Science.gov

Sample records for cost containment policies

  1. Multiple drug cost containment policies in Michigan's Medicaid program saved money overall, although some increased costs.

    PubMed

    Kibicho, Jennifer; Pinkerton, Steven D

    2012-04-01

    Michigan's Medicaid program implemented four cost containment policies--preferred drug lists, joint and multistate purchasing arrangements, and maximum allowable cost--during 2002-04. The goal was to control growth of drug spending for beneficiaries who were enrolled in both Medicaid and Medicare and taking antihypertensive or antihyperlipidemic prescription drugs. We analyzed the impact of each policy while holding the effect of all other policies constant. Preferred drug lists increased both preferred and generic drugs' market share and reduced daily cost--the cost per day for each prescription provided to a beneficiary. In contrast, the maximum allowable cost policy increased daily cost and was the only policy that did not generate cost savings. The joint and multistate arrangements did not affect daily cost. Despite these policy trade-offs, the cumulative effect was a 10 percent decrease in daily cost and a total cost savings of $46,195 per year. Our findings suggest that policy makers need to evaluate the impact of multiple policies aimed at restraining drug spending, and further evaluate the policy trade-offs, to ensure that scarce public dollars achieve the greatest return for money spent.

  2. Cost containment and the backdraft of competition policies.

    PubMed

    Light, D W

    2001-01-01

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

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

    ERIC Educational Resources Information Center

    McBain, Lesley

    2009-01-01

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

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

    PubMed

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

    2014-04-01

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

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

    PubMed

    Carrin, Guy; Hanvoravongchai, Piya

    2003-07-31

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

  6. Costs and cost containment in nursing homes.

    PubMed Central

    Smith, H L; Fottler, M D

    1981-01-01

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

  7. Containing Health Care Costs

    PubMed Central

    Derzon, Robert A.

    1980-01-01

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

  8. DRGs U.K. style: a comparison of U.K. and U.S. policies for hospital cost containment and their implications for health status.

    PubMed

    Birch, S

    1988-10-01

    Health care cost containment in the U.K. has been characterised by the imposition of cash limits on health and personal social services. More recently performance appraisal has been introduced. The U.S. approach, on the other hand, has linked both cost containment and implicit performance appraisal by funding hospital activities on a DRG basis. Under the U.K. approach there is an internal inconsistency between the funding of hospital activities, primarily determined by the characteristics of the served population, and the appraisal of hospital performance by reference to the use of resources in relation to national norms not necessarily corresponding to the characteristics of the served population. Under the U.S. approach performance is appraised implicitly, not by the use of real resources but by the cost to the hospital of the service provision for each individual patient. Consequently the incentive is to minimise the cost of the service provision regardless of the output produced. The incentives, in both the U.K. and the U.S. approach, generate similar effects: an off-loading of responsibility for service provision at the margin onto other sectors of the health care system. They are the response to the incentive to minimise the costs incurred by the hospital in providing services to the patient. Until greater attention in paid to the monitoring of the outcomes achieved by all sectors of the health care system, and to the incentives generated to shift demands between the sectors, the respective policies will continue to be successful simply in controlling the resource cost of the hospital system.

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

    SciTech Connect

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

    2011-06-01

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

  10. Containing health costs in the Americas.

    PubMed

    Márquez, P

    1990-01-01

    In recent years, a series of policy measures affecting both demand and supply components of health care have been adopted in different Latin American and Caribbean countries, as well as in Canada and the United States. In applying these measures various objectives have been pursued, among them: to mobilize additional resources to increase operating budgets; to reduce unnecessary utilization of health services and consumption of pharmaceuticals; to control increasing production costs; and to contain the escalation of health care expenditures. In terms of demand management, some countries have established cost-recovery programmes in an attempt to offset declining revenues. These measures have the potential to generate additional operating income in public facilities, particularly if charges are levied on hospital care. However, only scant information is available on the effects of user charges on demand, utilization, or unit costs. In terms of supply management, corrective measures have concentrated on limiting the quantity and the relative prices of different inputs and outputs. Hiring freezes, salary caps, limitations on new construction and equipment, use of drug lists, bulk procurement of medicines and vaccines, and budget ceilings are among the measures utilized to control production costs in the health sector. To moderate health care expenditures, various approaches have been followed to subject providers to 'financial discipline'. Among them, new reimbursement modalities such as prospective payment systems offer an array of incentives to modify medical practice. Cost-containment efforts have also spawned innovations in the organization and delivery of health services. Group plans have been established on the basis of prepaid premiums to provide directly much or all health care needs of affiliates and their families. The issue of intrasectorial co-ordination, particularly between ministries of health and social security institutions, has much relevance for cost

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

    SciTech Connect

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

    2011-06-01

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

  12. Personnel administration can act on cost containment.

    PubMed

    Adams, J

    1980-01-01

    Hosiptal personnel administration programs have the potential to contain costs in a variety of areas, including human resources management, payroll costs, benefits costs, labor turnover, and recruitment costs. Recognizing this, the Maine Society for Hospital Personnel Administration presented a seminar and prepared a guide for trustees and administrators on the role that personnel administration can play in the Voluntary Effort to contain costs. The following article is an adaptation of the information included in the seminar and guide.

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

    SciTech Connect

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

    2003-05-09

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

  14. Orbital Debris: Cost Impact on Setting Policy.

    DTIC Science & Technology

    1996-06-01

    As the exploration of space increases, the problems associated with orbital debris also increase. 0rbital debris continues to grow at a linear rate...and at worst, unusable. When mitigating orbital debris , cost and policy issues must be addressed. Currently no policy exists that makes the mitigation...of orbital debris mandatory but it only strongly recommends mitigation as long as it is cost effective. This thesis addresses the cost impact of

  15. Valuation effects of health cost containment measures.

    PubMed

    Strange, M L; Ezzell, J R

    2000-01-01

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

  16. Space Planning: A Basis for Cost Containment.

    ERIC Educational Resources Information Center

    Snyder, Fred A.; And Others

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

  17. A team approach to cost containment.

    PubMed

    Williams, Jeni

    2008-04-01

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

  18. Cost reductions from a smoking policy.

    PubMed

    Nixon, J C; West, J F

    1989-03-01

    The health of its workforce is of paramount importance to a business. The loss of even one key person to heart and lung disease can have a detrimental effect on organizational efficiency. Provided strides similar to those made in the last five years continue, perhaps within the next five years major employers will have all work areas smoke free. In large cities considerable help in implementing a nonsmoking policy is available to employers. Individual companies need to consider the merits of each type of program and then decide which best fits the organization. Compared with a nonsmoker, the average employed smoker in the United States 1. Takes approximately 50% more sick leave 2. Uses the health care system at least 50% more 3. Suffers over twice the mortality rate during working years 4. Spends 6% of working hours smoking 5. Causes indoor work facilities to expend six times the capital and operating outlays to maintain air circulation rates that meet building code specifications 6. Imposes a much greater maintenance burden for cleaning, repairing, repainting and replacing furnishings and equipment 7. Imposes unnecessary costly liability on employers for damages sustained by co-workers who are forced to work in a smoky environment 8. Exacts a high price in employee morale because of the irritation and discomfort suffered by fellow workers.

  19. The Remainder of the Cost Sharing Policy Agenda.

    ERIC Educational Resources Information Center

    Feller, Irwin

    2000-01-01

    Identifies issues not addressed by the National Science and Technology Council and the National Science Foundation in recent policy initiatives dealing with federal cost-sharing policies and practices within the research community. These include establishment of differential cost-sharing requirements for universities and states that traditionally…

  20. The costs of future polio risk management policies.

    PubMed

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

    2006-12-01

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

  1. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...., manufacturing process, gum type), thereby establishing a baseline for cost comparison purposes. The... 39 Postal Service 1 2011-07-01 2011-07-01 false Cost offset policy. 551.8 Section 551.8 Postal Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS SEMIPOSTAL STAMP PROGRAM § 551.8 Cost offset...

  2. The disease management approach to cost containment.

    PubMed

    Goldstein, R

    1998-01-01

    Disease management has been around a long time, certainly since Pasteur. Its initial focus was to eliminate or contain epidemics. In the 20th century, American public health scientists and officials have used disease management to address a high-risk, often poor population. Currently, the population-based principles of disease management, including disease prevention activities, are being applied to noninfectious diseases. Two examples of public health disease prevention strategies are vaccinations and chlorination of water. Hospitals are now providing post-hospital disease management programs for selected chronic conditions that account for a high volume of repeat admissions or emergency department visits, such as chronic heart failure, asthma, and cancer. In other words, hospitals are spending money on a program that, if done right, will reduce their inpatient revenues. They are doing so for various reasons (e.g., because they have established at-risk financial partnerships with their physicians, or possibly because other area hospitals are doing it, or possibly because they want to keep the ancillaries [x-rays, laboratory, pharmacy, ambulatory surgery, etc]). Regardless of the reasons, hospital case managers will be charged with referring qualified patients to both hospital-based and provider-based disease management programs.

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

    PubMed Central

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

    2004-01-01

    OBJECTIVE: An analysis was conducted to estimate the costs of different potential post-polio certification immunization policies currently under consideration, with the objective of providing this information to policy-makers. METHODS: We analyzed three global policy options: continued use of oral poliovirus vaccine (OPV); OPV cessation with optional inactivated poliovirus vaccine (IPV); and OPV cessation with universal IPV. Assumptions were made on future immunization policy decisions taken by low-, middle-, and high-income countries. We estimated the financial costs of each immunization policy, the number of vaccine-associated paralytic poliomyelitis (VAPP) cases, and the global costs of maintaining an outbreak response capacity. The financial costs of each immunization policy were based on estimates of the cost of polio vaccine, its administration, and coverage projections. The costs of maintaining outbreak response capacity include those associated with developing and maintaining a vaccine stockpile in addition to laboratory and epidemiological surveillance. We used the period 2005-20 as the time frame for the analysis. FINDINGS: OPV cessation with optional IPV, at an estimated cost of US$ 20,412 million, was the least costly option. The global cost of outbreak response capacity was estimated to be US$ 1320 million during 2005-20. The policy option continued use of OPV resulted in the highest number of VAPP cases. OPV cessation with universal IPV had the highest financial costs, but it also had the least number of VAPP cases. Sensitivity analyses showed that global costs were sensitive to assumptions on the cost of the vaccine. Analysis also showed that if the price per dose of IPV was reduced to US$ 0.50 for low-income countries, the cost of OPV cessation with universal IPV would be the same as the costs of continued use of OPV. CONCLUSION: Projections on the vaccine price per dose and future coverage rates were major drivers of the global costs of post

  4. Containment: Concept and Policy. Volume 1

    DTIC Science & Technology

    1986-01-01

    34contain" one another. For "con- tainment" was just another way of talking about restoring a bal- ance of power in the world, and that idea would surely...side but because of the compul- sions, the suspicions, the anxieties such a competition engen - ders, and because of the very serious dangers it carries...ronment as a support system for civilized living. And finally, there is much in our own life, here in this country, that needs early containment. It

  5. Costs of Juvenile Violence: Policy Implications.

    ERIC Educational Resources Information Center

    Miller, Ted; Fisher, Deborah A.; Cohen, Mark A.

    2001-01-01

    Investigated the magnitude of juvenile violence in Pennsylvania in terms of victimization and perpetration. Used archival data on violent crimes in Pennsylvania during 1993 to develop cost estimates reflecting the costs incurred by society for both victims and perpetrators. Overall, violence against children and adolescents proved to be a much…

  6. Warranty Policies: Consumer Value Versus Manufacturer Costs.

    DTIC Science & Technology

    1981-04-28

    customer pro rata (from the Latin word for propor- tional). Two generalizations of the pro rata warianty have appeared recently on the market . The...the fact that from a marketing point of view both generalizations are typically per- ceived as equivalent (by the average consumer), has led to the...policies without the use of renewal theory. Most of these deal with demand functions and market places. Glickman and Berger, for instance, consider

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

    PubMed

    Friedman, E

    1978-09-01

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

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

    PubMed

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

    2013-01-01

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... SECURITY Federal Emergency Management Agency Environmental Planning and Historic Preservation Compliance Costs Policy; Environmental Planning and Historic Preservation Mitigation Policy AGENCY: Federal... Preservation Compliance Costs policy and a draft Environmental Planning and Historic Preservation...

  10. Cost-effectiveness of breast cancer screening policies using simulation.

    PubMed

    Gocgun, Y; Banjevic, D; Taghipour, S; Montgomery, N; Harvey, B J; Jardine, A K S; Miller, A B

    2015-08-01

    In this paper, we study breast cancer screening policies using computer simulation. We developed a multi-state Markov model for breast cancer progression, considering both the screening and treatment stages of breast cancer. The parameters of our model were estimated through data from the Canadian National Breast Cancer Screening Study as well as data in the relevant literature. Using computer simulation, we evaluated various screening policies to study the impact of mammography screening for age-based subpopulations in Canada. We also performed sensitivity analysis to examine the impact of certain parameters on number of deaths and total costs. The analysis comparing screening policies reveals that a policy in which women belonging to the 40-49 age group are not screened, whereas those belonging to the 50-59 and 60-69 age groups are screened once every 5 years, outperforms others with respect to cost per life saved. Our analysis also indicates that increasing the screening frequencies for the 50-59 and 60-69 age groups decrease mortality, and that the average number of deaths generally decreases with an increase in screening frequency. We found that screening annually for all age groups is associated with the highest costs per life saved. Our analysis thus reveals that cost per life saved increases with an increase in screening frequency.

  11. Disease management. A global cost-containing initiative?

    PubMed

    Bloor, K; Maynard, A

    2000-06-01

    Disease management has been marketed by healthcare industry providers as a way of improving resource allocation in healthcare and containing costs. However, to achieve improved efficiency in healthcare requires the guidelines and protocols in the disease management process to be based on sound evidence of effectiveness and cost effectiveness. This has not always been the case. The approach itself has an inadequate evidence base in terms of randomised controlled trials, other rigorous methods of evaluation and the results of economic evaluation. Disease management can be viewed as an attempt by pharmaceutical companies to undertake forward vertical integration into other parts of the healthcare process. This could reduce uncertainty for purchasers and reduce transaction costs, thereby potentially facilitating both healthcare expenditure control and efficiency. However, such cost savings may be outweighed by a concentration of power in disease management (pharmaceutical) companies, and the exploitation of such power to inflate expenditure and misallocate resources. Disease management must be appraised with care.

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

    PubMed Central

    Richardson, Jeff RJ

    2005-01-01

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

  13. Toward strategies for cost containment in surgical patients.

    PubMed Central

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

    1983-01-01

    The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital costs. In 1980, 3935 patients at Strong Memorial Hospital (SMH) had at least one contact with a general surgical patient care or intensive care unit; 261 patients (6.6%) had total 1980 charges of more than $20,000 each. They contributed 32% of the total of both general surgical charges and patient days. A subset of 2021 patients was selected to represent more precisely the general surgical patient. The 85 high-cost patients (4.2%) of this subset were chosen for intensive study. These patients generated a significant and disproportionate per cent of total (2021) general surgical charges (26.8%) and hospital days (27.6%). Average total charges were more than 8 times those of the complementary general surgical subset (1936). Nineteen of the 85 patients (22.3%) died in the hospital and 42 patients (49.4%) were dead within 2 1/2 years. Forty patients (of the 85) were then further identified as "complex", based on multiple, usually unrelated, illnesses and multiple annual admissions. Tending to be elderly with poor prognoses, 60% of them had died by April 1983. The major criterion of complexity was the lack of a well-focused medical problem; the cure for one problem simply relinquished primacy to another. A parallel study of hospital ancillary procedures disclosed a similar high-cost pattern. Of approximately 4000 ancillary procedures, 100 (2.5%) had annual charges of $100,000 or over, accounting for two-thirds of total 1980 ancillary charges. Roughly 20% of a single patient's ordered procedures accounted for 80% of the patient's ancillary charges, thus allowing concentrated study of a relatively small number of charges. Means for cost containment may be

  14. 76 FR 60357 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... derived from 41 U.S.C. 1501. Cost Accounting Standards are rules governing the measurement, assignment... and 48 CFR Ch. 1 Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting... Procurement Policy (OFPP) Policy Letters, and Cost Accounting Standards Board (CASB) Cost Accounting...

  15. National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis with Policy Implications

    PubMed Central

    Harris, Catherine R.; Osterberg, E. Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W.; McAninch, Jack W.; McCulloch, Charles E.; Breyer, Benjamin N.

    2016-01-01

    Objective To determine which factors are associated with higher urethroplasty procedural costs and whether they have been increasing or decreasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality. Materials and Methods We conducted a retrospective analysis using the 2001–2010 Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP Cost-to-Charge Ratio. Log cost linear regression with sensitivity analysis was used to determine variables associated with increased costs. Extreme cost was defined as the top 20th percentile of expenditure, analyzed with logistic regression and expressed as Odds Ratios (OR). Results A total of 2298 urethroplasties were recorded in NIS over the study period. The median (interquartile range) calculated costs was $7321 ($5677–$10000). Patients with multiple comorbid conditions were associated with extreme costs (OR 1.56 95% CI 1.19–2.04, p=0.02) compared to patients with no comorbid disease. Inpatient complications raised the odds of extreme costs OR 3.2 CI 2.14–4.75, p<0.001). Graft urethroplasties were associated with extreme costs (OR 1.78 95% CI 1.2–2.64, p=0.005). Variation in patient age, race, hospital region, bed size, teaching status, payer type, and volume of urethroplasty cases were not associated with extremes of cost. Conclusion Cost variation for perioperative inpatient urethroplasty procedures is dependent on preoperative patient comorbidities, postoperative complications and surgical complexity related to graft usage. Procedural cost and cost variation are critical for understanding which aspects of care have the greatest impact on cost. PMID:27107626

  16. Evaluation of APACHE II for cost containment and quality assurance.

    PubMed Central

    Civetta, J M; Hudson-Civetta, J A; Nelson, L D

    1990-01-01

    APACHE II (an acronym formed from acute physiology score and chronic health evaluation) has been proposed to limit intensive care unit (ICU) admissions ('cost containment') and to judge outcome ('quality assurance') of surgical patients. To judge its performance, a 6-month study of 372 surgical ICU patients was performed. When patients were divided by mean duration of stay, mortality rates rose from 1% (short stay) to 19% (long stay) (p less than 0.001) for patients with APACHE II scores less than 10, but decreased from 94% (short stay) to 60% (long stay) (p less than 0.01) for patients with APACHE II scores more than 24. Exclusion of patients by high or low APACHE scores would 'save' 6% of ICU days but risk increasing morbidity, hospital costs, and deaths. Grouped APACHE II scores did not correlate with total hospital charges (r = 0.05, p = 0.89) or ICU days used (r = 0.42, p = 0.17). Grouping by APACHE II score and duration of ICU stay showed neither symmetry nor uniformity of mortality rates. Surgical patients would not be well served by APACHE II for quality assurance or cost containment. PMID:2396881

  17. Cost awareness and cost containment at the Hospital for Special Surgery. Strategies and total hip replacement cost centers.

    PubMed

    Levine, D B; Cole, B J; Rodeo, S A

    1995-02-01

    To help balance the operating budget of The Hospital for Special Surgery, which was encountering an annual major deficit of $4 million in 1989, a program of cost awareness leading to cost containment was instituted in 1990. Costs of supplies, implants, and equipment were identified and reviewed by the hospital staff, including orthopaedic surgeons, orthopaedic residents, health care personnel, and administration, for cost effectiveness. Methods to accomplish the goals included structuring committees for information; workshops organized by different services to affect change; feedback to health care professionals through posters and newsletters; and statistical identification for continued education. Major cost savings resulted from recycling wasted implants, reduction of costly implants, and reduction of unnecessary supplies. As a result, vendors had been challenged, leading to more competitive prices. This program has opened new avenues of cost reduction without sacrificing quality of medical care and has contributed to a breakdown of barriers between medical staff, administration, and finance, leading to a strong hospital-team commitment. The price of health care in the United States in 1993 exceeded $900 billion. Health care expenditures now account for approximately 14% of the gross domestic product. Health care costs have been rising faster than the inflation rate for more than a decade. The result is the current national focus on containment of health care expenditures.

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

    PubMed

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

    2005-11-15

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

  19. Japan's health care system: containing costs and attempting reform.

    PubMed

    Ikegami, Naoki; Campbell, John Creighton

    2004-01-01

    As Japan's economy declined, more intensive control of prices and even volume through the fee schedule, plus increases in various copayment rates, led to an actual reduction of medical spending in 2002 for the first time in history. To augment established mechanisms of cost containment, case-mix-based inclusive fees for inpatient care were introduced in university hospitals in 2003 and are planned for subacute and long-term care. However, substantial reform, including the introduction of market-based medicine, is not likely to occur in other areas. Progress in making the delivery system more accountable to patients has been meaningful but slow.

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

    PubMed Central

    Jensen, Jørgen D; Smed, Sinne

    2007-01-01

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

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

    PubMed

    Jensen, Jørgen D; Smed, Sinne

    2007-04-04

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

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

    SciTech Connect

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

    2011-03-01

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

  3. Administration knowledge of economic costs of foreign policy export controls

    SciTech Connect

    Not Available

    1983-09-02

    The Export Administration Act of 1979 requires consultation, as appropriate, with businesses affected by proposed controls and consideration of the controls economic impact. GAO found that although there was minimal formal business consultation, the business community and the Commerce and State Departments did provide decision-makers with the essential economic arguments against the use of export controls. Administration economic analyses usually did not provide estimates of the controls indirect effects, but important limits exist to Commerce's ability to better quantify such economic costs. GAO's review does not support the conclusion that the administration might have acted differently had it been aware of the total economic costs, and it shifts the debate back to the usefulness of such foreign policy controls.

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

    PubMed Central

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

    1985-01-01

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

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

    PubMed

    Huff-Rousselle, M; Burnett, F

    1996-01-01

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

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

    PubMed

    Carr, Edward W; Corbett, James J

    2015-08-18

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-04-01

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

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

    ERIC Educational Resources Information Center

    Ngolovoi, Mary S.

    2010-01-01

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

  10. Future European health care: cost containment, health care reform and scientific progress in drug research.

    PubMed

    Emilien, G

    1997-01-01

    The cost of the development of a new pharmaceutical product from its conception and synthesis through to the regulatory approval process has more than quadrupled in the last 20 years. Both clinical and total development times have increased substantially. To amortize the costs incurred, the pharmaceutical industry has taken an international dimension. The incentives for pharmaceutical firms to discover and develop new drugs depend on the length of the development and regulatory review process plus the potential market size. Recent regulatory, economic and political changes may have significant implications for the future of new drug developments in Europe. The European Union industrial policy felt that there is a need for convergence in the area of pricing. It is recommended that the policy should aim to contain growth in pharmaceutical expenses by means specific to reimbursement rather than direct price controls. By encouraging doctors to prescribe and customers to use generics, competition is enhanced to bring down drug prices. More emphasis is being laid by government in educating customers to cost-awareness and cost-benefit ratios with regard to pharmaceuticals. Concerning clinical trials, European harmonization has been achieved by significant developments: the rights and integrity of the trial subjects are protected; the credibility of the data is established; and the ethical, scientific and technical quality of the trials has improved. Future European health care forecasts a whole change in the pharmaceutical business. Important issues in cost and outcome measurement should be carefully planned and considered in drug development. Due to important mergers and acquisitions, the pharmaceutical sector will consist mainly of important multinational corporations. In this way, valuable new products may be brought to the market.

  11. Medical education, cost and policy: what are the drivers for change? Commentary.

    PubMed

    Walsh, Kieran

    2014-01-01

    Medical education is expensive. Its expense has led many stakeholders to speculate on how costs could be reduced. In an ideal world such decisions would be made on sound evidence; however this is impossible in the absence of evidence. Sometimes practice will be informed by policy, but policy will not always be evidence based. So how is policy in the field of cost and value in medical education actually developed? The foremost influence on policy in cost and value should be evidence-based knowledge. Unfortunately policy is sometimes influenced by what might at best be termed tradition and at worst inertia. Another influence on policy will be people--but some individuals may have more influence than others. A further influence on policy in this field is events, and mainly events that have gone wrong. One final influence on emerging policy in medical education cost analysis is that of the media.

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

    ERIC Educational Resources Information Center

    Stasica, Edward R.

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

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

    PubMed

    Shaw, S T; Miller, J M

    1985-12-01

    Hospital laboratories and hospital-independent reference laboratories will need to change in order to provide comprehensive, medically appropriate, and reasonably priced laboratory services in the cost-containment age we are entering. The change must be economically and technologically innovative and relevant to society's next generation of health care needs. Hospital laboratories and commercial laboratories may become weaker or stronger relative to one another, but our guess is that they will ultimately become more like one another or even may join forces to provide optimal patient care in the future. Until that time comes, hospital laboratories must decide whether to employ reference laboratory services more or less, enter a joint venture with a reference laboratory, or become a reference laboratory. Some of the items that could be considered in arriving at this decision are listed in Table 2. Some items favor hospital laboratories; some favor reference laboratories; some are a toss-up; and some suggest there are advantages in a team approach. For the present, we believe there are many arguments favoring a continuation and possibly even an expansion of hospital laboratory services, but this will likely be most feasible in financially sound and progressive hospitals having forward-looking administrators and imaginative but fiscally minded laboratory directors and managers. If decisions are made to send more tests to reference laboratories, each hospital or user laboratory must seek the best and most cost-effective services available. Various financial, technical, and medical considerations are described that should aid in the evaluation of where to have tests performed. We have provided suggestions on how agreements with reference laboratories can be established in either a formal (contractual) or an informal (verbal) way. Additionally, we have described methods for evaluating (or monitoring) the quality and quantity of services received from a reference

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

    PubMed

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

    2014-07-01

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

  15. 75 FR 34448 - Proposed CERCLA Administrative Cost Recovery Settlement; Great Lakes Container Corporation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

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

  16. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... differential revenue include, but are not limited to, the following: (1) Packaging costs in excess of the cost... with the withdrawal of the stamp issue from sale; (7) Costs associated with the destruction of...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  1. 42 CFR 100.2 - Average cost of a health insurance policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  2. 75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... SECURITY Federal Emergency Management Agency Recovery Policy, RP9525.7, Labor Costs--Emergency Work AGENCY...: The Federal Emergency Management Agency (FEMA) is accepting comments on RP9525.7, Labor Costs... policies are up to date, incorporate lessons learned and are consistent with current laws and...

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

    NASA Technical Reports Server (NTRS)

    Stone, Barbara A.

    1984-01-01

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

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

    ERIC Educational Resources Information Center

    Turk, Frederick J.

    1992-01-01

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

  5. Department of Defense Environmental Cleanup Cost Allowability Policy.

    DTIC Science & Technology

    1994-12-01

    with the Burbank facility would violate current cost accounting standards. [Ref. 47:p. 31] In 1992, Lockheed began negotiating with its insurers for...principle must restate both the credit requirement and the pursuit of insurance recovery. 3. Cost Accounting Standards The current Cost Accounting Standards

  6. The High Cost of Teacher Turnover. Policy Brief

    ERIC Educational Resources Information Center

    National Commission on Teaching and America's Future, 2007

    2007-01-01

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

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

    PubMed

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

    2015-11-25

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

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

    PubMed Central

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

    2015-01-01

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

  9. Identifying cost-effective dynamic policies to control epidemics.

    PubMed

    Yaesoubi, Reza; Cohen, Ted

    2016-12-10

    We describe a mathematical decision model for identifying dynamic health policies for controlling epidemics. These dynamic policies aim to select the best current intervention based on accumulating epidemic data and the availability of resources at each decision point. We propose an algorithm to approximate dynamic policies that optimize the population's net health benefit, a performance measure which accounts for both health and monetary outcomes. We further illustrate how dynamic policies can be defined and optimized for the control of a novel viral pathogen, where a policy maker must decide (i) when to employ or lift a transmission-reducing intervention (e.g. school closure) and (ii) how to prioritize population members for vaccination when a limited quantity of vaccines first become available. Within the context of this application, we demonstrate that dynamic policies can produce higher net health benefit than more commonly described static policies that specify a pre-determined sequence of interventions to employ throughout epidemics. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Environmental cost-effectiveness analysis in intertemporal natural resource policy: evaluation of selective fishing gear.

    PubMed

    Kronbak, Lone Grønbæk; Vestergaard, Niels

    2013-12-15

    In most decision-making involving natural resources, the achievements of a given policy (e.g., improved ecosystem or biodiversity) are rather difficult to measure in monetary units. To address this problem, the current paper develops an environmental cost-effectiveness analysis (ECEA) to include intangible benefits in intertemporal natural resource problems. This approach can assist managers in prioritizing management actions as least cost solutions to achieve quantitative policy targets. The ECEA framework is applied to a selective gear policy case in Danish mixed trawl fisheries in Kattegat and Skagerrak. The empirical analysis demonstrates how a policy with large negative net benefits might be justified if the intangible benefits are included.

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

    PubMed

    Martin, B G

    1985-12-01

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

  12. 24 CFR 891.670 - Cost containment and modest design standards.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Cost containment and modest design... Handicapped Families and Individuals-Section 162 Assistance § 891.670 Cost containment and modest design standards. (a) Restrictions on amenities. Projects must be modest in design. Except as provided in...

  13. 39 CFR 551.8 - Cost offset policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... incurred for stamps having similar sales; physical characteristics; and marketing, promotional, and public... to equipment; (4) Costs of developing and executing marketing and promotional plans in excess of the... distribution; (4) Estimated training costs for field staff, except for special training associated...

  14. Providing Medical Services to Undocumented Immigrants: Costs and Public Policy.

    ERIC Educational Resources Information Center

    Arnold, Fred

    1979-01-01

    Reviews cost estimates for treating illegal aliens made by hospitals and county governments. Discusses patterns of utilization of health services by illegal immigrant groups and the difficulties in arriving at accurate cost estimates. Describes the current status of legislative programs that address this issue. (Author/GC)

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

    ERIC Educational Resources Information Center

    Viadero, Debra

    2008-01-01

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

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

    PubMed Central

    Fairchild, A L; Tynan, E A

    1994-01-01

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

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

    PubMed

    Fairchild, A L; Tynan, E A

    1994-12-01

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

  18. Costs and benefits of the MRSA Search and Destroy policy in a Dutch hospital.

    PubMed

    van Rijen, M M L; Kluytmans, J A J W

    2009-10-01

    The objective of this study was to determine the costs and benefits of the MRSA Search and Destroy policy in a Dutch hospital during 2001 through 2006. Variable costs included costs for isolation, contact tracing, treatment of carriers and closure of wards. Fixed costs were the costs for the building of isolation rooms and the salary of one full-time infection control practitioner. To determine the benefits of the Search and Destroy policy, the transmission rate during the study period was calculated. Furthermore, the number of cases of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia prevented was estimated, as well as its associated prevented costs and patient lives. The costs of the MRSA policy were estimated to be euro 215,559 a year, which equals euro 5.54 per admission. The daily isolation costs for MRSA-suspected and -positive hospitalised patients were euro 95.59 and euro 436.62, respectively. Application of the Search and Destroy policy resulted in a transmission rate of 0.30 and was estimated to prevent 36 cases of MRSA bacteraemia per year, resulting in annual savings of euro 427,356 for the hospital and ten lives per year (95% confidence interval [CI] 8-14). In conclusion, application of the MRSA Search and Destroy policy in a hospital in a country with a low endemic MRSA incidence saves money and lives.

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

    PubMed

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

    2009-01-01

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

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

    SciTech Connect

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

    2012-02-28

    Power through Policy: 'Best Practices' for Cost-Effective Distributed Wind is a U.S. Department of Energy (DOE)-funded project to identify distributed wind technology policy best practices and to help policymakers, utilities, advocates, and consumers examine their effectiveness using a pro forma model. Incorporating a customized feed from the Database of State Incentives for Renewables and Efficiency (DSIRE), the Web-based Distributed Wind Policy Comparison Tool (Policy Tool) is designed to assist state, local, and utility officials in understanding the financial impacts of different policy options to help reduce the cost of distributed wind technologies. The project's final products include the Distributed Wind Policy Comparison Tool, found at www.windpolicytool.org, and its accompanying documentation: Distributed Wind Policy Comparison Tool Guidebook: User Instructions, Assumptions, and Case Studies. With only two initial user inputs required, the Policy Tool allows users to adjust and test a wide range of policy-related variables through a user-friendly dashboard interface with slider bars. The Policy Tool is populated with a variety of financial variables, including turbine costs, electricity rates, policies, and financial incentives; economic variables including discount and escalation rates; as well as technical variables that impact electricity production, such as turbine power curves and wind speed. The Policy Tool allows users to change many of the variables, including the policies, to gauge the expected impacts that various policy combinations could have on the cost of energy (COE), net present value (NPV), internal rate of return (IRR), and the simple payback of distributed wind projects ranging in size from 2.4 kilowatts (kW) to 100 kW. The project conducted case studies to demonstrate how the Policy Tool can provide insights into 'what if' scenarios and also allow the current status of incentives to be examined or defended when necessary. The ranking

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

    ERIC Educational Resources Information Center

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

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

  2. Cost justification of filmless PACS and national policy

    NASA Astrophysics Data System (ADS)

    Lim, Jae H.

    2002-05-01

    The expense of installing PACS is high so most Korean hospitals cannot afford to purchase the system easily. We can justify the cost of PACS by considering the visible and invisible benefits. As a visible benefit we can save the cost of films and equipments for film processing. Invisible benefits of PACS is the cost of film handling. Generally, doctors spend some 25 minutes in handling X-ray films everyday and they spend 10 days (84 hours) throughout a year. Radiology technicians, nurses, orderlies and clerks also handle films and the total salary for handling films by doctors and paramedics will be considerable. Considering the visible and invisible benefits, cost of PACS is justified and PACS can be installed in every hospital, whatever their size. The Korean Society of PACS tried to make reimbursement of the cost of PACS and persuaded the government officers and eventually the Ministry of Health and Welfare decided to reimburse the use of PACS in hospitals. Based on the money reimbursed, general hospitals or university hospitals will earn enough money to purchase a PACS in 3 - 5 years. After the Korean government started to reimburse the cost of PACS, many hospitals wanted to install PACS and the number of hospitals installing PACS is soaring.

  3. Secondary Containment for Underground Storage Tank Systems - 2005 Energy Policy Act

    EPA Pesticide Factsheets

    These grant guidelines implement the secondary containment provision in Section 9003(i)(1) of the Solid Waste Disposal Act, enacted by the Underground Storage Tank Compliance Act, part of the Energy Policy Act of 2005.

  4. Health care cost containment in Denmark and Norway: a question of relative professional status?

    PubMed

    Andersen, Lotte B

    2014-04-01

    The demand for publicly subsidized health care services is insatiable, but the costs can be contained in different ways: formal rules can limit access to and the number of subsidized services, demand and supply can be regulated through the price mechanism, the relevant profession can contain the costs through state-sanctioned self-regulation, and other professions can contain the costs (e.g. through referrals). The use of these cost containment measures varies between countries, depending on demand and supply factors, but the relative professional status of the health professions may help explain why different countries use cost containment measures differently for different services. This article compares cost containment measures in Denmark and Norway because these countries vary with regard to the professional status of the medical profession relative to other health care providers, while other relevant variables are approximately similar. The investigation is based on formal agreements and rules, historical documents, existing analyses and an analysis of 360 newspaper articles. It shows that high relative professional status seems to help professions to avoid user fees, steer clear of regulation from other professions and regulate the services produced by others. This implies that relative professional status should be taken into consideration in analyses of health care cost containment.

  5. Policies with Varying Costs and Benefits: A Land Conservation Classroom Game

    ERIC Educational Resources Information Center

    Dissanayake, Sahan T. M.; Jacobson, Sarah A.

    2016-01-01

    Some policies try to maximize net benefits by targeting different individuals to participate. This is difficult when costs and benefits of participation vary independently, such as in land conservation. The authors share a classroom game that explores cases in which minimizing costs may not maximize benefits and vice versa. The game is a…

  6. The role of the workplace in the production and containment of health costs: the case of stress-related disorders.

    PubMed

    Shain, M

    1999-01-01

    Workplaces vary enormously in the amount of harmful stress they produce, even within specific economic sectors. Stress of certain kinds and at certain levels tend to produce health harms and costs that are borne not only by individual employees and employers but also by families and society at large. Variations in stress levels within economic sectors can be traced to variations in management practices that govern key conditions of work involving demand, effort, control and reward. The costs of stress-related disorders produced by adverse governance practices are transferred outside the workplace in varying degrees. The actual extent of this cost transfer depends on policies and programs within the workplace. We can characterize workplaces according to a typology in which the key dimensions are commitment to abate harm through participatory management practices and the effectiveness and efficiency of harm containment through programs such as employee assistance and health promotion. The most health-promoting and cost-avoiding workplaces foster high control, high reward conditions and support employees with employee assistance and health promotion programs. The policy implications of this observation are drawn out.

  7. Status of costing hospital nursing work within Australian casemix activity-based funding policy.

    PubMed

    Heslop, Liza

    2012-02-01

    Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations.

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

    ERIC Educational Resources Information Center

    Bierma, Thomas J.; Walbert, Mark S.

    1987-01-01

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

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

    PubMed

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

    2016-02-01

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

  10. The cost escalation of social health insurance plans in China: its implication for public policy.

    PubMed

    Liu, X; Hsiao, W C

    1995-10-01

    China has been alarmed by its rapid rise in health care expenditures of social health insurance schemes. The health care expenditure per person for the 155 million people covered by the Chinese social insurance plans has been rising at an accelerative rate. We analyze why health care cost in China has risen, and show how other nations may benefit from this experience. The annual rate of increase in health expenditure per capita was only 3.1% during 1952 to 1978, the average rate rose to 8.2% during 1978 to 1985 and then 24.4% during 1985 to 1989. We found general inflation explained one-half of the high rates of increase between 1985-1989. Although China introduced patients co-payments in 1985, the residual expenditure per capita (after adjusting for general inflation and aging of the beneficiaries) increased at 7.4% per year due to the adoption of new technology, uses of more expensive drugs and increased quality of services. While we found the expenditure increases in China were largely caused by uncontrollable factors such as general inflation and aging of the population, we also found the change in Chinese hospital financing and payment policy caused rapid adoption of high-tech medicine and abusive usage of more expensive drugs which largely explained the annual increases in expenditures of 7.4% between 1985-1989. Chinese experience also shows that demand strategy (co-payment by patients) had very little effect to contain cost escalation.

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

    PubMed

    Pasman, H J

    2000-01-07

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

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

    ERIC Educational Resources Information Center

    Massy, William F.

    2013-01-01

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

  13. Simulating school closure policies for cost effective pandemic decision making

    PubMed Central

    2012-01-01

    Background Around the globe, school closures were used sporadically to mitigate the 2009 H1N1 influenza pandemic. However, such closures can detrimentally impact economic and social life. Methods Here, we couple a decision analytic approach with a mathematical model of influenza transmission to estimate the impact of school closures in terms of epidemiological and cost effectiveness. Our method assumes that the transmissibility and the severity of the disease are uncertain, and evaluates several closure and reopening strategies that cover a range of thresholds in school-aged prevalence (SAP) and closure durations. Results Assuming a willingness to pay per quality adjusted life-year (QALY) threshold equal to the US per capita GDP ($46,000), we found that the cost effectiveness of these strategies is highly dependent on the severity and on a willingness to pay per QALY. For severe pandemics, the preferred strategy couples the earliest closure trigger (0.5% SAP) with the longest duration closure (24 weeks) considered. For milder pandemics, the preferred strategies also involve the earliest closure trigger, but are shorter duration (12 weeks for low transmission rates and variable length for high transmission rates). Conclusions These findings highlight the importance of obtaining early estimates of pandemic severity and provide guidance to public health decision-makers for effectively tailoring school closures strategies in response to a newly emergent influenza pandemic. PMID:22713694

  14. A Cost-Containment Incentive for a University Research Contract with a Commercial Sponsor.

    ERIC Educational Resources Information Center

    Gedney, Matt

    1994-01-01

    A recent mechanical engineering research contract between the Georgia Institute of Technology and an international industrial manufacturer contains a clause providing an incentive for cost containment. The measure helps bridge the gap between the expectations of an industrial sponsor and the needs of the university. (Author/MSE)

  15. National vaccine injury compensation program: calculation of average cost of a health insurance policy. Final rule.

    PubMed

    2007-07-05

    Subtitle 2 of Title XXI of the Public Health Service Act, as enacted by the National Childhood Vaccine Injury Act of 1986, as amended (the Act), governs the National Vaccine Injury Compensation Program (VICP). The VICP, administered by the Secretary of Health and Human Services (the Secretary), provides that a proceeding for compensation for a vaccine-related injury or death shall be initiated by service upon the Secretary, and the filing of a petition with the United States Court of Federal Claims (the Court). In some cases, the injured individual may receive compensation for future lost earnings, less appropriate taxes and the "average cost of a health insurance policy, as determined by the Secretary." The final rule establishes the new method of calculating the average cost of a health insurance policy and determines the amount of the average cost of a health insurance policy to be deducted from the compensation award.

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

    NASA Astrophysics Data System (ADS)

    Moore, Jared; Apt, Jay

    2014-10-01

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

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

    ERIC Educational Resources Information Center

    Welner, Kevin

    2011-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Reger, Darren; Madanat, Samer; Horvath, Arpad

    2014-10-01

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

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

    PubMed Central

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

    1994-01-01

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

  20. Another Pill, Another Test, and Another Procedure: One Resident's Reflection on Healthcare Cost Containment.

    PubMed

    Chertoff, Jason

    2015-03-01

    In the United States, healthcare expenditures have continued to rise at alarming rates despite numerous strategies to contain costs. One area of focus that is underappreciated is doctor-patient communication about expectations of treatment. Studies have shown that clinicians' misperceptions of assumptions about patients' expectations are an essential component to our nation's healthcare overuse problem. Strategies to address these misperceptions and assumptions as a method of reducing costs and providing higher-quality care to our patients are warranted.

  1. Reduced-form approach for evaluating hospital cost-containment program in paired experiment

    SciTech Connect

    Liu, B.C.

    1980-01-01

    The paper investigates the feasibility, analyzes the project benefit, and establishes the cost-1 effectiveness of the Cooperative Utilization Review Program (CURP), the action plan for cost containment proposed by the Blue Cross and Blue Shield Company. A statistical evaluation framework is developed for analyzing the effects of the CURP through control and participating hospital selection, impatient discharge data collection, and the average length of stay delineation and explanation by diagnosis. (ACR)

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

    SciTech Connect

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

    1991-08-01

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

  3. 76 FR 70037 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... / Thursday, November 10, 2011 / Rules and Regulations#0;#0; ] OFFICE OF MANAGEMENT AND BUDGET 5 CFR Chapter III 48 CFR Chapter 1 Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards Included in the Semiannual Agenda of Federal Activities; Withdrawal AGENCY: Office of...

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

    PubMed

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

    2015-04-14

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

  5. Toward Policy-Relevant Benchmarks for Interpreting Effect Sizes: Combining Effects with Costs

    ERIC Educational Resources Information Center

    Harris, Douglas N.

    2009-01-01

    The common reporting of effect sizes has been an important advance in education research in recent years. However, the benchmarks used to interpret the size of these effects--as small, medium, and large--do little to inform educational administration and policy making because they do not account for program costs. The author proposes an approach…

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

    ERIC Educational Resources Information Center

    Ayalew, Sewale Abate

    2013-01-01

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

  7. The Cost-Effectiveness of Education Interventions in Poor Countries. Policy Insight, Volume 2, Issue 4

    ERIC Educational Resources Information Center

    Evans, David K.; Ghosh, Arkadipta

    2008-01-01

    Poor countries need development programs that are both effective and cost-effective. To assess effectiveness, researchers are increasingly using randomized trials (or quasi-experimental methods that imitate randomized trials), which provide a clear picture of which outcomes are attributable to the program being evaluated. This "Policy Insight"…

  8. Indexing Tuition and Fees to Cost of Education: Implications for State Policy.

    ERIC Educational Resources Information Center

    Viehland, Dennis; And Others

    Considerations for establishing a system for indexing tuition and fees to the cost of education and implications for state policy are examined. It is suggested that the attraction of the indexing approach to tuition arises from a number of causes including the upward pressure on tuition created by changing demographic and fiscal conditions.…

  9. Comparative Benefit-Cost Analysis of the Abecedarian Program and Its Policy Implications

    ERIC Educational Resources Information Center

    Barnett, W. S.; Masse, Leonard N.

    2007-01-01

    Child care and education are to some extent joint products of preschool programs, but public policy and research frequently approach these two goals independently. We present a benefit-cost analysis of a preschool program that provided intensive education during full-day child care. Data were obtained from a randomized trial with longitudinal…

  10. Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care.

    PubMed

    Ziebarth, Nicolas R

    2014-03-01

    This study empirically evaluates the effectiveness of different health care cost containment measures. The measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for rehabilitation care. Of the analyzed measures, doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in utilization of about [Formula: see text] . Indirect measures such as allowing employers to cut federally mandated sick pay or paid vacation during inpatient post-acute care stays did not significantly reduce utilization. There is evidence neither for adverse health effects nor for substitution effects in terms of more doctor visits.

  11. Optimal pricing policies for services with consideration of facility maintenance costs

    NASA Astrophysics Data System (ADS)

    Yeh, Ruey Huei; Lin, Yi-Fang

    2012-06-01

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

  12. Prescription cost sharing: economic and health impacts, and implications for health policy.

    PubMed

    Levy, R A

    1992-09-01

    Cost sharing for prescription pharmaceuticals--in the form of copayments, coinsurance, or deductibles--is now common in healthcare systems throughout the world. Although there are no studies that directly or convincingly measure the effects of prescription cost sharing on health status or treatment outcomes, cost sharing does appear to reduce utilisation of pharmaceuticals; however, more information is required concerning the relationship between cost sharing and prescription-filling behaviour. Additionally, outcomes studies are needed to define appropriate and inappropriate cost-sharing levels for particular groups of patients, based on income, disease, employment status, and other factors. Cost sharing for pharmaceuticals and other medical services is likely to increase in the near future. As a result, consumers will have a greater role in treatment decisions and will also become more interested in knowing the value of the medicines they are asked to purchase. They are therefore likely to demand pharmaceutical products that are more cost-effective and products that improve quality of life. The increased implementation of cost-sharing programmes necessitates the adoption of appropriate cost-sharing policies, which incorporate the following general principles: 1. Consumers must be provided with the information required to make informed decisions, including the value of the medication, its importance in the treatment plan, and the consequences of not having the prescription filled. 2. Aggressive or abusive cost-sharing features that deny access to optimal pharmaceutical therapy must be avoided. 3. Inappropriate cost sharing, either fixed level or percentage of the prescription cost, may affect disease control and ultimately health or functional status. 4. Cost sharing restricted to pharmaceuticals may encourage replacement of drug therapy with more expensive forms of treatment; therefore, cost sharing should apply to the full range of medical services to prevent

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

    PubMed

    Chang, Li

    2011-01-01

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

  14. Higher Education Cost Containment. Performance Audit, November 1995. Report of the State Auditor.

    ERIC Educational Resources Information Center

    Colorado State Office of State Auditor, Denver.

    Between June and September 1995, this performance audit examined Colorado higher education cost containment in debt refinancing and improvements to student loan processes according to generally accepted government auditing standards. With respect to debt refinancing, the audit concluded that in general, governing boards and institutions were…

  15. 7 CFR 246.16a - Infant formula and authorized foods cost containment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Infant formula and authorized foods cost containment. 246.16a Section 246.16a Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND... FOR WOMEN, INFANTS AND CHILDREN State Agency Provisions § 246.16a Infant formula and authorized...

  16. 7 CFR 246.16a - Infant formula and authorized foods cost containment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Infant formula and authorized foods cost containment. 246.16a Section 246.16a Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND... FOR WOMEN, INFANTS AND CHILDREN State Agency Provisions § 246.16a Infant formula and authorized...

  17. Alleviating inequality in climate policy costs: an integrated perspective on mitigation, damage and adaptation

    NASA Astrophysics Data System (ADS)

    De Cian, E.; Hof, A. F.; Marangoni, G.; Tavoni, M.; van Vuuren, D. P.

    2016-07-01

    Equity considerations play an important role in international climate negotiations. While policy analysis has often focused on equity as it relates to mitigation costs, there are large regional differences in adaptation costs and the level of residual damage. This paper illustrates the relevance of including adaptation and residual damage in equity considerations by determining how the allocation of emission allowances would change to counteract regional differences in total climate costs, defined as the costs of mitigation, adaptation, and residual damage. We compare emission levels resulting from a global carbon tax with two allocations of emission allowances under a global cap-and-trade system: one equating mitigation costs and one equating total climate costs as share of GDP. To account for uncertainties in both mitigation and adaptation, we use a model-comparison approach employing two alternative modeling frameworks with different damage, adaptation cost, and mitigation cost estimates, and look at two different climate goals. Despite the identified model uncertainties, we derive unambiguous results on the change in emission allowance allocation that could lessen the unequal distribution of adaptation costs and residual damages through the financial transfers associated with emission trading.

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

    PubMed Central

    Bishop, C E

    1998-01-01

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

  19. Cost-Benefit Analysis of Confidentiality Policies for Advanced Knowledge Management Systems

    SciTech Connect

    May, D

    2003-03-01

    Knowledge Discovery (KD) processes can create new information within a Knowledge Management (KM) system. In many domains, including government, this new information must be secured against unauthorized disclosure. Applying an appropriate confidentiality policy achieves this. However, it is not evident which confidentiality policy to apply, especially when the goals of sharing and disseminating knowledge have to be balanced with the requirements to secure knowledge. This work proposes to solve this problem by developing a cost-benefit analysis technique for examining the tradeoffs between securing and sharing discovered knowledge.

  20. Norway's pivotal role in regulatory health economics and pharmaceutical cost containment--what can other countries learn?

    PubMed

    Andersson, F

    1992-05-01

    With an increasing trend in health care consumption--together with the introduction of an increasing number of new medical technologies-- governments, insurance companies and other third party payers seek new ways of limiting increases in consumption, as well as limiting the use of new medical technologies to the most efficient ones (clinically, economically). One particular area of focus in this context is the pharmaceutical sector, where the innovational rate of new technologies (drugs) has been high. One of the forerunners in the areas of health care cost containment and regulatory health economics is Norway. This country has succeeded in keeping drug prices and drug consumption at moderate levels, as well as keeping the number of new drugs to a relatively modest level. This study describes the Norwegian drug regulatory process, the Norwegian drug market, the Norwegian cost-containment policies and future regulatory perspectives. For many European countries and in North America, where stricter price and reimbursement regulations are considered, the Norwegian drug regulatory process presents an interesting example of how a strict regulatory environment may affect the availability of drugs, as well as drug prices, drug reimbursement and drug consumption.

  1. A cost-benefit analysis of a deposit-refund program for beverage containers in Israel.

    PubMed

    Lavee, Doron

    2010-02-01

    The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program--storage, collection, and treatment costs of empty containers, and all potential benefits--savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearly economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.

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

    PubMed Central

    Suelves, Josep M; Barbería, Eneko

    2013-01-01

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

  3. Sustainability of least cost policies for meeting Mexico City's future water demand

    NASA Astrophysics Data System (ADS)

    Downs, Timothy J.; Mazari-Hiriart, Marisa; DomíNguez-Mora, Ramón; Suffet, I. H.

    2000-08-01

    Meeting future water demand without degrading ecosystems is one important indicator of sustainable development. Using simulations, we showed that compared to existing policy, more sustainable water supply options are similar or cheaper in cost. We probabilistically forecasted the Mexico City metropolitan zone population for the year 2015 to be 23.5 million and total required water supply to be 106 m3 s-1. We optimized existing and potential supply sources from aquifers, surface water, treatment/reuse, and efficiency/demand management by cost to meet future supply needs; the applied source supply limits determined the degree of sustainability. In two scenarios to supply 106 m3 s-1, the business-as-usual scenario (zero sustainability) had an average relative unit cost of 1.133; while for the most sustainable scenario (it includes reducing potential supply basins' exploitation limits by 50%), the value was 1.121. One extreme scenario to supply the forecast's 95% confidence value (124 m3 s-1) showed little unit cost change (1.106). The simulation shows sustainable policies can be cost-effective.

  4. Are Changes in Acquisition Policy and Process and in Funding Climate Associated With Cost Growth?

    DTIC Science & Technology

    2015-04-30

    ååì~ä=^Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= tÉÇåÉëÇ~ó=pÉëëáçåë= sçäìãÉ=f= = Are Changes in Acquisition Policy and Process and in Funding Climate ...acquisition policy and process. Changes in funding climate , however, are found to have a large influence on PAUC growth. These findings have three...fåÑçêãÉÇ=`Ü~åÖÉ= - 11 - Are Changes in Acquisition Policy and Process and in Funding Climate Associated With Cost Growth? David McNicol—joined the DoD

  5. Higher Education Cost Measurement: Public Policy Issues, Options, and Strategies. A Compilation of Background Papers Prepared for a Seminar on Cost Measurement and Management. The New Millennium Project on Higher Education Costs, Pricing, and Productivity.

    ERIC Educational Resources Information Center

    Wellman, Jane, Comp.; O'Brien, Colleen, Comp.

    This collection of papers is the result of a project by the Institute for Higher Education Policy designed to explore the public policy aspects of higher education cost measurement (expenditure analysis). Papers come from a 1-day seminar in 1999 that brought together individuals knowledgeable about cost measurement with institutional leaders and…

  6. Learning Near-Optimal Cost-Sensitive Decision Policy for Object Detection.

    PubMed

    Wu, Tianfu; Zhu, Song-Chun

    2015-05-01

    Many popular object detectors, such as AdaBoost, SVM and deformable part-based models (DPM), compute additive scoring functions at a large number of windows in an image pyramid, thus computational efficiency is an important consideration in real time applications besides accuracy. In this paper, a decision policy refers to a sequence of two-sided thresholds to execute early reject and early accept based on the cumulative scores at each step. We formulate an empirical risk function as the weighted sum of the cost of computation and the loss of false alarm and missing detection. Then a policy is said to be cost-sensitive and optimal if it minimizes the risk function. While the risk function is complex due to high-order correlations among the two-sided thresholds, we find that its upper bound can be optimized by dynamic programming efficiently. We show that the upper bound is very tight empirically and thus the resulting policy is said to be near-optimal. In experiments, we show that the decision policy outperforms state-of-the-art cascade methods significantly, in several popular detection tasks and benchmarks, in terms of computational efficiency with similar accuracy of detection.

  7. The cost of crime to society: new crime-specific estimates for policy and program evaluation.

    PubMed

    McCollister, Kathryn E; French, Michael T; Fang, Hai

    2010-04-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime.

  8. Achieving health care cost containment through provider payment reform that engages patients and providers.

    PubMed

    Ginsburg, Paul B

    2013-05-01

    The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

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

    ERIC Educational Resources Information Center

    Duncombe, William; Yinger, John

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

  10. Modelling geographic variation in the cost-effectiveness of control policies for infectious vector diseases: the example of Chagas disease.

    PubMed

    Castillo-Riquelme, Marianela; Chalabi, Zaid; Lord, Joanne; Guhl, Felipe; Campbell-Lendrum, Diarmid; Davies, Clive; Fox-Rushby, Julia

    2008-03-01

    Few cost-effectiveness analysis (CEA) models have accounted for geographic variation in input parameters. This paper describes a deterministic discrete-time multi-state model to estimate the cost-effectiveness of vector control policies for Chagas disease, where implementation varies according to village characteristics. The model outputs include the total number of new infections, disability adjusted life years (DALYs) incurred, costs of associated healthcare, and total costs of the Ministry of Health's control policy for house surveillance and spraying. Incremental net benefits were estimated to determine Colombian villages in which it is cost-effective to implement the control policy. The robustness of these conclusions was evaluated by deterministic sensitivity analyses. The model should help provide a decision-support system to compare control policies and to allocate resources geographically.

  11. Cost-benefit analysis of a plant sterol containing low-fat margarine for cholesterol reduction.

    PubMed

    Gerber, A; Evers, T; Haverkamp, H; Lauterbach, K W

    2006-12-01

    For decreasing the risk of coronary heart disease (CHD) it has been proposed to enrich food such as margarine with plant sterol esters which have been shown to reduce total and LDL cholesterol concentrations, two of the major risk factors. A Markov model was developed to assess the costs and benefits of consuming a low-fat plant sterol containing margarine (PS margarine). A health insurer's perspective was taken with a time frame of 10 years. Transition probabilities for CHD and CHD-related death were calculated on the basis of the Framingham risk equations. These were applied to a representative sample of the German population. The alteration in cholesterol levels after intake of PS margarine was estimated based on a meta-analysis of ten randomized controlled trials with parallel or crossover design that found a reduction of 5.7% in total cholesterol. Average annual costs of CHD were assumed to be at 3,000 euro. Costs for "no CHD" and "CHD-related death" were set to 0 euro since the intervention would solely be paid by the consumers. Sensitivity analyses were performed with regard to annual costs, risk estimation, PS margarine reduction in total cholesterol, discount factor, and risk of CHD-related death. The 10-year CHD risks are 6.1% (PS margarine) vs. 6.5% (control). Thus expected 10-year CHD costs are 696 euro (PS margarine) vs. 748 euro (control). The cost savings of 52 euro varied between 32 euro and 74 euro in the sensitivity analysis. A projection at the level of the population for which evidence (randomized controlled trials) exists that plant sterols lower cholesterol (25.35 million) leads to a reduction of 117,000 CHD cases over 10 years and a cost reduction of 1.3 billion euro for this time period (sensitivity analysis 0.8-1.9 billion euro).

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

    PubMed Central

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

    1999-01-01

    Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$186.90, whereas that of a

  13. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

    PubMed

    Anderson, Peter; Chisholm, Dan; Fuhr, Daniela C

    2009-06-27

    This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

  14. Three policy issues in deciding the cost of nursing home care: provincial differences and how they influence elderly couples' experiences.

    PubMed

    Stadnyk, Robin L

    2009-08-01

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

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

    PubMed Central

    2013-01-01

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

  16. Cost containment using cysteine HCl acidification to increase calcium/phosphate solubility in hyperalimentation solutions.

    PubMed

    Schmidt, G L; Baumgartner, T G; Fischlschweiger, W; Sitren, H S; Thakker, K M; Cerda, J J

    1986-01-01

    The purpose of this study was to determine if (1) the calcium/phosphate insoluble product was inversely related to pH [when cysteine HC1 (CH) was added as neonatal supplementation at 0.5 mM/kg/day to hyperalimentation (HAL) solutions] and (2) the potential cost savings to the hospital. The pH of the HAL solutions was adjusted by adding various amounts of CH to the HAL solution. HAL solutions containing 27 mEq of calcium/liter and 30 mEq (15 mM) of phosphate/liter were compounded. Ten-milliliter aliquots were analyzed at 0, 12, 24, and 48 hr. All samples (n = 56) were filtered (0.22 mu), viewed with 7-10,000 X magnification scanning electron microscopy, and qualitatively analyzed with a Philips Energy Dispersive X-Ray Analysis System equipped with a SW9100 Microprocessor. Calcium/phosphate insoluble product was present in the 0-, 12-, 24-, and 48-hr samples from the CH-free solutions. The solutions containing 759 mg (4.17 mM)/liter of CH however, remained free of precipitant. This investigation demonstrated that addition of CH to HAL can foster significant cost containment (projected $82,000/yr tangible hospital savings) by the elimination of current calcium/phosphate separation procedures for neonates on parenteral nutrition.

  17. A Cost-Effectiveness Tool for Informing Policies on Zika Virus Control

    PubMed Central

    Tamagnan, Jules A.; Medlock, Jan; Ndeffo-Mbah, Martial L.; Fish, Durland; Ávila-Agüero, María L.; Marín, Rodrigo; Ko, Albert I.; Galvani, Alison P.

    2016-01-01

    Background As Zika virus continues to spread, decisions regarding resource allocations to control the outbreak underscore the need for a tool to weigh policies according to their cost and the health burden they could avert. For example, to combat the current Zika outbreak the US President requested the allocation of $1.8 billion from Congress in February 2016. Methodology/Principal Findings Illustrated through an interactive tool, we evaluated how the number of Zika cases averted, the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an intervention is cost-effective. From Northeast Brazilian microcephaly incidence data, we estimated the probability of microcephaly in infants born to Zika-infected women (0.49% to 2.10%). We also estimated the probability of GBS arising from Zika infections in Brazil (0.02% to 0.06%) and Colombia (0.08%). We calculated that each microcephaly and GBS case incurs the loss of 29.95 DALYs and 1.25 DALYs per case, as well as direct medical costs for Latin America and the Caribbean of $91,102 and $28,818, respectively. We demonstrated the utility of our cost-effectiveness tool with examples evaluating funding commitments by Costa Rica and Brazil, the US presidential proposal, and the novel approach of genetically modified mosquitoes. Our analyses indicate that the commitments and the proposal are likely to be cost-effective, whereas the cost-effectiveness of genetically modified mosquitoes depends on the country of implementation. Conclusions/Significance Current estimates from our tool suggest that the health burden from microcephaly and GBS warrants substantial expenditures focused on Zika virus control. Our results justify the funding committed in Costa Rica and Brazil and many aspects of the budget outlined in the US president’s proposal. As data continue to be collected, new parameter estimates can be customized

  18. Military Compensation: DOD Needs More Complete and Consistent Data to Assess the Costs and Policies of Relocating Personnel

    DTIC Science & Technology

    2015-09-01

    MILITARY COMPENSATION DOD Needs More Complete and Consistent Data to Assess the Costs and Policies of Relocating...failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE SEP 2015 2. REPORT TYPE ...the Costs and Policies of Relocating Personnel 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  19. Evidence on the Effect of DoD Acquisition Policy and Process on Cost Growth of Major Defense Acquisition Programs

    DTIC Science & Technology

    2015-05-13

    Evidence on the Effect of DoD Acquisition Policy and Process on Cost Growth of Major Defense Acquisition Programs Naval Postgraduate School 12th...TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Evidence on the Effect of DoD Acquisition Policy and Process on Cost Growth...There are no obvious candidates.  The paper (Appendix B) provides evidence that PAUC growth is not systematically influenced by changes in budget

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

    PubMed Central

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

    1987-01-01

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

  1. A low-cost technique to manufacture a container to process meiofauna for scanning electron microscopy.

    PubMed

    Abolafia, J

    2015-09-01

    An easy and low-cost method to elaborate a container to dehydrate nematodes and other meiofauna in order to process them for scanning electron microscopy (SEM) is presented. Illustrations of its elaboration, step by step, are included. In addition, a brief methodology to process meiofauna, especially nematodes and kinorhynchs, and illustrations are provided. With this methodology it is possible to easily introduce the specimens, to lock them in a closed chamber allowing the infiltration of fluids and gases (ethanol, acetone, carbon dioxide) but avoiding losing the specimens. After using this meiofauna basket for SEM the results are efficient. Examples of nematode and kinorhynch SEM pictures obtained using this methodology are also included.

  2. How do high cost-sharing policies for physician care affect inpatient care use and costs among people with chronic disease?

    PubMed

    Xin, Haichang

    2015-01-01

    Rapidly rising health care costs continue to be a significant concern in the United States. High cost-sharing strategies thus have been widely used to address rising health care costs. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies for physician care are a good strategy for controlling costs among chronically ill patients, especially whether utilization and costs in inpatient care will increase in response. This study examined whether high cost sharing in physician care affects inpatient care utilization and costs differently between individuals with and without chronic conditions. Findings from this study will contribute to the insurance benefit design that can control care utilization and save costs of chronically ill individuals. Prior studies suffered from gaps that limit both internal validity and external validity of their findings. This study has its unique contributions by filling these gaps jointly. The study used data from the 2007 Medical Expenditure Panel Survey, a nationally representative sample, with a cross-sectional study design. Instrumental variable technique was used to address the endogeneity between health care utilization and cost-sharing levels. We used negative binomial regression to analyze the count data and generalized linear models for costs data. To account for national survey sampling design, weight and variance were adjusted. The study compared the effects of high cost-sharing policies on inpatient care utilization and costs between individuals with and without chronic conditions to answer the research question. The final study sample consisted of 4523 individuals; among them, 752 had hospitalizations. The multivariate analysis demonstrated consistent patterns. Compared with low cost-sharing policies, high cost-sharing policies for physician care were not associated with a greater increase in inpatient care utilization (P = .86 for chronically ill

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

    PubMed

    Chen, Stephanie C; Pearson, Steven D

    2016-08-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2015-05-01

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

  6. Costs of smoking and policy strategies for California American Indian communities.

    PubMed

    Satter, Delight E; Roby, Dylan H; Smith, Lauren M; Avendano, Kathalena K; Kaslow, Jackie; Wallace, Steven P

    2012-04-01

    The cost of smoking has been explored for residents of the U.S. living in several states. Recent evidence has indicated that the prevalence and cost of smoking are associated with racial and ethnic groups. This study provides information on tobacco prevention and control for American Indians (AI) (American Indians refers to American Indians and Alaska Natives throughout this article. Where we use the term California tribe we specifically mean persons who are members of Indigenous tribes geographically located in the geographic area now known as the state of California.) and examines the relative impact of smoking by using behavioral and demographic characteristics in order to predict the economic cost on AIs. The analysis suggests that AIs smoke more frequently than other Californians, which results in higher health care costs, as well as morbidity and mortality due to high levels of tobacco related chronic disease. Based on these factors we urge tribes to exercise their sovereignty as governments and implement local tobacco control policy strategies. We call for public health action by community leaders in Indian country and nationwide. We must act now to protect future generations.

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

    SciTech Connect

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

    2006-09-15

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

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

    PubMed

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

    2014-11-04

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

  9. Benefits and costs of oil palm expansion in Central Kalimantan, Indonesia, under different policy scenarios.

    PubMed

    Sumarga, Elham; Hein, Lars

    Deforestation and oil palm expansion in Central Kalimantan province are among the highest in Indonesia. This study examines the physical and monetary impacts of oil palm expansion in Central Kalimantan up to 2025 under three policy scenarios. Our modelling approach combines a spatial logistic regression model with a set of rules governing land use change as a function of the policy scenario. Our physical and monetary analyses include palm oil expansion and five other ecosystem services: timber, rattan, paddy rice, carbon sequestration, and orangutan habitat (the last service is analysed in physical units only). In monetary terms, our analysis comprises the contribution of land and ecosystems to economic production, as measured according to the valuation approach of the System of National Accounts. We focus our analysis on government-owned land which covers around 97 % of the province, where the main policy issues are. We show that, in the business-as-usual scenario, the societal costs of carbon emissions and the loss of other ecosystem services far exceed the benefits from increased oil palm production. This is, in particular, related to the conversion of peatlands. We also show that, for Central Kalimantan, the moratorium scenario, which is modelled based on the moratorium currently in place in Indonesia, generates important economic benefits compared to the business-as-usual scenario. In the moratorium scenario, however, there is still conversion of forest to plantation and associated loss of ecosystem services. We developed an alternative, sustainable production scenario based on an ecosystem services approach and show that this policy scenario leads to higher net social benefits including some more space for oil palm expansion.

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

    PubMed

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

    1998-09-01

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

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

    PubMed

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

    2013-01-01

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

  12. Financing end-use solar technologies in a restructured electricity industry: Comparing the cost of public policies

    SciTech Connect

    Jones, E.; Eto, J.

    1997-09-01

    Renewable energy technologies are capital intensive. Successful public policies for promoting renewable energy must address the significant resources needed to finance them. Public policies to support financing for renewable energy technologies must pay special attention to interactions with federal, state, and local taxes. These interactions are important because they can dramatically increase or decrease the effectiveness of a policy, and they determine the total cost of a policy to society as a whole. This report describes a comparative analysis of the cost of public policies to support financing for two end-use solar technologies: residential solar domestic hot water heating (SDHW) and residential rooftop photovoltaic (PV) systems. The analysis focuses on the cost of the technologies under five different ownership and financing scenarios. Four scenarios involve leasing the technologies to homeowners in return for a payment that is determined by the financing requirements of each form of ownership. For each scenario, the authors examine nine public policies that might be used to lower the cost of these technologies: investment tax credits (federal and state), production tax credits (federal and state), production incentives, low-interest loans, grants (taxable and two types of nontaxable), direct customer payments, property and sales tax reductions, and accelerated depreciation.

  13. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Policy-Public safety: Requirement for early identification of lands containing dangerous materials. 643.22 Section 643.22 National Defense Department of...—Public safety: Requirement for early identification of lands containing dangerous materials. (a) DA...

  14. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Policy-Public safety: Requirement for early identification of lands containing dangerous materials. 643.22 Section 643.22 National Defense Department of...—Public safety: Requirement for early identification of lands containing dangerous materials. (a) DA...

  15. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  16. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Policy-Public safety: Requirement for early identification of lands containing dangerous materials. 643.22 Section 643.22 National Defense Department of...—Public safety: Requirement for early identification of lands containing dangerous materials. (a) DA...

  17. 32 CFR 643.22 - Policy-Public safety: Requirement for early identification of lands containing dangerous materials.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  18. Lung cancer deaths from indoor radon and the cost effectiveness and potential of policies to reduce them

    PubMed Central

    Read, Simon; McGale, Paul; Darby, Sarah

    2009-01-01

    Objective To determine the number of deaths from lung cancer related to radon in the home and to explore the cost effectiveness of alternative policies to control indoor radon and their potential to reduce lung cancer mortality. Design Cost effectiveness analysis. Setting United Kingdom. Data sources Epidemiological data on risks from indoor radon and from smoking, vital statistics on deaths from lung cancer, survey information on effectiveness and costs of radon prevention and remediation. Main outcome measures Estimated number of deaths from lung cancer related to indoor radon, lifetime risks of death from lung cancer before and after various potential interventions to control radon, the cost per quality adjusted life year (QALY) gained from different policies for control of radon, and the potential of those policies to reduce lung cancer mortality. Results The mean radon concentration in UK homes is 21 becquerels per cubic metre (Bq/m3). Each year around 1100 deaths from lung cancer (3.3% of all deaths from lung cancer) are related to radon in the home. Over 85% of these arise from radon concentrations below 100 Bq/m3 and most are caused jointly by radon and active smoking. Current policy requiring basic measures to prevent radon in new homes in selected areas is highly cost effective, and such measures would remain cost effective if extended to the entire UK, with a cost per QALY gained of £11 400 ( €12 200; $16 913). Current policy identifying and remediating existing homes with high radon levels is, however, neither cost effective (cost per QALY gained £36 800) nor effective in reducing lung cancer mortality. Conclusions Policies requiring basic preventive measures against radon in all new homes throughout the UK would be cost effective and could complement existing policies to reduce smoking. Policies involving remedial work on existing homes with high radon levels cannot prevent most radon related deaths, as these are caused by moderate exposure

  19. Cost-Benefit and Cost-Effectiveness Analysis. Instructor's Manual. Module Number Five of Policy/Program Analysis and Evaluation Techniques, Package VI.

    ERIC Educational Resources Information Center

    Goldstein, Harvey

    This packet contains the materials necessary for presentation of the fifth of ten modules that comprise a portion of the National Training and Development Service Urban Management Curriculum Development Project. This module focuses on cost benefit and cost effectiveness analysis, a methodology for coping with the problem of allocating scarce…

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  1. It’s Time to Take the Chill Out of Cost Containment and Re-energize Key Acquisition Practice

    DTIC Science & Technology

    2010-05-01

    Lockheed Martin ? ? ? ? ZCORE Cost Oriented Resource  Estimating Model USAF ? ? ? ? ACEIT Automated Cost  Estimating  Integrated  Tools  (USAF, USA...and Logistics) Milestone III chair LCCH Criticisms of high cost, ASD (Acquisition and Logistics) Milestone III chair ACEIT (86 USAF at Hanscom...w/Tecolote Research) ACEIT (86 USAF at Hanscom w/Tecolote Research) ?? It’s Time to Take the Chill Out of Cost Containment and Re-energize a

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

    PubMed Central

    2013-01-01

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

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

    SciTech Connect

    Eto, Joseph H.; Lesieutre, Bernard C.

    2005-12-01

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

  4. Dredging Operations Technical Support Program. Planning-Level Cost Estimates of Dredged Material Containment Islands in New York Harbor.

    DTIC Science & Technology

    1988-04-01

    WES). Three sites are ... *considered: a. A--East Bank (off East Bank and Coney Island ). .. b. B--West Bank (Lower Bay west to Chapel Hill Channel). c...PROGRAM "P." US~~o ArCop MISCELLANEOUS PAPER D-88 3 PLANNING-LEVEL COST ESTIMATES OF AD-A194 812 DREDGED MATERIAL CONTAINMENT ISLANDS IN NEW YORK HARBOR...10278-0090 11. TITLE (include Security Classification) -’.. Planning-Level Cost Estimates of Dredged Material Containment Islands in New York Harbor

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Trombella, Jerry

    2011-01-01

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

  7. Geothermal power, policy, and design: Using levelized cost of energy and sensitivity analysis to target improved policy incentives for the U.S. geothermal market

    NASA Astrophysics Data System (ADS)

    Richard, Christopher L.

    At the core of the geothermal industry is a need to identify how policy incentives can better be applied for optimal return. Literature from Bloomquist (1999), Doris et al. (2009), and McIlveen (2011) suggest that a more tailored approach to crafting geothermal policy is warranted. In this research the guiding theory is based on those suggestions and is structured to represent a policy analysis approach using analytical methods. The methods being used are focus on qualitative and quantitative results. To address the qualitative sections of this research an extensive review of contemporary literature is used to identify the frequency of use for specific barriers, and is followed upon with an industry survey to determine existing gaps. As a result there is support for certain barriers and justification for expanding those barriers found within the literature. This method of inquiry is an initial point for structuring modeling tools to further quantify the research results as part of the theoretical framework. Analytical modeling utilizes the levelized cost of energy as a foundation for comparative assessment of policy incentives. Model parameters use assumptions to draw conclusions from literature and survey results to reflect unique attributes held by geothermal power technologies. Further testing by policy option provides an opportunity to assess the sensitivity of each variable with respect to applied policy. Master limited partnerships, feed in tariffs, RD&D, and categorical exclusions all result as viable options for mitigating specific barriers associated to developing geothermal power. The results show reductions of levelized cost based upon the model's exclusive parameters. These results are also compared to contemporary policy options highlighting the need for tailored policy, as discussed by Bloomquist (1999), Doris et al. (2009), and McIlveen (2011). It is the intent of this research to provide the reader with a descriptive understanding of the role of

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

    PubMed Central

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

    2014-01-01

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

  9. Benefits, cost requirements and cost-effectiveness of the HPV16,18 vaccine for cervical cancer prevention in developing countries: policy implications.

    PubMed

    Goldie, Sue J; O'Shea, Meredith; Diaz, Mireia; Kim, Sun-Young

    2008-11-01

    Approximately 70% of cases of cervical cancer worldwide are caused by genotypes 16 and 18 of human papillomavirus (HPV), which is sexually transmitted. With the availability of an effective vaccine against these HPV types, there is real hope for reducing the global burden of cervical cancer in developing countries. Stakeholders faced with decisions about where to invest money to improve health must consider the burden of disease caused by cervical cancer relative to other priorities and the comparative benefits of different interventions. We conducted a series of analyses to obtain information for agencies drafting immunisation policy recommendations, financing coordination mechanisms, and country decision-makers on the benefits, cost requirements and cost-effectiveness of the HPV16,18 vaccine. We found that making an HPV16,18 vaccine accessible to 70% of young adolescent girls in 72 of the poorest countries, China, Thailand, and all of Latin America and the Caribbean, could prevent the future deaths of more than four million women vaccinated over the next decade. Provided the cost per vaccinated girl is less than $10-$25, adolescent HPV16,18 vaccination would be cost-effective even in relatively poor countries. Concerns about financial costs and affordability highlight the need for lowering vaccine prices, cost-efficient mechanisms for delivery of vaccinations to adolescents, and creative sources of financing.

  10. 78 FR 17300 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ... Cooperative Agreements; Cost Principles and Administrative Requirements (Including Single Audit Act) AGENCY...; Cost Principles and Administrative Requirements (Including Single Audit Act) published February 1,...

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

    NASA Astrophysics Data System (ADS)

    Wu, Hongchao

    Advanced polymer nanocomposites/composites containing inorganic nanoparticles and novel carbonaceous fillers were processed and evaluated for the multifunctional purposes. To prepare the high performance conformal coating materials for microelectronic industries, epoxy resin was incorporated with zirconium tungstate (ZrW 2O8) nanoparticles synthesized from hydrothermal reaction to alleviate the significant thermal expansion behavior. Three types of ZrW 2O8 at different loading levels were selected to study their effect of physical (morphology, particle size, surface area, etc.) and thermal (thermal expansivity) properties on the rheological, thermo-mechanical, dynamic-mechanical, and dielectric properties of epoxy resin. Epoxy resin incorporated by Type-1 ZrW2O8 exhibited the overall excellent performance. Hexagonal boron nitride (h-BN) nanoplatelets were non-covalently encapsulated by a versatile and mussel-adhesive protein polydopamine through the strong pi-pi* interaction. The high-temperature thermoset bisphenol E cyanate ester (BECy) reinforced with homogenously dispersed h-BN at different volume fractions and functionalities were processed to investigate their effect on thermo-mechanical, dynamic-mechanical, dielectric properties and thermal conductivity. Different theoretical and empirical models were also successfully applied for the prediction of CTE, thermal conductivity and dielectric constant of h-BN/BECy nanocomposites. On the basis of the improvement in dimensional stability, the enhancement in storage modulus in both glassy and rubbery regions, associated with the increment in thermal conductivity without deterioration of thermal stability, glassy transition temperature and dielectric properties, pristine h-BN/BECy nanocomposites exhibited the prospective application in microelectronic packaging industry. Polydopamine functionalized h-BN significantly increased the dielectric constant of cyanate ester at lower frequency region. Asphaltene, a

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

    PubMed

    Dopoulos, Jason

    2016-01-01

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

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

    PubMed

    Affinnih, Yahya H

    2002-02-01

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

  14. 75 FR 48365 - Solicitation for a Cooperative Agreement-NIC Cost Containment Online Resource Center Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... materials to assist corrections practitioners with developing and implementing systems-level cost... guide providing a detailed review of existing evidence-based models, including their strengths... systems level; (2) gather supplemental materials designed to provide concrete and practical strategies...

  15. 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.

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

    PubMed Central

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

    2003-01-01

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

  17. METRA rail car cost-containment study. Final report, 1990-91

    SciTech Connect

    Not Available

    1991-05-01

    The Study/Program was directed to consideration of procurement and operation issues which could affect the total cost of ownership for the METRA BiLevel Cars which are planned for purchase in the near future. The issues addressed were organized in two parts: (1) Technical items such as Car Definition, Car Specifications, Car Cost Projections, Car(Procurement) Work Breakdown Structure, Standardization, Off-the-shelf Hardware, Energy Savings, and Handicapped Accessibility Requirements. (2) Non-Technical items included Contract Terms and Conditions, Project Management, Contract Types, Order Size, Chicago Area Assembly, Financing Alternatives, Life-Cycle Costing, Reliability and Maintainability with many of the above discussed in detail with existing rail car builders. The most significant findings included major savings to be derived in procurement through innovative financing and application of modern management methods, plus operational savings available from system-wide use of thorough maintenance and reliability provisions in planning, tracking and evaluation of car repair operations.

  18. Health Care Cost Containment Education for Physicians in the Military Health Services System

    DTIC Science & Technology

    1980-09-01

    34 OQuoted in-Fuchs 1974, p. 583. Victor Fuchs (1974, pp. 56-58) brings forth the idea of the physician as captain of the health team and identifies... Toledo . It began as a program in quality assurance with the introduction of cost components as a natural outgrowth of the examination of quality of care...1238. Friedman, Emily "Changing the Oourse of Things Costs Enter ’Medical. Education." Hospitala 53 (0 May 1979), pp. 82-85. Fuchs, Victor . "The

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

    ERIC Educational Resources Information Center

    Kahn, Lawrence M.

    2012-01-01

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

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

    PubMed

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

    2012-10-01

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

  1. Safety Is 99 Percent Attitude: Strategies to Contain Workers' Compensation Costs.

    ERIC Educational Resources Information Center

    Parnell, Janet

    1993-01-01

    The University of Denver (Colorado) reduced workers' compensation losses 97 percent in 1990-91 by developing a master safety plan, sponsoring safety training, managing medical costs, providing modified duty for injured employees, screening applicants, orienting new employees, investigating claims thoroughly, performing life-safety audits, and…

  2. Containing Venezuela’s Hugo Chavez: United States Foreign Policy Options

    DTIC Science & Technology

    2010-02-16

    Ecuadorian President Rafeal Correa and Bolivian President Evo Morales , offer little tangible support. Notably, the South American countries most able to...the FARC shares common socialist values with Chavez‟ Bolivarian Revolution. Venezuela also supports socialist regimes in Ecuador and Bolivia ...controversial foreign policies. With the exception of the state leaders of Iran, Cuba, Ecuador and Bolivia , Chavez has few supporters. Arguably, Russia

  3. Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations

    PubMed Central

    Webb, Michael; Fahimi, Saman; Singh, Gitanjali M; Khatibzadeh, Shahab; Micha, Renata; Powles, John

    2017-01-01

    Objective To quantify the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. Design Global modeling study. Setting 183 countries. Population Full adult population in each country. Intervention A “soft regulation” national policy that combines targeted industry agreements, government monitoring, and public education to reduce population sodium intake, modeled on the recent successful UK program. To account for heterogeneity in efficacy across countries, a range of scenarios were evaluated, including 10%, 30%, 0.5 g/day, and 1.5 g/day sodium reductions achieved over 10 years. We characterized global sodium intakes, blood pressure levels, effects of sodium on blood pressure and of blood pressure on cardiovascular disease, and cardiovascular disease rates in 2010, each by age and sex, in 183 countries. Country specific costs of a sodium reduction policy were estimated using the World Health Organization Noncommunicable Disease Costing Tool. Country specific impacts on mortality and disability adjusted life years (DALYs) were modeled using comparative risk assessment. We only evaluated program costs, without incorporating potential healthcare savings from prevented events, to provide conservative estimates of cost effectiveness Main outcome measure Cost effectiveness ratio, evaluated as purchasing power parity adjusted international dollars (equivalent to the country specific purchasing power of US$) per DALY saved over 10 years. Results Worldwide, a 10% reduction in sodium consumption over 10 years within each country was projected to avert approximately 5.8 million DALYs/year related to cardiovascular diseases, at a population weighted mean cost of I$1.13 per capita over the 10 year intervention. The population weighted mean cost effectiveness ratio was approximately I$204/DALY. Across nine world regions, estimated cost effectiveness of sodium reduction

  4. Cost and Performance Report of Incremental Sampling Methodology for Soil Containing Metallic Residues

    DTIC Science & Technology

    2013-09-01

    by the need for fewer ISM samples than grab samples to adequately char - acterize a DU. The cost differential between conventional grab samples and ISM...Ranney. 2003b. Evaluation of the Contamination by Explosives in Soils, Biomass and Surface Water at Cold Lake Air Weapons Range (CLAWR), Alberta, Phase...Environmental Conditions of Surface Soils and Biomass Prevailing in the Training Area at CFB Gagetown, New Brunswick. DRDC-TR-2003-152, Quebec, Canada

  5. Cost factors and chemical pretreatment effects in the membrane filtration of waters containing natural organic matter.

    PubMed

    Schäfer, A I; Fane, A G; Waite, T D

    2001-04-01

    This paper compares the membrane processes available for water treatment. Membranes have the advantage of currently decreasing capital cost, a relatively small footprint compared to conventional treatment, generally a reduction in chemicals usage and comparably low maintenance requirements. Three membrane processes applicable to water treatment, micro- (MF), ultra- (UF), and nanofiltration (NF), are compared in terms of intrinsic rejection, variation of rejection due to membrane fouling and increase in rejection by ferric chloride pretreatment. Twelve different membranes are compared on the basis of their membrane pore size which was calculated from their molecular weight cut-off. A pore size of < 6 nm is required to achieve substantial (> 50%) organics removal. For a fouled membrane this pore size is about 11 nm. UV rejection is higher than DOC rejection. Coagulation pretreatment allows a higher rejection of organics by MF and UF and the cut-off criterion due to initial membrane pore size is no longer valid. A water quality parameter (WQP) is introduced which describes the product water quality achieved as a function of colloid, DOC and cation rejection. The relationship between log (pore size) and WQP is linear. Estimation of membrane costs as a function of WQP suggests that open UF is superior to MF (similar cost at higher WQP) and NF is superior to tight UF. Chemical pretreatment could compensate for the difference between MF and UF. However, when considering chemicals and energy costs, it appears that a process operated at a higher energy is cheaper at a guaranteed product quality (less dependent on organic type). This argument is further supported by environmental issues of chemicals usage, as energy may be provided from renewable sources.

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

    NASA Technical Reports Server (NTRS)

    Forman, Michael; Nickum, William; Troendly, Gregory

    1993-01-01

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

  7. Farm tractors and mandatory roll-over protection retrofits: potential costs of the policy in New York.

    PubMed

    Kelsey, T W; Jenkins, P L

    1991-07-01

    Tractor roll-overs are the leading cause of fatal farm accidents, accounting for more than one-fourth of all agriculturally related deaths. Most of these deaths could be prevented if the tractors were equipped with roll-over protective structures (ROPS). This study estimates the number of tractors in New York without ROPS, projects their retirement, and then estimates the number of lives which would be saved if ROPS were retrofitted on old tractors. The basic costs associated with mandating ROPS are calculated from these estimates. The minimum economic cost of mandating ROPS is $511,136 per life saved for the retrofits, and an additional $253,254 per life saved for every $1 million spent annually on enforcement. It is concluded that a policy mandating ROPS on all tractors would be expensive, but should be considered with particular attention to the need for and cost effectiveness of enforcement.

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

    NASA Astrophysics Data System (ADS)

    Mashauri, Damas A.; Katko, Tapio S.

    1993-01-01

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

  9. Importance of cost-effectiveness and value in cancer care and healthcare policy

    PubMed Central

    Kang, Ravinder; Goodney, Philip P.; Wong, Sandra L.

    2016-01-01

    The cost of cancer care in the U.S. has increased by fivefold over the last three decades. Rising cancer prevalence, costly pharmaceuticals, physician and facility fees have all contributed to the expenditure. As our healthcare system shifts from volume to value, greater scrutiny of interventions with clinical equipoise is required. Traditionally, quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) have served as surrogate markers for value. However, these calculations fail to incorporate population or patient preferences. The diagnosis and treatment of prostate cancer, breast cancer and thyroid cancer are used as a framework to discuss value and cost-effectiveness. PMID:27334052

  10. Research ethics and law of healthcare system quality improvement: the conflict of cost containment and quality.

    PubMed

    Kofke, W Andrew; Rie, Michael A

    2003-03-01

    Quality improvement (QI) activities have been done as long as medicine has been practiced and are integral to safety and efficacy of patient care. The 20th century witnessed sophisticated advances of QI methods, with concurrent advances in research ethics. The suggestion that some interventional QI activities resemble research has led to a complex conundrum, with disparate forces driving for improvement and maintenance of patient care quality vs. the societal mandate to control healthcare costs. In the middle of these conflicting priorities are QI systems charged with effecting cost-effective and efficacious healthcare processes. Given the advances in research ethics, substantially grounded in the Nuremberg Code, and the increasing resemblance of interventional QI activities to research, the concern is raised of widespread and systematic Nuremberg Code violations occurring under the guise of QI in health care. Moreover, evidence is cited to suggest that if this is the case, then such activities may be subject to litigation or prosecutorial action. The ethical and legal foundations exist to support the systematic practice of informing patients of their participation in some types of QI procedures.

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

    ERIC Educational Resources Information Center

    Xie, Yan

    2010-01-01

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

  12. The Development of a Cost of Education Index: Some Empirical Estimates and Policy Issues.

    ERIC Educational Resources Information Center

    Chambers, Jay G.

    This paper outlines an approach for adjusting state aid for differences in educational costs. The approach focuses on determinants of the variation in the prices of school inputs such as cost of heating fuel, ability of the area to attract teachers, and needs for student transportation. The system attempts to isolate that component of the…

  13. Benefit-Cost Analysis of the Perry Preschool Program and Its Policy Implications.

    ERIC Educational Resources Information Center

    Barnett, W. Steven

    1985-01-01

    Benefit-cost analysis is applied to the Perry Preschool Program and its long-term follow-up in order to examine preschool education as a social investment. The net present value of benefits and costs is positive, indicating that the program was a profitable social investment. (Author/LMO)

  14. Development and evaluation of a low-cost amaranth (Amaranthus cruentus) containing food for preschool children.

    PubMed

    del Valle, F R; Sánchez-Marroquín, A; Escobedo, M; Avitia, R; Bourges, H; Maya, S; Vega, M; Becker, R

    1987-09-01

    A powdered blend for feeding preschool children was prepared from whole amaranth (Amaranthus cruentus) seeds, pearled oats, soybeans, sucrose and vegetable oil. The blend was similar in proximal chemical analysis and total caloric content, and identical in calorie distribution and vitamin and mineral patterns to a soy/oats infant formula previously developed. The amaranth blend equalled the FAO/WHO 1973 children's pattern in tryptophan and exceeded this pattern, as well as the soy/oats formula in all other essential amino acids; it reflected higher PER than casein and the soy/oats formula. In feeding trials with children 1-3 years of age, no significant differences in weight gain was observed when either product was fed. The anticipated cost of the amaranth blend is 6% lower than that of the soy/oats formula.

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

    SciTech Connect

    1996-05-01

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

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

    ERIC Educational Resources Information Center

    Pruslow, John T.

    2003-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1981-12-01

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

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

    ERIC Educational Resources Information Center

    Marra, Simona

    2008-01-01

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

  19. 77 FR 17360 - Reform of Federal Policies Relating to Grants and Cooperative Agreements; Cost Principles And...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

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

  20. The Perfect Storm: Changing National Policies to Reduce Flooding Impacts and Costs

    DTIC Science & Technology

    2011-12-01

    incapacitated transportation sectors, compromised law enforcement, and severely diminished access to basic needs, such as food, water, and medicine ... Prometheus Books. 155 Sawyer, T., & Tuchman, J. (2010). Congressman calls for ‘natural defense’ policy to spur effective land-use plans

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

    ERIC Educational Resources Information Center

    Bivens, Josh

    2010-01-01

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

  2. The role of cost-effectiveness analysis in developing nutrition policy.

    PubMed

    Cobiac, Linda J; Veerman, Lennert; Vos, Theo

    2013-01-01

    Concern about the overconsumption of unhealthy foods is growing worldwide. With high global rates of noncommunicable diseases related to poor nutrition and projections of more rapid increases of rates in low- and middle-income countries, it is vital to identify effective but low-cost interventions. Cost-effectiveness studies show that individually targeted dietary interventions can be effective and cost-effective, but a growing number of modeling studies suggest that population-wide approaches may bring larger and more sustained benefits for population health at a lower cost to society. Mandatory regulation of salt in processed foods, in particular, is highly recommended. Future research should focus on lacunae in the current evidence base: effectiveness of interventions addressing the marketing, availability, and price of healthy and unhealthy foods; modeling health impacts of complex dietary changes and multi-intervention strategies; and modeling health implications in diverse subpopulations to identify interventions that will most efficiently and effectively reduce health inequalities.

  3. The Costs and Valuation of Health Impacts of Measles and Rubella Risk Management Policies.

    PubMed

    Thompson, Kimberly M; Odahowski, Cassie L

    2016-07-01

    National and global health policymakers require good information about the costs and benefits of their investments in measles and rubella immunization programs. Building on our review of the existing measles and rubella health economics literature, we develop inputs for use in regional and global models of the expected future benefits and costs of vaccination, treatment, surveillance, and other global coordination activities. Given diversity in the world and limited data, we characterize the costs for countries according to the 2013 World Bank income levels using 2013 U.S. dollars (2013$US). We estimate that routine immunization and supplemental immunization activities will cost governments and donors over 2013$US 2.3 billion per year for the foreseeable future, with high-income countries accounting for 55% of the costs, to vaccinate global birth cohorts of approximately 134 million surviving infants and to protect the global population of over 7 billion people. We find significantly higher costs and health consequences of measles or rubella disease than with vaccine use, with the expected disability-adjusted life year (DALY) loss for case of disease generally at least 100 times the loss per vaccine dose. To support estimates of the economic benefits of investments in measles and/or rubella elimination or control, we characterize the probabilities of various sequelae of measles and rubella infections and vaccine adverse events, the DALY inputs for health outcomes, and the associated treatment costs. Managing measles and rubella to achieve the existing and future regional measles and rubella goals and the objectives of the Global Vaccine Action Plan will require an ongoing commitment of financial resources that will prevent adverse health outcomes and save the associated treatment costs.

  4. Further Evidence on the Effect of Acquisition Policy and Process on Cost Growth

    DTIC Science & Technology

    2016-04-30

    Climate Note. Numbers in parentheses are the number of observations in the cell. * Normalized for changes in quantity. A plausible reading of...stand as instances of a significant association between changes in OSD-level oversight and cost growth. The paper also provides evidence that average...funding climates on average had much higher cost growth than those that entered EMD during “boom” climates . Second, the paper found that additional

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

    NASA Technical Reports Server (NTRS)

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

    1979-01-01

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

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

    PubMed Central

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

    2010-01-01

    resource pressures grow. Policies regarding generics and their subsequent impact on reimbursement and utilization of single sourced products will continue to play a key role to release valuable resources. However, there must continue to be strategies to address concerns with generics when they exist. PMID:27713363

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

    PubMed

    Costa, Thadeu Estevam Moreira Maramaldo; Marin, Victor Augustus

    2011-08-01

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

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

    PubMed Central

    2011-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1981-10-01

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

  10. Thermophysical Properties and Corrosion Characterization of Low Cost Lithium Containing Nitrate Salts Produced in Northern Chile for Thermal Energy Storage

    SciTech Connect

    Fernandez, Angel G.; Gomez, Judith C.; Galleguillos, Hector; Fuentealba, Edward

    2016-05-31

    In recent years, lithium containing salts have been studied for thermal energy storage (TES) systems applications, because of their optimal thermophysical properties. In solar power plants, lithium is seen as a way to improve the properties of molten salts used today. Lithium nitrate is a good candidate for sensible heat storage, due to its ability to increase the salt mixture's working temperature range. In the present research, thermophysical properties characterization of lithium nitrate containing salts, produced in Chile, have been carried out. Corrosion evaluations of carbon and low chromium steels were performed at 390 degrees C for 1000 hours. Thermophysical properties of the salt mixtures, such as thermal stability and heat capacity, were measured before and after corrosion tests. Chemical composition of the salts was also determined and an estimation of Chilean production costs is reported. Results showed that purity, thermal stability and heat capacity of the salts were reduced, caused by partial thermal decomposition and incorporation of corrosion products from the steel.

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

    NASA Astrophysics Data System (ADS)

    Lawton, D. C.; Osadetz, K.

    2014-12-01

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

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

    SciTech Connect

    Not Available

    1984-12-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

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

    PubMed

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

    2015-09-15

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

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

    NASA Astrophysics Data System (ADS)

    Simpson, J. A.

    1981-08-01

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

  17. Education Program Cost Reimbursement in University Hospitals. Is There a Coherent National Policy?

    ERIC Educational Resources Information Center

    Jeddeloh, Norman P.

    1981-01-01

    Medicare reimbursement for educational program costs is a quagmire of conflicting rules, regulations, laws, procedures, and precedents. The reimbursement principles in force fail to recognize the special value to patient care provided by the integration of the university hospital with an academic health sciences center and are illogical and…

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

    ERIC Educational Resources Information Center

    Markowitz, Melissa

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Schaeffer, Adam

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Lucas, Deborah; Moore, Damien

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Lyell, Edward H.

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

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

    ERIC Educational Resources Information Center

    Wellman, Jane; Johnson, Nate; Steele, Patricia

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Ash, Katie

    2008-01-01

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

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

    SciTech Connect

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

    2008-01-07

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

  5. Perspectives on financing academic research facilities: A resource for policy formulation. [Contains bibliography

    SciTech Connect

    Not Available

    1989-10-01

    Facilities are vital to the nation's academic science and engineering enterprise. If investigators are the heart of the enterprise, facilities are its backbone. They support an environment for seeking new knowledge, educating technical human resources, and supporting the missions of federal agencies and the goals of industry -- all of which underpin the nation's social and economic future. This document has a two-fold purpose. First, it is designed to help policymakers address the complicated, interrelated issues in facility funding by identifying objectives and operational criteria for a comprehensive approach to facility needs and by describing what objectives and criteria are fulfilled by each funding mechanism. Second, it is compiled as a reference work, bringing together details on key policy issues, technical material on facility financing mechanisms and sources, and data on facility needs. The paper's premise is that the need for construction, renovation, and repair of facilities is an ongoing condition of the academic research enterprise. The focus on approaches to facility financing, then, is how they are best put in place and kept responsive, not whether they are needed. The document discusses the need for and objectives of facility financing, criteria relevant to a balanced, comprehensive approach to facility financing, and the strengths and weaknesses of current facility financing mechanisms. It reviews available data on support provided by the public and private sectors, and examines the complex relationships among them. It concludes with an analysis of proposals made by various groups in recent years to modify facility financing. Appendices provide detailed information on facility needs and financing sources, and descriptions of the operation, use, and history of the more commonly used financing mechanisms. 48 refs., 6 figs., 1 tab.

  6. Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy.

    PubMed

    Drake, Tom L; Lubell, Yoel; Kyaw, Shwe Sin; Devine, Angela; Kyaw, Myat Phone; Day, Nicholas P J; Smithuis, Frank M; White, Lisa J

    2017-02-10

    Healthcare services are often provided to a country as a whole, though in many cases the available resources can be more effectively targeted to specific geographically defined populations. In the case of malaria, risk is highly geographically heterogeneous, and many interventions, such as insecticide-treated bed nets and malaria community health workers, can be targeted to populations in a way that maximises impact for the resources available. This paper describes a framework for geographically targeted budget allocation based on the principles of cost-effectiveness analysis and applied to priority setting in malaria control and elimination. The approach can be used with any underlying model able to estimate intervention costs and effects given relevant local data. Efficient geographic targeting of core malaria interventions could significantly increase the impact of the resources available, accelerating progress towards elimination. These methods may also be applicable to priority setting in other disease areas.

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

    SciTech Connect

    Rouelle, P.; Roy, F.

    1998-12-31

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

  8. Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)

    PubMed Central

    Gray, Alastair; Raikou, Maria; McGuire, Alistair; Fenn, Paul; Stevens, Richard; Cull, Carole; Stratton, Irene; Adler, Amanda; Holman, Rury; Turner, Robert

    2000-01-01

    Objective To estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes. Design Incremental cost effectiveness analysis alongside randomised controlled trial. Setting 23 UK hospital clinic based study centres. Participants 3867 patients with newly diagnosed type 2 diabetes (mean age 53 years). Interventions Conventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin. Main outcome measures Incremental cost per event-free year gained within the trial period. Results Intensive glucose control increased trial treatment costs by £695 (95% confidence interval £555 to £836) per patient but reduced the cost of complications by £957 (£233 to £1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was £478 (−£275 to £1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was £1166 (costs and effects discounted at 6% a year) and £563 (costs discounted at 6% a year and effects not discounted). Conclusions Intensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications. PMID:10818026

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

    PubMed

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

    2015-08-01

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

  10. Home care for life-supported persons: the French system of quality control, technology assessment, and cost containment.

    PubMed Central

    Goldberg, A I

    1989-01-01

    Home care for persons who require the prolonged use of life-supportive medical technology is a reality in several nations. France has had more than a quarter of a century of experience with providing home care for patients with chronic respiratory insufficiency and with a system to evaluate the patients' outcomes. The French approach features decentralized regional organizations which offer grassroots involvement by the beneficiaries who participate directly in the system. Since June 1981, a national organization has provided patients, professionals, and others concerned with direct access to national funding authorities and governmental officials and has created a data base for evaluation of the experience. This system permits direct input by current users of the services and creates informed opinion among members of the general public, governmental officials, and others involved (health care professionals and service providers). This is essential for the development of responsive public policy and for the determination of the relevancy of programs. In the United States, increasing demands are being made upon expensive hospital services by patients with diseases such as AIDS and other catastrophic, long-term care conditions. Cost-saving, community-oriented home care models serving complex medical-societal needs abroad are worthy of study to discern possible applications to health and social problems in our nation. PMID:2502803

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

    ERIC Educational Resources Information Center

    Stringer, William L.; Cunningham, Alisa F.

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

  12. Draft environmental assessment: Davis Canyon site, Utah. Nuclear Waste Policy Act (Section 112). [Contains glossary

    SciTech Connect

    Not Available

    1984-12-01

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

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

    SciTech Connect

    Not Available

    1984-12-01

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

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

    SciTech Connect

    1997-01-01

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

  15. The impact of proposed changes in liver allocation policy on cold ischemia times and organ transportation costs.

    PubMed

    DuBay, D A; MacLennan, P A; Reed, R D; Fouad, M; Martin, M; Meeks, C B; Taylor, G; Kilgore, M L; Tankersley, M; Gray, S H; White, J A; Eckhoff, D E; Locke, J E

    2015-02-01

    Changes to the liver allocation system have been proposed to decrease regional variation in access to liver transplant. It is unclear what impact these changes will have on cold ischemia times (CITs) and donor transportation costs. Therefore, we performed a retrospective single center study (2008-2012) measuring liver procurement CIT and transportation costs. Four groups were defined: Local-within driving distance (Local-D, n = 262), Local-flight (Local-F, n = 105), Regional-flight <3 h (Regional <3 h, n = 61) and Regional-Flight >3 h (Regional >3 h, n = 53). The median travel distance increased in each group, varying from zero miles (Local-D), 196 miles (Local-F), 384 miles (Regional <3 h), to 1647 miles (Regional >3 h). Increasing travel distances did not significantly increase CIT until the flight time was >3 h. The average CIT ranged from 5.0 to 6.0 h for Local-D, Local-F and Regional <3 h, but increased to 10 h for Regional >3 h (p < 0.0001). Transportation costs increased with greater distance traveled: Local-D $101, Local-F $1993, Regional <3 h $8324 and Regional >3 h $27 810 (p < 0.0001). With proposed redistricting, local financial modeling suggests that the average liver donor procurement transportation variable direct costs will increase from $2415 to $7547/liver donor, an increase of 313%. These findings suggest that further discussion among transplant centers and insurance providers is needed prior to policy implementation.

  16. The impact of technology on health care cost and policy development.

    PubMed

    Wallner, Paul E; Konski, Andre

    2008-07-01

    As health care spending in the United States continues to increase at a pace significantly faster than that of other sectors of the economy, there seems to be greater interest and willingness to consider the root causes of the rise and to explore options for reform. Some of the reasons for cost escalation are associated with a growing and aging population that all too often makes inappropriate personal choices, but others are clearly attributable to growth in the cost of drugs, hospital and nursing home care, provider reimbursement, and durable medical equipment. Some health care economists have suggested that the rapid introduction of new technologies has also played a major role. Vendors understandably desire early market penetration of any new device or technology, but often this may be accomplished before significant evidence of benefit is available. Our current system of device approval unlinked to coverage and payment has produced further disruption in the system. The nature of the problem and consideration of various factors in the introduction, implementation, and evaluation of new technologies will be considered.

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

    PubMed

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

    2011-07-01

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

  18. Strategies for laboratory cost containment and for pathologist shortage: centralised pathology laboratories with microwave-stimulated histoprocessing and telepathology.

    PubMed

    Leong, Anthony S Y; Leong, F Joel W M

    2005-02-01

    The imposition of laboratory cost containment, often from external forces, dictates the necessity to develop strategies to meet laboratory cost savings. In addition, the national and worldwide shortage of anatomical pathologists makes it imperative to examine our current practice and laboratory set-ups. Some of the strategies employed in other areas of pathology and laboratory medicine include improvements in staff productivity and the adoption of technological developments that reduce manual intervention. However, such opportunities in anatomical pathology are few and far between. Centralisation has been an effective approach in bringing economies of scale, the adoption of 'best practices' and the consolidation of pathologists, but this has not been possible in anatomical pathology because conventional histoprocessing takes a minimum of 14 hours and clinical turnaround time requirements necessitate that the laboratory and pathologist be in proximity and on site. While centralisation of laboratories for clinical chemistry, haematology and even microbiology has been successful in Australia and other countries, the essential requirements for anatomical pathology laboratories are different. In addition to efficient synchronised courier networks, a method of ultra-rapid tissue processing and some expedient system of returning the prepared tissue sections to the remote laboratory are essential to maintain the turnaround times mandatory for optimal clinical management. The advent of microwave-stimulated tissue processing that can be completed in 30-60 minutes and the immediate availability of compressed digital images of entire tissue sections via telepathology completes the final components of the equation necessary for making centralised anatomical pathology laboratories a reality.

  19. New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly 'crisis care'.

    PubMed

    Koh, Howard K; Berwick, Donald M; Clancy, Carolyn M; Baur, Cynthia; Brach, Cindy; Harris, Linda M; Zerhusen, Eileen G

    2012-02-01

    Health literacy is the capacity to understand basic health information and make appropriate health decisions. Tens of millions of Americans have limited health literacy--a fact that poses major challenges for the delivery of high-quality care. Despite its importance, health literacy has until recently been relegated to the sidelines of health care improvement efforts aimed at increasing access, improving quality, and better managing costs. Recent federal policy initiatives, including the Affordable Care Act of 2010, the Department of Health and Human Services' National Action Plan to Improve Health Literacy, and the Plain Writing Act of 2010, have brought health literacy to a tipping point-that is, poised to make the transition from the margins to the mainstream. If public and private organizations make it a priority to become health literate, the nation's health literacy can be advanced to the point at which it will play a major role in improving health care and health for all Americans.

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

    PubMed

    Ramsey, Scott D

    2015-04-01

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

  1. Thermophysical properties and corrosion characterization of low cost lithium containing nitrate salts produced in northern Chile for thermal energy storage

    NASA Astrophysics Data System (ADS)

    Fernández, Ángel G.; Gomez, Judith C.; Galleguillos, Hector; Fuentealba, Edward

    2016-05-01

    In recent years, lithium containing salts have been studied for thermal energy storage (TES) systems applications, because of their optimal thermophysical properties. In solar power plants, lithium is seen as a way to improve the properties of molten salts used today. Lithium nitrate is a good candidate for sensible heat storage, due to its ability to increase the salt mixture's working temperature range. In the present research, thermophysical properties characterization of lithium nitrate containing salts, produced in Chile, have been carried out. Corrosion evaluations of carbon and low chromium steels were performed at 390°C for 1000 hours. Thermophysical properties of the salt mixtures, such as thermal stability and heat capacity, were measured before and after corrosion tests. Chemical composition of the salts was also determined and an estimation of Chilean production costs is reported. Results showed that purity, thermal stability and heat capacity of the salts were reduced, caused by partial thermal decomposition and incorporation of corrosion products from the steel.

  2. The financial impact of a state adopting a personal/philosophical belief exemption policy: modeling the cost of pertussis disease in infants, children and adolescents.

    PubMed

    Wells, Katelyn B; Omer, Saad B

    2012-09-07

    State school immunization exemption policies help reduce the risk of individual and community disease. Assessing the costs of vaccine preventable disease associated with a state adding a philosophical/personal belief school exemption policy is useful for making future policy decisions. Two formulas were developed to estimate the infant, child and adolescent hospitalization and non-medical costs of pertussis disease that are associated with adding a philosophical/personal belief school exemption policy. The parameter estimates were obtained from peer reviewed literature and the Centers for Disease Control and Prevention. The state of Iowa was used as an example in order to demonstrate how the formulas can be applied. The annual projected impact of pertussis disease in Iowa is $273,365 without a philosophical/personal belief exemption policy and an average of $410,047 (range of $281,566-$582,267) with adding a personal belief exemption policy. We project that adding a philosophical/personal belief exemption will cost 50% more dollars annually.

  3. 77 FR 43542 - Cost Accounting Standards: Cost Accounting Standards 412 and 413-Cost Accounting Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-25

    ... BUDGET Office of Federal Procurement Policy 48 CFR Part 9904 Cost Accounting Standards: Cost Accounting Standards 412 and 413--Cost Accounting Standards Pension Harmonization Rule AGENCY: Cost Accounting... correcting amendments. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting...

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

    ERIC Educational Resources Information Center

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

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

  5. Effects of design flow and treatment level on construction and operation costs of municipal wastewater treatment plants and their implications on policy making.

    PubMed

    Friedler, Eran; Pisanty, Ehud

    2006-12-01

    Construction costs of 55 municipal wastewater treatment plants in Israel (secondary, advanced secondary, and advanced treatment) were analysed in order to derive cost functions expressing the effects of design flow and treatment level on construction costs. Three equations were derived (statistically significant, p<0.01), one for each treatment level. These indicate that economy of scale may become weaker as treatment level rises. Analysis of the distribution of construction costs revealed negative correlation (p<0.05) between the proportional cost of civil engineering and design flow, positive correlation (p<0.05) between the proportional cost of elecromechanical equipment and design flow, and no correlation between the proportional cost of electricity and control and design flow. Operation costs were found to be 20-70% more sensitive than construction costs to treatment level. The share of operation costs as part of the total annual costs was found to increase both with design flow and treatment level, whereas the share of construction costs concurrently decreased. The implication of the findings on policy, and consequently on treatment plants performance is discussed in the last part of the paper.

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

    NASA Astrophysics Data System (ADS)

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

    1981-10-01

    environmental and/or political interest. The impact of each management scheme was then evaluated in terms of lost or foregone power against a `base regulation' in which the objective was to generate as much power as possible over the critical period. Lost power was conservatively evaluated at 35 mills per lost kilowatt-hour for baseload, with much higher costs possible for lost peaking.

  7. Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning

    PubMed Central

    Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

    2016-01-01

    ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

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

    PubMed

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

    2015-09-23

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

  9. Does competition by health maintenance organizations affect the adoption of cost-containment measures by fee-for-service plans?

    PubMed

    Joesch, J M; Wickizer, T M; Feldstein, P J

    1998-06-01

    How groups insured by fee-for-service health plans react to increased competition from health maintenance organizations (HMOs) is an unresolved question. We investigated whether groups insured by indemnity plans respond to HMO market competition by changing selected health insurance features, such as deductible amounts, stop loss levels, and coinsurance rates, or by adopting utilization management or preferred provider organization (PPO) benefit options. We collected benefit design data for the years 1985 through 1992 from 95 insured groups in 62 US metropolitan statistical areas. Multivariate hazard analysis showed that groups located in markets with higher rates of change in HMO enrollment were less likely to increase deductibles or stop loss levels. Groups located in markets with higher HMO enrollment were more likely to adopt utilization management or PPO benefit options. A group located in a market with an HMO penetration rate of 20% was 65% more likely to have included a PPO option as part of its insurance benefit plan than a group located in a market with an HMO penetration rate of 15% (p < 0.05). Concern about possible adverse selection effects may deter some fee-for-service groups from changing their health insurance coverage. Under some conditions, however, groups insured under fee-for-service plans do respond to managed care competition by changing their insurance benefits to achieve greater cost containment.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Titus, James G.

    1991-01-01

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

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

    PubMed

    van der Kamp, Jonathan; Bachmann, Till M

    2015-03-03

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

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

    ERIC Educational Resources Information Center

    Amundson, Bruce

    2005-01-01

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

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

    PubMed

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

    2014-12-01

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

  16. Cost-Effectiveness of Colorectal Cancer Screening in High Risk Spanish Patients: Use of a Validated Model to Inform Public Policy

    PubMed Central

    Ladabaum, Uri; Ferrandez, Angel; Lanas, Angel I.

    2011-01-01

    Background The European Community has made a commitment to colorectal cancer (CRC) screening, but regional considerations may affect the design of national screening programs. We developed a decision analytic model tailored to a pilot screening program for high risk persons in Spain with the aim of informing public policy decisions. Methods We constructed a decision analytic Markov model based on our validated model of CRC screening that reflected CRC epidemiology and costs in persons with first-degree relatives with CRC in Aragón, Spain, and superimposed colonoscopy every 5 or 10 years from ages 40-80 years. The pilot program’s preliminary clinical results and our modeling results were presented to regional health authorities. Results In the model, without screening, 88 CRC cases occurred per 1,000 persons from age 40-85 years. In the base case, screening reduced this by 72-77% and gained 0.12 discounted life-years/person. Screening every 10 years was cost-saving, and screening every 5 years vs. every 10 years cost 7,250 €/life-year gained. Based on these savings, 36-39 €/person/year could go towards operating costs while maintaining a neutral budget. If screening costs doubled, screening remained highly cost-effective, but no longer cost-saving. These results contributed to the health authorities’ decision to expand the pilot program to the entire region in 2009. Conclusions Colonoscopic screening of first-degree relatives of persons with CRC may be cost-saving in public systems like Spain’s. Decision analytic modeling tailored to regional considerations can inform public policy decisions. Impact Tailored decision analytic modeling can inform regional policy decisions on cancer screening. PMID:20810603

  17. Medicare program; prospective payment system for long-term care hospitals RY 2009: annual payment rate updates, policy changes, and clarifications; and electronic submission of cost reports: revision to effective date of cost reporting period. Final rule.

    PubMed

    2008-05-09

    This final rule updates the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs). We are also consolidating the annual July 1 update for payment rates and the October 1 update for Medicare severity long-term care diagnosis-related group (MS-LTC-DRG) weights to a single rulemaking cycle that coincides with the Federal fiscal year (FFY). In addition, we are clarifying various policy issues. This final rule also finalizes the provisions from the Electronic Submission of Cost Reports: Revision to Effective Date of Cost Reporting Period interim final rule with comment period that was published in the May 27, 2005 Federal Register which revises the existing effective date by which all organ procurement organizations (OPOs), rural health clinics (RHCs), Federally qualified health centers (FQHCs), and community mental health centers (CMHCs) are required to submit their Medicare cost reports in a standardized electronic format from cost reporting periods ending on or after December 31, 2004 to cost reporting periods ending on or after March 31, 2005. This final rule does not affect the current cost reporting requirement for hospices and end-stage renal disease (ESRD) facilities. Hospices and ESRD facilities are required to continue to submit cost reports under the Medicare regulations in a standardized electronic format for cost reporting periods ending on or after December 31, 2004.

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

    ERIC Educational Resources Information Center

    American Association of State Colleges and Universities, 2010

    2010-01-01

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

  19. Marginal cost curves for water footprint reduction in irrigated agriculture: a policy and decision making guide for efficient water use in crop production

    NASA Astrophysics Data System (ADS)

    Chukalla, Abebe; Krol, Maarten; Hoekstra, Arjen

    2016-04-01

    Reducing water footprints (WF) in irrigated crop production is an essential element in water management, particularly in water-scarce areas. To achieve this, policy and decision making need to be supported with information on marginal cost curves that rank measures to reduce the WF according to their cost-effectiveness and enable the estimation of the cost associated with a certain WF reduction target, e.g. towards a certain reasonable WF benchmark. This paper aims to develop marginal cost curves (MCC) for WF reduction. The AquaCrop model is used to explore the effect of different measures on evapotranspiration and crop yield and thus WF that is used as input in the MCC. Measures relate to three dimensions of management practices: irrigation techniques (furrow, sprinkler, drip and subsurface drip); irrigation strategies (full and deficit irrigation); and mulching practices (no mulching, organic and synthetic mulching). A WF benchmark per crop is calculated as resulting from the best-available production technology. The marginal cost curve is plotted using the ratios of the marginal cost to WF reduction of the measures as ordinate, ranking with marginal costs rise with the increase of the reduction effort. For each measure, the marginal cost to reduce WF is estimated by comparing the associated WF and net present value (NPV) to the reference case (furrow irrigation, full irrigation, no mulching). The NPV for each measure is based on its capital costs, operation and maintenances costs (O&M) and revenues. A range of cases is considered, including: different crops, soil types and different environments. Key words: marginal cost curve, water footprint benchmark, soil water balance, crop growth, AquaCrop

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

    PubMed

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

    2014-01-13

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

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

    SciTech Connect

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

    1993-03-16

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

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

    ERIC Educational Resources Information Center

    LaPlante, Josephine M.; Durham, Taylor R.

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

  3. ALEC (Aggregate Lifecycle Effectiveness and Cost): A Model for Analyzing the Cost-Effectiveness of Air Force Enlisted Personnel Policies. Volume 2. Documentation and User’s Guide.

    DTIC Science & Technology

    1987-08-01

    CLASSIFICATION OF This PAGE (Wmn D Entered) PAGE READ INSTRUCTIONSREPORT DOCUMENTATION BEFORE COMPLETING FORM r I REPORT NUMBER GOVT ACCESSION NO. 3...an Identify by block nuinlf) See reverse side DO D I ,, 1473 UNCLASSIFIED SECURITY CLAI VIICATION OF THIS PAGE ,hen Dts Enteredi) * - - !’ *.-O...Policies (Documentation and User’s Guide) C. Peter Rydell August 1987 Prepared for The United States Air Force Accesioli NTIS Ai D TI C T A,5 By RAND

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

    ERIC Educational Resources Information Center

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

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

  5. ''When Cost Measures Contradict''

    SciTech Connect

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

    2003-05-09

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

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

    PubMed Central

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

    2015-01-01

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

  7. Update of cost information contained in a previous GAO report on specific aspects of the Clinch River Breeder Reactor Project

    SciTech Connect

    Not Available

    1981-06-26

    As part of our June 23, 1977, report, the Energy Research and Development Administration (ERDA)--now part of the Department of Energy (DOE)--provided us with some cost and schedule information for the Clinch River Breeder Reactor Project as it related to three different licensing cases. At the time, the administration was attempting to terminate the Clinch River Project. And then, as now, it was a topic of heated debate within the Congress and between the Congress and the executive branch. Consequently, it was against this backdrop that we asked ERDA officials to provide us with specific cost and schedule data for the Clinch River Project, assuming it would be terminated and then restarted about 4 months later, after the Congress had an opportunity to fully consider whether to go ahead with the entire breeder reactor program. At the time, we used the 4-month lapse as an estimate that would provide an indication of the impact the project termination would have on the Clinch River Project's cost and schedule.

  8. Measuring the Readiness Cost of One-Size-Shoe-Fits-All Public Policy: A Look at Cost-, Hybrid-, and Price-Based Purchasing

    DTIC Science & Technology

    2000-01-01

    Harvard Business Review , pp. 94-102. DoD. Federal Acquisition Regulations. Parts 15 and 13. Washington...small businesses. Harvard Business Review , pp. 16–24. Myer, R. (1989, November-December). Suppliers—manage your customers. Harvard Business Review , pp... Business Review , pp. 127–135. Baron, D., & Meyerson, R. (1982). Regu- lating a monopolist with unknown costs. Econometrica, 50, pp. 911–930. DoD

  9. How Much Does Medical Education Cost? A Review. Health Manpower Policy Discussion Paper Series No. A3.

    ERIC Educational Resources Information Center

    MacBride, Owen

    This survey of studies of medical school costs was made in order to evaluate and compare the methodologies and findings of those studies. The survey covered studies of one or more medical schools that either produced figures for average annual per-student cost of education and/or discussed the methodologies and problems involved in producing such…

  10. Payment mechanisms and the composition of physician practices: balancing cost-containment, access, and quality of care.

    PubMed

    Barham, Victoria; Milliken, Olga

    2015-07-01

    We take explicit account of the way in which the supply of physicians and patients in the economy affects the design of physician remuneration schemes, highlighting the three-way trade-off between quality of care, access, and cost. Both physicians and patients are heterogeneous. Physicians choose both the number of patients and the quality of care to provide to their patients. When determining physician payment rates, the principal must ensure access to care for all patients. When physicians can adjust the number of patients seen, there is no incentive to over-treat. In contrast, altruistic physicians always quality stint: they prefer to add an additional patient, rather than to increase the quality of service provided. A mixed payment mechanism does not increase the quality of service provided with respect to capitation. Offering a menu of compensation schemes may constitute a cost-effective strategy for inducing physicians to choose a given overall caseload but may also generate difficulties with access to care for frail patients.

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

    PubMed Central

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Lawrence, Barbara Kent

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

  13. Contributions and Costs of Manpower Development and Training. Policy Papers in Human Resources and Industrial Relations No. 5.

    ERIC Educational Resources Information Center

    Mangum, Garth L.

    As a part of a larger project under grant from the Ford Foundation to evaluate federal manpower policies and programs, this evaluation of the training efforts under Title II of the Manpower Development and Training Act (MDTA) made use of data provided by the Departments of Labor and Health, Education, and Welfare. By the end of fiscal 1967, 1.2…

  14. The Problem of High-Cost Education and the Potential Cure in Federal Tax Policy: "One Riot, One Ranger".

    ERIC Educational Resources Information Center

    Pace, Christopher Rebel J.

    1991-01-01

    Summarizes the federal treasury regulation governing the deductibility of educational expenses and outlines why it is disadvantageous to student taxpayers. Proposes that Congress permit the accelerated amortization of qualified educational costs over a five-year horizon. (155 references) (MLF)

  15. Report: Policies Needed for Proper Use and Management of Cost-Reimbursement Contracts Based on Duncan Hunter Act

    EPA Pesticide Factsheets

    Report #12-P-0320, March 6, 2012. EPA did not comply with several key revisions to the FAR as amended by the interim rule, Proper Use and Management of Cost Reimbursement Contracts (FAR Case 2008-030).

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

    PubMed Central

    Guest, Julian F; Weidlich, Diana; Kaczmarski, Maciej; Jarocka-Cyrta, Elzbieta; Kobelska-Dubiel, Natalia; Krauze, Agnieszka; Sakowska-Maliszewska, Iwona; Zawadzka-Krajewska, Anna

    2016-01-01

    Objective To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula (eHCF) containing the probiotic Lactobacillus rhamnosus GG (eHCF + LGG; Nutramigen LGG) as an initial treatment for cow’s milk allergy compared with eHCF alone and amino acid formulas (AAF) in Poland from the perspective of the Polish National Health Fund (Narodowy Fundusz Zdrowia [NFZ]) and parents. Methods Decision modeling was used to estimate the probability of cow’s milk allergic infants developing tolerance to cow’s milk by 18 months. The model also estimated the cost to the NFZ and parents (Polish Zloty [PLN] at 2013–2014 prices) for managing infants over 18 months after starting one of the formulas as well as the relative cost-effectiveness of each of the formulas. Results The probability of developing tolerance to cow’s milk by 18 months was higher among infants who were fed eHCF + LGG (0.82) compared with those fed eHCF alone (0.53) or an AAF (0.22). An infant who is initially managed with eHCF + LGG is expected to consume fewer health care resources than infants managed with the other formulas. Hence, the estimated total health care cost incurred by the NFZ for initially feeding infants with eHCF + LGG (PLN 5,693) was less than that of feeding infants with eHCF alone (PLN 7,749) or an AAF (PLN 24,333). However, the total cost incurred by parents for initially feeding infants with an AAF (PLN 815) was marginally less than that of feeding with eHCF + LGG (PLN 993), which was less than that of feeding with eHCF alone (PLN 1,226). Conclusion Using eHCF + LGG instead of eHCF alone or an AAF for first-line management of newly diagnosed infants with cow’s milk allergy affords a cost-effective use of NFZ-funded resources, since it improves outcome for less cost. Whether eHCF + LGG would be viewed as being cost-effective by parents is dependent on their willingness to pay an additional cost for additional tolerance acquisition to cow’s milk. PMID:27418845

  17. Measuring treatment costs of typical waste electrical and electronic equipment: A pre-research for Chinese policy making.

    PubMed

    Li, Jinhui; Dong, Qingyin; Liu, Lili; Song, Qingbin

    2016-11-01

    Waste Electrical and Electronic Equipment (WEEE) volume is increasing, worldwide. In 2011, the Chinese government issued new regulations on WEEE recycling and disposal, establishing a WEEE treatment subsidy funded by a levy on producers of electrical and electronic equipment. In order to evaluate WEEE recycling treatment costs and revenue possibilities under the new regulations, and to propose suggestions for cost-effective WEEE management, a comprehensive revenue-expenditure model (REM), were established for this study, including 7 types of costs, 4 types of fees, and one type of revenue. Since TV sets dominated the volume of WEEE treated from 2013 to 2014, with a contribution rate of 87.3%, TV sets were taken as a representative case. Results showed that the treatment cost varied from 46.4RMB/unit to 82.5RMB/unit, with a treatment quantity of 130,000 units to 1,200,000 units per year in China. Collection cost accounted for the largest portion (about 70.0%), while taxes and fees (about 11.0 %) and labor cost (about 7.0 %) contributed less. The average costs for disposal, sales, and taxes had no influence on treatment quantity (TQ). TQ might have an adverse effect on average labor and management costs; while average collection and purchase fees, and financing costs, would vary with purchase price, and the average sales fees and taxes would vary with the sales of dismantled materials and other recycled products. Recycling enterprises could reduce their costs by setting up online and offline collection platforms, cooperating with individual collectors, creating door-to-door collection channels, improving production efficiency and reducing administrative expenditures. The government could provide economic incentives-such as subsidies, low-cost loans, tax cuts and credits-and could also raise public awareness of waste management and environmental protection, in order to capture some of the WEEE currently discarded into the general waste stream. Foreign companies with

  18. Assessing the impact of state "opt-out" policy on access to and costs of surgeries and other procedures requiring anesthesia services.

    PubMed

    Schneider, John E; Ohsfeldt, Robert; Li, Pengxiang; Miller, Thomas R; Scheibling, Cara

    2017-12-01

    In 2001, the U.S. government released a rule that allowed states to "opt-out" of the federal requirement that a physician supervise the administration of anesthesia by a nurse anesthetist. To date, 17 states have opted out. The majority of the opt-out states cited increased access to anesthesia care as the primary rationale for their decision. In this study, we assess the impact of state opt-out policy on access to and costs of surgeries and other procedures requiring anesthesia services. Our null hypothesis is that opt-out rule adoption had little or no effect on surgery access or costs. We estimate an inpatient model of surgeries and costs and an outpatient model of surgeries. Each model uses data from multiple years of U.S. inpatient hospital discharges and outpatient surgeries. For inpatient cost models, the coefficient of the opt-out variable was consistently positive and also statistically significant in most model specifications. In terms of access to inpatient surgical care, the opt-out rules did not increase or decrease access in opt-out states. The results for the outpatient access models are less consistent, with some model specifications indicating a reduction in access associated with opt-out status, while other model specifications suggesting no discernable change in access. Given the sensitivity of model findings to changes in model specification, the results do not provide support for the belief that opt-out policy improves access to outpatient surgical care, and may even reduce access to outpatient surgical care (among freestanding facilities).

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

    SciTech Connect

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

    2003-01-01

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

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

    PubMed

    Dougherty, Christopher P; Howard, Timothy

    2013-09-01

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

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

    PubMed

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

    2013-02-01

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

  2. Reform and Non-Reform in Education: The Political Costs and Benefits of Reform Policies in France and Japan.

    ERIC Educational Resources Information Center

    Weiler, Hans N.; Miyake, Eriko

    This paper examines how the perception and anticipation of political costs and benefits affects decisions about whether and how plans for educational reforms are to be pursued. Two case studies of major educational reform attempts are described: France and Japan. The study analyzes the two societies' underlying dilemmas, which manifest themselves…

  3. Understanding Cost-Effectiveness of Energy Efficiency Programs: Best Practices, Technical Methods, and Emerging Issues for Policy-Makers

    EPA Pesticide Factsheets

    This paper is provided to assist utility regulators, gas and electric utilities, and others in meeting the 10 implementation goals of the National Action Plan for Energy Effi ciency’s Vision to achieve all cost-effective energy effi ciency by 2025.

  4. Costs and health effects of adding functional foods containing phytosterols/-stanols to statin therapy in the prevention of cardiovascular disease.

    PubMed

    Eussen, Simone R B M; Feenstra, Talitha L; Toxopeus, Ido B; Hoekstra, Jeljer; Klungel, Olaf H; Verhagen, Hans; van Kranen, Henk J; Rompelberg, Cathy J M

    2011-09-01

    The present modelling study aimed to evaluate if and by how much functional foods containing phytosterols/-stanols add to the benefits of statins in the prevention of cardiovascular disease in terms of cost-effectiveness. Long-term health effects, measured as quality-adjusted life-years gained, and costs for scenarios with additional phytosterol/-stanol use were compared to scenarios without extra use. Phytosterols/-stanols were given only to persons who were eligible for use according to their 10-year absolute risk of fatal cardiovascular disease (SCORE-risk). Intake levels and discontinuation rates as observed in daily practice were included in the model. Two situations were compared: 1) A real-life situation in which persons at high SCORE-risk were identified through clinical case-finding and, 2) A theoretical maximum situation where universal screening was implemented resulting in known SCORE-risks for the whole Dutch population aged 35-75 years (8.4 million people). Sensitivity analyses were performed for variations in the cholesterol-lowering effect and intake level of phytosterols/-stanols, indirect health care costs, time horizon and discount rates. At the model's start year, a total of 1.0 (real-life situation) to 3.3 (maximum situation) million persons qualified for phytosterol/-stanol use based on their SCORE-risk (both statin users and statin non-users). Over the model's time horizon, this resulted in a gain of 2700 to 16,300 quality-adjusted life-years, and yielded cost-effectiveness ratios that ranged between €92,000 and €203,000 per quality-adjusted life-year. This simulation study showed that the cost-effectiveness of phytosterols/-stanols as monotherapy and as add-on to statins is above thresholds for cost-effectiveness, generally ranging between €20,000 and €50,000, and is thus a non-cost-effective strategy to reduce cardiovascular disease.

  5. Mangrove and Freshwater Wetland Conservation Through Carbon Offsets: A Cost-Benefit Analysis for Establishing Environmental Policies

    NASA Astrophysics Data System (ADS)

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

    2017-02-01

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

  6. Mangrove and Freshwater Wetland Conservation Through Carbon Offsets: A Cost-Benefit Analysis for Establishing Environmental Policies.

    PubMed

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

    2017-02-01

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

  7. Deepwater Horizon Oil Spill: Preliminary Assessment of Federal Financial Risks and Cost Reimbursement and Notification Policies and Procedures

    DTIC Science & Technology

    2010-11-12

    amended (OPA), which Congress enacted after the Exxon Valdez spill in 1989, authorized use of the Oil Spill Liability Trust Fund (Fund), which is...regulations affects which parties ultimately are subject to the various liabilities and financial risks. In 1990, after the Exxon Valdez oil spill in the...to charge certain costs 77Congress created the Fund in 1986, but not until the Exxon Valdez grounding and the passage

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

    PubMed

    Mayes, Rick; Hurley, Robert E

    2006-07-01

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

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

    ERIC Educational Resources Information Center

    Somerset, Anthony

    2011-01-01

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

  10. Ethics committees and cost containment.

    PubMed

    Brock, D W

    1990-01-01

    Cohen introduces a section of articles on hospital ethics committees that appears twice a year in the Hastings Center Report. Articles by Dan W. Brock, Alan R. Fleischman, Suzanne M. Mitchell and Martha S. Swartz, and Janet Fleetwood support the idea that hospital ethics committees are performing a needed service. Ethics committees have been in existence long enough, however, to begin to explore new issues and activities.

  11. The practicalities and pitfalls of establishing a policy-relevant and cost-effective soil biological monitoring scheme.

    PubMed

    Faber, Jack H; Creamer, Rachel E; Mulder, Christian; Römbke, Jörg; Rutgers, Michiel; Sousa, J Paulo; Stone, Dorothy; Griffiths, Bryan S

    2013-04-01

    A large number of biological indicators have been proposed over the years for assessing soil quality. Although many of those have been applied in monitoring schemes across Europe, no consensus exists on the extent to which these indicators might perform best and how monitoring schemes can be further optimized in terms of scientific and policy relevance. Over the past decade, developments in environmental monitoring and risk assessment converged toward the use of indicators and endpoints that are related to soil functioning and ecosystem services. In view of the proposed European Union (EU) Soil Framework Directive, there is an urgent need to identify and evaluate indicators for soil biodiversity and ecosystem services. The recently started integrated project, Ecological Function and Biodiversity Indicators in European Soils (EcoFINDERS), aims to address this specific issue within the EU Framework Program FP7. Here, we 1) discuss how to use the concept of ecosystem services in soil monitoring, 2) review former and ongoing monitoring schemes, and 3) present an analysis of metadata on biological indicators in some EU member states. Finally, we discuss our experiences in establishing a logical sieve approach to devise a monitoring scheme for a standardized and harmonized application at European scale.

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

    NASA Astrophysics Data System (ADS)

    White, Robert E.; Davidson, Brian

    2015-07-01

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

  13. Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

    PubMed

    Amundson, Bruce

    2005-01-01

    The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

  14. The impact of policy and institutional environment on costs and benefits of sustainable agricultural land uses: the case of the Chittagong Hill Tracts, Bangladesh.

    PubMed

    Rasul, Golam; Thapa, Gopal B

    2007-08-01

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

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

    NASA Astrophysics Data System (ADS)

    Rasul, Golam; Thapa, Gopal B.

    2007-08-01

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

  16. Democracy and justice in health policy.

    PubMed

    Jennings, B

    1990-01-01

    This is one of a set of six short articles, grouped under the umbrella title "Grassroots bioethics revisited: health care priorities and community values," with a very brief introduction by Bruce Jennings. The articles focus on the involvement of community health decisions projects with public policy issues of access to health care, allocation of resources, setting health care priorities, cost containment, and rationing.

  17. 76 FR 53378 - Cost Accounting Standards: Accounting for Insurance Costs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... the measurement and allocation of the cost of infrequent and difficult to predict events. The FAR at... BUDGET Office of Federal Procurement Policy 48 CFR Part 9904 Cost Accounting Standards: Accounting for Insurance Costs AGENCY: Cost Accounting Standards Board (Board), Office of Federal Procurement Policy...

  18. GME: at what cost?

    PubMed

    Young, David W

    2003-11-01

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

  19. Accelerating Improvements in the Energy Efficiency of Room Air Conditioners (RACs) in India: Potential, Cost-Benefit, and Policies (Interim Assessment)

    SciTech Connect

    Abhyankar, Nikit; Shah, Nihar; Park, Won Young; Phadke, Amol

    2016-06-01

    Falling AC prices, increasing incomes, increasing urbanization, and high cooling requirements due to hot climate are all driving increasing uptake of Room Air Conditioners (RACs) in the Indian market. Air conditioning already comprises 40-60% of summer peak load in large metropolitan Indian cities such as Delhi and is likely to contribute 150 GW to the peak demand in 2030. Standards and labeling policies have contributed to improving the efficiency of RACs in India by about 2.5% in the last 10 years (2.5% per year) while inflation adjusted RAC prices have continued to decline. In this paper, we assess the technical feasibility, cost-benefit, and required policy enhancements by further accelerating the efficiency improvement of RACs in India. We find that there are examples of significantly more accelerated improvements such as those in Japan and Korea where AC efficiency improved by more than 7% per year resulting in almost a doubling of energy efficiency in 7 to 10 years while inflation adjusted AC prices continued to decline. We find that the most efficient RAC sold on the Indian market is almost twice as efficient as the typical AC sold on the market and hence see no technology constraints in a similar acceleration of improvement of efficiency. If starting 2018, AC efficiency improves at a rate of 6% instead of 3%, 40-60 GW of peak load (equivalent to connected load of 5-6 billion LED bulbs), and over 75 TWh/yr (equivalent to 60 million consumers consuming 100 kWh/month) will be saved by 2030; total peak load reduction would be as high as 50 GW. The net present value (NPV) of the consumer benefit between 2018-2030 will range from Rs 18,000 Cr in the most conservative case (in which prices don’t continue to decline and increase based estimates of today’s cost of efficiency improvement) to 140,000 Cr in a more realistic case (in which prices are not affected by accelerated efficiency improvement as shown by historical experience). This benefit is achievable by

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

    ERIC Educational Resources Information Center

    Wellman, Jane V.

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

  1. 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…

  2. 76 FR 49365 - Cost Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... BUDGET Office of Federal Procurement Policy 48 CFR Part 9903 Cost Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for Contracts and Subcontracts Executed and Performed... Budget (OMB), Office of Federal Procurement Policy (OFPP), Cost Accounting Standards Board...

  3. Assessment and Educational Policy.

    ERIC Educational Resources Information Center

    Smith, Virginia B.

    1975-01-01

    Because of increased access of postsecondary education in the 1950's and 1960's, higher education cost analysis gained importance. Attempts have been made to develop a standard unit cost, but it is hard to see unit cost accounting by itself as a valuable tool for public accountability or policy making. For these purposes a cost-effectiveness ratio…

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

    SciTech Connect

    Harto, C. B.; Schroeder, J. N.; Horner, R. M.; Patton, T. L.; Durham, L. A.; Murphy, D. J.; Clark, C. E.

    2014-10-01

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

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

    DOE Data Explorer

    Schroeder, Jenna N.

    2014-12-16

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

  6. UPDATING PERFORMANCE AND COST OF NOX CONTROL TECHNOLOGIES IN THE INTEGRATED PLANNING MODEL

    EPA Science Inventory

    The US EPA uses the Integrated Planning Model (IPM) to evaluate the cost and emission impacts of proposed policies. Studies were undertaken recently to update the performance and cost factors contained in this model for various NOx control technologies. The studies showed a sig...

  7. Markets and childhood obesity policy.

    PubMed

    Cawley, John

    2006-01-01

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

  8. "But what is the object of educating these children, if it costs their lives to educate them?": federal Indian education policy in western Canada in the late 1800s.

    PubMed

    Enns, Richard A

    2009-01-01

    Debates in the Canadian House of Commons in the last two decades of the nineteenth century revealed persistent differences between the Conservatives and the Liberals over federal Indian education policy and the administration of industrial schools. Until their defeat in 1896, the Conservatives supported a denominational industrial school system and a policy of rapid assimilation. The Liberals generally opposed denominational schools and believed the industrial school system was too costly and was not leading to rapid assimilation. After gaining power, the Liberals stopped construction of industrial schools in favour of boarding and day schools, but denominational influence remained strong. The Conservative emphasis on assimilation was replaced by measures that supported reserve-based segregation as earlier hopes for rapid assimilation diminished. Despite policy differences, neither the Conservatives nor the Liberals held Aboriginal cultures in high regard, and debates regarding the means and intent of Indian education played out against well-known, high mortality rates and often abysmal conditions in the schools.

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

    PubMed

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

    2011-01-01

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

  10. Controlling the Costs of Education in Eastern Africa: A Review of Data, Issues, and Policies. World Bank Staff Working Papers No. 702.

    ERIC Educational Resources Information Center

    Wolff, Laurence

    Data and issues on costs of primary, secondary, and higher education in Eastern Africa are presented. Practical recommendations for controlling or reducing costs while paying attention to effects on quality and equity are made. For each level of education the report reviews student-teacher ratios, teacher salaries, non-teaching costs, and…

  11. The Future of the Army’s Civilian Workforce: Comparing Projected Inventory with Anticipated Requirements and Estimating Cost Under Different Personnel Policies

    DTIC Science & Technology

    2014-01-01

    in percentage terms) include Medical and Veterinary , Transport Equipment Operations, and Human Resources Management. Similar to commands, under...YORE –5 to –1, YORE 0 to 4, and YORE 5 and above. We then applied OPM’s formula to estimate the average, per-employee cost of a RIF for an...Multiplying the number of employees involved in a RIF by the per-employee cost of a RIF produced a total estimated RIF cost. 10 The basic formula

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

    PubMed

    Gerlinger, Thomas; Urban, Hans-Jürgen

    2007-01-01

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

  13. Federal Government Electronic Bulletin Boards: An Assessment with Policy Recommendations.

    ERIC Educational Resources Information Center

    Bertot, John Carlo; McClure, Charles R.

    1993-01-01

    Identifies and analyzes federal government electronic bulletin boards; assesses the types of information available to users, including costs and technological access issues; discusses federal information policy; and considers the role of federal bulletin boards in accessing and managing electronic government information. (Contains 29 references.)…

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

    SciTech Connect

    Barron, Robert W.; McJeon, Haewon C.

    2015-05-01

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

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

    ERIC Educational Resources Information Center

    Needham, John K.

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Davis, Christopher Scott

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    von Kuster, Thomas, Jr.

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

  18. An optimal policy for a single-vendor and a single-buyer integrated system with setup cost reduction and process-quality improvement

    NASA Astrophysics Data System (ADS)

    Shu, Hui; Zhou, Xideng

    2014-05-01

    The single-vendor single-buyer integrated production inventory system has been an object of study for a long time, but little is known about the effect of investing in reducing setup cost reduction and process-quality improvement for an integrated inventory system in which the products are sold with free minimal repair warranty. The purpose of this article is to minimise the integrated cost by optimising simultaneously the number of shipments and the shipment quantity, the setup cost, and the process quality. An efficient algorithm procedure is proposed for determining the optimal decision variables. A numerical example is presented to illustrate the results of the proposed models graphically. Sensitivity analysis of the model with respect to key parameters of the system is carried out. The paper shows that the proposed integrated model can result in significant savings in the integrated cost.

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

    USGS Publications Warehouse

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

    2000-01-01

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

  20. Measurement of costs.

    PubMed

    Riewpaiboon, Arthorn

    2008-06-01

    Costing plays an important role in health economics, particularly economic evaluation. However, there are some controversial issues: concepts, methods and reference values. Hence, it is pivotal to standardize can be con costing methods and use these as national guidelines to produce comparable studies. This report is divided perspectives. into 3 parts: theoretical issues, international guidelines comparison, and recommendations for the Thai technology assessment guidelines. Each section is composed of three general costing steps: identification, appropriate, measuring and valuation. It is recommended to measure economic or opportunity cost mainly in societal perspective. Cost category is composed of direct medical, direct non-medical and indirect costs. The level of reliability of each kind of costing source data is provided. Valuation of resource use based on national government, standard cost menu is recommended for national policy making. The recommendations on cost measurement are appropriate for the Thai context and in the current situation.

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

    NASA Technical Reports Server (NTRS)

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

    1979-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Pfurtscheller, Clemens; Brucker, Anja; Seebauer, Sebastian

    2014-05-01

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

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

    SciTech Connect

    Uchida, Toshihito; Itoh, Ichiro; Harada, Koji

    1996-12-31

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

  4. Policy opportunities

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

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

    ERIC Educational Resources Information Center

    Dickeson, Robert C.

    2004-01-01

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

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

    ERIC Educational Resources Information Center

    Barrera-Osorio, Felipe; Raju, Dhushyanth

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Commonwealth of Learning, 2004

    2004-01-01

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

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

    PubMed

    Seghatchian, Jerard

    2015-04-01

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

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

    SciTech Connect

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

    2009-05-15

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

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

    PubMed

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

    2009-05-01

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

  11. Work force policy perspectives: registered nurses.

    PubMed

    Friss, L O

    1981-01-01

    If the decline in full-time labor force participation by registered nurses in hospitals is to be reversed, the issue of equal pay for comparable work must be addressed. Under pressure for cost containment, policies tend to focus on labor force economics rather than on limitations of services. While the two are interrelated, wage policies must be considered independently. This article describes the network which determines how nurse salaries are set: the relationship between the private sector, the general schedule and the Veteran's Administration. The effects of this system are documented, using testimony from a case in the tenth circuit, as well as comparisons with other reference groups: policemen, teachers, laborers, and VA career fields. The evidence suggests that there is a need for policy intervention. Prime areas for action are the comparability practices by governments, particularly in the areas of classification standards and pay setting. Hospital personnel practices which continue past effects of occupational segregation also should be changed.

  12. Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

    PubMed

    Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

    2015-09-28

    For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

  13. Commodity Foods Contain Costs and Create Customers.

    ERIC Educational Resources Information Center

    Gilroy, Susan K.

    1983-01-01

    San Diego food manufacturers were invited to submit bids on new food items--using as possible ingredients Department of Agriculture donated commodity foods--for the school food service programs. (MLF)

  14. Early Retirement Incentive Programs for Teachers. Policy Issue Series No. 6.

    ERIC Educational Resources Information Center

    Tarter, Scott; McCarthy, Martha

    The first section of this policy paper provides an overview of the historical development of early retirement incentive programs (ERIPs), the legal status of ERIPs under the Age Discrimination in Employment Act (ADEA), cost/benefit analyses involving ERIPs, and consideration of ERIPs in Indiana. The second section contains a brief synopsis of…

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

    ERIC Educational Resources Information Center

    Ewing Marion Kauffman Foundation, Kansas City, MO.

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

  16. Technology and international climate policy

    SciTech Connect

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

    2009-05-01

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

  17. Agriculture Policy Is Health Policy

    PubMed Central

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

    2009-01-01

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

  18. [Costs and benefits of smoking].

    PubMed

    Polder, J J; van Gils, P F; Kok, L; Talhout, R; Feenstra, T L

    2017-01-01

    - Two recent societal cost-benefit analyses have documented the costs of smoking and the cost-effectiveness of preventing smoking.- Smoking costs the Netherlands society EUR 33 billion per year.- The majority of this is the monetary value of health loss; these are "soft" euros that cannot be re-spent.- There is not a great deal of difference between costs and benefits when expressed in "hard" euros, which means that there is no clear business case for anti-smoking policy.- The greatest benefit of discouraging smoking is improved health for the individual and increased productivity for the business sector; however, the benefits cannot be easily realised, because even in the most favourable scenario the number of smokers will decrease slowly.- Excise duties seem to offer the most promising avenue for combating smoking. The benefits of anti-smoking policy, therefore, consist mainly of tax revenues for the government.- Stringent policy is required to transform tax revenues into health gains.

  19. Containment: Concept and Policy. Volume 2

    DTIC Science & Technology

    1986-01-01

    their wider rivalry with the United States. And in Vietnam, the Soviet leadership, against some internal opposition from Alexander Shelepin and Piotr ...identify the United States with the insurgent cause. Former National Security Adviser Zbigniew Brzezinski states in his memoirs, "in April 1979, I...David Newsom, who was representing the State Department.’ 2 Brzezinski is deliber- ately opaque with respect to the ways in which American sym- pathy

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

    SciTech Connect

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

    2014-03-12

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

  1. 48 CFR 3035.003 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Department's fair share of its investment in nonrecurring costs related to the items acquired. Advice of legal counsel shall be obtained prior to establishing cost sharing policies and recoupment...

  2. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.

    PubMed

    2016-08-22

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2017. In addition, we are making changes relating to direct graduate medical education (GME) and indirect medical education payments; establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities), including related provisions for eligible hospitals and critical access hospitals (CAHs) participating in the Electronic Health Record Incentive Program; updating policies relating to the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program; implementing statutory provisions that require hospitals and CAHs to furnish notification to Medicare beneficiaries, including Medicare Advantage enrollees, when the beneficiaries receive outpatient observation services for more than 24 hours; announcing the implementation of the Frontier Community Health Integration Project Demonstration; and

  3. STS pricing policy

    NASA Technical Reports Server (NTRS)

    Lee, C. M.; Stone, B.

    1982-01-01

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

  4. Recent Contributions to the Urban Policy Debate.

    ERIC Educational Resources Information Center

    Morrison, Peter A.; And Others

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

  5. Life Cycle Costing in Government Procurement.

    DTIC Science & Technology

    1985-05-01

    majority of this work, treatment is also given to state procurement policies . Primary Sources: Decisions of the Comptroller General Federal...decisions has become clear to a number of procurement policy makers.2 While still quite limited, the consideration of post-acquisition costs is...make no mention of life cycle Ii costing. However, the concepts and policies dictated by 29 _ Comp. Gen. Report B-178214, May 21, 1973, where the

  6. The Shuttle Cost and Price model

    NASA Technical Reports Server (NTRS)

    Leary, Katherine; Stone, Barbara

    1983-01-01

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

  7. Environmental Technology Verification Program (ETV) Policy Compendium

    EPA Science Inventory

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

  8. 48 CFR 223.7301 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Minimizing the Use of Materials Containing Hexavalent Chromium 223.7301 Policy. It is DoD policy to minimize hexavalent chromium (an anti-corrosive) in items acquired...

  9. 48 CFR 223.7301 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Minimizing the Use of Materials Containing Hexavalent Chromium 223.7301 Policy. It is DoD policy to minimize hexavalent chromium (an anti-corrosive) in items acquired...

  10. 48 CFR 223.7301 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Minimizing the Use of Materials Containing Hexavalent Chromium 223.7301 Policy. It is DoD policy to minimize hexavalent chromium (an anti-corrosive) in items acquired...

  11. 48 CFR 223.7301 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Minimizing the Use of Materials Containing Hexavalent Chromium 223.7301 Policy. It is DoD policy to minimize hexavalent chromium (an anti-corrosive) in items acquired...

  12. Formulating a Policy on IT Provision

    ERIC Educational Resources Information Center

    Oxley, Alan

    2005-01-01

    It is difficult to estimate the costs of not writing thorough IT policy. Misuse of IT resources, whether through ignorance or malice, costs money, as do court cases that can result from abuse. Furthermore, a poor university accreditation report caused in part by poor policy documents will likely have an adverse impact on student enrollment. There…

  13. Policy Problematization

    ERIC Educational Resources Information Center

    Webb, P. Taylor

    2014-01-01

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

  14. 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.

  15. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Basic policies. 277.6 Section 277.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE...

  16. 33 CFR 277.6 - Basic policies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Basic policies. 277.6 Section 277.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE WATER RESOURCES POLICIES AND AUTHORITIES: NAVIGATION POLICY: COST APPORTIONMENT OF BRIDGE...

  17. 33 CFR 279.5 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... USE: ESTABLISHMENT OF OBJECTIVES § 279.5 Policy. (a) It is the policy of the Chief of Engineers that... objectives. These objectives will be based upon the expressed preferences of the residents of the region... administrative cost-sharing policy. Preparation of regional studies and establishment of these objectives...

  18. 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…

  19. A review of existing models and methods to estimate employment effects of pollution control policies

    SciTech Connect

    Darwin, R.F.; Nesse, R.J.

    1988-02-01

    The purpose of this paper is to provide information about existing models and methods used to estimate coal mining employment impacts of pollution control policies. The EPA is currently assessing the consequences of various alternative policies to reduce air pollution. One important potential consequence of these policies is that coal mining employment may decline or shift from low-sulfur to high-sulfur coal producing regions. The EPA requires models that can estimate the magnitude and cost of these employment changes at the local level. This paper contains descriptions and evaluations of three models and methods currently used to estimate the size and cost of coal mining employment changes. The first model reviewed is the Coal and Electric Utilities Model (CEUM), a well established, general purpose model that has been used by the EPA and other groups to simulate air pollution control policies. The second model reviewed is the Advanced Utility Simulation Model (AUSM), which was developed for the EPA specifically to analyze the impacts of air pollution control policies. Finally, the methodology used by Arthur D. Little, Inc. to estimate the costs of alternative air pollution control policies for the Consolidated Coal Company is discussed. These descriptions and evaluations are based on information obtained from published reports and from draft documentation of the models provided by the EPA. 12 refs., 1 fig.

  20. Dataset Lifecycle Policy

    NASA Technical Reports Server (NTRS)

    Armstrong, Edward; Tauer, Eric

    2013-01-01

    The presentation focused on describing a new dataset lifecycle policy that the NASA Physical Oceanography DAAC (PO.DAAC) has implemented for its new and current datasets to foster improved stewardship and consistency across its archive. The overarching goal is to implement this dataset lifecycle policy for all new GHRSST GDS2 datasets and bridge the mission statements from the GHRSST Project Office and PO.DAAC to provide the best quality SST data in a cost-effective, efficient manner, preserving its integrity so that it will be available and usable to a wide audience.

  1. 45 CFR 63.22 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Cost sharing. 63.22 Section 63.22 Public Welfare... THE ASSISTANT SECRETARY FOR PLANNING AND EVALUATION Financial Provisions § 63.22 Cost sharing. Policy... amount equal to as much as the entire cost of the project....

  2. 44 CFR 204.63 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HOMELAND SECURITY DISASTER ASSISTANCE FIRE MANAGEMENT ASSISTANCE GRANT PROGRAM Grant Administration § 204.63 Allowable costs. 44 CFR 13.22 establishes general policies for determining allowable costs. (a) We will reimburse direct costs for the administration of a fire management assistance grant under 44...

  3. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Allowable costs. 206.228 Section 206.228 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... Allowable costs. General policies for determining allowable costs are established in 44 CFR...

  4. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Allowable costs. 206.228 Section 206.228 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... Allowable costs. General policies for determining allowable costs are established in 44 CFR...

  5. 44 CFR 206.228 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Allowable costs. 206.228 Section 206.228 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... Allowable costs. General policies for determining allowable costs are established in 44 CFR...

  6. 21 CFR 1403.22 - Allowable costs.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Allowable costs. 1403.22 Section 1403.22 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND... the applicable cost principles. For the costs of a— Use the principles in— State, local or...

  7. 21 CFR 1403.22 - Allowable costs.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Allowable costs. 1403.22 Section 1403.22 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND... the applicable cost principles. For the costs of a— Use the principles in— State, local or...

  8. 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.].

  9. Toward a Record Retention Policy

    ERIC Educational Resources Information Center

    Vaughan, Jason

    2007-01-01

    An academic library working group was charged in 2005 to create a records retention schedule and policy applicable to records containing personally identifiable information of library patrons. This group conducted a survey and extensive research, culminating in an adopted library records retention schedule and policy implemented in 2006.

  10. Acquisition Policies. SPEC Kit 12.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    This collection of acquisition materials from member libraries of the Association of Research Libraries (ARL) contains: (1) acquisition policies from Brigham Young University, Iowa State University, and the University of Cincinnati; (2) book selection policies from the University of Nebraska Undergraduate Library and Georgetown University; (3) an…

  11. Analyzing Screening Policies for Childhood Obesity

    PubMed Central

    Yang, Yan; Goldhaber-Fiebert, Jeremy D.; Wein, Lawrence M.

    2013-01-01

    Due to the health and economic costs of childhood obesity, coupled with studies suggesting the benefits of comprehensive (dietary, physical activity and behavioral counseling) intervention, the United States Preventive Services Task Force recently recommended childhood screening and intervention for obesity beginning at age six. Using a longitudinal data set consisting of the body mass index of 3164 children up to age 18 and another longitudinal data set containing the body mass index at ages 18 and 40 and the presence or absence of disease (hypertension and diabetes) at age 40 for 747 people, we formulate and numerically solve – separately for boys and girls – a dynamic programming problem for the optimal biennial (i.e., at ages 2, 4, …, 16) obesity screening thresholds. Unlike most screening problem formulations, we take a societal viewpoint, where the state of the system at each age is the population-wide probability density function of the body mass index. Compared to the biennial version of the task force’s recommendation, the screening thresholds derived from the dynamic program achieve a relative reduction in disease prevalence of 3% at the same screening (and treatment) cost, or – due to the flatness of the disease vs. screening tradeoff curve – achieves the same disease prevalence at a 28% relative reduction in cost. Compared to the task force’s policy, which uses the 95th percentile of body mass index (from cross-sectional growth charts tabulated by the Centers for Disease Control and Prevention) as the screening threshold for each age, the dynamic programming policy treats mostly 16 year olds (including many who are not obese) and very few males under 14 years old. While our results suggest that adult hypertension and diabetes are minimized by focusing childhood obesity screening and treatment on older adolescents, the shortcomings in the available data and the narrowness of the medical outcomes considered prevent us from making a

  12. 48 CFR 9904.405 - Accounting for unallowable costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... costs. 9904.405 Section 9904.405 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.405 Accounting for unallowable costs....

  13. Costs in Perspective: Understanding Cost-Effectiveness Analysis.

    PubMed

    Detsky

    1996-01-01

    This paper covers five questions: (1) What is cost-effectiveness analysis;quest; (2) How can cost-effectiveness analysis help policymakers allocate scarce resources;quest; (3) What are misconceptions about the cost effectiveness of health care interventions;quest; (4) What is an attractive cost-effectiveness ratio;quest; (5) What is the relevance of cost effectiveness to clinicians? The cost side of the equation includes more than simply the cost of the intervention, but rather the cost of all of the downstream clinical events that occur with either therapeutic alternative. Cost-effectiveness analyses are used to help decisionmakers rank programs competing for scarce resources in order to achieve the following objective: to maximize the net health benefits derived from a fixed budget for a target population. A simple example is shown. Measured cost-effectiveness ratios for selected cardiovascular interventions are displayed. The systematic use of information on effectiveness and cost effectiveness should help those involved in setting policies to have a more rational basis for funding of new programs and discontinuation of funding for old programs. In Canadian health care it is important that we use this information to make room for innovations that are effective and efficient, and to remove funding from programs that are either known to be ineffective and costly or inefficient use of resources. More energy should be put toward generating the information necessary to make these kinds of decisions.

  14. Sharps container

    NASA Technical Reports Server (NTRS)

    Lee, Angelene M. (Inventor)

    1992-01-01

    This invention relates to a system for use in disposing of potentially hazardous items and more particularly a Sharps receptacle for used hypodermic needles and the like. A Sharps container is constructed from lightweight alodined nonmagnetic metal material with a cup member having an elongated tapered shape and length greater than its transverse dimensions. A magnet in the cup member provides for metal retention in the container. A nonmagnetic lid member has an opening and spring biased closure flap member. The flap member is constructed from stainless steel. A Velcro patch on the container permits selective attachment at desired locations.

  15. 26 CFR 1.263A-1 - Uniform capitalization of costs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... include the costs of tools and equipment which are not otherwise capitalized. (S) Quality control. Quality control includes the costs of quality control and inspection. (T) Bidding costs. Bidding costs are costs... retired workers). (F) Quality control policy. (G) Safety engineering policy. (H) Insurance or...

  16. Audit of health benefit costs at the Department`s Management and Operating Contractors

    SciTech Connect

    Not Available

    1994-06-23

    The audit disclosed that the Department and certain of its contractors had initiated several positive actions to contain health benefit costs: improving data collection, increasing training, reviewing changes to health plans, improving the language in one contract, increasing the employees, share of health costs at one contractor, and initiating self-insurance at another contractor. Despite these actions, further improvements are needed in the administration of the contractor employee health benefit plans. It was found that the Department did not have the policies and procedures necessary to ensure that the health benefit costs met the tests for reasonableness. The audit of $95 million in health benefit costs incurred at six Management and Operating contractors showed that $15.4 million of these costs were excessive compared to national norms.

  17. Critical Policy Sociology: Historiography, Archaeology and Genealogy as Methods of Policy Analysis.

    ERIC Educational Resources Information Center

    Gale, Trevor

    2001-01-01

    Examines the essential characteristics of three approaches to conducting critical policy sociology of higher education: Historiography, archaeology, and genealogy. Draws on Australian higher education policy research to illustrate the use of these three methods. (Contains 65 references.) (PKP)

  18. Preventing the importation of illicit nuclear materials in shipping containers.

    PubMed

    Wein, Lawrence M; Wilkins, Alex H; Baveja, Manas; Flynn, Stephen E

    2006-10-01

    We develop a mathematical model to find the optimal inspection strategy for detecting a nuclear weapon (or nuclear material to make a weapon) from being smuggled into the United States in a shipping container, subject to constraints of port congestion and an overall budget. We consider an 11-layer security system consisting of shipper certification, container seals, and a targeting software system, followed by passive (neutron and gamma), active (gamma radiography), and manual testing at overseas and domestic ports. Currently implemented policies achieve a low detection probability, and improved security requires passive and active testing of trusted containers and manually opening containers that cannot be penetrated by radiography. The annual cost of achieving a high detection probability of a plutonium weapon using existing equipment in traditional ways is roughly several billion dollars if testing is done domestically, and is approximately five times higher if testing is performed overseas. Our results suggest that employing high-energy x-ray radiography and elongating the passive neutron tests at overseas ports may provide significant cost savings, and several developing technologies, radiation sensors inside containers and tamper-resistant electronic seals, should be pursued aggressively. Further effort is critically needed to develop a practical neutron interrogation scheme that reliably detects moderately shielded, highly enriched uranium.

  19. ECOM - ESA's cost modelling

    NASA Astrophysics Data System (ADS)

    Fatelnig, Peter K.

    1996-01-01

    ESA, as an international procurement agency dealing with more than 1200 companies at the same time, must have the ability to assess the price for a product independently from other sources. Especially in the today's environment of flat or even declining budgets ESA has to ensure the value of the contributions coming from their member states. The paper presents a software tool developed by the Cost Analysis Division of ESTEC/ESA, which fits exactly the need for precise and retracable cost estimates for space business projects and components. As an introduction the driving needs and basic cost estimation techniques are presented. ECOM was conceived as a tool for independent price assessment and cost estimation. The gem within ECOM is the database, it contains historical data from ESA projects. The items are grouped in classes and the available data comprises the cost breakdown and the technical description, which are the main performance parameter, number of models, design status and beside the comments, also pictures are available. On the estimate part of ECOM it features all the well-known cost estimation techniques, like estimating using analogy, cost estimating relationship, parametric cost modelling, and includes links to commercial products (PCM, Price-H) as well. ECOM is capable of escalating for any given economical condition and any member state. To prepare reliable prize estimates, the cost analysts need the product tree, the work-package description, the technical description and the HW-matrix. The paper shows examples for the important steps of producing an estimate and is enhanced with authentical screen prints. ECOM is used by the Cost Analysis Division as an expert tool for professional cost estimation for space business projects.

  20. Distributed Wind Policy Comparison Tool

    SciTech Connect

    2011-12-01

    Power through Policy: 'Best Practices' for Cost-Effective Distributed Wind is a U.S. Department of Energy (DOE)-funded project to identify distributed wind technology policy best practices and to help policymakers, utilities, advocates, and consumers examine their effectiveness using a pro forma model. Incorporating a customized feed from the Database of State Incentives for Renewables and Efficiency (DSIRE), the Web-based Distributed Wind Policy Comparison Tool (Policy Tool) is designed to assist state, local, and utility officials in understanding the financial impacts of different policy options to help reduce the cost of distributed wind technologies. The Policy Tool can be used to evaluate the ways that a variety of federal and state policies and incentives impact the economics of distributed wind (and subsequently its expected market growth). It also allows policymakers to determine the impact of policy options, addressing market challenges identified in the U.S. DOE’s '20% Wind Energy by 2030' report and helping to meet COE targets.

  1. 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.

  2. Curbing Workers' Comp Costs.

    ERIC Educational Resources Information Center

    Deeb, William S.

    1998-01-01

    An actuarial study revealed that Pasadena Schools had an unfunded worker's compensation liability of over $10 million and 400 open claims. Advised to implement strong cost-containment measures (an early return-to-work program) and equally strong accountability measures (strict performance guides and safe work practices), the district achieved…

  3. Internet Policy

    DTIC Science & Technology

    1999-11-17

    activities. F. Responsibilities 1. The CIO shall: a. Approve, for the OIG, DoD, policies implementing laws and guidelines on Internet use . IGDINST 4630.2 3 b...Provide leadership to manage Internet use within the OIG, DoD. c. Authorize monitoring. d. Oversee the promulgation of policies and guidance to ensure

  4. A predictive model of hospitalization cost after cerebral aneurysm clipping

    PubMed Central

    Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A.; Labropoulos, Nicos; Roberts, David W.

    2016-01-01

    Background Cost containment is the cornerstone of the Affordable Care Act. Although studies have compared the cost of cerebral aneurysm clipping (CAC) and coiling, they haven’t focused on the identification of drivers of cost after CAC, or the prediction of its magnitude. The objective of the present study was to develop and validate a predictive model of hospitalization cost after CAC. Methods We performed a retrospective study involving CAC patients who were registered in the Nationwide Inpatient Sample (NIS) database from 2005–2010. The two cohorts of ruptured and unruptured aneurysms underwent 1:1 randomization to create derivation and validation subsamples. Regression techniques were used for the creation of a parsimonious predictive model. Results Of the 7,798 patients undergoing CAC, 4,505 (58%) presented with unruptured, and 3,293 (42%) with ruptured aneurysms. The median hospitalization cost was $24,398 (Interquartile Range (IQR), $17,079 – $38,249), and $73,694 (IQR, $46,270 – $115,128) for the two cohorts, respectively. Common drivers of cost identified in the multivariate analyses included: length of stay, number of admission diagnoses and procedures, hospital size and region, and patient income. The models were validated in independent cohorts and demonstrated final R2 very similar to the initial models. The predicted and observed values in the validation cohort demonstrated good correlation. Conclusions This national study identified significant drivers of hospitalization cost after CAC. The presented model can be utilized as an adjunct in the cost containment debate and the creation of data-driven policies. PMID:25583532

  5. Hydrogen storage container

    DOEpatents

    Wang, Jy-An John; Feng, Zhili; Zhang, Wei

    2017-02-07

    An apparatus and system is described for storing high-pressure fluids such as hydrogen. An inner tank and pre-stressed concrete pressure vessel share the structural and/or pressure load on the inner tank. The system and apparatus provide a high performance and low cost container while mitigating hydrogen embrittlement of the metal tank. System is useful for distributing hydrogen to a power grid or to a vehicle refueling station.

  6. The true cost of precautionary chemicals regulation.

    PubMed

    Durodié, Bill

    2003-04-01

    This article explores the possible social costs of introducing an overly precautionary regulatory regime for chemicals It begins by examining research by the UK Medical Research Council Institute for Environment and Health (MRC-IEH), which suggests that the resource implications of the proposals contained in the European Commission White Paper "Strategy for a Future Chemicals Policy" are unrealistic and even unrealizable. The article then focuses on contemporary debates pertaining to endocrine disrupting chemicals (EDCs) and goes on to question whether a "right to know" is always necessarily a good thing, or whether in certain instances it can lead to a society that feels more sorry than safe. Finally, problems relating to the representation and inclusion of public values in decision-making processes are raised prior to concluding with a call for an ambitious orientation toward social change rather than a self-limiting obsession with safety.

  7. Predictable Unpredictability: the Problem with Basing Medicare Policy on Long-Term Financial Forecasting.

    PubMed

    Glied, Sherry; Zaylor, Abigail

    2015-07-01

    The authors assess how Medicare financing and projections of future costs have changed since 2000. They also assess the impact of legislative reforms on the sources and levels of financing and compare cost forecasts made at different times. Although the aging U.S. population and rising health care costs are expected to increase the share of gross domestic product devoted to Medicare, changes made in the program over the past decade have helped stabilize Medicare's financial outlook--even as benefits have been expanded. Long-term forecasting uncertainty should make policymakers and beneficiaries wary of dramatic changes to the program in the near term that are intended to alter its long-term forecast: the range of error associated with cost forecasts rises as the forecast window lengthens. Instead, policymakers should focus on the immediate policy window, taking steps to reduce the current burden of Medicare costs by containing spending today.

  8. 48 CFR 439.101 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Policy. 439.101 Section 439.101 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY General 439.101 Policy. (a) In addition to policy and regulatory guidance contained in the FAR and AGAR:...

  9. 48 CFR 439.101 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Policy. 439.101 Section 439.101 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY General 439.101 Policy. (a) In addition to policy and regulatory guidance contained in the FAR and AGAR:...

  10. 48 CFR 439.101 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Policy. 439.101 Section 439.101 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SPECIAL CATEGORIES OF CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY General 439.101 Policy. (a) In addition to policy and regulatory guidance contained in the FAR and AGAR:...

  11. 32 CFR 247.4 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Policy. 247.4 Section 247.4 National Defense... DEFENSE NEWSPAPERS, MAGAZINES AND CIVILIAN ENTERPRISE PUBLICATIONS § 247.4 Policy. It is DoD policy that...) The masthead of all DoD publications shall contain the following disclaimer printed in type no...

  12. [Public policy analysis].

    PubMed

    Subirats, J

    2001-01-01

    This article presents to public health professionals concepts and perspectives from political science relevant for creating a healthier public policy. Currently, there is no uniform vision of what constitutes public interest and the decisions of public administrations tend to be based on compromise. In public debate, what is paramount is the capacity to persuade. From the perspective of public policy analysis, the crucial issue is definition: the final decision depends on the definition of the problem that has emerged triumphant in the public debate among competing actors with different definitions of the problem. From a policy analysis perspective, the problems entering the agenda of public administration does not necessarily correspond to their severity, as competing actors try to impose their point of view. Because of its historical evolution, the Spanish political system has specific traits. The relatively weak democratic tradition tends to make the decision process less visibles, with strong technocratic elements and weaker social articulation. Both the juridical tradition and liberal rhetoric portray lobbying as contrary to public interest, when in fact it is constantly performed by powerful vested interest groups, through both personal contacts and economic connections. Regulatory policies, with concentrated costs and diffuse benefits, seem to be moving from Spain to the European Union. To promote healthier public policies, the development of civil society initiatives and the building of coalitions will play an increasingly greater role in the future.

  13. Seeking value as cancer drug costs soar.

    PubMed

    Bender, Eric

    2013-08-01

    As significant increases in the costs of cancer drugs cause financial difficulties for many U.S. patients, some oncologists suggest that changes in pricing policies at the federal and state levels are inevitable.

  14. Collapsing Containers.

    ERIC Educational Resources Information Center

    Brown, Justina L.; Battino, Rubin

    1994-01-01

    Describes variations on atmospheric pressure demonstrations and some systematic studies. Demonstrations use steam, generated either externally or internally to the container, to sweep out residual air. Preferred vessels collapsed slowly. Demonstrations use plastic milk jugs set in layers of aluminum foil, pop bottles immersed in 4-L beakers…

  15. CONTAINMENT TECHNOLOGIES

    EPA Science Inventory

    Hazardous waste containment's primary objective is to isolate wastes deemed as hazardous from man and environmental systems of air, soil, and water. Hazardous wastes differ from other waste classifications due to their increased potential to cause human health effects or environ...

  16. 76 FR 53377 - Cost Accounting Standards; Allocation of Home Office Expenses to Segments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... BUDGET Office of Federal Procurement Policy 48 CFR Part 9904 Cost Accounting Standards; Allocation of... Procurement Policy (OFPP), Cost Accounting Standards Board (Board). ACTION: Notice of Discontinuation of Rulemaking. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS)...

  17. Commentary on NTIS Document Costs

    ERIC Educational Resources Information Center

    Richardson, Robert J.

    1973-01-01

    The author believes it would be appropriate to review the current National Technical Information Service (NTIS) pricing policy in terms of its rationale, legality, and the possibility of mitigating or reversing the demonstrated pattern of repeated cost increases. (Author/SJ)

  18. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard-consistency in estimating, accumulating and reporting costs. 9904.401 Section 9904.401 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF...

  19. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard-consistency in estimating, accumulating and reporting costs. 9904.401 Section 9904.401 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF...

  20. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-consistency in estimating, accumulating and reporting costs. 9904.401 Section 9904.401 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF...

  1. 48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard-consistency in estimating, accumulating and reporting costs. 9904.401 Section 9904.401 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF...

  2. 48 CFR 9904.406 - Cost accounting standard-cost accounting period.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost accounting standard-cost accounting period. 9904.406 Section 9904.406 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET...

  3. 48 CFR 9904.406 - Cost accounting standard-cost accounting period.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Cost accounting standard-cost accounting period. 9904.406 Section 9904.406 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET...

  4. 48 CFR 9904.406 - Cost accounting standard-cost accounting period.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost accounting standard-cost accounting period. 9904.406 Section 9904.406 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET...

  5. 48 CFR 9904.406 - Cost accounting standard-cost accounting period.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-cost accounting period. 9904.406 Section 9904.406 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET...

  6. 48 CFR 1552.242-70 - Indirect costs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Protection Agency, Chief, Cost Policy and Rate Negotiation Branch (3804F), Cost Advisory and Financial Analysis Division, Washington, DC 20460. Where EPA is not the cognizant agency, the final rate...

  7. 48 CFR 1552.242-70 - Indirect costs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Protection Agency, Chief, Cost Policy and Rate Negotiation Branch (3804F), Cost Advisory and Financial Analysis Division, Washington, DC 20460. Where EPA is not the cognizant agency, the final rate...

  8. 48 CFR 1552.242-70 - Indirect costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Protection Agency, Chief, Cost Policy and Rate Negotiation Branch (3804F), Cost Advisory and Financial Analysis Division, Washington, DC 20460. Where EPA is not the cognizant agency, the final rate...

  9. 48 CFR 1552.242-70 - Indirect costs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Protection Agency, Chief, Cost Policy and Rate Negotiation Branch (3804F), Cost Advisory and Financial Analysis Division, Washington, DC 20460. Where EPA is not the cognizant agency, the final rate...

  10. Costs of pain in rheumatology.

    PubMed

    Marsico, A; Atzeni, F; Piroddi, A; Cazzola, M; Stisi, S; Sarzi-Puttini, P

    2014-06-06

    Chronic pain has been identified as an important issue related to various rheumatic diseases. At the time of a major government spending review, it is appropriate to discuss the pain characterising rheumatic diseases and its related costs. It is clearly essential for healthcare authorities to rationalise their policies on the basis of the increasing expectations of the users of healthcare services while simultaneously balancing their books. There are few published studies concerning the costs of pain of any kind, and the same is true of the costs of the chronic pain associated with diseases such as rheumatoid arthritis, osteoarthritis, and fibromyalgia.

  11. COST MODEL FOR LARGE URBAN SCHOOLS.

    ERIC Educational Resources Information Center

    O'BRIEN, RICHARD J.

    THIS DOCUMENT CONTAINS A COST SUBMODEL OF AN URBAN EDUCATIONAL SYSTEM. THIS MODEL REQUIRES THAT PUPIL POPULATION AND PROPOSED SCHOOL BUILDING ARE KNOWN. THE COST ELEMENTS ARE--(1) CONSTRUCTION COSTS OF NEW PLANTS, (2) ACQUISITION AND DEVELOPMENT COSTS OF BUILDING SITES, (3) CURRENT OPERATING EXPENSES OF THE PROPOSED SCHOOL, (4) PUPIL…

  12. Why do we recycle: Markets, values, and public policy

    SciTech Connect

    Ackerman, F.

    1996-12-01

    Contents of the book include: Externality issues-unit pricing for waste disposal, effluent taxes, virgin materials subsidies, advance disposal fees; The landfill crisis and disposal facility siting; Container deposit (``bottle bill``) legislation; Environmental issues that fall outside of market theory; Calculating costs and benefits of municipal recycling programs; Life-cycle analysis and packaging policy, Germany`s ``Green Dot`` packaging system and producer responsibility; The impacts of production in extractive and manufacturing industries; Composting and organic waste management; and Economics of conservation, and material use and long-term sustainability.

  13. Effect of prospective reimbursement on nursing home costs.

    PubMed Central

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

    1993-01-01

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

  14. Costing blood products and services.

    PubMed

    Wallace, E L

    1991-05-01

    At present, blood centers and transfusion services have limited alternatives for offsetting the ever-rising costs of health care inputs. In the face of current revenue constraints, cost reduction or cost containment through efficiency improvements or service reduction is the principal available means. Such methods ought to be pursued vigorously by blood bankers with the aid of well-designed costing and other physical measurements systems. Experience indicates, however, that blood bankers, in their attempts to reduce or contain costs, are likely to place undue reliance on cost accounting systems as the means of capturing sought-for benefits. Management must learn enough about methods of costing to judge directly the uses and limitations of the information produced. Such understanding begins with recognition that all costs and cost comparisons should be specific to the purpose for which they are developed. No costing procedure is capable of producing measures generally applicable to all management decisions. A measure relevant to a planning decision is unlikely to be appropriate for performance evaluation. Useful comparisons among sets of organizations of costs, or of measures of physical inputs and outputs, require assurance that the methods of measurement employed are the same and that the sets of organizations from which the measures are drawn are reasonably comparable.

  15. How to Cut Publications Costs.

    ERIC Educational Resources Information Center

    Carter, Virginia L., Ed.; Alberger, Patricia A., Ed.

    This handbook on how to cut costs in college publications contains the following articles: "Stretching Your Publications Dollar: The Basics," by Kelvin J. Arden and William J. Whalen; "How to Print Cheaper," by M. Frederic Volkmann; "How Your Colleagues Cut Costs," by Robert S. Topor; "Printing Specifications: Writing Them Right," by M. Frederic…

  16. Repository containment

    SciTech Connect

    Beale, H.; Mogg, C.

    1994-12-31

    UK Nirex Limited is concentrating its further investigations at Sellafield in Cumbria to establish the sites suitability as a safe location for a deep disposal facility for intermediate and low level radioactive waste. Good progress has been achieved in the Site Characterization Program. The emerging picture of the geology and hydrogeology continues to suggest that the site holds good promise as a potential repository location. This paper sets out the latest results from site investigations at Sellafield and reviews some possibilities for enhancing waste containment deep underground at the site.

  17. 25 CFR 700.81 - Monthly housing cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Monthly housing cost. 700.81 Section 700.81 Indians THE... Policies and Instructions Definitions § 700.81 Monthly housing cost. (a) General. The term monthly housing...) Computation of monthly housing cost for replacement dwelling. A person's monthly housing cost for...

  18. 25 CFR 700.81 - Monthly housing cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Monthly housing cost. 700.81 Section 700.81 Indians THE... Policies and Instructions Definitions § 700.81 Monthly housing cost. (a) General. The term monthly housing...) Computation of monthly housing cost for replacement dwelling. A person's monthly housing cost for...

  19. 25 CFR 700.81 - Monthly housing cost.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 2 2012-04-01 2012-04-01 false Monthly housing cost. 700.81 Section 700.81 Indians THE... Policies and Instructions Definitions § 700.81 Monthly housing cost. (a) General. The term monthly housing...) Computation of monthly housing cost for replacement dwelling. A person's monthly housing cost for...

  20. Population distribution policies.

    PubMed

    Richardson, H W

    1983-01-01

    because of their high costs and minimal impact. Success in population distribution policies has been hampered by implementation problems as well as poorly designed strategies. Nevertheless, policy makers should persevere, expecially in the countries that combine modest urbanization levels with high rates of aggregate population growth, since improvements in the distribution of population may generate a variety of social benefits, such as efficiency, equity, environmental quality, national security and integration.

  1. Grade Retention: A Three Part Series. Policy Briefs. Grade Retention: A Flawed Education Strategy [and] Cost-Benefit Analysis of Grade Retention [and] Grade Retention: The Gap between Research and Practice

    ERIC Educational Resources Information Center

    Xia, Claire; Glennie, Elizabeth

    2005-01-01

    This document compiles a series of three policy briefs focused on the subject of grade retention. The first brief, "Grade Retention: A Flawed Education Strategy," suggests educators and policymakers caution the use of grade retention as a remedy for poor student performance. As concluded by the majority of past studies, grade retention is a failed…

  2. Assessment of the costs, risks and benefits of selected integrated policy options to adapt to flood and drought in the water and agricultural sectors of the Warta River Basin

    NASA Astrophysics Data System (ADS)

    Sendzimir, Jan; Dubel, Anna; Linnerooth-Bayer, Joanne; Damurski, Jakub; Schroeter, Dagmar

    2014-05-01

    Historically large reservoirs have been the dominant strategy to counter flood and drought risk in Europe. However, a number of smaller-scale approaches have emerged as alternative strategies. To compare the cost effectiveness of reservoirs and these alternatives, we calculated the Investment & maintenance costs in terms of (euros) /m3 water stored or annual runoff reduced for five different strategies: large reservoirs (1.68 euros), large on-farm ponds (5.88 euros), small on-farm ponds (558.00 euros), shelterbelts (6.86 euros), switching to conservation tillage (-9.20 euros). The most cost effective measure for reducing runoff is switching to conservation tillage practices because this switch reduces machinery and labor costs in addition to reducing water runoff. Although shelterbelts that reduce annual runoff cannot be directly compared to ponds and reservoirs that store water, our estimates show that they likely compare favorably as a natural water retention measure, especially when taking account of their co-benefits in terms of erosion control, biodiversity and pollination. Another useful result is our demonstration of the economies of scale among reservoirs and ponds for storing water. Small ponds are two orders of magnitude more costly to construct and maintain as a flood and drought prevention measure than large reservoirs. Here, again, there are large co-benefits that should be factored into the cost-benefit equation, including especially the value of small ponds in promoting corridors for migration. This analysis shows the importance of carrying out more extensive cost-benefit estimates across on-farm and off-farm measures for tackling drought and flood risk in the context of a changing climate. While concrete recommendations for supporting water retention measures will depend on a more detailed investigation of their costs and benefits, this research highlights the potential of natural water retention measures as a complement to conventional investments

  3. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  4. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  5. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  6. 48 CFR 1334.201-70 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... CONTRACTING MAJOR SYSTEM ACQUISITION Earned Value Management System 1334.201-70 Policy. (a) In accordance with the Department's Information Technology Investment Performance Measurement and Performance Reporting... information technology development in which the development/modernization/enhancement costs are anticipated...

  7. 48 CFR 917.7001 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 917.7001 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Cost Participation 917.7001 Policy. (a) When DOE supports performer..., conversion, and utilization of energy resources....

  8. 48 CFR 917.7001 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 917.7001 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Cost Participation 917.7001 Policy. (a) When DOE supports performer..., conversion, and utilization of energy resources....

  9. 48 CFR 917.7001 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 917.7001 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Cost Participation 917.7001 Policy. (a) When DOE supports performer..., conversion, and utilization of energy resources....

  10. 48 CFR 917.7001 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 917.7001 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Cost Participation 917.7001 Policy. (a) When DOE supports performer..., conversion, and utilization of energy resources....

  11. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  12. 48 CFR 925.7002 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ACQUISITION Acquisition of Nuclear Hot Cell Services 925.7002 Policy. In selecting offer(s) for award of contracts for nuclear hot cell services, costs related to the decommissioning of nuclear facilities...

  13. 48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-consistency in allocating costs incurred for the same purpose by educational institutions. 9905.502 Section... PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS FOR EDUCATIONAL INSTITUTIONS 9905.502 Cost accounting standard—consistency in...

  14. 48 CFR 9905.501 - Cost accounting standard-consistency in estimating, accumulating and reporting costs by...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-consistency in estimating, accumulating and reporting costs by educational institutions. 9905.501 Section 9905... PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS FOR EDUCATIONAL INSTITUTIONS 9905.501 Cost accounting standard—consistency in...

  15. 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…

  16. Three essays on monetary policy responses to oil price shocks

    NASA Astrophysics Data System (ADS)

    Plante, Michael

    This dissertation contains three chapters which explore the question of how monetary policy should respond to changes in the price of oil. Each chapter explores the question from the perspective of a different economic environment. The first chapter examines welfare maximizing optimal monetary policy in a closed economy New Keynesian model that is extended to include household and firm demand for oil products, sticky wages, and capital accumulation. When households and firms demand oil products a natural difference arises between the Consumer Price Index (CPI), the core CPI, and the GDP deflator. I show that when nominal wages are flexible then the optimal policy places a heavy emphasis on stabilizing the inflation rate of the core CPI. If aggregate nominal wages are sticky then the central bank should focus on stabilizing some combination of core inflation and nominal wage inflation. Under no case examined is it optimal to stabilize either GDP deflator or CPI inflation. The second chapter examines monetary policy responses to oil price shocks in a small open economy with traded and non-traded goods. Oil and labor are used to produce the traded and non-traded goods and prices are sticky in the non-traded sector. I show analytically that the ratio of the oil and labor cost shares in the traded and non-traded sectors is crucial for determining the dynamic behavior of many macroeconomic variables after a rise in the price of oil. A policy of fixed exchange rates can produce higher or lower inflation in the non-traded sector depending upon the ratio. Likewise, a policy that stabilizes the inflation rate of prices in the non-traded sector can cause the nominal exchange rate to appreciate or depreciate. For the proper calibration, a policy that stabilizes core inflation produces results very close to the one that stabilizes non-traded inflation. Analytical results show that the fixed exchange rate always produces a unique solution. The policy of stabilizing non

  17. Doses per vaccine vial container: An understated and underestimated driver of performance that needs more evidence.

    PubMed

    Heaton, Alexis; Krudwig, Kirstin; Lorenson, Tina; Burgess, Craig; Cunningham, Andrew; Steinglass, Robert

    2017-04-19

    The widespread use of multidose vaccine containers in low and middle income countries' immunization programs is assumed to have multiple benefits and efficiencies for health systems, yet the broader impacts on immunization coverage, costs, and safety are not well understood. To document what is known on this topic, how it has been studied, and confirm the gaps in evidence that allow us to assess the complex system interactions, the authors undertook a review of published literature that explored the relationship between doses per container and immunization systems. The relationships examined in this study are organized within a systems framework consisting of operational costs, timely coverage, safety, product costs/wastage, and policy/correct use, with the idea that a change in dose per container affects all of them, and the optimal solution will depend on what is prioritized and used to measure performance. Studies on this topic are limited and largely rely on modeling to assess the relationship between doses per container and other aspects of immunization systems. Very few studies attempt to look at how a change in doses per container affects vaccination coverage rates and other systems components simultaneously. This article summarizes the published knowledge on this topic to date and suggests areas of current and future research to ultimately improve decision making around vaccine doses per container and increase understanding of how this decision relates to other program goals.

  18. Policy Overview and Options for Maximizing the Role of Policy in Geothermal Electricity Development

    SciTech Connect

    Doris, E.; Kreycik, C.; Young, K.

    2009-09-01

    Geothermal electricity production capacity has grown over time because of multiple factors, including its renewable, baseload, and domestic attributes; volatile and high prices for competing technologies; and policy intervention. Overarching federal policies, namely the Public Utilities Regulatory Policies Act (PURPA), provided certainty to project investors in the 1980s, leading to a boom in geothermal development. In addition to market expansion through PURPA, research and development policies provided an investment of public dollars toward developing technologies and reducing costs over time to increase the market competitiveness of geothermal electricity. Together, these efforts are cited as the primary policy drivers for the currently installed capacity. Informing policy decisions depends on the combined impacts of policies at the federal and state level on geothermal development. Identifying high-impact suites of policies for different contexts, and the government levels best equipped to implement them, would provide a wealth of information to both policy makers and project developers.

  19. How to calculate total purchase cost.

    PubMed

    Harding, M L

    1998-05-01

    Companies wanting to implement a total cost-based supplier selection process often stumble over how to include nonmonetary issues such as delivery and quality performance, lead time, services, and social policies. This article describes a process that allows a company to include any issue it deems relevant and to determine its cost factor.

  20. 45 CFR 63.22 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... THE ASSISTANT SECRETARY FOR PLANNING AND EVALUATION Financial Provisions § 63.22 Cost sharing. Policy Research funds shall not be used to pay any recipient of a grant for the conduct of a research project an amount equal to as much as the entire cost of the project....

  1. 33 CFR 239.8 - Cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Cost sharing. 239.8 Section 239.8 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE WATER... for recreation facilities at local protection projects. Cost-sharing policies for project...

  2. 33 CFR 239.8 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Cost sharing. 239.8 Section 239.8 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE WATER... for recreation facilities at local protection projects. Cost-sharing policies for project...

  3. 33 CFR 239.8 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Cost sharing. 239.8 Section 239.8 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE WATER... for recreation facilities at local protection projects. Cost-sharing policies for project...

  4. Reliability and cost analysis methods

    NASA Technical Reports Server (NTRS)

    Suich, Ronald C.

    1991-01-01

    In the design phase of a system, how does a design engineer or manager choose between a subsystem with .990 reliability and a more costly subsystem with .995 reliability? When is the increased cost justified? High reliability is not necessarily an end in itself but may be desirable in order to reduce the expected cost due to subsystem failure. However, this may not be the wisest use of funds since the expected cost due to subsystem failure is not the only cost involved. The subsystem itself may be very costly. We should not consider either the cost of the subsystem or the expected cost due to subsystem failure separately but should minimize the total of the two costs, i.e., the total of the cost of the subsystem plus the expected cost due to subsystem failure. This final report discusses the Combined Analysis of Reliability, Redundancy, and Cost (CARRAC) methods which were developed under Grant Number NAG 3-1100 from the NASA Lewis Research Center. CARRAC methods and a CARRAC computer program employ five models which can be used to cover a wide range of problems. The models contain an option which can include repair of failed modules.

  5. Standard cost elements for technology programs

    NASA Technical Reports Server (NTRS)

    Christensen, Carisa B.; Wagenfuehrer, Carl

    1992-01-01

    The suitable structure for an effective and accurate cost estimate for general purposes is discussed in the context of a NASA technology program. Cost elements are defined for research, management, and facility-construction portions of technology programs. Attention is given to the mechanisms for insuring the viability of spending programs, and the need for program managers is established for effecting timely fund disbursement. Formal, structures, and intuitive techniques are discussed for cost-estimate development, and cost-estimate defensibility can be improved with increased documentation. NASA policies for cash management are examined to demonstrate the importance of the ability to obligate funds and the ability to cost contracted funds. The NASA approach to consistent cost justification is set forth with a list of standard cost-element definitions. The cost elements reflect the three primary concerns of cost estimates: the identification of major assumptions, the specification of secondary analytic assumptions, and the status of program factors.

  6. Sweetener lowers costs

    SciTech Connect

    Muller, T.; Rosenstock, G.

    1983-10-01

    Mericat sweetening was used to get increased capacity needed by debottlenecking the FCCU at the Ruhr Refinery, Deutsche BP. A low conversion cost initiated the decision to adapt an existing copper chloride sweetener to Mericat but operating experience underscores the value of the choice because operating costs have been only 84% of design while anticipated capacity has been exceeded. Consequently, payout was accelerated to only about four months. Design specifications required that Light Cat Cracked Naphtha (LCCN) containing a maximum of 100 ppmw of mercaptan sulfur be sweetened to a maximum of 10 ppmw while caustic carryover sodium content not exceed 5 ppmw and that the sweetened LCCN meet Copper Strip No. 1 rating. Official tests based on runs with two different crude sources resulted in performance as shown in this paper. Operating costs of the copper chloride sweetening system before conversion and the Mericat system after conversion are also shown.

  7. Globalisation and social policy.

    PubMed

    Langmore, J

    2001-01-01

    This paper discusses six major themes: that economic and social issues are closely interdependent and that the appropriate stance is to work on both together, simultaneously; that though the threats from globalisation have been exaggerated, there can be substantial costs as well as considerable benefits; that constraints on national policy are significant but are less severe than is commonly considered; that the vitality-the vigour-of national and international political processes must be increased to cope effectively with the changes which are underway; that the private sector, unions and civil society have crucial roles in the provision of services and in advocating socially responsible values, standards and policies; and that one of the most effective means of addressing the erosion of national autonomy from globalisation is for countries to cooperate in setting and implementing shared objectives and international standards and establishing more global public goods.

  8. 48 CFR 48.102 - Policies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by Section 36 of the Office... cost-effective value engineering procedures and processes. Agencies shall provide contractors a... engineering provisions in appropriate supply, service, architect-engineer and construction contracts...

  9. 7 CFR 1709.601 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES Recovery of Financial Assistance Used for Unauthorized Purposes § 1709.601 Policy. This subpart prescribes the policies of the Rural Utilities Service (RUS) when it...

  10. 33 CFR 241.4 - General policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY PROVISION § 241.4 General policy. (a...(a) or 103(b) be subject to the ability to pay test. The test must therefore be applied not only to... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false General policy. 241.4 Section...

  11. 33 CFR 241.4 - General policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY PROVISION § 241.4 General policy. (a...(a) or 103(b) be subject to the ability to pay test. The test must therefore be applied not only to... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false General policy. 241.4 Section...

  12. 33 CFR 241.4 - General policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY PROVISION § 241.4 General policy. (a...(a) or 103(b) be subject to the ability to pay test. The test must therefore be applied not only to... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false General policy. 241.4 Section...

  13. 33 CFR 241.4 - General policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY PROVISION § 241.4 General policy. (a...(a) or 103(b) be subject to the ability to pay test. The test must therefore be applied not only to... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false General policy. 241.4 Section...

  14. 48 CFR 48.102 - Policies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by Section 36 of the Office... cost-effective value engineering procedures and processes. Agencies shall provide contractors a... savings on accepted VECP's. (c) Agencies shall consider requiring incorporation of value...

  15. American Students' Perceptions of American Foreign Policy.

    ERIC Educational Resources Information Center

    Barger, Robert N.

    The perception of typical U.S. college students toward the Reagan administration's foreign policy is that it is based on the principle that Communism must be stopped at any cost. Students' beliefs are defined according to their reactions to specific U.S. foreign policy initiatives. Three areas have aroused considerable campus reaction and…

  16. Integrated Cost Accounting System.

    DTIC Science & Technology

    1992-07-27

    few other companies. Harvard Business Review contained articles explaining the ideas behind the new costing methods and examples of applications...technical report. Peter Drucker in an article in Harvard Business Review ’carefully explains that accounting must change in response to the changes in...Kaplan in a Harvard Business Review article develop the idea of four levels of activities: facility sustaining activities; product-sustaining activities

  17. Public policy and pharmaceutical innovation.

    PubMed

    Grabowski, H G

    1982-09-01

    Historically, new drug introductions have played a central role in medical progress and the availability of cost-effective therapies. Nevertheless, public policy toward pharmaceuticals has been characterized in recent times by increasingly stringent regulatory controls, shorter effective patent terms, and increased encouragement of generic product usage. This has had an adverse effect on the incentives and capabilities of firms to undertake new drug research and development activity. The industry has experienced sharply rising research and development costs, declining annual new drug introductions, and fewer independent sources of drug development. This paper considers the effects of government regulatory policies on the pharmaceutical innovation process from several related perspectives. It also examines the merits of current public policy proposals designed to stimulate drug innovation including patent restoration and various regulatory reform measures.

  18. Public Policy and Pharmaceutical Innovation

    PubMed Central

    Grabowski, Henry G.

    1982-01-01

    Historically, new drug introductions have played a central role in medical progress and the availability of cost-effective therapies. Nevertheless, public policy toward pharmaceuticals has been characterized in recent times by increasingly stringent regulatory controls, shorter effective patent terms, and increased encouragement of generic product usage. This has had an adverse effect on the incentives and capabilities of firms to undertake new drug research and development activity. The industry has experienced sharply rising research and development costs, declining annual new drug introductions, and fewer independent sources of drug development. This paper considers the effects of government regulatory policies on the pharmaceutical innovation process from several related perspectives. It also examines the merits of current public policy proposals designed to stimulate drug innovation including patent restoration and various regulatory reform measures. PMID:10309721

  19. 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.

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

    PubMed

    Cartwright, William S

    2008-03-01

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

  1. Economic Stimulus: Issues and Policies

    DTIC Science & Technology

    2009-01-23

    provide broader support for the economy than monetary policy actions alone.” Quoted in Ben Bernanke , “The Economic Outlook,” testimony before the House...have sought to contain damages spilling over from housing and financial markets to the broader economy , including monetary policy, which is the...including leaving the government holding large amounts of mortgage debt. With the worsening performance of the economy , congressional leaders and

  2. Economic Stimulus: Issues and Policies

    DTIC Science & Technology

    2009-02-27

    for the economy than monetary policy actions alone.” Quoted in Ben Bernanke , “The Economic Outlook,” testimony before the House Committee on the...have sought to contain damages spilling over from housing and financial markets to the broader economy , including monetary policy, which is the...disadvantages, including leaving the government holding large amounts of mortgage debt. With the worsening performance of the economy beginning in September

  3. Calculating Amortized Capital Costs

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  4. 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.

  5. Role of State Policy in Renewable Energy Development

    SciTech Connect

    Doris, E.; Busche, S.; Hockett, S.; McLaren, J.

    2009-07-01

    State policies can support renewable energy development by driving markets, providing certainty in the investment market, and incorporating the external benefits of the technologies into cost/benefit calculations. Using statistical analyses and policy design best practices, this paper quantifies the impact of state-level policies on renewable energy development in order to better understand the role of policy on development and inform policy makers on the policy mechanisms that provide maximum benefit. The results include the identification of connections between state policies and renewable energy development, as well as a discussion placing state policy efforts in context with other factors that influence the development of renewable energy (e.g. federal policy, resource availability, technology cost, public acceptance).

  6. Proposed reliability cost model

    NASA Technical Reports Server (NTRS)

    Delionback, L. M.

    1973-01-01

    The research investigations which were involved in the study include: cost analysis/allocation, reliability and product assurance, forecasting methodology, systems analysis, and model-building. This is a classic example of an interdisciplinary problem, since the model-building requirements include the need for understanding and communication between technical disciplines on one hand, and the financial/accounting skill categories on the other. The systems approach is utilized within this context to establish a clearer and more objective relationship between reliability assurance and the subcategories (or subelements) that provide, or reenforce, the reliability assurance for a system. Subcategories are further subdivided as illustrated by a tree diagram. The reliability assurance elements can be seen to be potential alternative strategies, or approaches, depending on the specific goals/objectives of the trade studies. The scope was limited to the establishment of a proposed reliability cost-model format. The model format/approach is dependent upon the use of a series of subsystem-oriented CER's and sometimes possible CTR's, in devising a suitable cost-effective policy.

  7. The role of multi-target policy instruments in agri-environmental policy mixes.

    PubMed

    Schader, Christian; Lampkin, Nicholas; Muller, Adrian; Stolze, Matthias

    2014-12-01

    The Tinbergen Rule has been used to criticise multi-target policy instruments for being inefficient. The aim of this paper is to clarify the role of multi-target policy instruments using the case of agri-environmental policy. Employing an analytical linear optimisation model, this paper demonstrates that there is no general contradiction between multi-target policy instruments and the Tinbergen Rule, if multi-target policy instruments are embedded in a policy-mix with a sufficient number of targeted instruments. We show that the relation between cost-effectiveness of the instruments, related to all policy targets, is the key determinant for an economically sound choice of policy instruments. If economies of scope with respect to achieving policy targets are realised, a higher cost-effectiveness of multi-target policy instruments can be achieved. Using the example of organic farming support policy, we discuss several reasons why economies of scope could be realised by multi-target agri-environmental policy instruments.

  8. 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.

  9. Laboratory cost control and financial management software.

    PubMed

    Mayer, M

    1998-02-09

    Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

  10. 77 FR 801 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-06

    ...: Revised Amount of the Average Cost of a Health Insurance Policy The Health Resources and Services Administration (HRSA) is publishing an updated monetary amount of the average cost of a health insurance policy... available as the baseline for the average monthly cost of a health insurance policy. This baseline...

  11. 23 CFR 1252.4 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GENERAL PROVISIONS STATE MATCHING OF PLANNING AND ADMINISTRATION COSTS § 1252.4 Policy. Federal participation in P&A activities shall not exceed 50 percent of the total cost of such activities, or the applicable sliding...

  12. Rural Policy in a New Century.

    ERIC Educational Resources Information Center

    Marshall, Ray

    Past rural policies are reviewed, noting the effects of globalization and information technology. Rural business profits can be maximized by direct cost or value-added competition, but cost competition limits the development of productive capacity and leads to unequal income distribution. In contrast, value-added competition could create steep…

  13. 48 CFR 234.7100 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DEFENSE SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Cost and Software Data Reporting 234.7100 Policy. (a) The cost and software data reporting (CSDR) requirement is mandatory for major defense... data reporting and software resources data reporting. (b) Prior to contract award, contracting...

  14. 48 CFR 234.7100 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... DEFENSE SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Cost and Software Data Reporting 234.7100 Policy. (a) The cost and software data reporting (CSDR) requirement is mandatory for major defense... data reporting and software resources data reporting. (b) Prior to contract award, contracting...

  15. 48 CFR 234.7100 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DEFENSE SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Cost and Software Data Reporting 234.7100 Policy. (a) The cost and software data reporting (CSDR) requirement is mandatory for major defense... data reporting and software resources data reporting. (b) Prior to contract award, contracting...

  16. 48 CFR 234.7100 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... DEFENSE SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Cost and Software Data Reporting 234.7100 Policy. (a) The cost and software data reporting (CSDR) requirement is mandatory for major defense... data reporting and software resources data reporting. (b) Prior to contract award, contracting...

  17. 7 CFR 1709.102 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost Grant Program § 1709.102 Policy. (a) All high...). (b) RUS may give priority consideration to projects that benefit smaller rural communities, communities experiencing economic hardship, projects that extend service to households that lack...

  18. Secondary Containers and Service Containers for Pesticides

    EPA Pesticide Factsheets

    Secondary containers and service containers are used by pesticide applicators in the process of applying a pesticide. EPA does not require secondary containers or service containers to be labeled or to meet particular construction standards. Learn more.

  19. Economic assessment of alternative energy policies

    SciTech Connect

    Groncki, P J; Goettle, IV, R J; Hudson, E A

    1980-04-01

    Current US energy policy includes many programs directed toward the restructuring of the energy system so as to decrease US dependence on foreign supplies and to increase our reliance on plentiful and environmentally benign energy forms. However, recent events have led to renewed concern over the direction of current energy policy. This study describes three possible energy strategies and analyzes each in terms of its economic, environmental, and national security benefits and costs. Each strategy is represented by a specific policy. The first strategy is to initiate no additional programs or policies beyond those currently in effect or announced. The second is to direct policy toward reducing the growth in energy demand, i.e., energy conservation. The third is to promote increased supply through accelerated development of synthetic and unconventional fuels. The analysis focuses on the evaluation and comparison of these strategy alternatives with respect to their energy, economic, and environmental consequences. The analysis indicates that conservation can substantially reduce import dependence and slow the growth of energy demand, with only a small macroeconomic cost and with substantial environmental benefits; the synfuels policy reduces imports by a smaller amount, does not reduce the growth in energy demand, and involves substantial environmental costs and impacts on economic performance. However, these relationships could be different if the energy savings per unit cost for conservation turned out to be less than anticipated; therefore, both conservation and R, D, and D support for synfuels should be included in future energy policy.

  20. Hospitalization and cost after switching from atypical to typical antipsychotics in schizophrenia patients in Thailand

    PubMed Central

    Boonlue, Tuanthon; Subongkot, Suphat; Dilokthornsakul, Piyameth; Kongsakon, Ronnachai; Pattanaprateep, Oraluck; Suanchang, Orabhorn; Chaiyakunapruk, Nathorn

    2016-01-01

    Background Several clinical practice guidelines suggest using atypical over typical antipsychotics in patients diagnosed with schizophrenia. Nevertheless, cost-containment policy urged restricting usage of atypical antipsychotics and switching from atypical to typical antipsychotics. Objective This study aimed to evaluate clinical and economic impacts of switching from atypical to typical antipsychotics in schizophrenia patients in Thailand. Methods From October 2010 through September 2013, a retrospective cohort study was performed utilizing electronic database of two tertiary hospitals. Schizophrenia patients aged 18 years or older and being treated with atypical antipsychotics were included. Patients were classified as atypical antipsychotic switching group if they switched to typical antipsychotics after 180 days of continual atypical antipsychotics therapy. Outcomes were schizophrenia-related hospitalization and total health care cost. Logistic and Poisson regression were used to evaluate the risk of hospitalization, and generalized linear model with gamma distribution was used to determine the health care cost. All analyses were adjusted by employing propensity score and multivariable analyses. All cost estimates were adjusted according to 2013 consumer price index and converted to US$ at an exchange rate of 32.85 Thai bahts/US$. Results A total of 2,354 patients were included. Of them, 166 (7.1%) patients switched to typical antipsychotics. The adjusted odds ratio for schizophrenia-related hospitalization in atypical antipsychotic switching group was 1.87 (95% confidence interval [CI] 1.23–2.83). The adjusted incidence rate ratio was 2.44 (95% CI 1.57–3.79) for schizophrenia-related hospitalizations. The average total health care cost was lower in patients with antipsychotic switching (−$64; 95% CI −$459 to $332). Conclusion Switching from atypical to typical antipsychotics is associated with an increased risk of schizophrenia-related hospitalization

  1. Board Policies on Policy Development. Educational Policies Development Kit.

    ERIC Educational Resources Information Center

    National School Boards Association, Waterford, CT. Educational Policies Service.

    This is the 16th in a continuing series of kit-booklets issued to help school boards develop written policies in key subject areas. The material supports the contention that a set of well-defined policies on board policy development and administrative execution of policies reduces the likelihood of trouble and tends to eliminate instant, sloppy,…

  2. Federal Contractors and Sticky Costs

    DTIC Science & Technology

    2014-11-05

    NPS-CM-14-188 ACQUISITION RESEARCH PROGRAM SPONSORED REPORT SERIES Federal Contractors and Sticky Costs 5 November 2014 Stephen C. Hansen...average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed...Public Policy - iv - Naval Postgraduate School NPS-CM-14-188 Acquisition Research Program Sponsored Report Series Federal Contractors and

  3. Advanced Fuel Cycle Cost Basis

    SciTech Connect

    D. E. Shropshire; K. A. Williams; W. B. Boore; J. D. Smith; B. W. Dixon; M. Dunzik-Gougar; R. D. Adams; D. Gombert; E. Schneider

    2009-12-01

    This report, commissioned by the U.S. Department of Energy (DOE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the Advanced Fuel Cycle Initiative (AFCI) Program. The report describes the AFCI cost basis development process, reference information on AFCI cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This report contains reference cost data for 25 cost modules—23 fuel cycle cost modules and 2 reactor modules. The cost modules were developed in the areas of natural uranium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste.

  4. Advanced Fuel Cycle Cost Basis

    SciTech Connect

    D. E. Shropshire; K. A. Williams; W. B. Boore; J. D. Smith; B. W. Dixon; M. Dunzik-Gougar; R. D. Adams; D. Gombert

    2007-04-01

    This report, commissioned by the U.S. Department of Energy (DOE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the Advanced Fuel Cycle Initiative (AFCI) Program. The report describes the AFCI cost basis development process, reference information on AFCI cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This report contains reference cost data for 26 cost modules—24 fuel cycle cost modules and 2 reactor modules. The cost modules were developed in the areas of natural uranium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, and high-level waste.

  5. Advanced Fuel Cycle Cost Basis

    SciTech Connect

    D. E. Shropshire; K. A. Williams; W. B. Boore; J. D. Smith; B. W. Dixon; M. Dunzik-Gougar; R. D. Adams; D. Gombert; E. Schneider

    2008-03-01

    This report, commissioned by the U.S. Department of Energy (DOE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the Advanced Fuel Cycle Initiative (AFCI) Program. The report describes the AFCI cost basis development process, reference information on AFCI cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This report contains reference cost data for 25 cost modules—23 fuel cycle cost modules and 2 reactor modules. The cost modules were developed in the areas of natural uranium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste.

  6. Renewable Portfolio Standards: Costs and Benefits (Poster)

    SciTech Connect

    Bird, L.; Heeter, J.; Barbose, G.; Weaver, S.; Flores, F.; Kuskova-Burns, K.; Wiser, R.

    2014-10-01

    This report summarizes state-level RPS costs to date, and considers how those costs may evolve going forward given scheduled increases in RPS targets and cost containment mechanisms. The report also summarizes RPS benefits estimates, based on published studies for individual states and discusses key methodological considerations.

  7. State and Local Clean Energy Policy Primer: Getting from Here to Clean Electricity with Policy (Fact Sheet)

    SciTech Connect

    Not Available

    2011-04-01

    This fact sheet proposes a framework for how states and localities can build policy portfolios by first setting the stage for clean energy in the market with low cost policies, and then growing the market with successive policies until the need for financial incentives can be reduced and eventually eliminated.

  8. Accounting for the Full Cost of Research. A Study of Indirect Costs.

    ERIC Educational Resources Information Center

    Zuiches, James J.; Vallely, Rebecca

    Faculty and administrative concern over the rising indirect cost rates at Cornell University (New York) precipitated this study, focusing on research funding and the expenses not easily identifiable with specific projects. Some of the questions addressed include: what are the costs, who pays for them, and which arrangements, policies,…

  9. 77 FR 69422 - Cost Accounting Standards: Revision of the Exemption From Cost Accounting Standards for Contracts...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... BUDGET Office of Federal Procurement Policy 48 CFR Part 9903 Cost Accounting Standards: Revision of the Exemption From Cost Accounting Standards for Contracts and Subcontracts for the Acquisition of Commercial... Accounting Standards (CAS) Board. ACTION: Proposed rule. SUMMARY: The OFPP and CAS Board invite...

  10. 76 FR 61660 - Cost Accounting Standards: Clarification of the Exemption From Cost Accounting Standards for Firm...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... Cost Accounting Standards.'' Included in the provision was a revision to paragraph (2)(B) of Section 26... Accounting Standards by covered Government contractors and subcontractors, consistent with the provisions of... BUDGET Office of Federal Procurement Policy 48 CFR Part 9903 Cost Accounting Standards: Clarification...

  11. JERM model of care: an in-principle model for dental health policy.

    PubMed

    Lam, Raymond; Kruger, Estie; Tennant, Marc

    2014-01-01

    Oral diseases are the most prevalent conditions in the community. Their economic burden is high and their impact on quality of life is profound. There is an increasing body of evidence indicating that oral diseases have wider implications beyond the confines of the mouth. The importance of oral health has not been unnoticed by the government. The Commonwealth (Federal) government under the Howard-led Coalition in 2004 had broken tradition by placing dentistry in its universal health insurance scheme, Medicare. Known as the Chronic Disease Dental Scheme (CDDS), the program aimed to manage patients with chronic conditions as part of the Enhanced Primary Care initiative. This scheme was a landmark policy for several reasons. Besides being the first major dental policy under Medicare, the program proved to be the most expensive and controversial. Unfortunately, cost containment and problems with service provision led to its cessation in 2012 by the Gillard Labor Government. Despite being seen as a failure, the CDDS provided a unique opportunity to assess national policy in practice. By analysing the policy-relevant effects of the CDDS, important lessons can be learnt for policy development. This paper discusses these lessons and has formulated a set of principles recommended for effective oral health policy. The JERM model represents the principles of a justified, economical and research-based model of care.

  12. Patients With High Mental Health Costs Incur Over 30 Percent More Costs Than Other High-Cost Patients.

    PubMed

    de Oliveira, Claire; Cheng, Joyce; Vigod, Simone; Rehm, Jürgen; Kurdyak, Paul

    2016-01-01

    A small proportion of health care users, called high-cost patients, account for a disproportionately large share of health care costs. Most literature on these patients has focused on the entire population. However, high-cost patients whose use of mental health care services is substantial are likely to differ from other members of the population. We defined a mental health high-cost patient as someone for whom mental health-related services accounted for at least 50 percent of total health care costs. We examined these patients' health care utilization and costs in Ontario, Canada. We found that their average cost for health care, in 2012 Canadian dollars, was $31,611. In contrast, the cost was $23,681 for other high-cost patients. Mental health high-cost patients were younger, lived in poorer neighborhoods, and had different health care utilization patterns, compared to other high-cost patients. These findings should be considered when implementing policies or interventions to address quality of care for mental health patients so as to ensure that mental health high-cost patients receive appropriate care in a cost-effective manner. Furthermore, efforts to manage mental health patients' health care use should address their complex profile through integrated multidisciplinary health care delivery.

  13. 32 CFR 197.4 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Policy. 197.4 Section 197.4 National Defense... RESEARCH IN THE FILES OF THE OFFICE OF THE SECRETARY OF DEFENSE (OSD) § 197.4 Policy. It is DoD policy... information is contained in OSD files whose overall markings are classified. (e) Under E.O. 12958, or...

  14. Documenting investment policy boosts safety, returns.

    PubMed

    Kovener, R R

    1992-02-01

    The process and responsibility for a healthcare organization's investment decisions should be clearly documented in an investment policy. Any investment policy should contain at least seven elements: how investments relate to the organization's mission; responsibilities of involved parties; long- and short-term objectives; desired balance between return and risk; proportions of a portfolio held in stocks, bonds, and other investments; disposition of donated assets; desired investment reports; and the process for keeping the policy current.

  15. Revised Seasonal Afterburner Policy

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  16. Policy watch: Medicare.

    PubMed

    Newhouse, J P

    1996-01-01

    Public policies are often made without much recourse to economic reasoning. Economists are sometimes unaware of what is happening in the world of public affairs. As a result, both the quality of public decision making and the role that economists play in it are less than optimal. This feature contains short articles on topics that are currently on the agendas of policymakers, thus illustrating the role of economic analysis in illuminating current debates. Suggestions for future columns and comments on past ones should be sent to Daniel Weinberg, c/o Journal of Economic Perspectives, HHES Division, Bureau of the Census, Department of Commerce, Washington, D.C. 20233.

  17. Interpretation of Offset Policy

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  18. 48 CFR 731.205-46 - Travel costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Travel costs. 731.205-46... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 731.205-46 Travel costs. It is USAID policy to require prior written approval of international travel...

  19. 48 CFR 731.205-46 - Travel costs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Travel costs. 731.205-46... CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 731.205-46 Travel costs. It is USAID policy to require prior written approval of international travel...

  20. 40 CFR 35.937-6 - Cost and price considerations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Cost and price considerations. 35.937-6... Cost and price considerations. (a) General. EPA policy is that the cost or price of all subagreements... equivalent process. (b) Subagreements over $100,000. For each subagreement expected to exceed $100,000,...