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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Actual United States risks. 1.953-2 Section 1... (CONTINUED) INCOME TAXES Controlled Foreign Corporations § 1.953-2 Actual United States risks. (a) In general. For purposes of paragraph (a) of § 1.953-1, the term “United States risks” means risks described...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Actual United States risks. 1.953-2 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.953-2 Actual United States risks. (a) In general. For purposes of paragraph (a) of § 1.953-1, the term “United States risks” means...

  4. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 10 2014-04-01 2013-04-01 true Actual United States risks. 1.953-2 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.953-2 Actual United States risks. (a) In general. For purposes of paragraph (a) of § 1.953-1, the term “United States risks” means...

  5. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 10 2013-04-01 2013-04-01 false Actual United States risks. 1.953-2 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.953-2 Actual United States risks. (a) In general. For purposes of paragraph (a) of § 1.953-1, the term “United States risks” means...

  6. 26 CFR 1.953-2 - Actual United States risks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 10 2012-04-01 2012-04-01 false Actual United States risks. 1.953-2 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.953-2 Actual United States risks. (a) In general. For purposes of paragraph (a) of § 1.953-1, the term “United States risks” means...

  7. Computer/PERT technique monitors actual versus allocated costs

    NASA Technical Reports Server (NTRS)

    Houry, E.; Walker, J. D.

    1967-01-01

    A computer method measures the users performance in cost-type contracts utilizing the existing nasa program evaluation review technique without imposing any additional reporting requirements. progress is measured by comparing actual costs with a value of work performed in a specific period.

  8. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Requirements for Application, Commitment, and... Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... before final endorsement, except that in the case of an existing project that does not...

  9. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Requirements for Application, Commitment, and... Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... before final endorsement, except that in the case of an existing project that does not...

  10. An evaluation of contractor projected and actual costs

    NASA Technical Reports Server (NTRS)

    Kwiatkowski, K. A.; Buffalano, C.

    1974-01-01

    GSFC contractors with cost-plus contracts provide cost estimates for each of the next four quarters on a quarterly basis. Actual expenditures over a two-year period were compared to the estimates, and the data were sorted in different ways to answer several questions and give quantification to observations, such as how much does the accuracy of estimates degrade as they are made further into the future? Are estimates made for small dollar amounts more accurate than for large dollar estimates? Other government agencies and private companies with cost-plus contracts may be interested in this analysis as potential methods of contract management for their organizations. It provides them with the different methods one organization is beginning to use to control costs.

  11. 25 CFR 39.201 - Does ISEF reflect the actual cost of school operations?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does ISEF reflect the actual cost of school operations... Does ISEF reflect the actual cost of school operations? ISEF does not attempt to assess the actual cost of school operations either at the local school level or in the aggregate nationally. ISEF is...

  12. 25 CFR 39.101 - Does ISEF assess the actual cost of school operations?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does ISEF assess the actual cost of school operations? 39... SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula § 39.101 Does ISEF assess the actual cost of school operations? No. ISEF does not attempt to assess the actual cost of school operations...

  13. Calculation of the Actual Cost of Engine Maintenance

    DTIC Science & Technology

    2003-03-01

    Cost Estimating Integrated Tools ( ACEIT ) helps analysts store, retrieve, and analyze data; build cost models; analyze risk; time phase budgets; and...Tools ( ACEIT ).” n. pag. http://www.aceit.com/ 21 February 2003. • USAMC Logistics Support Activity (LOGSA). “Cost Analysis Strategy Assessment

  14. 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.

  15. 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.

  16. 45 CFR 149.335 - Documentation of costs of actual claims involved.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 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...

  17. 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…

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 41 CFR 302-4.304 - For relocation outside the continental United States (OCONUS), may my agency allow actual expense...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? Yes... the continental United States (OCONUS), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? 302-4.304 Section 302-4.304 Public Contracts and...

  4. 41 CFR 302-4.304 - For relocation outside the continental United States (OCONUS), may my agency allow actual expense...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? Yes... the continental United States (OCONUS), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? 302-4.304 Section 302-4.304 Public Contracts and...

  5. 41 CFR 302-4.304 - For relocation outside the continental United States (OCONUS), may my agency allow actual expense...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? Yes... the continental United States (OCONUS), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? 302-4.304 Section 302-4.304 Public Contracts and...

  6. 41 CFR 302-4.304 - For relocation outside the continental United States (OCONUS), may my agency allow actual expense...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? Yes... the continental United States (OCONUS), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? 302-4.304 Section 302-4.304 Public Contracts and...

  7. 41 CFR 302-4.304 - For relocation outside the continental United States (OCONUS), may my agency allow actual expense...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? Yes... the continental United States (OCONUS), may my agency allow actual expense reimbursement instead of the POV mileage rate for PCS travel? 302-4.304 Section 302-4.304 Public Contracts and...

  8. 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...

  9. 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…

  10. 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.

  11. Unit Reference Sheet (URS) Cost Methodology.

    DTIC Science & Technology

    1980-08-01

    Z52163 RADAR SET: AN/SPS-64 (V) 5 Z52435 RADAR SET: AN/TPN-18 Z52457 RADAR SET: AN/TPQ-37 LESS POWER Z53412 RADAR WARNING SYSTEM : AN/APR-44 ( ) (V) 1...Z53414 RADAR WARNING SYSTEM : AN/APR-44 ( ) (V) 2 Z53416 RADAR WARNING SYSTEM : AN/APR-44 ( ) (V) 3 Z53850 RADIO INTERFERENCE MEASURING SET: AN/URM-200...method of force costing requires having a complete AURS installed on the Force Cost Information System (FCIS) data base at USAMSSA, and detailed cost

  12. 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

    ... other forms of information technology, e.g., permitting electronic submission of responses. This Notice... profits. Its provides a base for evaluating housing programs, labor costs, and ] physical improvements in.... Estimation of the total numbers of hours needed to prepare the information collection including number...

  13. 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…

  14. Operations and Maintenance Costs for New Major U.S. Coast Guard Platforms: Projected Versus Actual Costs

    DTIC Science & Technology

    1989-06-01

    expected OG-41 costs during two years out of the four years of data available. Even so, the budget predictions were sig - nificantly higher in the...the t-distribution table for a 0.05 sig - nificance level is used to identify the critical value, denoted as tdf . This test is called a two-tailed...the unusually high degree. Multiple regressions were conducted for the cutters and more sig - nificant results were obtained. 48 TABLE 8 CORRELATION

  15. Hospital Utilization and Cost Trends in Canada and the United States

    PubMed Central

    Andersen, Ronald; Hull, John T.

    1969-01-01

    Differences in hospital costs and utilization between the United States and Canada are analyzed and an attempt made to measure the significance of various demographic, economic, and other factors thought to be related to the differences. Increases in utilization are traced to population increases and to actual increased use per person; and cost increases tied to general inflationary trends are separated from those attributable to specific hospital price increases. Differences in the financing and reimbursement mechanisms in the two countries are shown to have had little effect on relative cost increases, which in the period under consideration were parallelled by similar or greater increases in other industrialized nations. PMID:4981616

  16. 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

  17. 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)

  18. 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...

  19. 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.

  20. 48 CFR 252.225-7006 - Quarterly reporting of actual contract performance outside the United States.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of DD Form 2139 from the Contracting Officer or via the Internet at http://www.dtic.mil/whs...) Definition. United States, as used in this clause, means the 50 States, the District of Columbia,...

  1. 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

  2. Costs of crashes to government, United States, 2008.

    PubMed

    Miller, Ted R; Bhattacharya, Soma; Zaloshnja, Eduard; Taylor, Dexter; Bahar, Geni; David, Iuliana

    2011-01-01

    We estimated how much the Federal government and state/local government pay for different kinds of crashes in the United States. Government costs include reductions in an array of public services (emergency, incident management, vocational rehabilitation, coroner court processing of liability litigation), medical payments, social safety net assistance to the injured and their families, and taxes foregone because victims miss work. Government also pays when its employees crash while working and covers fringe benefits for crash-involved employees and their benefit-eligible dependents in non-work hours. We estimated government shares of crash costs by component. We applied those estimates to existing US Department of Transportation estimates of crash costs to society and employers. Government pays an estimated $35 billion annually because of crashes, an estimated 12.6% of the economic cost of crashes (Federal 7.1%, State/local 5.5%). Government bears a higher percentage of the monetary costs of injury crashes than fatal crashes or crashes involving property damage only. Government is increasingly recovering the medical cost of crashes from auto insurers. Nevertheless, medical costs and income and sales tax losses account for 75% of government's crash costs. For State/local government to break even on a 100%-State funded investment in road safety, the intervention would need to have an unrealistically high benefit-cost ratio of 34. Government invests in medical treatment of illness to save lives and improve quality of life. Curing a child's leukemia, for example, is not less costly than leaving that leukemia untreated. Safety should not be held to a different standard.

  3. 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,…

  4. Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India

    PubMed Central

    Gajuryal, SH; Daga, A; Siddharth, V; Bal, CS; Satpathy, S

    2017-01-01

    Context: PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. Aims: The study aims to determine the cost of providing PET/CT Scan services in a hospital. Methods and Material: This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Results: Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Conclusions: Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64) PMID:28242974

  5. 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

  6. High target attainment for β-lactam antibiotics in intensive care unit patients when actual minimum inhibitory concentrations are applied.

    PubMed

    Woksepp, H; Hällgren, A; Borgström, S; Kullberg, F; Wimmerstedt, A; Oscarsson, A; Nordlund, P; Lindholm, M-L; Bonnedahl, J; Brudin, L; Carlsson, B; Schön, T

    2017-03-01

    Patients in the intensive care unit (ICU) are at risk for suboptimal levels of β-lactam antibiotics, possibly leading to poor efficacy. Our aim was to investigate whether the actual minimum inhibitory concentration (MIC) compared to the more commonly used arbitrary epidemiological cut-off values (ECOFFs) would affect target attainment in ICU patients on empirical treatment with broad-spectrum β-lactam antibiotics and to identify risk factors for not reaching target. In a prospective, multicenter study, ICU patients ≥18 years old and treated with piperacillin/tazobactam, meropenem, or cefotaxime were included. Clinical and laboratory data were recorded. Serum trough antibiotic levels from three consecutive days were analyzed by liquid chromatography-mass spectrometry (LC-MS). The target was defined as the free trough concentration above the MIC (100% fT>MIC). MICECOFF was used as the target and, when available, the actual MIC (MICACTUAL) was applied. The median age of the patients was 70 years old, 52% (58/111) were males, and the median estimated glomerular filtration rate (eGFR) was 48.0 mL/min/1.73 m(2). The rate of patients reaching 100% fT > MICACTUAL was higher (89%, 31/35) compared to the same patients using MICECOFF (60%, p = 0.002). In total, 55% (61/111) reached 100% fT > MICECOFF. Increased renal clearance was independently associated to not reaching 100% fT > MICECOFF. On repeated sampling, >77% of patients had stable serum drug levels around the MICECOFF. Serum concentrations of β-lactam antibiotics vary extensively between ICU patients. The rate of patients not reaching target was markedly lower for the actual MIC than when the arbitrary MIC based on the ECOFF was used, which is important to consider in future studies.

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. Low-Cost Sensor Units for Measuring Urban Air Quality

    NASA Astrophysics Data System (ADS)

    Popoola, O. A.; Mead, M.; Stewart, G.; Hodgson, T.; McLoed, M.; Baldovi, J.; Landshoff, P.; Hayes, M.; Calleja, M.; Jones, R.

    2010-12-01

    Measurements of selected key air quality gases (CO, NO & NO2) have been made with a range of miniature low-cost sensors based on electrochemical gas sensing technology incorporating GPS and GPRS for position and communication respectively. Two types of simple to operate sensors units have been designed to be deployed in relatively large numbers. Mobile handheld sensor units designed for operation by members of the public have been deployed on numerous occasions including in Cambridge, London and Valencia. Static sensor units have also been designed for long-term autonomous deployment on existing street furniture. A study was recently completed in which 45 sensor units were deployed in the Cambridge area for a period of 3 months. Results from these studies indicate that air quality varies widely both spatially and temporally. The widely varying concentrations found suggest that the urban environment cannot be fully understood using limited static site (AURN) networks and that a higher resolution, more dispersed network is required to better define air quality in the urban environment. The results also suggest that higher spatial and temporal resolution measurements could improve knowledge of the levels of individual exposure in the urban environment.

  13. 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

    ... 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...

  14. 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

    ... 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...

  15. 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.

  16. 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...

  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. 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…

  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. Quality and Growth Implications of Incremental Costing Models for Distance Education Units

    ERIC Educational Resources Information Center

    Crawford, C. B.; Gould, Lawrence V.; King, Dennis; Parker, Carl

    2010-01-01

    The purpose of this article is to explore quality and growth implications emergent from various incremental costing models applied to distance education units. Prior research relative to costing models and three competing costing models useful in the current distance education environment are discussed. Specifically, the simple costing model, unit…

  2. Costs of occupational injuries in construction in the United States.

    PubMed

    Waehrer, Geetha M; Dong, Xiuwen S; Miller, Ted; Haile, Elizabeth; Men, Yurong

    2007-11-01

    This paper presents costs of fatal and nonfatal injuries for the construction industry using 2002 national incidence data from the Bureau of Labor Statistics and a comprehensive cost model that includes direct medical costs, indirect losses in wage and household productivity, as well as an estimate of the quality of life costs due to injury. Costs are presented at the three-digit industry level, by worker characteristics, and by detailed source and event of injury. The total costs of fatal and nonfatal injuries in the construction industry were estimated at $11.5 billion in 2002, 15% of the costs for all private industry. The average cost per case of fatal or nonfatal injury is $27,000 in construction, almost double the per-case cost of $15,000 for all industry in 2002. Five industries accounted for over half the industry's total fatal and nonfatal injury costs. They were miscellaneous special trade contractors (SIC 179), followed by plumbing, heating and air-conditioning (SIC 171), electrical work (SIC 173), heavy construction except highway (SIC 162), and residential building construction (SIC 152), each with over $1 billion in costs.

  3. The net national costs of illegal immigration into the United States.

    PubMed

    Huddle, D L

    1995-04-01

    "This article examines the major economic pros and cons of illegal immigration and answers the question: what, if any, are the public and private costs of illegal immigration in the United States? In brief, the article finds that between four and 5.4 million illegal immigrants reside here.... The article also finds that illegal immigrants and their own citizen children cost taxpayers an additional $12 to $16.2 billion annually for education, public services, and incarceration after deducting all local, state, and federal taxes paid in by them. In the private sector, illegal aliens are found to save their employers and owners of capital about $1.5 billion more than U.S. workers lose due to wage depression. The article also considers what legal and enforcement reforms would be necessary to dramatically slow the current flow of 300,000 illegals yearly and concludes that, although improvements in the system are now being proposed, the actual reforms will be insufficient to more than stem the currently rising tide of illegals due to economic instability in Mexico and the Third World."

  4. 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.

  5. 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

  6. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... location suitable for its intended use. The following is representative of the types of costs that shall be... services for designs, plans, specifications, and surveys. (6) Acquisition and preparation costs of.... Where estimates are used, there must be a documented methodology based on a historical basis....

  7. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... location suitable for its intended use. The following is representative of the types of costs that shall be... services for designs, plans, specifications, and surveys. (6) Acquisition and preparation costs of.... Where estimates are used, there must be a documented methodology based on a historical basis....

  8. Cost of Crashes Related to Road Conditions, United States, 2006

    PubMed Central

    Zaloshnja, Eduard; Miller, Ted R.

    2009-01-01

    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

  9. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... allowable project costs of an airport planning project shall be— (1) In the case of an airport master plan... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false United States share of project costs. 152... TRANSPORTATION (CONTINUED) AIRPORTS AIRPORT AID PROGRAM Funding of Approved Projects § 152.205 United...

  10. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... allowable project costs of an airport planning project shall be— (1) In the case of an airport master plan... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false United States share of project costs. 152... TRANSPORTATION (CONTINUED) AIRPORTS AIRPORT AID PROGRAM Funding of Approved Projects § 152.205 United...

  11. [Cost analysis of hospital care for newborns at risk: comparison of an Intermediate Neonatal Care Unit and a Kangaroo Unit].

    PubMed

    Entringer, Aline Piovezan; Gomes, Maria Auxiliadora de Sousa Mendes; Pinto, Márcia; Caetano, Rosângela; Magluta, Cynthia; Lamy, Zeni Carvalho

    2013-06-01

    The aim of this study was to compare the direct costs of implementation of the Kangaroo Method and an Intermediate Neonatal Care Unit, from the perspective of the Brazilian Unified National Health System (SUS) in Rio de Janeiro, Brazil. Newborns were eligible for inclusion if they were clinically stable and were able to receive care in those two modalities. A decision tree model was developed that incorporated baseline variables and costs into a hypothetical cohort of 1,000 newborns, according to the literature and expert opinions. Daily cost was BR$343.53 for the second stage of the Kangaroo Unit and BR$394.22 for the Intermediate Neonatal Care Unit. The total cost for the hypothetical cohort was BR$5,710,281.66 for the second and third stages of the Kangaroo Unit and R$7,119,865.61 for the Intermediate Neonatal Care Unit. The Intermediate Neonatal Care Unit cost 25% more than the Kangaroo Unit. The study can contribute to decision-making in health, in addition to providing support for studies related to economic evaluation in neonatal health.

  12. Childhood injuries in the United States. Mortality, Morbidity, and cost.

    PubMed

    Guyer, B; Ellers, B

    1990-06-01

    National estimates of the mortality, morbidity, and cost of childhood injuries are presented by specific causes. Motor vehicle-related injuries, homicide, and suicide are the leading causes of childhood injury deaths. Falls and sports-related injuries are the leading causes of hospitalizations and emergency department visits. We estimate that unintentional childhood injuries cost the nation $7.5 billion in 1982. The highest direct costs per year for unintentional injuries are attributable to falls, sports, and motor vehicle occupant injuries, while the highest indirect costs are related to motor vehicle occupant injuries, pedestrian injuries, and drowning. Injury accounts for 78% of the total fatalities among late adolescents (age 15 to 19 years), the pediatric age group at highest risk for injury mortality. A stronger federal and state commitment is needed to prevent childhood injury.

  13. 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.

  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. 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

    ... measurement of the estimated annual operating costs or other measures of energy consumption for certain... that the estimated annual operating costs of a covered product be calculated from measurements of...: Representative Average Unit Costs of Energy AGENCY: Office of Energy Efficiency and Renewable Energy,...

  16. 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

    ... measurement of the estimated annual operating costs or other measures of energy consumption for certain... that the estimated annual operating costs of a covered product be calculated from measurements of...: Representative Average Unit Costs of Energy AGENCY: Office of Energy Efficiency and Renewable Energy,...

  17. Fiscal Year 1992 Unit Cost Report for the Illinois Public Community Colleges.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    Used to determine grant rates for state financial support and as an accountability report to citizens, this unit cost report presents data for fiscal year (FY) 1992 on course offerings, enrollments and costs for Illinois public community colleges. Specifically, data are presented on midterm enrollments in student semester credit hours; costs for…

  18. 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.

  19. [Cost of functioning of a centralised pharmaceutical unit: evaluation of mean costs of chemotherapy preparations according to the level of production of the unit].

    PubMed

    Galy, Guillaume; Bauler, Stéphanie; Buchi, Marjolaine; Pirot, Fabrice; Pivot, Christine

    2011-10-01

    The interest of centralization of preparations of chemotherapy drugs is in addition to its economic aspect, to secure drugs circuit. The aims of this study are to determine needs in employees and equipments of 11 theoretical levels of production from 1,000 to 50,000 preparations per year and to determine the cost of chemotherapy's preparation for each theoretical unit. The operating cost was divided in four areas of expenditure: employees (66-78%), investment (5-15%), maintenance (3-15%) and consumables (4-16%). If we consider the 11 units, the theoretical cost varies between 27.4 € for a unit with 50,000 preparations per year and 114.1 € for a unit with 1,000 preparations per year. This study shows the importance of setting up an optimal unit of preparations according to its activity and highlights the high cost's variation in relation to the activity of the unit.

  20. 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

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San... Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los... to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund....

  1. 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

    ... AGENCY Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San... Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los... to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund....

  2. 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.

  3. Global Hawk: Root Cause Analysis of Projected Unit Cost Growth

    DTIC Science & Technology

    2011-05-01

    2009 (WSARA). This report describes our task analysis and findings. The Global Hawk Program Global Hawk is a family of high -altitude, high -endurance...Document (CDD) • Cost Analysis Requirements Description (CARD) • Test and Evaluation Master Plan ( TEMP ) • Acquisition Program Baseline (APB...fixed content and completion criteria as defined by the new CDD, CARD, TEMP , and ASR. The four increments shown in the table above reflect the

  4. Factors Impacting Decommissioning Costs - 13576

    SciTech Connect

    Kim, Karen; McGrath, Richard

    2013-07-01

    The Electric Power Research Institute (EPRI) studied United States experience with decommissioning cost estimates and the factors that impact the actual cost of decommissioning projects. This study gathered available estimated and actual decommissioning costs from eight nuclear power plants in the United States to understand the major components of decommissioning costs. Major costs categories for decommissioning a nuclear power plant are removal costs, radioactive waste costs, staffing costs, and other costs. The technical factors that impact the costs were analyzed based on the plants' decommissioning experiences. Detailed cost breakdowns by major projects and other cost categories from actual power plant decommissioning experiences will be presented. Such information will be useful in planning future decommissioning and designing new plants. (authors)

  5. Defense Finance and Accounting Service Administration of Unit Costs

    DTIC Science & Technology

    2007-11-02

    additional copies of this audit report, contact the Secondary Reports Distribution Unit of the Analysis, Planning , and Technical Support Directorate at (703...604-8937 (DSN 664-8937) or FAX (703) 604-8932. Suggestions for Future Audits To suggest ideas for or to request future audits, contact the Planning ...and Coordination Branch of the Analysis, Planning , and Technical Support Directorate at (703) 604-8939 (DSN 664-8939) or FAX (703) 604-8932. Ideas and

  6. Cost of vaccinating refugees overseas versus after arrival in the United States, 2005.

    PubMed

    2008-03-07

    Since 2000, approximately 50,000 refugees have entered the United States each year from various regions of the world. Although persons with immigrant status are legally required to be vaccinated before entering the United States, this requirement does not extend to U.S.-bound persons with refugee status. After 1 year in the United States, refugees can apply for a change of status to that of legal permanent resident, at which time they are required to be fully vaccinated in accordance with recommendations of the Advisory Committee on Immunization Practices (ACIP). A potentially less costly alternative might be to vaccinate U.S.-bound refugees overseas routinely, before they depart from refugee camps. To compare the cost of vaccinating refugees overseas versus after their arrival in the United States, CDC analyzed 2005 data on the number of refugees, cost of vaccine, and cost of vaccine administration. This report summarizes the results of that analysis, which suggested that, in 2005, vaccinating 50,787 refugees overseas would have cost an estimated $7.7 million, less than one third of the estimated $26.0 million cost of vaccinating in the United States. Costs were calculated from the perspective of the U.S. health-care system. To achieve public health cost savings, routine overseas vaccination of U.S.-bound refugees should be considered.

  7. Cost Implications of Hardware Manpower Balance. Phase II - Unit Sustainment Manpower cost Methodology.

    DTIC Science & Technology

    1981-06-01

    I7(1’ ’ CCC’ C ICCo .’ CC C) I C, o 1 - - .1 -C ’-C ".--- - -,.. GJ .0 ’U .. t; I C’ I * . 1- - 1 4’ CC . A ’.. ’N -, C - C . -, 4~..’ ’I...The Baseline Cost Estimat.e s (_. Manager and the Independent Cost Es*_. Yate of the Air Force Systems Command orrne .- ,.] . Improvement Group of the...inter;e:<. stallation support anQ indrect cally, these personnel are ldentifiea a - gated total of officers and e-. calculated these reqireen-ts

  8. 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.

  9. 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…

  10. 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

    ... 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 electricity... energy Btu \\1\\ In commonly used terms test procedure Electricity $34.14 11.65 /kWh \\2,3\\...

  11. 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

    ... 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 electricity... energy \\1\\ In commonly used terms procedure Electricity $33.70 11.50 /kWh 2 3...... $.1150/kWh...

  12. 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...

  13. 42 CFR 447.206 - Cost limit for providers operated by units of government.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... section applies to payments made to health care providers that are operated by units of government as...) of the Act. (a) General rules. (1) All health care providers that are operated by units of government are limited to reimbursement not in excess of the individual health care provider's cost of...

  14. 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.

  15. Medical costs of smoking in the United States: estimates, their validity, and their implications

    PubMed Central

    Warner, K.; Hodgson, T.; Carroll, C.

    1999-01-01

    OBJECTIVE—To compare estimates of the medical costs of smoking in the United States and to consider their relevance to assessing the costs of smoking in developing countries and the net economic burden of smoking.
DATA SOURCES—A Medline search through early 1999 using keywords "smoking" and "cost", with review of article reference lists.
STUDY SELECTION—Peer-reviewed papers examining medical costs in a single year, covering the non-institutionalised American population.
DATA EXTRACTION—Methods underlying study estimates were identified, described, and compared with attributable expenditure methodology in the literature dealing with costs of illness. Differences in methods were associated with implied differences in findings.
DATA SYNTHESIS—With one exception, the studies find the annual medical costs of smoking to constitute approximately 6-8% of American personal health expenditures. The exception, a recent study, found much larger attributable expenditures. The lower estimates may reflect the limitation of analysis to costs associated with the principal smoking-related diseases. The higher estimate derives from analysis of smoking-attributable differences in all medical costs. However, the finding from the most recent study, also considering all medical costs, fell in the 6-8% range.
CONCLUSIONS—The medical costs of smoking in the United States equal, and may well exceed, the commonly referenced figure of 6-8%. This literature has direct methodological relevance to developing countries interested in assessing the magnitude of their current cost-of-smoking burden and their future burdens, with differences in tobacco use histories and the availability of chronic disease treatment affecting country-specific estimates. The debate over the use of gross or net medical cost estimates is likely to intensify with the proliferation of lawsuits against the tobacco industry to recover expenditures on tobacco-produced disease.


Keywords: medical

  16. 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

  17. [Costs and consumption of material resources in pediatric intensive and semi-intensive care units].

    PubMed

    Zuliani, Larissa Lenotti; Jericó, Marli de Carvalho; de Castro, Liliana Cristina; Soler, Zaida Aurora Sperli Geraldes

    2012-01-01

    Cost management of hospital material resources is a trendy research topic, especially in specialized health units. Nurses are pointed out as the main managers for costs and consumption of hospital materials resources. This study aimed to characterize Pediatric Intensive and Semi-Intensive Care Units of a teaching hospital and investigate costs and consumption of material resources used to treat patients admitted to these units. This is a descriptive exploratory study with retrospective data and quantitative approach. Data were obtained from a Hospital Information System and analyzed according to the ABC classification. The average expenditures were similar in both the neonatal and cardiac units, and lower in Pediatric Intensive and Semi-Intensive care units. There was a significant variation in the monthly consumption of materials. Higher cost materials had a greater impact on the budget of the studied units. The data revealed the importance of using a systematic method for the analysis of materials consumption and expenditure in pediatric units. They subsidize administrative and economic actions.

  18. Impact of pharmacist’s interventions on cost of drug therapy in intensive care unit

    PubMed Central

    Saokaew, Surasak; Maphanta, Sirada; Thangsomboon., Pornchanok

    2008-01-01

    Pharmacist participation in patient care team has been shown to reduce incidence of adverse drug events, and overall drug costs. However, impact of pharmacist participation in the multidisciplinary intensive care team on cost saving and cost avoidance has little been studied in Thailand. Objective: To describe the characteristics of the interventions and to determine pharmacist’s interventions led to change in cost saving and cost avoidance in intensive care unit (ICU). Methods: A Prospective, standard care-controlled study design was used to compare cost saving and cost avoidance of patients receiving care from patient care team (including a clinical pharmacist) versus standard care (no pharmacist on team). All patients admitted to the medical intensive care unit 1 and 2 during the same period were included in the study. The outcome measures were overall drug cost and length of ICU stay. Interventions made by the pharmacist in the study group were documented. The analyses of acceptance and cost saving and/or cost avoidance were also performed. Results: A total of 65 patients were admitted to either ICU 1 or 2 during the 5 week-study period. The pharmacist participated in patient care and made total of 127 interventions for the ICU-1 team. Ninety-eight percent of the interventions were accepted and implemented by physicians. The difference of overall drug cost per patient between two groups was 182.01 USD (1,076.37 USD in study group and 1,258.38 USD in control group, p=0.138). The average length of ICU stay for the intervention group and the control group was not significantly different (7.16 days vs. 6.18 days, p=0.995). The 125 accepted interventions were evaluated for cost saving and cost avoidance. Pharmacist’s interventions yielded a total of 1,971.43 USD from drug cost saving and 294.62 USD from adverse drug event cost avoidance. The net cost saved and avoided from pharmacist interventions was 2,266.05 USD. Interventions involving antibiotic use

  19. The cost-effectiveness of supported employment for adults with autism in the United Kingdom.

    PubMed

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

    2014-11-01

    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. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings.

  20. 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.

  1. 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…

  2. 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.

  3. CONSUMPTION AND RESPONSE OUTPUT AS A FUNCTION OF UNIT PRICE: MANIPULATION OF COST AND BENEFIT COMPONENTS

    PubMed Central

    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 that the cost and benefit components that defined unit price would not influence overall consumption considerably when unit price values were equal. We tested these predictions by arranging unit price such that the denominator was one (e.g., two responses produced one reinforcer) or two (e.g., four responses produced two reinforcers). Results showed that consumption decreased as unit price increased and that unit price values with different components produced similar consumption. PMID:20190922

  4. Consumption and response output as a function of unit price: manipulation of cost and benefit components.

    PubMed

    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 that the cost and benefit components that defined unit price would not influence overall consumption considerably when unit price values were equal. We tested these predictions by arranging unit price such that the denominator was one (e.g., two responses produced one reinforcer) or two (e.g., four responses produced two reinforcers). Results showed that consumption decreased as unit price increased and that unit price values with different components produced similar consumption.

  5. Inpatient Hospitalization Costs Associated with Birth Defects Among Persons of All Ages - United States, 2013.

    PubMed

    Arth, Annelise C; Tinker, Sarah C; Simeone, Regina M; Ailes, Elizabeth C; Cragan, Janet D; Grosse, Scott D

    2017-01-20

    In the United States, major structural or genetic birth defects affect approximately 3% of live births (1) and are responsible for 20% of infant deaths (2). Birth defects can affect persons across their lifespan and are the cause of significant lifelong disabilities. CDC used the Healthcare Cost and Utilization Project (HCUP) 2013 National Inpatient Sample (NIS), a 20% stratified sample of discharges from nonfederal community hospitals, to estimate the annual cost of birth defect-associated hospitalizations in the United States, both for persons of all ages and by age group. Birth defect-associated hospitalizations had disproportionately high costs, accounting for 3.0% of all hospitalizations and 5.2% of total hospital costs. The estimated annual cost of birth defect-associated hospitalizations in the United States in 2013 was $22.9 billion. Estimates of the cost of birth defect-associated hospitalizations offer important information about the impact of birth defects among persons of all ages on the overall health care system and can be used to prioritize prevention, early detection, and care.

  6. 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.

  7. 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

  8. The cost and funding of family practice graduate education in the United States.

    PubMed

    Ciriacy, E W; Liang, F Z; Godes, J R; Dunn, L D

    1985-03-01

    This paper reports the findings of a national cost survey of 369 nonmilitary family practice graduate education programs in the United States, 1981-82. The purpose of the study was to develop a reliable revenue and cost information data base to enable an understanding of current family practice education costs and funding. The availability of this information will be of assistance in the development of future budgetary plans for family practice graduate education. The results presented are based on 147 programs associated with hospitals using a non-cost center accounting protocol. These programs provided 100 percent complete revenue and cost data (40 percent of the targeted programs). Major sources of income were hospital support (35 percent), patient income (31 percent), and public dollars (28 percent). The mean cost per accredited position was $57,471. Expenses, each at approximately one third of the total, were resident stipends, faculty salaries, and clinic expenses. Statistically significant differences were found only for source of income when program structure, program size, and geographic location were examined. Recommendations for future family practice funding include modification of present reimbursement formulas and other third-party payment mechanisms, increasing hospital support, maintenance of public subsidies, and development of a uniform system of monitoring and evaluating costs of residency programs operated under both cost center and non-cost center accounting protocols.

  9. The cost of medicines in the United Kingdom. A survey of general practitioners' opinions and knowledge.

    PubMed

    Silcock, J; Ryan, M; Bond, C M; Taylor, R J

    1997-01-01

    Prescribing costs in general practice continue to grow. Their importance is underlined by the amount of information concerned with costs that general practitioners (GPs) receive, and by the existence of target budgets. In 1986 and 1991, surveys showed that GPs agreed that cost should be borne in mind when choosing medicines, but that their knowledge of drug prices was often inaccurate. This study assessed the current knowledge and attitudes of GPs in the UK in respect of prescribing costs, and examined the influence of various developments in general practice since 1986 on the accuracy of drug price estimation. 1000 randomly selected GP principals (500 in Scotland and 125 in each of 4 English health regions) were sent a postal questionnaire. The GPs' level of agreement with 5 statements concerned with prescribing costs, and the accuracy of their estimates of the basic price of 31 drugs, were analysed. Most GPs (71%) agreed that prescribing costs should be taken into account when deciding on the best treatment for patients. Fundholders were more likely than non-fundholders: (i) to agree that prescribing costs could be reduced without affecting patient care; (ii) to agree that providing more information on costs would lower the cost of prescribing; and (iii) to comment that cost guidelines had changed their prescribing habits. Fundholders were less likely than non-fundholders to reject the principle of fixed limits on prescribing costs. Overall, one-third of the price estimates given were accurate (within 25% of the actual cost). For the most expensive drugs in the survey [those priced over 10 pounds sterling (Pound) per pack], half of the price estimates were accurate. There were significant differences between non-fundholders' and fundholders' estimates of the price of less expensive drugs (those priced at less than 10 pounds per pack). Use of a formulary or computer-displayed drug price information did not affect the accuracy of price estimates. It may be that GPs

  10. 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...

  11. 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...

  12. 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.…

  13. 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.

  14. 26 CFR 1.168A-7 - Payment by United States of unamortized cost of facility.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the following examples: Example 1. On January 31, 1954, the X Corporation purchases an emergency facility at a cost of $600,000. The certificate covers the entire acquisition. The X Corporation elects to... the cancellation of certain contracts with the X Corporation, the United States makes a payment...

  15. 26 CFR 1.168A-7 - Payment by United States of unamortized cost of facility.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the following examples: Example 1. On January 31, 1954, the X Corporation purchases an emergency facility at a cost of $600,000. The certificate covers the entire acquisition. The X Corporation elects to... the cancellation of certain contracts with the X Corporation, the United States makes a payment...

  16. 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...

  17. 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...

  18. State-Level Lifetime Medical and Work-Loss Costs of Fatal Injuries - United States, 2014.

    PubMed

    Luo, Feijun; Florence, Curtis

    2017-01-13

    Injury-associated deaths have substantial economic consequences in the United States. The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 were $214 billion (1). In 2014, unintentional injury, suicide, and homicide (the fourth, tenth, and seventeenth leading causes of death, respectively) accounted for 194,635 deaths in the United States (2). In 2014, a total of 199,756 fatal injuries occurred in the United States, and the associated lifetime medical and work-loss costs were $227 billion (3). This report examines the state-level economic burdens of fatal injuries by extending a previous national-level study (1). Numbers and rates of fatal injuries, lifetime costs, and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for four injury intent categories (all intents, unintentional, suicide, and homicide). During 2014, injury mortality rates and economic burdens varied widely among the states and DC. Among fatal injuries of all intents, the mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 per 100,000 and $491 (New York). States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas.

  19. The direct health care costs of obesity in the United States.

    PubMed Central

    Allison, D B; Zannolli, R; Narayan, K M

    1999-01-01

    OBJECTIVES: Recent estimates suggest that obesity accounts for 5.7% of US total direct health care costs, but these estimates have not accounted for the increased death rate among obese people. This article examines whether the estimated direct health care costs attributable to obesity are offset by the increased mortality rate among obese individuals. METHODS: Data on death rates, relative risks of death with obesity, and health care costs at different ages were used to estimate direct health care costs of obesity from 20 to 85 years of age with and without accounting for increased death rates associated with obesity. Sensitivity analyses used different values of relative risk of death, given obesity, and allowed the relative costs due to obesity per unit of time to vary with age. RESULTS: Direct health care costs from 20 to 85 years of age were estimated to be approximately 25% lower when differential mortality was taken into account. Sensitivity analyses suggested that direct health care costs of obesity are unlikely to exceed 4.32% or to be lower than 0.89%. CONCLUSIONS: Increased mortality among obese people should be accounted for in order not to overestimate health care costs. PMID:10432905

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

    PubMed

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

    2015-10-02

    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.

  1. 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

  2. "Cost creep due to age creep" phenomenon: pattern analyses of in-patient hospitalization costs for various age brackets in the United States.

    PubMed

    Chinta, Ravi; Burns, David J; Manolis, Chris; Nighswander, Tristan

    2013-01-01

    The expectation that aging leads to a progressive deterioration of biological functions leading to higher healthcare costs is known as the healthcare cost creep due to age creep phenomenon. The authors empirically test the validity of this phenomenon in the context of hospitalization costs based on more than 8 million hospital inpatient records from 1,056 hospitals in the United States. The results question the existence of cost creep due to age creep after the age of 65 years as far as average hospitalization costs are concerned. The authors discuss implications for potential knowledge transfer for cost minimization and medical tourism.

  3. 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

  4. Stranded cost recovery: Reregulating the electricity markets in the United States

    NASA Astrophysics Data System (ADS)

    Wagle, Pushkar Ghanashyam

    2000-10-01

    For the past few years, Stranded Cost recovery has been one of the most contentious issues regarding the restructuring of electricity markets among the regulators, researchers, and the other interested parties. Among the states that have moved towards retail competition, some have already made decisions regarding the levels of the stranded cost recovery. So the question is: how have these states handled the "stranded cost problem"? Following the introduction and the historical perspective of the industry in the first chapter, the second chapter takes a broad view for understanding the overall process of deregulation. It attempts to analyze why some states have made a rapid transition to competition in the electric utility industry, while other states are just beginning to consider the issue. White (1996) and Ando & Palmer (1998) have conducted a similar exercise. We present a more comprehensive and theoretically informed econometric analysis that sheds light over some of the crucial issues involved in restructuring, such as, stranded cost recovery, regulation of transmission and distribution sectors, and establishment of Independent System Operator, etc. This chapter offers the rationale for alternative econometric techniques, and extends the political economy analysis to incorporate actual timings of retail competition. Once we have identified the role of stranded cost in restructuring and the theoretical foundations, we study empirically the political economy of states' decisions to grant stranded cost recovery. This constitutes the third chapter. Here, we concentrate on California and Pennsylvania, two states that are at the frontiers of deregulation, and compare their respective treatments of the stranded cost. We probe the reasons behind Pennsylvania's lead over California on the path towards deregulation.

  5. 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.

  6. Estimates of incidence and costs of intestinal infectious diseases in the United States.

    PubMed

    Garthright, W E; Archer, D L; Kvenberg, J E

    1988-01-01

    The incidence of acute episodes of intestinal infectious diseases in the United States was estimated through analysis of community-based studies and national interview surveys. Their differing results were reconciled by adjusting the study population age distributions in the community-based studies, by excluding those cases that also showed respiratory symptoms, and by accounting for structural differences in the surveys. The reconciliation process provided an estimate of 99 million acute cases of either vomiting or diarrhea, or both, each year in this country, half of which involved more than a full day of restricted activity. The analysis was limited to cases of acute gastrointestinal diseases with vomiting or diarrhea but without respiratory symptoms. Physicians were consulted for 8.2 million illnesses; 250,000 of these required hospitalization. In 1985, hospitalizations incurred $560 million in medical costs and $200 million in lost productivity. Nonhospitalized cases (7.9 million) for which physicians were consulted incurred $690 million in medical costs and $2.06 billion in lost productivity. More than 90 million cases for which no physician was consulted cost an estimated $19.5 billion in lost productivity. The estimates excluded such costs as death, pain and suffering, lost leisure time, financial losses to food establishments, and legal expenses. According to these estimates, medical costs and lost productivity from acute intestinal infectious diseases amount to a minimum of about $23 billion a year in the United States.

  7. 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.

  8. Costs Attributable to Overweight and Obesity in Working Asthma Patients in the United States

    PubMed Central

    Chang, Chongwon; Lee, Seung-Mi; Choi, Byoung-Whui; Song, Jong-hwa; Song, Hee; Jung, Sujin; Bai, Yoon Kyeong; Park, Haedong; Jeung, Seungwon

    2017-01-01

    Purpose To estimate annual health care and productivity loss costs attributable to overweight or obesity in working asthmatic patients. Materials and Methods This study was conducted using the 2003–2013 Medical Expenditure Panel Survey (MEPS) in the United States. Patients aged 18 to 64 years with asthma were identified via self-reported diagnosis, a Clinical Classification Code of 128, or a ICD-9-CM code of 493.xx. All-cause health care costs were estimated using a generalized linear model with a log function and a gamma distribution. Productivity loss costs were estimated in relation to hourly wages and missed work days, and a two-part model was used to adjust for patients with zero costs. To estimate the costs attributable to overweight or obesity in asthma patients, costs were estimated by the recycled prediction method. Results Among 11670 working patients with a diagnosis of asthma, 4428 (35.2%) were obese and 3761 (33.0%) were overweight. The health care costs attributable to obesity and overweight in working asthma patients were estimated to be $878 [95% confidence interval (CI): $861–$895] and $257 (95% CI: $251–$262) per person per year, respectively, from 2003 to 2013. The productivity loss costs attributable to obesity and overweight among working asthma patients were $256 (95% CI: $253–$260) and $26 (95% CI: $26–$27) per person per year, respectively. Conclusion Health care and productivity loss costs attributable to overweight and obesity in asthma patients are substantial. This study's results highlight the importance of effective public health and educational initiatives targeted at reducing overweight and obesity among patients with asthma, which may help lower the economic burden of asthma. PMID:27873513

  9. Predicting Disposal Costs for United States Air Force Aircraft (Briefing Charts)

    DTIC Science & Technology

    2015-05-01

    I N S T I T U T E F O R D E F E N S E A N A L Y S E S Predicting Disposal Costs for United States Air Force Aircraft (Presentation) Mark F. Kaye...control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 2. REPORT TYPE 3. DATES COVERED (From - To) 4

  10. ERISA, agency costs, and the future of health care in the United States.

    PubMed

    Bronsteen, John; Maher, Brendan S; Stris, Peter K

    2008-04-01

    Because so many Americans receive health insurance through their employers, the Employee Retirement Income Security Act (ERISA) of 1974 plays a dominant role in the delivery of health care in the United States. The ERISA system enables employers and insurers to save money by providing inadequate health care to employees, thereby creating incentives for these agents to act contrary to the interests of their principals. Such agency costs play a significant role in the current health care crisis and require attention when considering reform. We evaluate the two major health care reform movements by exploring the extent to which each reduces agency costs. We find that agency cost analysis clarifies the benefits, limits, and uncertainties of each approach.

  11. Cost effective interprofessional training: an evaluation of a training unit in Denmark.

    PubMed

    Hansen, Torben Baek; Jacobsen, Flemming; Larsen, Kristian

    2009-05-01

    In 2004, the first Danish undergraduate interprofessional training unit (ITU) was established at the Regional Hospital Holstebro, inspired by experiences from Sweden. In this unit, medical, nursing, occupational therapy and physiotherapy students are given responsibility, under supervision by trained and motivated personnel, for rehabilitation and care of patients in a subunit of an orthopaedic department. The aim of this study was to see whether the ITU was cost effective in treating patients compared with a conventional orthopaedic ward. One-hundred and thirty-four patients admitted for primary hip or knee replacement surgery were included in the study. All costs were recorded in the ITU and in the conventional ward. Follow-up was done by a quality of life questionnaire three months after the operation. Comparison was done by univariable and multivariable testing of costs and effect. In both, the ITU was more cost effective than the conventional ward. No difference was found in complications and patient-reported quality of life. In conclusion, clinical training can be given to students in an ITU without reducing productivity in a hospital environment if pedagogic principles, clinical tutors and patient logistics all adapt to the challenge of the teaching environment.

  12. Attributable cost of a nosocomial infection in the intensive care unit: A prospective cohort study

    PubMed Central

    Chacko, Binila; Thomas, Kurien; David, Thambu; Paul, Hema; Jeyaseelan, Lakshmanan; Peter, John Victor

    2017-01-01

    AIM To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included. The impact of HAI on treatment cost and mortality was assessed. RESULTS The mean (± SD) age of the cohort (n = 499) was 42.3 ± 16.5 years. Acute physiology and chronic health evaluation-II score was 13.9 (95%CI: 13.3-14.5); 86% were ventilated. ICU and hospital length of stay were 7.8 ± 5.5 and 13.9 ± 10 d respectively. Hospital mortality was 27.9%. During ICU stay, 76 (15.3%) patients developed an infection (ventilator-associated pneumonia 50; bloodstream infection 35; urinary tract infections 3), translating to 19.7 infections/1000 ICU days. When compared with those who did not develop an infection, an infection occurring during ICU stay was associated with significantly higher treatment cost [median (inter-quartile range, IQR) INR 92893 (USD 1523) (IQR 57168-140286) vs INR 180469 (USD 2958) (IQR 140030-237525); P < 0.001 and longer duration of ICU (6.7 ± 4.5 d vs 13.4 ± 7.0 d; P < 0.01) and hospital stay (12.4 ± 8.2 d vs 21.8 ± 13.9 d; P < 0.001)]. However ICU acquired infections did not impact hospital mortality (31.6% vs 27.2%; P = 0.49). CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality. PMID:28224111

  13. 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

    ..., or dental care. This change responds to the increase in medical costs since 1992, when the current... Part 43 Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United States... intervening period, the cost of medical care and treatment has increased substantially. That increase...

  14. 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

  15. Cost and utilization of blood transfusion associated with spinal surgeries in the United States.

    PubMed

    Blanchette, Christopher M; Wang, Peter F; Joshi, Ashish V; Asmussen, Mikael; Saunders, William; Kruse, Peter

    2007-03-01

    The purpose of this study was to examine factors associated with the utilization and cost of blood transfusion during and post-spinal fusion surgery. A retrospective, observational study of 42,029 inpatients undergoing spinal fusion surgery in United States hospitals participating in the Perspective( Comparative Database for inpatient use was conducted. Descriptive analysis, logistic regression, and ordinary least squares (OLS) regression were used to describe the factors associated with the use and cost of allogeneic blood transfusion (ABT). Hospitalization costs were $18,690 (SD=14,159) per patient, erythropoietin costs were $85.25 (SD=3,691.66) per patient, and topical sealant costs were $414.34 (SD=1,020.06) per patient. Sub-analysis of ABT restricted to users revealed ABT costs ranged from $312.24 (SD=543.35) per patient with whole blood to $2,520 (SD=3,033.49) per patient with fresh frozen plasma. Patients that received hypotensive anesthesia (OR,1.61; 95% CI, 1.47-1.77), a volume expander (OR,1.95; 95% CI, 1.75-2.18), autologous blood (OR, 2.04; 95% CI, 1.71-2.42), or an erythropoietic agent (OR=1.64; 95% CI, 1.27-2.12) had a higher risk of ABT. Patients that received cell salvage had a lower risk of transfusion (OR=0.40; 95% CI, 0.32-0.50). Most blood avoidance techniques have low utilization or do not reduce the burden of transfusion associated with spinal fusion.

  16. Economic costs of the foot and mouth disease outbreak in the United Kingdom in 2001.

    PubMed

    Thompson, D; Muriel, P; Russell, D; Osborne, P; Bromley, A; Rowland, M; Creigh-Tyte, S; Brown, C

    2002-12-01

    The authors present estimates of the economic costs to agriculture and industries affected by tourism of the outbreak of foot and mouth disease (FMD) in the United Kingdom (UK) in 2001. The losses to agriculture and the food chain amount to about Pound Sterling3.1 billion. The majority of the costs to agriculture have been met by the Government through compensation for slaughter and disposal as well as clean-up costs. Nonetheless, agricultural producers will have suffered losses, estimated at Pound Sterling355 million, which represents about 20% of the estimated total income from farming in 2001. Based on data from surveys of tourism, businesses directly affected by tourist expenditure are estimated to have lost a similar total amount (between Pound Sterling2.7 and Pound Sterling3.2 billion) as a result of reduced numbers of people visiting the countryside. The industries which supply agriculture, the food industries and tourist-related businesses will also have suffered losses. However, the overall costs to the UK economy are substantially less than the sum of these components, as much of the expenditure by tourists was not lost, but merely displaced to other sectors of the economy. Overall, the net effect of FMD is estimated to have reduced the gross domestic product in the UK by less than 0.2% in 2001.

  17. A strategy for assessing costs of implementing new practices in the child welfare system: adapting the English cost calculator in the United States.

    PubMed

    Chamberlain, Patricia; Snowden, Lonnie R; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

    2011-01-01

    In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided.

  18. Could CT screening for lung cancer ever be cost effective in the United Kingdom?

    PubMed Central

    Whynes, David K

    2008-01-01

    Background The absence of trial evidence makes it impossible to determine whether or not mass screening for lung cancer would be cost effective and, indeed, whether a clinical trial to investigate the problem would be justified. Attempts have been made to resolve this issue by modelling, although the complex models developed to date have required more real-world data than are currently available. Being founded on unsubstantiated assumptions, they have produced estimates with wide confidence intervals and of uncertain relevance to the United Kingdom. Method I develop a simple, deterministic, model of a screening regimen potentially applicable to the UK. The model includes only a limited number of parameters, for the majority of which, values have already been established in non-trial settings. The component costs of screening are derived from government guidance and from published audits, whilst the values for test parameters are derived from clinical studies. The expected health gains as a result of screening are calculated by combining published survival data for screened and unscreened cohorts with data from Life Tables. When a degree of uncertainty over a parameter value exists, I use a conservative estimate, i.e. one likely to make screening appear less, rather than more, cost effective. Results The incremental cost effectiveness ratio of a single screen amongst a high-risk male population is calculated to be around £14,000 per quality-adjusted life year gained. The average cost of this screening regimen per person screened is around £200. It is possible that, when obtained experimentally in any future trial, parameter values will be found to differ from those previously obtained in non-trial settings. On the basis both of differing assumptions about evaluation conventions and of reasoned speculations as to how test parameters and costs might behave under screening, the model generates cost effectiveness ratios as high as around £20,000 and as low as around

  19. Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision

    PubMed Central

    Halton, Kate A; Cook, David A; Whitby, Michael; Paterson, David L; Graves, Nicholas

    2009-01-01

    Introduction Some types of antimicrobial-coated central venous catheters (A-CVC) have been shown to be cost effective in preventing catheter-related bloodstream infection (CR-BSI). However, not all types have been evaluated, and there are concerns over the quality and usefulness of these earlier studies. There is uncertainty amongst clinicians over which, if any, A-CVCs to use. We re-evaluated the cost effectiveness of all commercially available A-CVCs for prevention of CR-BSI in adult intensive care unit (ICU) patients. Methods We used a Markov decision model to compare the cost effectiveness of A-CVCs relative to uncoated catheters. Four catheter types were evaluated: minocycline and rifampicin (MR)-coated catheters, silver, platinum and carbon (SPC)-impregnated catheters, and two chlorhexidine and silver sulfadiazine-coated catheters; one coated on the external surface (CH/SSD (ext)) and the other coated on both surfaces (CH/SSD (int/ext)). The incremental cost per quality-adjusted life year gained and the expected net monetary benefits were estimated for each. Uncertainty arising from data estimates, data quality and heterogeneity was explored in sensitivity analyses. Results The baseline analysis, with no consideration of uncertainty, indicated all four types of A-CVC were cost-saving relative to uncoated catheters. MR-coated catheters prevented 15 infections per 1,000 catheters and generated the greatest health benefits, 1.6 quality-adjusted life years, and cost savings (AUD $130,289). After considering uncertainty in the current evidence, the MR-coated catheters returned the highest incremental monetary net benefits of AUD $948 per catheter; however there was a 62% probability of error in this conclusion. Although the MR-coated catheters had the highest monetary net benefits across multiple scenarios, the decision was always associated with high uncertainty. Conclusions Current evidence suggests that the cost effectiveness of using A-CVCs within the ICU is

  20. A Present Value-Unit Cost Methodology for Evaluating Wastewater Reclamation and Direct Reuse at a Military Base of Operations

    DTIC Science & Technology

    1974-12-01

    KEY WORDS (Conllnut on rtvtrt^ tldt II ntctttmry mnd Idtntlly by block numbtr) Waslewater reciainalion Wat(;r renovation Water reuse Present...applied to a water supply problem typical for a military operation. A relevant unit cost figure, called the "present value-unit cost" (PVUC), is...determined and applied to alternative methods for meeting a projected need for water . The concepls of reclamation am! dual supply systems are

  1. 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.

  2. Antibiotic prescription and cost patterns in a general intensive care unit

    PubMed Central

    Krivoy, Norberto; El-Ahal, Wissam Abed; Bar-Lavie, Yaron; Haddad, Salim

    Antibiotic prescription habits, cost pattern, and the prospective intervention in an Intensive Care Unit were analyzed. Methods Data on antibiotic utilization and costs were collected prospectively from individual electronic charts from August 2003 to January 2004, and retrospectively from August to December 2002. Results A total of 180 and 107 patients were surveyed in 2002 and 2003. In 2002, Piperacillin-Tazobactam (13.8%) and Imipenem/Cilastin (11.2%) were the most prescribed medications; while, in 2003, Vancomycin (12.6%) and Imipenem/Cilastin (11.3%) were prescribed, respectively. Total defined daily dose (DDD) and Drug Utilization 90% (DU90%) index for 2002 and 2003 were 2031.15 and 2325.90 DDDs (p>0.1) and 1777.57 and 2079.61 DU90%, respectively (p>0.1). The Median Total Cost /100 admission days (CI 95%) were NIS13,310 (11,110;18,420) and NIS13,860 (6,710;18,020) (p=0.66), respectively. Conclusions Interventional programs should focus on promoting infectious control with rational antibiotic prescription aimed at minimizing the future emergence of bacterial resistance and futile expenses. PMID:25214920

  3. 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…

  4. Statistical Power and Optimum Sample Allocation Ratio for Treatment and Control Having Unequal Costs Per Unit of Randomization

    ERIC Educational Resources Information Center

    Liu, Xiaofeng

    2003-01-01

    This article considers optimal sample allocation between the treatment and control condition in multilevel designs when the costs per sampling unit vary due to treatment assignment. Optimal unequal allocation may reduce the cost from that of a balanced design without sacrificing any power. The optimum sample allocation ratio depends only on the…

  5. 23 CFR 645.117 - Cost development and reimbursement.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... with utility companies to develop, other acceptable costing methods, such as unit costs, to estimate... accepted industry practices and be reasonably supported by recent actual expenditures. Unit costs should be... replaced, such as a building, pumping station, filtration plant, power plant, substation, or any...

  6. 23 CFR 645.117 - Cost development and reimbursement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... with utility companies to develop, other acceptable costing methods, such as unit costs, to estimate... accepted industry practices and be reasonably supported by recent actual expenditures. Unit costs should be... replaced, such as a building, pumping station, filtration plant, power plant, substation, or any...

  7. 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.

  8. 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

  9. 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.

  10. The economic costs of chronic pain among a cohort of treatment seeking adolescents in the United States

    PubMed Central

    Groenewald, Cornelius B.; Essner, Bonnie S.; Wright, Davene; Fesinmeyer, Megan D.; Palermo, Tonya M.

    2014-01-01

    The aim of this study was to assess the economic cost of chronic pain among adolescents receiving interdisciplinary pain treatment. Information was gathered from 149 adolescents (ages 10-17) presenting for evaluation and treatment at interdisciplinary pain clinics in the United States. Parents completed a validated measure of family economic attributes, the Client Service Receipt Inventory, to report on health service use and productivity losses due to their child's chronic pain retrospectively over 12 months. Health care costs were calculated by multiplying reported utilization estimates by unit visit costs from the 2010 Medical Expenditure Panel Survey. The estimated mean and median costs per participant were $11,787 and $6,770 respectively. Costs were concentrated in a small group of participants, the top 5 % of those patients incurring the highest costs accounted for 30 % of total costs while the lower 75 % of participants accounted for only 34 % of costs. Total costs to society for adolescents with moderate to severe chronic pain were extrapolated to $19.5 billion annually in the U.S. The cost of childhood chronic pain presents a substantial economic burden to families and society. Future research should focus on predictors of increased health services use and costs in adolescents with chronic pain. Perspective This cost of illness study comprehensively estimates the economic costs of chronic pain in a cohort of treatment-seeking adolescents. The primary driver of costs was direct medical costs followed by productivity losses. Because of its economic impact, policy makers should invest resources in the prevention, diagnosis, and treatment of chronic pediatric pain. PMID:24953887

  11. Economic Evaluation of Munitions Manufacturing Pink Wastewater Treatment Alternatives Using a Present Value-Unit Cost Methodology

    DTIC Science & Technology

    1982-02-01

    present value- unit cost (PVUC) methodology and compares seven state -of-the- art processes: activated granular carbon adsorption with and without...The United States Army controls seventeen Army Ammunition Plants (AAP) engaged in explosive or propellant manufacture. Seven AAP’s engage only in mar...Army manufactures all explosives (except nitroglycerin) employed by the United States Air Force and the Army LAP facilities process Air Force munitions

  12. Cost-efficient design of a quantum multiplier-accumulator unit

    NASA Astrophysics Data System (ADS)

    Babu, Hafiz Md. Hasan

    2017-01-01

    This paper proposes a cost-efficient quantum multiplier-accumulator unit. The paper also presents a fast multiplication algorithm and designs a novel quantum multiplier device based on the proposed algorithm with the optimum time complexity as multiplier is the major device of a multiplier-accumulator unit. We show that the proposed multiplication technique has time complexity O((3 log2n)+1), whereas the best known existing technique has O(n log2 n), where n is the number of qubits. In addition, our design proposes three new quantum circuits: a circuit representing a quantum full-adder, a circuit known as quantum ANDing circuit, which performs the ANDing operation and a circuit presenting quantum accumulator. Moreover, the proposed quantum multiplier-accumulator unit is the first ever quantum multiplier-accumulator circuit in the literature till now, which has reduced garbage outputs and ancillary inputs to a great extent. The comparative study shows that the proposed quantum multiplier performs better than the existing multipliers in terms of depth, quantum gates, delays, area and power with the increasing number of qubits. Moreover, we design the proposed quantum multiplier-accumulator unit, which performs better than the existing ones in terms of hardware and delay complexities, e.g., the proposed (n× n)—qubit quantum multiplier-accumulator unit requires O(n2) hardware and O(log2n) delay complexities, whereas the best known existing quantum multiplier-accumulator unit requires O(n3) hardware and O((n-1)2 +1+n) delay complexities. In addition, the proposed design achieves an improvement of 13.04, 60.08 and 27.2% for 4× 4, 7.87, 51.8 and 27.1% for 8× 8, 4.24, 52.14 and 27% for 16× 16, 2.19, 52.15 and 27.26% for 32 × 32 and 0.78, 52.18 and 27.28% for 128 × 128-qubit multiplications over the best known existing approach in terms of number of quantum gates, ancillary inputs and garbage outputs, respectively. Moreover, on average, the proposed design gains an

  13. 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

  14. Diabetes Mellitus and Infection: An Evaluation of Hospital Utilization and Management Costs in the United States

    PubMed Central

    Korbel, Lindsey; Spencer, John David

    2014-01-01

    Aims The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. Methods We accessed the Healthcare Cost and Utilization Project’s Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006-2011. Results Emergency Department Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM and infection was responsible for over $48 billion dollars in aggregate hospital charges. Conclusions Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. PMID:25488325

  15. Comparative Assessment of Patient Care Expenses among Intensive Care Units of a Tertiary Care Teaching Hospital using Cost Block Method

    PubMed Central

    Kundury, Kanakavalli Kiranmai; Mamatha, H. K.; Rao, Divya

    2017-01-01

    Introduction: Intensive care services of a hospital are found to consume major chunk of hospital resources as well draining the savings of patients. Implementing proper control measures facilitates effective functioning of critical care services. Aim: Identify various costs involved in operating Surgical Intensive Care Unit (SICU) and Respiratory Intensive Care Unit (RICU); also find out the running cost of the same. Methodology: Retrospective data was collected for 12 months period and prospectively through informal interactions with staff. Results: Construction and estate costs of the respective ICU's were found to be high, followed by laboratory charges. Running cost of RICU was found to be more than SICU. Conclusion: Costing of intensive care service is essential for controlled operations and to provide efficient patient care. PMID:28250603

  16. Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

    PubMed Central

    Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

    1996-01-01

    OBJECTIVES: Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. METHODS: A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. RESULTS: Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. CONCLUSIONS: EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress. PMID:8659653

  17. 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

  18. A New Improved Hybrid Meta-Heuristics Method for Unit Commitment with Nonlinear Fuel Cost Function

    NASA Astrophysics Data System (ADS)

    Okawa, Kenta; Mori, Hiroyuki

    In this paper, a new improved hybrid meta-heuristic method is proposed to solve the unit commitment problem effectively. The objective is to minimize operation cost while satisfying the power balance constraints and so on. It may be formulated as a nonlinear mixed-integer problem. In other words, the unit commitment problem is hard to solve. Therefore, this paper makes use of a hybrid meta-heuristic method with two layers. Layer 1 determines the on/off conditions of generators with tabu search (TS) while Layer 2 evaluates output of generators with evolutionary particle swarm optimization (EPSO). The construction phase of Greedy Randomized Adaptive Search Procedure (GRASP) is used to create initial feasible solutions efficiently. Three kinds of meta-heuristic methods such as TS, EPSO and GRASP are combined to solve the problem. In addition, a parallel scheme of EPSO is developed to improve the computational efficient as well as the accuracy. The effectiveness of the proposed method is tested in sample systems.

  19. Calibration and Validation of the Sage Software Cost/Schedule Estimating System to United States Air Force Databases

    DTIC Science & Technology

    1997-09-01

    factor values are identified. For SASET, revised cost estimating relationships are provided ( Apgar et al., 1991). A 1991 AFIT thesis by Gerald Ourada...time to complete. Finally, development effort decreases at an increasing rate as the effective technology rating (Cte) increases. In SAGE, higher scores ...environment complexity, and target environment. (Lucas, 1991: 2) The effective technology rating (Cte) is actually a composite score resulting from

  20. 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).

  1. 50 CFR 253.16 - Actual cost.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... such land is utilized by the facility; and (3) The net present value of the payments due under a long...'s useful life, using a 10-percent salvage value; and (2) The current market value of appurtenant... straightline basis over the Project Property's useful life, using a 10-percent salvage value; (2) The...

  2. 50 CFR 253.16 - Actual cost.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... such land is utilized by the facility; and (3) The net present value of the payments due under a long...'s useful life, using a 10-percent salvage value; and (2) The current market value of appurtenant... straightline basis over the Project Property's useful life, using a 10-percent salvage value; (2) The...

  3. 50 CFR 253.16 - Actual cost.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... such land is utilized by the facility; and (3) The net present value of the payments due under a long...'s useful life, using a 10-percent salvage value; and (2) The current market value of appurtenant... straightline basis over the Project Property's useful life, using a 10-percent salvage value; (2) The...

  4. Physician response to the United Mine Workers' cost-sharing program: the other side of the coin.

    PubMed Central

    Fahs, M C

    1992-01-01

    The effect of cost sharing on health services utilization is analyzed from a new perspective, that is, its effects on physician response to cost sharing. A primary data set was constructed using medical records and billing files from a large multispecialty group practice during the three-year period surrounding the introduction of cost sharing to the United Mine Workers Health and Retirement Fund. This same group practice also served an equally large number of patients covered by United Steelworkers' health benefit plans, for which similar utilization data were available. The questions addressed in this interinsurer study are: (1) to what extent does a physician's treatment of medically similar cases vary, following a drop in patient visits as a result of cost sharing? and (2) what is the impact, if any, on costs of care for other patients in the practice (e.g., "spillover effects" such as cost shifting)? Answers to these kinds of questions are necessary to predict the effects of cost sharing on overall health care costs. A fixed-effects model of physician service use was applied to data on episodes of treatment for all patients in a private group practice. This shows that the introduction of cost sharing to some patients in a practice does, in fact, increase the treatment costs to other patients in the same practice who remain under stable insurance plans. The analysis demonstrates that when the economic effects of cost sharing on physician service use are analyzed for all patients within a physician practice, the findings are remarkably different from those of an analysis limited to those patients directly affected by cost sharing. PMID:1563952

  5. Time from accident to admission to a burn intensive care unit: how long does it actually take? A 25-year retrospective data analysis from a german burn center

    PubMed Central

    Schiefer, J.L.; Alischahi, A.; Perbix, W.; Grigutsch, D.; Graeff, I.; Zinser, M.; Demir, E.; Fuchs, P.C.; Schulz, A.

    2016-01-01

    Summary Severe burn injuries often require specialized treatment at a burn center. It is known that prompt admission to an intensive care unit is essential for achieving good outcome. Nevertheless, very little is known about the duration of time before a patient is admitted to a specialized center after a burn injury in Germany, and whether the situation has improved over time. We retrospectively analyzed time from burn injury to admission to the burn intensive care unit in the Cologne-Merheim Medical Center - one of Germany’s specialized burn centers - over the last 25 years. Moreover, we analyzed the data based on differences according to time of injury and day of the week, as well as severity of the burn injury. There was no weekend effect with regard to transfer time; instead transfer time was particularly short on a Monday or on Sundays. Furthermore, patients with severe burn injuries of 40-89% total body surface area (TBSA) showed the least differences in transfer time. Interestingly, the youngest and the oldest patients arrived at the burn intensive care unit (BICU) the fastest. This study should help elucidate published knowledge regarding transfer time from the scene of the accident to admission to a BICU in Germany. PMID:27857646

  6. Time from accident to admission to a burn intensive care unit: how long does it actually take? A 25-year retrospective data analysis from a german burn center.

    PubMed

    Schiefer, J L; Alischahi, A; Perbix, W; Grigutsch, D; Graeff, I; Zinser, M; Demir, E; Fuchs, P C; Schulz, A

    2016-03-31

    Severe burn injuries often require specialized treatment at a burn center. It is known that prompt admission to an intensive care unit is essential for achieving good outcome. Nevertheless, very little is known about the duration of time before a patient is admitted to a specialized center after a burn injury in Germany, and whether the situation has improved over time. We retrospectively analyzed time from burn injury to admission to the burn intensive care unit in the Cologne-Merheim Medical Center - one of Germany's specialized burn centers - over the last 25 years. Moreover, we analyzed the data based on differences according to time of injury and day of the week, as well as severity of the burn injury. There was no weekend effect with regard to transfer time; instead transfer time was particularly short on a Monday or on Sundays. Furthermore, patients with severe burn injuries of 40-89% total body surface area (TBSA) showed the least differences in transfer time. Interestingly, the youngest and the oldest patients arrived at the burn intensive care unit (BICU) the fastest. This study should help elucidate published knowledge regarding transfer time from the scene of the accident to admission to a BICU in Germany.

  7. 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.

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

    USGS Publications Warehouse

    Harris, A.; Pirie, D.; Horton, K.; Garbeil, H.; Pilger, E.; Ramm, H.; Hoblitt, R.; Thornber, C.; Ripepe, M.; Marchetti, E.; Poggi, P.

    2005-01-01

    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 ???US$10,000 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 US$5500 for a single sensor system. We have also constructed self-contained units

  9. 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

  10. 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…

  11. Anemia, bleeding, and blood transfusion in the intensive care unit: causes, risks, costs, and new strategies.

    PubMed

    McEvoy, Michael T; Shander, Aryeh

    2013-11-01

    The definition of anemia is controversial and varies with the sex, age, and ethnicity of the patient. Anemia afflicts half of hospitalized patients and most elderly hospitalized patients. Acute anemia in the operating room or intensive care unit is associated with increased morbidity as well as other adverse outcomes, including death. The risks of anemia are compounded by the added risks associated with transfusion of red blood cells, the most common treatment for severe anemia. The causes of anemia in hospitalized patients include iron deficiency, suppression of erythropoietin and iron transport, trauma, phlebotomy, coagulopathies, adverse effects of and reactions to medications, and stress-induced gastrointestinal bleeding. The types and causes of anemia and the increased health care utilization and costs associated with anemia and undetected internal bleeding are described. The potential benefits and risks associated with transfusion of red blood cells also are explored. Last, the strategies and new tools to help prevent anemia, allow earlier detection of internal bleeding, and avoid unnecessary blood transfusions are discussed.

  12. 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

  13. Secondary-care costs associated with lung cancer diagnosed at emergency hospitalisation in the United Kingdom.

    PubMed

    Kennedy, Martyn P T; Hall, Peter S; Callister, Matthew E J

    2017-01-30

    Lung cancer diagnosis during emergency hospital admission has been associated with higher early secondary-care costs and lower longer-term costs than outpatient diagnoses. This retrospective cohort study analyses the secondary-care costs of 3274 consecutive patients with lung cancer. Patients diagnosed during emergency admissions incurred greater costs during the first month and had a worse prognosis compared with outpatient diagnoses. In patients who remained alive, costs after the first month were comparable between diagnostic routes. In addition to improving patient experience and outcome, strategies to increase earlier diagnosis may reduce the additional healthcare costs associated with this route to diagnosis.

  14. An Analysis of COLA (Cost of Living Adjustment) Allocation within the United States Coast Guard.

    DTIC Science & Technology

    1983-09-01

    0515 .0877 .0866 1975-1976 .0639 .0666 .0746 .0755 .0609 .0611 .0795 .0791 .0758 .0763 1976-1977 .0690 .0555 .0716 .0706 .0710 . 0718 .0692 .0691 .0584...ACTUAL 79-80 30 .0438 . 0527 .1098 41 .0560 .0620 .1087 42 .0522 .0531 .1086 *43 .0550 .0550 .0531 45 .0508 .0561 .1218 46 .0442 .0554 .0723 54 .0500...8217. . .. "..... .. .. . . .. . .... ,. ... .. ... . .... TABLE 4-2 (CONT.) PREDICTIONS FOR FY 1981 ACCOUNT LINEAR PREDICTION LOG PREDICTION ACTUAL 80-81 30 . 0527 .0676 .1024

  15. The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs

    PubMed Central

    Grosse, Scott D.; Nelson, Richard E.; Nyarko, Kwame A.; Richardson, Lisa C.; Raskob, Gary E.

    2015-01-01

    Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is an important cause of preventable mortality and morbidity. In this study, we summarize estimates of per-patient and aggregate medical costs or expenditures attributable to incident VTE in the United States. Per-patient estimates of incremental costs can be calculated as the difference in costs between patients with and without an event after controlling for differences in underlying health status. We identified estimates of the incremental per-patient costs of acute VTEs and VTE-related complications, including recurrent VTE, post-thrombotic syndrome, chronic thromboembolic pulmonary hypertension, and anticoagulation-related adverse drug events. Based on the studies identified, treatment of an acute VTE on average appears to be associated with incremental direct medical costs of $12,000 to $15,000 (2014 US dollars) among first-year survivors, controlling for risk factors. Subsequent complications are conservatively estimated to increase cumulative costs to $18,000–23,000 per incident case. Annual incident VTE events conservatively cost the US healthcare system $7–10 billion each year for 375,000 to 425,000 newly diagnosed, medically treated incident VTE cases. Future studies should track long-term costs for cohorts of people with incident VTE, control for comorbid conditions that have been shown to be associated with VTE, and estimate incremental medical costs for people with VTE who do not survive. The costs associated with treating VTE can be used to assess the potential economic benefit and cost-savings from prevention efforts, although costs will vary among different patient groups. PMID:26654719

  16. The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs.

    PubMed

    Grosse, Scott D; Nelson, Richard E; Nyarko, Kwame A; Richardson, Lisa C; Raskob, Gary E

    2016-01-01

    Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is an important cause of preventable mortality and morbidity. In this study, we summarize estimates of per-patient and aggregate medical costs or expenditures attributable to incident VTE in the United States. Per-patient estimates of incremental costs can be calculated as the difference in costs between patients with and without an event after controlling for differences in underlying health status. We identified estimates of the incremental per-patient costs of acute VTEs and VTE-related complications, including recurrent VTE, post-thrombotic syndrome, chronic thromboembolic pulmonary hypertension, and anticoagulation-related adverse drug events. Based on the studies identified, treatment of an acute VTE on average appears to be associated with incremental direct medical costs of $12,000 to $15,000 (2014 US dollars) among first-year survivors, controlling for risk factors. Subsequent complications are conservatively estimated to increase cumulative costs to $18,000-23,000 per incident case. Annual incident VTE events conservatively cost the US healthcare system $7-10 billion each year for 375,000 to 425,000 newly diagnosed, medically treated incident VTE cases. Future studies should track long-term costs for cohorts of people with incident VTE, control for comorbid conditions that have been shown to be associated with VTE, and estimate incremental medical costs for people with VTE who do not survive. The costs associated with treating VTE can be used to assess the potential economic benefit and cost-savings from prevention efforts, although costs will vary among different patient groups.

  17. 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.

  18. An Analysis of the Factors Which Affect Instructional Unit Cost in the Public Community Colleges of Illinois.

    ERIC Educational Resources Information Center

    Wallhaus, Penny; Lach, Ivan J.

    Methodology and findings are reported for a series of statistical analyses conducted to identify those factors that account for variations in instructional unit costs (IUC) among the Illinois community colleges. The first analysis described in the report correlates five measures of district wealth with total IUC (i.e., total instructional costs…

  19. Health care utilization, costs, and the burden of disease related to eosinophilic esophagitis in the United States

    PubMed Central

    Jensen, Elizabeth T.; Kappelman, Michael D.; Martin, Christopher F.; Dellon, Evan S.

    2015-01-01

    Objectives Eosinophilic esophagitis (EoE) has rapidly become a major cause of upper GI morbidity, but health care costs related to EoE have not been described. This study aimed to estimate EoE-related health care costs and utilization in the United States. Methods We performed a study of health care utilization of EoE cases compared to age- and sex-matched controls using administrative claims data, representative of the commercially insured population in the U.S. Cases of EoE were identified using a previously validated definition. We assessed inpatient, outpatient, emergency department, outpatient prescription, and endoscopy-related costs for patients with EoE, and estimated total costs related to EoE extrapolated to the U.S. population. Results We identified 8,135 cases of EoE and 32,540 controls. The median total annual cost per EoE case was $3,304 compared to $1,001 for controls (p<0.001). For EoE, median costs included $2,508/year for outpatient visits, $157 for endoscopies, and $325 for pharmacy claims, compared to $699, $0, and $76 for controls (p<0.001 for all). The overall median costs associated with EoE were $2,302/year/patient. Total costs in the U.S. ranged from $503 million to $1.36 billion/year, depending on the prevalence estimate, with costs attributable to EoE ranging from $350-$947 million/year. Conclusions Patients with EoE have an estimated annual health care cost of as much as $1.4 billion in the U.S. This represents a remarkable burden of disease for an entity that was essentially unknown two decades ago. These cost data can be used by policy makers to guide resource allocation. PMID:25267327

  20. 78 FR 59817 - Revision to United States Marshals Service Fees for Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... Marshals Service fees to reflect current costs to the United States Marshals Service for service of process....S.C. 1921(a). To the extent practicable, these fees shall reflect the actual and reasonable costs of... in 1991 based on the actual costs, e.g., salaries, overhead, etc., of the services rendered and...

  1. 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

  2. [Cooperation with the electronic medical record and accounting system of an actual dose of drug given by a radiology information system].

    PubMed

    Yamamoto, Hideo; Yoneda, Tarou; Satou, Shuji; Ishikawa, Toru; Hara, Misako

    2009-12-20

    By input of the actual dose of a drug given into a radiology information system, the system converting with an accounting system into a cost of the drug from the actual dose in the electronic medical record was built. In the drug master, the first unit was set as the cost of the drug, and we set the second unit as the actual dose. The second unit in the radiology information system was received by the accounting system through electronic medical record. In the accounting system, the actual dose was changed into the cost of the drug using the dose of conversion to the first unit. The actual dose was recorded on a radiology information system and electronic medical record. The actual dose was indicated on the accounting system, and the cost for the drug was calculated. About the actual dose of drug, cooperation of the information in a radiology information system and electronic medical record were completed. It was possible to decide the volume of drug from the correct dose of drug at the previous inspection. If it is necessary for the patient to have another treatment of medicine, it is important to know the actual dose of drug given. Moreover, authenticity of electronic medical record based on a statute has also improved.

  3. Cost effectiveness of topiramate in the prevention of migraines in the United States: an update.

    PubMed

    Brown, Jeffrey S; Rupnow, Marcia F T; Neumann, Peter; Friedman, Mark; Menzin, Joseph

    2006-12-01

    A previously published decision-analytic model assessing the clinical and economic consequences of topiramate versus no preventive treatment in migraineurs was updated with new published literature and unpublished clinical trial data. The model captured baseline migraine days, treatment discontinuation, treatment response (i.e., > or = 75%, 50%-74%, and < 50% reduction in migraine frequency), hours of disability, cost of preventive therapy, cost of acute treatment (pharmacy and medical service), and wages. Topiramate was associated with 29 fewer migraine-days and 78 fewer hours of disability per year, compared with no preventive treatment. The incremental cost per migraine-day averted for topiramate versus no preventive treatment was dollar 29 when only direct medical costs were considered and dollar 2 when total costs were included. Model results were sensitive to baseline migraine-days, response probability, and probability of an attack being treated with a triptan. Topiramate may be a cost-effective treatment for the prevention of migraine.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. Geological studies of the COST GE-1 well, United States South Atlantic outer continental shelf area

    USGS Publications Warehouse

    Scholle, Peter A.

    1979-01-01

    The COST No. GE-1 well is the first deep stratigraphic test to be drilled in the southern part of the U.S. Atlantic Outer Continental Shelf (AOCS) area. The well was drilled within the Southeast Georgia Embayment to a total depth of 13,254 ft (4,040 m). It penetrated a section composed largely of chalky limestones to a depth of about 3,300 ft (1,000 m) below the drill platform. Limestones and calcareous shales with some dolomite predominate between 3,300 and 7,200 ft (1,000 and 2,200 m), whereas interbedded sandstones and shales are dominant from 7,200 to 11,000 ft (2,200 to 3,350 m). From 11,000 ft (3,350 m) to the bottom, the section consists of highly indurated to weakly metamorphosed pelitic sedimentary rocks and meta-igneous flows or intrusives. Biostratigraphic examination has shown that the section down to approximately 3,500 ft (1,060 m) is Tertiary, the interval from 3,500 to 5,900 ft (1,060 to 1,800 m) is Upper Cretaceous, and the section from 5,900 to 11,000 ft (1,800 to 3,350 m) is apparently Lower Cretaceous. The indurated to weakly metamorphosed section below 11,000 ft (3,350 m) is barren of fauna or flora but is presumed to be Paleozoic based on radiometric age determinations. Rocks deposited at upper-slope water depths were encountered in the Upper Cretaceous, Oligocene, and Miocene parts of the section. All other units were deposited in outer-shelf to terrestrial environments. Examination of cores, well cuttings, and electric logs shows that potential hydrocarbon-reservoir units are present within the chalks in the uppermost part of the section as well as in sandstone beds to a depth of at least 10,000 ft (3,000 m). Sandstones below that depth, and the metamorphic section between 11,000 and 13.250 ft (3,350 and 4,040 m) have extremely low permeabilities and are unlikely to contain potential reservoir rock. Studies of organic geochemistry, vitrinite reflectance, and color alteration of visible organic matter indicate that the chalk section down to

  10. Developing a United States Marine Corps Organizational and Intermediate Level Maintenance Performance Cost Model

    DTIC Science & Technology

    2009-12-01

    to maintain a primary system, training devices, simulators , and support equipment.  Organization-Level Consumables—This includes the cost of...a primary system, simulators , training devices, and associated support equipment.  Intermediate Level Consumable Parts—The specified cost of...government furnished consumable materials used in maintaining and repairing a primary system, simulator , training devices, and associated support

  11. 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...

  12. 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

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

    PubMed Central

    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.

    2016-01-01

    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

  14. 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

  15. National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in the United States

    PubMed Central

    Peck, Richard M.; Babb, Stephen D.

    2014-01-01

    Introduction Despite progress in implementing smoke-free laws in indoor public places and workplaces, millions of Americans remain exposed to secondhand smoke at home. The nation’s 80 million multiunit housing residents, including the nearly 7 million who live in subsidized or public housing, are especially susceptible to secondhand smoke infiltration between units. Methods We calculated national and state costs that could have been averted in 2012 if smoking were prohibited in all US subsidized housing, including public housing: 1) secondhand smoke-related direct health care, 2) renovation of smoking-permitted units; and 3) smoking-attributable fires. Annual cost savings were calculated by using residency estimates from the Department of Housing and Urban Development and cost data reported elsewhere. Data were adjusted for inflation and variations in state costs. National and state estimates (excluding Alaska and the District of Columbia) were calculated by cost type. Results Prohibiting smoking in subsidized housing would yield annual cost savings of $496.82 million (range, $258.96–$843.50 million), including $310.48 million ($154.14–$552.34 million) in secondhand smoke-related health care, $133.77 million ($75.24–$209.01 million) in renovation expenses, and $52.57 million ($29.57–$82.15 million) in smoking-attributable fire losses. By state, cost savings ranged from $0.58 million ($0.31–$0.94 million) in Wyoming to $124.68 million ($63.45–$216.71 million) in New York. Prohibiting smoking in public housing alone would yield cost savings of $152.91 million ($79.81–$259.28 million); by state, total cost savings ranged from $0.13 million ($0.07–$0.22 million) in Wyoming to $57.77 million ($29.41–$100.36 million) in New York. Conclusion Prohibiting smoking in all US subsidized housing, including public housing, would protect health and could generate substantial societal cost savings. PMID:25275808

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. Cost of Outpatient Arthroscopic Anterior Cruciate Ligament Reconstruction Among Commercially Insured Patients in the United States, 2005-2013

    PubMed Central

    Herzog, Mackenzie M.; Marshall, Stephen W.; Lund, Jennifer L.; Pate, Virginia; Spang, Jeffrey T.

    2017-01-01

    Background: Despite the significance of anterior cruciate ligament (ACL) injuries, these conditions have been under-researched from a population-level perspective. It is important to determine the economic effect of these injuries in order to document the public health burden in the United States. Purpose: To describe the cost of outpatient arthroscopic ACL reconstruction and health care utilization among commercially insured beneficiaries in the United States. Study Design: Economic and decision analysis; Level of evidence, 3. Methods: The study used the Truven Health Analytics MarketScan Commercial Claims and Encounters database, an administrative claims database that contains a large sample (approximately 148 million) of privately insured individuals aged <65 years and enrolled in employer-sponsored plans. All claims with Current Procedural Terminology (CPT) code 29888 (arthroscopically aided ACL reconstruction or augmentation) from 2005 to 2013 were included. “Immediate procedure” cost was computed assuming a 3-day window of care centered on date of surgery. “Total health care utilization” cost was computed using a 9-month window of care (3 months preoperative and 6 months postoperative). Results: There were 229,446 outpatient arthroscopic ACL reconstructions performed over the 9-year study period. Median immediate procedure cost was $9399.49. Median total health care utilization cost was $13,403.38. Patients who underwent concomitant collateral ligament (medial [MCL], lateral [LCL]) repair or reconstruction had the highest costs for both immediate procedure ($12,473.24) and health care utilization ($17,006.34). For patients who had more than 1 reconstruction captured in the database, total health care utilization costs were higher for the second procedure than the first procedure ($16,238.43 vs $15,000.36), despite the fact that immediate procedure costs were lower for second procedures ($8685.73 vs $9445.26). Conclusion: These results provide a

  2. 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 ...

  3. 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

  4. Return to 1990: The cost of mitigating United States carbon emissions in the post-2000 period

    SciTech Connect

    Edmonds, J.A.; Kim, S.H.; MacCracken, C.N.; Sands, R.D.; Wise, M.A.

    1997-10-01

    The Second Generation Model (SGM) is employed to examine four hypothetical agreements to reduce emissions in Annex 1 nations (OECD nations plus most of the nations of Eastern Europe and the former Soviet Union) to levels in the neighborhood of those which existed in 1990, with obligations taking effect in the year 2010. The authors estimate the cost to the US of complying with such agreements under three distinct conditions: no trading of emissions rights, trading of emissions rights only among Annex 1 nations, and a fully global trading regime. The authors find that the marginal cost of returning to 1990 emissions levels in the US in the absence of trading opportunities is approximately $108 per metric ton carbon in 2010. The total cost in that year is approximately 0.2% of GDP. International trade in emissions permits lowers the cost of achieving any mitigation objective by equalizing the marginal cost of carbon mitigation among countries. For the four mitigation scenarios in this study, economic costs to the US remain below 1% of GDP through at least the year 2020.

  5. Dropping Out of School in the North Central Region of the United States: Costs and Consequences. Success for Students at Risk.

    ERIC Educational Resources Information Center

    Catterall, James S.

    This study examines the individual and social costs associated with dropping out of high school in the North Central Region of the United States. Dropouts incur personal costs in the form of reduced earnings, higher chances of being unemployed, and higher likelihood of involvement with crime. Social costs appear in the form of lower total…

  6. 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

  7. Developing a Predictive Model for Facility Repair Costs on United States Air Force Installations

    DTIC Science & Technology

    2011-06-01

    Department of Defense, or the United States Government . This material is declared a work of the U.S. Government and is not subject to copyright...is investing 9%; and the United States is spending only 2.4% (American Society of Civil Engineers, 2009). According to the 2009 Repot Card for...2007. This delta between the obligation amounts and the FSM represents what the Government Accountability Office (GAO) refers to as “deferred

  8. 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.

  9. Health resource utilization and cost associated with myeloproliferative neoplasms in a large United States health plan.

    PubMed

    Mehta, Jyotsna; Wang, Hongwei; Fryzek, Jon P; Iqbal, Sheikh Usman; Mesa, Ruben

    2014-10-01

    Myelofibrosis (MF), polycythemia vera (PV) and essential thrombocythemia (ET) may lead to bone marrow fibrosis. Because the disease course of ET and PV are long and the disease course of MF may be fatal, healthcare resource utilization (HRU) associated costs of these neoplasms are especially important to understand. We used a large US health insurance claim database to describe the costs of these diseases. Compared to age-gender matched comparisons without myeloproliferative neoplasms (MPN), all aspects of HRU that we examined, including inpatient, outpatient and emergency room visits and pharmacy, as well as overall healthcare expenditures, were significantly higher in patients with MF, PV and ET (e.g. MF total costs = $54 168 vs. $10 203; PV = $14 903 vs. $7913; ET = $29 553 vs. $8026) than in matched comparisons. In order to reduce the burden of illness associated with these diseases, continued efforts in the development of more efficacious treatments for these disorders are needed.

  10. 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

  11. Annual cost of illness and quality-adjusted life year losses in the United States due to 14 foodborne pathogens.

    PubMed

    Hoffmann, Sandra; Batz, Michael B; Morris, J Glenn

    2012-07-01

    In this article we estimate the annual cost of illness and quality-adjusted life year (QALY) loss in the United States caused by 14 of the 31 major foodborne pathogens reported on by Scallan et al. (Emerg. Infect. Dis. 17:7-15, 2011), based on their incidence estimates of foodborne illness in the United States. These 14 pathogens account for 95 % of illnesses and hospitalizations and 98 % of deaths due to identifiable pathogens estimated by Scallan et al. We estimate that these 14 pathogens cause $14.0 billion (ranging from $4.4 billion to $33.0 billion) in cost of illness and a loss of 61,000 QALYs (ranging from 19,000 to 145,000 QALYs) per year. Roughly 90 % of this loss is caused by five pathogens: nontyphoidal Salmonella enterica ($3.3 billion; 17,000 QALYs), Campylobacter spp. ($1.7 billion; 13,300 QALYs), Listeria monocytogenes ($2.6 billion; 9,400 QALYs), Toxoplasma gondii ($3 billion; 11,000 QALYs), and norovirus ($2 billion; 5,000 QALYs). A companion article attributes losses estimated in this study to the consumption of specific categories of foods. To arrive at these estimates, for each pathogen we create disease outcome trees that characterize the symptoms, severities, durations, outcomes, and likelihoods of health states associated with that pathogen. We then estimate the cost of illness (medical costs, productivity loss, and valuation of premature mortality) for each pathogen. We also estimate QALY loss for each health state associated with a given pathogen, using the EuroQol 5D scale. Construction of disease outcome trees, outcome-specific cost of illness, and EuroQol 5D scoring are described in greater detail in a second companion article.

  12. The Course of Actualization

    ERIC Educational Resources Information Center

    De Smet, Hendrik

    2012-01-01

    Actualization is traditionally seen as the process following syntactic reanalysis whereby an item's new syntactic status manifests itself in new syntactic behavior. The process is gradual in that some new uses of the reanalyzed item appear earlier or more readily than others. This article accounts for the order in which new uses appear during…

  13. United States Marine Corps Cost Reduction and the Joint Battle Command Platform

    DTIC Science & Technology

    2013-09-01

    35   Figure 8.   Change in AAO over time (After MCSC, 2012b) .......................................... 37   Figure 9...categories ................................... 32   Table 3.   Change in AAO and cost with relationship to time (After MCSC, 2012b) .... 37...38   xii THIS PAGE INTENTIONALLY LEFT BLANK xiii LIST OF ACRONYMS AND ABBREVIATIONS AAO

  14. 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...

  15. Incidence and Cost of Pneumonia in Older Adults with COPD in the United States

    PubMed Central

    Ryan, Marian; Suaya, Jose A.; Chapman, John D.; Stason, William B.; Shepard, Donald S.; Parks Thomas, Cindy

    2013-01-01

    Objectives To estimate the incidence of pneumonia by COPD status and the excess cost of inpatient primary pneumonia in elders with COPD. Study Design A retrospective, longitudinal study using claims linked to eligibility/demographic data for a 5% sample of fee-for-service Medicare beneficiaries from 2005 through 2007. Methods Incidence rates of pneumonia were calculated for elders with and without COPD and for elders with COPD and coexistent congestive heart failure (CHF). Propensity-score matching with multivariate generalized linear regression was used to estimate the excess direct medical cost of inpatient primary pneumonia in elders with COPD as compared with elders with COPD but without a pneumonia hospitalization. Results Elders with COPD had nearly six-times the incidence of pneumonia compared with elders without COPD (167.6/1000 person-years versus 29.5/1000 person-years; RR=5.7, p <0 .01); RR increased to 8.1 for elders with COPD and CHF compared with elders without COPD. The incidence of inpatient primary pneumonia among elders with COPD was 54.2/1000 person-years compared with 7/1000 person-years for elders without COPD; RR=7.7, p<0.01); RR increased to 11.0 for elders with COPD and CHF compared with elders without COPD. The one-year excess direct medical cost of inpatient pneumonia in COPD patients was $ 22,697 ($45,456 in cases vs. $ 22,759 in controls (p <0.01)); 70.2% of this cost was accrued during the quarter of the index hospitalization. During months 13 through 24 following the index hospitalization, the excess direct medical cost was $ 5,941 ($23,215 in cases vs. $ 17,274 in controls, p<0.01). Conclusions Pneumonia occurs more frequently in elders with COPD than without COPD. The excess direct medical cost in elders with inpatient pneumonia extends up to 24 months following the index hospitalization and represents $28,638 in 2010 dollars. PMID:24130749

  16. 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...

  17. High Throughput Transmission Optical Projection Tomography Using Low Cost Graphics Processing Unit

    PubMed Central

    Vinegoni, Claudio; Fexon, Lyuba; Feruglio, Paolo Fumene; Pivovarov, Misha; Figueiredo, Jose-Luiz; Nahrendorf, Matthias; Pozzo, Antonio; Sbarbati, Andrea; Weissleder, Ralph

    2009-01-01

    We implement the use of a graphics processing unit (GPU) in order to achieve real time data processing for high-throughput transmission optical projection tomography imaging. By implementing the GPU we have obtained a 300 fold performance enhancement in comparison to a CPU workstation implementation. This enables to obtain on-the-fly reconstructions enabling for high throughput imaging. PMID:20052155

  18. Poor Prescription: The Costs of Imprisoning Drug Offenders in the United States. Policy Report.

    ERIC Educational Resources Information Center

    Schiraldi, Vincent; Holman, Barry; Beatty, Phillip

    Using data from the National Corrections Reporting Program, this study examined trends in imprisoning drug offenders in the United States, focusing on the numbers of incarcerated drug offenders and the relationship between incarceration for drug use and rates of drug use. Overall, the increase in drug admissions to prison from 1986 to 1996 is…

  19. International trade and air pollution: estimating the economic costs of air emissions from waterborne commerce vessels in the United States.

    PubMed

    Gallagher, Kevin P

    2005-10-01

    Although there is a burgeoning literature on the effects of international trade on the environment, relatively little work has been done on where trade most directly effects the environment: the transportation sector. This article shows how international trade is affecting air pollution emissions in the United States' shipping sector. Recent work has shown that cargo ships have been long overlooked regarding their contribution to air pollution. Indeed, ship emissions have recently been deemed "the last unregulated source of traditional air pollutants". Air pollution from ships has a number of significant local, national, and global environmental effects. Building on past studies, we examine the economic costs of this increasing and unregulated form of environmental damage. We find that total emissions from ships are largely increasing due to the increase in foreign commerce (or international trade). The economic costs of SO2 pollution range from dollars 697 million to dollars 3.9 billion during the period examined, or dollars 77 to dollars 435 million on an annual basis. The bulk of the cost is from foreign commerce, where the annual costs average to dollars 42 to dollars 241 million. For NOx emissions the costs are dollars 3.7 billion over the entire period or dollars 412 million per year. Because foreign trade is driving the growth in US shipping, we also estimate the effect of the Uruguay Round on emissions. Separating out the effects of global trade agreements reveals that the trade agreement-led emissions amounted to dollars 96 to dollars 542 million for SO2 between 1993 and 2001, or dollars 10 to dollars 60 million per year. For NOx they were dollars 745 million for the whole period or dollars 82 million per year. Without adequate policy responses, we predict that these trends and costs will continue into the future.

  20. 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.

  1. Costs of Flying Units in Air Force Active and Reserve Components

    DTIC Science & Technology

    2013-01-01

    alternatives in several weapon systems. Our objective is to provide an approach that is sufficiently comprehensive, uses accessible data, and yields replicable...are widely accessible , and yielding results that can be rep- licated by other analysts. Cost information with sufficient granularity for this approach...All DoD employees are authorized to gain access to the AFTOC site; contractors must have DoD sponsorship. Separate composite rates are used for

  2. Effectiveness and Cost of Alcohol Rehabilitation in the United States Air Force.

    DTIC Science & Technology

    1981-12-01

    treat - ment must be maintained over a considerable time span for the cost of the more intensive interventions to be offset by the savings realized...alcohol abuse in the military may constitute a more serious problem than drug abuse. The implication was that defense agency expenditures to treat alcohol...allocation of treat - merts differs considerably from that used in several other large programs: in particular, it differs from the heavy emphasis of inpatient

  3. Report of the Defense Science Board 1979 Summer Study on Reducing the Unit Cost of Equipment

    DTIC Science & Technology

    1980-03-01

    RESTRAINTS ARE RECOGNIZED AT THE BEGINNING: • DO NOT DESIGN FOR THREAT GROWTH AND DEPEND ON EVOLUTION OF WEAPON SYSTEMS ^ • ASSESS COST...competitive buyout or winner take all when the end of production could be reliably fore- cast, provided a rational acquisition strategy. With these...at attractive prices . Examples abound - sophisticated LSI chips, micro- processors, computer peripheral devices, display consoles - and many more

  4. The Analysis of TRICARE Navy Obstetric Delivery Costs within Continental United States Military Treatment Facilities

    DTIC Science & Technology

    2009-12-01

    1 A baby born vaginally is called a birth, while a baby born by cesarean section is called a...MTFs DESCRIPTION DRG CESAREAN SECTION W CC 370 CESAREAN SECTION W/O CC 371 VAGINAL DELIVERY W COMPLICATING DIAGNOSES 372 VAGINAL DELIVERY W/O...with complicated vaginal deliveries and cesarean sections , there was a large variation in costs associated with complicated deliveries. Thus, for

  5. 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.

  6. A cost-benefit analysis of a routine varicella vaccination program for United States Air Force Academy cadets.

    PubMed

    Burnham, B R; Wells, T S; Riddle, J R

    1998-09-01

    The United States Air Force Academy (USAFA) is one of the nation's military universities, with the mission to educate and motivate cadets to be career Air Force officers. This diverse population arrives at the USAFA with varying immunization records and disease histories. A review of USAFA cadet medical records identified an alarming cost of treating a simple, preventable, generally childhood disease: chickenpox. In July 1995, a cost-benefit analysis was performed on the use of varicella vaccine among cadets and preparatory school students at the USAFA. Based on this analysis, the USAFA implemented a strategy of serologic screening and vaccination. Although this study does not establish causation, follow-up data showed a dramatic decrease in cases, associated hospitalizations, and therefore costs during the first year after implementation. Fiscal projections indicate that these costs savings should increase through year 4 of the program and continue thereafter. At year 4, the total cadet population will have been serologically screened and/or vaccinated against chickenpox.

  7. Long-term implications of sustained wind power growth in the United States: Direct electric system impacts and costs

    SciTech Connect

    Lantz, Eric; Mai, Trieu; Wiser, Ryan H.; Krishnan, Venkat

    2016-10-01

    This paper evaluates potential changes in the power system associated with sustained growth in wind generation in the United States to 35% of end-use demand by 2050; Wiser et al. (2016) evaluate societal benefits and other impacts for this same scenario. Under reference or central conditions, the analysis finds cumulative wind capacity of 404 gigawatts (GW) would be required to reach this level and drive 2050 incremental electricity rate and cumulative electric sector savings of 2% and 3% respectively, relative to a scenario with no new wind capacity additions. Greater savings are estimated under higher fossil fuel costs or with greater advancements in wind technologies. Conversely, incremental costs are found when fossil fuel costs are lower than central assumptions or wind technology improvements are more-limited. Through 2030, the primary generation sources displaced by new wind capacity include natural gas and coal-fired generation. By 2050, wind could displace other renewables. Incremental new transmission infrastructure totaling 29 million megawatt-miles is estimated to be needed by 2050. In conjunction with related societal benefits, this work demonstrates that 35% wind energy by 2050 is plausible, could support enduring benefits, and could result in long-term consumer savings, if nearer-term (pre-2030) cost barriers are overcome; at the same time, these opportunities are not anticipated to be realized in their full form under 'business-as-usual' conditions.

  8. 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

  9. 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.

  10. 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.

  11. Carbon dioxide control costs for gasification combined-cycle plants in the United States

    SciTech Connect

    Brown, D.R.; Humphreys, K.K.; Vail, L.W.

    1993-06-01

    This study focused on evaluating the cost of recovering CO{sub 2} from coal gasification, combined-cycle (GCC) power plants and transporting the CO{sub 2} in pipelines for disposal in deep ocean water, depleted oil and gas reservoirs, or aquifers. Other fuels and conversion technologies were not evaluated. Technical feasibility, environmental acceptability, and other implementation issues were not addressed in detail. Ocean disposal of CO{sub 2} offers essentially unlimited capacity, but is distant from most US coal-fired power plants and presents environmental concerns at the disposal point. Depleted oil and gas reservoirs are also distant from most US coal-fired power plants and have a more limited disposal capacity,, but were calculated to have a potential capacity more than double that required to dispose of all CO{sub 2} from 830 GCC power plants (380-mwe each) for a period of 40 years. The existence of oil and gas reservoirs provides ``proof`` of the long-term CO{sub 2} confinement potential in these formations. In contrast, aquifer disposal is believed to be significantly riskier. Key concerns are lack of geologic knowledge at depths adequate for CO{sub 2} disposal; uncertainty about geochemical impacts from decreased water pH; and long-term confinement, which is unproven for non-petroleum formations. Carbon dioxide recovery at GCC plants increased the levelized energy cost (LEC) by about one third relative to a reference GCC plant without CO{sub 2} recovery. The transmission distance is the key factor affecting total CO{sub 2} control costs.

  12. Efficiency in the United States electric industry: Transaction costs, deregulation, and governance structures

    NASA Astrophysics Data System (ADS)

    Peterson, Carl

    Transaction costs economics (TCE) posits that firms have an incentive to bypass the market mechanisms in situations where the cost of using the market is prohibitive. Vertical integration, among other governance mechanisms, can be used to minimize the transactions costs associated with the market mechanism. The study analyses different governance mechanisms, which range from complete vertical integration to the use of market mechanisms, for firms in the US electric sector. This sector has undergone tremendous change in the past decade including the introduction of retail competition in some jurisdictions. As a result of the push toward deregulation of the industry, vertically integration, while still significant in the sector, has steadily been replaced by alternative governance structures. Using a sample of 136 investor-owned electric utilities that reported data the US Federal Energy Regulatory Commission between 1996 and 2002, this study estimates firm level efficiency using Data Envelopment Analysis (DEA) and relates these estimates to governance structure and public policies. The analysis finds that vertical integration is positively related to firm efficiency, although in a non-linear fashion suggesting that hybrid governance structures tend to be associated with lower efficiency scores. In addition, while some evidence is found for negative short-term effects on firm efficiency from the choice to deregulate, this result is sensitive to DEA model choice. Further, competition in retail markets is found to be positively related to firm level efficiency, but the retreat from deregulation, which occurred after 2000, is negatively associated with firm-level efficiency. These results are important in the ongoing academic and public policy debates concerning deregulation of the electric section and indicate that vertical economies remain in the industry, but that competition has provided incentives for improving firm level efficiency.

  13. 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.

  14. 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.

  15. More Money, Fewer Lives: The Cost Effectiveness of Welfare Reform in the United States

    PubMed Central

    Caleyachetty, Rishi; Rosen, Zohn; Korotzer, Andrew

    2015-01-01

    Objectives. We evaluated the economic benefits of Temporary Assistance to Needy Families (TANF) relative to the previous program, Aid to Families with Dependent Children (AFDC). Methods. We used pooled mortality hazard ratios from 2 randomized controlled trials—Connecticut Jobs First and the Florida Transition Program, which had follow-up from the early and mid-1990s through December 2011—and previous estimates of health and economic benefits of TANF and AFDC. We entered them into a Markov model to evaluate TANF’s economic benefits relative to AFDC and weigh them against the potential health threats of TANF. Results. Over the working life of the average cash assistance recipient, AFDC would cost approximately $28 000 more than TANF from the societal perspective. However, it would also bring 0.44 additional years of life. The incremental cost effectiveness of AFDC would be approximately $64 000 per life-year saved relative to TANF. Conclusions. AFDC may provide more value as a health investment than TANF. Additional attention given to the neediest US families denied cash assistance could improve the value of TANF. PMID:25521891

  16. 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.

  17. 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

  18. 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

    2015-09-25

    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.

  19. 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

  20. 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

    2016-05-03

    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.

  1. Incidence and costs of defensive medicine among orthopedic surgeons in the United States: a national survey study.

    PubMed

    Sethi, Manish K; Obremskey, William T; Natividad, Hazel; Mir, Hassan R; Jahangir, A Alex

    2012-02-01

    Defensive medicine is defined as medical practices that may exonerate physicians from liability without significant benefit to patients. No study has evaluated the United States national incidence of defensive medicine in the field of orthopedic surgery. In the study reported here, we investigated the practice of defensive medicine and the resultant financial implications of such behavior by orthopedic surgeons in the US. A Web-based survey was sent to 2000 orthopedic surgeons in the US. Of the 1214 respondents, 1168 (96%) reported having practiced defensive medicine by ordering imaging, laboratory tests, specialist referrals, or hospital admissions mainly to avoid possible malpractice liability. On average, 24% of all ordered tests were for defensive reasons. Mean national Medicare payment information was used to calculate the cost of defensive medicine per respondent: approximately $100,000 per year. With there being 20,400 practicing orthopedic surgeons in the US, we estimated that the national cost of defensive medicine for the specialty of orthopedic surgery is $2 billion annually. Orthopedic surgeons' defensive medicine is a significant factor in health care costs and is of marginal benefit to patients. Policies aimed at managing liability risk may be useful in containing such practices.

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

    PubMed Central

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

    2016-01-01

    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

  3. 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.

  4. 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.

  5. 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.

  6. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children.

    PubMed

    Bibus, Douglas M

    2016-02-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega-3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in the U.S. with 8-12 ounces of fish per week, as recommended by the Food and Drug Administration (FDA), throughout the duration of pregnancy and lactation. Based on the FDA's quantitative assessment, this may result in a net increase of IQ by 5.5 points in children and improve their early age verbal development.

  7. Utility-Scale Solar 2015: An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    SciTech Connect

    Bolinger, Mark; Seel, Joachim

    2016-08-17

    The utility-scale solar sector—defined here to include any ground-mounted photovoltaic (“PV”), concentrating photovoltaic (“CPV”), or concentrating solar power (“CSP”) project that is larger than 5 MWAC in capacity—has led the overall U.S. solar market in terms of installed capacity since 2012. It is expected to maintain its market-leading position for at least another five years, driven in part by December 2015’s three-year extension of the 30% federal investment tax credit (“ITC”) through 2019 (coupled with a favorable switch to a “start construction” rather than a “placed in service” eligibility requirement, and a gradual phase down of the credit to 10% by 2022). In fact, in 2016 alone, the utility-scale sector is projected to install more than twice as much new capacity as it ever has previously in a single year. This unprecedented boom makes it difficult, yet more important than ever, to stay abreast of the latest utility-scale market developments and trends. This report—the fourth edition in an ongoing annual series—is intended to help meet this need, by providing in-depth, annually updated, data-driven analysis of the utility-scale solar project fleet in the United States. Drawing on empirical project-level data from a wide range of sources, this report analyzes not just installed project costs or prices—i.e., the traditional realm of most solar economic analyses—but also operating costs, capacity factors, and power purchase agreement (“PPA”) prices from a large sample of utility-scale solar projects throughout 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 also presented where appropriate.

  8. 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

  9. Sympathy for the Devil: Detailing the Effects of Planning-Unit Size, Thematic Resolution of Reef Classes, and Socioeconomic Costs on Spatial Priorities for Marine Conservation.

    PubMed

    Cheok, Jessica; Pressey, Robert L; Weeks, Rebecca; Andréfouët, Serge; Moloney, James

    2016-01-01

    Spatial data characteristics have the potential to influence various aspects of prioritising biodiversity areas for systematic conservation planning. There has been some exploration of the combined effects of size of planning units and level of classification of physical environments on the pattern and extent of priority areas. However, these data characteristics have yet to be explicitly investigated in terms of their interaction with different socioeconomic cost data during the spatial prioritisation process. We quantify the individual and interacting effects of three factors-planning-unit size, thematic resolution of reef classes, and spatial variability of socioeconomic costs-on spatial priorities for marine conservation, in typical marine planning exercises that use reef classification maps as a proxy for biodiversity. We assess these factors by creating 20 unique prioritisation scenarios involving combinations of different levels of each factor. Because output data from these scenarios are analogous to ecological data, we applied ecological statistics to determine spatial similarities between reserve designs. All three factors influenced prioritisations to different extents, with cost variability having the largest influence, followed by planning-unit size and thematic resolution of reef classes. The effect of thematic resolution on spatial design depended on the variability of cost data used. In terms of incidental representation of conservation objectives derived from finer-resolution data, scenarios prioritised with uniform cost outperformed those prioritised with variable cost. Following our analyses, we make recommendations to help maximise the spatial and cost efficiency and potential effectiveness of future marine conservation plans in similar planning scenarios. We recommend that planners: employ the smallest planning-unit size practical; invest in data at the highest possible resolution; and, when planning across regional extents with the intention

  10. Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study.

    PubMed

    Sigurdsson, Eyjolfur; Siggeirsdottir, Kristin; Jonsson, Halldor; Gudnason, Vilmundur; Matthiasson, Thorolfur; Jonsson, Brynjolfur Y

    2008-09-01

    Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.

  11. Sympathy for the Devil: Detailing the Effects of Planning-Unit Size, Thematic Resolution of Reef Classes, and Socioeconomic Costs on Spatial Priorities for Marine Conservation

    PubMed Central

    Pressey, Robert L.; Weeks, Rebecca; Andréfouët, Serge; Moloney, James

    2016-01-01

    Spatial data characteristics have the potential to influence various aspects of prioritising biodiversity areas for systematic conservation planning. There has been some exploration of the combined effects of size of planning units and level of classification of physical environments on the pattern and extent of priority areas. However, these data characteristics have yet to be explicitly investigated in terms of their interaction with different socioeconomic cost data during the spatial prioritisation process. We quantify the individual and interacting effects of three factors—planning-unit size, thematic resolution of reef classes, and spatial variability of socioeconomic costs—on spatial priorities for marine conservation, in typical marine planning exercises that use reef classification maps as a proxy for biodiversity. We assess these factors by creating 20 unique prioritisation scenarios involving combinations of different levels of each factor. Because output data from these scenarios are analogous to ecological data, we applied ecological statistics to determine spatial similarities between reserve designs. All three factors influenced prioritisations to different extents, with cost variability having the largest influence, followed by planning-unit size and thematic resolution of reef classes. The effect of thematic resolution on spatial design depended on the variability of cost data used. In terms of incidental representation of conservation objectives derived from finer-resolution data, scenarios prioritised with uniform cost outperformed those prioritised with variable cost. Following our analyses, we make recommendations to help maximise the spatial and cost efficiency and potential effectiveness of future marine conservation plans in similar planning scenarios. We recommend that planners: employ the smallest planning-unit size practical; invest in data at the highest possible resolution; and, when planning across regional extents with the

  12. Geological studies of the COST No. B-3 Well, United States Mid-Atlantic continental slope area

    USGS Publications Warehouse

    Scholle, Peter A.

    1980-01-01

    The COST No. B-3 well is the first deep stratigraphic test to be drilled on the Continental Slope off the Eastern United States. The well was drilled in 2,686 ft (819 m) of water in the Baltimore Canyon trough area to a total depth of 15,820 ft (4,844 m) below the drill platform. It penetrated a section composed of mudstones, calcareous mudstones, and limestones of generally deep water origin to a depth of about 8.200 ft (2,500 m) below the drill floor. Light-colored, medium- to coarse-grained sandstones with intercalated gray and brown shales, micritic limestones, and minor coal and dolomite predominate from about 8,200 to 12,300 ft (2,500 to 3,750 m). From about 12,300 ft (3,750 m) to the bottom, the section consists of limestones (including oolitic and intraclastic grainstones) with interbedded fine-to medium-grained sandstones, dark-colored fissile shales, and numerous coal seams. Biostratigraphic examination has shown that the section down to approximately 6,000 ft (1,830 m) is Tertiary. The boundary between the Lower and Upper Cretaceous sections is placed between 8,600 and 9,200 ft (2,620 and 2,800 m) by various workers. Placement of the Jurassic-Cretaceous boundary shows an even greater range based on different organisms; it is placed variously between 12,250 and 13,450 ft (3,730 and 5,000 m). The oldest unit penetrated in the well is considered to be Upper Jurassic (Kimmeridgian) by some workers and Middle Jurassic (Callovian) by others. The Lower Cretaceous and Jurassic parts of the section represent nonmarine to shallow-marine shelf sedimentation. Upper Cretaceous and Tertiary units reflect generally deeper water conditions at the B-3 well site and show a general transition from deposition at shelf to slope water depths. Examination of cores, well cuttings, and electric logs indicates that potential hydrocarbon-reservoir units are present throughout the Jurassic and Cretaceous section. Porous and moderately permeable limestones and sandstones have been

  13. A Cost-Effectiveness Analysis of Proposed Inpatient Child and Adolescent Psychiatric Units at Eisenhower Army Medical Center

    DTIC Science & Technology

    1992-05-28

    average length of stay and average cost per stay, have to be defined to support the cost-effectiveness analysis. As...Hospital of Augusta. Average Length of Stay (in Days) 60 56 ..............--- .---------- .---- -- ------------. ----- 251 Fiscal Year(s) Cost...Effectiveness Analysis 27 As the average length of stay at Charter Hospital decreased, the total costs associated with each stay decreased. Figure 4

  14. 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.

  15. 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.

  16. Geological studies of the COST nos. G-1 and G-2 wells, United States North Atlantic outer continental shelf

    USGS Publications Warehouse

    Scholle, Peter A.; Wenkam, Chiye R.

    1982-01-01

    The COST Nos. G-1 and G-2 wells (fig. 1) are the second and third deep stratigraphic test wells drilled in the North Atlantic Outer Continental Shelf of the United States. COST No. G-1 was drilled in the Georges Bank basin to a total depth of 16,071 ft (4,898 m). G-1 bottomed in phyllite, slate, and metaquartzite overlain by weakly metamorphosed dolomite, all of Cambrian age. From approximately 15,600 to 12,400 ft (4,755 to 3,780 m) the strata are Upper Triassic(?), Lower Jurassic(?), and Middle Jurassic, predominantly red shales, sandstones, and conglomerates. Thin, gray Middle Jurassic beds of shale, sandstone, limestone, and dolomite occur from 12,400 to 9,900 ft (3,780 to 3,018 m). From 9,900 to 1,030 ft (3,018 to 314 m) are coarse-grained unconsolidated sands and loosely cemented sandstones, with beds of gray shale, lignite, and coal. The microfossils indicate the rocks are Upper Jurassic from 10,100 ft (3,078 m) up to 5,400 ft (1,646 m) and Cretaceous from that depth to 1,030 ft (314 m). No younger or shallower rocks were recovered in the drilling at the COST No. G-1 site, but an Eocene limestone is inferred to be disconformable over Santonian strata. The Jurassic strata of the COST No. G-1 well were deposited in shallow marine, marginal marine, and nonmarine environments, which changed to a dominantly shallow marine but still nearshore environment in the Cretaceous. The COST No. G-2 well was drilled 42 statute miles {68 km) east of the G-1 site, still within the Georges Bank basin, to a depth of 21,874 ft (6,667 m). The bottom 40 ft (12 m) of salt and anhydrite is overlain by approximately 7,000 ft {2,134 m) of Upper Triassic{?), Lower Jurassic{?) and Middle Jurassic dolomite, limestone, and interbedded anhydrite from 21,830 to 13,615 ft (6,654 to 4,153 m). From 13,500 to 9,700 ft (4,115 to 2,957 m) are Middle Jurassic limestones with interbedded sandstone. From 9,700 to 4,000 ft (2,957 to 1,219 m) are Upper Jurassic and Cretaceous interbedded sandstones and

  17. 78 FR 21862 - Revision to United States Marshals Service Fees for Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-12

    ... reflects the current costs to the United States Marshals Service for service of process in federal court... current fee schedule is inadequate and no longer reflects the actual and reasonable costs of the services... under the current fee structure. This revenue increase represents a recovery of costs based on...

  18. 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…

  19. 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

  20. Ebola Preparedness Resources for Acute-Care Hospitals in the United States: A Cross-Sectional Study of Costs, Benefits, and Challenges.

    PubMed

    Smit, Michael A; Rasinski, Kenneth A; Braun, Barbara I; Kusek, Linda L; Milstone, Aaron M; Morgan, Daniel J; Mermel, Leonard A

    2017-04-01

    OBJECTIVE To assess resource allocation and costs associated with US hospitals preparing for the possible spread of the 2014-2015 Ebola virus disease (EVD) epidemic in the United States. METHODS A survey was sent to a stratified national probability sample (n=750) of US general medical/surgical hospitals selected from the American Hospital Association (AHA) list of hospitals. The survey was also sent to all children's general hospitals listed by the AHA (n=60). The survey assessed EVD preparation supply costs and overtime staff hours. The average national wage was multiplied by labor hours to calculate overtime labor costs. Additional information collected included challenges, benefits, and perceived value of EVD preparedness activities. RESULTS The average amount spent by hospitals on combined supply and overtime labor costs was $80,461 (n=133; 95% confidence interval [CI], $56,502-$104,419). Multivariate analysis indicated that small hospitals (mean, $76,167) spent more on staff overtime costs per 100 beds than large hospitals (mean, $15,737; P<.0001). The overall cost for acute-care hospitals in the United States to prepare for possible EVD cases was estimated to be $361,108,968. The leading challenge was difficulty obtaining supplies from vendors due to shortages (83%; 95% CI, 78%-88%) and the greatest benefit was improved knowledge about personal protective equipment (89%; 95% CI, 85%-93%). CONCLUSIONS The financial impact of EVD preparedness activities was substantial. Overtime cost in smaller hospitals was >3 times that in larger hospitals. Planning for emerging infectious disease identification, triage, and management should be conducted at regional and national levels in the United States to facilitate efficient and appropriate allocation of resources in acute-care facilities. Infect Control Hosp Epidemiol 2017;38:405-410.

  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. 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.

  3. 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.

  4. Assessing the cost burden of United States FDA-mandated post-approval studies for medical devices.

    PubMed

    Wimmer, Neil J; Robbins, Susan; Ssemaganda, Henry; Yang, Erin; Normand, Sharon-Lise; Matheny, Michael E; Herz, Naomi; Rising, Josh; Resnic, Frederic S

    2016-01-01

    Approved medical devices frequently undergo FDA mandated post-approval studies (PAS). However, there is uncertainty as to the value of PAS in assessing the safety of medical devices and the cost of these studies to the healthcare system is unknown. Since PAS costs are funded through device manufacturers who do not share the costs with regulators, we sought to estimate the total PAS costs through interviews with a panel of experts in medical device clinical trial design in order to design a general cost model for PAS which was then applied to the FDA PAS. A total of 277 PAS were initiated between 3/1/05 through 6/30/13 and demonstrated a median cost of $2.16 million per study and an overall cost of $1.22 billion over the 8.25 years of study. While these costs are funded through manufacturers, the ultimate cost is borne by the healthcare system through the medical device costs. Given concerns regarding the informational value of PAS, the resources used to support mandated PAS may be better allocated to other approaches to assure safety.

  5. Assessing the cost burden of United States FDA-mandated post-approval studies for medical devices

    PubMed Central

    Wimmer, Neil J.; Robbins, Susan; Ssemaganda, Henry; Yang, Erin; Normand, Sharon-Lise; Matheny, Michael E.; Herz, Naomi; Rising, Josh; Resnic, Frederic S.

    2016-01-01

    Approved medical devices frequently undergo FDA mandated post-approval studies (PAS). However, there is uncertainty as to the value of PAS in assessing the safety of medical devices and the cost of these studies to the healthcare system is unknown. Since PAS costs are funded through device manufacturers who do not share the costs with regulators, we sought to estimate the total PAS costs through interviews with a panel of experts in medical device clinical trial design in order to design a general cost model for PAS which was then applied to the FDA PAS. A total of 277 PAS were initiated between 3/1/05 through 6/30/13 and demonstrated a median cost of $2.16 million per study and an overall cost of $1.22 billion over the 8.25 years of study. While these costs are funded through manufacturers, the ultimate cost is borne by the healthcare system through the medical device costs. Given concerns regarding the informational value of PAS, the resources used to support mandated PAS may be better allocated to other approaches to assure safety. PMID:28280294

  6. A reevaluation of the costs of heart failure and its implications for allocation of health resources in the United States.

    PubMed

    Voigt, Jeff; Sasha John, M; Taylor, Andrew; Krucoff, Mitchell; Reynolds, Matthew R; Michael Gibson, C

    2014-05-01

    The annual cost of heart failure (HF) is estimated at $39.2 billion. This has been acknowledged to underestimate the true costs for care. The objective of this analysis is to more accurately assess these costs. Publicly available data sources were used. Cost calculations incorporated relevant factors such as Medicare hospital cost-to-charge ratios, reimbursement from both government and private insurance, and out-of-pocket expenditures. A recently published Atherosclerosis Risk in Communities (ARIC) HF scheme was used to adjust the HF classification scheme. Costs were calculated with HF as the primary diagnosis (HF in isolation, or HFI) or HF as one of the diagnoses/part of a disease milieu (HF syndrome, or HFS). Total direct costs for HF were calculated at $60.2 billion (HFI) and $115.4 billion (HFS). Indirect costs were $10.6 billion for both. Costs attributable to HF may represent a much larger burden to US health care than what is commonly referenced. These revised and increased costs have implications for policy makers.

  7. 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.

  8. 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).

  9. Cost-effectiveness of seasonal quadrivalent versus trivalent influenza vaccination in the United States: A dynamic transmission modeling approach

    PubMed Central

    Brogan, Anita J.; Talbird, Sandra E.; Davis, Ashley E.; Thommes, Edward W.; Meier, Genevieve

    2017-01-01

    ABSTRACT Trivalent inactivated influenza vaccines (IIV3s) protect against 2 A strains and one B lineage; quadrivalent versions (IIV4s) protect against an additional B lineage. The objective was to assess projected health and economic outcomes associated with IIV4 versus IIV3 for preventing seasonal influenza in the US. A cost-effectiveness model was developed to interact with a dynamic transmission model. The transmission model tracked vaccination, influenza cases, infection-spreading interactions, and recovery over 10 y (2012–2022). The cost-effectiveness model estimated influenza-related complications, direct and indirect costs (2013–2014 US$), health outcomes, and cost-effectiveness. Inputs were taken from published/public sources or estimated using regression or calibration. Outcomes were discounted at 3% per year. Scenario analyses tested the reliability of the results. Seasonal vaccination with IIV4 versus IIV3 is predicted to reduce annual influenza cases by 1,973,849 (discounted; 2,325,644 undiscounted), resulting in 12–13% fewer cases and influenza-related complications and deaths. These reductions are predicted to translate into 18,485 more quality-adjusted life years (QALYs) accrued annually for IIV4 versus IIV3. Increased vaccine-related costs ($599 million; 5.7%) are predicted to be more than offset by reduced influenza treatment costs ($699 million; 12.2%), resulting in direct medical cost saving annually ($100 million; 0.6%). Including indirect costs, savings with IIV4 are predicted to be $7.1 billion (5.6%). Scenario analyses predict IIV4 to be cost-saving in all scenarios tested apart from low infectivity, where IIV4 is predicted to be cost-effective. In summary, seasonal influenza vaccination in the US with IIV4 versus IIV3 is predicted to improve health outcomes and reduce costs. PMID:27780425

  10. 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

  11. 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

  12. 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…

  13. 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.

  14. 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.

  15. HIV Pre-exposure Prophylaxis (PrEP) in the United States: Impact on Lifetime Infection Risk, Clinical Outcomes, and Cost-effectiveness

    PubMed Central

    Paltiel, A. David; Freedberg, Kenneth A.; Scott, Callie A.; Schackman, Bruce R.; Losina, Elena; Wang, Bingxia; Seage, George R.; Sloan, Caroline E.; Sax, Paul E.; Walensky, Rochelle P.

    2010-01-01

    Background The combination of tenofovir and emtricitabine (TDF/FTC) shows promise as HIV pre-exposure prophylaxis (PrEP). We sought to forecast clinical, epidemiologic, and economic outcomes of PrEP, taking into account uncertainties regarding efficacy, risk of resistance and toxicity, behavioral disinhibition, and drug costs. Methods We adapted a computer simulation of HIV acquisition, detection, and care to model PrEP in high-risk (1.6% average annual HIV incidence) men who have sex with men (MSM) in the United States. Base case assumptions included: 50% PrEP efficacy and $753 monthly TDF/FTC costs. We used sensitivity analyses to examine the stability of results and to identify critical input parameters. Results In a cohort with mean age 34 years, PrEP reduced lifetime HIV infection risk from 44% to 25% and increased average life expectancy from 39.9 to 40.7 years (21.7 to 22.2 discounted, quality-adjusted life-years or QALYs). Discounted mean lifetime treatment costs increased from $81,100 to $232,700 per person, indicating an incremental cost-effectiveness ratio (ICER) of $298,000 per QALY gained. Markedly larger reductions in lifetime infection risk (from 43.5% to 5.8%) were observed assuming greater (90%) PrEP efficacy. More favorable ICERs were obtained by targeting younger, higher-incidence populations and with improvements in the efficacy and cost of PrEP. Conclusions PrEP could substantially reduce HIV transmission in high-risk populations in the United States. Although it is unlikely to confer sufficient benefits to justify current TDF/FTC costs, price reductions and/or increases in efficacy could make PrEP a cost-effective option in younger or higher-risk populations. Given recent disappointments in HIV prevention and vaccine development, further study of PrEP-based HIV prevention is warranted. PMID:19193111

  16. 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

  17. 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.

  18. 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.

  19. The association of willingness-to-pay and patient attributes: a cost-volume-profit analysis of cardiac catheter unit services in Ramallah Hospital, Palestine.

    PubMed

    Jabr, Samer F K; Younis, Mustafa Mike Z; Forgione, Dana A

    2009-01-01

    The purpose of this study is to examine the association of willingness-to-pay and patient attributes in relation to the multi-service cost-volume-profit structure of a cardiac catheter unit in Ramallah Hospital. This article contributes to the literature by providing primary evidence on patient willingness-to-pay, by identifying the specific break-even parameters of three hospital cardiac catheter unit service types (diagnosis, balloon, and pacemaker), and by demonstrating the cross-subsidization of patient income groups that is inherent in the existing hospital rate structure. Our results provide information useful for (1) evidence-based policy making with respect to hospital rate setting and cross-subsidies of patient income groups; (2) the advancement of hospital management, by demonstrating the estimated variable and fixed cost parameters and the impact of patient revenue mix on the profitability of cardiac catheter unit services; and (3) the advancement of theory, by documenting the relationship of patient demand and the cost of supply in a multi-patient-group, multi-service hospital setting.

  20. 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.

  1. [Opportunity for development of laparoscopic procedures in the hospital setting: costs and benefits for the surgical unit].

    PubMed

    Vino, F; Trerotoli, P; Serio, G

    2002-01-01

    Physician are induced, by technical development, to demand new devices and instruments and to introduce new method for diagnosis and treatment. In order to do a right economic planning in public health, it's necessary to evaluate costs of technologies, because sometimes there isn't neither a right plan for acquisition nor an efficient control system. One the most stressed medical branch by innovative technologies is the surgery, in particular after the coming of laparoscopic surgery. The will to do, in every way laparoscopic approach, induces to evaluate costs of this surgery, specially cholecystectomy, that is identified by four specific DRGs. In this paper we compare laparotomic versus laparoscopic cholecystectomy in terms of costs and length of stay; the break-even analysis has been performed to determine the number of laparoscopic operations necessary to balance the costs.

  2. The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units

    PubMed Central

    Edmans, Judi; Bradshaw, Lucy; Gladman, John R. F.; Franklin, Matthew; Berdunov, Vladislav; Elliott, Rachel; Conroy, Simon P.

    2013-01-01

    Background: tools are required to identify high-risk older people in acute emergency settings so that appropriate services can be directed towards them. Objective: to evaluate whether the Identification of Seniors At Risk (ISAR) predicts the clinical outcomes and health and social services costs of older people discharged from acute medical units. Design: an observational cohort study using receiver–operator curve analysis to compare baseline ISAR to an adverse clinical outcome at 90 days (where an adverse outcome was any of death, institutionalisation, hospital readmission, increased dependency in activities of daily living (decrease of 2 or more points on the Barthel ADL Index), reduced mental well-being (increase of 2 or more points on the 12-point General Health Questionnaire) or reduced quality of life (reduction in the EuroQol-5D) and high health and social services costs over 90 days estimated from routine electronic service records. Setting: two acute medical units in the East Midlands, UK. Participants: a total of 667 patients aged ≥70 discharged from acute medical units. Results: an adverse outcome at 90 days was observed in 76% of participants. The ISAR was poor at predicting adverse outcomes (AUC: 0.60, 95% CI: 0.54–0.65) and fair for health and social care costs (AUC: 0.70, 95% CI: 0.59–0.81). Conclusions: adverse outcomes are common in older people discharged from acute medical units in the UK; the poor predictive ability of the ISAR in older people discharged from acute medical units makes it unsuitable as a sole tool in clinical decision-making. PMID:23666405

  3. 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

  4. 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.

  5. Predicting hospital accounting costs

    PubMed Central

    Newhouse, Joseph P.; Cretin, Shan; Witsberger, Christina J.

    1989-01-01

    Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40 percent of hospitals had predicted costs within plus or minus 5 percent of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated. PMID:10313352

  6. 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

  7. 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

  8. The cost-effectiveness of ivermectin vs. albendazole in the presumptive treatment of strongyloidiasis in immigrants to the United States.

    PubMed Central

    Muennig, P.; Pallin, D.; Challah, C.; Khan, K.

    2004-01-01

    The presumptive treatment of parasitosis among immigrants with albendazole has been shown to save both money and lives, primarily via a reduction in the burden of Strongyloides stercoralis. Ivermectin is more effective than albendazole, but is also more expensive. This coupled with confusion surrounding the cost-effectiveness of guiding therapy based on eosinophil counts has led to disparate practices. We used the newly arrived year 2000 immigrant population as a hypothetical cohort in a decision analysis model to examine the cost-effectiveness of various interventions to reduce parasitosis among immigrants. When the prevalence of S. stercoralis is greater than 2%, the incremental cost-effectiveness ratios of all presumptive treatment strategies were similar. Ivermectin is associated with an incremental cost-effectiveness ratio of 1700 dollars per QALY gained for treatment with 12 mg ivermectin relative to 5 days of albendazole when the prevalence is 10%. Any presumptive treatment strategy is cost-effective when compared with most common medical interventions. PMID:15635962

  9. Future costs for long-term care: cost projections for long-term care for older people in the United Kingdom.

    PubMed

    Karlsson, Martin; Mayhew, Les; Plumb, Robert; Rickayzen, Ben

    2006-01-01

    The purpose of this paper is to analyse the future sustainability of the UK system for provision of long-term care (LTC) due to changes in demography and health status among the older people. It considers how demand for LTC will evolve and to what extent there will be sufficient supply to meet demand. For formal care, this requires an estimate of how much the public purses, and hence taxpayers, will be burdened with LTC costs. For informal care, it involves estimating whether there will be enough carers if current patterns of provision were to continue. The results show that demand for long-term care will start to take off 10 years from now, and reach a peak somewhere after 2040. The research finds that the most significant increase will be in demand for informal care, where the number of recipients are projected to increase from 2.2 million today to 3.0 million in 2050. Relative increases will be similar in all care settings, amounting to between 30 and 50% compared with the levels today; however, the most noticeable increase will be in demand for formal home care, which is projected to be 60% above current levels by 2040. Total expenditure on formal long-term care will increase from 11 billion pounds per year today to approximately 15 billion pounds per year by 2040 (in 2001 prices). Expressed in taxation terms the effective contribution rate will increase from around 1.0% of total wages today to 1.3% in 2050. Availability of informal carers is potentially a big problem, but the extent of the problem is very sensitive to the assumptions made concerning health improvements and care-giving patterns.

  10. 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…

  11. Cost-Effectiveness Analysis of Treating Acute Promyelocytic Leukemia Patients with Arsenic Trioxide and Retinoic Acid in the United States

    PubMed Central

    Tallman, Martin; Lo-Coco, Francesco; Barnes, Gisoo; Kruse, Morgan; Wildner, Rebecca; Martin, Monique; Udo Mueller, U; Tang, Boxiong

    2016-01-01

    Introduction This study estimated the cost-effectiveness of arsenic trioxide (ATO) added to all-trans retinoic acid (ATRA) when used in first-line acute promyelocytic leukemia (APL) treatment. Methods A Markov cohort model was developed with three states: stable disease (during first- or second-line treatment), disease event, and death. Newly diagnosed patients with low/intermediate risk APL were included and each month could remain in their current health state or move to another. Treatment consisted of ATO + ATRA, ATRA + idarubicin (IDA), or ATRA + cytarabine (AraC) + additional chemotherapy. After an initial disease event, patients discontinued first-line and switched to a second-line ATO regimen. Efficacy/safety data were obtained from published trials; quality of life/utility estimates were obtained from the literature; costs were obtained from US data sources. Costs and outcomes over time were used to calculate incremental cost-effectiveness ratios (ICERs). Deterministic and probabilistic sensitivity analyses were conducted. Results Compared to ATRA + AraC + additional chemotherapy, ATRA + IDA treatment had ICERs of $2,933 per life year (LY) saved and $3,122 per quality-adjusted life year (QALY) gained. Compared to the ATRA + IDA regimen, first-line ATO + ATRA treatment had ICERs of $4,512 per LY saved and $5,614 per QALY gained. Results were sensitive to changes in pharmacy costs of the ATO + ATRA regimen during consolidation. Conclusion The ATO + ATRA regimen is highly cost-effective compared to ATRA + AraC + additional chemotherapy or ATRA + IDA in the treatment of newly diagnosed low to intermediate risk APL patients. PMID:26361645

  12. Evaluation of rationality in prescribing, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: A prospective observational study

    PubMed Central

    Christian, Rohan P.; Rana, Devang A.; Malhotra, Supriya D.; Patel, Varsha J.

    2014-01-01

    Background: Cardiovascular diseases (CVDs) remain the most common cause of sudden death. Hence, appropriate drug therapy in intensive cardiac care unit (ICCU) is crucial in managing cardiovascular emergencies and to decrease morbidity and mortality. Objective: To evaluate prescribing pattern of drugs and direct cost of therapy in patients admitted in ICCU. Materials and Methods: Patients admitted in ICCU of a tertiary care teaching hospital were enrolled. Demographic data, clinical history, and complete drug therapy received during their stay in ICCU were noted. Data were analyzed for drug utilization pattern and direct cost of treatment calculated using patient's hospital and pharmacy bills. Rationality of therapy was evaluated based on American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Result: Data of 170 patients were collected over 2 months. Mean age of patients was 54.67 ± 13.42 years. Male to female ratio was 2.33:1. Most common comorbid condition was hypertension 76 (44.7%). Most common diagnosis was acute coronary syndrome (ACS) 49.4%. Mean stay in ICCU was 4.42 ± 1.9 days. Mean number of drugs prescribed per patient was 11.43 ± 2.85. Antiplatelet drugs were the most frequently prescribed drug group (86.5%). Mean cost of pharmacotherapy per patient was ‘2701.24 ± 3111.94. Mean direct cost of treatment per patient was ‘10564.74 ± 14968.70. Parenteral drugs constituted 42% of total drugs and 90% of total cost of pharmacotherapy. Cost of pharmacotherapy was positively correlated with number of drugs (P = 0.000) and duration of stay (P = 0.027). Conclusion: Antiplatelet drugs were the most frequently prescribed drug group. Mean number of drugs per encounter were high, which contributed to the higher cost of pharmacotherapy. ACC/AHA guidelines were followed in majority of the cases. PMID:24914255

  13. Evaluation of the cost effectiveness of exenatide versus insulin glargine in patients with sub-optimally controlled Type 2 diabetes in the United Kingdom

    PubMed Central

    Woehl, Anette; Evans, Mark; Tetlow, Anthony P; McEwan, Philip

    2008-01-01

    Objective Exenatide belongs to a new therapeutic class in the treatment of diabetes (incretin mimetics), allowing glucose-dependent glycaemic control in Type 2 diabetes. Randomised controlled trial data suggest that exenatide is as effective as insulin glargine at reducing HbA1c in combination therapy with metformin and sulphonylureas; with reduced weight but higher incidence of adverse gastrointestinal events. The objective of this study is to evaluate the cost effectiveness of exenatide versus insulin glargine using RCT data and a previously published model of Type 2 diabetes disease progression that is based on the United Kingdom Prospective Diabetes Study; the perspective of the health-payer of the United Kingdom National Health Service. Methods The study used a discrete event simulation model designed to forecast the costs and health outcome of a cohort of 1,000 subjects aged over 40 years with sub-optimally-controlled Type 2 diabetes, following initiation of either exenatide, or insulin glargine, in addition to oral hypoglycaemic agents. Sensitivity analysis for a higher treatment discontinuation rate in exenatide patients was applied to the cohort in three different scenarios; (1) either ignored or (2) exenatide-failures excluded or (3) exenatide-failures switched to insulin glargine. Analyses were undertaken to evaluate the price sensitivity of exenatide in terms of relative cost effectiveness. Baseline cohort profiles and effectiveness data were taken from a published randomised controlled trial. Results The relative cost-effectiveness of exenatide and insulin glargine was tested under a variety of conditions, in which insulin glargine was dominant in all cases. Using the most conservative of assumptions, the cost-effectiveness ratio of exenatide vs. insulin glargine at the current UK NHS price was -£29,149/QALY (insulin glargine dominant) and thus exenatide is not cost-effective when compared with insulin glargine, at the current UK NHS price. Conclusion

  14. 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

  15. 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…

  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. 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

    2015-10-02

    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.

  18. Procalcitonin Biomarker Algorithm Reduces Antibiotic Prescriptions, Duration of Therapy, and Costs in Chronic Obstructive Pulmonary Disease: A Comparison in the Netherlands, Germany, and the United Kingdom.

    PubMed

    van der Maas, Marloes E; Mantjes, Gertjan; Steuten, Lotte M G

    2017-04-01

    Antibiotics are often recommended as treatment for patients with chronic obstructive pulmonary disease (COPD) exacerbations. However, not all COPD exacerbations are caused by bacterial infections and there is consequently considerable misuse and overuse of antibiotics among patients with COPD. This poses a severe burden on healthcare resources such as increased risk of developing antibiotic resistance. The biomarker procalcitonin (PCT) displays specificity to distinguish bacterial inflammations from nonbacterial inflammations and may therefore help to rationalize antibiotic prescriptions. We report in this study, a three-country comparison of the health and economic consequences of a PCT biomarker-guided prescription and clinical decision-making strategy compared to current practice in hospitalized patients with COPD exacerbations. A decision tree was developed, comparing the expected costs and effects of the PCT algorithm to current practice in the Netherlands, Germany, and the United Kingdom. The time horizon of the model captured the length of hospital stay and a societal perspective was also adopted. The primary health outcome was the duration of antibiotic therapy. The incremental cost-effectiveness ratio was defined as the incremental costs per antibiotic day avoided. The incremental cost savings per day on antibiotic therapy avoided were (in Euros) €90 in the Netherlands, €125 in Germany, and €52 in the United Kingdom. Probabilistic sensitivity analyses showed that in the majority of simulations, the PCT biomarker strategy was superior to current practice (the Netherlands: 58%, Germany: 58%, and the United Kingdom: 57%). In conclusion, the PCT biomarker algorithm to optimize antibiotic prescriptions in COPD is likely to be cost-effective compared to current practice. Both the percentage of patients who start with antibiotic treatment as well as the duration of antibiotic therapy are reduced with the PCT decision algorithm, leading to a decrease in

  19. Cost Realism Handbook for Assuring More Realistic Contractor Cost Proposals

    DTIC Science & Technology

    1985-05-01

    realism. Solicitation: Specify cost realism in addition ,:) Government estimated cost as cost evaluation sub- - ieria in the solicitation and specify the...Analogy techniques involve extrapolations from actual costs for similar systems. Other techniques may include the use of industry wide factors. Parametric...of sources (e.g., actual costs for similar systems and industry wide factors) may be used to supplement the estimates based on specific contractor

  20. 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…

  1. Assessment of cost of innovation versus the value of health gains associated with treatment of chronic hepatitis C in the United States

    PubMed Central

    Younossi, Zobair M.; Park, Haesuk; Dieterich, Douglas; Saab, Sammy; Ahmed, Aijaz; Gordon, Stuart C.

    2016-01-01

    Abstract Background: New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. Aim: The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. Design: A decision-analytic Markov model. Data source: Published literature and clinical trial data. Time horizon: Life Time. Perspective: Third-party payer. Intervention: This study compared four approved regimens in treatment-naïve genotype 1 chronic hepatitis C patients, including pegylated interferon and ribavirin (PR), first generation triple therapy (boceprevir + PR and telaprevir + PR), second generation triple therapy (sofosbuvir + PR and simeprevir + PR) and all-oral DAA regimens (ledipasvir/sofosbuvir and ombitasvir + paritaprevir/ritonavir + dasabuvir ± ribavirin). Outcome measure: Quality-adjusted cost of care (QACC). QACC was defined as the increase in treatment cost minus the increase in the patient's quality-adjusted life years (QALYs) when valued at $50,000 per QALY. Results: All-oral therapy improved the average sustained virologic response (SVR) rate to 96%, thereby offsetting the high drug acquisition cost of $85,714, which resulted in the highest benefit based on the efficiency frontier. Furthermore, while oral therapies increased HCV drug costs by $48,350, associated QALY gains decreased quality-adjusted cost of care by $14,120 compared to dual therapy. When the value of a QALY was varied from $100,000 to $300,000, the quality adjusted cost of care compared to dual therapy ranged from − $21,234 to − $107,861, − $89,007 to − $293,130, − $176,280 to − $500,599 for first generation triple, second generation triple, and all-oral therapies

  2. Comparative Cost Analysis of Increasing Registered Nursing Staff on the Labor and Delivery Unit at the National Naval Medical Center.

    DTIC Science & Technology

    1991-07-01

    recognized L&D Nurses 9 the central role of the registered nurse. In its most recent Accreditation Manual for Hospitals, JCAHO requires that "a...far beyond that of a L&D Nurses 60 comparably-sized civilian instituCion . Above all else NNMC is a Navy hospital, with responsibilities far beyond...1990). Accreditation Manual for Hospitals, 1990. Chicago: Author. Klarman, H. E. (1974). Application of cost-benefit analysis to the health services and

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. Condliff v North Staffordshire Primary Care Trust: can human rights redress inequities in United Kingdom and Australian cost-containment-driven health care reforms?

    PubMed

    Townsend, Ruth; Faunce, Thomas

    2011-12-01

    A recent case from the English Court of Appeal (R (on the application of Condliff) v North Staffordshire Primary Care Trust [2011] EWCA Civ 910, concerning denial by a regional health care rationing committee of laparoscopic gastric bypass surgery for morbid obesity) demonstrates the problems of attempting to rely post hoc on human rights protections to ameliorate inequities in health care reforms that emphasise institutional budgets rather than universal access. This column analyses the complexities of such an approach in relation to recent policy debates and legislative reform of the health systems in the United Kingdom and Australia. Enforceable human rights, such as those available in the United Kingdom to the patient Tom Condliff, appear insufficient to adequately redress issues of inequity promoted by such "reforms". Equity may fare even worse under Australian cost-containment health care reforms, given the absence of relevant enforceable human rights in that jurisdiction.

  8. Utility-Scale Solar 2013: An empirical analysis of project cost, performance, and pricing trends in the United States

    SciTech Connect

    Bolinger, Mark; Weaver, Samantha

    2014-09-17

    Other than the SEGS I-IX parabolic trough projects built in the 1980s, virtually no large-scale or "utility-scale" solar projects-defined here to include any ground-mounted photovoltaic ("PV"), concentrating photovoltaic ("CPV"), or concentrating solar power ("CSP" or solar thermal) project larger than 5 MWAC-existed in the United States prior to 2007.

  9. 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.

  10. 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

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

    2014-07-01

    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.

  11. 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

  12. 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

  13. 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

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

    PubMed Central

    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. population. PMID:27618076

  15. 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.

  16. Healthcare Data Analytics for Parkinson’s Disease Patients: A Study of Hospital Cost and Utilization in the United States

    PubMed Central

    Mukherjee, Sunanda; Wu, Huanmei; Jones, Josette

    2016-01-01

    Parkinson’s Disease (PD), a prevalent problem, especially for the aged populations, is a progressive but non-fatal nervous system disorder. PD patients have special motor as well as non-motor symptoms over time. There are several limitations in the study of PD such as unavailability of data, proper diagnosis and treatment methods. These limitations significantly reduce the quality of PD patient life quality, either directly or indirectly. PD also imposes great financial burdens to PD patients and their family. This project aims to analyze the most common reasons for PD patient hospitalization, review complications that occur during inpatient stays, and measure the costs associated with PD patient characteristics. Using the HCUP NIS data, comprehensive data analysis has been performed. The results are customized visualized using Tableau and other software systems. The preliminary findings sheds light into how to improve the life quality of PD patients. PMID:28269954

  17. Helmet use among motorcyclists who died in crashes and economic cost savings associated with state motorcycle helmet laws--United States, 2008-2010.

    PubMed

    2012-06-15

    In 2010, the 4,502 motorcyclists (operators and passengers) killed in motorcycle crashes made up 14% of all road traffic deaths, yet motorcycles accounted for <1% of all vehicle miles traveled. Helmet use consistently has been shown to reduce motorcycle crash-related injuries and deaths, and the most effective strategy to increase helmet use is enactment of universal helmet laws. Universal helmet laws require all motorcyclists to wear helmets whenever they ride. To examine the association between states' motorcycle helmet laws and helmet use or nonuse among fatally injured motorcyclists, CDC analyzed 2008-2010 National Highway Traffic Safety Administration (NHTSA) data from the Fatality Analysis Reporting System (FARS), a census of fatal traffic crashes in the United States. Additionally, economic cost data from NHTSA were obtained to compare the costs saved as a result of helmet use, by type of state motorcycle helmet law. The findings indicated that, on average, 12% of fatally injured motorcyclists were not wearing helmets in states with universal helmet laws, compared with 64% in partial helmet law states (laws that only required specific groups, usually young riders, to wear helmets) and 79% in states without a helmet law. Additionally, in 2010, economic costs saved from helmet use by society in states with a universal helmet law were, on average, $725 per registered motorcycle, nearly four times greater than in states without such a law ($198).

  18. 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.

  19. 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

    2013-05-07

    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.

  20. 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.

  1. A parametric analysis of transport aircraft system weights and costs

    NASA Technical Reports Server (NTRS)

    Anderson, J. L.

    1974-01-01

    In determining unit and operating costs for advanced aircraft, it has been found that by having first-order weight and performance approximations for the aircraft systems and structural components, a step increase in cost prediction accuracy results. This paper presents first-order approximation equations for these systems and components. These equations were developed from data for most current jet transports, and they have been ordered to use a minimum number of performance parameters such as aircraft style, number of passengers, empty and gross weight, cargo load, and operating range. A NASA Ames Research Center aircraft cost program has been used to compare calculated and actual weights for the same aircraft. Good aircraft cost correlation is shown to exist between calculated first-order and actual aircraft weight data.

  2. 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.

  3. Climate change and the rising cost of living for forests in the southwestern United States and beyond

    NASA Astrophysics Data System (ADS)

    Williams, P.; Allen, C. D.; Macalady, A. K.; Griffin, D.; Woodhouse, C. A.; Meko, D. M.; Swetnam, T. W.; Rauscher, S.; Seager, R.; Grissino-Mayer, H.; Dean, J.; Cook, E.; Gangodagamage, C.; Cai, M.; McDowell, N. G.

    2012-12-01

    As climate changes, drought may reduce tree productivity and survival across many forest ecosystems; however, the relative influence of specific climate parameters on forest decline is poorly understood. We derive a forest drought-stress index (FDSI) for the southwestern United States using a comprehensive tree-ring dataset representing CE 1000-2007. FDSI is approximately equally influenced by warm-season atmospheric moisture demand (largely controlled by temperature) and cold-season precipitation, together explaining 82% of FDSI variability. Correspondence between FDSI and measures of forest productivity, mortality, bark-beetle outbreak, and wildfire validate FDSI as a holistic indicator of forest vigor throughout the region. In fact, the exceptionally large burned areas in 2002, 2011, and 2012 were all predictable based upon FDSI. If atmospheric moisture demand continues increasing as projected by climate models, average forest drought stress levels by the 2050s will exceed those of the worst megadroughts in at least 1000 years. Collectively, these results foreshadow 21st century changes in southwestern forest structures and compositions, with a transition of southwestern forests, and perhaps water-limited forests globally, toward distributions unfamiliar to modern civilization.

  4. 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

  5. Secondary Measures of Access to Abortion Services in the United States, 2011 and 2012: Gestational Age Limits, Cost, and Harassment

    PubMed Central

    Jerman, Jenna; Jones, Rachel K.

    2016-01-01

    Background Aspects of U.S. clinical abortion service provision such as gestational age limits, charges for abortion services, and anti-abortion harassment can impact the accessibility of abortion; this study documents changes in these measures between 2008 and 2012. Methods In 2012 and 2013, we surveyed all known abortion-providing facilities in the United States (n = 1,720). This study summarizes information obtained about gestational age limits, charges, and exposure to anti-abortion harassment among clinics; response rates for relevant items ranged from 54% (gestational limits) to 80% (exposure to harassment). Weights were constructed to compensate for nonresponding facilities. We also examine the distribution of abortions and abortion facilities by region. Findings Almost all abortion facilities (95%) offered abortions at 8 weeks’ gestation; 72% did so at 12 weeks, 34% at 20 weeks, and 16% at 24 weeks in 2012. In 2011 and 2012, the median charge for a surgical abortion at 10 weeks gestation was $495, and $500 for an early medication abortion, compared with $503 and $524 (adjusted for inflation) in 2009. In 2011, 84% of clinics experienced at least one form of harassment, only slightly higher than found in 2009. Hospitals and physicians’ offices accounted for a substantially smaller proportion of facilities in the Midwest and South. Clinics in the Midwest and South were exposed to more harassment than their counterparts in the Northeast and West. Conclusions Although there was a substantial decline in abortion incidence between 2008 and 2011, the secondary measures of abortion access examined in this study changed little during this time period. PMID:24981401

  6. 23 CFR 140.906 - Labor costs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of actual costs provided that (i) the rate is based on historical cost data of the company, (ii) such... 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,...

  7. 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

  8. 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

  9. Surgical Cost Disclosure May Reduce Operating Room Expenditures.

    PubMed

    Austin, Luke S; Tjoumakaris, Fotios P; Ong, Alvin C; Lombardi, Nicholas J; Wowkanech, Charles D; Mehnert, Michael J

    2017-03-01

    Health care expenditures are rising in the United States. Recent policy changes are attempting to reduce spending through the development of value-based payment systems that rely heavily on cost transparency. This study was conducted to investigate whether cost disclosure influences surgeons to reduce operating room expenditures. Beginning in 2012, surgeon scorecards were distributed at a regional health care system. The scorecard reported the actual direct supply cost per case for a specific procedure and compared each surgeon's data with those of other surgeons in the same subspecialty. Rotator cuff repair was chosen for analysis. Actual direct supply cost per case was calculated quarterly and collected over a 2-year period. Surgeons were given a questionnaire to determine their interest in the scorecard. Actual direct supply cost per rotator cuff repair procedure decreased by $269 during the study period. A strong correlation (R(2)=0.77) between introduction of the scorecards and cost containment was observed. During the study period, a total of $39,831 was saved. Of the surgeons who were queried, 89% were interested in the scorecard and 56% altered their practice as a result. Disclosure of surgical costs may be an effective way to control operating room spending. The findings suggest that providing physicians with knowledge about their surgical charges can alter per-case expenditures. [Orthopedics. 2017; 40(2):e269-e274.].

  10. 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

    2016-06-07

    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.

  11. A comparison of applicant and matriculant trends, and rising costs of medical education in United States medical schools and at the University of Kentucky College of Medicine.

    PubMed

    Elam, Carol L; Scott, Kimberly L; Gilbert, Linda A; Hartmann, Beth A

    2003-05-01

    This paper addresses fluctuations in the applicant and matriculant pools both across United States medical schools and at the University of Kentucky College of Medicine (UKCOM) for 1992-2002. It also presents data regarding the increasing costs of a medical education. Over the past decade, both nationally and at the UKCOM, there has been an over-all reduction in the number of applicants to medical school. In this changing applicant pool, the percentage of female matriculants has increased both nationally and at the UKCOM. However, the number of underrepresented minorities applying to and matriculating in the US and at the UKCOM has dropped since the mid-1990s. Although the applicant pool has decreased in size over the time period examined, the academic quality of applicants as measured by the undergraduate grade point average and Medical College Admission Test scores has increased both nationally and at UKCOM. Costs of a medical education have risen over time, as has the debt burden of medical school graduates due to increasing undergraduate debt, consumer debt, and medical school tuition. Potential causes for and implication of these changing trends are discussed.

  12. 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

  13. Waste processing cost recovery at Los Alamos National Laboratory--analysis and recommendations

    SciTech Connect

    Booth, Steven Richard

    2008-01-01

    Los Alamos National Laboratory is implementing full cost recovery for waste processing in fiscal year 2009 (FY2009), after a transition year in FY2008. Waste processing cost recovery has been implemented in various forms across the nuclear weapons complex and in corporate America. The fundamental reasoning of sending accurate price signals to waste generators is economically sound, and leads to waste minimization and reduced waste expense over time. However, Los Alamos faces significant implementation challenges because of its status as a government-owned, contractor-operated national scientific institution with a diverse suite of experimental and environmental cleanup activities, and the fact that this represents a fundamental change in how waste processing is viewed by the institution. This paper describes the issues involved during the transition to cost recovery and the ultimate selection of the business model. Of the six alternative cost recovery models evaluated, the business model chosen to be implemented in FY2009 is Recharge Plus Generators Pay Distributed Direct. Under this model, all generators who produce waste must pay a distributed direct share associated with their specific waste type to use a waste processing capability. This cost share is calculated using the distributed direct method on the fixed cost only, i.e., the fixed cost share is based on each program's forecast proportion of the total Los Alamos volume forecast of each waste type. (Fixed activities are those required to establish the waste processing capability, i.e., to make the process ready, permitted, certified, and prepared to handle the first unit ofwaste. Therefore, the fixed cost ends at the point just before waste begins 'to be processed. The activities to actually process the waste are considered variable.) The volume of waste actually sent for processing is charged a unit cost based solely on the variable cost of disposing of that waste. The total cost recovered each year is the

  14. Effect of Intravenous Acetaminophen on Post-Anesthesia Care Unit Length of Stay, Opioid Consumption, Pain, and Analgesic Drug Costs After Ambulatory Surgery

    PubMed Central

    Khobrani, Moteb A.; Camamo, James M.; Patanwala, Asad E.

    2017-01-01

    Objectives The primary objective was to assess whether the use of intravenous acetaminophen (APAP) in the ambulatory surgery setting is associated with a decreased length of stay in the post-anesthesia care unit (PACU). The secondary outcomes evaluated were pain scores, opioid consumption, and total cost of analgesics used in the PACU. Methods This was a retrospective cohort study conducted in adult patients (18 years of age or older) who received an eye, ear, nose, or throat (EENT) procedure at an outpatient surgery center between January 2014 and January 2015. Patients were consecutively included until the desired sample was reached during two six-month time periods: 1) intravenous APAP available on the formulary (APAP group) and 2) intravenous APAP not available on the formulary (non-APAP group). Results The cohort included 174 patients who received an EENT procedure (87 patients in the APAP group and 87 patients in the non-APAP group). The median PACU length of stay was 66 minutes (interquartile range [IQR], 48–92) in the APAP group and 71 minutes (IQR, 52–89) in the non-APAP group (P = 0.269). Mean pain score categories in the APAP versus non-APAP group were mild (85% versus 53%, respectively; P < 0.001), moderate (13% versus 33%, respectively; P = 0.002), and severe (2% versus 14%, respectively; P = 0.005). The median opioid consumption in morphine equivalents was 9 mg (IQR, 5–13) in the APAP group and 8 mg (IQR, 5–12) in the non-APAP group (P = 0.081). The total cost of analgesics used in the PACU was significantly greater in the APAP group ($15 versus $1; P < 0.001). Conclusions Intravenous APAP use in EENT ambulatory surgery is not associated with decreased PACU length of stay. However, it may decrease postoperative pain following EENT procedures. PMID:28163558

  15. 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.

  16. Cost-Effectiveness of a Specialist Geriatric Medical Intervention for Frail Older People Discharged from Acute Medical Units: Economic Evaluation in a Two-Centre Randomised Controlled Trial (AMIGOS)

    PubMed Central

    Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Edmans, Judi; Conroy, Simon; Bradshaw, Lucy E.; Gladman, John R. F.; Elliott, Rachel A.

    2015-01-01

    Background Poor outcomes and high resource-use are observed for frail older people discharged from acute medical units. A specialist geriatric medical intervention, to facilitate Comprehensive Geriatric Assessment, was developed to reduce the incidence of adverse outcomes and associated high resource-use in this group in the post-discharge period. Objective To examine the costs and cost-effectiveness of a specialist geriatric medical intervention for frail older people in the 90 days following discharge from an acute medical unit, compared with standard care. Methods Economic evaluation was conducted alongside a two-centre randomised controlled trial (AMIGOS). 433 patients (aged 70 or over) at risk of future health problems, discharged from acute medical units within 72 hours of attending hospital, were recruited in two general hospitals in Nottingham and Leicester, UK. Participants were randomised to the intervention, comprising geriatrician assessment in acute units and further specialist management, or to control where patients received no additional intervention over and above standard care. Primary outcome was incremental cost per quality adjusted life year (QALY) gained. Results We undertook cost-effectiveness analysis for 417 patients (intervention: 205). The difference in mean adjusted QALYs gained between groups at 3 months was -0.001 (95% confidence interval [CI]: -0.009, 0.007). Total adjusted secondary and social care costs, including direct costs of the intervention, at 3 months were £4412 (€5624, $6878) and £4110 (€5239, $6408) for the intervention and standard care groups, the incremental cost was £302 (95% CI: 193, 410) [€385, $471]. The intervention was dominated by standard care with probability of 62%, and with 0% probability of cost-effectiveness (at £20,000/QALY threshold). Conclusions The specialist geriatric medical intervention for frail older people discharged from acute medical unit was not cost-effective. Further research on

  17. Excerpta Medica abstracting journals: a case study of costs to medical school libraries.

    PubMed

    La Rocco, A; Feng, C

    1977-04-01

    A cost comparison study was made of Excerpta Medica's abstracting journals, based upon actual costs to a library. Unit costs were determined for six sections of EM as compared with six corresponding abstract journals. On average, EM sections were found to be 138% more costly than corresponding abstract journals. The effects of splitting of EM journal titles were also analyzed. This practice increases the price of a total subscription to EM and makes comprehensive information retrieval more difficult. A survey of medical school librarians as users of EM points to dissatisfaction with its increasing price, particularly when it results from title splitting.

  18. 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

    2011-09-07

    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.

  19. 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

  20. 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

  1. Cost Overrun Optimism: Fact or Fiction

    DTIC Science & Technology

    2016-02-29

    COST VARIANCE, TERMED COST OVERRUN COST NOW MONTHS EAC Overrun at Completion Current Overrun BAC ACWP BCWS...ALL 64 18 -3 109 36 -3 493 Equations 1, 2, and 3 define the current cost overrun, the projected cost overrun at completion, and final cost overrun. Of...completion cost . The others are simply the difference between the budget and actual cost of the work. Current overrun (CO) = Cumulative (Cum) BCWP -

  2. Community Air Sensor Network (CAIRSENSE) project: evaluation of low-cost sensor performance in a suburban environment in the southeastern United States

    NASA Astrophysics Data System (ADS)

    Jiao, Wan; Hagler, Gayle; Williams, Ronald; Sharpe, Robert; Brown, Ryan; Garver, Daniel; Judge, Robert; Caudill, Motria; Rickard, Joshua; Davis, Michael; Weinstock, Lewis; Zimmer-Dauphinee, Susan; Buckley, Ken

    2016-11-01

    Advances in air pollution sensor technology have enabled the development of small and low-cost systems to measure outdoor air pollution. The deployment of a large number of sensors across a small geographic area would have potential benefits to supplement traditional monitoring networks with additional geographic and temporal measurement resolution, if the data quality were sufficient. To understand the capability of emerging air sensor technology, the Community Air Sensor Network (CAIRSENSE) project deployed low-cost, continuous, and commercially available air pollution sensors at a regulatory air monitoring site and as a local sensor network over a surrounding ˜ 2 km area in the southeastern United States. Collocation of sensors measuring oxides of nitrogen, ozone, carbon monoxide, sulfur dioxide, and particles revealed highly variable performance, both in terms of comparison to a reference monitor as well as the degree to which multiple identical sensors produced the same signal. Multiple ozone, nitrogen dioxide, and carbon monoxide sensors revealed low to very high correlation with a reference monitor, with Pearson sample correlation coefficient (r) ranging from 0.39 to 0.97, -0.25 to 0.76, and -0.40 to 0.82, respectively. The only sulfur dioxide sensor tested revealed no correlation (r < 0.5) with a reference monitor and erroneously high concentration values. A wide variety of particulate matter (PM) sensors were tested with variable results - some sensors had very high agreement (e.g., r = 0.99) between identical sensors but moderate agreement with a reference PM2.5 monitor (e.g., r = 0.65). For select sensors that had moderate to strong correlation with reference monitors (r > 0.5), step-wise multiple linear regression was performed to determine if ambient temperature, relative humidity (RH), or age of the sensor in number of sampling days could be used in a correction algorithm to improve the agreement. Maximum improvement in agreement with a reference

  3. 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...

  4. 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...

  5. 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.

  6. 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

  7. Long-Term Secondary Care Costs of Endometrial Cancer: A Prospective Cohort Study Nested within the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

    PubMed Central

    Karpinskyj, Chloe; Miners, Alec; Taylor, Julie; Manchanda, Ranjit; Iyer, Rema; Griffin, Michelle; Ryan, Andy; Jacobs, Ian; Menon, Usha; Legood, Rosa

    2016-01-01

    Background There is limited evidence on the costs of Endometrial Cancer (EC) by stage of disease. We estimated the long-term secondary care costs of EC according to stage at diagnosis in an English population-based cohort. Methods Women participating in UKCTOCS and diagnosed with EC following enrolment (2001–2005) and prior to 31st Dec 2009 were identified to have EC through multiple sources. Survival was calculated through data linkage to death registry. Costs estimates were derived from hospital records accessed from Hospital Episode Statistics (HES) with additional patient level covariates derived from case notes and patient questionnaires. Missing and censored data was imputed using Multiple Imputation. Regression analysis of cost and survival was undertaken. Results 491 of 641 women with EC were included. Five year total costs were strongly dependent on stage, ranging from £9,475 (diagnosis at stage IA/IB) to £26,080 (diagnosis at stage III). Stage, grade and BMI were the strongest predictors of costs. The majority of costs for stage I/II EC were incurred in the first six months after diagnosis while for stage III / IV considerable costs accrued after the first six months. Conclusions In addition to survival advantages, there are significant cost savings if patients with EC are detected earlier. PMID:27829038

  8. 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

  9. 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…

  10. Marginal Costs and Formula-Based Funding.

    ERIC Educational Resources Information Center

    O'Connor, Ellen

    Marginal cost is the cost of producing an additional unit. In higher education, one marginal cost would be cost of educating an additional student. Formula-based budget determination for public higher education is usually based on average cost per student. This study estimates marginal cost and compares it with average cost. There are several…

  11. 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

  12. 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

  13. How Well Do All Patient Refined–Diagnosis-Related Groups Explain Costs of Pediatric Cancer Chemotherapy Admissions in the United States?

    PubMed Central

    Street, Andrew; Ho, Vivian

    2016-01-01

    Purpose: State-based Medicaid programs have begun using All Patient Refined–Diagnosis-Related Groups (APR-DRGs) to determine hospital reimbursement rates. Medicaid provides coverage for 45% of childhood cancer admissions. This study aimed to examine how well APR-DRGs reflect admission costs for childhood cancer chemotherapy to inform clinicians, hospitals, and policymakers in the wake of policy changes. Methods: We identified 25,613 chemotherapy admissions in the 2009 Kids’ Inpatient Database. To determine how well APR-DRGs explain costs, we applied a hierarchic linear regression model of hospital costs, allowing for a variety of patient, hospital, and geographic confounders. Results: APR-DRGs proved to be the most important predictors of admission costs (P < .001), with costs increasing by DRG severity code. Diagnosis, age, and hospital characteristics also predicted costs above and beyond those explained by APR-DRGs. Compared with admissions for patients with acute lymphoblastic leukemia, costs of admissions for patients with acute myelomonocytic leukemia were 82% higher; non-Hodgkin lymphoma, 20% higher; Hodgkin lymphoma, 25% lower; and CNS tumors, 27% lower. Admissions for children who were 10 years of age or older cost 26% to 35% more than admissions for infants. Admissions to children’s hospitals cost 46% more than admissions to other hospital types. Conclusion: APR-DRGs developed for adults are applicable to childhood cancer chemotherapy but should be refined to account for cancer diagnosis and patient age. Possible policy and clinical management changes merit further study to address factors not captured by APR-DRGs. PMID:27118158

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Preventing Unnecessary Costs of Drug-Induced Hypoglycemia in Older Adults with Type 2 Diabetes in the United States and Canada

    PubMed Central

    Boulin, Mathieu; Diaby, Vakaramoko; Tannenbaum, Cara

    2016-01-01

    Background The costs of drug-induced hypoglycemia are a critical but often neglected component of value-based arguments to reduce tight glycemic control in older adults with type 2 diabetes. Methods An economic (decision-tree) analysis compared rates, costs, quality-adjusted life-years, and incremental costs per quality-adjusted life-year gained associated with mild, moderate and severe hypoglycemic events for 6 glucose-lowering medication classes in type 2 diabetic adults aged 65–79 versus those 80 years and older. The national U.S. (Center for Medicare Services) and Canadian public health payer perspectives were adopted. Findings Incidence rates of drug-induced hypoglycemia were the highest for basal insulin and sulfonylureas: 8.64 and 4.32 events per person-year in 65–79 year olds, and 12.06 and 6.03 events per person-year for 80 years and older. In both the U.S. and Canada, metformin dominated sulfonylureas, basal insulin and glucagon-like peptide1 receptor agonists. Relative to sulfonylureas, thiazolidinediones had the lowest incremental cost-effectiveness ratios in the U.S. and dominated sulfonylureas in Canada for adults 80 years and older. Relative to sulfonylureas, dipeptidyl peptidase4 inhibitors were cost-effective for adults 80 years and older in both countries, and for 65–79 year olds in Canada. Annual costs of hypoglycemia for older adults attaining very tight glycemic control with the use of insulin or sulfonylureas were estimated at U.S.$509,214,473 in the U.S. and CAN$65,497,849 in Canada. Conclusions Optimizing drug therapy for older type 2 diabetic adults through the avoidance of drug-induced hypoglycemia will dramatically improve patient health while also generating millions of dollars by saving unnecessary medical costs. PMID:27648831

  19. United States v. Oswego Barge Corporation

    SciTech Connect

    Lyons, A.S.

    1984-01-01

    The Federal Water Pollution Control Act (FWPCA) holds polluters liable to the federal government for costs incurred in cleaning up an oil spill, but there is a dollar limit on the amount the government can recover from the responsible vessel owner or operator for its actual cleanup costs. In United States v. Oswego Barge Corporation the Second Circuit Court applied an earlier holding to claims based on traditional maritime law, federal common law of nuisance, and the Refuse Act for costs incurred in cleanup by the federal government, and concluded that they were preempted by the FWPCA. The author discusses the facts of the Oswego oil spill and the analysis used by the court. He concludes that the government's source of compensation is limited to the frequently inadequate provisions of the FWPCA. 51 references.

  20. 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.

  1. 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)

  2. 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…

  3. 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)

  4. 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)

  5. 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,…

  6. 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

  7. 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.

  8. Review of the cost components of introducing industrially fortified rice.

    PubMed

    Roks, Eveline

    2014-09-01

    Micronutrient deficiencies affect over two billion people worldwide, particularly in developing countries. Fortification of staple foods with multiple micronutrients is a cost-effective strategy to increase vitamin and mineral intake. The objective of this paper is to review the cost elements of industrially fortified rice by identifying the costs related to the implementation of rice fortification programs, using the experience of the United Nations World Food Programme in its pilot countries. The actual total costs of rice fortification are not easily captured. Core cost elements include the production of fortified rice kernels, transportation to the point of blending, blending of fortified with unfortified rice, costs related to sales or distribution, quality control and assurance, and additional planning. In the introduction phase, organizations or coalitions seeking to advance rice fortification will face additional costs related to the initiation of rice fortification. In the scale-up phase, greater efficiency in the supply chain and economies of scale can be expected. Different cost elements are normally borne by different stakeholders. This makes the implementation of rice fortification programs a feasible option to reach vulnerable populations with inadequate access to affordable nutrition solutions.

  9. 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.

  10. Community Air Sensor Network (CAIRSENSE) project: Evaluation of low-cost sensor performance in a suburban environment in the southeastern United States

    EPA Science Inventory

    Advances in air pollution sensor technology have enabled the development of small and low cost systems to measure outdoor air pollution. The deployment of a large number of sensors across a small geographic area would have potential benefits to supplement traditional monitoring n...

  11. 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…

  12. 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,…

  13. Does Choice of Influenza Vaccine Type Change Disease Burden and Cost-Effectiveness in the United States? An Agent-Based Modeling Study.

    PubMed

    DePasse, Jay V; Smith, Kenneth J; Raviotta, Jonathan M; Shim, Eunha; Nowalk, Mary Patricia; Zimmerman, Richard K; Brown, Shawn T

    2017-04-10

    Offering a choice of influenza vaccine type may increase vaccine coverage and reduce disease burden, but it is more costly. This study calculated the public health impact and cost-effectiveness of 4 strategies: no choice, pediatric choice, adult choice, or choice for both age groups. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through a population in Washington, DC. Influenza vaccination coverage derived from data from the Centers for Disease Control and Prevention was increased by 6.5% (range, 3.25%-11.25%), reflecting changes due to vaccine choice. With moderate influenza infectivity, the number of cases averaged 1,117,285 for no choice, 1,083,126 for pediatric choice, 1,009,026 for adult choice, and 975,818 for choice for both age groups. Averted cases increased with increased coverage and were highest for the choice-for-both-age-groups strategy; adult choice also reduced cases in children. In cost-effectiveness analysis, choice for both age groups was dominant when choice increased vaccine coverage by ≥3.25%. Offering a choice of influenza vaccines, with reasonable resultant increases in coverage, decreased influenza cases by >100,000 with a favorable cost-effectiveness profile. Clinical trials testing the predictions made based on these simulation results and deliberation of policies and procedures to facilitate choice should be considered.

  14. The Departmental Technical Curriculum Instructional Costs of Emergency Medical Technician-Paramedic Programs in Two-Year Public Colleges in the United States.

    ERIC Educational Resources Information Center

    Ruple, Judith A.

    This dissertation surveys, analyzes and reports the comparison of direct departmental costs associated with the technical core curriculum of emergency medical technology programs at nine public two-year community colleges for the academic years of 1989-90, 1990-91, and 1991-92. Data were collected using The Emergency Medical Training Technology…

  15. 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…

  16. 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

  17. 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.

  18. 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.

  19. Yankee Nuclear Power Station - analysis of decommissioning costs

    SciTech Connect

    Lessard, L.P.

    1996-12-31

    The preparation of decommissioning cost estimates for nuclear power generating stations has received a great deal of interest in the last few years. Owners are required by regulation to ensure that adequate funds are collected for the timely decommissioning of their facilities. The unexpected premature shutdown of several facilities and uncertainties associated with radioactive waste disposal and long-term spent-fuel storage, when viewed in the light of a deregulated electric utility industry, has caused many companies to reevaluate their decommissioning cost estimates. The decommissioning of the Yankee Nuclear Power Station represents the first large-scale project involving the complete decontamination and dismantlement of a commercial light water nuclear power generation facility in the United States. Since this pressurized water reactor operated for 32 yr at a respectable 74% lifetime capacity factor, the actual costs and resources required to decommission the plant, when compared with decommissioning estimates, will yield valuable benchmarking data.

  20. Development and Implications of a Predictive Cost Methodology for Modular Pumped Storage Hydropower (m-PSH) Projects in the United States

    SciTech Connect

    Witt, Adam; Chalise, Dol Raj; Hadjerioua, Boualem; Manwaring, Michael; Bishop, Norm

    2016-10-01

    The slow pace of Pumped Storage Hydropower development in the US over the past twenty years has led to widespread interest in the feasibility and viability of alternative PSH designs, development schemes, and technologies. Since 2011, Oak Ridge National Lab has been exploring the economic viability of modular Pumped Storage Hydropower (m-PSH) development through targeted case studies, revenue simulations, and analysis of innovative configurations and designs. This paper outlines the development and supporting analysis of a scalable, comprehensive cost modeling tool designed to simulate the initial capital costs for a variety of potential m-PSH projects and deployment scenarios. The tool is used to explore and determine innovative research strategies that can improve the economic viability of m-PSH in US markets.

  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. Effectiveness and Cost-Effectiveness of Sequential Treatment of Patients with Chronic Myeloid Leukemia in the United States: A Decision Analysis.

    PubMed

    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.

  3. 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

  4. An Educational Intervention to Decrease Drug Costs Related to Terminal Secretions in a Hospice Organization.

    PubMed

    Brock, Cara; Cooper, Sarah; Herndon, Christopher M

    2017-03-01

    Terminal secretions is a common symptom seen in hospice patients. Antimuscarinic drugs are commonly used to treat this symptom despite a lack of supporting data. Wide variability in cost exists among these treatments. Hospice program data were assessed to identify high-use and high-cost medications. An educational intervention (EI) was developed to target one such medication, transdermal scopolamine. The EI focused on efficacy, safety, and actual cost (by unit and total expenditure) for each possible treatment of terminal secretions. Following the EI, drug utilization data was re-evaluated. Prior to the deployment of the EI, total monthly hospice drug costs averaged $91,405 (SD 1,444) with an average drug cost per patient per day of $11.42 (SD 0.54). Monthly costs of drugs frequently employed to treat terminal secretions averaged $7,187.67 (SD 2,253) pre-intervention. Following the EI, monthly drug costs decreased 22.5%, average daily patient drug costs decreased 11.1%, and total anti-secretion costs decreased 28.5% after adjusting for difference in census. Education regarding the use and cost of medications to treat symptoms at end-of-life in hospice patients can be an intervention used to lead to significant cost savings to hospice organizations while maintaining appropriate symptom management for patients. Future interventions to target additional high-cost medications are warranted.

  5. 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.

  6. 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

  7. Eight-Year Summary of Fort Irwin, CA, Family Housing Comparison Test: Operation and Maintenance Costs of Manufactured vs. Conventionally Built Units

    DTIC Science & Technology

    1993-07-01

    is acetal that has been chemically modified. Figures 31 and 32 are the scans produced for the grey outer part and the white inner part respectively...Figure 33, showing the two scans overlayed, shows that all of the chemical components in the grey outer material are present in the white inner ...other malformations will not be acceptable. Because to the choice of materials by the contractor who built and erected the housing units and the

  8. Learning/cost-improvement curves

    NASA Technical Reports Server (NTRS)

    Delionback, L. M.

    1976-01-01

    Review guide is an aid to manager or engineer who must determine production costs for components, systems, or services. Methods are described by which manufacturers may use historical data, task characteristics, and current cost data to estimate unit prices as function of number of units to be produced.

  9. Explosive Percolation Transition is Actually Continuous

    NASA Astrophysics Data System (ADS)

    da Costa, R. A.; Dorogovtsev, S. N.; Goltsev, A. V.; Mendes, J. F. F.

    2010-12-01

    Recently a discontinuous percolation transition was reported in a new “explosive percolation” problem for irreversible systems [D. Achlioptas, R. M. D’Souza, and J. Spencer, Science 323, 1453 (2009)SCIEAS0036-807510.1126/science.1167782] in striking contrast to ordinary percolation. We consider a representative model which shows that the explosive percolation transition is actually a continuous, second order phase transition though with a uniquely small critical exponent of the percolation cluster size. We describe the unusual scaling properties of this transition and find its critical exponents and dimensions.

  10. Neoadjuvant Treatment in Rectal Cancer: Actual Status

    PubMed Central

    Garajová, Ingrid; Di Girolamo, Stefania; de Rosa, Francesco; Corbelli, Jody; Agostini, Valentina; Biasco, Guido; Brandi, Giovanni

    2011-01-01

    Neoadjuvant (preoperative) concomitant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal adenocarcinomas. The clinical stages II (cT3-4, N0, M0) and III (cT1-4, N+, M0) according to International Union Against Cancer (IUCC) are concerned. It can reduce tumor volume and subsequently lead to an increase in complete resections (R0 resections), shows less toxicity, and improves local control rate. The aim of this review is to summarize actual approaches, main problems, and discrepancies in the treatment of locally advanced rectal adenocarcinomas. PMID:22295206

  11. 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.

  12. 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.

  13. 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.

  14. A better approach to cost estimation.

    PubMed

    Richmond, Russ

    2013-03-01

    Using ratios of costs to charges (RCCs) to estimate costs can cause hospitals to significantly over- or under-invest in service lines. A focus on improving cost estimation in cost centers where physicians have significant control over operating expenses, such as drugs or implants, can strengthen decision making and strategic planning. Connecting patient file information to purchasing data can lead to more accurate reflections of actual costs and help hospitals gain better visibility across service lines.

  15. 24 CFR Appendix to Part 971 - Methodology of Comparing Cost of Public Housing With Cost of Tenant-Based Assistance

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... occupied unit basis. The costs shall be expressed in current dollar terms for the period for which the most... the current per-unit operating cost of the development, then the plan should detail how the... operating costs are lower than current operating costs, the current per-unit operating costs of...

  16. Costs and benefits of industrial reporting and voluntary targets for energy efficiency. A report to the Congress of the United States. Volume I: Main report

    SciTech Connect

    Not Available

    1994-02-01

    Section 131(c) of the Energy Policy Act of 1992 (EPACT) (Public Law 102-486) requires the Department of Energy (DOE) to evaluate the costs and benefits of federally mandated energy efficiency reporting requirements and voluntary energy efficiency improvement targets for energy-intensive industries. It also requires DOE to evaluate the role of reporting and targets in improving energy efficiency. Specifically, the legislation states: Not later than one year after the data of the enactment of this Act, the Secretary shall, in consultation with affected industries, evaluate and report to the Congress regarding the establishment of Federally mandated energy efficiency reporting requirements and voluntary energy efficiency improvement targets for energy intensive industries. Such report shall include an evaluation of the costs and benefits of such reporting requirements and voluntary energy efficiency improvement targets, and recommendations regarding the role of such activities in improving energy efficiency in energy intensive industries. This report is DOE`s response to that directive. It is the culmination of a year-long study that included (1) analysis of documents pertaining to a previous reporting and targets effort, the industrial Energy Efficiency Improvements Program (or the CE-189 program, following the designation of the reporting form used to collect data in that program), administered by DOE from 1976 to 1985, as well as other important background information; (2) extensive consultations with government and industry officials regarding the CE-189 Program, experience with other programs that have reporting elements, and the attributes of possible alternative strategies for reporting and targets; and (3) analyses of the costs and benefits of the CE-189 Program and several alternatives to the CE-189 approach.

  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. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Feasibility study for retrofitting/repowering of Unit 2, Station A at Kosovo, (EPK) Yugoslavia: Scope of work and detailed cost estimate. Export trade information

    SciTech Connect

    Not Available

    1988-09-30

    The primary objective of the feasibility study is to examine the life extension of the existing Unit 2 at Station A of the Electric Power Company of Kosovo (EPK). The study will consider state-of-the-art fluidized bed combustion boiler technology along with revitalization and retrofitting of the existing boiler with conventonal environmental controls for reduction of sulfur and particulate emissions. in addition, the study will include the examination of the rest of the power plant equipment for refurbishment and/or replacement.

  4. Testing different storage conditions for (99m)Tc-MAG3 kit: can hot fractioning reduce the cost per unit dose?

    PubMed

    Kiratli, Pinar Ozgen; Salanci, Bilge Volkan

    2003-06-01

    Since its release for routine clinical use, (99m)Tc-mercaptoacetyltriglycine (MAG3) has become an important alternative to (131)I-labeled orthoiodohippuran. The cold kit for MAG3 is expensive, especially in developing countries. Therefore, unique storage conditions should be provided for cost reduction. Cold fractioning is a well-known procedure but has special requirements, such as a nitrogen tank and a laminar flow hood. The aim of this study was to prolong the shelf life of (99m)Tc-labeled MAG3 by a hot fractioning method, which separates the patient doses after (99m)Tc labeling. The radiochemical purity of the (99m)Tc-labeled MAG3 kit was tested under different storage conditions. Hot fractioning of the (99m)Tc-labeled MAG3 kit was found to be a possible alternative to cold fractioning for routine clinical studies.

  5. Reline 33 year old kettle for more corrosive process at about 1/3 cost of new unit: lightweight foamed glass block protects corroded cast iron cover

    SciTech Connect

    Not Available

    1982-06-01

    This article presents a solution to a chemical plant's need for a lining material to reline a 33 year old kettle that would be resistant to attack by aqueous bromine and hydrochloric, nitrous, and bromic acid. The solution was to use an elastomeric polyisobutylene sheeting as a primary lining for the kettle. The problem was also solved by using a light weight foamed glass block which protected the corroded cast iron dome cover for the kettle. Installation of the two-step lining for the kettle and cover by Chemsteel Construction Company of New Kensington, PA was completed in 5 weeks. The cost was about 1/3 as much as fabricating, installing, and lining a new steel 5000 gal vessel. The kettle has been in service about 12 months and the acid brick/polyisobutylene membrance liner shows no signs of damage from the highly corrosive chemicals and elevated temperatures required for the process change.

  6. 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…

  7. 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

  8. 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…

  9. 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.

  10. 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

  11. The United States Special Operations Command Civil Military Engagement Program - A Model for Military-Interagency Low Cost / Small Footprint Activities

    DTIC Science & Technology

    2014-05-02

    institutional and educational initiatives. 15. SUBJECT TERMS United States public diplomacy, doctrine and strategy; Foreign Internal Defense; Building...through institutional and educational initiatives. The purpose of the CME Program is to develop 1...46 CHAPTER 5:…………………………………………………………………………….51 Recommendations……………………………………………………………………..51 Education and Training...………………………………………………………...51

  12. 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.

  13. Actualizing Flexible National Security Space Systems

    DTIC Science & Technology

    2011-01-01

    single launch vehicle is a decision unique to small satellites that adds an extra dimension to the launch risk calculation. While bundling...following a launch failure. The ability to bundle multiple payloads on a single launch vehicle is a decision unique to small satellites that adds an extra ... dimension to the launch risk calculation. While bundling multiple small satellites on a single launch vehicle spreads the initial launch cost across

  14. 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.

  15. 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).

  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. 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

  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. 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…

  20. 12 CFR 408.5 - Ensuring environmental documents are actually considered in Agency decision-making.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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:...

  1. 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:...

  2. 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:...

  3. 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:...

  4. 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:...

  5. 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.

  6. Pension Costs on DOD Contracts: Additional Guidance Needed to Ensure Costs Are Consistent and Reasonable

    DTIC Science & Technology

    2013-01-01

    support from a team of DOD actuaries . DOD audits projected and actual costs for contracts, including pension costs, to ensure they are allowable...qualified and credentialed actuaries ) and collected contractor data on incurred CAS pension costs from 2002 to 2011. To understand how pension costs... Actuary of the GAO for actuarial soundness. We also gathered contractor projections of CAS pension costs for 2012 to 2016. See appendix I for additional

  7. 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…

  8. Estimating 'costs' for cost-effectiveness analysis.

    PubMed

    Miners, Alec

    2008-01-01

    Since 1999, the National Institute for Health and Clinical Excellence (NICE) Technology Appraisal Programme has been charged with producing guidance for the NHS in England and Wales on the appropriate use of new and existing healthcare programmes. Guidance is based on an assessment of a number of factors, including cost effectiveness. The identification, measurement and valuation of costs are important components of any cost-effectiveness analysis. However, working through these steps raises a number of important methodological questions. For example, how should 'future' resource use be estimated, and is there a need to consider all 'future' costs? Given that NICE produces national guidance, should national unit cost data be used to value resources or should local variations in negotiated prices be taken into account? This paper was initially prepared as a briefing paper as part of the process of updating NICE's 2004 Guide to the Methods of Technology Appraisal for a workshop on 'costs'. It outlines the issues that were raised in the original briefing paper and the subsequent questions that were discussed at the workshop.

  9. The Cost Analysis of Instructional Development: Some Managerial Considerations.

    ERIC Educational Resources Information Center

    Rogers, Donald D.

    The ability to develop lower unit cost instruction requires the ability to both determine the unit cost of current instruction and to predict with some degree of accuracy the unit cost of the proposed instruction. From the managerial viewpoint the cost of instruction can be determined by using basic design models which reflect the actual…

  10. 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…

  11. 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…

  12. THE HIGH COST OF DISCRIMINATION.

    ERIC Educational Resources Information Center

    ROPER, ELMO

    ON THE BASIS OF EMPLOYEE SURVEYS AND IN-PLANT RESEARCH, THE TOTAL COST OF DISCRIMINATION TO AMERICAN BUSINESS AND INDUSTRY IN ACTUAL DOLLARS IS ESTIMATED AT ROUGHLY $30 BILLION ANNUALLY. DISCRIMINATION IN INDUSTRY BEGINS AT THE HIRING GATE WHERE MINORITY GROUPS ARE REFUSED EMPLOYMENT BECAUSE OF RACE, COLOR, RELIGION, NATIONALITY, POLITICAL…

  13. 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,…

  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. [Comparison analysis between potential and actual pattern of artificial oases in arid region].

    PubMed

    Jia, B; Ci, L; Yang, X; Yang, J; Pan, B

    2000-12-01

    Based on theoretical analysis and demonstration research, the conception of potential pattern in the agriculture landscape of artificial oases in Xinjiang arid region and its analysis unit were discussed. The potential landscape pattern was defined as the one composed by spatial units with basic characteristics and properties which had no change or less change with the time. In agriculture landscape, soil was found to be a relatively stable element, and hence, different soil classification unit could be used to analyze the potential landscape pattern. A case study was carried out to analyze the potential and actual pattern of the artificial cases in Shihezi reclamation area by using the indexes of diversity, evenness, aggregation, mean patch elongation, patch shape fragmentation and mean patch fractal dimension. The result showed that the landscape pattern changed orderly from the potential to actual pattern, and the potential pattern could be used as the absolute criterion for researches on pattern changes in agriculture landscape.

  16. From preferred to actual mate characteristics: the case of human body shape.

    PubMed

    Courtiol, Alexandre; Picq, Sandrine; Godelle, Bernard; Raymond, Michel; Ferdy, Jean-Baptiste

    2010-09-27

    The way individuals pair to produce reproductive units is a major factor determining evolution. This process is complex because it is determined not only by individual mating preferences, but also by numerous other factors such as competition between mates. Consequently, preferred and actual characteristics of mates obtained should differ, but this has rarely been addressed. We simultaneously measured mating preferences for stature, body mass, and body mass index, and recorded corresponding actual partner's characteristics for 116 human couples from France. Results show that preferred and actual partner's characteristics differ for male judges, but not for females. In addition, while the correlation between all preferred and actual partner's characteristics appeared to be weak for female judges, it was strong for males: while men prefer women slimmer than their actual partner, those who prefer the slimmest women also have partners who are slimmer than average. This study therefore suggests that the influences of preferences on pair formation can be sex-specific. It also illustrates that this process can lead to unexpected results on the real influences of mating preferences: traits considered as highly influencing attractiveness do not necessarily have a strong influence on the actual pairing, the reverse being also possible.

  17. 24 CFR Appendix to Part 971 - Methodology of Comparing Cost of Public Housing With Cost of Tenant-Based Assistance

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Methodology of Comparing Cost of... Comparing Cost of Public Housing With Cost of Tenant-Based Assistance I. Public Housing The costs used for... housing. That per unit monthly cost of public housing must be compared to the per unit monthly Section...

  18. 24 CFR Appendix to Part 971 - Methodology of Comparing Cost of Public Housing With Cost of Tenant-Based Assistance

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Methodology of Comparing Cost of... Comparing Cost of Public Housing With Cost of Tenant-Based Assistance I. Public Housing The costs used for... housing. That per unit monthly cost of public housing must be compared to the per unit monthly Section...

  19. Actualities in big segments replantation surgery.

    PubMed

    Battiston, Bruno; Tos, Pierluigi; Clemente, Alessandra; Pontini, Italo

    2007-01-01

    Replantation of an amputation is no longer a difficult technical problem. Indeed, the experience gathered over the last few decades, right from the first concepts posed by the pioneers up to the present era and the improved technical aids, all go to suggest that the majority of amputated segments may now be reconstructed. However, what we really want from a replant is not just survival but function. Indications for replantations must follow careful and objective patient selection together with the evaluation of type and site of lesion and possible complications. Furthermore, the important role of emergency organization in this type of surgery is to be emphasized. Nowadays, clean cut injuries are rarer and are being substituted by high energy trauma which may produce extensive tissue lesions that increase complications and lead to poor functional results. Consequently, some authors were induced to describe evaluation systems for decision making which still present problems which are in part due to the large number of parameters to be taken into consideration as well as to the complex functionality of the upper limb. This led us to evaluate our case series of 52 major replantations of the upper limb over the last 10 years and to compare it with other published series. The best form of reconstruction following total amputation of a major limb segment is still its replantation. The highly significant increase in the quality of life is able to justify the higher social costs and the number of operations required.

  20. Virtual reality as telemedicine tool: technology, ergonomics and actual applications.

    PubMed

    Riva, G; Gamberini, L

    2000-01-01

    This paper surveys the state of the art in telemedicine applications of virtual environments (VEs) and related technologies for health care. The possible use of VEs as telemedicine tool has attracted much interest in medicine. Actually this technology is commonly used in remote or augmented surgery, and surgical training, which are critically dependent upon eye-hand coordination. Recently, however, different researchers have tried to use VEs in anatomic learning and for the assessment and rehabilitation in neuro-psychology. To date, such applications have improved the quality of health care, and later they will lead to substantial cost savings. Tools that respond to the needs of present VE systems are being refined or developed. However, the possible use of VEs in telemedicine is not linked to the solution of technical problems only. In fact telemedicine is not simply a technology but a complex process whose successful exploitation needs significant attention to ergonomics, human factors and organizational changes in the structure of the relevant health service.

  1. 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.

  2. External Validity of Contingent Valuation: Comparing Hypothetical and Actual Payments.

    PubMed

    Ryan, Mandy; Mentzakis, Emmanouil; Jareinpituk, Suthi; Cairns, John

    2016-10-09

    Whilst contingent valuation is increasingly used in economics to value benefits, questions remain concerning its external validity that is do hypothetical responses match actual responses? We present results from the first within sample field test. Whilst Hypothetical No is always an Actual No, Hypothetical Yes exceed Actual Yes responses. A constant rate of response reversals across bids/prices could suggest theoretically consistent option value responses. Certainty calibrations (verbal and numerical response scales) minimise hypothetical-actual discrepancies offering a useful solution. Helping respondents resolve uncertainty may reduce the discrepancy between hypothetical and actual payments and thus lead to more accurate policy recommendations. Copyright © 2016 John Wiley & Sons, Ltd.

  3. 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...

  4. 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....

  5. Health Care Technology Assessment. Hearing Before the Committee on Labor and Human Resources. United States Senate, Ninety-Eighth Congress, Second Session on Examination of the Health Cost Containment Issue: Health Technology Assessment; General Cost Containment Strategies; and Cost Implications of Defensive Medicine and Medical Malpractice.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This committee hearing was held to consider factors in federal suport of health care services, including the roles of professional organizations, insurance companies, and hospitals. The process of evaluating whether the use of medical technology, diagnostic tests, and therapeutic procedures are cost-effective and beneficial is identified as…

  6. 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...

  7. 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...

  8. 49 CFR 1139.3 - Cost study.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 8 2012-10-01 2012-10-01 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...

  9. 49 CFR 1139.3 - Cost study.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 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...

  10. 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...

  11. 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...

  12. 49 CFR 1139.3 - Cost study.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 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...

  13. 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...

  14. Cost effectiveness of combination therapy. Based on a presentation by Daniel Hilleman, PharmD.

    PubMed

    1999-06-01

    The ultimate economic goal of hypertension management is to balance costs and benefits, but defining these entities may be difficult. The overall cost of treating high blood pressure includes direct costs, such as drug acquisition, physician fees, laboratory and diagnostic tests, and management of side effects, as well as indirect costs, such as inadequate blood pressure control, noncompliance with therapy, and loss to follow up. Determining actual costs can be complicated. For example, medical charges are rarely paid as billed to third-party payers, and actual payments received for services are reimbursed at rates that vary from patient to patient and provider to provider. As difficult as determining treatment costs may be, quantifying the benefits and outcomes of treatment is probably even more difficult, especially because outcome can be classified as long term (with few available outcomes data on fixed-dose combinations), intermediate-term, and short-term. If blood pressure is considered a surrogate marker for mortality, it could be used in comparing the economic value of some antihypertensive agents. Cost-effectiveness studies evaluating hypertension treatment typically compare 2 or more alternatives, with the cost defined by 1 or more of 4 units of effectiveness. These units include: the money that needs to be spent to achieve the following: reach a specific mm-Hg reduction in blood pressure, reach a specific percentage reduction in blood pressure, treat a patient successfully to target blood pressure level, and treat a patient per quality-adjusted life-year gained. In studies evaluating fixed-dose combination therapy versus monotherapy in terms of response rates, costs per patient per year, and costs per successfully treated patient per year, combination therapy was found to be more effective in lowering blood pressure, but more expensive. However, the higher response rates seen with combination therapy either offset the added costs of managing patients with

  15. 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.

  16. Relative Cost and Training Effectiveness of the 6883 Three-Dimensional Simulator and Actual Equipment.

    DTIC Science & Technology

    1980-09-01

    impacts on training effectiveness (Miller, 1978). Second , there is the need for a criterion measure of training effectiveness. Previous researchers have...personnel, the second method , may be biased by senior NCO or commander preferences which are not necessarily the most effective methods of training. The task... Research Methods & Instrumentation, 1978, 10, 228-230. Dick, R.A.; Royal, J.W.; Simpson, H.K. & Mackie, R.R. Personnel Tech- nology: !’sing an inexpensive

  17. Brazil's worst mining disaster: Corporations must be compelled to pay the actual environmental costs.

    PubMed

    Garcia, Letícia Couto; Ribeiro, Danilo Bandini; de Oliveira Roque, Fabio; Ochoa-Quintero, Jose Manuel; Laurance, William F

    2017-01-01

    In November 2015, a large mine-tailing dam owned by Samarco Corporation collapsed in Brazil, generating a massive wave of toxic mud that spread down the Doce River, killing 20 people and affecting biodiversity across hundreds of kilometers of river, riparian lands, and Atlantic coast. Besides the disaster's serious human and socioeconomic tolls, we estimate the regional loss of environmental services to be ~US$521 million per year. Although our estimate is conservative, it is still six times higher than the fine imposed on Samarco by Brazilian environmental authorities. To reduce such disparities between estimated damages and levied fines, we advocate for an environmental bond policy that considers potential risks and environmental services that could possibly be impacted by irresponsible mining activity. Environmental bonds and insurance are commonly used policy instruments in many countries, but there are no clear environmental bond policies in Brazil. Environmental bonds are likely to be more effective at securing environmental restitution than post-disaster fines, which generally are inadequate and often unpaid. We estimate that at least 126 mining dams in Brazil are vulnerable to failure in the forthcoming years. Any such event could have severe social-environmental consequences, underscoring the need for effective disaster-management strategies for large-scale mining operations.

  18. Estimating nursing costs--a methodological review.

    PubMed

    Chiang, Bea

    2009-05-01

    A critical cost accounting issue relating to nursing costs is that nursing costs are currently averaged into the daily room rate in the hospitals. This accounting practice treats nursing units as cost centers as nursing costs are bundled into a per diem rate instead of billed separately. As a result, all patients in a given care unit of the hospital are presumed to consume the same amount of nursing care resources. This costing and billing system creates a mismatch between resources consumption and billed charges. The objective of this paper is to (1) demonstrate current practice to estimate nursing costs, (2) classify nursing costs into direct and indirect costs in order to refine the existing approaches and (3) argue that a system of billing nursing costs separately better reflects the costs of patient care.

  19. Transmission line capital costs

    SciTech Connect

    Hughes, K.R.; Brown, D.R.

    1995-05-01

    The displacement or deferral of conventional AC transmission line installation is a key benefit associated with several technologies being developed with the support of the U.S. Department of Energy`s Office of Energy Management (OEM). Previous benefits assessments conducted within OEM have been based on significantly different assumptions for the average cost per mile of AC transmission line. In response to this uncertainty, an investigation of transmission line capital cost data was initiated. The objective of this study was to develop a database for preparing preliminary estimates of transmission line costs. An extensive search of potential data sources identified databases maintained by the Bonneville Power Administration (BPA) and the Western Area Power Administration (WAPA) as superior sources of transmission line cost data. The BPA and WAPA data were adjusted to a common basis and combined together. The composite database covers voltage levels from 13.8 to 765 W, with cost estimates for a given voltage level varying depending on conductor size, tower material type, tower frame type, and number of circuits. Reported transmission line costs vary significantly, even for a given voltage level. This can usually be explained by variation in the design factors noted above and variation in environmental and land (right-of-way) costs, which are extremely site-specific. Cost estimates prepared from the composite database were compared to cost data collected by the Federal Energy Regulatory Commission (FERC) for investor-owned utilities from across the United States. The comparison was hampered because the only design specifications included with the FERC data were voltage level and line length. Working within this limitation, the FERC data were not found to differ significantly from the composite database. Therefore, the composite database was judged to be a reasonable proxy for estimating national average costs.

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

    PubMed Central

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

    2016-01-01

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

  1. 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.

  2. Strategic missile (Minuteman) operating and support cost factors

    NASA Astrophysics Data System (ADS)

    Eaton, M. W.

    1985-09-01

    The objective of this special study was to review the spectrum of available cost models and cost studies addressing strategic missiles, evaluate the elements of cost pertaining to operation and support, establish a comprehensive cost element structure to serve as both a standard or checklist in accomplishing cost estimates and the basis from which to develop Air Force cost factors. And finally, actually develop operations and support cost factors for Air Force strategic missiles and make them available to the cost community through publication in AFR 173-13. This paper was presented at the Annual DOD Cost Analysis Symposium.

  3. Costing and cost analysis in randomized controlled trials: caveat emptor.

    PubMed

    Polsky, Daniel; Glick, Henry

    2009-01-01

    This article provides an overview of the central issues regarding cost valuation and analysis for a decision maker's evaluation of costing performed within randomized controlled trials (RCTs). Costing involves specific choices for valuation and analysis that involve trade-offs. Understanding these choices and their implications is necessary for proper evaluation of how costs are valued and analyzed within an RCT and cannot be assessed through a checklist of adherence to general principles. Resource costing, the most common method of costing, involves measuring medical service use in study case report forms and translating this use into a cost by multiplying the number of units of each medical service by price weights for those services. A choice must be made as to how detailed the measurement of resources will be. Micro-costing improves the specificity of the cost estimate, but it is often impractical to precisely measure resources at this level and the price weights for these micro-units may not be available. Gross-costing may be more practical, and price weights are often easier to find and are more reliable, but important resource differences between treatment groups may be lost in the bundling of resources. Price weights can either be nationally determined or centre specific, but the appropriate price weight will depend on perspective, convenience, completeness and accuracy. Identifying the resource types and the appropriate price weights for these resources are the essential elements to an accurate valuation of costs. Once medical services are valued, the resulting individual patient cost estimates must be analysed. The difference in the mean cost between treatment groups is the important summary statistic for cost-effectiveness analysis from both the budgetary and the social perspectives. The statistical challenges with cost data typically stem from its skewed distribution and the resulting possibility that the sample mean may be inefficient and possibly

  4. 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

  5. 28 CFR 100.13 - Directly assignable costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., COMMUNICATIONS ASSISTANCE FOR LAW ENFORCEMENT ACT OF 1994 § 100.13 Directly assignable costs. (a) A cost is... projects, business units, or cost objectives of the carrier shall not be charged to the CALEA...

  6. 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.

  7. Cost-utility analysis.

    PubMed Central

    Robinson, R

    1993-01-01

    Decisions have to be made about allocating health resources. Currently the best economic evaluation method for doing this is cost-utility analysis. This compares the costs of different procedures with their outcomes measured in "utility based" units--that is, units that relate to a person's level of wellbeing. The most commonly used unit is the quality adjusted life year (QALY). QALYs are calculated by estimating the total life years gained from a procedure and weighting each year to reflect the quality of life in that year. To compare outcomes of different programmes the Rosser index is one measure that is widely used to assign quality of life scores to patients. Combined with a measure of life years gained from a procedure, this enables QALYs to be calculated and procedures ranked according to cost per QALY gained. In this article Ray Robinson explains the measures used and discusses how QALY league tables can be used to guide decisions on resource allocation. Images p862-a PMID:8401133

  8. 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)

  9. 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)

  10. 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)

  11. 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…

  12. 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…

  13. 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…

  14. 10 CFR 440.20 - Low-cost/no-cost weatherization activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Low-cost/no-cost weatherization activities. 440.20 Section 440.20 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION WEATHERIZATION ASSISTANCE FOR LOW-INCOME PERSONS § 440.20 Low-cost/no-cost weatherization activities. (a) An eligible dwelling unit may...

  15. Managing costs and managing care.

    PubMed

    Rivers, P A; Tsai, K L

    2001-01-01

    With a defined population served, contracted provider panels and the nature of care delivery integration, managed care has provided a solution, though not a panacea, to provide equitable services, standardized and prevention oriented cares to its enrolled members. Combined with the earmarked capitation reimbursement system and a series of cost containment and utilization review techniques, managed care has also demonstrated potently its capacity in cost-saving and quality promotion. Presents steps and measures related to managed care that federal government has taken to manage care and contain cost. It is crucial to identify and promulgate best practices continually, while managing utilization of resources for improving health care, containing cost, and equalizing medical care access to a greater proportion of the population. Concludes that it may take time for a universal adoption of managed care. However, Americans may actually benefit more from having a standard level of health care that managed care could achieve and provide.

  16. Introduction to Psychology and Leadership. Cost Effectiveness.

    ERIC Educational Resources Information Center

    Cole, James A.

    Westinghouse Learning Corporation's (WLC) cost and effectiveness experiences for the preparation of instructional units in the United States Naval Academy leadership course (see the final reports which summarize the course development project, EM 010 418, EM 010 419, and EM 010 484) are reported in this document. The cost collection system is…

  17. Cost Control

    ERIC Educational Resources Information Center

    Foreman, Phillip

    2009-01-01

    Education administrators involved in construction initiatives unanimously agree that when it comes to change orders, less is more. Change orders have a negative rippling effect of driving up building costs and producing expensive project delays that often interfere with school operations and schedules. Some change orders are initiated by schools…

  18. Actual 10-Year Survivors Following Resection of Adrenocortical Carcinoma

    PubMed Central

    Tran, Thuy B.; Postlewait, Lauren M.; Maithel, Shishir K.; Prescott, Jason D.; Wang, Tracy S.; Glenn, Jason; Phay, John E.; Keplinger, Kara; Fields, Ryan C.; Jin, Linda X.; Weber, Sharon M.; Salem, Ahmed; Sicklick, Jason K.; Gad, Shady; Yopp, Adam C.; Mansour, John C.; Duh, Quan-Yang; Seiser, Natalie; Solorzano, Carmen C.; Kiernan, Colleen M.; Votanopoulos, Konstantinos I.; Levine, Edward A.; Hatzaras, Ioannis; Shenoy, Rivfka; Pawlik, Timothy M.; Norton, Jeffrey A.; Poultsides, George A.

    2017-01-01

    Background Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options beyond surgical resection. The characteristics of actual long-term survivors following surgical resection for ACC have not been previously reported. Method Patients who underwent resection for ACC at one of 13 academic institutions participating in the US Adrenocortical Carcinoma Group from 1993 to 2014 were analyzed. Patients were stratified into four groups: early mortality (died within 2 years), late mortality (died within 2–5 years), actual 5-year survivor (survived at least 5 years), and actual 10-year survivor (survived at least 10 years). Patients with less than 5 years of follow-up were excluded. Results Among the 180 patients available for analysis, there were 49 actual 5-year survivors (27%) and 12 actual 10-year survivors (7%). Patients who experienced early mortality had higher rates of cortisol-secreting tumors, nodal metastasis, synchronous distant metastasis, and R1 or R2 resections (all P < 0.05). The need for multi-visceral resection, perioperative blood transfusion, and adjuvant therapy correlated with early mortality. However, nodal involvement, distant metastasis, and R1 resection did not preclude patients from becoming actual 10-year survivors. Ten of twelve actual 10-year survivors were women, and of the seven 10-year survivors who experienced disease recurrence, five had undergone repeat surgery to resect the recurrence. Conclusion Surgery for ACC can offer a 1 in 4 chance of actual 5-year survival and a 1 in 15 chance of actual 10-year survival. Long-term survival was often achieved with repeat resection for local or distant recurrence, further underscoring the important role of surgery in managing patients with ACC. PMID:27633419

  19. Statistical Cost Estimation in Higher Education: Some Alternatives.

    ERIC Educational Resources Information Center

    Brinkman, Paul T.; Niwa, Shelley

    Recent developments in econometrics that are relevant to the task of estimating costs in higher education are reviewed. The relative effectiveness of alternative statistical procedures for estimating costs are also tested. Statistical cost estimation involves three basic parts: a model, a data set, and an estimation procedure. Actual data are used…

  20. 48 CFR 1602.170-5 - Cost or pricing data.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for experience-rated carriers includes: (1) Information such as claims data; (2) Actual or negotiated...

  1. 48 CFR 1602.170-5 - Cost or pricing data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for experience-rated carriers includes: (1) Information such as claims data; (2) Actual or negotiated...

  2. 48 CFR 1602.170-5 - Cost or pricing data.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Cost or pricing data. 1602... Terms 1602.170-5 Cost or pricing data. (a) Experience-rated carriers. Cost or pricing data for experience-rated carriers includes: (1) Information such as claims data; (2) Actual or negotiated...

  3. The Health Care Costs of Violence against Women

    ERIC Educational Resources Information Center

    Kruse, Marie; Sorensen, Jan; Bronnum-Hansen, Henrik; Helweg-Larsen, Karin

    2011-01-01

    The aim of this study is to analyze the health care costs of violence against women. For the study, we used a register-based approach where we identified victims of violence and assessed their actual health care costs at individual level in a bottom-up analysis. Furthermore, we identified a reference population. We computed the attributable costs,…

  4. 14 CFR 1274.801 - Adjustments to performance costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... NASA's initial cost share or funding levels, detailed cost analysis techniques may be applied, which... (cash and/or in-kind contributions) by NASA and the recipient beyond the initial agreement may be needed. There may also be occasions where actual costs of NASA and the recipient may be less than...

  5. 14 CFR 1274.801 - Adjustments to performance costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... NASA's initial cost share or funding levels, detailed cost analysis techniques may be applied, which... (cash and/or in-kind contributions) by NASA and the recipient beyond the initial agreement may be needed. There may also be occasions where actual costs of NASA and the recipient may be less than...

  6. Launch Vehicle Production and Operations Cost Metrics

    NASA Technical Reports Server (NTRS)

    Watson, Michael D.; Neeley, James R.; Blackburn, Ruby F.

    2014-01-01

    Traditionally, launch vehicle cost has been evaluated based on $/Kg to orbit. This metric is calculated based on assumptions not typically met by a specific mission. These assumptions include the specified orbit whether Low Earth Orbit (LEO), Geostationary Earth Orbit (GEO), or both. The metric also assumes the payload utilizes the full lift mass of the launch vehicle, which is rarely true even with secondary payloads.1,2,3 Other approaches for cost metrics have been evaluated including unit cost of the launch vehicle and an approach to consider the full program production and operations costs.4 Unit cost considers the variable cost of the vehicle and the definition of variable costs are discussed. The full program production and operation costs include both the variable costs and the manufacturing base. This metric also distinguishes operations costs from production costs, including pre-flight operational testing. Operations costs also consider the costs of flight operations, including control center operation and maintenance. Each of these 3 cost metrics show different sensitivities to various aspects of launch vehicle cost drivers. The comparison of these metrics provides the strengths and weaknesses of each yielding an assessment useful for cost metric selection for launch vehicle programs.

  7. The Silver Lining in Rising Health Costs.

    ERIC Educational Resources Information Center

    McDowell, Don

    2001-01-01

    Discusses the emotional, financial, and structural reasons that health care costs in the United States, and therefore for colleges, continue to rise at staggering rates. Asserts that colleges must build health care cost reality into budget strategy, and level with constituents that there will not be a solution for the cost explosion any time soon.…

  8. Recession curbs gas pipeline construction costs

    SciTech Connect

    Morgan, J.M.

    1983-01-24

    This paper shows how after 5 yrs. of inflation, gas pipeline construction costs have finally felt the effects of a severe building recession. First quarter (1982) construction activity, compressor equipment and drive units, and high-pressure gas-station piping are discussed. Graphs of OGJ-Morgan composite gas pipeline cost, and gas pipeline cost component indexes are presented.

  9. Cost Accounting and Analysis for University Libraries.

    ERIC Educational Resources Information Center

    Leimkuhler, Ferdinand F.; Cooper, Michael D.

    The approach to library planning studied in this report is the use of accounting models to measure library costs and implement program budgets. A cost-flow model for a university library is developed and listed with historical data from the Berkeley General Library. Various comparisons of an exploratory nature are made of the unit costs for…

  10. Estimates of costs by DRG in Sydney teaching hospitals: an application of the Yale cost model.

    PubMed

    Palmer, G; Aisbett, C; Fetter, R; Winchester, L; Reid, B; Rigby, E

    1991-01-01

    The results are reported of a first round of costing by DRG in seven major teaching hospital sites in Sydney using the Yale cost model. These results, when compared between the hospitals and with values of relative costs by DRG from the United States, indicate that the cost modelling procedure has produced credible and potentially useful estimates of casemix costs. The rationale and underlying theory of cost modelling is explained, and the need for further work to improve the method of allocating costs to DRGs, and to improve the cost centre definitions currently used by the hospitals, is emphasised.

  11. Electrodermal responses to implied versus actual violence on television.

    PubMed

    Kalamas, A D; Gruber, M L

    1998-01-01

    The electrodermal response (EDR) of children watching a violent show was measured. Particular attention was paid to the type of violence (actual or implied) that prompted an EDR. In addition, the impact of the auditory component (sounds associated with violence) of the show was evaluated. Implied violent stimuli, such as the villain's face, elicited the strongest EDR. The elements that elicited the weakest responses were the actual violent stimuli, such as stabbing. The background noise and voices of the sound track enhanced the total number of EDRs. The results suggest that implied violence may elicit more fear (as measured by EDRs) than actual violence does and that sounds alone contribute significantly to the emotional response to television violence. One should not, therefore, categorically assume that a show with mostly actual violence evokes less fear than one with mostly implied violence.

  12. 40. Photocopy of plan of the Castillo c. 1779 (Actual ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    40. Photocopy of plan of the Castillo c. 1779 (Actual Negative 4'x5') STAR PLAN, COURTYARD FACADE PROFILE AND DEFENSIVE LINKS - Castillo de San Marcos, 1 Castillo Drive, Saint Augustine, St. Johns County, FL

  13. Actuarial and actual analysis of surgical results: empirical validation.

    PubMed

    Grunkemeier, G L; Anderson, R P; Starr, A

    2001-06-01

    This report validates the use of the Kaplan-Meier (actuarial) method of computing survival curves by comparing 12-year estimates published in 1978 with current assessments. It also contrasts cumulative incidence curves, referred to as "actual" analysis in the cardiac-related literature with Kaplan-Meier curves for thromboembolism and demonstrates that with the former estimate the percentage of events that will actually occur.

  14. Small-scale demonstration of high-level radioactive waste processing and solidification using actual SRP waste

    SciTech Connect

    Okeson, J K; Galloway, R M; Wilhite, E L; Woolsey, G B; B, Ferguson R

    1980-01-01

    A small-scale demonstration of the high-level radioactive waste solidification process by vitrification in borosilicate glass is being conducted using 5-6 liter batches of actual waste. Equipment performance and processing characteristics of the various unit operations in the process are reported and, where appropriate, are compared to large-scale results obtained with synthetic waste.

  15. 41 CFR 301-11.6 - Where do I find maximum per diem and actual expense rates?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES 11-PER...? Consult this table to find out where to access per diem rates for various types of Government travel: For travel in Rates set by For per diem and actual expense see (a) Continental United States (CONUS)...

  16. Recession holds quarterly pipeline building costs to less than 1%

    SciTech Connect

    Morgan, J.M.

    1983-02-21

    Pipeline construction costs for the first 6 months of 1982 were substantially retarded when material costs fell drastically. Discusses first half (1982) cost components; steel line pipe; rail freight rates; labor rates; pumping unit costs; and steel storage tanks. Presents graphs showing the OGJ-Morgan oil pipeline cost index and cost component indexes. Gives table which indicates that the total composite cost index for building oil pipelines increased a meager 0.97.

  17. Method and apparatus for distinguishing actual sparse events from sparse event false alarms

    DOEpatents

    Spalding, Richard E.; Grotbeck, Carter L.

    2000-01-01

    Remote sensing method and apparatus wherein sparse optical events are distinguished from false events. "Ghost" images of actual optical phenomena are generated using an optical beam splitter and optics configured to direct split beams to a single sensor or segmented sensor. True optical signals are distinguished from false signals or noise based on whether the ghost image is presence or absent. The invention obviates the need for dual sensor systems to effect a false target detection capability, thus significantly reducing system complexity and cost.

  18. Heliostat cost reduction study.

    SciTech Connect

    Jones, Scott A.; Lumia, Ronald. (University of New Mexico, Albuquerque, NM); Davenport, Roger (Science Applications International Corporation, San Diego, CA); Thomas, Robert C. (Advanced Thermal Systems, Centennial, CO); Gorman, David; Kolb, Gregory J.; Donnelly, Matthew W.

    2007-06-01

    Power towers are capable of producing solar-generated electricity and hydrogen on a large scale. Heliostats are the most important cost element of a solar power tower plant. Since they constitute {approx} 50% of the capital cost of the plant it is important to reduce heliostat cost as much as possible to improve the economic performance of power towers. In this study we evaluate current heliostat technology and estimate a price of $126/m{sup 2} given year-2006 materials and labor costs for a deployment of {approx}600 MW of power towers per year. This 2006 price yields electricity at $0.067/kWh and hydrogen at $3.20/kg. We propose research and development that should ultimately lead to a price as low as $90/m{sup 2}, which equates to $0.056/kWh and $2.75/kg H{sup 2}. Approximately 30 heliostat and manufacturing experts from the United States, Europe, and Australia contributed to the content of this report during two separate workshops conducted at the National Solar Thermal Test Facility.

  19. Solar energy systems cost

    SciTech Connect

    Lavender, J.A.

    1980-01-01

    Five major areas of work currently being pursued in the United States in solar energy which will have a significant impact on the world's energy situation in the future are addressed. The five significant areas discussed include a technical description of several solar technologies, current and projected cost of the selected solar systems, and cost methodologies which are under development. In addition, sensitivity considerations which are unique to solar energy systems and end user applications are included. A total of six solar technologies - biomass, photovoltaics, wind, ocean thermal energy conversion (OTEC), solar thermal, and industrial process heat (IPH) have been included in a brief technical description to present the variety of systems and their techncial status. System schematics have been included of systems which have been constructed, are currently in the detail design and test stage of development, or are of a conceptual nature.

  20. The social costs to the US of monopolization of the world oil market, 1972--1991

    SciTech Connect

    Greene, D.L.; Leiby, P.N.

    1993-03-01

    The partial monopolization of the world oil market by the OPEC cartel has produced significant economic costs to the economies of the world. This paper reports estimates of the costs of monopolization of oil to the US over the period 1972--1991. Two fundamental assumptions of the analysis are, (1) that OPEC has acted as a monopoly, albeit with limited control, knowledge, and ability to act and, (2) that the US and other consuming nations could, through collective (social) action affect the cartel's ability to act as a monopoly. We measure total costs by comparing actual costs for the 1972--1991 period to a hypothetical more competitive'' world oil market scenario. By measuring past costs we avoid the enormous uncertainties about the future course of the world oil market and leave to the reader's judgment the issue of how much the future will be like the past. We note that total cost numbers cannot be used to determine the value of reducing US oil use by one barrel. They are useful for describing the overall size of the petroleum problem and are one important factor in deciding how much effort should be devoted to solving it. Monopoly pricing of oil transfers wealth from US oil consumers to foreign oil producers and, by increasing theeconomic scarcity of oil, reduces the economy's potential to produce. The actions of the OPEC cartel have also produced oil price shocks, both upward and downward, that generate additional costs because of the economy's inherent inability to adjust quickly to a large change in energy prices. Estimated total costs to the United States from these three sources for the 1972--1991 period are put at $4.1 trillion in 1990$($1.2 T wealth transfer, $0.8 T macroeconomic adjustment costs, $2.1 T potential GNP losses). The cost of the US's primary oil supply contingency program is small ($10 B) by comparison.