simulant waste in a large pilot scale unit, the Fluidized Bed Steam Reformer (FBSR), operated at Hazen Research Inc. in Golden, CO. The purpose of this work was to prove that the actual waste reacted in the same manner as the simulant waste in order to validate the work performed in the pilot scale unit which could only use simulant waste.

  9. Planter unit test stand

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A planter test stand was developed to evaluate individual row-crop metering units in early 2013. This test stand provided the ability to quantify actual seed metering in terms of population, seed spacing, skips, and multiples over a range of meter RPMs and vacuum pressures. Preliminary data has been...

  10. Calculation of the Average Cost per Case of Dengue Fever in Mexico Using a Micro-Costing Approach

    PubMed Central

    2016-01-01

    Introduction The increasing burden of dengue fever (DF) in the Americas, and the current epidemic in previously unaffected countries, generate major costs for national healthcare systems. There is a need to quantify the average cost per DF case. In Mexico, few data are available on costs, despite DF being endemic in some areas. Extrapolations from studies in other countries may prove unreliable and are complicated by the two main Mexican healthcare systems (the Secretariat of Health [SS] and the Mexican Social Security Institute [IMSS]). The present study aimed to generate specific average DF cost-per-case data for Mexico using a micro-costing approach. Methods Expected medical costs associated with an ideal management protocol for DF (denoted ´ideal costs´) were compared with the medical costs of current treatment practice (denoted ´real costs´) in 2012. Real cost data were derived from chart review of DF cases and interviews with patients and key personnel from 64 selected hospitals and ambulatory care units in 16 states for IMSS and SS. In both institutions, ideal and real costs were estimated using the program, actions, activities, tasks, inputs (PAATI) approach, a micro-costing technique developed by us. Results Clinical pathways were obtained for 1,168 patients following review of 1,293 charts. Ideal and real costs for SS patients were US$165.72 and US$32.60, respectively, in the outpatient setting, and US$587.77 and US$490.93, respectively, in the hospital setting. For IMSS patients, ideal and real costs were US$337.50 and US$92.03, respectively, in the outpatient setting, and US$2,042.54 and US$1,644.69 in the hospital setting. Conclusions The markedly higher ideal versus real costs may indicate deficiencies in the actual care of patients with DF. It may be necessary to derive better estimates with micro-costing techniques and compare the ideal protocol with current practice when calculating these costs, as patients do not always receive optimal care

  11. An Introduction to the NCHEMS Costing and Data Management System. Technical Report No. 55.

    ERIC Educational Resources Information Center

    Haight, Mike; Martin, Ron

    The NCHEMS Costing and Data Management System is designed to assist institutions in the implementation of cost studies. There are at least two kinds of cost studies: historical cost studies which display cost-related data that reflect actual events over a specific prior time period, and predictive cost studies which forecast costs that will be…

  12. Independent Study Course Development Costs.

    ERIC Educational Resources Information Center

    Wright, Clayton R.

    1988-01-01

    Discusses actual costs for developing independent study print courses for use in learning centers or for distance delivery, and presents a resource allocation guideline based on figures from Grant MacEwan Community College (Alberta). Topics discussed include the course writer/developer, clerical support, copyright clearance, instructional design,…

  13. Cost goals

    NASA Technical Reports Server (NTRS)

    Hoag, J.

    1981-01-01

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

  14. What Do Cost Functions Tell Us about the Cost of an Adequate Education?

    ERIC Educational Resources Information Center

    Costrell, Robert; Hanushek, Eric; Loeb, Susanna

    2008-01-01

    Econometric cost functions have begun to appear in education adequacy cases with greater frequency. Cost functions are superficially attractive because they give the impression of objectivity, holding out the promise of scientifically estimating the cost of achieving specified levels of performance from actual data on spending. By contrast, the…

  15. Avoidable waste management costs

    SciTech Connect

    Hsu, K.; Burns, M.; Priebe, S.; Robinson, P.

    1995-01-01

    This report describes the activity based costing method used to acquire variable (volume dependent or avoidable) waste management cost data for routine operations at Department of Energy (DOE) facilities. Waste volumes from environmental restoration, facility stabilization activities, and legacy waste were specifically excluded from this effort. A core team consisting of Idaho National Engineering Laboratory, Los Alamos National Laboratory, Rocky Flats Environmental Technology Site, and Oak Ridge Reservation developed and piloted the methodology, which can be used to determine avoidable waste management costs. The method developed to gather information was based on activity based costing, which is a common industrial engineering technique. Sites submitted separate flow diagrams that showed the progression of work from activity to activity for each waste type or treatability group. Each activity on a flow diagram was described in a narrative, which detailed the scope of the activity. Labor and material costs based on a unit quantity of waste being processed were then summed to generate a total cost for that flow diagram. Cross-complex values were calculated by determining a weighted average for each waste type or treatability group based on the volume generated. This study will provide DOE and contractors with a better understanding of waste management processes and their associated costs. Other potential benefits include providing cost data for sites to perform consistent cost/benefit analysis of waste minimization and pollution prevention (WMIN/PP) options identified during pollution prevention opportunity assessments and providing a means for prioritizing and allocating limited resources for WMIN/PP.

  16. Tracking Costs

    ERIC Educational Resources Information Center

    Erickson, Paul W.

    2010-01-01

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

  17. Comparison of actual and predicted energy savings in Minnesota gas-heated single-family homes

    SciTech Connect

    Hirst, E.; Goeltz, R.

    1984-03-01

    Data available from a recent evaluation of a home energy audit program in Minnesota are sufficient to allow analysis of the actual energy savings achieved in audited homes and of the relationship between actual and predicted savings. The program, operated by Northern States Power in much of the southern half of the state, is part of Minnesota's version of the federal Residential Conservation Service. NSP conducted almost 12 thousand RCS audits between April 1981 (when the progam began) and the end of 1982. The data analyzed here, available for 346 homes that obtained an NSP energy audit, include monthly natural gas bills from October 1980 through April 1983; heating degree day data matched to the gas bills; energy audit reports; and information on household demographics, structure characteristics, and recent conservation actions from mail and telephone surveys. The actual reduction in weather-adjusted natural gas use between years 1 and 3 averaged 19 MBtu across these homes (11% of preprogram consumption); the median value of the saving was 16 MBtu/year. The variation in actual saving is quite large: gas consumption increased in almost 20% of the homes, while gas consumption decreased by more than 50 MBtu/year in more than 10% of the homes. These households reported an average expenditure of almost $1600 for the retrofit measures installed in their homes; the variation in retrofit cost, while large, was not as great as the variation in actual natural gas savings.

  18. 76 FR 22410 - Notice of Proposed Information Collection: Comment Request; Mortgagor's Certificate of Actual Cost

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ... Federal Information Relay Service, (1-800-877-8339). FOR FURTHER INFORMATION CONTACT: Joyce Allen... of 1995 (44 U.S.C. chapter 35, as amended). This Notice is soliciting comments from members of the... approved collection. Authority: The Paperwork Reduction Act of 1995, 44 U.S.C., Chapter 35, as...

  19. Marginal Costing Techniques for Higher Education.

    ERIC Educational Resources Information Center

    Allen, Richard; Brinkman, Paul

    The techniques for calculating marginal costs in higher education are examined in detail. Marginal costs, as defined in economics, is the change in total cost associated with producing one additional unit of output. In higher education, the most frequently selected unit of output is a full-time-equivalent student or, alternatively, a student…

  20. Reflex Estrogen Receptor (ER) and Progesterone Receptor (PR) Analysis of Ductal Carcinoma In Situ (DCIS) in Breast Needle Core Biopsy Specimens: An Unnecessary Exercise That Costs the United States $35 Million/y.

    PubMed

    VandenBussche, Christopher J; Cimino-Mathews, Ashley; Park, Ben Ho; Emens, Leisha A; Tsangaris, Theodore N; Argani, Pedram

    2016-08-01

    %), indicating that ER/PR testing costing $20,685.72 ($357/patient in the study) had been performed unnecessarily. PR testing could have been omitted in the 16 cases in which ER/PR results were used, which would have saved $5014.72, or $86.46 per patient. Extrapolating the increased cost of $583 per DCIS diagnosis on core needle biopsy to 60,000 new cases of DCIS in the United States each year, reflex core needle biopsy ER/PR testing unnecessarily increases costs by approximately $35 million. We recommend that ER/PR not be reflexively ordered on core needle biopsy specimens or surgical excision specimens containing DCIS, but instead that ER alone be performed on surgical excision specimens only when hormone therapy is a serious consideration after medical oncology consultation. PMID:27299796

  1. 47 CFR 27.1164 - The cost-sharing formula.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...; back-up power equipment; monitoring or control equipment; engineering costs (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works; zoning costs; training... actual costs associated with providing a replacement system, such as equipment and engineering...

  2. 47 CFR 27.1180 - The cost-sharing formula.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...; engineering costs (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works; zoning costs; training; disposal of old equipment; test equipment (vendor required); spare... system, such as equipment and engineering expenses. There is no cap on the actual costs of relocation....

  3. Self-actualization: Its Use and Misuse in Teacher Education.

    ERIC Educational Resources Information Center

    Ivie, Stanley D.

    1982-01-01

    The writings of Abraham Maslow are analyzed to determine the meaning of the psychological term "self-actualization." After pointing out that self-actualization is a rare quality and that it has little to do with formal education, the author concludes that the concept has little practical relevance for teacher education. (PP)

  4. The Self-Actualization of Polk Community College Students.

    ERIC Educational Resources Information Center

    Pearsall, Howard E.; Thompson, Paul V., Jr.

    This article investigates the concept of self-actualization introduced by Abraham Maslow (1954). A summary of Maslow's Needs Hierarchy, along with a description of the characteristics of the self-actualized person, is presented. An analysis of humanistic education reveals it has much to offer as a means of promoting the principles of…

  5. From Self-Awareness to Self-Actualization

    ERIC Educational Resources Information Center

    Cangemi, Joseph P.; Englander, Meryl R.

    1974-01-01

    Highest priority of education is to help students utilize as much of their talent as is possible. Third Force psychologists would interpret this as becoming self-actualized. Self-awareness is required for psychological growth. Without self-awareness there can be no growth, no mental hygiene, and no self-actualization. (Author)

  6. 12 CFR 1806.203 - Selection Process, actual award amounts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Selection Process, actual award amounts. 1806... OF THE TREASURY BANK ENTERPRISE AWARD PROGRAM Awards § 1806.203 Selection Process, actual award... round: (1) To select Applicants not previously selected, using the calculation and selection...

  7. Self-Actualization and the Effective Social Studies Teacher.

    ERIC Educational Resources Information Center

    Farmer, Rodney B.

    1980-01-01

    Discusses a study undertaken to investigate the relationship between social studies teachers' degrees of self-actualization and their teacher effectiveness. Investigates validity of using Maslow's theory of self-actualization as a way of identifying the effective social studies teacher personality. (Author/DB)

  8. Facebook as a Library Tool: Perceived vs. Actual Use

    ERIC Educational Resources Information Center

    Jacobson, Terra B.

    2011-01-01

    As Facebook has come to dominate the social networking site arena, more libraries have created their own library pages on Facebook to create library awareness and to function as a marketing tool. This paper examines reported versus actual use of Facebook in libraries to identify discrepancies between intended goals and actual use. The results of a…

  9. Perceived and Actual Student Support Needs in Distance Education.

    ERIC Educational Resources Information Center

    Visser, Lya; Visser, Yusra Laila

    2000-01-01

    This study sought to determine the academic, affective, and administrative support expectations of distance education students, and to compare actual expectations of distance education students with the instructor's perceptions of such expectations. Results demonstrated divergence between perceived and actual expectations of student support in…

  10. Self-Actualizing Men and Women: A Comparison Study.

    ERIC Educational Resources Information Center

    Hall, Eleanor G.; Hansen, Jan B.

    1997-01-01

    The self-actualization of 167 women who lived in the Martha Cook (MC) dormitory of the University of Michigan (1950-1970) was compared to that of a group of Ivy League men researched in another study. In addition, two groups of MC women were compared to each other to identify differences which might explain why some self-actualized while other did…

  11. SELF-ACTUALIZATION AND THE UTILIZATION OF TALENT.

    ERIC Educational Resources Information Center

    FRENCH, JOHN R.P.; MILLER, DANIEL R.

    THIS STUDY ATTEMPTED (1) TO DEVELOP A THEORY OF THE CAUSES AND CONSEQUENCES OF SELF-ACTUALIZATION AS RELATED TO THE UTILIZATION OF TALENT, (2) TO FIT THE THEORY TO EXISTING DATA, AND (3) TO PLAN ONE OR MORE RESEARCH PROJECTS TO TEST THE THEORY. TWO ARTICLES ON IDENTITY AND MOTIVATION AND SELF-ACTUALIZATION AND SELF-IDENTITY THEORY REPORTED THE…

  12. Self-Actualization Effects Of A Marathon Growth Group

    ERIC Educational Resources Information Center

    Jones, Dorothy S.; Medvene, Arnold M.

    1975-01-01

    This study examined the effects of a marathon group experience on university student's level of self-actualization two days and six weeks after the experience. Gains in self-actualization as a result of marathon group participation depended upon an individual's level of ego strength upon entering the group. (Author)

  13. 26 CFR 1.962-3 - Treatment of actual distributions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 10 2013-04-01 2013-04-01 false Treatment of actual distributions. 1.962-3... TAX (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.962-3 Treatment of actual... a foreign corporation. (ii) Treatment of section 962 earnings and profits under § 1.959-3....

  14. School Guidance Counselors' Perceptions of Actual and Preferred Job Duties

    ERIC Educational Resources Information Center

    Edwards, John Dexter

    2010-01-01

    The purpose of this study was to provide process data for school counselors, administrators, and the public, regarding school counselors' actual roles within the guidance counselor preferred job duties and actual job duties. In addition, factors including National Certification or no National Certification, years of counseling experience, and…

  15. The Yale Cost Model and cost centres: servant or master?

    PubMed

    Rigby, E

    1993-01-01

    Cost accounting describes that aspect of accounting which collects, allocates and controls the cost of producing a service. Costing information is primarily reported to management to enable control of costs and to ensure the financial viability of units, departments and divisions. As costing studies continue to produce estimates of Diagnosis Related Group (DRG) costs in New South Wales hospitals, as well as in other states, costs for different hospitals are being externally compared, using a tool which is usually related to internal management and reporting. Comparability of costs is assumed even though accounting systems differ. This paper examines the cost centre structures at five major teaching hospitals in Sydney. It describes the similarities and differences in how the cost centres were constituted, and then details the line items of expenditure that are charged to each cost centre. The results of a comparative study of a medical specialty are included as evidence of different costing methodologies in the hospitals. The picture that emerged from the study is that the hospitals are constituting their cost centres to meet their internal management needs, that is, to know the cost of running a ward or nursing unit, a medical specialty, department and so on. The rationale for the particular cost centre construction was that cost centre managers could manage and control costs and assign responsibility. There are variations in procedures for assigning costs to cost centres, and the question is asked 'Do these variations in procedures make a material difference to our ability to compare costs per Diagnosis Related Group at the various hospitals?' It is contended that the accounting information, which is produced as a result of different practices, is primarily for internal management, not external comparison. It would be better for hospitals to compare their estimated costs per Diagnosis Related Group to an internal standard cost rather than the costs from other

  16. Department of Energy Environmental Management cost infrastructure development program: Cost analysis requirements

    SciTech Connect

    Custer, W.R. Jr.; Messick, C.D.

    1996-03-31

    This report was prepared to support development of the Department of Energy Environmental Management cost infrastructure -- a new capability to independently estimate and analyze costs. Currently, the cost data are reported according to a structure that blends level of effort tasks with product and process oriented tasks. Also. the budgetary inputs are developed from prior year funding authorizations and from contractor-developed parametric estimates that have been adjusted to planned funding levels or appropriations. Consequently, it is difficult for headquarters and field-level activities to use actual cost data and technical requirements to independently assess the costs generated and identify trends, potential cost savings from process improvements, and cost reduction strategies.

  17. 23 CFR 140.906 - Labor costs.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Labor costs. 140.906 Section 140.906 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT Reimbursement for Railroad Work § 140.906 Labor costs. (a) General. (1) Salaries and wages, at actual or average rates, and related expenses paid by a company...

  18. Costing Child Protective Services Staff Turnover.

    ERIC Educational Resources Information Center

    Graef, Michelle I.; Hill, Erick L.

    2000-01-01

    Details process of determining a child welfare agency's actual dollar costs directly attributed to protective services staff turnover, using the agency's human resources database and interviews with administrative personnel. Provides formulas and process for calculating specific cost elements due to employee separation, replacement, and training.…

  19. 49 CFR 1139.3 - Cost study.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Cost study. 1139.3 Section 1139.3 Transportation... Commodities § 1139.3 Cost study. (a) The respondents shall submit a cost study. Highway Form B may be used for this purpose. Service unit-costs shall be developed for each individual study carrier, adjusted by...

  20. 39 CFR 491.5 - Costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Costs. 491.5 Section 491.5 Postal Service UNITED... RATE COMMISSION § 491.5 Costs. The Postal Service's administrative costs in executing the garnishment action shall be added to each garnishment and the costs recovered shall be retained as...

  1. A Cost Analysis Process for Rural Schools.

    ERIC Educational Resources Information Center

    Sparkman, William E.

    Cost analysis involves breaking down operating costs of a school district and allocating those costs to the appropriate unit of analysis so various comparisons can be made and used by school boards in making decisions about whether to continue certain programs or whether to close or consolidate school buildings. A cost analysis does not provide…

  2. 49 CFR 1139.3 - Cost study.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Cost study. 1139.3 Section 1139.3 Transportation... Commodities § 1139.3 Cost study. (a) The respondents shall submit a cost study. Highway Form B may be used for this purpose. Service unit-costs shall be developed for each individual study carrier, adjusted by...

  3. 39 CFR 491.5 - Costs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Costs. 491.5 Section 491.5 Postal Service UNITED... RATE COMMISSION § 491.5 Costs. The Postal Service's administrative costs in executing the garnishment action shall be added to each garnishment and the costs recovered shall be retained as...

  4. 39 CFR 491.5 - Costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Costs. 491.5 Section 491.5 Postal Service UNITED... RATE COMMISSION § 491.5 Costs. The Postal Service's administrative costs in executing the garnishment action shall be added to each garnishment and the costs recovered shall be retained as...

  5. 39 CFR 491.5 - Costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Costs. 491.5 Section 491.5 Postal Service UNITED... RATE COMMISSION § 491.5 Costs. The Postal Service's administrative costs in executing the garnishment action shall be added to each garnishment and the costs recovered shall be retained as...

  6. 39 CFR 491.5 - Costs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Costs. 491.5 Section 491.5 Postal Service UNITED... RATE COMMISSION § 491.5 Costs. The Postal Service's administrative costs in executing the garnishment action shall be added to each garnishment and the costs recovered shall be retained as...

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

    PubMed

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

    2016-06-01

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

  8. Costing the OMNIUM-G system 7500

    NASA Technical Reports Server (NTRS)

    Fortgang, H. R.

    1980-01-01

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

  9. Perceived and actual wildfire danger: an economic and spatial analysis study in Colorado (USA).

    PubMed

    Kaval, Pamela

    2009-04-01

    Over the last 20 years, costs for wildfire initial attack in the U.S. have increased significantly. The increased cost relates to wildfire suppression practices, as well as the growing number of homes in the wildland urban interface. Requiring wildland urban interface residents to pay an annual tax for their wildfire risk could lower costs to the general taxpayer. Willingness-to-pay for wildfire prevention, in relation to both perceived and actual wildfire danger, was the focus of this study. Surveyed Colorado wildland urban interface residents were found to have a high awareness of wildfire risk and were willing-to-pay over $400 annually to reduce this risk. Respondents' beliefs about wildfire frequency were comparable to the wildfire regimes of their areas' pre-European settlement. PMID:19155120

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

    PubMed Central

    2013-01-01

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

  11. 48 CFR 252.225-7006 - Quarterly reporting of actual contract performance outside the United States.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... this clause is not required if— (1) A foreign place of performance is the principal place of performance of the contract; and (2) The Contractor specified the foreign place of performance in its offer... Director of Defense Procurement and Acquisition Policy (Contract Policy and International...

  12. Safety of patients--actual problem of modern medicine (review).

    PubMed

    Tsintsadze, Neriman; Samnidze, L; Beridze, T; Tsintsadze, M; Tsintsadze, Nino

    2011-09-01

    Safety of patients is actual problem of up-to-date medicine. The current successful treatment of various sicknesses is achieved by implementation in clinical practice such medical preparations (medications), which are characterized with the high therapeutic activity, low toxicity and prolonged effects. In spite of evidence of the pharmacotherapeutical advances, the frequency of complications after medication has grown - that is why the safety of patients is the acute actual problem of medicine and ecological state of human population today. PMID:22156680

  13. Underestimation of Project Costs

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.

    2015-01-01

    Large projects almost always exceed their budgets. Estimating cost is difficult and estimated costs are usually too low. Three different reasons are suggested: bad luck, overoptimism, and deliberate underestimation. Project management can usually point to project difficulty and complexity, technical uncertainty, stakeholder conflicts, scope changes, unforeseen events, and other not really unpredictable bad luck. Project planning is usually over-optimistic, so the likelihood and impact of bad luck is systematically underestimated. Project plans reflect optimism and hope for success in a supposedly unique new effort rather than rational expectations based on historical data. Past project problems are claimed to be irrelevant because "This time it's different." Some bad luck is inevitable and reasonable optimism is understandable, but deliberate deception must be condemned. In a competitive environment, project planners and advocates often deliberately underestimate costs to help gain project approval and funding. Project benefits, cost savings, and probability of success are exaggerated and key risks ignored. Project advocates have incentives to distort information and conceal difficulties from project approvers. One naively suggested cure is more openness, honesty, and group adherence to shared overall goals. A more realistic alternative is threatening overrun projects with cancellation. Neither approach seems to solve the problem. A better method to avoid the delusions of over-optimism and the deceptions of biased advocacy is to base the project cost estimate on the actual costs of a large group of similar projects. Over optimism and deception can continue beyond the planning phase and into project execution. Hard milestones based on verified tests and demonstrations can provide a reality check.

  14. Tele-ICU: Efficacy and Cost-Effectiveness of Remotely Managing Critical Care

    PubMed Central

    Kumar, Sajeesh; Merchant, Shezana; Reynolds, Rebecca

    2013-01-01

    Tele-ICU is the use of an off-site command center in which a critical care team (intensivists and critical care nurses) is connected with patients in distant ICUs to exchange health information through real-time audio, visual, and electronic means. The aim of this study is to review the available literature related to the efficacy and cost-effectiveness of tele-ICU applications and to study the possible barriers to broader adoption. While the available studies draw conclusions on cost based on mortality and length of stay, actual costs were not reported. Another problem with the studies is the lack of consistent measurement, reporting, and adjustment for patient severity. From the data available, tele-ICU seems to be a promising path, especially in the United States, where there is a limited number of board-certified intensivists. PMID:23805066

  15. Improving the efficiency of a four-unit generating station

    SciTech Connect

    Kornegay, D.L.

    1995-12-31

    Increasing the efficiency of hydro generating stations is gaining importance as more and more power stations become automated. The increase in annual revenues due to efficiency improvements is one factor in evaluating the cost justification of an automation project. Several previous works have stated that the efficiency of a generating can be improved by using certain generation dispatching methods. The purpose of this study is to quantify the gain in annual revenues for a four-unit hydro generating station, using actual data from an existing station. The method used in this study does not require a rigorous analytical study. It should, however, provide a reasonably accurate estimate of the potential revenue gain achievable by using an automated generation dispatching control. This method is adaptable to stations with any number of units.

  16. Coal supply and cost under technological and environmental uncertainty

    NASA Astrophysics Data System (ADS)

    Chan, Melissa

    This thesis estimates available coal resources, recoverability, mining costs, environmental impacts, and environmental control costs for the United States under technological and environmental uncertainty. It argues for a comprehensive, well-planned research program that will resolve resource uncertainty, and innovate new technologies to improve recovery and environmental performance. A stochastic process and cost (constant 2005) model for longwall, continuous, and surface mines based on current technology and mining practice data was constructed. It estimates production and cost ranges within 5-11 percent of 2006 prices and production rates. The model was applied to the National Coal Resource Assessment. Assuming the cheapest mining method is chosen to extract coal, 250-320 billion tons are recoverable. Two-thirds to all coal resource can be mined at a cost less than 4/mmBTU. If U.S. coal demand substantially increases, as projected by alternate Energy Information Administration (EIA), resources might not last more than 100 years. By scheduling cost to meet EIA projected demand, estimated cost uncertainty increases over time. It costs less than 15/ton to mine in the first 10 years of a 100 year time period, 10-30/ton in the following 50 years, and 15-$90/ton thereafter. Environmental impacts assessed are subsidence from underground mines, surface mine pit area, erosion, acid mine drainage, air pollutant and methane emissions. The analysis reveals that environmental impacts are significant and increasing as coal demand increases. Control technologies recommended to reduce these impacts are backfilling underground mines, surface pit reclamation, substitution of robotic underground mining systems for surface pit mining, soil replacement for erosion, placing barriers between exposed coal and the elements to avoid acid formation, and coalbed methane development to avoid methane emissions during mining. The costs to apply these technologies to meet more stringent

  17. Treatment program operations and costs.

    PubMed

    Broome, Kirk M; Knight, Danica K; Joe, George W; Flynn, Patrick M

    2012-03-01

    This study investigates how average costs for an episode of care in outpatient drug-free (ODF) treatment relate to clinical intensity (length of stay and weekly counseling hours) and program structure (e.g., size, staffing), controlling for prices paid and selected clientele measures. Based on cost assessments from a naturalistic sample of 67 programs located across the United States (using the Treatment Cost Analysis Tool), robust regression techniques showed that programs having 10% longer treatment stays had episode costs 7% higher; those having 10% more weekly counseling hours per client had 4% higher episode costs. Other important factors included wages, amount of counselors' time conducting sessions, and serving more clients referred from the criminal justice system. The study provides valuable information on treatment program features that relate to costs. Most importantly, cost differences associated with longer stays or more intensive counseling protocols appear modest and may be justified by improved client outcomes. PMID:22154033

  18. Natural gas cost for evaluating energy resource opportunities at Fort Stewart

    SciTech Connect

    Stucky, D.J.; Shankle, S.A.

    1993-01-01

    Ft. Stewart, a United States Army Forces Command (FORSCOM) installation located near Hinesville, Georgia, is currently undergoing an evaluation of its energy usage, which is being performed by Pacific Northwest Laboratory. In order to examine the energy resource opportunities (EROs) at Ft. Stewart, marginal fuel costs must be calculated. The marginal, or avoided, cost of gas service is used in conjunction with the estimated energy savings of an ERO to calculate the dollar value of those savings. In the case of natural gas, the costing becomes more complicated due to the installation of a propane-air mixing station. The propane-air station is being built under a shared energy savings (SES) contract. The building of a propane-air station allows Ft. Stewart to purchase natural gas from their local utility at an interruptible rate, which is lower than the rate for contracting natural gas on a firm basis. The propane-air station will also provide Ft. Stewart with fuel in the event that the natural gas supply is curtailed. While the propane-air station does not affect the actual cost of natural gas, it does affect the cost of services provided by gas. Because the propane-air station and the SES contract affect the cost of gas service, they must be included in the analysis. Our analysis indicates a marginal cost of gas service of 30.0 cents per therm, assuming a total propane usage by the mixing station of 42,278 gallons (38,600 therms) annually. Because the amount of propane that may be required in the event of a curtailment is small relative to the total service requirement, variations in the actual amount should not significantly affect the cost per therm.

  19. Evaluation of activity-based costing versus resource-based relative value costing.

    PubMed

    Berlin, Mark F; Smith, Tommy H

    2004-01-01

    Activity-based costing (ABC) and relative value units costing (RVU) are two approaches that a practice manager can use to determine the cost of physician services. Each costing approach has features that provide distinction as well as differentiation in the cost estimates that are estimated. This paper will provide cost estimates under each approach along with cost estimates under a hybrid approach that merges features from each costing approach known as the ABC-RVU costing technique. A comparison of the results will be provided. PMID:15018372

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

    PubMed Central

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

    2015-01-01

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