Sample records for cost efficiency analysis

  1. Opportunity cost based analysis of corporate eco-efficiency: a methodology and its application to the CO2-efficiency of German companies.

    PubMed

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

    2010-10-01

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

  2. Cost drivers and resource allocation in military health care systems.

    PubMed

    Fulton, Larry; Lasdon, Leon S; McDaniel, Reuben R

    2007-03-01

    This study illustrates the feasibility of incorporating technical efficiency considerations in the funding of military hospitals and identifies the primary drivers for hospital costs. Secondary data collected for 24 U.S.-based Army hospitals and medical centers for the years 2001 to 2003 are the basis for this analysis. Technical efficiency was measured by using data envelopment analysis; subsequently, efficiency estimates were included in logarithmic-linear cost models that specified cost as a function of volume, complexity, efficiency, time, and facility type. These logarithmic-linear models were compared against stochastic frontier analysis models. A parsimonious, three-variable, logarithmic-linear model composed of volume, complexity, and efficiency variables exhibited a strong linear relationship with observed costs (R(2) = 0.98). This model also proved reliable in forecasting (R(2) = 0.96). Based on our analysis, as much as $120 million might be reallocated to improve the United States-based Army hospital performance evaluated in this study.

  3. Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.

    PubMed

    Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas

    2011-12-01

    This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

  4. Life-cycle costs of high-performance cells

    NASA Technical Reports Server (NTRS)

    Daniel, R.; Burger, D.; Reiter, L.

    1985-01-01

    A life cycle cost analysis of high efficiency cells was presented. Although high efficiency cells produce more power, they also cost more to make and are more susceptible to array hot-spot heating. Three different computer analysis programs were used: SAMICS (solar array manufacturing industry costing standards), PVARRAY (an array failure mode/degradation simulator), and LCP (lifetime cost and performance). The high efficiency cell modules were found to be more economical in this study, but parallel redundancy is recommended.

  5. The efficiency of life insurance and family Takaful in Malaysia: Relative efficiency using the stochastic cost frontier analysis

    NASA Astrophysics Data System (ADS)

    Baharin, Roziana; Isa, Zaidi

    2013-04-01

    This paper focuses on the Stochastic cost Frontier Analysis (SFA) approach, in an attempt to measure the relationship between efficiency and organizational structure for Takaful and insurance operators in Malaysia's dual financial system. This study applied a flexible cost functional form i.e., Fourier Flexible Functional Form, for a sample consisting of 19 firms, chosen between 2002 and 2010, by employing the Battese and Coelli invariant efficiency model. The findings show that on average, there is a significant difference in cost efficiency between the Takaful industry and the insurance industry. It was found that Takaful has lower cost efficiency than conventional insurance, which shows that the organization form has an influence on efficiency. Overall, it was observed that the level of efficiency scores for both life insurance and family Takaful do not vary across time.

  6. Full cost accounting in the analysis of separated waste collection efficiency: A methodological proposal.

    PubMed

    D'Onza, Giuseppe; Greco, Giulio; Allegrini, Marco

    2016-02-01

    Recycling implies additional costs for separated municipal solid waste (MSW) collection. The aim of the present study is to propose and implement a management tool - the full cost accounting (FCA) method - to calculate the full collection costs of different types of waste. Our analysis aims for a better understanding of the difficulties of putting FCA into practice in the MSW sector. We propose a FCA methodology that uses standard cost and actual quantities to calculate the collection costs of separate and undifferentiated waste. Our methodology allows cost efficiency analysis and benchmarking, overcoming problems related to firm-specific accounting choices, earnings management policies and purchase policies. Our methodology allows benchmarking and variance analysis that can be used to identify the causes of off-standards performance and guide managers to deploy resources more efficiently. Our methodology can be implemented by companies lacking a sophisticated management accounting system. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Costs and cost-efficiency of a mobile cash transfer to prevent child undernutrition during the lean season in Burkina Faso: a mixed methods analysis from the MAM'Out randomized controlled trial.

    PubMed

    Puett, Chloe; Salpéteur, Cécile; Houngbe, Freddy; Martínez, Karen; N'Diaye, Dieynaba S; Tonguet-Papucci, Audrey

    2018-01-01

    This study assessed the costs and cost-efficiency of a mobile cash transfer implemented in Tapoa Province, Burkina Faso in the MAM'Out randomized controlled trial from June 2013 to December 2014, using mixed methods and taking a societal perspective by including costs to implementing partners and beneficiary households. Data were collected via interviews with implementing staff from the humanitarian agency and the private partner delivering the mobile money, focus group discussions with beneficiaries, and review of accounting databases. Costs were analyzed by input category and activity-based cost centers. cost-efficiency was analyzed by cost-transfer ratios (CTR) and cost per beneficiary. Qualitative analysis was conducted to identify themes related to implementing electronic cash transfers, and barriers to efficient implementation. The CTR was 0.82 from a societal perspective, within the same range as other humanitarian transfer programs; however the intervention did not achieve the same degree of cost-efficiency as other mobile transfer programs specifically. Challenges in coordination between humanitarian and private partners resulted in long wait times for beneficiaries, particularly in the first year of implementation. Sensitivity analyses indicated a potential 6% reduction in CTR through reducing beneficiary wait time by one-half. Actors reported that coordination challenges improved during the project, therefore inefficiencies likely would be resolved, and cost-efficiency improved, as the program passed the pilot phase. Despite the time required to establish trusting relationships among actors, and to set up a network of cash points in remote areas, this analysis showed that mobile transfers hold promise as a cost-efficient method of delivering cash in this setting. Implementation by local government would likely reduce costs greatly compared to those found in this study context, and improve cost-efficiency especially by subsidizing expansion of mobile money network coverage and increasing cash distribution points in remote areas which are unprofitable for private partners.

  8. A Cost-Effectiveness Analysis Model for Evaluating and Planning Secondary Vocational Programs

    ERIC Educational Resources Information Center

    Kim, Jin Eun

    1977-01-01

    This paper conceptualizes a cost-effectiveness analysis and describes a cost-effectiveness analysis model for secondary vocational programs. It generates three kinds of cost-effectiveness measures: program effectiveness, cost efficiency, and cost-effectiveness and/or performance ratio. (Author)

  9. Economic analysis in medical education: definition of essential terms.

    PubMed

    Walsh, Kieran

    2014-10-01

    Medical education is expensive. There is a growing interest in the subject of cost and value in medical education. However, in the medical education literature, terms are sometimes used loosely - and so there is a need for basic grounding in the meaning of commonly used and important terms in medical education economics. The purpose of this article is to define some terms that are frequently used in economic analysis in medical education. In this article, terms are described, and the descriptions are followed by a worked example of how the terms might be used in practice. The following terms are described: opportunity cost, total cost of ownership, sensitivity analysis, viewpoint, activity-based costing, efficiency, technical efficiency, allocative efficiency, price and transaction costs.

  10. Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists

    PubMed Central

    Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

    2010-01-01

    The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of ‘off-label prescribing’ and ‘indication creep’ behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists. PMID:20716234

  11. Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists.

    PubMed

    Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

    2010-09-01

    The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of 'off-label prescribing' and 'indication creep' behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists.

  12. Cost Efficiency in the University: A Departmental Evaluation Model

    ERIC Educational Resources Information Center

    Gimenez, Victor M.; Martinez, Jose Luis

    2006-01-01

    This article presents a model for the analysis of cost efficiency within the framework of data envelopment analysis models. It calculates the cost excess, separating a unit of production from its optimal or frontier levels, and, at the same time, breaks these excesses down into three explanatory factors: (a) technical inefficiency, which depends…

  13. Characteristics of High- and Low-Efficiency Hospitals.

    PubMed

    Rosko, Michael; Wong, Herbert S; Mutter, Ryan

    2017-01-01

    We compared performance, operating characteristics, and market environments of low- and high-efficiency hospitals in the 37 states that supplied inpatient data to the Healthcare Cost and Utilization Project from 2006 to 2010. Hospital cost-inefficiency estimates using stochastic frontier analysis were generated. Hospitals were then grouped into the 100 most- and 100 least-efficient hospitals for subsequent analysis. Compared with the least efficient hospitals, high-efficiency hospitals tended to have lower average costs, higher labor productivity, and higher profit margins. The most efficient hospitals tended to be nonteaching, investor-owned, and members of multihospital systems. Hospitals in the high-efficiency group were located in areas with lower health maintenance organization penetration and less competition, and they had a higher share of Medicaid and Medicare admissions. Results of the analysis suggest there are opportunities for public policies to support improved efficiency in the hospital sector.

  14. The productivity and cost-efficiency of models for involving nurse practitioners in primary care: a perspective from queueing analysis.

    PubMed

    Liu, Nan; D'Aunno, Thomas

    2012-04-01

    To develop simple stylized models for evaluating the productivity and cost-efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how. The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness-to-care requirement; cost-efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings. Employing an NP, whose salary is usually lower than a primary care physician, may not be cost-efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost-efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery. The productivity and cost-efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model. © Health Research and Educational Trust.

  15. [Cost-benefit analysis of the active screening of pulmonary tuberculosis in a recluse population entering prison].

    PubMed

    Martín, V; Domínguez, A; Alcaide, J

    1997-01-01

    In spanish prisons, tuberculosis is a serious problem of public health and health authorities don't take it seriously. To prove the efficiency of pulmonary tuberculosis case-finding on arrival at prison in order to get location resources in this activity. Cost-benefit analysis of a case-finding program compared with to wait for diagnostic to illness. The sensitivity of test was fixed in 80% and the specificity in 99.99%. The cost was based on market prices. Sensitivity analysis was done in every variables as well as tridimensional analysis in those one of more influence. The case-finding was efficient on prevalences of tuberculosis over 5 per mil. Its efficiency was hardly affected by discount social rates or the sensitivity of diagnostic tests. The prevalence of illness, the cost of diagnostic activities as well as the success of treatment and the specificity of diagnostic tests used had as influence on the efficiency model. The tridimensional analysis proved that the case-finding of pulmonary tuberculosis has efficiency on low prevalences (1 per thousand), provided the number of people cured is a 5% higher than the alternative one and the costs of case-finding less than 1,000 pesetas per subject. The case-finding pulmonary tuberculosis on arrival at prisons is of high efficiency. In a cost-opportunity situation (location of available resources, penitentiary and extrapenitentiary) the program is very efficacious taking into account the fact of higher prevalence of pulmonary tuberculosis in this people.

  16. Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

    PubMed

    Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

    2010-12-01

    The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

  17. Save Money and the Planet: Make Your School Energy Efficient.

    ERIC Educational Resources Information Center

    Lewis, Eleanor J.; Weltman, Eric

    1993-01-01

    Examines ways in which schools can cut their energy costs. Suggestions are provided for making school lighting more efficient, conducting a life-cycle cost analysis to facilitate energy efficiency, and developing funding for implementing energy-efficient projects. (GLR)

  18. Cost effectiveness and efficiency in assistive technology service delivery.

    PubMed

    Warren, C G

    1993-01-01

    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  19. Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models.

    PubMed Central

    Nunamaker, T R

    1983-01-01

    This article provides an illustrative application of Data Envelopment Analysis (DEA) methodology to the measurement of routine nursing service efficiency at a group of Wisconsin hospitals. The DEA efficiency ratings and cost savings estimates are then compared to those resulting from application of Medicare's routine cost limitation to the sample data. DEA is also used to determine if any changes in the potential for efficient operations occurred during the 1978-1979 period. Empirical results were representative of the fundamental differences existing between the DEA and cost per patient day approaches. No evidence was found to support the notion that the overall potential for efficient delivery of routine services by the sample institutions was greater in one year than another. PMID:6874357

  20. [A cost-benefit analysis of different therapeutic methods in menorrhagia].

    PubMed

    Kirschner, R

    1995-02-20

    When deciding the right forms of treatment for various medical conditions it has been usual to consider medical knowledge, norms and experience. Increasingly, economic factors and principles are being introduced by the management, in the form of health economics and pharmaco-economic analyses, enforced as budgetary cuts and demands for rationalisation and measures to increase efficiency. Economic evaluations require construction of models for analyses. We have used DRG-information, National Health reimbursements and pharmacological retail prices to make a cost-efficiency analysis of treatments of menorrhagia. The analysis showed better cost-efficiency for certain pharmacological treatments than for surgery.

  1. Economic analysis of greenhouse lighting: light emitting diodes vs. high intensity discharge fixtures.

    PubMed

    Nelson, Jacob A; Bugbee, Bruce

    2014-01-01

    Lighting technologies for plant growth are improving rapidly, providing numerous options for supplemental lighting in greenhouses. Here we report the photosynthetic (400-700 nm) photon efficiency and photon distribution pattern of two double-ended HPS fixtures, five mogul-base HPS fixtures, ten LED fixtures, three ceramic metal halide fixtures, and two fluorescent fixtures. The two most efficient LED and the two most efficient double-ended HPS fixtures had nearly identical efficiencies at 1.66 to 1.70 micromoles per joule. These four fixtures represent a dramatic improvement over the 1.02 micromoles per joule efficiency of the mogul-base HPS fixtures that are in common use. The best ceramic metal halide and fluorescent fixtures had efficiencies of 1.46 and 0.95 micromoles per joule, respectively. We also calculated the initial capital cost of fixtures per photon delivered and determined that LED fixtures cost five to ten times more than HPS fixtures. The five-year electric plus fixture cost per mole of photons is thus 2.3 times higher for LED fixtures, due to high capital costs. Compared to electric costs, our analysis indicates that the long-term maintenance costs are small for both technologies. If widely spaced benches are a necessary part of a production system, the unique ability of LED fixtures to efficiently focus photons on specific areas can be used to improve the photon capture by plant canopies. Our analysis demonstrates, however, that the cost per photon delivered is higher in these systems, regardless of fixture category. The lowest lighting system costs are realized when an efficient fixture is coupled with effective canopy photon capture.

  2. Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation

    PubMed Central

    2012-01-01

    Purpose A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a “real-lifeâ application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. Key messages (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. Conclusion (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care. PMID:22506504

  3. Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation.

    PubMed

    Turner-Stokes, Lynne; Poppleton, Rob; Williams, Heather; Schoewenaars, Katie; Badwan, Derar

    2012-01-01

    A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.

  4. The Productivity and Cost-Efficiency of Models for Involving Nurse Practitioners in Primary Care: A Perspective from Queueing Analysis

    PubMed Central

    Liu, Nan; D'Aunno, Thomas

    2012-01-01

    Objective To develop simple stylized models for evaluating the productivity and cost-efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how. Data Sources and Study Design The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness-to-care requirement; cost-efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings. Principal Findings Employing an NP, whose salary is usually lower than a primary care physician, may not be cost-efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost-efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery. Conclusions The productivity and cost-efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model. PMID:22092009

  5. Comparative cost-efficiency across the European G5 countries of various regimens of filgrastim, biosimilar filgrastim, and pegfilgrastim to reduce the incidence of chemotherapy-induced febrile neutropenia.

    PubMed

    Aapro, Matti; Cornes, Paul; Abraham, Ivo

    2012-06-01

    This cost-efficiency analysis of the granulocyte colony-stimulating factors (G-CSF) filgrastim (originator Neupogen® and biosimilar Zarzio®) and pegfilgrastim (Neulasta®) examined against a time horizon of 1-14 days of treatment and across the European Union G5 countries (a) when, cost-wise, using Neulasta® 6 mg versus Neupogen® or Zarzio® 300 µg may be cost-saving in reducing the incidence of chemotherapy-induced febrile neutropenia; and (b) if cost-wise, treatment with Zarzio® 300 µg yields a savings advantage over Neupogen® 300 µg. Cost-efficiency analysis of the direct costs a buyer or payer would incur when purchasing or covering any of these agents for managing one patient during one cycle of chemotherapy under regimens of 1-14 days of standard filgrastim using the population-weighted average unit dose cost of each agent per their public pack cost across the European G5 countries. The cost of Neupogen® treatment ranged from €128.16 (1 day) to €1794.30 (14 days), compared to €95.46 and €1336.46 for Zarzio®, thus yielding potential cost savings from €32.70 to €457.84 for the latter. Neulasta® turns cost-saving at day 12 of Neupogen® treatment. At no point over a 14-day treatment period did Neulasta® yield a savings advantage over Zarzio®. Prophylaxis or treatment of febrile neutropenia with Zarzio® is cost-efficient under all possible treatment scenarios relative to Neupogen® and to Neulasta®. In the absence of convincing evidence that pegfilgrastim is pharmacotherapeutically superior to standard filgrastim, there is no cost-efficiency rationale to treat with Neulasta® over Zarzio®, though there may be a small window of approximately 3 days where Neulasta® is cost-efficient over Neupogen®. Regardless, our analysis shows Zarzio® to be the most cost-efficient approach to reducing the incidence of febrile neutropenia in chemotherapy-treated patients.

  6. Analysis of extreme values of the economic efficiency indicators of transport infrastructure projects

    NASA Astrophysics Data System (ADS)

    Korytárová, J.; Vaňková, L.

    2017-10-01

    Paper builds on previous research of the authors into the evaluation of economic efficiency of transport infrastructure projects evaluated by the economic efficiency ratio - NPV, IRR and BCR. Values of indicators and subsequent outputs of the sensitivity analysis show extremely favourable values in some cases. The authors dealt with the analysis of these indicators down to the level of the input variables and examined which inputs have a larger share of these extreme values. NCF for the calculation of above mentioned ratios is created by benefits that arise as the difference between zero and investment options of the project (savings in travel and operating costs, savings in travel time costs, reduction in accident costs and savings in exogenous costs) as well as total agency costs. Savings in travel time costs which contribute to the overall utility of projects by more than 70% appear to be the most important benefits in the long term horizon. This is the reason why this benefit emphasized. The outcome of the article has resulted how the particular basic variables contributed to the total robustness of economic efficiency of these project.

  7. Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data.

    PubMed

    Heimeshoff, Mareike; Schreyögg, Jonas; Kwietniewski, Lukas

    2014-06-01

    This is the first study to use stochastic frontier analysis to estimate both the technical and cost efficiency of physician practices. The analysis is based on panel data from 3,126 physician practices for the years 2006 through 2008. We specified the technical and cost frontiers as translog function, using the one-step approach of Battese and Coelli to detect factors that influence the efficiency of general practitioners and specialists. Variables that were not analyzed previously in this context (e.g., the degree of practice specialization) and a range of control variables such as a patients' case-mix were included in the estimation. Our results suggest that it is important to investigate both technical and cost efficiency, as results may depend on the type of efficiency analyzed. For example, the technical efficiency of group practices was significantly higher than that of solo practices, whereas the results for cost efficiency differed. This may be due to indivisibilities in expensive technical equipment, which can lead to different types of health care services being provided by different practice types (i.e., with group practices using more expensive inputs, leading to higher costs per case despite these practices being technically more efficient). Other practice characteristics such as participation in disease management programs show the same impact throughout both cost and technical efficiency: participation in disease management programs led to an increase in both, technical and cost efficiency, and may also have had positive effects on the quality of care. Future studies should take quality-related issues into account.

  8. Cost-effectiveness analysis and innovation.

    PubMed

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

  9. Efficiency and quality of care in nursing homes: an Italian case study.

    PubMed

    Garavaglia, Giulia; Lettieri, Emanuele; Agasisti, Tommaso; Lopez, Silvano

    2011-03-01

    This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over a 3-year period (2005-2007). Lombardy is a very peculiar setting, since it is the only Region in Italy where the healthcare industry is organised as a quasi-market, in which the public authority buys health and nursing services from independent providers-establishing a reimbursement system for this purpose. The analysis is conducted by generating bootstrapped DEA efficiency scores for each nursing home (stage one), then regressing those scores on explanatory variables (stage two). Our DEA model employed two input (i.e. costs for health and nursing services and costs for residential services) and three output variables (case mix, extra nursing hours and residential charges). In the second-stage analysis, Tobit regressions and the Kruskall-Wallis tests of hypothesis to the efficiency scores were applied to define what are the factors that affect efficiency: (a) the ownership (private nursing houses outperform their public counterparts); and (b) the capability to implement strategies for labour cost and nursing costs containment, since the efficiency heavily depends upon the alignment of the costs to the public reimbursement system. Lastly, even though the public institutions are less efficient than the private ones, the results suggest that public nursing homes are moving towards their private counterparts, and thus competition is benefiting efficiency.

  10. Complementary effect of patient volume and quality of care on hospital cost efficiency.

    PubMed

    Choi, Jeong Hoon; Park, Imsu; Jung, Ilyoung; Dey, Asoke

    2017-06-01

    This study explores the direct effect of an increase in patient volume in a hospital and the complementary effect of quality of care on the cost efficiency of U.S. hospitals in terms of patient volume. The simultaneous equation model with three-stage least squares is used to measure the direct effect of patient volume and the complementary effect of quality of care and volume. Cost efficiency is measured with a data envelopment analysis method. Patient volume has a U-shaped relationship with hospital cost efficiency and an inverted U-shaped relationship with quality of care. Quality of care functions as a moderator for the relationship between patient volume and efficiency. This paper addresses the economically important question of the relationship of volume with quality of care and hospital cost efficiency. The three-stage least square simultaneous equation model captures the simultaneous effects of patient volume on hospital quality of care and cost efficiency.

  11. Cost-effectiveness Analysis on Measures to Improve China's Coal-fired Industrial Boiler

    DOE PAGES

    Liu, Manzhi; Shen, Bo; Han, Yafeng; ...

    2015-08-01

    Tackling coal-burning industrial boiler is becoming one of the key programs to solve the environmental problem in China. Assessing the economics of various options to address coal-fired boiler is essential to identify cost-effective solutions. This paper discusses our work in conducting a cost-effectiveness analysis on various types of improvement measures ranging from energy efficiency retrofits to switch from coal to other fuels in China. Sensitivity analysis was also performed in order to understand the impacts of some economic factors such as discount rate and energy price on the economics of boiler improvement options. The results show that nine out ofmore » 14 solutions are cost-effective, and a lower discount rate and higher energy price will result in more energy efficiency measures being cost-effective. Both monetary and non-monetary barriers to energy-efficiency improvement are discussed and policies to tackle these barriers are recommended. Our research aims at providing a methodology to assess cost-effective solutions to boiler problems.« less

  12. III-Vs at Scale: A PV Manufacturing Cost Analysis of the Thin Film Vapor-Liquid-Solid Growth Mode

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

    Zheng, Maxwell; Horowitz, Kelsey; Woodhouse, Michael

    The authors present a manufacturing cost analysis for producing thin-film indium phosphide modules by combining a novel thin-film vapor-liquid-solid (TF-VLS) growth process with a standard monolithic module platform. The example cell structure is ITO/n-TiO2/p-InP/Mo. For a benchmark scenario of 12% efficient modules, the module cost is estimated to be $0.66/W(DC) and the module cost is calculated to be around $0.36/W(DC) at a long-term potential efficiency of 24%. The manufacturing cost for the TF-VLS growth portion is estimated to be ~$23/m2, a significant reduction compared with traditional metalorganic chemical vapor deposition. The analysis here suggests the TF-VLS growth mode could enablemore » lower-cost, high-efficiency III-V photovoltaics compared with manufacturing methods used today and open up possibilities for other optoelectronic applications as well.« less

  13. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    PubMed

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  14. Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania: a cross-sectional study.

    PubMed

    Saronga, Happiness P; Duysburgh, Els; Massawe, Siriel; Dalaba, Maxwell A; Savadogo, Germain; Tonchev, Pencho; Dong, Hengjin; Sauerborn, Rainer; Loukanova, Svetla

    2014-02-28

    Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible and necessary. This will stimulate utilization of ANC and childbirth services in resource-constrained health facilities. Efficiency analyses through simple techniques such as measurement of unit costs should be made standard in health care provision, health managers can then use the performance results to gauge progress and reward efficiency through performance based incentives.

  15. Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system.

    PubMed

    Gok, Mehmet Sahin; Altındağ, Erkut

    2015-06-01

    This paper analyzes the effects of the pay for performance (PFP) system on the efficiencies of public and private hospitals in Turkey. In order to evaluate these effects, we examine the relationship between hospital efficiency and health care costs in Turkey, and address the impact of the PFP system on the efficiencies of public and private hospitals. In an effort to analyze the efficiencies of public and private hospitals, this study uses data envelopment analysis. The Malmquist Productivity Index is also used to analyze the patterns of efficiency change for the study years from 2001 to 2008. This study shows that health care costs and hospital efficiency are negatively correlated for private hospitals, while they are positively correlated for public hospitals. In other words, increased health care costs might reduce efficiency in private hospitals in contrast to public hospitals. Our findings also indicate that average efficiencies of public hospitals tend to increase, particularly during the implementation period of PFP system. The efficiency trend of private hospitals, conversely, decreased in the latter periods of the PFP system. Suggestions for improvement are provided to the health care policy makers regarding the impact of health care reforms on public and private hospitals.

  16. Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

    PubMed

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

    2009-02-01

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

  17. Are Public Master's Institutions Cost Efficient? A Stochastic Frontier and Spatial Analysis

    ERIC Educational Resources Information Center

    Titus, Marvin A.; Vamosiu, Adriana; McClure, Kevin R.

    2017-01-01

    The current study examines costs, measured by educational and general (E&G) spending, and cost efficiency at 252 public master's institutions in the United States over a nine-year (2004-2012) period. We use a multi-product quadratic cost function and results from a random-effects model with a first-order autoregressive (AR1) disturbance term…

  18. Assessing value-for-money in maternal and newborn health.

    PubMed

    Banke-Thomas, Aduragbemi; Madaj, Barbara; Kumar, Shubha; Ameh, Charles; van den Broek, Nynke

    2017-01-01

    Responding to increasing demands to demonstrate value-for-money (VfM) for maternal and newborn health interventions, and in the absence of VfM analysis in peer-reviewed literature, this paper reviews VfM components and methods, critiques their applicability, strengths and weakness and proposes how VfM assessments can be improved. VfM comprises four components: economy, efficiency, effectiveness and cost-effectiveness. Both 'economy' and 'efficiency' can be assessed with detailed cost analysis utilising costs obtained from programme accounting data or generic cost databases. Before-and-after studies, case-control studies or randomised controlled trials can be used to assess 'effectiveness'. To assess 'cost-effectiveness', cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-benefit analysis (CBA) or social return on investment (SROI) analysis are applicable. Generally, costs can be obtained from programme accounting data or existing generic cost databases. As such 'economy' and 'efficiency' are relatively easy to assess. However, 'effectiveness' and 'cost-effectiveness' which require establishment of the counterfactual are more difficult to ascertain. Either a combination of CEA or CUA with tools for assessing other VfM components, or the independent use of CBA or SROI are alternative approaches proposed to strengthen VfM assessments. Cross-cutting themes such as equity, sustainability, scalability and cultural acceptability should also be assessed, as they provide critical contextual information for interpreting VfM assessments. To select an assessment approach, consideration should be given to the purpose, data availability, stakeholders requiring the findings and perspectives of programme beneficiaries. Implementers and researchers should work together to improve the quality of assessments. Standardisation around definitions, methodology and effectiveness measures to be assessed would help.

  19. Benefit-Cost Analysis of Drug Abuse Prevention Programs: A Macroscopic Approach.

    ERIC Educational Resources Information Center

    Kim, Sehwan; And Others

    1995-01-01

    Determines the overall strategy for initiating benefit-cost analysis (BCA) in relation to drug abuse prevention programs, followed by definitions of BCA and cost-effectiveness analysis. Determines the most likely population benefit-cost efficiency ratio of 15:1, indicating that there is a $15 savings on every dollar spent on drug abuse education.…

  20. Energy savings and cost-benefit analysis of the new commercial building standard in China

    DOE PAGES

    Zhao, Shanguo; Feng, Wei; Zhang, Shicong; ...

    2015-10-07

    In this study, a comprehensive comparison of the commercial building energy efficiency standard between the previous 2005 version and the new proposed version is conducted, including the energy efficiency analysis and cost-benefit analysis. To better understand the tech-economic performance of the new Chinese standard, energy models were set up based on a typical commercial office building in Chinese climate zones. The building energy standard in 2005 is used as the baseline for this analysis. Key building technologies measures are analyzed individually, including roof, wall, window, lighting and chiller and so on and finally whole building cost-benefit analysis was conducted. Resultsmore » show that the new commercial building energy standard demonstrates good cost-effective performance, with whole building payback period around 4 years.« less

  1. Energy savings and cost-benefit analysis of the new commercial building standard in China

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

    Zhao, Shanguo; Feng, Wei; Zhang, Shicong

    In this study, a comprehensive comparison of the commercial building energy efficiency standard between the previous 2005 version and the new proposed version is conducted, including the energy efficiency analysis and cost-benefit analysis. To better understand the tech-economic performance of the new Chinese standard, energy models were set up based on a typical commercial office building in Chinese climate zones. The building energy standard in 2005 is used as the baseline for this analysis. Key building technologies measures are analyzed individually, including roof, wall, window, lighting and chiller and so on and finally whole building cost-benefit analysis was conducted. Resultsmore » show that the new commercial building energy standard demonstrates good cost-effective performance, with whole building payback period around 4 years.« less

  2. Efficiency evaluation with feedback for regional water use and wastewater treatment

    NASA Astrophysics Data System (ADS)

    Hu, Zhineng; Yan, Shiyu; Yao, Liming; Moudi, Mahdi

    2018-07-01

    Clean water is crucial for sustainable economic and social development; however, around the world low water use efficiency and increasing water pollution have become serious problems. To comprehensively evaluate water use and wastewater treatment, this paper integrated bi-level programming (BLP) and Data Envelopment Analysis (DEA) with a feedback variable to deal with poor output to rank DMUs using a super efficiency DEA. The proposed model was applied to a case study of 10 cities in the Minjiang River Basin to demonstrate the applicability and effectiveness, from which it was found that a water system can only be cost-efficient when both the water use and wastewater treatment subsystems are both cost-efficient. The comparison analysis demonstrated that the proposed model was more discriminating, and stable than traditional DEA models and was able to better improve total water system cost efficiencies than a BLP-DEA model.

  3. Payment schemes and cost efficiency: evidence from Swiss public hospitals.

    PubMed

    Meyer, Stefan

    2015-03-01

    This paper aims at analysing the impact of prospective payment schemes on cost efficiency of acute care hospitals in Switzerland. We study a panel of 121 public hospitals subject to one of four payment schemes. While several hospitals are still reimbursed on a per diem basis for the treatment of patients, most face flat per-case rates-or mixed schemes, which combine both elements of reimbursement. Thus, unlike previous studies, we are able to simultaneously analyse and isolate the cost-efficiency effects of different payment schemes. By means of stochastic frontier analysis, we first estimate a hospital cost frontier. Using the two-stage approach proposed by Battese and Coelli (Empir Econ 20:325-332, 1995), we then analyse the impact of these payment schemes on the cost efficiency of hospitals. Controlling for hospital characteristics, local market conditions in the 26 Swiss states (cantons), and a time trend, we show that, compared to per diem, hospitals which are reimbursed by flat payment schemes perform better in terms of cost efficiency. Our results suggest that mixed schemes create incentives for cost containment as well, although to a lesser extent. In addition, our findings indicate that cost-efficient hospitals are primarily located in cantons with competitive markets, as measured by the Herfindahl-Hirschman index in inpatient care. Furthermore, our econometric model shows that we obtain biased estimates from frontier analysis if we do not account for heteroscedasticity in the inefficiency term.

  4. Potential gains from hospital mergers in Denmark.

    PubMed

    Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller

    2010-12-01

    The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.

  5. The Application of Cost-Benefit Analysis in Manpower Area.

    ERIC Educational Resources Information Center

    Barsby, Steven L.

    The relative efficiency of various manpower programs as seen through cost-benefit analysis is assessed, and the contribution that cost-benefit analysis has made in evaluating manpower programs is discussed, taking into account a variety of methodologies presented in different studies. Vocational rehabilitation appears to yield the highest…

  6. Defense Commissaries: DOD Needs to Improve Business Processes to Ensure Patron Benefits and Achieve Operational Efficiencies

    DTIC Science & Technology

    2017-03-01

    sales, leverage efficiencies, and achieve savings in commissary operations. Second, DeCA has not conducted cost - benefit analyses for costs ...conduct comprehensive cost - benefit analyses for service contracts and distribution options. DOD concurred with GAO’s first two recommendations and...partially concurred with the third recommendation. GAO continues to believe the cost - benefit analysis recommendation is valid

  7. A sensitivity analysis of central flat-plate photovoltaic systems and implications for national photovoltaics program planning

    NASA Technical Reports Server (NTRS)

    Crosetti, M. R.

    1985-01-01

    The sensitivity of the National Photovoltaic Research Program goals to changes in individual photovoltaic system parameters is explored. Using the relationship between lifetime cost and system performance parameters, tests were made to see how overall photovoltaic system energy costs are affected by changes in the goals set for module cost and efficiency, system component costs and efficiencies, operation and maintenance costs, and indirect costs. The results are presented in tables and figures for easy reference.

  8. Cost analysis helps evaluate contract profitability.

    PubMed

    Sides, R W

    2000-02-01

    A cost-accounting analysis can help group practices assess their costs of doing business and determine the profitability of managed care contracts. Group practices also can use cost accounting to develop budgets and financial benchmarks. To begin a cost analysis, group practices need to determine their revenue and cost centers. Then they can allocate their costs to each center, using an appropriate allocation basis. The next step is to calculate costs per procedure. The results can be used to evaluate operational cost efficiency as well as help negotiate managed care contracts.

  9. Efficiency of U.S. Dialysis Centers: An Updated Examination of Facility Characteristics That Influence Production of Dialysis Treatments

    PubMed Central

    Shreay, Sanatan; Ma, Martin; McCluskey, Jill; Mittelhammer, Ron C; Gitlin, Matthew; Stephens, J Mark

    2014-01-01

    Objective To explore the relative efficiency of dialysis facilities in the United States and identify factors that are associated with efficiency in the production of dialysis treatments. Data Sources/Study Setting Medicare cost report data from 4,343 free-standing dialysis facilities in the United States that offered in-center hemodialysis in 2010. Study Design A cross-sectional, facility-level retrospective database analysis, utilizing data envelopment analysis (DEA) to estimate facility efficiency. Data Collection/Extraction Methods Treatment data and cost and labor inputs of dialysis treatments were obtained from 2010 Medicare Renal Cost Reports. Demographic data were obtained from the 2010 U.S. Census. Principal Findings Only 26.6 percent of facilities were technically efficient. Neither the intensity of market competition nor the profit status of the facility had a significant effect on efficiency. Facilities that were members of large chains were less likely to be efficient. Cost and labor savings due to changes in drug protocols had little effect on overall dialysis center efficiency. Conclusions The majority of free-standing dialysis facilities in the United States were functioning in a technically inefficient manner. As payment systems increasingly employ capitation and bundling provisions, these institutions will need to evaluate their efficiency to remain competitive. PMID:24237043

  10. Stirling heat pump external heat systems - An appliance perspective

    NASA Astrophysics Data System (ADS)

    Vasilakis, Andrew D.; Thomas, John F.

    A major issue facing the Stirling Engine Heat Pump is system cost, and, in particular, the cost of the External Heat System (EHS). The need for high temperature at the heater head (600 C to 700 C) results in low combustion system efficiencies unless efficient heat recovery is employed. The balance between energy efficiency and use of costly high temperature materials is critical to design and cost optimization. Blower power consumption and NO(x) emissions are also important. A new approach to the design and cost optimization of the EHS was taken by viewing the system from a natural gas-fired appliance perspective. To develop a design acceptable to gas industry requirements, American National Standards Institute (ANSI) code considerations were incorporated into the design process and material selections. A parametric engineering design and cost model was developed to perform the analysis, including the impact of design on NO(x) emissions. Analysis results and recommended EHS design and material choices are given.

  11. Stirling heat pump external heat systems: An appliance perspective

    NASA Astrophysics Data System (ADS)

    Vasilakis, A. D.; Thomas, J. F.

    1992-08-01

    A major issue facing the Stirling Engine Heat Pump is system cost, and, in particular, the cost of the External Heat System (EHS). The need for high temperature at the heater head (600 C to 700 C) results in low combustion system efficiencies unless efficient heat recovery is employed. The balance between energy efficiency and use of costly high temperature materials is critical to design and cost optimization. Blower power consumption and NO(x) emissions are also important. A new approach to the design and cost optimization of the EHS system was taken by viewing the system from a natural gas-fired appliance perspective. To develop a design acceptable to gas industry requirements, American National Standards Institute (ANSI) code considerations were incorporated into the design process and material selections. A parametric engineering design and cost model was developed to perform the analysis, including the impact of design on NO(x) emissions. Analysis results and recommended EHS design and material choices are given.

  12. On the Path to SunShot. The Role of Advancements in Solar Photovoltaic Efficiency, Reliability, and Costs

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

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

    2016-05-01

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

  13. 34 CFR 75.232 - The cost analysis; basis for grant amount.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Secretary sets the amount of a new grant, the Secretary does a cost analysis of the project. The Secretary... objectives of the project with reasonable efficiency and economy under the budget in the application... 34 Education 1 2010-07-01 2010-07-01 false The cost analysis; basis for grant amount. 75.232...

  14. Technical- and environmental-efficiency analysis of irrigated cotton-cropping systems in Punjab, Pakistan using data envelopment analysis.

    PubMed

    Ullah, Asmat; Perret, Sylvain R

    2014-08-01

    Cotton cropping in Pakistan uses substantial quantities of resources and adversely affects the environment with pollutants from the inputs, particularly pesticides. A question remains regarding to what extent the reduction of such environmental impact is possible without compromising the farmers' income. This paper investigates the environmental, technical, and economic performances of selected irrigated cotton-cropping systems in Punjab to quantify the sustainability of cotton farming and reveal options for improvement. Using mostly primary data, our study quantifies the technical, cost, and environmental efficiencies of different farm sizes. A set of indicators has been computed to reflect these three domains of efficiency using the data envelopment analysis technique. The results indicate that farmers are broadly environmentally inefficient; which primarily results from poor technical inefficiency. Based on an improved input mix, the average potential environmental impact reduction for small, medium, and large farms is 9, 13, and 11 %, respectively, without compromising the economic return. Moreover, the differences in technical, cost, and environmental efficiencies between small and medium and small and large farm sizes were statistically significant. The second-stage regression analysis identifies that the entire farm size significantly affects the efficiencies, whereas exposure to extension and training has positive effects, and the sowing methods significantly affect the technical and environmental efficiencies. Paradoxically, the formal education level is determined to affect the efficiencies negatively. This paper discusses policy interventions that can improve the technical efficiency to ultimately increase the environmental efficiency and reduce the farmers' operating costs.

  15. Protons in head-and-neck cancer: bridging the gap of evidence.

    PubMed

    Ramaekers, Bram L T; Grutters, Janneke P C; Pijls-Johannesma, Madelon; Lambin, Philippe; Joore, Manuela A; Langendijk, Johannes A

    2013-04-01

    To use Normal Tissue Complication Probability (NTCP) models and comparative planning studies to explore the (cost-)effectiveness of swallowing sparing intensity modulated proton radiotherapy (IMPT) compared with swallowing sparing intensity modulated radiotherapy with photons (IMRT) in head and neck cancer (HNC). A Markov model was constructed to examine and compare the costs and quality-adjusted life years (QALYs) of the following strategies: (1) IMPT for all patients; (2) IMRT for all patients; and (3) IMPT if efficient. The assumption of equal survival for IMPT and IMRT in the base case analysis was relaxed in a sensitivity analysis. Intensity modulated proton radiation therapy and IMRT for all patients yielded 6.620 and 6.520 QALYs and cost €50,989 and €41,038, respectively. Intensity modulated proton radiation therapy if efficient yielded 6.563 QALYs and cost €43,650. The incremental cost-effectiveness ratio of IMPT if efficient versus IMRT for all patients was €60,278 per QALY gained. In the sensitivity analysis, IMRT was more effective (0.967 QALYs) and less expensive (€8218) and thus dominated IMPT for all patients. Cost-effectiveness analysis based on normal tissue complication probability models and planning studies proved feasible and informative and enables the analysis of individualized strategies. The increased effectiveness of IMPT does not seem to outweigh the higher costs for all head-and-neck cancer patients. However, when assuming equal survival among both modalities, there seems to be value in identifying those patients for whom IMPT is cost-effective. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Low-Cost CdTe/Silicon Tandem Solar Cells

    DOE PAGES

    Tamboli, Adele C.; Bobela, David C.; Kanevce, Ana; ...

    2017-09-06

    Achieving higher photovoltaic efficiency in single-junction devices is becoming increasingly difficult, but tandem modules offer the possibility of significant efficiency improvements. By device modeling we show that four-terminal CdTe/Si tandem solar modules offer the prospect of 25%-30% module efficiency, and technoeconomic analysis predicts that these efficiency gains can be realized at costs per Watt that are competitive with CdTe and Si single junction alternatives. The cost per Watt of the modeled tandems is lower than crystalline silicon, but slightly higher than CdTe alone. But, these higher power modules reduce area-related balance of system costs, providing increased value especially in area-constrainedmore » applications. This avenue for high-efficiency photovoltaics enables improved performance on a near-term timeframe, as well as a path to further reduced levelized cost of electricity as module and cell processes continue to advance.« less

  17. Low-Cost CdTe/Silicon Tandem Solar Cells

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

    Tamboli, Adele C.; Bobela, David C.; Kanevce, Ana

    Achieving higher photovoltaic efficiency in single-junction devices is becoming increasingly difficult, but tandem modules offer the possibility of significant efficiency improvements. By device modeling we show that four-terminal CdTe/Si tandem solar modules offer the prospect of 25%-30% module efficiency, and technoeconomic analysis predicts that these efficiency gains can be realized at costs per Watt that are competitive with CdTe and Si single junction alternatives. The cost per Watt of the modeled tandems is lower than crystalline silicon, but slightly higher than CdTe alone. But, these higher power modules reduce area-related balance of system costs, providing increased value especially in area-constrainedmore » applications. This avenue for high-efficiency photovoltaics enables improved performance on a near-term timeframe, as well as a path to further reduced levelized cost of electricity as module and cell processes continue to advance.« less

  18. [Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

    PubMed

    Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

    2011-08-01

    Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

  19. Governance and performance: the performance of Dutch hospitals explained by governance characteristics.

    PubMed

    Blank, Jos L T; van Hulst, Bart Laurents

    2011-10-01

    This paper describes the efficiency of Dutch hospitals using the Data Envelopment Analysis (DEA) method with bootstrapping. In particular, the analysis focuses on accounting for cost inefficiency measures on the part of hospital corporate governance. We use bootstrap techniques, as introduced by Simar and Wilson (J. Econom. 136(1):31-64, 2007), in order to obtain more efficient estimates of the effects of governance on the efficiency. The results show that part of the cost efficiency can be explained with governance. In particular we find that a higher remuneration of the board as well as a higher remuneration of the supervisory board does not implicate better performance.

  20. Techno-Economic Analysis of Indian Draft Standard Levels for RoomAir Conditioners

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

    McNeil, Michael A.; Iyer, Maithili

    The Indian Bureau of Energy Efficiency (BEE) finalized its first set of efficiency standards and labels for room air conditioners in July of 2006. These regulations followed soon after the publication of levels for frost-free refrigerators in the same year. As in the case of refrigerators, the air conditioner program introduces Minimum Efficiency Performance Standards (MEPS) and comparative labels simultaneously, with levels for one to five stars. Also like the refrigerator program, BEE defined several successive program phases of increasing stringency. In support of BEE's refrigerator program, Lawrence Berkeley National Laboratory (LBNL) produced an analysis of national impacts of standardsmore » in collaboration with the Collaborative Labeling and Standards Program (CLASP). That analysis drew on LBNL's experience with standards programs in the United States, as well as many other countries. Subsequently, as part of the process for setting optimal levels for air conditioner regulations, CLASP commissioned LBNL to provide support to BEE in the form of a techno-economic evaluation of air conditioner efficiency technologies. This report describes the methodology and results of this techno-economic evaluation. The analysis consists of three components: (1) Cost effectiveness to consumers of efficiency technologies relative to current baseline. (2) Impacts on the current market from efficiency regulations. (3) National energy and financial impacts. The analysis relied on detailed and up-to-date technical data made available by BEE and industry representatives. Technical parameters were used in conjunction with knowledge about air conditioner use patterns in the residential and commercial sectors, and prevailing marginal electricity prices, in order to give an estimate of per-unit financial impacts. In addition, the overall impact of the program was evaluated by combining unit savings with market forecasts in order to yield national impacts. LBNL presented preliminary results of these analyses in May 2006, at a meeting of BEEs Technical Committee for Air Conditioners. This meeting was attended by a wide array of stakeholder, including industry representatives, engineers and consumer advocates. Comments made by stakeholders at this meeting are incorporated into the final analysis presented in this report. The current analysis begins with the Rating Plan drafted by BEE in 2006, along with an evaluation of the market baseline according to test data submitted by manufacturers. MEPS, label rating levels, and baseline efficiencies are presented in Section 2. First, we compare Indian MEPS with current standards in other countries, and assess their relative stringency. Baseline efficiencies are then used to estimate the fraction of models likely to remain on the market at each phase of the program, and the impact on market-weighted efficiency levels. Section 3 deals with cost-effectiveness of higher efficiency design options. The cost-benefit analysis is grounded in technical parameters provided by industry representatives in India. This data allows for an assessment of financial costs and benefits to consumers as a result of the standards and labeling program. A Life-Cycle Cost (LCC) calculation is used to evaluate the impacts of the program at the unit level, thus providing some insight into the appropriateness of the levels chosen, and additional opportunities for further ratcheting. In addition to LCC, we also calculate payback periods, cost of conserved energy (CCE), and return on investment (ROI). Finally, Section 4 covers national impacts. This is an extension of unit level estimates in the two previous sections. Extrapolation to the national level depends on a forecast of air conditioner purchases (shipments), which we describe here. Following the cost-benefit analysis, we construct several efficiency scenarios including the BEE plan, but also considering further potential for efficiency improvement. These are combined with shipments through a stock accounting model in order to forecast air conditioner energy consumption in each scenario, and associated electricity savings and carbon emission mitigation. Finally, financial costs and savings are scaled to the national level to evaluate net fiscal benefits.« less

  1. Analysis and Evaluation of Processes and Equipment in Tasks 2 and 4 of the Low-cost Solar Array Project

    NASA Technical Reports Server (NTRS)

    Wolf, M.

    1979-01-01

    To facilitate the task of objectively comparing competing process options, a methodology was needed for the quantitative evaluation of their relative cost effectiveness. Such a methodology was developed and is described, together with three examples for its application. The criterion for the evaluation is the cost of the energy produced by the system. The method permits the evaluation of competing design options for subsystems, based on the differences in cost and efficiency of the subsystems, assuming comparable reliability and service life, or of competing manufacturing process options for such subsystems, which include solar cells or modules. This process option analysis is based on differences in cost, yield, and conversion efficiency contribution of the process steps considered.

  2. Analysis of simulated angiographic procedures. Part 2: extracting efficiency data from audio and video recordings.

    PubMed

    Duncan, James R; Kline, Benjamin; Glaiberman, Craig B

    2007-04-01

    To create and test methods of extracting efficiency data from recordings of simulated renal stent procedures. Task analysis was performed and used to design a standardized testing protocol. Five experienced angiographers then performed 16 renal stent simulations using the Simbionix AngioMentor angiographic simulator. Audio and video recordings of these simulations were captured from multiple vantage points. The recordings were synchronized and compiled. A series of efficiency metrics (procedure time, contrast volume, and tool use) were then extracted from the recordings. The intraobserver and interobserver variability of these individual metrics was also assessed. The metrics were converted to costs and aggregated to determine the fixed and variable costs of a procedure segment or the entire procedure. Task analysis and pilot testing led to a standardized testing protocol suitable for performance assessment. Task analysis also identified seven checkpoints that divided the renal stent simulations into six segments. Efficiency metrics for these different segments were extracted from the recordings and showed excellent intra- and interobserver correlations. Analysis of the individual and aggregated efficiency metrics demonstrated large differences between segments as well as between different angiographers. These differences persisted when efficiency was expressed as either total or variable costs. Task analysis facilitated both protocol development and data analysis. Efficiency metrics were readily extracted from recordings of simulated procedures. Aggregating the metrics and dividing the procedure into segments revealed potential insights that could be easily overlooked because the simulator currently does not attempt to aggregate the metrics and only provides data derived from the entire procedure. The data indicate that analysis of simulated angiographic procedures will be a powerful method of assessing performance in interventional radiology.

  3. An opportunity cost approach to sample size calculation in cost-effectiveness analysis.

    PubMed

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

    2008-01-01

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

  4. Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study.

    PubMed

    Lévesque, Renee; Marcelli, Daniele; Cardinal, Héloïse; Caron, Marie-Line; Grooteman, Muriel P C; Bots, Michiel L; Blankestijn, Peter J; Nubé, Menso J; Grassmann, Aileen; Canaud, Bernard; Gandjour, Afschin

    2015-12-01

    The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l'Université de Montréal) arm of a parallel-group randomized controlled trial (RCT), the CONvective TRAnsport STudy. An economic evaluation was conducted for the period of the RCT (74 months). In addition, a Markov state transition model was constructed to simulate costs and health benefits over lifetime. The primary outcome was costs per quality-adjusted life-year (QALY) gained. The analysis had the perspective of the Quebec public healthcare system. A total of 130 patients were randomly allocated to OL-HDF (n = 67) and LF-HD (n = 63). The cost-utility ratio of OL-HDF versus LF-HD was Can$53,270 per QALY gained over lifetime. This ratio was fairly robust in the sensitivity analysis. The cost-utility ratio was lower than that of LF-HD compared with no treatment (immediate death), which was Can$93,008 per QALY gained. High-efficiency OL-HDF can be considered a cost-effective treatment for ESRD in a Canadian setting. Further research is needed to assess cost effectiveness in other settings and healthcare systems.

  5. Educational Cost Analysis in Action: Case Studies for Planners -- I.

    ERIC Educational Resources Information Center

    Coombs, Philip H.; Hallak, Jacques

    This document is the first in a series of three documents, which together contains 27 case studies on the uses of cost analysis in educational planning. The case studies have been presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, or how to get the best value from…

  6. Educational Cost Analysis in Action: Case Studies for Planners -- III.

    ERIC Educational Resources Information Center

    Coombs, Philip H.; Hallak, Jacques

    This document is the third in a series of three documents, which together contain 27 case studies on the uses of cost analysis in educational planning. The case studies have been presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, and to get the best value from…

  7. Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

    PubMed

    Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

    2013-08-01

    Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

  8. Avoided electricity subsidy payments can finance substantial appliance efficiency incentive programs: Case study of Mexico

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

    Leventis, Greg; Gopal, Anand; Rue du Can, Stephane de la

    Numerous countries use taxpayer funds to subsidize residential electricity for a variety of socioeconomic objectives. These subsidies lower the value of energy efficiency to the consumer while raising it for the government. Further, while it would be especially helpful to have stringent Minimum Energy Performance Standards (MEPS) for appliances and buildings in this environment, they are hard to strengthen without imposing a cost on ratepayers. In this secondbest world, where the presence of subsidies limits the government’s ability to strengthen standards, we find that avoided subsidies are a readily available source of financing for energy efficiency incentive programs. Here, wemore » introduce the LBNL Energy Efficiency Revenue Analysis (LEERA) model to estimate the appliance efficiency improvements that can be achieved in Mexico by the revenue neutral financing of incentive programs from avoided subsidy payments. LEERA uses the detailed techno-economic analysis developed by LBNL for the Super-efficient Equipment and Appliance Deployment (SEAD) Initiative to calculate the incremental costs of appliance efficiency improvements. We analyze Mexico’s tariff structures and the long-run marginal cost of supply to calculate the marginal savings for the government from appliance efficiency. We find that avoided subsidy payments alone can finance incentive programs that cover the full incremental cost of refrigerators that are 27% more efficient and TVs that are 32% more efficient than baseline models. We find less substantial market transformation potential for room ACs primarily because AC energy savings occur at less subsidized tariffs.« less

  9. Costs and cost-efficacy analysis of the 2016 GESIDA/Spanish AIDS National Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    PubMed

    Rivero, Antonio; Pérez-Molina, José Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Crespo, Manuel; Domingo, Pere; Estrada, Vicente; Iribarren, José Antonio; Knobel, Hernando; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Moreno, Santiago; Palacios, Rosario; Pineda, Juan Antonio; Pulido, Federico; Rubio, Rafael; de la Torre, Javier; Tuset, Montserrat; Gatell, Josep M

    2017-02-01

    GESIDA and the AIDS National Plan panel of experts suggest preferred (PR), alternative (AR), and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for the year 2016. The objective of this study is to evaluate the costs and the efficacy of initiating treatment with these regimens. Economic assessment of costs and efficiency (cost/efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48 in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting is Spain and the costs correspond to those of 2016. A sensitivity deterministic analysis was conducted, building three scenarios for each regimen: base case, most favourable, and least favourable. In the base case scenario, the cost of initiating treatment ranges from 4663 Euros for 3TC+LPV/r (OR) to 10,894 Euros for TDF/FTC+RAL (PR). The efficacy varies from 0.66 for ABC/3TC+ATV/r (AR) and ABC/3TC+LPV/r (OR), to 0.89 for TDF/FTC+DTG (PR) and TDF/FTC/EVG/COBI (AR). The efficiency, in terms of cost/efficacy, ranges from 5280 to 12,836 Euros per responder at 48 weeks, for 3TC+LPV/r (OR), and RAL+DRV/r (OR), respectively. Despite the overall most efficient regimen being 3TC+LPV/r (OR), among the PR and AR, the most efficient regimen was ABC/3TC/DTG (PR). Among the AR regimes, the most efficient was TDF/FTC/RPV. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  10. Performance, Cost, and Market Share of Conventional Vehicle Efficiency Technologies? Retrospective Comparison of Regulatory Document Projections for Corporate Average Fuel Economy and Greenhouse Gas Standards

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

    Xie, Fei; Lin, Zhenhong; Nealer, Rachael

    This paper conducted an analysis of regulatory documents on current energy- and greenhouse gas–relevant conventional vehicle efficiency technologies in the corporate average fuel economy standards (2017 to 2025) and greenhouse gas rulemaking context by NHTSA and EPA. The focus was on identifying what technologies today—as estimated now (2015 to 2016)—receive higher or lower expectations with regard to effectiveness, cost, and consumer adoption than what experts projected during the 2010 to 2011 rulemaking period. A broad range of conventional vehicle efficiency technologies, including gasoline engine and diesel engine, transmission, accessory, hybrid, and vehicle body technologies, was investigated in this analysis. Finally,more » most assessed technologies were found to have had better competitiveness than expected with regard to effectiveness or costs, or both, with costs and market penetration more difficult to predict than technology effectiveness.« less

  11. Performance, Cost, and Market Share of Conventional Vehicle Efficiency Technologies? Retrospective Comparison of Regulatory Document Projections for Corporate Average Fuel Economy and Greenhouse Gas Standards

    DOE PAGES

    Xie, Fei; Lin, Zhenhong; Nealer, Rachael

    2017-09-30

    This paper conducted an analysis of regulatory documents on current energy- and greenhouse gas–relevant conventional vehicle efficiency technologies in the corporate average fuel economy standards (2017 to 2025) and greenhouse gas rulemaking context by NHTSA and EPA. The focus was on identifying what technologies today—as estimated now (2015 to 2016)—receive higher or lower expectations with regard to effectiveness, cost, and consumer adoption than what experts projected during the 2010 to 2011 rulemaking period. A broad range of conventional vehicle efficiency technologies, including gasoline engine and diesel engine, transmission, accessory, hybrid, and vehicle body technologies, was investigated in this analysis. Finally,more » most assessed technologies were found to have had better competitiveness than expected with regard to effectiveness or costs, or both, with costs and market penetration more difficult to predict than technology effectiveness.« less

  12. The efficiency and budgeting of public hospitals: case study of iran.

    PubMed

    Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

    2013-05-01

    Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance.

  13. Costs and cost-efficacy analysis of the 2014 GESIDA/Spanish National AIDS Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    PubMed

    Blasco, Antonio Javier; Llibre, Josep M; Berenguer, Juan; González-García, Juan; Knobel, Hernando; Lozano, Fernando; Podzamczer, Daniel; Pulido, Federico; Rivero, Antonio; Tuset, Montserrat; Lázaro, Pablo; Gatell, Josep M

    2015-03-01

    GESIDA and the National AIDS Plan panel of experts suggest preferred (PR) and alternative (AR) regimens of antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2014. The objective of this study is to evaluate the costs and the efficiency of initiating treatment with these regimens. An economic assessment was made of costs and efficiency (cost/efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied by considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting is Spain and costs correspond to those of 2014. A sensitivity deterministic analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranges from 5133 Euros for ABC/3TC+EFV to 11,949 Euros for TDF/FTC+RAL. The efficacy varies between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.89 for TDF/FTC/EVG/COBI. Efficiency, in terms of cost/efficacy, ranges from 7546 to 13,802 Euros per responder at 48 weeks, for ABC/3TC+EFV and TDF/FTC+RAL respectively. Considering ART official prices, the most efficient regimen was ABC/3TC+EFV (AR), followed by the non-nucleoside containing PR (TDF/FTC/RPV and TDF/FTC/EFV). The sensitivity analysis confirms the robustness of these findings. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. Costs and cost-efficacy analysis of the 2017 GESIDA/Spanish National AIDS Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    PubMed

    Rivero, Antonio; Pérez-Molina, José Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Asensi, Víctor; Crespo, Manuel; Domingo, Pere; Iribarren, José Antonio; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Martínez, Esteban; Moreno, Santiago; Palacios, Rosario; Pineda, Juan Antonio; Pulido, Federico; Rubio, Rafael; Santos, Jesús; de la Torre, Javier; Tuset, Montserrat; Gatell, Josep M

    2018-05-01

    GESIDA and the Spanish National AIDS Plan panel of experts have recommended preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral therapy (ART) as initial therapy in HIV-infected patients for 2017. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. Economic assessment of costs and efficiency (cost-efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied considering only differential direct costs: ART (official prices), management of adverse effects, resistance studies and HLA B*5701 screening. The setting was Spain and the costs correspond to those of 2017. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranged from 6882 euro for TFV/FTC/RPV (AR) to 10,904 euros for TFV/FTC+RAL (PR). The efficacy varied from 0.82 for TFV/FTC+DRV/p (AR) to 0.92 for TAF/FTC/EVG/COBI (PR). The efficiency, in terms of cost-efficacy, ranged from 7923 to 12,765 euros per responder at 48 weeks, for ABC/3TC/DTG (PR) and TFV/FTC+RAL (PR), respectively. Considering ART official prices, the most efficient regimen was ABC/3TC/DTG (PR), followed by TFV/FTC/RPV (AR) and TAF/FTC/EVG/COBI (PR). Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Analysis of the costs and cost-effectiveness of the guidelines recommended by the 2018 GESIDA/Spanish National AIDS Plan for initial antiretroviral therapy in HIV-infected adults.

    PubMed

    Pérez-Molina, José Antonio; Martínez, Esteban; Blasco, Antonio Javier; Arribas, José Ramón; Domingo, Pere; Iribarren, José Antonio; Knobel, Hernando; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Mariño, Ana; Miró, José M; Moreno, Santiago; Negredo, Eugenia; Pulido, Federico; Rubio, Rafael; Santos, Jesús; de la Torre, Javier; Tuset, Montserrat; von Wichmann, Miguel A; Gatell, Josep M

    2018-06-05

    The GESIDA/National AIDS Plan expert panel recommended preferred regimens (PR), alternative regimens (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2018. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. Economic assessment of costs and efficiency (cost-effectiveness) based on decision tree analyses. Effectiveness was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug-resistance studies) over the first 48 weeks. The payer perspective (National Health System) was applied considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting was Spain and the costs correspond to those of 2018. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base-case scenario, the cost of initiating treatment ranges from 6788 euros for TAF/FTC/RPV (AR) to 10,649 euros for TAF/FTC+RAL (PR). The effectiveness varies from 0.82 for TAF/FTC+DRV/r (AR) to 0.91 for TAF/FTC+DTG (PR). The efficiency, in terms of cost-effectiveness, ranges from 7814 to 12,412 euros per responder at 48 weeks, for ABC/3TC/DTG (PR) and TAF/FTC+RAL (PR), respectively. Considering ART official prices, the most efficient regimen was ABC/3TC/DTG (PR), followed by TAF/FTC/RPV (AR) and TAF/FTC/EVG/COBI (AR). Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  16. Regression analysis on the variation in efficiency frontiers for prevention stage of HIV/AIDS.

    PubMed

    Kamae, Maki S; Kamae, Isao; Cohen, Joshua T; Neumann, Peter J

    2011-01-01

    To investigate how the cost effectiveness of preventing HIV/AIDS varies across possible efficiency frontiers (EFs) by taking into account potentially relevant external factors, such as prevention stage, and how the EFs can be characterized using regression analysis given uncertainty of the QALY-cost estimates. We reviewed cost-effectiveness estimates for the prevention and treatment of HIV/AIDS published from 2002-2007 and catalogued in the Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry. We constructed efficiency frontier (EF) curves by plotting QALYs against costs, using methods used by the Institute for Quality and Efficiency in Health Care (IQWiG) in Germany. We stratified the QALY-cost ratios by prevention stage, country of study, and payer perspective, and estimated EF equations using log and square-root models. A total of 53 QALY-cost ratios were identified for HIV/AIDS in the Tufts CEA Registry. Plotted ratios stratified by prevention stage were visually grouped into a cluster consisting of primary/secondary prevention measures and a cluster consisting of tertiary measures. Correlation coefficients for each cluster were statistically significant. For each cluster, we derived two EF equations - one based on the log model, and one based on the square-root model. Our findings indicate that stratification of HIV/AIDS interventions by prevention stage can yield distinct EFs, and that the correlation and regression analyses are useful for parametrically characterizing EF equations. Our study has certain limitations, such as the small number of included articles and the potential for study populations to be non-representative of countries of interest. Nonetheless, our approach could help develop a deeper appreciation of cost effectiveness beyond the deterministic approach developed by IQWiG.

  17. Framework for Financial Ratio Analysis of Audited Federal Financial Reports

    DTIC Science & Technology

    1999-12-01

    franchising operations, allowing them to lower costs and share administrative support services with other agencies. [Ref. 60:sec. 402-403] The GMRA also...96 Federal Financial Reporting Statement of Net Cost Report Format 97 Federal Financial Reporting Statement of Changes in Net Position Report Format...analysis for sales, profitability, efficiency, marketing, investment, debt and capital analysis. Monitor growth Monitor costs Measure profitability and

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

    ERIC Educational Resources Information Center

    Krutilla, Kerry

    2005-01-01

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

  19. Estimated Costs for Delivery of HIV Antiretroviral Therapy to Individuals with CD4+ T-Cell Counts >350 cells/uL in Rural Uganda.

    PubMed

    Jain, Vivek; Chang, Wei; Byonanebye, Dathan M; Owaraganise, Asiphas; Twinomuhwezi, Ellon; Amanyire, Gideon; Black, Douglas; Marseille, Elliot; Kamya, Moses R; Havlir, Diane V; Kahn, James G

    2015-01-01

    Evidence favoring earlier HIV ART initiation at high CD4+ T-cell counts (CD4>350/uL) has grown, and guidelines now recommend earlier HIV treatment. However, the cost of providing ART to individuals with CD4>350 in Sub-Saharan Africa has not been well estimated. This remains a major barrier to optimal global cost projections for accelerating the scale-up of ART. Our objective was to compute costs of ART delivery to high CD4+count individuals in a typical rural Ugandan health center-based HIV clinic, and use these data to construct scenarios of efficient ART scale-up. Within a clinical study evaluating streamlined ART delivery to 197 individuals with CD4+ cell counts >350 cells/uL (EARLI Study: NCT01479634) in Mbarara, Uganda, we performed a micro-costing analysis of administrative records, ART prices, and time-and-motion analysis of staff work patterns. We computed observed per-person-per-year (ppy) costs, and constructed models estimating costs under several increasingly efficient ART scale-up scenarios using local salaries, lowest drug prices, optimized patient loads, and inclusion of viral load (VL) testing. Among 197 individuals enrolled in the EARLI Study, median pre-ART CD4+ cell count was 569/uL (IQR 451-716). Observed ART delivery cost was $628 ppy at steady state. Models using local salaries and only core laboratory tests estimated costs of $529/$445 ppy (+/-VL testing, respectively). Models with lower salaries, lowest ART prices, and optimized healthcare worker schedules reduced costs by $100-200 ppy. Costs in a maximally efficient scale-up model were $320/$236 ppy (+/- VL testing). This included $39 for personnel, $106 for ART, $130/$46 for laboratory tests, and $46 for administrative/other costs. A key limitation of this study is its derivation and extrapolation of costs from one large rural treatment program of high CD4+ count individuals. In a Ugandan HIV clinic, ART delivery costs--including VL testing--for individuals with CD4>350 were similar to estimates from high-efficiency programs. In higher efficiency scale-up models, costs were substantially lower. These favorable costs may be achieved because high CD4+ count patients are often asymptomatic, facilitating more efficient streamlined ART delivery. Our work provides a framework for calculating costs of efficient ART scale-up models using accessible data from specific programs and regions.

  20. Cost and efficiency of disaster waste disposal: A case study of the Great East Japan Earthquake.

    PubMed

    Sasao, Toshiaki

    2016-12-01

    This paper analyzes the cost and efficiency of waste disposal associated with the Great East Japan Earthquake. The following two analyses were performed: (1) a popular parametric approach, which is an ordinary least squares (OLS) method to estimate the factors that affect the disposal costs; (2) a non-parametric approach, which is a two-stage data envelopment analysis (DEA) to analyze the efficiency of each municipality and clarify the best performance of the disaster waste management. Our results indicate that a higher recycling rate of disaster waste and a larger amount of tsunami sediments decrease the average disposal costs. Our results also indicate that area-wide management increases the average cost. In addition, the efficiency scores were observed to vary widely by municipality, and more temporary incinerators and secondary waste stocks improve the efficiency scores. However, it is likely that the radioactive contamination from the Fukushima Daiichi nuclear power station influenced the results. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Preliminary engineering analysis for clothes washers

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

    Biermayer, Peter J.

    1996-10-01

    The Engineering Analysis provides information on efficiencies, manufacturer costs, and other characteristics of the appliance class being analyzed. For clothes washers, there are two classes: standard and compact. Since data were not available to analyze the compact class, only clothes washers were analyzed in this report. For this analysis, individual design options were combined and ordered in a manner that resulted in the lowest cumulative cost/savings ratio. The cost/savings ratio is the increase in manufacturer cost for a design option divided by the reduction in operating costs due to fuel and water savings.

  2. SSL Pricing and Efficacy Trend Analysis for Utility Program Planning

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

    Tuenge, J. R.

    2013-10-01

    Report to help utilities and energy efficiency organizations forecast the order in which important SSL applications will become cost-effective and estimate when each "tipping point" will be reached. Includes performance trend analysis from DOE's LED Lighting Facts® and CALiPER programs plus cost analysis from various sources.

  3. Cost-effectiveness analysis of sandhill crane habitat management

    USGS Publications Warehouse

    Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

    2013-01-01

    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

  4. Estimated Costs for Delivery of HIV Antiretroviral Therapy to Individuals with CD4+ T-Cell Counts >350 cells/uL in Rural Uganda

    PubMed Central

    Jain, Vivek; Chang, Wei; Byonanebye, Dathan M.; Owaraganise, Asiphas; Twinomuhwezi, Ellon; Amanyire, Gideon; Black, Douglas; Marseille, Elliot; Kamya, Moses R.; Havlir, Diane V.; Kahn, James G.

    2015-01-01

    Background Evidence favoring earlier HIV ART initiation at high CD4+ T-cell counts (CD4>350/uL) has grown, and guidelines now recommend earlier HIV treatment. However, the cost of providing ART to individuals with CD4>350 in Sub-Saharan Africa has not been well estimated. This remains a major barrier to optimal global cost projections for accelerating the scale-up of ART. Our objective was to compute costs of ART delivery to high CD4+count individuals in a typical rural Ugandan health center-based HIV clinic, and use these data to construct scenarios of efficient ART scale-up. Methods Within a clinical study evaluating streamlined ART delivery to 197 individuals with CD4+ cell counts >350 cells/uL (EARLI Study: NCT01479634) in Mbarara, Uganda, we performed a micro-costing analysis of administrative records, ART prices, and time-and-motion analysis of staff work patterns. We computed observed per-person-per-year (ppy) costs, and constructed models estimating costs under several increasingly efficient ART scale-up scenarios using local salaries, lowest drug prices, optimized patient loads, and inclusion of viral load (VL) testing. Findings Among 197 individuals enrolled in the EARLI Study, median pre-ART CD4+ cell count was 569/uL (IQR 451–716). Observed ART delivery cost was $628 ppy at steady state. Models using local salaries and only core laboratory tests estimated costs of $529/$445 ppy (+/-VL testing, respectively). Models with lower salaries, lowest ART prices, and optimized healthcare worker schedules reduced costs by $100–200 ppy. Costs in a maximally efficient scale-up model were $320/$236 ppy (+/- VL testing). This included $39 for personnel, $106 for ART, $130/$46 for laboratory tests, and $46 for administrative/other costs. A key limitation of this study is its derivation and extrapolation of costs from one large rural treatment program of high CD4+ count individuals. Conclusions In a Ugandan HIV clinic, ART delivery costs—including VL testing—for individuals with CD4>350 were similar to estimates from high-efficiency programs. In higher efficiency scale-up models, costs were substantially lower. These favorable costs may be achieved because high CD4+ count patients are often asymptomatic, facilitating more efficient streamlined ART delivery. Our work provides a framework for calculating costs of efficient ART scale-up models using accessible data from specific programs and regions. PMID:26632823

  5. Measuring the operational efficiency of individual theme park attractions.

    PubMed

    Kim, Changhee; Kim, Soowook

    2016-01-01

    This study assesses the operation efficiency of theme park attractions using the data envelopment analysis, utilizing actual data on 15 attractions at Samsung Everland located in Yongin-si, Republic of Korea. In particular, this study identifies crowding and waiting time as one of the main causes of visitor's satisfaction, and analyzes the efficiency of individual attractions in terms of waiting time. The installation area, installation cost, and annual repair cost are set as input factors and the number of annual users and customer satisfaction as output factors. The results show that the roller coaster-type attractions were less efficient than other types of attractions while rotating-type attractions were relatively more efficient. However, an importance performance analysis on individual attraction's efficiency and satisfaction showed that operational efficiency should not be the sole consideration in attraction installation. In addition, the projection points for input factors for efficient use of attractions and the appropriate reference set for benchmarking are provided as guideline for attraction efficiency management.

  6. The trade-off between hospital cost and quality of care. An exploratory empirical analysis.

    PubMed

    Morey, R C; Fine, D J; Loree, S W; Retzlaff-Roberts, D L; Tsubakitani, S

    1992-08-01

    The debate concerning quality of care in hospitals, its "value" and affordability, is increasingly of concern to providers, consumers, and purchasers in the United States and elsewhere. We undertook an exploratory study to estimate the impact on hospital-wide costs if quality-of-care levels were varied. To do so, we obtained costs and service output data regarding 300 U.S. hospitals, representing approximately a 5% cross section of all hospitals operating in 1983; both inpatient and outpatient services were included. The quality-of-care measure used for the exploratory analysis was the ratio of actual deaths in the hospital for the year in question to the forecasted number of deaths for the hospital; the hospital mortality forecaster had earlier (and elsewhere) been built from analyses of 6 million discharge abstracts, and took into account each hospital's actual individual admissions, including key patient descriptors for each admission. Such adjusted death rates have increasingly been used as potential indicators of quality, with recent research lending support for the viability of that linkage. The authors then utilized the economic construct of allocative efficiency relying on "best practices" concepts and peer groupings, built using the "envelopment" philosophy of Data Envelopment Analysis and Pareto efficiency. These analytical techniques estimated the efficiently delivered costs required to meet prespecified levels of quality of care. The marginal additional cost per each death deferred in 1983 was estimated to be approximately $29,000 (in 1990 dollars) for the average efficient hospital. Also, over a feasible range, a 1% increase in the level of quality of care delivered was estimated to increase hospital cost by an average of 1.34%. This estimated elasticity of quality on cost also increased with the number of beds in the hospital.

  7. Present-value analysis: A systems approach to public decisionmaking for cost effectiveness

    NASA Technical Reports Server (NTRS)

    Herbert, T. T.

    1971-01-01

    Decision makers within Governmental agencies and Congress must evaluate competing (and sometimes conflicting) proposals which seek funding and implementation. Present value analysis can be an effective decision making tool by enabling the formal evaluation of the effects of competing proposals on efficient national resource utilization. A project's costs are not only its direct disbursements, but its social costs as well. How much does it cost to have those funds diverted from their use and economic benefit by the private sector to the public project? Comparisons of competing projects' social costs allow decision makers to expand their decision bases by quantifying the projects' impacts upon the economy and the efficient utilization of the country's limited national resources. A conceptual model is established for the choosing of the appropriate discount rate to be used in evaluation decisions through the technique.

  8. A user-friendly approach to cost accounting in laboratory animal facilities.

    PubMed

    Baker, David G

    2011-08-19

    Cost accounting is an essential management activity for laboratory animal facility management. In this report, the author describes basic principles of cost accounting and outlines steps for carrying out cost accounting in laboratory animal facilities. Methods of post hoc cost accounting analysis for maximizing the efficiency of facility operations are also described.

  9. Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan.

    PubMed

    Yamauchi, Yasuhiro

    2015-07-12

    Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care.

  10. The evolution of cost-efficiency in neural networks during recovery from traumatic brain injury.

    PubMed

    Roy, Arnab; Bernier, Rachel A; Wang, Jianli; Benson, Monica; French, Jerry J; Good, David C; Hillary, Frank G

    2017-01-01

    A somewhat perplexing finding in the systems neuroscience has been the observation that physical injury to neural systems may result in enhanced functional connectivity (i.e., hyperconnectivity) relative to the typical network response. The consequences of local or global enhancement of functional connectivity remain uncertain and this is particularly true for the overall metabolic cost of the network. We examine the hyperconnectivity hypothesis in a sample of 14 individuals with TBI with data collected at approximately 3, 6, and 12 months following moderate and severe TBI. As anticipated, individuals with TBI showed increased network strength and cost early after injury, but by one-year post injury hyperconnectivity was more circumscribed to frontal DMN and temporal-parietal attentional control regions. Cost in these subregions was a significant predictor of cognitive performance. Cost-efficiency analysis in the Power 264 data parcellation suggested that at 6 months post injury the network requires higher cost connections to achieve high efficiency as compared to the network 12 months post injury. These results demonstrate that networks self-organize to re-establish connectivity while balancing cost-efficiency trade-offs.

  11. The evolution of cost-efficiency in neural networks during recovery from traumatic brain injury

    PubMed Central

    Roy, Arnab; Bernier, Rachel A.; Wang, Jianli; Benson, Monica; French, Jerry J.; Good, David C.; Hillary, Frank G.

    2017-01-01

    A somewhat perplexing finding in the systems neuroscience has been the observation that physical injury to neural systems may result in enhanced functional connectivity (i.e., hyperconnectivity) relative to the typical network response. The consequences of local or global enhancement of functional connectivity remain uncertain and this is particularly true for the overall metabolic cost of the network. We examine the hyperconnectivity hypothesis in a sample of 14 individuals with TBI with data collected at approximately 3, 6, and 12 months following moderate and severe TBI. As anticipated, individuals with TBI showed increased network strength and cost early after injury, but by one-year post injury hyperconnectivity was more circumscribed to frontal DMN and temporal-parietal attentional control regions. Cost in these subregions was a significant predictor of cognitive performance. Cost-efficiency analysis in the Power 264 data parcellation suggested that at 6 months post injury the network requires higher cost connections to achieve high efficiency as compared to the network 12 months post injury. These results demonstrate that networks self-organize to re-establish connectivity while balancing cost-efficiency trade-offs. PMID:28422992

  12. What does free cash flow tell us about hospital efficiency? A stochastic frontier analysis of cost inefficiency in California hospitals.

    PubMed

    Pratt, William R

    2010-01-01

    Hospitals are facing substantial financial and economic pressure as a result of health plan payment restructuring, unfunded mandates, and other factors. This article analyzes the relationship between free cash flow (FCF) and hospital efficiency given these financial challenges. Data from 270 California hospitals were used to estimate a stochastic frontier model of hospital cost efficiency that explicitly takes into account outpatient heterogeneity. The findings indicate that hospital FCF is significantly linked to firm efficiency/inefficiency. The results indicate that higher positive cash flows are related to lower cost inefficiency, but higher negative cash flows are related to higher cost inefficiency. Thus, cash flows not only impact the ability of hospitals to meet current liabilities, they are also related to the ability of the hospitals to use resources effectively.

  13. Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India.

    PubMed

    Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

    2013-12-01

    Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. The cost of referral transport per year varied from [symbol: see text] 5.2 million in Narnaul to [symbol: see text] 9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average [symbol: see text] 15.5 per km to [symbol: see text] 9.57 per km. Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.

  14. Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India

    PubMed Central

    Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

    2013-01-01

    Background & objectives: Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Methods: Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. Results: The cost of referral transport per year varied from ₹5.2 million in Narnaul to ₹9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average ₹ 15.5 per km to ₹ 9.57 per km. Interpretation & conclusions: Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances. PMID:24521648

  15. Probabilistic cost-benefit analysis of disaster risk management in a development context.

    PubMed

    Kull, Daniel; Mechler, Reinhard; Hochrainer-Stigler, Stefan

    2013-07-01

    Limited studies have shown that disaster risk management (DRM) can be cost-efficient in a development context. Cost-benefit analysis (CBA) is an evaluation tool to analyse economic efficiency. This research introduces quantitative, stochastic CBA frameworks and applies them in case studies of flood and drought risk reduction in India and Pakistan, while also incorporating projected climate change impacts. DRM interventions are shown to be economically efficient, with integrated approaches more cost-effective and robust than singular interventions. The paper highlights that CBA can be a useful tool if certain issues are considered properly, including: complexities in estimating risk; data dependency of results; negative effects of interventions; and distributional aspects. The design and process of CBA must take into account specific objectives, available information, resources, and the perceptions and needs of stakeholders as transparently as possible. Intervention design and uncertainties should be qualified through dialogue, indicating that process is as important as numerical results. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

  16. A cost and technical efficiency analysis of two alternative models for implementing the basic package of health services in Afghanistan.

    PubMed

    Blaakman, Aaron Philip; Salehi, Ahmad Shah; Boitard, Romain

    2014-01-01

    Since 2003, the Afghan Ministry of Public Health (MoPH) and international partners have directed a contracting-out model through which non-governmental organisations (NGOs) deliver the Basic Package of Health Services (BPHS) in 31 of the 34 Afghan provinces. The MoPH also managed health service delivery in three provinces under an alternative initiative entitled Strengthening Mechanisms (SM). In 2011, under the authority of the MoPH and Delegation of the European Union to Afghanistan, EPOS Health Management conducted a cost and technical efficiency study of the contracting-out and SM mechanisms in six provinces to examine economic trade-offs in the provision of the BPHS. The study provides analyses of all resource inputs and primary outputs of the BPHS in the six provinces during 2008 and 2009. The authors examined technical efficiency using Data Envelopment Analysis (DEA) at the BPHS facility level. Cost analysis results indicate that the weighted average cost per BPHS outpatient visit totalled $3.41 in the SM provinces and $5.39 in the NGO-led provinces in 2009. Furthermore, the data envelopment analyses (DEAs) indicate that facilities in the three NGO-led provinces scored 0.168 points higher on the DEA scale (0-1) than SM facilities. The authors conclude that an approximate 60% increase in costs yielded a 16.8% increase in technical efficiency in the delivery of the BPHS during 2009 in the six provinces.

  17. Fitting of full Cobb-Douglas and full VRTS cost frontiers by solving goal programming problem

    NASA Astrophysics Data System (ADS)

    Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Madhusudhana Rao, B.

    2017-11-01

    The present research article first defines two popular production functions viz, Cobb-Douglas and VRTS production frontiers and their dual cost functions and then derives their cost limited maximal outputs. This paper tells us that the cost limited maximal output is cost efficient. Here the one side goal programming problem is proposed by which the full Cobb-Douglas cost frontier, full VRTS frontier can be fitted. This paper includes the framing of goal programming by which stochastic cost frontier and stochastic VRTS frontiers are fitted. Hasan et al. [1] used a parameter approach Stochastic Frontier Approach (SFA) to examine the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur stock Exchange (KLSE) market over the period 2005-2010. AshkanHassani [2] exposed Cobb-Douglas Production Functions application in construction schedule crashing and project risk analysis related to the duration of construction projects. Nan Jiang [3] applied Stochastic Frontier analysis to a panel of New Zealand dairy forms in 1998/99-2006/2007.

  18. Cost-effectiveness analysis of two treatment strategies for chronic hepatitis C before and after access to direct-acting antivirals in Spain.

    PubMed

    Turnes, Juan; Domínguez-Hernández, Raquel; Casado, Miguel Ángel

    To evaluate the cost-effectiveness of a strategy based on direct-acting antivirals (DAAs) following the marketing of simeprevir and sofosbuvir (post-DAA) versus a pre-direct-acting antiviral strategy (pre-DAA) in patients with chronic hepatitis C, from the perspective of the Spanish National Health System. A decision tree combined with a Markov model was used to estimate the direct health costs (€, 2016) and health outcomes (quality-adjusted life years, QALYs) throughout the patient's life, with an annual discount rate of 3%. The sustained virological response, percentage of patients treated or not treated in each strategy, clinical characteristics of the patients, annual likelihood of transition, costs of treating and managing the disease, and utilities were obtained from the literature. The cost-effectiveness analysis was expressed as an incremental cost-effectiveness ratio (incremental cost per QALY gained). A deterministic sensitivity analysis and a probabilistic sensitivity analysis were performed. The post-DAA strategy showed higher health costs per patient (€30,944 vs. €23,707) than the pre-DAA strategy. However, it was associated with an increase of QALYs gained (15.79 vs. 12.83), showing an incremental cost-effectiveness ratio of €2,439 per QALY. The deterministic sensitivity analysis and the probabilistic sensitivity analysis showed the robustness of the results, with the post-DAA strategy being cost-effective in 99% of cases compared to the pre-DAA strategy. Compared to the pre-DAA strategy, the post-DAA strategy is efficient for the treatment of chronic hepatitis C in Spain, resulting in a much lower cost per QALY than the efficiency threshold used in Spain (€30,000 per QALY). Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  19. Energy Efficiency Potential in the U.S. Single-Family Housing Stock

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

    Wilson, Eric J.; Christensen, Craig B.; Horowitz, Scott G.

    Typical approaches for assessing energy efficiency potential in buildings use a limited number of prototypes, and therefore suffer from inadequate resolution when pass-fail cost-effectiveness tests are applied, which can significantly underestimate or overestimate the economic potential of energy efficiency technologies. This analysis applies a new approach to large-scale residential energy analysis, combining the use of large public and private data sources, statistical sampling, detailed building simulations, and high-performance computing to achieve unprecedented granularity - and therefore accuracy - in modeling the diversity of the single-family housing stock. The result is a comprehensive set of maps, tables, and figures showing themore » technical and economic potential of 50 plus residential energy efficiency upgrades and packages for each state. Policymakers, program designers, and manufacturers can use these results to identify upgrades with the highest potential for cost-effective savings in a particular state or region, as well as help identify customer segments for targeted marketing and deployment. The primary finding of this analysis is that there is significant technical and economic potential to save electricity and on-site fuel use in the single-family housing stock. However, the economic potential is very sensitive to the cost-effectiveness criteria used for analysis. Additionally, the savings of particular energy efficiency upgrades is situation-specific within the housing stock (depending on climate, building vintage, heating fuel type, building physical characteristics, etc.).« less

  20. Efficiency assessment of wastewater treatment plants: A data envelopment analysis approach integrating technical, economic, and environmental issues.

    PubMed

    Castellet, Lledó; Molinos-Senante, María

    2016-02-01

    The assessment of the efficiency of wastewater treatment plants (WWTPs) is essential to compare their performance and consequently to identify the best operational practices that can contribute to the reduction of operational costs. Previous studies have evaluated the efficiency of WWTPs using conventional data envelopment analysis (DEA) models. Most of these studies have considered the operational costs of the WWTPs as inputs, while the pollutants removed from wastewater are treated as outputs. However, they have ignored the fact that each pollutant removed by a WWTP involves a different environmental impact. To overcome this limitation, this paper evaluates for the first time the efficiency of a sample of WWTPs by applying the weighted slacks-based measure model. It is a non-radial DEA model which allows assigning weights to the inputs and outputs according their importance. Thus, the assessment carried out integrates environmental issues with the traditional "techno-economic" efficiency assessment of WWTPs. Moreover, the potential economic savings for each cost item have been quantified at a plant level. It is illustrated that the WWTPs analyzed have significant room to save staff and energy costs. Several managerial implications to help WWTPs' operators make informed decisions were drawn from the methodology and empirical application carried out. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Integrating Hospital Administrative Data to Improve Health Care Efficiency and Outcomes: “The Socrates Story”

    PubMed Central

    Lawrence, Justin; Delaney, Conor P.

    2013-01-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  2. Integrating hospital administrative data to improve health care efficiency and outcomes: "the socrates story".

    PubMed

    Lawrence, Justin; Delaney, Conor P

    2013-03-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes.

  3. 4E analysis and multi objective optimization of a micro gas turbine and solid oxide fuel cell hybrid combined heat and power system

    NASA Astrophysics Data System (ADS)

    Sanaye, Sepehr; Katebi, Arash

    2014-02-01

    Energy, exergy, economic and environmental (4E) analysis and optimization of a hybrid solid oxide fuel cell and micro gas turbine (SOFC-MGT) system for use as combined generation of heat and power (CHP) is investigated in this paper. The hybrid system is modeled and performance related results are validated using available data in literature. Then a multi-objective optimization approach based on genetic algorithm is incorporated. Eight system design parameters are selected for the optimization procedure. System exergy efficiency and total cost rate (including capital or investment cost, operational cost and penalty cost of environmental emissions) are the two objectives. The effects of fuel unit cost, capital investment and system power output on optimum design parameters are also investigated. It is observed that the most sensitive and important design parameter in the hybrid system is fuel cell current density which has a significant effect on the balance between system cost and efficiency. The selected design point from the Pareto distribution of optimization results indicates a total system exergy efficiency of 60.7%, with estimated electrical energy cost 0.057 kW-1 h-1, and payback period of about 6.3 years for the investment.

  4. Sludge digestion instead of aerobic stabilisation - a cost benefit analysis based on experiences in Germany.

    PubMed

    Gretzschel, Oliver; Schmitt, Theo G; Hansen, Joachim; Siekmann, Klaus; Jakob, Jürgen

    2014-01-01

    As a consequence of a worldwide increase of energy costs, the efficient use of sewage sludge as a renewable energy resource must be considered, even for smaller wastewater treatment plants (WWTPs) with design capacities between 10,000 and 50,000 population equivalent (PE). To find the lower limit for an economical conversion of an aerobic stabilisation plant into an anaerobic stabilisation plant, we derived cost functions for specific capital costs and operating cost savings. With these tools, it is possible to evaluate if it would be promising to further investigate refitting aerobic plants into plants that produce biogas. By comparing capital costs with operation cost savings, a break-even point for process conversion could be determined. The break-even point varies depending on project specific constraints and assumptions related to future energy and operation costs and variable interest rates. A 5% increase of energy and operation costs leads to a cost efficient conversion for plants above 7,500 PE. A conversion of WWTPs results in different positive effects on energy generation and plant operations: increased efficiency, energy savings, and on-site renewable power generation by digester gas which can be used in the plant. Also, the optimisation of energy efficiency results in a reduction of primary energy consumption.

  5. Costs and benefits of future heavy Space Freighters

    NASA Astrophysics Data System (ADS)

    Arend, H.

    1987-10-01

    A class of two-stage reusable ballistic Space Freighters with nominal launch masses of 7000 metric tons for transport of heavy payloads into low earth orbits is investigated in this paper with spcial regard to vehicle cost efficiency. A life-cycle cost analysis shows that Space Freighters with a conventional aluminum structure offer significantly lower specific transportation costs than today's systems for large payload markets and high launch rates. Advanced structural materials and thermal protection systems offer further important reductions not only with regard to vehicle mass but also with respect to specific transportation cost. A phased introduction of these technologies is cost efficient for larger programs with more than 100 vehicles.

  6. Environmentally friendly and cost-efficient analysis of aflatoxins in corn

    USDA-ARS?s Scientific Manuscript database

    The extraction procedure adds a significant cost to the overall expense of aflatoxin analysis in agricultural commodities. An inexpensive and low-waste extraction method using a household espresso coffee maker was tested. This appliance was used for the high-temperature /high-pressure extraction of ...

  7. Are larger dental practices more efficient? An analysis of dental services production.

    PubMed Central

    Lipscomb, J; Douglass, C W

    1986-01-01

    Whether cost-efficiency in dental services production increases with firm size is investigated through application of an activity analysis production function methodology to data from a national survey of dental practices. Under this approach, service delivery in a dental practice is modeled as a linear programming problem that acknowledges distinct input-output relationships for each service. These service-specific relationships are then combined to yield projections of overall dental practice productivity, subject to technical and organizational constraints. The activity analysis reported here represents arguably the most detailed evaluation yet of the relationship between dental practice size and cost-efficiency, controlling for such confounding factors as fee and service-mix differences across firms. We conclude that cost-efficiency does increase with practice size, over the range from solo to four-dentist practices. Largely because of data limitations, we were unable to test satisfactorily for scale economies in practices with five or more dentists. Within their limits, our findings are generally consistent with results from the neoclassical production function literature. From the standpoint of consumer welfare, the critical question raised (but not resolved) here is whether these apparent production efficiencies of group practice are ultimately translated by the market into lower fees, shorter queues, or other nonprice benefits. PMID:3102404

  8. Costs and cost-effectiveness analysis of 2015 GESIDA/Spanish AIDS National Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    PubMed

    Berenguer, Juan; Rivero, Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Boix, Vicente; Clotet, Bonaventura; Domingo, Pere; González-García, Juan; Knobel, Hernando; Lázaro, Pablo; López, Juan Carlos; Llibre, Josep M; Lozano, Fernando; Miró, José M; Podzamczer, Daniel; Tuset, Montserrat; Gatell, Josep M

    2016-01-01

    GESIDA and the AIDS National Plan panel of experts suggest a preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2015. The objective of this study is to evaluate the costs and the effectiveness of initiating treatment with these regimens. Economic assessment of costs and effectiveness (cost/effectiveness) based on decision tree analyses. Effectiveness was defined as the probability of reporting a viral load <50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting is Spain and the costs correspond to those of 2015. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranges from 4663 Euros for 3TC+LPV/r (OR) to 10,902 Euros for TDF/FTC+RAL (PR). The effectiveness varies from 0.66 for ABC/3TC+ATV/r (AR) and ABC/3TC+LPV/r (OR), to 0.89 for TDF/FTC+DTG (PR) and TDF/FTC/EVG/COBI (AR). The efficiency, in terms of cost/effectiveness, ranges from 5280 to 12,836 Euros per responder at 48 weeks, for 3TC+LPV/r (OR) and RAL+DRV/r (OR), respectively. The most efficient regimen was 3TC+LPV/r (OR). Among the PR and AR, the most efficient regimen was TDF/FTC/RPV (AR). Among the PR regimes, the most efficient was ABC/3TC+DTG. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  9. Cost Analysis In A Multi-Mission Operations Environment

    NASA Technical Reports Server (NTRS)

    Newhouse, M.; Felton, L.; Bornas, N.; Botts, D.; Roth, K.; Ijames, G.; Montgomery, P.

    2014-01-01

    Spacecraft control centers have evolved from dedicated, single-mission or single missiontype support to multi-mission, service-oriented support for operating a variety of mission types. At the same time, available money for projects is shrinking and competition for new missions is increasing. These factors drive the need for an accurate and flexible model to support estimating service costs for new or extended missions; the cost model in turn drives the need for an accurate and efficient approach to service cost analysis. The National Aeronautics and Space Administration (NASA) Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center (MSFC) provides operations services to a variety of customers around the world. HOSC customers range from launch vehicle test flights; to International Space Station (ISS) payloads; to small, short duration missions; and has included long duration flagship missions. The HOSC recently completed a detailed analysis of service costs as part of the development of a complete service cost model. The cost analysis process required the team to address a number of issues. One of the primary issues involves the difficulty of reverse engineering individual mission costs in a highly efficient multimission environment, along with a related issue of the value of detailed metrics or data to the cost model versus the cost of obtaining accurate data. Another concern is the difficulty of balancing costs between missions of different types and size and extrapolating costs to different mission types. The cost analysis also had to address issues relating to providing shared, cloud-like services in a government environment, and then assigning an uncertainty or risk factor to cost estimates that are based on current technology, but will be executed using future technology. Finally the cost analysis needed to consider how to validate the resulting cost models taking into account the non-homogeneous nature of the available cost data and the decreasing flight rate. This paper presents the issues encountered during the HOSC cost analysis process, and the associated lessons learned. These lessons can be used when planning for a new multi-mission operations center or in the transformation from a dedicated control center to multi-center operations, as an aid in defining processes that support future cost analysis and estimation. The lessons can also be used by mature serviceoriented, multi-mission control centers to streamline or refine their cost analysis process.

  10. Cost Analysis in a Multi-Mission Operations Environment

    NASA Technical Reports Server (NTRS)

    Felton, Larry; Newhouse, Marilyn; Bornas, Nick; Botts, Dennis; Ijames, Gayleen; Montgomery, Patty; Roth, Karl

    2014-01-01

    Spacecraft control centers have evolved from dedicated, single-mission or single mission-type support to multi-mission, service-oriented support for operating a variety of mission types. At the same time, available money for projects is shrinking and competition for new missions is increasing. These factors drive the need for an accurate and flexible model to support estimating service costs for new or extended missions; the cost model in turn drives the need for an accurate and efficient approach to service cost analysis. The National Aeronautics and Space Administration (NASA) Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center (MSFC) provides operations services to a variety of customers around the world. HOSC customers range from launch vehicle test flights; to International Space Station (ISS) payloads; to small, short duration missions; and has included long duration flagship missions. The HOSC recently completed a detailed analysis of service costs as part of the development of a complete service cost model. The cost analysis process required the team to address a number of issues. One of the primary issues involves the difficulty of reverse engineering individual mission costs in a highly efficient multi-mission environment, along with a related issue of the value of detailed metrics or data to the cost model versus the cost of obtaining accurate data. Another concern is the difficulty of balancing costs between missions of different types and size and extrapolating costs to different mission types. The cost analysis also had to address issues relating to providing shared, cloud-like services in a government environment, and then assigning an uncertainty or risk factor to cost estimates that are based on current technology, but will be executed using future technology. Finally the cost analysis needed to consider how to validate the resulting cost models taking into account the non-homogeneous nature of the available cost data and the decreasing flight rate. This paper presents the issues encountered during the HOSC cost analysis process, and the associated lessons learned. These lessons can be used when planning for a new multi-mission operations center or in the transformation from a dedicated control center to multi-center operations, as an aid in defining processes that support future cost analysis and estimation. The lessons can also be used by mature service-oriented, multi-mission control centers to streamline or refine their cost analysis process.

  11. The Efficiency and Budgeting of Public Hospitals: Case Study of Iran

    PubMed Central

    Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

    2013-01-01

    Background Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. Objective The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. Materials and Methods This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. Results The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Conclusions Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance. PMID:24349726

  12. Analysis and optimization of hybrid electric vehicle thermal management systems

    NASA Astrophysics Data System (ADS)

    Hamut, H. S.; Dincer, I.; Naterer, G. F.

    2014-02-01

    In this study, the thermal management system of a hybrid electric vehicle is optimized using single and multi-objective evolutionary algorithms in order to maximize the exergy efficiency and minimize the cost and environmental impact of the system. The objective functions are defined and decision variables, along with their respective system constraints, are selected for the analysis. In the multi-objective optimization, a Pareto frontier is obtained and a single desirable optimal solution is selected based on LINMAP decision-making process. The corresponding solutions are compared against the exergetic, exergoeconomic and exergoenvironmental single objective optimization results. The results show that the exergy efficiency, total cost rate and environmental impact rate for the baseline system are determined to be 0.29, ¢28 h-1 and 77.3 mPts h-1 respectively. Moreover, based on the exergoeconomic optimization, 14% higher exergy efficiency and 5% lower cost can be achieved, compared to baseline parameters at an expense of a 14% increase in the environmental impact. Based on the exergoenvironmental optimization, a 13% higher exergy efficiency and 5% lower environmental impact can be achieved at the expense of a 27% increase in the total cost.

  13. Persistent and transient cost efficiency—an application to the Swiss hydropower sector

    DOE PAGES

    Filippini, Massimo; Geissmann, Thomas; Greene, William H.

    2017-11-27

    Electricity prices on the European market have decreased significantly over the past few years, resulting in a deterioration of Swiss hydropower firms’ competitiveness and profitability. One option to improve the sector’s competitiveness is to increase cost efficiency. The goal of this study is to quantify the level of persistent and transient cost efficiency of individual firms by applying the generalized true random effects (GTRE) model introduced by Colombi et al. (Journal of Productivity Analysis 42(2): 123–136, 2014) and Filippini and Greene (Journal of Productivity Analysis 45(2): 187–196, 2016). Applying this newly developed GTRE model to a total cost function, themore » level of cost efficiency of 65 Swiss hydropower firms is analyzed for the period between 2000 and 2013. A true random effects specification is estimated as a benchmark for the transient level of cost efficiency. The results show the presence of both transient as well as persistent cost inefficiencies. The GTREM predicts the aggregate level of cost inefficiency to amount to 21.8% (8.0% transient, 13.8% persistent) on average between 2000 and 2013. These two components differ in interpretation and implication. From an individual firm’s perspective, the two types of cost inefficiencies might require a firm’s management to respond with different improvement strategies. The existing level of persistent inefficiency could prevent the hydropower firms from adjusting their production processes to new market environments. From a regulatory point of view, the results of this study could be used in the scope and determination of the amount of financial support given to struggling firms.« less

  14. Persistent and transient cost efficiency—an application to the Swiss hydropower sector

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

    Filippini, Massimo; Geissmann, Thomas; Greene, William H.

    Electricity prices on the European market have decreased significantly over the past few years, resulting in a deterioration of Swiss hydropower firms’ competitiveness and profitability. One option to improve the sector’s competitiveness is to increase cost efficiency. The goal of this study is to quantify the level of persistent and transient cost efficiency of individual firms by applying the generalized true random effects (GTRE) model introduced by Colombi et al. (Journal of Productivity Analysis 42(2): 123–136, 2014) and Filippini and Greene (Journal of Productivity Analysis 45(2): 187–196, 2016). Applying this newly developed GTRE model to a total cost function, themore » level of cost efficiency of 65 Swiss hydropower firms is analyzed for the period between 2000 and 2013. A true random effects specification is estimated as a benchmark for the transient level of cost efficiency. The results show the presence of both transient as well as persistent cost inefficiencies. The GTREM predicts the aggregate level of cost inefficiency to amount to 21.8% (8.0% transient, 13.8% persistent) on average between 2000 and 2013. These two components differ in interpretation and implication. From an individual firm’s perspective, the two types of cost inefficiencies might require a firm’s management to respond with different improvement strategies. The existing level of persistent inefficiency could prevent the hydropower firms from adjusting their production processes to new market environments. From a regulatory point of view, the results of this study could be used in the scope and determination of the amount of financial support given to struggling firms.« less

  15. Assessment of Energy Efficiency Improvement in the United States Petroleum Refining Industry

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

    Morrow, William R.; Marano, John; Sathaye, Jayant

    2013-02-01

    Adoption of efficient process technologies is an important approach to reducing CO 2 emissions, in particular those associated with combustion. In many cases, implementing energy efficiency measures is among the most cost-effective approaches that any refiner can take, improving productivity while reducing emissions. Therefore, careful analysis of the options and costs associated with efficiency measures is required to establish sound carbon policies addressing global climate change, and is the primary focus of LBNL’s current petroleum refining sector analysis for the U.S. Environmental Protection Agency. The analysis is aimed at identifying energy efficiency-related measures and developing energy abatement supply curves andmore » CO 2 emissions reduction potential for the U.S. refining industry. A refinery model has been developed for this purpose that is a notional aggregation of the U.S. petroleum refining sector. It consists of twelve processing units and account s for the additional energy requirements from steam generation, hydrogen production and water utilities required by each of the twelve processing units. The model is carbon and energy balanced such that crud e oil inputs and major refinery sector outputs (fuels) are benchmarked to 2010 data. Estimates of the current penetration for the identified energy efficiency measures benchmark the energy requirements to those reported in U.S. DOE 2010 data. The remaining energy efficiency potential for each of the measures is estimated and compared to U.S. DOE fuel prices resulting in estimates of cost- effective energy efficiency opportunities for each of the twelve major processes. A combined cost of conserved energy supply curve is also presented along with the CO 2 emissions abatement opportunities that exist in the U.S. petroleum refinery sector. Roughly 1,200 PJ per year of primary fuels savings and close to 500 GWh per y ear of electricity savings are potentially cost-effective given U.S. DOE fuel price forecasts. This represents roughly 70 million metric tonnes of CO 2 emission reductions assuming 2010 emissions factor for grid electricity. Energy efficiency measures resulting in an additional 400 PJ per year of primary fuels savings and close to 1,700 GWh per year of electricity savings, and an associated 24 million metric tonnes of CO 2 emission reductions are not cost-effective given the same assumption with respect to fuel prices and electricity emissions factors. Compared to the modeled energy requirements for the U.S. petroleum refining sector, the cost effective potential represents a 40% reduction in fuel consumption and a 2% reduction in electricity consumption. The non-cost-effective potential represents an additional 13% reduction in fuel consumption and an additional 7% reduction in electricity consumption. The relative energy reduction potentials are mu ch higher for fuel consumption than electricity consumption largely in part because fuel is the primary energy consumption type in the refineries. Moreover, many cost effective fuel savings measures would increase electricity consumption. The model also has the potential to be used to examine the costs and benefits of the other CO 2 mitigation options, such as combined heat and power (CHP), carbon capture, and the potential introduction of biomass feedstocks. However, these options are not addressed in this report as this report is focused on developing the modeling methodology and assessing fuels savings measures. These opportunities to further reduce refinery sector CO 2 emissions and are recommended for further research and analysis.« less

  16. An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

    PubMed

    Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

    2016-01-01

    Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. © The Author(s) 2015.

  17. An Efficient, Non-iterative Method of Identifying the Cost-Effectiveness Frontier

    PubMed Central

    Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D.

    2015-01-01

    Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we additionally provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. PMID:25926282

  18. 10 CFR 436.42 - Evaluation of Life-Cycle Cost Effectiveness.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the life-cycle cost analysis method in part 436, subpart A, of title 10 of the Code of Federal... 10 Energy 3 2011-01-01 2011-01-01 false Evaluation of Life-Cycle Cost Effectiveness. 436.42... PROGRAMS Agency Procurement of Energy Efficient Products § 436.42 Evaluation of Life-Cycle Cost...

  19. Test Basher Benefit-Cost Analysis.

    ERIC Educational Resources Information Center

    Phelps, Richard P.

    1996-01-01

    Starting in the late 1980s, two teams of researchers, well known for their criticism of standardized tests on equity and validity grounds, began attacking standardized testing on efficiency grounds as well, using cost-benefit analysis to do it. Their analyses are reviewed, and their conclusions discussed. The first team, Lorrie A. Shepard, Amelia…

  20. 76 FR 57982 - Building Energy Codes Cost Analysis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy [Docket No. EERE-2011-BT-BC-0046] Building Energy Codes Cost Analysis Correction In notice document 2011-23236 beginning on page... heading ``Table 1. Cash flow components'' should read ``Table 7. Cash flow components''. [FR Doc. C1-2011...

  1. Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan

    PubMed Central

    Yamauchi, Yasuhiro

    2016-01-01

    Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care. PMID:26493427

  2. Barriers to Building Energy Efficiency (BEE) promotion: A transaction costs perspective

    NASA Astrophysics Data System (ADS)

    Qian Kun, Queena

    Worldwide, buildings account for a surprisingly high 40% of global energy consumption, and the resulting carbon footprint significantly exceeds that of all forms of transportation combined. Large and attractive opportunities exist to reduce buildings' energy use at lower costs and higher returns than in other sectors. This thesis analyzes the concerns of the market stakeholders, mainly real estate developers and end-users, in terms of transaction costs as they make decisions about investing in Building Energy Efficiency (BEE). It provides a detailed analysis of the current situation and future prospects for BEE adoption by the market's stakeholders. It delineates the market and lays out the economic and institutional barriers to the large-scale deployment of energy-efficient building techniques. The aim of this research is to investigate the barriers raised by transaction costs that hinder market stakeholders from investing in BEES. It explains interactions among stakeholders in general and in the specific case of Hong Kong as they consider transaction costs. It focuses on the influence of transaction costs on the decision-making of the stakeholders during the entire process of real estate development. The objectives are: 1) To establish an analytical framework for understanding the barriers to BEE investment with consideration of transaction costs; 2) To build a theoretical game model of decision making among the BEE market stakeholders; 3) To study the empirical data from questionnaire surveys of building designers and from focused interviews with real estate developers in Hong Kong; 4) To triangulate the study's empirical findings with those of the theoretical model and analytical framework. The study shows that a coherent institutional framework needs to be established to ensure that the design and implementation of BEE policies acknowledge the concerns of market stakeholders by taking transaction costs into consideration. Regulatory and incentive options should be integrated into BEE policies to minimize efficiency gaps and to realize a sizeable increase in the number of energy-efficient buildings in the next decades. Specifically, the analysis shows that a thorough understanding of the transaction costs borne by particular stakeholders could improve the energy efficiency of buildings, even without improvements in currently available technology.

  3. Cost Scaling of a Real-World Exhaust Waste Heat Recovery Thermoelectric Generator: A Deeper Dive

    NASA Astrophysics Data System (ADS)

    Hendricks, Terry J.; Yee, Shannon; LeBlanc, Saniya

    2016-03-01

    Cost is equally important to power density or efficiency for the adoption of waste heat recovery thermoelectric generators (TEG) in many transportation and industrial energy recovery applications. In many cases, the system design that minimizes cost (e.g., the /W value) can be very different than the design that maximizes the system's efficiency or power density, and it is important to understand the relationship between those designs to optimize TEG performance-cost compromises. Expanding on recent cost analysis work and using more detailed system modeling, an enhanced cost scaling analysis of a waste heat recovery TEG with more detailed, coupled treatment of the heat exchangers has been performed. In this analysis, the effect of the heat lost to the environment and updated relationships between the hot-side and cold-side conductances that maximize power output are considered. This coupled thermal and thermoelectric (TE) treatment of the exhaust waste heat recovery TEG yields modified cost scaling and design optimization equations, which are now strongly dependent on the heat leakage fraction, exhaust mass flow rate, and heat exchanger effectiveness. This work shows that heat exchanger costs most often dominate the overall TE system costs, that it is extremely difficult to escape this regime, and in order to achieve TE system costs of 1/W it is necessary to achieve heat exchanger costs of 1/(W/K). Minimum TE system costs per watt generally coincide with maximum power points, but preferred TE design regimes are identified where there is little cost penalty for moving into regions of higher efficiency and slightly lower power outputs. These regimes are closely tied to previously identified low cost design regimes. This work shows that the optimum fill factor F opt minimizing system costs decreases as heat losses increase, and increases as exhaust mass flow rate and heat exchanger effectiveness increase. These findings have profound implications on the design and operation of various TE waste heat recovery systems. This work highlights the importance of heat exchanger costs on the overall TEG system costs, quantifies the possible TEG performance-cost domain space based on heat exchanger effects, and provides a focus for future system research and development efforts.

  4. Financial analysis for the infusion alliance.

    PubMed

    Perucca, Roxanne

    2010-01-01

    Providing high-quality, cost-efficient care is a major strategic initiative of every health care organization. Today's health care environment is transparent; very competitive; and focused upon providing exceptional service, safety, and quality. Establishing an infusion alliance facilitates the achievement of organizational strategic initiatives, that is, increases patient throughput, decreases length of stay, prevents the occurrence of infusion-related complications, enhances customer satisfaction, and provides greater cost-efficiency. This article will discuss how to develop a financial analysis that promotes value and enhances the financial outcomes of an infusion alliance.

  5. [Effects, safety and cost-benefit analysis of Down syndrome screening in first trimester].

    PubMed

    Shengmou, Lin; Min, Chen; Chenhong, Wang; Shengli, Li; Jiansheng, Xie; Hui, Yuan; Dinghao, Lin; Xiaoxia, Wu; Wei, Wang; Hongyun, Zhang; Haiyan, Tang

    2014-05-01

    To investigate the effects, safety and cost-benefit analysis of Down syndrome screening in first trimester. From January 2009 to December 2012, 43 729 pregnant women undergoing 3 methods of Down syndrome traditional screening strategies in Shenzhen Maternity and Child Healthcare Hospital were studied retrospectively, including in 17 502 cases in pregnancy associated plasma protein A (PAPP-A) and free β-hCG measured biochemistry screening, 14 080 cases in nuchal translucency (NT) screening and 12 147 cases in combined screening, meanwhile, 7 389 cases on non-invasive fetal trisomy test (NIFTY) were performed in Huada Gene Research Institute(BGI). The effects and safety of four screening strategies were assessed throughout a decision tree. The economical characters of each screening strategy were compared by cost-effectiveness analysis as well as cost-benefit analysis. (1) The effects of four strategies are: NIFTY > combined screening > NT screening > biochemistry screening. (2) The safety of four strategies are: NIFTY > combined screening > NT screening > biochemistry screening. (3) Cost-effectiveness analysis and cost-benefit analysis:the biochemistry screening has lowest cost-effectiveness ratio (CER) and highest cost-benefit ratio (CBR), which performed a better economical efficiency. The incremental CER of three traditional screening strategies are all less than the economical burden of Down syndrome.NIFTY has highest CER and negative net present value (NPV), NPV would be positive and CBR would be more than 1 if the price of NIFTY reduce to 1 434 Yuan. Combined screening possess best screening efficiency, while biochemistry screening was demonstrated more economical in traditional screening.NIFTY is the future of Down syndrome screening.

  6. Excimer laser annealing to fabricate low cost solar cells

    NASA Technical Reports Server (NTRS)

    1984-01-01

    The objective is to show whether or not pulsed excimer laser annealing (PELA) of ion-implanted junctions is a cost effective replacement for diffused junctions in fabricating crystalline silicon solar cells. The preliminary economic analysis completed shows that the use of PELA to fabricate both the front junction and back surface field (BSF) would cost approximately 35 cents per peak watt (Wp), compared to a cost of 15 cents/Wp for diffusion, aluminum BSF and an extra cleaning step in the baseline process. The cost advantage of the PELA process depends on improving the average cell efficiency from 14% to 16%, which would lower the overall cost of the module by about 15 cents/Wp. An optimized PELA process compatible with commercial production is to be developed, and increased cell efficiency with sufficient product for adequate statistical analysis demonstrated. An excimer laser annealing station was set-up and made operational. The first experiment used 248 nm radiation to anneal phosphorus implants in polished and texture-etched silicon.

  7. Cost Considerations in Nonlinear Finite-Element Computing

    NASA Technical Reports Server (NTRS)

    Utku, S.; Melosh, R. J.; Islam, M.; Salama, M.

    1985-01-01

    Conference paper discusses computational requirements for finiteelement analysis using quasi-linear approach to nonlinear problems. Paper evaluates computational efficiency of different computer architecturtural types in terms of relative cost and computing time.

  8. Analysis of Minimum Efficiency Performance Standards for Residential General Service Lighting in Chile

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

    Letschert, Virginie E.; McNeil, Michael A.; Leiva Ibanez, Francisco Humberto

    2011-06-01

    Minimum Efficiency Performance Standards (MEPS) have been chosen as part of Chile's national energy efficiency action plan. As a first MEPS, the Ministry of Energy has decided to focus on a regulation for lighting that would ban the sale of inefficient bulbs, effectively phasing out the use of incandescent lamps. Following major economies such as the US (EISA, 2007) , the EU (Ecodesign, 2009) and Australia (AS/NZS, 2008) who planned a phase out based on minimum efficacy requirements, the Ministry of Energy has undertaken the impact analysis of a MEPS on the residential lighting sector. Fundacion Chile (FC) and Lawrencemore » Berkeley National Laboratory (LBNL) collaborated with the Ministry of Energy and the National Energy Efficiency Program (Programa Pais de Eficiencia Energetica, or PPEE) in order to produce a techno-economic analysis of this future policy measure. LBNL has developed for CLASP (CLASP, 2007) a spreadsheet tool called the Policy Analysis Modeling System (PAMS) that allows for evaluation of costs and benefits at the consumer level but also a wide range of impacts at the national level, such as energy savings, net present value of savings, greenhouse gas (CO2) emission reductions and avoided capacity generation due to a specific policy. Because historically Chile has followed European schemes in energy efficiency programs (test procedures, labelling program definitions), we take the Ecodesign commission regulation No 244/2009 as a starting point when defining our phase out program, which means a tiered phase out based on minimum efficacy per lumen category. The following data were collected in order to perform the techno-economic analysis: (1) Retail prices, efficiency and wattage category in the current market, (2) Usage data (hours of lamp use per day), and (3) Stock data, penetration of efficient lamps in the market. Using these data, PAMS calculates the costs and benefits of efficiency standards from two distinct but related perspectives: (1) The Life-Cycle Cost (LCC) calculation examines costs and benefits from the perspective of the individual household; and (2) The National Perspective projects the total national costs and benefits including both financial benefits, and energy savings and environmental benefits. The national perspective calculations are called the National Energy Savings (NES) and the Net Present Value (NPV) calculations. PAMS also calculate total emission mitigation and avoided generation capacity. This paper describes the data and methodology used in PAMS and presents the results of the proposed phase out of incandescent bulbs in Chile.« less

  9. Commercial Discount Rate Estimation for Efficiency Standards Analysis

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

    Fujita, K. Sydny

    2016-04-13

    Underlying each of the Department of Energy's (DOE's) federal appliance and equipment standards are a set of complex analyses of the projected costs and benefits of regulation. Any new or amended standard must be designed to achieve significant additional energy conservation, provided that it is technologically feasible and economically justified (42 U.S.C. 6295(o)(2)(A)). A proposed standard is considered economically justified when its benefits exceed its burdens, as represented by the projected net present value of costs and benefits. DOE performs multiple analyses to evaluate the balance of costs and benefits of commercial appliance and equipment e efficiency standards, at themore » national and individual building or business level, each framed to capture different nuances of the complex impact of standards on the commercial end user population. The Life-Cycle Cost (LCC) analysis models the combined impact of appliance first cost and operating cost changes on a representative commercial building sample in order to identify the fraction of customers achieving LCC savings or incurring net cost at the considered efficiency levels.1 Thus, the choice of commercial discount rate value(s) used to calculate the present value of energy cost savings within the Life-Cycle Cost model implicitly plays a key role in estimating the economic impact of potential standard levels.2 This report is intended to provide a more in-depth discussion of the commercial discount rate estimation process than can be readily included in standard rulemaking Technical Support Documents (TSDs).« less

  10. Energy Efficiency in Libraries.

    ERIC Educational Resources Information Center

    Lewis, Eleanor J.; And Others

    1993-01-01

    Shows how libraries can save money and energy with energy-efficient technologies, improving maintenance, and encouraging staff efforts to conserve energy. Specific techniques such as life-cycle cost analysis and energy audits focusing on lighting, heating, ventilation, air conditioning, and water efficiency are described. Funding options and…

  11. Analysis of a fuel cell on-site integrated energy system for a residential complex

    NASA Technical Reports Server (NTRS)

    Simons, S. N.; Maag, W. L.

    1979-01-01

    The energy use and costs of the on-site integrated energy system (OS/IES) which provides electric power from an on-site power plant and recovers heat that would normally be rejected to the environment is compared to a conventional system purchasing electricity from a utility and a phosphoric acid fuel cell powered system. The analysis showed that for a 500-unit apartment complex a fuel OS/IES would be about 10% more energy conservative in terms of total coal consumption than a diesel OS/IES system or a conventional system. The fuel cell OS/IES capital costs could be 30 to 55% greater than the diesel OS/IES capital costs for the same life cycle costs. The life cycle cost of a fuel cell OS/IES would be lower than that for a conventional system as long as the cost of electricity is greater than $0.05 to $0.065/kWh. An analysis of several parametric combinations of fuel cell power plant and state-of-art energy recovery systems and annual fuel requirement calculations for four locations were made. It was shown that OS/IES component choices are a major factor in fuel consumption, with the least efficient system using 25% more fuel than the most efficient. Central air conditioning and heat pumps result in minimum fuel consumption while individual air conditioning units increase it, and in general the fuel cell of highest electrical efficiency has the lowest fuel consumption.

  12. Specialty hospitals emulating focused factories: a case study.

    PubMed

    Kumar, Sameer

    2010-01-01

    For 15 years general hospital managers faced new competition from for-profit specialty hospitals that operate on a "focused factory" model, which threaten to siphon-off the most profitable patients. This paper aims to discuss North American specialty hospitals and to review rising costs impact on general hospital operations. The focus is to discover whether specialty hospitals are more efficient than general hospitals; if so, how significant is the difference and also what can general hospitals do in light of the rising specialty hospitals. The case study involves stochastic frontier regression analysis using Cobb-Douglas and Translog cost functions to compare Minnesota general and specialty hospital efficiency. Analysis is based on data from 117 general and 19 specialty hospitals. The results suggest that specialty hospitals are significantly more efficient than general hospitals. Overall, general hospitals were found to be more than twice as inefficient compared with specialty hospitals in the sample. Some cost-cutting factors highlighted can be implemented to trim rising costs. The case study highlights some managerial levers that general hospital operational managers might use to control rising costs. This also helps them compete with specialty hospitals by reducing overheads and other major costs. The study is based on empirical modeling for an important healthcare operational challenge and provides additional in-depth information that has health policy implications. The analysis and findings enable healthcare managers to guide their institutions in a new direction during a time of change within the industry.

  13. The Impending Revolution in School Business Management.

    ERIC Educational Resources Information Center

    James, H. Thomas

    The development of logically sophisticated analytical models in a growing number of fields has placed new emphasis on efficiency in school management. Recent systems models guiding the longrun analysis of school management in terms of efficiency--through cost-benefit studies, systems analysis, and program planning and budgeting systems--are in…

  14. Process development and exergy cost sensitivity analysis of a hybrid molten carbonate fuel cell power plant and carbon dioxide capturing process

    NASA Astrophysics Data System (ADS)

    Mehrpooya, Mehdi; Ansarinasab, Hojat; Moftakhari Sharifzadeh, Mohammad Mehdi; Rosen, Marc A.

    2017-10-01

    An integrated power plant with a net electrical power output of 3.71 × 105 kW is developed and investigated. The electrical efficiency of the process is found to be 60.1%. The process includes three main sub-systems: molten carbonate fuel cell system, heat recovery section and cryogenic carbon dioxide capturing process. Conventional and advanced exergoeconomic methods are used for analyzing the process. Advanced exergoeconomic analysis is a comprehensive evaluation tool which combines an exergetic approach with economic analysis procedures. With this method, investment and exergy destruction costs of the process components are divided into endogenous/exogenous and avoidable/unavoidable parts. Results of the conventional exergoeconomic analyses demonstrate that the combustion chamber has the largest exergy destruction rate (182 MW) and cost rate (13,100 /h). Also, the total process cost rate can be decreased by reducing the cost rate of the fuel cell and improving the efficiency of the combustion chamber and heat recovery steam generator. Based on the total avoidable endogenous cost rate, the priority for modification is the heat recovery steam generator, a compressor and a turbine of the power plant, in rank order. A sensitivity analysis is done to investigate the exergoeconomic factor parameters through changing the effective parameter variations.

  15. 10 CFR 436.11 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Life Cycle Cost Analyses § 436.11 Definitions. As used in this subpart— Base Year means the fiscal year in which a life cycle cost analysis is conducted. Building energy system means an energy conservation... building that improve energy efficiency and are life cycle cost effective and that involve energy...

  16. Cost analysis of percutaneous fixation of hand fractures in the main operating room versus the ambulatory setting.

    PubMed

    Gillis, Joshua A; Williams, Jason G

    2017-08-01

    To date, there have been no studies identifying the cost differential for performing closed reduction internal fixation (CRIF) of hand fractures in the operating room (OR) versus an ambulatory setting. Our goal was to analyse the cost and efficiency of performing CRIF in these two settings and to investigate current practice trends in Canada. A detailed analysis of the costs involved both directly and indirectly in the CRIF of a hand fracture was conducted. Hospital records were used to calculate efficiency. A survey was distributed to practicing plastic surgeons across Canada regarding their current practice of managing hand fractures. In an eight-hour surgical block we are able to perform five CRIF in the OR versus eight in an ambulatory setting. The costs of performing a CRIF in the OR under local anaesthetic, not including surgeon compensation, is $461.27 Canadian (CAD) compared to $115.59 CAD in the ambulatory setting, a 299% increase. The use of a regional block increases the cost to $665.49 CAD, a 476% increase. The main barrier to performing CRIFs in an outpatient setting is the absence of equipment necessary to perform these cases effectively, based on survey results. The use of the OR for CRIF of hand fractures is associated with a significant increase in cost and hospital resources with decreased efficiency. For appropriately selected hand fractures, CRIF in an ambulatory setting is less costly and more efficient compared to the OR and resources should be allocated to facilitate CRIF in this setting. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries.

    PubMed

    Marseille, Elliot; Dandona, Lalit; Marshall, Nell; Gaist, Paul; Bautista-Arredondo, Sergio; Rollins, Brandi; Bertozzi, Stefano M; Coovadia, Jerry; Saba, Joseph; Lioznov, Dmitry; Du Plessis, Jo-Ann; Krupitsky, Evgeny; Stanley, Nicci; Over, Mead; Peryshkina, Alena; Kumar, S G Prem; Muyingo, Sowedi; Pitter, Christian; Lundberg, Mattias; Kahn, James G

    2007-07-12

    Economic theory and limited empirical data suggest that costs per unit of HIV prevention program output (unit costs) will initially decrease as small programs expand. Unit costs may then reach a nadir and start to increase if expansion continues beyond the economically optimal size. Information on the relationship between scale and unit costs is critical to project the cost of global HIV prevention efforts and to allocate prevention resources efficiently. The "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project collected 2003 and 2004 cost and output data from 206 HIV prevention programs of six types in five countries. The association between scale and efficiency for each intervention type was examined for each country. Our team characterized the direction, shape, and strength of this association by fitting bivariate regression lines to scatter plots of output levels and unit costs. We chose the regression forms with the highest explanatory power (R2). Efficiency increased with scale, across all countries and interventions. This association varied within intervention and within country, in terms of the range in scale and efficiency, the best fitting regression form, and the slope of the regression. The fraction of variation in efficiency explained by scale ranged from 26-96%. Doubling in scale resulted in reductions in unit costs averaging 34.2% (ranging from 2.4% to 58.0%). Two regression trends, in India, suggested an inflection point beyond which unit costs increased. Unit costs decrease with scale across a wide range of service types and volumes. These country and intervention-specific findings can inform projections of the global cost of scaling up HIV prevention efforts.

  18. Estimating multi-period global cost efficiency and productivity change of systems with network structures

    NASA Astrophysics Data System (ADS)

    Tohidnia, S.; Tohidi, G.

    2018-02-01

    The current paper develops three different ways to measure the multi-period global cost efficiency for homogeneous networks of processes when the prices of exogenous inputs are known at all time periods. A multi-period network data envelopment analysis model is presented to measure the minimum cost of the network system based on the global production possibility set. We show that there is a relationship between the multi-period global cost efficiency of network system and its subsystems, and also its processes. The proposed model is applied to compute the global cost Malmquist productivity index for measuring the productivity changes of network system and each of its process between two time periods. This index is circular. Furthermore, we show that the productivity changes of network system can be defined as a weighted average of the process productivity changes. Finally, a numerical example will be presented to illustrate the proposed approach.

  19. Optimal cost design of water distribution networks using a decomposition approach

    NASA Astrophysics Data System (ADS)

    Lee, Ho Min; Yoo, Do Guen; Sadollah, Ali; Kim, Joong Hoon

    2016-12-01

    Water distribution network decomposition, which is an engineering approach, is adopted to increase the efficiency of obtaining the optimal cost design of a water distribution network using an optimization algorithm. This study applied the source tracing tool in EPANET, which is a hydraulic and water quality analysis model, to the decomposition of a network to improve the efficiency of the optimal design process. The proposed approach was tested by carrying out the optimal cost design of two water distribution networks, and the results were compared with other optimal cost designs derived from previously proposed optimization algorithms. The proposed decomposition approach using the source tracing technique enables the efficient decomposition of an actual large-scale network, and the results can be combined with the optimal cost design process using an optimization algorithm. This proves that the final design in this study is better than those obtained with other previously proposed optimization algorithms.

  20. Managerial performance and cost efficiency of Japanese local public hospitals: a latent class stochastic frontier model.

    PubMed

    Besstremyannaya, Galina

    2011-09-01

    The paper explores the link between managerial performance and cost efficiency of 617 Japanese general local public hospitals in 1999-2007. Treating managerial performance as unobservable heterogeneity, the paper employs a panel data stochastic cost frontier model with latent classes. Financial parameters associated with better managerial performance are found to be positively significant in explaining the probability of belonging to the more efficient latent class. The analysis of latent class membership was consistent with the conjecture that unobservable technological heterogeneity reflected in the existence of the latent classes is related to managerial performance. The findings may support the cause for raising efficiency of Japanese local public hospitals by enhancing the quality of management. Copyright © 2011 John Wiley & Sons, Ltd.

  1. A cost analysis of family planning in Bangladesh.

    PubMed

    Fiedler, J L; Day, L M

    1997-01-01

    This article presents a step-down cost analysis using secondary data sources from 26 Bangladesh non-government organizations (NGOs) providing family planning services under a US Agency for International Development-funded umbrella organization. The unit costs of the NGOs' Maternal-Child Health (MCH) clinics and community-based distribution (CBD) systems were calculated and found to be minimally different. Several simulations were conducted to investigate the impact of alternative cost-reduction measures. The more general financial analysis proved more insightful than the unit cost analysis in terms of identifying means by which to improve the efficiency of the family planning operations of these NGOs. The analysis revealed that 56 per cent of total expenditures in the two-tiered umbrella's organizational structure are incurred in management operations and overheads. Of the remaining 44 per cent of project expenditures, 39 per cent is spent on the CBD program and 5 per cent on the MCH clinics. Within the CBD program, most resources are spent providing 4 million contacts (two-thirds of the annual total) which do not involve contraceptive re-supply. The clinics devote more resources to providing MCH services than to providing family planning services. The findings suggest that significant savings could be generated by containing administrative costs, improving operational efficiency, and reducing unnecessary or redundant fieldworker contacts. The magnitude of the potential savings raises a fundamental question about the continued viability and sustainability of this supply-driven CBD strategy.

  2. Is law enforcement of drug-impaired driving cost-efficient? An explorative study of a methodology for cost-benefit analysis.

    PubMed

    Veisten, Knut; Houwing, Sjoerd; Mathijssen, M P M René; Akhtar, Juned

    2013-03-01

    Road users driving under the influence of psychoactive substances may be at much higher relative risk (RR) in road traffic than the average driver. Legislation banning blood alcohol concentrations above certain threshold levels combined with roadside breath-testing of alcohol have been in lieu for decades in many countries, but new legislation and testing of drivers for drug use have recently been implemented in some countries. In this article we present a methodology for cost-benefit analysis (CBA) of increased law enforcement of roadside drug screening. This is an analysis of the profitability for society, where costs of control are weighed against the reduction in injuries expected from fewer drugged drivers on the roads. We specify assumptions regarding costs and the effect of the specificity of the drug screening device, and quantify a deterrence effect related to sensitivity of the device yielding the benefit estimates. Three European countries with different current enforcement levels were studied, yielding benefit-cost ratios in the approximate range of 0.5-5 for a tripling of current levels of enforcement, with costs of about 4000 EUR per convicted and in the range of 1.5 and 13 million EUR per prevented fatality. The applied methodology for CBA has involved a simplistic behavioural response to enforcement increase and control efficiency. Although this methodology should be developed further, it is clearly indicated that the cost-efficiency of increased law enforcement of drug driving offences is dependent on the baseline situation of drug-use in traffic and on the current level of enforcement, as well as the RR and prevalence of drugs in road traffic. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. A study of power generation from a low-cost hydrokinetic energy system

    NASA Astrophysics Data System (ADS)

    Davila Vilchis, Juana Mariel

    The kinetic energy in river streams, tidal currents, or other artificial water channels has been used as a feasible source of renewable power through different conversion systems. Thus, hydrokinetic energy conversion systems are attracting worldwide interest as another form of distributed alternative energy. Because these systems are still in early stages of development, the basic approaches need significant research. The main challenges are not only to have efficient systems, but also to convert energy more economically so that the cost-benefit analysis drives the growth of this alternative energy form. One way to view this analysis is in terms of the energy conversion efficiency per unit cost. This study presents a detailed assessment of a prototype hydrokinetic energy system along with power output costs. This experimental study was performed using commercial low-cost blades of 20 in diameter inside a tank with water flow speed up to 1.3 m/s. The work was divided into two stages: (a) a fixed-pitch blade configuration, using a radial permanent magnet generator (PMG), and (b) the same hydrokinetic turbine, with a variable-pitch blade and an axial-flux PMG. The results indicate that even though the efficiency of a simple blade configuration is not high, the power coefficient is in the range of other, more complicated designs/prototypes. Additionally, the low manufacturing and operation costs of this system offer an option for low-cost distributed power applications.

  4. Cost inefficiency under financial strain: a stochastic frontier analysis of hospitals in Washington State through the Great Recession.

    PubMed

    Izón, Germán M; Pardini, Chelsea A

    2017-06-01

    The importance of increasing cost efficiency for community hospitals in the United States has been underscored by the Great Recession and the ever-changing health care reimbursement environment. Previous studies have shown mixed evidence with regards to the relationship between linking hospitals' reimbursement to quality of care and cost efficiency. Moreover, current evidence suggests that not only inherently financially disadvantaged hospitals (e.g., safety-net providers), but also more financially stable providers, experienced declines to their financial viability throughout the recession. However, little is known about how hospital cost efficiency fared throughout the Great Recession. This study contributes to the literature by using stochastic frontier analysis to analyze cost inefficiency of Washington State hospitals between 2005 and 2012, with controls for patient burden of illness, hospital process of care quality, and hospital outcome quality. The quality measures included in this study function as central measures for the determination of recently implemented pay-for-performance programs. The average estimated level of hospital cost inefficiency before the Great Recession (10.4 %) was lower than it was during the Great Recession (13.5 %) and in its aftermath (14.1 %). Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased cost inefficiency.

  5. ResStock Analysis Tool | Buildings | NREL

    Science.gov Websites

    Energy and Cost Savings for U.S. Homes Contact Eric Wilson to learn how ResStock can benefit your approach to large-scale residential energy analysis by combining: Large public and private data sources uncovered $49 billion in potential annual utility bill savings through cost-effective energy efficiency

  6. The Probabilistic Efficiency Frontier: A Framework for Cost-Effectiveness Analysis in Germany Put into Practice for Hepatitis C Treatment Options.

    PubMed

    Mühlbacher, Axel C; Sadler, Andrew

    2017-02-01

    The German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) adapted the efficiency frontier (EF) approach to conform to statutory provisions on cost-effectiveness analysis of health technologies. EF serves as a framework for evaluating cost-effectiveness and indirectly for pricing and reimbursement decisions. To calculate an EF on the basis of single multidimensional benefit by taking patient preferences and uncertainty into account; to evaluate whether EF is useful to inform decision makers about cost-effectiveness of new therapies; and to find whether a treatment is efficient at given prices demonstrated through a case study on chronic hepatitis C. A single multidimensional benefit was calculated by linear additive aggregation of multiple patient-relevant end points. End points were identified and weighted by patients in a previous discrete-choice experiment (DCE). Aggregation of overall benefit was ascertained using preferences and clinical data. Monte-Carlo simulation was applied. Uncertainty was addressed by price acceptability curve (PAC) and net monetary benefit (NMB). The case study illustrates that progress in benefit and efficiency of hepatitis C virus treatments could be depicted very well with the EF. On the basis of cost, effect, and preference data, the latest generations of interferon-free treatments are shown to yield a positive NMB and be efficient at current prices. EF was implemented taking uncertainty into account. For the first time, a DCE was used with the EF. The study shows how DCEs in combination with EF, PAC, and NMB can contribute important information in the course of reimbursement and pricing decisions. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. No Cost – Low Cost Compressed Air System Optimization in Industry

    NASA Astrophysics Data System (ADS)

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

    2018-04-01

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

  8. Flat plate vs. concentrator solar photovoltaic cells - A manufacturing cost analysis

    NASA Technical Reports Server (NTRS)

    Granon, L. A.; Coleman, M. G.

    1980-01-01

    The choice of which photovoltaic system (flat plate or concentrator) to use for utilizing solar cells to generate electricity depends mainly on the cost. A detailed, comparative manufacturing cost analysis of the two types of systems is presented. Several common assumptions, i.e., cell thickness, interest rate, power rate, factory production life, polysilicon cost, and direct labor rate are utilized in this analysis. Process sequences, cost variables, and sensitivity analyses have been studied, and results of the latter show that the most important parameters which determine manufacturing costs are concentration ratio, manufacturing volume, and cell efficiency. The total cost per watt of the flat plate solar cell is $1.45, and that of the concentrator solar cell is $1.85, the higher cost being due to the increased process complexity and material costs.

  9. An Evaluation of the Consumer Costs and Benefits of Energy Efficiency Resource Standards

    NASA Astrophysics Data System (ADS)

    Lessans, Mark D.

    Of the modern-day policies designed to encourage energy efficiency, one with a significant potential for impact is that of Energy Efficiency Resource Standards (EERS). EERS policies place the responsibility for meeting an efficiency target on the electric and gas utilities, typically setting requirements for annual reductions in electricity generation or gas distribution to customers as a percentage of sales. To meet these requirements, utilities typically implement demand-side management (DSM) programs, which encourage energy efficiency at the customer level through incentives and educational initiatives. In Maryland, a statewide EERS has provided for programs which save a significant amount of energy, but is ultimately falling short in meeting the targets established by the policy. This study evaluates residential DSM programs offered by Pepco, a utility in Maryland, for cost-effectiveness. However, unlike most literature on the topic, analysis focuses on the costs-benefit from the perspective of the consumer, and not the utility. The results of this study are encouraging: the majority of programs analyzed show that the cost of electricity saved, or levelized cost of saved energy (LCSE), is less expensive than the current retail cost of electricity cost in Maryland. A key goal of this study is to establish a metric for evaluating the consumer cost-effectiveness of participation in energy efficiency programs made available by EERS. In doing so, the benefits of these programs can be effectively marketed to customers, with the hope that participation will increase. By increasing consumer awareness and buy-in, the original goals set out through EERS can be realized and the policies can continue to receive support.

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

    NASA Astrophysics Data System (ADS)

    Peterson, Carl

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

  11. Incentive pricing and cost recovery at the basin scale.

    PubMed

    Ward, Frank A; Pulido-Velazquez, Manuel

    2009-01-01

    Incentive pricing programs have potential to promote economically efficient water use patterns and provide a revenue source to compensate for environmental damages. However, incentive pricing may impose disproportionate costs and aggravate poverty where high prices are levied for basic human needs. This paper presents an analysis of a two-tiered water pricing system that sets a low price for subsistence needs, while charging a price equal to marginal cost, including environmental cost, for discretionary uses. This pricing arrangement can promote efficient and sustainable water use patterns, goals set by the European Water Framework Directive, while meeting subsistence needs of poor households. Using data from the Rio Grande Basin of North America, a dynamic nonlinear program, maximizes the basin's total net economic and environmental benefits subject to several hydrological and institutional constraints. Supply costs, environmental costs, and resource costs are integrated in a model of a river basin's hydrology, economics, and institutions. Three programs are compared: (1) Law of the River, in which water allocations and prices are determined by rules governing water transfers; (2) marginal cost pricing, in which households pay the full marginal cost of supplying treated water; (3) two-tiered pricing, in which households' subsistence water needs are priced cheaply, while discretionary uses are priced at efficient levels. Compared to the Law of the River and marginal cost pricing, two-tiered pricing performs well for efficiency and adequately for sustainability and equity. Findings provide a general framework for formulating water pricing programs that promote economically and environmentally efficient water use programs while also addressing other policy goals.

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

    Feibel, C.E.

    This study uses multiple data collection and research methods including in depth interviews, 271 surveys of shared taxi and minibus operators, participant observation, secondary sources, and the literature on public transport from low, medium, and high-income countries. Extensive use is also made of a survey administered in Istanbul in 1976 to 1935 paratransit operators. Primary findings are that private buses are more efficient than public buses on a cost per passenger-km basis, and that private minibuses are as efficient as public buses. In terms of energy efficiency, minibuses are almost as efficient as public and private buses using actual-occupancy levels.more » Large shared taxis are twice as cost and energy efficient as cars, and small shared taxis 50% more efficient. In terms of investment cost per seat, large shared taxis have the lowest cost followed by smaller shared taxis, minibuses, and buses. Considering actual occupancy levels, minibuses are only slightly less effective in terms of congestion than buses, and large and small shared taxis are twice as effective as cars. It is also shown that minibuses and shared taxis have better service quality than buses because of higher frequencies and speeds, and because they provide a much higher probability of getting a seat than buses. Analysis of regulation and policy suggests that there are many unintended cost of public-transport regulations.« less

  13. Cost minimisation analysis of fingolimod vs natalizumab as a second line of treatment for relapsing-remitting multiple sclerosis.

    PubMed

    Crespo, C; Izquierdo, G; García-Ruiz, A; Granell, M; Brosa, M

    2014-05-01

    At present, there is a lack of economic assessments of second-line treatments for relapsing-recurring multiple sclerosis. The aim of this study was to compare the efficiency between fingolimod and natalizumab in Spain. A cost minimisation analysis model was developed for a 2-year horizon. The same relapse rate was applied to both treatment arms and the cost of resources was calculated using Spain's stipulated rates for 2012 in euros. The analysis was conducted from the perspective of Spain's national health system and an annual discount rate of 3% was applied to future costs. A sensitivity analysis was performed to validate the robustness of the model. Indirect comparison of fingolimod with natalizumab revealed no significant differences (hazard ratio between 0.82 and 1.07). The total direct cost, considering a 2-year analytical horizon, a 7.5% discount stipulated by Royal Decree, and a mean annual relapse rate of 0.22, was € 40914.72 for fingolimod and € 45890.53 for natalizumab. Of the total direct costs that were analysed, the maximum cost savings derived from prescribing fingolimod prescription was € 4363.63, corresponding to lower administration and treatment maintenance costs. Based on the sensitivity analysis performed, fingolimod use was associated with average savings of 11% (range 3.1%-18.7%). Fingolimod is more efficient than natalizumab as a second-line treatment option for relapsing-remitting multiple sclerosis and it generates savings for the Spanish national health system. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  14. Using cost-effectiveness analysis to evaluate targeting strategies: the case of vitamin A supplementation.

    PubMed

    Loevinsohn, B P; Sutter, R W; Costales, M O

    1997-03-01

    Given the demonstrated efficacy of vitamin A supplements in reducing childhood mortality, health officials now have to decide whether it would be efficient to target the supplements to high risk children. Decisions about targeting are complex because they depend on a number of factors; the degree of clustering of preventable deaths, the cost of the intervention, the side-effects of the intervention, the cost of identifying the high risk group, and the accuracy of the 'diagnosis' of risk. A cost-effectiveness analysis was used in the Philippines to examine whether vitamin A supplements should be given universally to all children 6-59 months, targeted broadly to children suffering from mild, moderate, or severe malnutrition, or targeted narrowly to pre-schoolers with moderate and severe malnutrition. The first year average cost of the universal approach was US$67.21 per death averted compared to $144.12 and $257.20 for the broad and narrow targeting approaches respectively. When subjected to sensitivity analysis the conclusion about the most cost-effective strategy was robust to changes in underlying assumptions such as the efficacy of supplements, clustering of deaths, and toxicity. Targeting vitamin A supplements to high risk children is not an efficient use of resources. Based on the results of this cost-effectiveness analysis and a consideration of alternate strategies, it is apparent that vitamin A, like immunization, should be provided to all pre-schoolers in the developing world. Issues about targeting public health interventions can usefully be addressed by cost-effectiveness analysis.

  15. Micro-cost Analysis of ALK Rearrangement Testing by FISH to Determine Eligibility for Crizotinib Therapy in NSCLC: Implications for Cost Effectiveness of Testing and Treatment.

    PubMed

    Parker, David; Belaud-Rotureau, Marc-Antoine

    2014-01-01

    Break-apart fluorescence in situ hybridization (FISH) is the gold standard test for anaplastic lymphoma kinase (ALK) gene rearrangement. However, this methodology often is assumed to be expensive and potentially cost-prohibitive given the low prevalence of ALK-positive non-small cell lung cancer (NSCLC) cases. To more accurately estimate the cost of ALK testing by FISH, we developed a micro-cost model that accounts for all cost elements of the assay, including laboratory reagents, supplies, capital equipment, technical and pathologist labor, and the acquisition cost of the commercial test and associated reagent kits and controls. By applying a set of real-world base-case parameter values, we determined that the cost of a single ALK break-apart FISH test result is $278.01. Sensitivity analysis on the parameters of batch size, testing efficiency, and the cost of the commercial diagnostic testing products revealed that the cost per result is highly sensitive to batch size, but much less so to efficiency or product cost. This implies that ALK testing by FISH will be most cost effective when performed in high-volume centers. Our results indicate that testing cost may not be the primary determinant of crizotinib (Xalkori(®)) treatment cost effectiveness, and suggest that testing cost is an insufficient reason to limit the use of FISH testing for ALK rearrangement.

  16. Micro-cost Analysis of ALK Rearrangement Testing by FISH to Determine Eligibility for Crizotinib Therapy in NSCLC: Implications for Cost Effectiveness of Testing and Treatment

    PubMed Central

    Parker, David; Belaud-Rotureau, Marc-Antoine

    2014-01-01

    Break-apart fluorescence in situ hybridization (FISH) is the gold standard test for anaplastic lymphoma kinase (ALK) gene rearrangement. However, this methodology often is assumed to be expensive and potentially cost-prohibitive given the low prevalence of ALK-positive non-small cell lung cancer (NSCLC) cases. To more accurately estimate the cost of ALK testing by FISH, we developed a micro-cost model that accounts for all cost elements of the assay, including laboratory reagents, supplies, capital equipment, technical and pathologist labor, and the acquisition cost of the commercial test and associated reagent kits and controls. By applying a set of real-world base-case parameter values, we determined that the cost of a single ALK break-apart FISH test result is $278.01. Sensitivity analysis on the parameters of batch size, testing efficiency, and the cost of the commercial diagnostic testing products revealed that the cost per result is highly sensitive to batch size, but much less so to efficiency or product cost. This implies that ALK testing by FISH will be most cost effective when performed in high-volume centers. Our results indicate that testing cost may not be the primary determinant of crizotinib (Xalkori®) treatment cost effectiveness, and suggest that testing cost is an insufficient reason to limit the use of FISH testing for ALK rearrangement. PMID:25520569

  17. Costs, equity, efficiency and feasibility of identifying the poor in Ghana's National Health Insurance Scheme: empirical analysis of various strategies.

    PubMed

    Aryeetey, Genevieve Cecilia; Jehu-Appiah, Caroline; Spaan, Ernst; Agyepong, Irene; Baltussen, Rob

    2012-01-01

    To analyse the costs and evaluate the equity, efficiency and feasibility of four strategies to identify poor households for premium exemptions in Ghana's National Health Insurance Scheme (NHIS): means testing (MT), proxy means testing (PMT), participatory wealth ranking (PWR) and geographic targeting (GT) in urban, rural and semi-urban settings in Ghana. We conducted the study in 145-147 households per setting with MT as our gold standard strategy. We estimated total costs that included costs of household surveys and cost of premiums paid to the poor, efficiency (cost per poor person identified), equity (number of true poor excluded) and the administrative feasibility of implementation. The cost of exempting one poor individual ranged from US$15.87 to US$95.44; exclusion of the poor ranged between 0% and 73%. MT was most efficient and equitable in rural and urban settings with low-poverty incidence; GT was efficient and equitable in the semi-urban setting with high-poverty incidence. PMT and PWR were less equitable and inefficient although feasible in some settings. We recommend MT as optimal strategy in low-poverty urban and rural settings and GT as optimal strategy in high-poverty semi-urban setting. The study is relevant to other social and developmental programmes that require identification and exemptions of the poor in low-income countries. © 2011 Blackwell Publishing Ltd.

  18. Laser-zone growth in a Ribbon-To-Ribbon, RTR, process silicon sheet growth development for the large area silicon sheet task of the low cost silicon solar array project

    NASA Technical Reports Server (NTRS)

    Gurtler, R. W.; Baghdadi, A.

    1977-01-01

    A ribbon-to-ribbon process was used for routine growth of samples for analysis and fabrication into solar cells. One lot of solar cells was completely evaluated: ribbon solar cell efficiencies averaged 9.23% with a highest efficiency of 11.7%. Spherical reflectors have demonstrated significant improvements in laser silicon coupling efficiencies. Material analyses were performed including silicon photovoltage and open circuit photovoltage diffusion length measurements, crystal morphology studies, modulus of rupture measurements, and annealing/gettering studies. An initial economic analysis was performed indicating that ribbon-to-ribbon add-on costs of $.10/watt might be expected in the early 1980's.

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

    PubMed Central

    Vogel, Ronald J.

    1984-01-01

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

  20. Integrating Efficiency of Industry Processes and Practices Alongside Technology Effectiveness in Space Transportation Cost Modeling and Analysis

    NASA Technical Reports Server (NTRS)

    Zapata, Edgar

    2012-01-01

    This paper presents past and current work in dealing with indirect industry and NASA costs when providing cost estimation or analysis for NASA projects and programs. Indirect costs, when defined as those costs in a project removed from the actual hardware or software hands-on labor; makes up most of the costs of today's complex large scale NASA space/industry projects. This appears to be the case across phases from research into development into production and into the operation of the system. Space transportation is the case of interest here. Modeling and cost estimation as a process rather than a product will be emphasized. Analysis as a series of belief systems in play among decision makers and decision factors will also be emphasized to provide context.

  1. Cost-efficiency of specialist inpatient rehabilitation for working-aged adults with complex neurological disabilities: a multicentre cohort analysis of a national clinical data set.

    PubMed

    Turner-Stokes, Lynne; Williams, Heather; Bill, Alan; Bassett, Paul; Sephton, Keith

    2016-02-24

    To evaluate functional outcomes, care needs and cost-efficiency of specialist rehabilitation for a multicentre cohort of inpatients with complex neurological disability, comparing different diagnostic groups across 3 levels of dependency. A multicentre cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database, 2010-2015. All 62 specialist (levels 1 and 2) rehabilitation services in England. Working-aged adults (16-65 years) with complex neurological disability. all episodes with length of stay (LOS) 8-400 days and complete outcome measures recorded on admission and discharge. Total N=5739: acquired brain injury n=4182 (73%); spinal cord injury n=506 (9%); peripheral neurological conditions n=282 (5%); progressive conditions n=769 (13%). Specialist inpatient multidisciplinary rehabilitation. Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA). Functional independence: UK Functional Assessment Measure (UK Functional Independence Measure (FIM)+FAM). Cost-efficiency: (1) time taken to offset rehabilitation costs by savings in NPCNA-estimated costs of ongoing care, (2) FIM efficiency (FIM gain/LOS days), (3) FIM+FAM efficiency (FIM+FAM gain/LOS days). Patients were analysed in 3 groups of dependency. Mean LOS 90.1 (SD 66) days. All groups showed significant reduction in dependency between admission and discharge on all measures (paired t tests: p<0.001). Mean reduction in 'weekly care costs' was greatest in the high-dependency group at £760/week (95% CI 726 to 794)), compared with the medium-dependency (£408/week (95% CI 370 to 445)), and low-dependency (£130/week (95% CI 82 to 178)), groups. Despite longer LOS, time taken to offset the cost of rehabilitation was 14.2 (95% CI 9.9 to 18.8) months in the high-dependency group, compared with 22.3 (95% CI 16.9 to 29.2) months (medium dependency), and 27.7 (95% CI 15.9 to 39.7) months (low dependency). FIM efficiency appeared greatest in medium-dependency patients (0.54), compared with the low-dependency (0.37) and high-dependency (0.38) groups. Broadly similar patterns were seen across all 4 diagnostic groups. Specialist rehabilitation can be highly cost-efficient for all neurological conditions, producing substantial savings in ongoing care costs, especially in high-dependency patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Identification of High Performance, Low Environmental Impact Materials and Processes Using Systematic Substitution (SyS)

    NASA Technical Reports Server (NTRS)

    Dhooge, P. M.; Nimitz, J. S.

    2001-01-01

    Process analysis can identify opportunities for efficiency improvement including cost reduction, increased safety, improved quality, and decreased environmental impact. A thorough, systematic approach to materials and process selection is valuable in any analysis. New operations and facilities design offer the best opportunities for proactive cost reduction and environmental improvement, but existing operations and facilities can also benefit greatly. Materials and processes that have been used for many years may be sources of excessive resource use, waste generation, pollution, and cost burden that should be replaced. Operational and purchasing personnel may not recognize some materials and processes as problems. Reasons for materials or process replacement may include quality and efficiency improvements, excessive resource use and waste generation, materials and operational costs, safety (flammability or toxicity), pollution prevention, compatibility with new processes or materials, and new or anticipated regulations.

  3. Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring.

    PubMed

    Snider, Melissa; Carnes, Cynthia; Grover, Janel; Davis, Rich; Kalbfleisch, Steven

    2012-09-15

    The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated. Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency. The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities. Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

  4. 76 FR 40646 - Notice of Availability of Preliminary Plan for Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ..., Assistant General Counsel for Legislation, Regulation, and Energy Efficiency, U.S. Department of Energy... ineffectively used. Related to appliance efficiency standards rulemakings, two comments expressed concern that... encouraged DOE to streamline its reporting databases to improve efficiency and reduce maintenance costs...

  5. Costs of a school-based dental mobile service in South Africa.

    PubMed

    Molete, M P; Chola, L; Hofman, K J

    2016-10-19

    The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.

  6. The costs and cost-efficiency of providing food through schools in areas of high food insecurity.

    PubMed

    Gelli, Aulo; Al-Shaiba, Najeeb; Espejo, Francisco

    2009-03-01

    The provision of food in and through schools has been used to support the education, health, and nutrition of school-aged children. The monitoring of financial inputs into school health and nutrition programs is critical for a number of reasons, including accountability, transparency, and equity. Furthermore, there is a gap in the evidence on the costs, cost-efficiency, and cost-effectiveness of providing food through schools, particularly in areas of high food insecurity. To estimate the programmatic costs and cost-efficiency associated with providing food through schools in food-insecure, developing-country contexts, by analyzing global project data from the World Food Programme (WFP). Project data, including expenditures and number of schoolchildren covered, were collected through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The average yearly expenditure per child, standardized over a 200-day on-site feeding period and an average ration, excluding school-level costs, was US$21.59. The costs varied substantially according to choice of food modality, with fortified biscuits providing the least costly option of about US$11 per year and take-home rations providing the most expensive option at approximately US$52 per year. Comparisons across the different food modalities suggested that fortified biscuits provide the most cost-efficient option in terms of micronutrient delivery (particularly vitamin A and iodine), whereas on-site meals appear to be more efficient in terms of calories delivered. Transportation and logistics costs were the main drivers for the high costs. The choice of program objectives will to a large degree dictate the food modality (biscuits, cooked meals, or take-home rations) and associated implementation costs. Fortified biscuits can provide substantial nutritional inputs at a fraction of the cost of school meals, making them an appealing option for service delivery in food-insecure contexts. Both costs and effects should be considered carefully when designing the appropriate school-based intervention. The costs estimates in this analysis do not include all school-level costs and are therefore lower-bound estimates of full implementation costs.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  8. Cost analysis and efficiency of sub-district health facilities in two districts in Ghana.

    PubMed

    Aboagye, Anthony Q Q; Degboe, Arnold N K

    2011-01-01

    To establish the full costs borne by sub-district health facilities in providing services, we analysed the costs and revenues of 10 sub-district health facilities located in two districts in Ghana. The full costs were obtained by considering staff costs, cost of utilities, cost of using health facility equipment, cost of non-drug consumables, equipment maintenance expenses, amounts spent on training, community information sessions and other outreach activities as well as all other costs incurred in running the facilities. We found that (i) a large proportion of sub-district health facility costs is made up of staff salaries; (ii) at all facilities, internally generated funds (IGFs) are substantially lower than costs incurred in running the facilities; (iii) average IGF is several times higher in one district than the other; (iv) wide variations exist in efficiency indicators and (v) there is some evidence that sub-district health facilities may not necessarily be financially more efficient than hospitals in using financial resources. We suggest that the study should be replicated in other districts; but in the mean time, the health authorities should take note of the conclusions and recommendations of this study. Efforts should also be made to improve record keeping at these facilities. Copyright © 2010 John Wiley & Sons, Ltd.

  9. Cost Scaling of a Real-World Exhaust Waste Heat Recovery Thermoelectric Generator: A Deeper Dive

    NASA Technical Reports Server (NTRS)

    Hendricks, Terry J.; Yee, Shannon; LeBlanc, Saniya

    2015-01-01

    Cost is equally important to power density or efficiency for the adoption of waste heat recovery thermoelectric generators (TEG) in many transportation and industrial energy recovery applications. In many cases the system design that minimizes cost (e.g., the $/W value) can be very different than the design that maximizes the system's efficiency or power density, and it is important to understand the relationship between those designs to optimize TEG performance-cost compromises. Expanding on recent cost analysis work and using more detailed system modeling, an enhanced cost scaling analysis of a waste heat recovery thermoelectric generator with more detailed, coupled treatment of the heat exchangers has been performed. In this analysis, the effect of the heat lost to the environment and updated relationships between the hot-side and cold-side conductances that maximize power output are considered. This coupled thermal and thermoelectric treatment of the exhaust waste heat recovery thermoelectric generator yields modified cost scaling and design optimization equations, which are now strongly dependent on the heat leakage fraction, exhaust mass flow rate, and heat exchanger effectiveness. This work shows that heat exchanger costs most often dominate the overall TE system costs, that it is extremely difficult to escape this regime, and in order to achieve TE system costs of $1/W it is necessary to achieve heat exchanger costs of $1/(W/K). Minimum TE system costs per watt generally coincide with maximum power points, but Preferred TE Design Regimes are identified where there is little cost penalty for moving into regions of higher efficiency and slightly lower power outputs. These regimes are closely tied to previously-identified low cost design regimes. This work shows that the optimum fill factor Fopt minimizing system costs decreases as heat losses increase, and increases as exhaust mass flow rate and heat exchanger effectiveness increase. These findings have profound implications on the design and operation of various thermoelectric (TE) waste heat 3 recovery systems. This work highlights the importance of heat exchanger costs on the overall TEG system costs, quantifies the possible TEG performance-cost domain space based on heat exchanger effects, and provides a focus for future system research and development efforts.

  10. Analysis And Design Of A Water Purification System For The West African Area Of Operation

    DTIC Science & Technology

    2016-12-01

    harmful metals and in disinfecting the water prior to human consumption . Research conducted proved that the BWS is more cost effective , efficient...and test a feasible and cost- effective prototype of a purification system to the BWS for improved capability. This study uses a design-based and...design. The prototype test results showed that the water purification system performed effectively and efficiently in accordance with the

  11. An efficient Bayesian data-worth analysis using a multilevel Monte Carlo method

    NASA Astrophysics Data System (ADS)

    Lu, Dan; Ricciuto, Daniel; Evans, Katherine

    2018-03-01

    Improving the understanding of subsurface systems and thus reducing prediction uncertainty requires collection of data. As the collection of subsurface data is costly, it is important that the data collection scheme is cost-effective. Design of a cost-effective data collection scheme, i.e., data-worth analysis, requires quantifying model parameter, prediction, and both current and potential data uncertainties. Assessment of these uncertainties in large-scale stochastic subsurface hydrological model simulations using standard Monte Carlo (MC) sampling or surrogate modeling is extremely computationally intensive, sometimes even infeasible. In this work, we propose an efficient Bayesian data-worth analysis using a multilevel Monte Carlo (MLMC) method. Compared to the standard MC that requires a significantly large number of high-fidelity model executions to achieve a prescribed accuracy in estimating expectations, the MLMC can substantially reduce computational costs using multifidelity approximations. Since the Bayesian data-worth analysis involves a great deal of expectation estimation, the cost saving of the MLMC in the assessment can be outstanding. While the proposed MLMC-based data-worth analysis is broadly applicable, we use it for a highly heterogeneous two-phase subsurface flow simulation to select an optimal candidate data set that gives the largest uncertainty reduction in predicting mass flow rates at four production wells. The choices made by the MLMC estimation are validated by the actual measurements of the potential data, and consistent with the standard MC estimation. But compared to the standard MC, the MLMC greatly reduces the computational costs.

  12. Analysis of multigrid methods on massively parallel computers: Architectural implications

    NASA Technical Reports Server (NTRS)

    Matheson, Lesley R.; Tarjan, Robert E.

    1993-01-01

    We study the potential performance of multigrid algorithms running on massively parallel computers with the intent of discovering whether presently envisioned machines will provide an efficient platform for such algorithms. We consider the domain parallel version of the standard V cycle algorithm on model problems, discretized using finite difference techniques in two and three dimensions on block structured grids of size 10(exp 6) and 10(exp 9), respectively. Our models of parallel computation were developed to reflect the computing characteristics of the current generation of massively parallel multicomputers. These models are based on an interconnection network of 256 to 16,384 message passing, 'workstation size' processors executing in an SPMD mode. The first model accomplishes interprocessor communications through a multistage permutation network. The communication cost is a logarithmic function which is similar to the costs in a variety of different topologies. The second model allows single stage communication costs only. Both models were designed with information provided by machine developers and utilize implementation derived parameters. With the medium grain parallelism of the current generation and the high fixed cost of an interprocessor communication, our analysis suggests an efficient implementation requires the machine to support the efficient transmission of long messages, (up to 1000 words) or the high initiation cost of a communication must be significantly reduced through an alternative optimization technique. Furthermore, with variable length message capability, our analysis suggests the low diameter multistage networks provide little or no advantage over a simple single stage communications network.

  13. Cost evaluation to optimise radiation therapy implementation in different income settings: A time-driven activity-based analysis.

    PubMed

    Van Dyk, Jacob; Zubizarreta, Eduardo; Lievens, Yolande

    2017-11-01

    With increasing recognition of growing cancer incidence globally, efficient means of expanding radiotherapy capacity is imperative, and understanding the factors impacting human and financial needs is valuable. A time-driven activity-based costing analysis was performed, using a base case of 2-machine departments, with defined cost inputs and operating parameters. Four income groups were analysed, ranging from low to high income. Scenario analyses included department size, operating hours, fractionation, treatment complexity, efficiency, and centralised versus decentralised care. The base case cost/course is US$5,368 in HICs, US$2,028 in LICs; the annual operating cost is US$4,595,000 and US$1,736,000, respectively. Economies of scale show cost/course decreasing with increasing department size, mainly related to the equipment cost and most prominent up to 3 linacs. The cost in HICs is two or three times as high as in U-MICs or LICs, respectively. Decreasing operating hours below 8h/day has a dramatic impact on the cost/course. IMRT increases the cost/course by 22%. Centralising preparatory activities has a moderate impact on the costs. The results indicate trends that are useful for optimising local and regional circumstances. This methodology can provide input into a uniform and accepted approach to evaluating the cost of radiotherapy. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  14. Using learning curves on energy-efficient technologies to estimate future energy savings and emission reduction potentials in the U.S. iron and steel industry

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

    Karali, Nihan; Park, Won Young; McNeil, Michael A.

    Increasing concerns on non-sustainable energy use and climate change spur a growing research interest in energy efficiency potentials in various critical areas such as industrial production. This paper focuses on learning curve aspects of energy efficiency measures in the U.S iron and steel sector. A number of early-stage efficient technologies (i.e., emerging or demonstration technologies) are technically feasible and have the potential to make a significant contribution to energy saving and CO 2 emissions reduction, but fall short economically to be included. However, they may also have the cost effective potential for significant cost reduction and/or performance improvement in themore » future under learning effects such as ‘learning-by-doing’. The investigation is carried out using ISEEM, a technology oriented, linear optimization model. We investigated how steel demand is balanced with/without the availability learning curve, compared to a Reference scenario. The retrofit (or investment in some cases) costs of energy efficient technologies decline in the scenario where learning curve is applied. The analysis also addresses market penetration of energy efficient technologies, energy saving, and CO 2 emissions in the U.S. iron and steel sector with/without learning impact. Accordingly, the study helps those who use energy models better manage the price barriers preventing unrealistic diffusion of energy-efficiency technologies, better understand the market and learning system involved, predict future achievable learning rates more accurately, and project future savings via energy-efficiency technologies with presence of learning. We conclude from our analysis that, most of the existing energy efficiency technologies that are currently used in the U.S. iron and steel sector are cost effective. Penetration levels increases through the years, even though there is no price reduction. However, demonstration technologies are not economically feasible in the U.S. iron and steel sector with the current cost structure. In contrast, some of the demonstration technologies are adapted in the mid-term and their penetration levels increase as the prices go down with learning curve. We also observe large penetration of 225kg pulverized coal injection with the presence of learning.« less

  15. Reducing Transaction Costs for Energy Efficiency Investments and Analysis of Economic Risk Associated With Building Performance Uncertainties: Small Buildings and Small Portfolios Program

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

    Langner, R.; Hendron, B.; Bonnema, E.

    2014-08-01

    The small buildings and small portfolios (SBSP) sector face a number of barriers that inhibit SBSP owners from adopting energy efficiency solutions. This pilot project focused on overcoming two of the largest barriers to financing energy efficiency in small buildings: disproportionately high transaction costs and unknown or unacceptable risk. Solutions to these barriers can often be at odds, because inexpensive turnkey solutions are often not sufficiently tailored to the unique circumstances of each building, reducing confidence that the expected energy savings will be achieved. To address these barriers, NREL worked with two innovative, forward-thinking lead partners, Michigan Saves and Energi,more » to develop technical solutions that provide a quick and easy process to encourage energy efficiency investments while managing risk. The pilot project was broken into two stages: the first stage focused on reducing transaction costs, and the second stage focused on reducing performance risk. In the first stage, NREL worked with the non-profit organization, Michigan Saves, to analyze the effects of 8 energy efficiency measures (EEMs) on 81 different baseline small office building models in Holland, Michigan (climate zone 5A). The results of this analysis (totaling over 30,000 cases) are summarized in a simple spreadsheet tool that enables users to easily sort through the results and find appropriate small office EEM packages that meet a particular energy savings threshold and are likely to be cost-effective.« less

  16. Generalized Redistribute-to-the-Right Algorithm: Application to the Analysis of Censored Cost Data

    PubMed Central

    CHEN, SHUAI; ZHAO, HONGWEI

    2013-01-01

    Medical cost estimation is a challenging task when censoring of data is present. Although researchers have proposed methods for estimating mean costs, these are often derived from theory and are not always easy to understand. We provide an alternative method, based on a replace-from-the-right algorithm, for estimating mean costs more efficiently. We show that our estimator is equivalent to an existing one that is based on the inverse probability weighting principle and semiparametric efficiency theory. We also propose an alternative method for estimating the survival function of costs, based on the redistribute-to-the-right algorithm, that was originally used for explaining the Kaplan–Meier estimator. We show that this second proposed estimator is equivalent to a simple weighted survival estimator of costs. Finally, we develop a more efficient survival estimator of costs, using the same redistribute-to-the-right principle. This estimator is naturally monotone, more efficient than some existing survival estimators, and has a quite small bias in many realistic settings. We conduct numerical studies to examine the finite sample property of the survival estimators for costs, and show that our new estimator has small mean squared errors when the sample size is not too large. We apply both existing and new estimators to a data example from a randomized cardiovascular clinical trial. PMID:24403869

  17. Techno-economic analysis of fuel cell auxiliary power units as alternative to idling

    NASA Astrophysics Data System (ADS)

    Jain, Semant; Chen, Hsieh-Yeh; Schwank, Johannes

    This paper presents a techno-economic analysis of fuel-cell-based auxiliary power units (APUs), with emphasis on applications in the trucking industry and the military. The APU system is intended to reduce the need for discretionary idling of diesel engines or gas turbines. The analysis considers the options for on-board fuel processing of diesel and compares the two leading fuel cell contenders for automotive APU applications: proton exchange membrane fuel cell and solid oxide fuel cell. As options for on-board diesel reforming, partial oxidation and auto-thermal reforming are considered. Finally, using estimated and projected efficiency data, fuel consumption patterns, capital investment, and operating costs of fuel-cell APUs, an economic evaluation of diesel-based APUs is presented, with emphasis on break-even periods as a function of fuel cost, investment cost, idling time, and idling efficiency. The analysis shows that within the range of parameters studied, there are many conditions where deployment of an SOFC-based APU is economically viable. Our analysis indicates that at an APU system cost of 100 kW -1, the economic break-even period is within 1 year for almost the entire range of conditions. At 500 kW -1 investment cost, a 2-year break-even period is possible except for the lowest end of the fuel consumption range considered. However, if the APU investment cost is 3000 kW -1, break-even would only be possible at the highest fuel consumption scenarios. For Abram tanks, even at typical land delivered fuel costs, a 2-year break-even period is possible for APU investment costs as high as 1100 kW -1.

  18. An Analysis of the Cost and Performance of Photovoltaic Systems as a Function of Module Area

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

    Horowitz, Kelsey A.W.; Fu, Ran; Silverman, Tim

    We investigate the potential effects of module area on the cost and performance of photovoltaic systems. Applying a bottom-up methodology, we analyzed the costs associated with mc-Si and thin-film modules and systems as a function of module area. We calculate a potential for savings of up to $0.04/W, $0.10/W, and $0.13/W in module manufacturing costs for mc-Si, CdTe, and CIGS respectively, with large area modules. We also find that an additional $0.05/W savings in balance-of-systems costs may be achieved. However, these savings are dependent on the ability to maintain efficiency and manufacturing yield as area scales. Lifetime energy yield mustmore » also be maintained to realize reductions in the levelized cost of energy. We explore the possible effects of module size on efficiency and energy production, and find that more research is required to understand these issues for each technology. Sensitivity of the $/W cost savings to module efficiency and manufacturing yield is presented. We also discuss non-cost barriers to adoption of large area modules.« less

  19. Clinical process analysis and activity-based costing at a heart center.

    PubMed

    Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

    2002-08-01

    Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

  20. Cost-effectiveness Analysis with Influence Diagrams.

    PubMed

    Arias, M; Díez, F J

    2015-01-01

    Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

  1. Airfoil Design and Optimization by the One-Shot Method

    NASA Technical Reports Server (NTRS)

    Kuruvila, G.; Taasan, Shlomo; Salas, M. D.

    1995-01-01

    An efficient numerical approach for the design of optimal aerodynamic shapes is presented in this paper. The objective of any optimization problem is to find the optimum of a cost function subject to a certain state equation (governing equation of the flow field) and certain side constraints. As in classical optimal control methods, the present approach introduces a costate variable (Lagrange multiplier) to evaluate the gradient of the cost function. High efficiency in reaching the optimum solution is achieved by using a multigrid technique and updating the shape in a hierarchical manner such that smooth (low-frequency) changes are done separately from high-frequency changes. Thus, the design variables are changed on a grid where their changes produce nonsmooth (high-frequency) perturbations that can be damped efficiently by the multigrid. The cost of solving the optimization problem is approximately two to three times the cost of the equivalent analysis problem.

  2. Airfoil optimization by the one-shot method

    NASA Technical Reports Server (NTRS)

    Kuruvila, G.; Taasan, Shlomo; Salas, M. D.

    1994-01-01

    An efficient numerical approach for the design of optimal aerodynamic shapes is presented in this paper. The objective of any optimization problem is to find the optimum of a cost function subject to a certain state equation (Governing equation of the flow field) and certain side constraints. As in classical optimal control methods, the present approach introduces a costate variable (Language multiplier) to evaluate the gradient of the cost function. High efficiency in reaching the optimum solution is achieved by using a multigrid technique and updating the shape in a hierarchical manner such that smooth (low-frequency) changes are done separately from high-frequency changes. Thus, the design variables are changed on a grid where their changes produce nonsmooth (high-frequency) perturbations that can be damped efficiently by the multigrid. The cost of solving the optimization problem is approximately two to three times the cost of the equivalent analysis problem.

  3. Modeling efficiency at the process level: an examination of the care planning process in nursing homes.

    PubMed

    Lee, Robert H; Bott, Marjorie J; Gajewski, Byron; Taunton, Roma Lee

    2009-02-01

    To examine the efficiency of the care planning process in nursing homes. We collected detailed primary data about the care planning process for a stratified random sample of 107 nursing homes from Kansas and Missouri. We used these data to calculate the average direct cost per care plan and used data on selected deficiencies from the Online Survey Certification and Reporting System to measure the quality of care planning. We then analyzed the efficiency of the assessment process using corrected ordinary least squares (COLS) and data envelopment analysis (DEA). Both approaches suggested that there was considerable inefficiency in the care planning process. The average COLS score was 0.43; the average DEA score was 0.48. The correlation between the two sets of scores was quite high, and there was no indication that lower costs resulted in lower quality. For-profit facilities were significantly more efficient than not-for-profit facilities. Multiple studies of nursing homes have found evidence of inefficiency, but virtually all have had measurement problems that raise questions about the results. This analysis, which focuses on a process with much simpler measurement issues, finds evidence of inefficiency that is largely consistent with earlier studies. Making nursing homes more efficient merits closer attention as a strategy for improving care. Increasing efficiency by adopting well-designed, reliable processes can simultaneously reduce costs and improve quality.

  4. GT-WGS: an efficient and economic tool for large-scale WGS analyses based on the AWS cloud service.

    PubMed

    Wang, Yiqi; Li, Gen; Ma, Mark; He, Fazhong; Song, Zhuo; Zhang, Wei; Wu, Chengkun

    2018-01-19

    Whole-genome sequencing (WGS) plays an increasingly important role in clinical practice and public health. Due to the big data size, WGS data analysis is usually compute-intensive and IO-intensive. Currently it usually takes 30 to 40 h to finish a 50× WGS analysis task, which is far from the ideal speed required by the industry. Furthermore, the high-end infrastructure required by WGS computing is costly in terms of time and money. In this paper, we aim to improve the time efficiency of WGS analysis and minimize the cost by elastic cloud computing. We developed a distributed system, GT-WGS, for large-scale WGS analyses utilizing the Amazon Web Services (AWS). Our system won the first prize on the Wind and Cloud challenge held by Genomics and Cloud Technology Alliance conference (GCTA) committee. The system makes full use of the dynamic pricing mechanism of AWS. We evaluate the performance of GT-WGS with a 55× WGS dataset (400GB fastq) provided by the GCTA 2017 competition. In the best case, it only took 18.4 min to finish the analysis and the AWS cost of the whole process is only 16.5 US dollars. The accuracy of GT-WGS is 99.9% consistent with that of the Genome Analysis Toolkit (GATK) best practice. We also evaluated the performance of GT-WGS performance on a real-world dataset provided by the XiangYa hospital, which consists of 5× whole-genome dataset with 500 samples, and on average GT-WGS managed to finish one 5× WGS analysis task in 2.4 min at a cost of $3.6. WGS is already playing an important role in guiding therapeutic intervention. However, its application is limited by the time cost and computing cost. GT-WGS excelled as an efficient and affordable WGS analyses tool to address this problem. The demo video and supplementary materials of GT-WGS can be accessed at https://github.com/Genetalks/wgs_analysis_demo .

  5. Financial Analysis for Academic Units. AAHE-ERIC/Higher Education Research Report No. 7, 1981.

    ERIC Educational Resources Information Center

    Walters, Donald L.

    The state-of-the-art of financial analysis for academic units within institutions of higher education is evaluated with attention directed to: how the cost of an academic unit is determined, how revenue is identified with academic units, how costs are analyzed, how revenues and expenditures are projected, and how the financial efficiency of an…

  6. Are quantitative trait-dependent sampling designs cost-effective for analysis of rare and common variants?

    PubMed

    Yilmaz, Yildiz E; Bull, Shelley B

    2011-11-29

    Use of trait-dependent sampling designs in whole-genome association studies of sequence data can reduce total sequencing costs with modest losses of statistical efficiency. In a quantitative trait (QT) analysis of data from the Genetic Analysis Workshop 17 mini-exome for unrelated individuals in the Asian subpopulation, we investigate alternative designs that sequence only 50% of the entire cohort. In addition to a simple random sampling design, we consider extreme-phenotype designs that are of increasing interest in genetic association analysis of QTs, especially in studies concerned with the detection of rare genetic variants. We also evaluate a novel sampling design in which all individuals have a nonzero probability of being selected into the sample but in which individuals with extreme phenotypes have a proportionately larger probability. We take differential sampling of individuals with informative trait values into account by inverse probability weighting using standard survey methods which thus generalizes to the source population. In replicate 1 data, we applied the designs in association analysis of Q1 with both rare and common variants in the FLT1 gene, based on knowledge of the generating model. Using all 200 replicate data sets, we similarly analyzed Q1 and Q4 (which is known to be free of association with FLT1) to evaluate relative efficiency, type I error, and power. Simulation study results suggest that the QT-dependent selection designs generally yield greater than 50% relative efficiency compared to using the entire cohort, implying cost-effectiveness of 50% sample selection and worthwhile reduction of sequencing costs.

  7. Evaluation of economic efficiencies in clinical retina practice: activity-based cost analysis and modeling to determine impacts of changes in patient management

    PubMed Central

    Murray, Timothy G; Tornambe, Paul; Dugel, Pravin; Tong, Kuo Bianchini

    2011-01-01

    Background The purpose of this study is to report the use of activity-based cost analysis to identify areas of practice efficiencies and inefficiencies within a large academic retinal center and a small single-specialty group. This analysis establishes a framework for evaluating rapidly shifting clinical practices (anti-vascular endothelial growth factor therapy, microincisional vitrectomy surgery) and incorporating changing reimbursements for care delivery (intravitreal injections, optical coherence tomography [OCT]) to determine the impact on practice profitability. Pro forma modeling targeted the impact of declining reimbursement for OCT imaging and intravitreal injection using a strategy that incorporates activity-based cost analysis into a direct evaluation schema for clinical operations management. Methods Activity-based costing analyses were performed at two different types of retinal practices in the US, ie, a small single-specialty group practice and an academic hospital-based practice (Bascom Palmer Eye Institute). Retrospective claims data were utilized to identify all procedures performed and billed, submitted charges, allowed charges, and net collections from each of these two practices for the calendar years 2005–2006 and 2007–2008. A pro forma analysis utilizing current reimbursement profiles was performed to determine the impact of altered reimbursement on practice profitability. All analyses were performed by a third party consulting firm. Results The small single-specialty group practice outperformed the academic hospital-based practice on almost all markers of efficiency. In the academic hospital-based practice, only four service lines were profitable, ie, nonlaser surgery, laser surgery, non-OCT diagnostics, and injections. Profit margin varied from 62% for nonlaser surgery to 1% for intravitreal injections. Largest negative profit contributions were associated with office visits and OCT imaging. Conclusion Activity-based cost analysis is a powerful tool to evaluate retinal practice efficiencies. These two distinct practices were able to provide significant increases in clinical care (office visits, ophthalmic imaging, and patient procedures) through maintaining efficiencies of care. Pro forma analysis of 2011 data noted that OCT payments to facilities and physicians continue to decrease dramatically and that this payment decrease further reduced the profitability for the two largest aspects of these retinal practices, ie, intravitreal injections and OCT retinal imaging. Ultimately, all retinal practices are at risk for significant shifts in financial health related to rapidly evolving changes in patterns of care and reimbursement associated with providing outstanding clinical care. PMID:21792278

  8. Fuel economy and life-cycle cost analysis of a fuel cell hybrid vehicle

    NASA Astrophysics Data System (ADS)

    Jeong, Kwi Seong; Oh, Byeong Soo

    The most promising vehicle engine that can overcome the problem of present internal combustion is the hydrogen fuel cell. Fuel cells are devices that change chemical energy directly into electrical energy without combustion. Pure fuel cell vehicles and fuel cell hybrid vehicles (i.e. a combination of fuel cell and battery) as energy sources are studied. Considerations of efficiency, fuel economy, and the characteristics of power output in hybridization of fuel cell vehicle are necessary. In the case of Federal Urban Driving Schedule (FUDS) cycle simulation, hybridization is more efficient than a pure fuel cell vehicle. The reason is that it is possible to capture regenerative braking energy and to operate the fuel cell system within a more efficient range by using battery. Life-cycle cost is largely affected by the fuel cell size, fuel cell cost, and hydrogen cost. When the cost of fuel cell is high, hybridization is profitable, but when the cost of fuel cell is less than 400 US$/kW, a pure fuel cell vehicle is more profitable.

  9. A data envelope analysis to assess factors affecting technical and economic efficiency of individual broiler breeder hens.

    PubMed

    Romero, L F; Zuidhof, M J; Jeffrey, S R; Naeima, A; Renema, R A; Robinson, F E

    2010-08-01

    This study evaluated the effect of feed allocation and energetic efficiency on technical and economic efficiency of broiler breeder hens using the data envelope analysis methodology and quantified the effect of variables affecting technical efficiency. A total of 288 Ross 708 pullets were placed in individual cages at 16 wk of age and assigned to 1 of 4 feed allocation groups. Three of them had feed allocated on a group basis with divergent BW targets: standard, high (standard x 1.1), and low (standard x 0.9). The fourth group had feed allocated on an individual bird basis following the standard BW target. Birds were classified in 3 energetic efficiency categories: low, average, and high, based on estimated maintenance requirements. Technical efficiency considered saleable chicks as output and cumulative ME intake and time as inputs. Economic efficiency of feed allocation treatments was analyzed under different cost scenarios. Birds with low feed allocation exhibited a lower technical efficiency (69.4%) than standard (72.1%), which reflected a reduced egg production rate. Feed allocation of the high treatment could have been reduced by 10% with the same chick production as the standard treatment. The low treatment exhibited reduced economic efficiency at greater capital costs, whereas high had reduced economic efficiency at greater feed costs. The average energetic efficiency hens had a lower technical efficiency in the low compared with the standard feed allocation. A 1% increment in estimated maintenance requirement changed technical efficiency by -0.23%, whereas a 1% increment in ME intake had a -0.47% effect. The negative relationship between technical efficiency and ME intake was counterbalanced by a positive correlation of ME intake and egg production. The negative relationship of technical efficiency and maintenance requirements was synergized by a negative correlation of hen maintenance and egg production. Economic efficiency methodologies are effective tools to assess the economic effect of selection and flock management programs because biological, allocative, and economic factors can be independently analyzed.

  10. (Power sector efficiency analysis in Costa Rica). [Power Sector Efficiency Analysis in Costa Rica

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

    Waddle, D.B.

    I traveled to San Jose, Costa Rica, to review the state of the electric power utility with a team of specialists, including a transmission and distribution specialist, a hydroelectric engineering specialist, and a thermal power plant specialist. The purpose of the mission was to determine the costs and benefits of efficiency improvements to supply side technologies employed by the Instituto Costarricense de Electricidad, the national power company in Costa Rica, and the potential contribution of these efficiency measures to the future electric power needs of Costa Rica.

  11. Rectenna session: Micro aspects

    NASA Technical Reports Server (NTRS)

    Gutmann, R. J.

    1980-01-01

    Two micro aspects of rectenna design are discussed: evaluation of the degradation in net rectenna RF to DC conversion efficiency due to power density variations across the rectenna (power combining analysis) and design of Yagi-Uda receiving elements to reduce rectenna cost by decreasing the number of conversion circuits (directional receiving elements). The first of these involves resolving a fundamental question of efficiency potential with a rectenna, while the second involves a design modification with a large potential cost saving.

  12. Solar power satellite rectenna design study: Directional receiving elements and parallel-series combining analysis

    NASA Technical Reports Server (NTRS)

    Gutmann, R. J.; Borrego, J. M.

    1978-01-01

    Rectenna conversion efficiencies (RF to dc) approximating 85 percent were demonstrated on a small scale, clearly indicating the feasibility and potential of efficiency of microwave power to dc. The overall cost estimates of the solar power satellite indicate that the baseline rectenna subsystem will be between 25 to 40 percent of the system cost. The directional receiving elements and element extensions were studied, along with power combining evaluation and evaluation extensions.

  13. Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

    PubMed

    Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M

    2015-04-01

    (1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  14. Efficiency of dairy farms participating and not participating in veterinary herd health management programs.

    PubMed

    Derks, Marjolein; Hogeveen, Henk; Kooistra, Sake R; van Werven, Tine; Tauer, Loren W

    2014-12-01

    This paper compares farm efficiencies between dairies who were participating in a veterinary herd health management (VHHM) program with dairies not participating in such a program, to determine whether participation has an association with farm efficiency. In 2011, 572 dairy farmers received a questionnaire concerning the participation and execution of a VHHM program on their farms. Data from the questionnaire were combined with farm accountancy data from 2008 through 2012 from farms that used calendar year accounting periods, and were analyzed using Stochastic Frontier Analysis (SFA). Two separate models were specified: model 1 was the basic stochastic frontier model (output: total revenue; input: feed costs, land costs, cattle costs, non-operational costs), without explanatory variables embedded into the efficiency component of the error term. Model 2 was an expansion of model 1 which included explanatory variables (number of FTE; total kg milk delivered; price of concentrate; milk per hectare; cows per FTE; nutritional yield per hectare) inserted into the efficiency component of the joint error term. Both models were estimated with the financial parameters expressed per 100 kg fat and protein corrected milk and per cow. Land costs, cattle costs, feed costs and non-operational costs were statistically significant and positive in all models (P<0.01). Frequency distributions of the efficiency scores for the VHHM dairies and the non-VHHM dairies were plotted in a kernel density plot, and differences were tested using the Kolmogorov-Smirnov two-sample test. VHHM dairies had higher total revenue per cow, but not per 100 kg milk. For all SFA models, the difference in distribution was not statistically different between VHHM dairies and non-VHHM dairies (P values 0.94, 0.35, 0.95 and 0.89 for the basic and complete model per 100 kg fat and protein corrected milk and per cow respectively). Therefore we conclude that with our data farm participation in VHHM is not related to overall farm efficiency. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. 44 CFR 13.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... consolidating or breaking out procurements to obtain a more economical purchase. Where appropriate, an analysis... most economical approach. (5) To foster greater economy and efficiency, grantees and subgrantees are... consistent with Federal cost principles (see § 13.22). Grantees may reference their own cost principles that...

  16. 24 CFR 85.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... consolidating or breaking out procurements to obtain a more economical purchase. Where appropriate, an analysis... most economical approach. (5) To foster greater economy and efficiency, grantees and subgrantees are... consistent with Federal cost principles (see § 85.22). Grantees may reference their own cost principles that...

  17. 29 CFR 97.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... consolidating or breaking out procurements to obtain a more economical purchase. Where appropriate, an analysis... most economical approach. (5) To foster greater economy and efficiency, grantees and subgrantees are... consistent with Federal cost principles (see § 97.22). Grantees may reference their own cost principles that...

  18. Does integration of HIV and SRH services achieve economies of scale and scope in practice? A cost function analysis of the Integra Initiative.

    PubMed

    Obure, Carol Dayo; Guinness, Lorna; Sweeney, Sedona; Initiative, Integra; Vassall, Anna

    2016-03-01

    Policy-makers have long argued about the potential efficiency gains and cost savings from integrating HIV and sexual reproductive health (SRH) services, particularly in resource-constrained settings with generalised HIV epidemics. However, until now, little empirical evidence exists on whether the hypothesised efficiency gains associated with such integration can be achieved in practice. We estimated a quadratic cost function using data obtained from 40 health facilities, over a 2-year-period, in Kenya and Swaziland. The quadratic specification enables us to determine the existence of economies of scale and scope. The empirical results reveal that at the current output levels, only HIV counselling and testing services are characterised by service-specific economies of scale. However, no overall economies of scale exist as all outputs are increased. The results also indicate cost complementarities between cervical cancer screening and HIV care; post-natal care and HIV care and family planning and sexually transmitted infection treatment combinations only. The results from this analysis reveal that contrary to expectation, efficiency gains from the integration of HIV and SRH services, if any, are likely to be modest. Efficiency gains are likely to be most achievable in settings that are currently delivering HIV and SRH services at a low scale with high levels of fixed costs. The presence of cost complementarities for only three service combinations implies that careful consideration of setting-specific clinical practices and the extent to which they can be combined should be made when deciding which services to integrate. NCT01694862. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Does integration of HIV and SRH services achieve economies of scale and scope in practice? A cost function analysis of the Integra Initiative

    PubMed Central

    Obure, Carol Dayo; Guinness, Lorna; Sweeney, Sedona; Initiative, Integra; Vassall, Anna

    2016-01-01

    Objective Policy-makers have long argued about the potential efficiency gains and cost savings from integrating HIV and sexual reproductive health (SRH) services, particularly in resource-constrained settings with generalised HIV epidemics. However, until now, little empirical evidence exists on whether the hypothesised efficiency gains associated with such integration can be achieved in practice. Methods We estimated a quadratic cost function using data obtained from 40 health facilities, over a 2-year-period, in Kenya and Swaziland. The quadratic specification enables us to determine the existence of economies of scale and scope. Findings The empirical results reveal that at the current output levels, only HIV counselling and testing services are characterised by service-specific economies of scale. However, no overall economies of scale exist as all outputs are increased. The results also indicate cost complementarities between cervical cancer screening and HIV care; post-natal care and HIV care and family planning and sexually transmitted infection treatment combinations only. Conclusions The results from this analysis reveal that contrary to expectation, efficiency gains from the integration of HIV and SRH services, if any, are likely to be modest. Efficiency gains are likely to be most achievable in settings that are currently delivering HIV and SRH services at a low scale with high levels of fixed costs. The presence of cost complementarities for only three service combinations implies that careful consideration of setting-specific clinical practices and the extent to which they can be combined should be made when deciding which services to integrate. Trial registration number NCT01694862. PMID:26438349

  20. SOLVE II: A Technique to Improve Efficiency and Solve Problems in Hardwood Sawmills

    Treesearch

    Edward L. Adams; Daniel E. Dunmire

    1977-01-01

    The squeeze between rising costs and product values is getting tighter for sawmill managers. So, they are taking a closer took at the efficiency of their sawmills by making a complete analysis of their milling situation. Such an analysis requires considerable time and expense. To aid the manager with this task, the USDA Forest Service's Northeastern Forest...

  1. Impact of Financial Liberalization on Banking Sectors Performance from Central and Eastern European Countries

    PubMed Central

    Andries, Alin Marius; Capraru, Bogdan

    2013-01-01

    In this paper we analyse the impact of financial liberalization and reforms on the banking performance in 17 countries from CEE for the period 2004–2008 using a two-stage empirical model that involves estimating bank performance in the first stage and assessing its determinants in the second one. From our analysis it results that banks from CEE countries with higher level of liberalization and openness are able to increase cost efficiency and eventually to offer cheaper services to clients. Banks from non-member EU countries are less cost efficient but experienced much higher total productivity growth level, and large sized banks are much more cost efficient than medium and small banks, while small sized banks show the highest growth in terms of productivity. PMID:23555745

  2. Impact of financial liberalization on banking sectors performance from central and eastern European countries.

    PubMed

    Andries, Alin Marius; Capraru, Bogdan

    2013-01-01

    In this paper we analyse the impact of financial liberalization and reforms on the banking performance in 17 countries from CEE for the period 2004-2008 using a two-stage empirical model that involves estimating bank performance in the first stage and assessing its determinants in the second one. From our analysis it results that banks from CEE countries with higher level of liberalization and openness are able to increase cost efficiency and eventually to offer cheaper services to clients. Banks from non-member EU countries are less cost efficient but experienced much higher total productivity growth level, and large sized banks are much more cost efficient than medium and small banks, while small sized banks show the highest growth in terms of productivity.

  3. Brain Network Analysis: Separating Cost from Topology Using Cost-Integration

    PubMed Central

    Ginestet, Cedric E.; Nichols, Thomas E.; Bullmore, Ed T.; Simmons, Andrew

    2011-01-01

    A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i) differences in weighted costs and (ii) differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration. PMID:21829437

  4. Design, processing and testing of LSI arrays: Hybrid microelectronics task

    NASA Technical Reports Server (NTRS)

    Himmel, R. P.; Stuhlbarg, S. M.; Ravetti, R. G.; Zulueta, P. J.

    1979-01-01

    Mathematical cost factors were generated for both hybrid microcircuit and printed wiring board packaging methods. A mathematical cost model was created for analysis of microcircuit fabrication costs. The costing factors were refined and reduced to formulae for computerization. Efficient methods were investigated for low cost packaging of LSI devices as a function of density and reliability. Technical problem areas such as wafer bumping, inner/outer leading bonding, testing on tape, and tape processing, were investigated.

  5. Computational Analysis of Nanoparticles-Molten Salt Thermal Energy Storage for Concentrated Solar Power Systems

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

    Kumar, Vinod

    2017-05-05

    High fidelity computational models of thermocline-based thermal energy storage (TES) were developed. The research goal was to advance the understanding of a single tank nanofludized molten salt based thermocline TES system under various concentration and sizes of the particles suspension. Our objectives were to utilize sensible-heat that operates with least irreversibility by using nanoscale physics. This was achieved by performing computational analysis of several storage designs, analyzing storage efficiency and estimating cost effectiveness for the TES systems under a concentrating solar power (CSP) scheme using molten salt as the storage medium. Since TES is one of the most costly butmore » important components of a CSP plant, an efficient TES system has potential to make the electricity generated from solar technologies cost competitive with conventional sources of electricity.« less

  6. Placement and efficiency effects on radiative forcing of solar installations

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

    Burg, Brian R.; Ruch, Patrick; Paredes, Stephan

    2015-09-28

    The promise for harnessing solar energy being hampered by cost, triggered efforts to reduce them. As a consequence low-efficiency, low-cost photovoltaics (PV) panels prevail. Conversely, in the traditional energy sector efficiency is extremely important due to the direct costs associated to fuels. This also affects solar energy due to the radiative forcing caused by the dark solar panels. In this paper we extend the concept of energy payback time by including the effect of albedo change, which gives a better assessment of the system sustainability. We present an analysis on the short and medium term climate forcing effects of differentmore » solar collectors in Riyadh, Saudi Arabia and demonstrate that efficiency is important to reduce the collector area and cost. This also influences the embodied energy and the global warming potential. We show that a placement of a high concentration photovoltaic thermal solar power station outside of the city using a district cooling system has a double beneficial effect since it improves the solar conversion efficiency and reduces the energy demand for cooling in the city. We also explain the mechanisms of the current economic development of solar technologies and anticipate changes.« less

  7. Systems Analysis of GPS Electrical Power System Redesign

    DTIC Science & Technology

    1995-12-01

    Table 8 - System Efficiencies & Multipliers for Solar Direct Model (12:102; 15:864) Component Efficiency AMTEC 0.180 Receiver and Thermal Energy Storage...and low temperatures of the working fluid. Extreme high and low temperatures provide a greater efficiency , but require extensive thermal control and...direct conversion category. The Alkali Metal Thermal -to-Electric Converter ( AMTEC ) shows mass and cost savings due to efficiencies significantly higher

  8. Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries

    PubMed Central

    Siapka, Mariana; Remme, Michelle; Obure, Carol Dayo; Maier, Claudia B; Dehne, Karl L

    2014-01-01

    Abstract Objective To synthesize the data available – on costs, efficiency and economies of scale and scope – for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale-up of human immunodeficiency virus (HIV) services in low- and middle-income countries. Methods The relevant peer-reviewed and “grey” literature from low- and middle-income countries was systematically reviewed. Search and analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Findings Of the 82 empirical costing and efficiency studies identified, nine provided data on economies of scale. Scale explained much of the variation in the costs of several HIV services, particularly those of targeted HIV prevention for key populations and HIV testing and treatment. There is some evidence of economies of scope from integrating HIV counselling and testing services with several other services. Cost efficiency may also be improved by reducing input prices, task shifting and improving client adherence. Conclusion HIV programmes need to optimize the scale of service provision to achieve efficiency. Interventions that may enhance the potential for economies of scale include intensifying demand-creation activities, reducing the costs for service users, expanding existing programmes rather than creating new structures, and reducing attrition of existing service users. Models for integrated service delivery – which is, potentially, more efficient than the implementation of stand-alone services – should be investigated further. Further experimental evidence is required to understand how to best achieve efficiency gains in HIV programmes and assess the cost–effectiveness of each service-delivery model. PMID:25110375

  9. 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.

  10. Development and Analysis of New Integrated Energy Systems for Sustainable Buildings

    NASA Astrophysics Data System (ADS)

    Khalid, Farrukh

    Excessive consumption of fossil fuels in the residential sector and their associated negative environmental impacts bring a significant challenge to engineers within research and industrial communities throughout the world to develop more environmentally benign methods of meeting energy needs of residential sector in particular. This thesis addresses potential solutions for the issue of fossils fuel consumption in residential buildings. Three novel renewable energy based multigeneration systems are proposed for different types of residential buildings, and a comprehensive assessment of energetic and exergetic performances is given on the basis of total occupancy, energy load, and climate conditions. System 1 is a multigeneration system based on two renewable energy sources. It uses biomass and solar resources. The outputs of System 1 are electricity, space heating, cooling, and hot water. The energy and exergy efficiencies of System 1 are 91.0% and 34.9%, respectively. The results of the optimisation analysis show that the net present cost of System 1 is 2,700,496 and that the levelised cost of electricity is 0.117/kWh. System 2 is a multigeneration system, integrating three renewable energy based subsystems; wind turbine, concentrated solar collector, and Organic Rankine Cycle supplied by a ground source heat exchanger. The outputs of the System 2 are electricity, hot water, heating and cooling. The optimisation analysis shows that net present cost is 35,502 and levelised cost of electricity is 0.186/kWh. The energy and exergy efficiencies of System 2 are found to be 34.6% and 16.2%, respectively. System 3 is a multigeneration system, comprising two renewable energy subsystems-- geothermal and solar to supply power, cooling, heating, and hot water. The optimisation analysis shows that the net present cost of System 3 is 598,474, and levelised cost of electricity of 0.111/kWh. The energy and exergy efficiencies of System 3 are 20.2% and 19.2%, respectively, with outputs of electricity, hot water, cooling and space heating. A performance assessment for identical conditions indicates that System 3 offers the best performance, with the minimum net present cost of 26,001 and levelised cost of electricity of 0.136/kWh.

  11. Non-Epitaxial Thin-Film Indium Phosphide Photovoltaics: Growth, Devices, and Cost Analysis

    NASA Astrophysics Data System (ADS)

    Zheng, Maxwell S.

    In recent years, the photovoltaic market has grown significantly as module prices have continued to come down. Continued growth of the field requires higher efficiency modules at lower manufacturing costs. In particular, higher efficiencies reduce the area needed for a given power output, thus reducing the downstream balance of systems costs that scale with area such as mounting frames, installation, and soft costs. Cells and modules made from III-V materials have the highest demonstrated efficiencies to date but are not yet at the cost level of other thin film technologies, which has limited their large-scale deployment. There is a need for new materials growth, processing and fabrication techniques to address this major shortcoming of III-V semiconductors. Chapters 2 and 3 explore growth of InP on non-epitaxial Mo substrates by MOCVD and CSS, respectively. The results from these studies demonstrate that InP optoelectronic quality is maintained even by growth on non-epitaxial metal substrates. Structural characterization by SEM and XRD show stoichiometric InP can be grown in complete thin films on Mo. Photoluminescence measurements show peak energies and widths to be similar to those of reference wafers of similar doping concentrations. In chapter 4 the TF-VLS growth technique is introduced and cells fabricated from InP produced by this technique are characterized. The TF-VLS method results in lateral grain sizes of >500 mum and exhibits superior optoelectronic quality. First generation devices using a n-TiO2 window layer along with p-type TF-VLS grown InP have reached ˜12.1% power conversion efficiency under 1 sun illumination with VOC of 692 mV, JSC of 26.9 mA/cm2, and FF of 65%. The cells are fabricated using all non-epitaxial processing. Optical measurements show the InP in these cells have the potential to support a higher VOC of ˜795 mV, which can be achieved by improved device design. Chapter 5 describes a cost analysis of a manufacturing process using an InP cell as the active layer in a monolithically integrated module. Importantly, TF-VLS growth avoids the hobbles of traditional growth: the epitaxial wafer substrate, low utilization efficiency of expensive metalorganic precursors, and high capital depreciation costs due to low throughput. Production costs are projected to be 0.76/W(DC) for the benchmark case of 12% efficient modules and would decrease to 0.40/W(DC) for the long-term potential case of 24% efficient modules.

  12. Design and analysis issues for economic analysis alongside clinical trials.

    PubMed

    Marshall, Deborah A; Hux, Margaret

    2009-07-01

    Clinical trials can offer a valuable and efficient opportunity to collect the health resource use and outcomes data for economic evaluation. However, economic and clinical studies differ fundamentally in the question they seek to answer. The design and analysis of trial-based cost-effectiveness studies require special consideration, which are reviewed in this article. Traditional randomized controlled trials, using an experimental design with a controlled protocol, are designed to measure safety and efficacy for product registration. Cost-effectiveness analysis seeks to measure effectiveness in the context of routine clinical practice, and requires collection of health care resources to allow estimation of cost over an equal timeframe for each treatment alternative. In assessing suitability of a trial for economic data collection, the comparator treatment and other protocol factors need to reflect current clinical practice and the trial follow-up must be sufficiently long to capture important costs and effects. The broadest available population and a measure of effectiveness reflecting important benefits for patients are preferred for economic analyses. Special analytical issues include dealing with missing and censored cost data, assessing uncertainty of the incremental cost-effectiveness ratio, and accounting for the underlying heterogeneity in patient subgroups. Careful consideration also needs to be given to data from multinational studies since practice patterns can differ across countries. Although clinical trials can be an efficient opportunity to collect data for economic evaluation, careful consideration of the suitability of the study design, and appropriate analytical methods must be applied to obtain rigorous results.

  13. 45 CFR 602.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... Consideration should be given to consolidating or breaking out procurements to obtain a more economical purchase... appropriate analysis to determine the most economical approach. (5) To foster greater economy and efficiency... consistent with Federal cost principles (see § 602.22). Grantees may reference their own cost principles that...

  14. 45 CFR 1157.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 1157.22). Grantees may reference their own cost principles...

  15. 34 CFR 80.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 80.22). Grantees may reference their own cost principles that...

  16. 10 CFR 600.236 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 600.422). Grantees may reference their own cost principles...

  17. 28 CFR 66.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 66.22). Grantees may reference their own cost principles that...

  18. 22 CFR 135.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 135.22). Grantees may reference their own cost principles that...

  19. 21 CFR 1403.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... Consideration should be given to consolidating or breaking out procurements to obtain a more economical purchase... appropriate analysis to determine the most economical approach. (5) To foster greater economy and efficiency... consistent with Federal cost principles (see § 1403.22). Grantees may reference their own cost principles...

  20. 49 CFR 18.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... should be given to consolidating or breaking out procurements to obtain a more economical purchase. Where... analysis to determine the most economical approach. (5) To foster greater economy and efficiency, grantees... consistent with Federal cost principles (see § 18.22). Grantees may reference their own cost principles that...

  1. 45 CFR 1174.36 - Procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... Consideration should be given to consolidating or breaking out procurements to obtain a more economical purchase... appropriate analysis to determine the most economical approach. (5) To foster greater economy and efficiency... consistent with Federal cost principles (see § 1174.22). Grantees may reference their own cost principles...

  2. Efficient and equitable spatial allocation of renewable power plants at the country scale

    NASA Astrophysics Data System (ADS)

    Drechsler, Martin; Egerer, Jonas; Lange, Martin; Masurowski, Frank; Meyerhoff, Jürgen; Oehlmann, Malte

    2017-09-01

    Globally, the production of renewable energy is undergoing rapid growth. One of the most pressing issues is the appropriate allocation of renewable power plants, as the question of where to produce renewable electricity is highly controversial. Here we explore this issue through analysis of the efficient and equitable spatial allocation of wind turbines and photovoltaic power plants in Germany. We combine multiple methods, including legal analysis, economic and energy modelling, monetary valuation and numerical optimization. We find that minimum distances between renewable power plants and human settlements should be as small as is legally possible. Even small reductions in efficiency lead to large increases in equity. By considering electricity grid expansion costs, we find a more even allocation of power plants across the country than is the case when grid expansion costs are neglected.

  3. Industry survey of space system cost benefits from New Ways Of Doing Business

    NASA Technical Reports Server (NTRS)

    Rosmait, Russell L.

    1992-01-01

    The cost of designing, building and operating space system hardware has always been expensive. Small quantities of specialty parts escalate engineering design, production and operations cost. Funding cutbacks and shrinking revenues dictate aggressive cost saving programs. NASA's highest priority is providing economical transportation to and from space. Over the past three decades NASA has seen technological advances that provide grater efficiencies in designing, building, and operating of space system hardware. As future programs such as NLS, LUTE and SEI begin, these greater efficiencies and cost savings should be reflected in the cost models. There are several New Ways Of Doing Business (NWODB) which, when fully implemented will reduce space system costs. These philosophies and/or culture changes are integrated in five areas: (1) More Extensive Pre-Phase C/D & E, (2) Multi Year Funding Stability, (3) Improved Quality, Management and Procurement Processes, (4) Advanced Design Methods, and (5) Advanced Production Methods. Following is an overview of NWODB and the Cost Quantification Analysis results using an industry survey, one of the four quantification techniques used in the study. The NWODB Cost Quantification Analysis is a study performed at Marshall Space Flight Center by the Engineering Cost Group, Applied Research Incorporated and Pittsburg State University. This study took place over a period of four months in mid 1992. The purpose of the study was to identify potential NWODB which could lead to improved cost effectiveness within NASA and to quantify potential cost benefits that might accrue if these NWODB were implemented.

  4. The long memory and the transaction cost in financial markets

    NASA Astrophysics Data System (ADS)

    Li, Daye; Nishimura, Yusaku; Men, Ming

    2016-01-01

    In the present work, we investigate the fractal dimensions of 30 important stock markets from 2006 to 2013; the analysis indicates that the Hurst exponent of emerging markets shifts significantly away from the standard Brownian motion. We propose a model based on the Hurst exponent to explore the considerable profits from the predictable long-term memory. We take the transaction cost into account to justify why the market inefficiency has not been arbitraged away in the majority of cases. The empirical evidence indicates that the majority of the markets are efficient with a certain transaction cost under the no-arbitrage assumption. Furthermore, we use the Monte Carlo simulation to display "the efficient frontier" of the Hurst exponent with different transaction costs.

  5. Rectenna session: Micro aspects. [energy conversion

    NASA Technical Reports Server (NTRS)

    Gutmann, R. J.

    1980-01-01

    Two micro aspects of the rectenna design are addressed: evaluation of the degradation in net rectenna RF to DC conversion efficiency due to power density variations across the rectenna (power combining analysis) and design of Yagi-Uda receiving elements to reduce rectenna cost by decreasing the number of conversion circuits (directional receiving elements). The first of these micro aspects involves resolving a fundamental question of efficiency potential with a rectenna, while the second involves a design modification with a large potential cost saving.

  6. A comparative cost analysis of insecticide-treated nets and indoor residual spraying in highland Kenya.

    PubMed

    Guyatt, H L; Kinnear, J; Burini, M; Snow, R W

    2002-06-01

    The relative cost of indoor residual house-spraying (IRS) versus insecticide-treated bednets (ITNs) forms part of decisions regarding selective malaria prevention. This paper presents a cost comparison of these two approaches as recently implemented by Merlin, a UK emergency relief organization funded through international donor support and working in the highland districts of Gucha and Kisii in Kenya. The financial costs (cash expenditures) and the economic costs (including the opportunity costs of using existing staff and volunteers, and an annualized cost for capital items) were assessed. The financial cost for IRS was US dollars 0.86 per person protected, compared with 4.21 dollars for ITNs (reducing to 3.42 dollars to the provider assuming cost recovery). The economic cost per person protected for IRS was 0.88 dollars, compared with 2.34 dollars for ITNs. The costs for ITNs were sensitive to the number of nets sold per community group ('efficiency'), as the delivery costs constituted upwards of 40% of the total cost. However, even marked increases in efficiency of these groups could not reduce the costs of ITNs to that comparable with IRS, except if more than one cycle of IRS was needed. The implications of predicted reductions in the cost of insecticide for both IRS and ITNs are also explored. The provision of itemized cost data allows predictions to be made on changes in the design of these programmes. Under almost all design scenarios, IRS would appear to be a more cost-efficient means of vector control in the Kenyan highlands.

  7. Thermo-economic analysis of a trigeneration HCPVT power plant

    NASA Astrophysics Data System (ADS)

    Selviaridis, Angelos; Burg, Brian R.; Wallerand, Anna Sophia; Maréchal, François; Michel, Bruno

    2015-09-01

    The increasing need for electricity and heat in a growing global economy must be combined with CO2 emissions reduction, in order to limit the human influence on the environment. This calls for energy-efficient and cost-competitive renewable energy systems that are able to satisfy both pressing needs. A High-Concentration Photovoltaic Thermal (HCPVT) system is a cogeneration concept that shows promising potential in delivering electricity and heat in an efficient and cost-competitive manner. This study investigates the transient behavior of the HCPVT system and presents a thermo-economic analysis of a MW-scale trigeneration (electricity, heating and cooling) power plant. Transient simulations show a fast dynamic response of the system which results in short heat-up intervals, maximizing heat recuperation throughout the day. Despite suboptimal coupling between demand and supply, partial heat utilization throughout the year and low COP of commercially available devices for the conversion of heat into cooling, the thermo-economic analysis shows promising economic behavior, with a levelized cost of electricity close to current retail prices.

  8. Cost and performance model for redox flow batteries

    NASA Astrophysics Data System (ADS)

    Viswanathan, Vilayanur; Crawford, Alasdair; Stephenson, David; Kim, Soowhan; Wang, Wei; Li, Bin; Coffey, Greg; Thomsen, Ed; Graff, Gordon; Balducci, Patrick; Kintner-Meyer, Michael; Sprenkle, Vincent

    2014-02-01

    A cost model is developed for all vanadium and iron-vanadium redox flow batteries. Electrochemical performance modeling is done to estimate stack performance at various power densities as a function of state of charge and operating conditions. This is supplemented with a shunt current model and a pumping loss model to estimate actual system efficiency. The operating parameters such as power density, flow rates and design parameters such as electrode aspect ratio and flow frame channel dimensions are adjusted to maximize efficiency and minimize capital costs. Detailed cost estimates are obtained from various vendors to calculate cost estimates for present, near-term and optimistic scenarios. The most cost-effective chemistries with optimum operating conditions for power or energy intensive applications are determined, providing a roadmap for battery management systems development for redox flow batteries. The main drivers for cost reduction for various chemistries are identified as a function of the energy to power ratio of the storage system. Levelized cost analysis further guide suitability of various chemistries for different applications.

  9. Nurse staffing patterns and hospital efficiency in the United States.

    PubMed

    Bloom, J R; Alexander, J A; Nuchols, B A

    1997-01-01

    The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.

  10. The Costs of Delivering Integrated HIV and Sexual Reproductive Health Services in Limited Resource Settings.

    PubMed

    Obure, Carol Dayo; Sweeney, Sedona; Darsamo, Vanessa; Michaels-Igbokwe, Christine; Guinness, Lorna; Terris-Prestholt, Fern; Muketo, Esther; Nhlabatsi, Zelda; Warren, Charlotte E; Mayhew, Susannah; Watts, Charlotte; Vassall, Anna

    2015-01-01

    To present evidence on the total costs and unit costs of delivering six integrated sexual reproductive health and HIV services in a high and medium HIV prevalence setting, in order to support policy makers and planners scaling up these essential services. A retrospective facility based costing study conducted in 40 non-government organization and public health facilities in Kenya and Swaziland. Economic and financial costs were collected retrospectively for the year 2010/11, from each study site with an aim to estimate the cost per visit of six integrated HIV and SRH services. A full cost analysis using a combination of bottom-up and step-down costing methods was conducted from the health provider's perspective. The main unit of analysis is the economic unit cost per visit for each service. Costs are converted to 2013 International dollars. The mean cost per visit for the HIV/SRH services ranged from $Int 14.23 (PNC visit) to $Int 74.21 (HIV treatment visit). We found considerable variation in the unit costs per visit across settings with family planning services exhibiting the least variation ($Int 6.71-52.24) and STI treatment and HIV treatment visits exhibiting the highest variation in unit cost ranging from ($Int 5.44-281.85) and ($Int 0.83-314.95), respectively. Unit costs of visits were driven by fixed costs while variability in visit costs across facilities was explained mainly by technology used and service maturity. For all services, variability in unit costs and cost components suggest that potential exists to reduce costs through better use of both human and capital resources, despite the high proportion of expenditure on drugs and medical supplies. Further work is required to explore the key drivers of efficiency and interventions that may facilitate efficiency improvements.

  11. Financial sustainability in municipal solid waste management--costs and revenues in Bahir Dar, Ethiopia.

    PubMed

    Lohri, Christian Riuji; Camenzind, Ephraim Joseph; Zurbrügg, Christian

    2014-02-01

    Providing good solid waste management (SWM) services while also ensuring financial sustainability of the system continues to be a major challenge in cities of developing countries. Bahir Dar in northwestern Ethiopia outsourced municipal waste services to a private waste company in 2008. While this institutional change has led to substantial improvement in the cleanliness of the city, its financial sustainability remains unclear. Is the private company able to generate sufficient revenues from their activities to offset the costs and generate some profit? This paper presents a cost-revenue analysis, based on data from July 2009 to June 2011. The analysis reveals that overall costs in Bahir Dar's SWM system increased significantly during this period, mainly due to rising costs related to waste transportation. On the other hand, there is only one major revenue stream in place: the waste collection fee from households, commercial enterprises and institutions. As the efficiency of fee collection from households is only around 50%, the total amount of revenues are not sufficient to cover the running costs. This results in a substantial yearly deficit. The results of the research therefore show that a more detailed cost structure and cost-revenue analysis of this waste management service is important with appropriate measures, either by the privates sector itself or with the support of the local authorities, in order to enhance cost efficiency and balance the cost-revenues towards cost recovery. Delays in mitigating the evident financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Corps of Engineers’ Acquisition of Fish Hatchery Proves Costly.

    DTIC Science & Technology

    1981-09-18

    location, size, esti- mated cost, design , and construction timetables for facilities needed to meet the steelhead production requirements. To limit...hatchery "* * * is not recognized to be one of the more efficient and productive facilities in Idaho due to obvious con- straints in design , construction...agency’s decision to supply the product or service it- self because it would cost less must be supported by a comparativ , cost analysis. According to Corps

  13. Are drug-coated balloons cost effective for femoropopliteal occlusive disease? A comparison of bare metal stents and uncoated balloons.

    PubMed

    Poder, Thomas G; Fisette, Jean-François

    2016-07-01

    To perform a cost-effectiveness analysis to help hospital decision-makers with regard to the use of drug-coated balloons compared with bare metal stents and uncoated balloons for femoropopliteal occlusive disease. Clinical outcomes were extracted from the results of meta-analyses already published, and cost units are those used in the Quebec healthcare network. The literature review was limited to the last four years to obtain the most recent data. The cost-effectiveness analysis was based on a 2-year perspective, and risk factors of reintervention were considered. The cost-effectiveness analysis indicated that drug-coated balloons were generally more efficient than bare metal stents, particularly for patients with higher risk of reintervention (up to CAD$1686 per patient TASC II C or D). Compared with uncoated balloons, results indicated that drug-coated balloons were more efficient if the reintervention rate associated with uncoated balloons is very high and for patients with higher risk of reintervention (up to CAD$3301 per patient). The higher a patient's risk of reintervention, the higher the savings associated with the use of a drug-coated balloon will be. For patients at lower risk, the uncoated balloon strategy is still recommended as a first choice for endovascular intervention.

  14. The Importance of Powertrain Downsizing in a Benefit-Cost Analysis of Vehicle Lightweighting

    NASA Astrophysics Data System (ADS)

    Ward, J.; Gohlke, D.; Nealer, R.

    2017-04-01

    Reducing vehicle weight is an important avenue to improve energy efficiency and decrease greenhouse gas emissions from our cars and trucks. Conventionally, models have estimated acceptable increased manufacturing cost as proportional to the lifetime fuel savings associated with reduced vehicle weight. Vehicle lightweighting also enables a decrease in powertrain size and significant reductions in powertrain cost. Accordingly, we propose and apply a method for calculating the maximum net benefits and breakeven cost of vehicle lightweighting that considers both efficiency and powertrain downsizing for a conventional internal combustion engine vehicle, a battery electric vehicle with a range of 300 miles (BEV300), and a fuel cell electric vehicle (FCEV). We find that excluding powertrain downsizing cost savings undervalues the potential total net benefits of vehicle lightweighting, especially for the BEV300 and FCEV.

  15. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    PubMed Central

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V.; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    Background: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. Methods: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Results: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). Conclusion: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level. PMID:24688915

  16. Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

    PubMed

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

  17. Pavement Smoothness and Fuel Efficiency: An Analysis of the Economic Dimensions of the Missouri Smooth Roads Initiative.

    DOT National Transportation Integrated Search

    2006-11-01

    Its widely accepted that smooth roads provide greater driver comfort and satisfaction, decreased vehicle maintenance costs, and better fuel economy. Now thanks to a recently completed study, the affect of pavement smoothness on fuel efficiency has...

  18. Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

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

    Letschert, Virginie E.; Bojda, Nicholas; Ke, Jing

    2012-07-01

    This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programsmore » while still saving consumers money?« less

  19. Solar cells and modules from dentritic web silicon

    NASA Technical Reports Server (NTRS)

    Campbell, R. B.; Rohatgi, A.; Seman, E. J.; Davis, J. R.; Rai-Choudhury, P.; Gallagher, B. D.

    1980-01-01

    Some of the noteworthy features of the processes developed in the fabrication of solar cell modules are the handling of long lengths of web, the use of cost effective dip coating of photoresist and antireflection coatings, selective electroplating of the grid pattern and ultrasonic bonding of the cell interconnect. Data on the cells is obtained by means of dark I-V analysis and deep level transient spectroscopy. A histogram of over 100 dentritic web solar cells fabricated in a number of runs using different web crystals shows an average efficiency of over 13%, with some efficiencies running above 15%. Lower cell efficiency is generally associated with low minority carrier time due to recombination centers sometimes present in the bulk silicon. A cost analysis of the process sequence using a 25 MW production line indicates a selling price of $0.75/peak watt in 1986. It is concluded that the efficiency of dentritic web cells approaches that of float zone silicon cells, reduced somewhat by the lower bulk lifetime of the former.

  20. Cost-efficiency of specialist hyperacute in-patient rehabilitation services for medically unstable patients with complex rehabilitation needs: a prospective cohort analysis.

    PubMed

    Turner-Stokes, Lynne; Bavikatte, Ganesh; Williams, Heather; Bill, Alan; Sephton, Keith

    2016-09-08

    To evaluate functional outcomes, care needs and cost-efficiency of hyperacute (HA) rehabilitation for a cohort of in-patients with complex neurological disability and unstable medical/surgical conditions. A multicentre cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database, 2012-2015. Two HA specialist rehabilitation services in England, providing different service models for HA rehabilitation. All patients admitted to each of the units with an admission rehabilitation complexity M score of ≥3 (N=190; mean age 46 (SD16) years; males:females 63:37%). Diagnoses were acquired brain injury (n=166; 87%), spinal cord injury (n=9; 5%), peripheral neurological conditions (n=9; 5%) and other (n=6; 3%). Specialist in-patient multidisciplinary rehabilitation combined with management and stabilisation of intercurrent medical and surgical problems. Rehabilitation complexity and medical acuity: Rehabilitation Complexity Scale-version 13. Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA). Functional independence: UK Functional Assessment Measure (UK FIM+FAM). (1) reduction in dependency and (2) cost-efficiency, measured as the time taken to offset rehabilitation costs by savings in NPCNA-estimated costs of on-going care in the community. The mean length of stay was 103 (SD66) days. Some differences were observed between the two units, which were in keeping with the different service models. However, both units showed a significant reduction in dependency and acuity between admission and discharge on all measures (Wilcoxon: p<0.001). For the 180 (95%) patients with complete NPCNA data, the mean episode cost was £77 119 (bootstrapped 95% CI £70 614 to £83 894) and the mean reduction in 'weekly care costs' was £462/week (95% CI 349 to 582). The mean time to offset the cost of rehabilitation was 27.6 months (95% CI 13.2 to 43.8). Despite its relatively high initial cost, specialist HA rehabilitation can be highly cost-efficient, producing substantial savings in on-going care costs, and relieving pressure in the acute care services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Efficient Coding and Energy Efficiency Are Promoted by Balanced Excitatory and Inhibitory Synaptic Currents in Neuronal Network

    PubMed Central

    Yu, Lianchun; Shen, Zhou; Wang, Chen; Yu, Yuguo

    2018-01-01

    Selective pressure may drive neural systems to process as much information as possible with the lowest energy cost. Recent experiment evidence revealed that the ratio between synaptic excitation and inhibition (E/I) in local cortex is generally maintained at a certain value which may influence the efficiency of energy consumption and information transmission of neural networks. To understand this issue deeply, we constructed a typical recurrent Hodgkin-Huxley network model and studied the general principles that governs the relationship among the E/I synaptic current ratio, the energy cost and total amount of information transmission. We observed in such a network that there exists an optimal E/I synaptic current ratio in the network by which the information transmission achieves the maximum with relatively low energy cost. The coding energy efficiency which is defined as the mutual information divided by the energy cost, achieved the maximum with the balanced synaptic current. Although background noise degrades information transmission and imposes an additional energy cost, we find an optimal noise intensity that yields the largest information transmission and energy efficiency at this optimal E/I synaptic transmission ratio. The maximization of energy efficiency also requires a certain part of energy cost associated with spontaneous spiking and synaptic activities. We further proved this finding with analytical solution based on the response function of bistable neurons, and demonstrated that optimal net synaptic currents are capable of maximizing both the mutual information and energy efficiency. These results revealed that the development of E/I synaptic current balance could lead a cortical network to operate at a highly efficient information transmission rate at a relatively low energy cost. The generality of neuronal models and the recurrent network configuration used here suggest that the existence of an optimal E/I cell ratio for highly efficient energy costs and information maximization is a potential principle for cortical circuit networks. Summary We conducted numerical simulations and mathematical analysis to examine the energy efficiency of neural information transmission in a recurrent network as a function of the ratio of excitatory and inhibitory synaptic connections. We obtained a general solution showing that there exists an optimal E/I synaptic ratio in a recurrent network at which the information transmission as well as the energy efficiency of this network achieves a global maximum. These results reflect general mechanisms for sensory coding processes, which may give insight into the energy efficiency of neural communication and coding. PMID:29773979

  2. Efficient Coding and Energy Efficiency Are Promoted by Balanced Excitatory and Inhibitory Synaptic Currents in Neuronal Network.

    PubMed

    Yu, Lianchun; Shen, Zhou; Wang, Chen; Yu, Yuguo

    2018-01-01

    Selective pressure may drive neural systems to process as much information as possible with the lowest energy cost. Recent experiment evidence revealed that the ratio between synaptic excitation and inhibition (E/I) in local cortex is generally maintained at a certain value which may influence the efficiency of energy consumption and information transmission of neural networks. To understand this issue deeply, we constructed a typical recurrent Hodgkin-Huxley network model and studied the general principles that governs the relationship among the E/I synaptic current ratio, the energy cost and total amount of information transmission. We observed in such a network that there exists an optimal E/I synaptic current ratio in the network by which the information transmission achieves the maximum with relatively low energy cost. The coding energy efficiency which is defined as the mutual information divided by the energy cost, achieved the maximum with the balanced synaptic current. Although background noise degrades information transmission and imposes an additional energy cost, we find an optimal noise intensity that yields the largest information transmission and energy efficiency at this optimal E/I synaptic transmission ratio. The maximization of energy efficiency also requires a certain part of energy cost associated with spontaneous spiking and synaptic activities. We further proved this finding with analytical solution based on the response function of bistable neurons, and demonstrated that optimal net synaptic currents are capable of maximizing both the mutual information and energy efficiency. These results revealed that the development of E/I synaptic current balance could lead a cortical network to operate at a highly efficient information transmission rate at a relatively low energy cost. The generality of neuronal models and the recurrent network configuration used here suggest that the existence of an optimal E/I cell ratio for highly efficient energy costs and information maximization is a potential principle for cortical circuit networks. We conducted numerical simulations and mathematical analysis to examine the energy efficiency of neural information transmission in a recurrent network as a function of the ratio of excitatory and inhibitory synaptic connections. We obtained a general solution showing that there exists an optimal E/I synaptic ratio in a recurrent network at which the information transmission as well as the energy efficiency of this network achieves a global maximum. These results reflect general mechanisms for sensory coding processes, which may give insight into the energy efficiency of neural communication and coding.

  3. PRODUCTION AND ECONOMIC OPTIMIZATION OF DIETARY PROTEIN AND CARBOHYDRATE IN THE CULTURE OF JUVENILE SEA URCHIN Lytechinus variegatus

    PubMed Central

    Heflin, Laura E.; Makowsky, Robert; Taylor, J. Christopher; Williams, Michael B.; Lawrence, Addison L.; Watts, Stephen A.

    2016-01-01

    Juvenile Lytechinus variegatus (ca. 3.95± 0.54 g) were fed one of 10 formulated diets with different protein (ranging from 11- 43%) and carbohydrate (12 or 18%; brackets determined from previous studies) levels. Urchins (n= 16 per treatment) were fed a daily sub-satiation ration equivalent to 2.0% of average body weight for 10 weeks. Our objective was (1) to create predictive models of growth, production and efficiency outcomes and (2) to generate economic analysis models in relation to these dietary outcomes for juvenile L. variegatus held in culture. At dietary protein levels below ca. 30%, models for most growth and production outcomes predicted increased rates of growth and production among urchins fed diets containing 18% dietary carbohydrate levels as compared to urchins fed diets containing 12% dietary carbohydrate. For most outcomes, growth and production was predicted to increase with increasing level of dietary protein up to ca. 30%, after which, no further increase in growth and production were predicted. Likewise, dry matter production efficiency was predicted to increase with increasing protein level up to ca. 30%, with urchins fed diets with 18% carbohydrate exhibiting greater efficiency than those fed diets with 12% carbohydrate. The energetic cost of dry matter production was optimal at protein levels less than those required for maximal weight gain and gonad production, suggesting an increased energetic cost (decreased energy efficiency) is required to increase gonad production relative to somatic growth. Economic analysis models predict when cost of feed ingredients are low, the lowest cost per gram of wet weight gain will occur at 18% dietary carbohydrate and ca. 25- 30% dietary protein. In contrast, lowest cost per gram of wet weight gain will occur at 12% dietary carbohydrate and ca. 35- 40% dietary protein when feed ingredient costs are high or average. For both 18 and 12% levels of dietary carbohydrate, cost per gram of wet weight gain is predicted to be maximized at low dietary protein levels, regardless of feed ingredient costs. These models will compare dietary requirements and growth outcomes in relation to economic costs and provide insight for future commercialization of sea urchin aquaculture. PMID:28082753

  4. PRODUCTION AND ECONOMIC OPTIMIZATION OF DIETARY PROTEIN AND CARBOHYDRATE IN THE CULTURE OF JUVENILE SEA URCHIN Lytechinus variegatus.

    PubMed

    Heflin, Laura E; Makowsky, Robert; Taylor, J Christopher; Williams, Michael B; Lawrence, Addison L; Watts, Stephen A

    2016-10-01

    Juvenile Lytechinus variegatus (ca. 3.95± 0.54 g) were fed one of 10 formulated diets with different protein (ranging from 11- 43%) and carbohydrate (12 or 18%; brackets determined from previous studies) levels. Urchins (n= 16 per treatment) were fed a daily sub-satiation ration equivalent to 2.0% of average body weight for 10 weeks. Our objective was (1) to create predictive models of growth, production and efficiency outcomes and (2) to generate economic analysis models in relation to these dietary outcomes for juvenile L. variegatus held in culture. At dietary protein levels below ca. 30%, models for most growth and production outcomes predicted increased rates of growth and production among urchins fed diets containing 18% dietary carbohydrate levels as compared to urchins fed diets containing 12% dietary carbohydrate. For most outcomes, growth and production was predicted to increase with increasing level of dietary protein up to ca. 30%, after which, no further increase in growth and production were predicted. Likewise, dry matter production efficiency was predicted to increase with increasing protein level up to ca. 30%, with urchins fed diets with 18% carbohydrate exhibiting greater efficiency than those fed diets with 12% carbohydrate. The energetic cost of dry matter production was optimal at protein levels less than those required for maximal weight gain and gonad production, suggesting an increased energetic cost (decreased energy efficiency) is required to increase gonad production relative to somatic growth. Economic analysis models predict when cost of feed ingredients are low, the lowest cost per gram of wet weight gain will occur at 18% dietary carbohydrate and ca. 25- 30% dietary protein. In contrast, lowest cost per gram of wet weight gain will occur at 12% dietary carbohydrate and ca. 35- 40% dietary protein when feed ingredient costs are high or average. For both 18 and 12% levels of dietary carbohydrate, cost per gram of wet weight gain is predicted to be maximized at low dietary protein levels, regardless of feed ingredient costs. These models will compare dietary requirements and growth outcomes in relation to economic costs and provide insight for future commercialization of sea urchin aquaculture.

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

    Lohri, Christian Riuji, E-mail: christian.lohri@eawag.ch; Camenzind, Ephraim Joseph, E-mail: ephraimcamenzind@hotmail.com; Zurbrügg, Christian, E-mail: christian.zurbruegg@eawag.ch

    Highlights: • Cost-revenue analysis over 2 years revealed insufficient cost-recovery. • Expenses for motorized secondary collection increased by 82% over two years. • Low fee collection rate and reliance on only one revenue stream are problematic. • Different options for cost reduction and enhanced revenue streams are recommended. • Good public–private alliance is crucial to plan and implement improvement measures. - Abstract: Providing good solid waste management (SWM) services while also ensuring financial sustainability of the system continues to be a major challenge in cities of developing countries. Bahir Dar in northwestern Ethiopia outsourced municipal waste services to a privatemore » waste company in 2008. While this institutional change has led to substantial improvement in the cleanliness of the city, its financial sustainability remains unclear. Is the private company able to generate sufficient revenues from their activities to offset the costs and generate some profit? This paper presents a cost-revenue analysis, based on data from July 2009 to June 2011. The analysis reveals that overall costs in Bahir Dar’s SWM system increased significantly during this period, mainly due to rising costs related to waste transportation. On the other hand, there is only one major revenue stream in place: the waste collection fee from households, commercial enterprises and institutions. As the efficiency of fee collection from households is only around 50%, the total amount of revenues are not sufficient to cover the running costs. This results in a substantial yearly deficit. The results of the research therefore show that a more detailed cost structure and cost-revenue analysis of this waste management service is important with appropriate measures, either by the privates sector itself or with the support of the local authorities, in order to enhance cost efficiency and balance the cost-revenues towards cost recovery. Delays in mitigating the evident financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented.« less

  6. Staged, High-Pressure Oxy-Combustion Technology: Development and Scale-Up

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

    Axelbaum, Richard; Kumfer, Benjamin; Gopan, Akshay

    The immediate need for a high efficiency, low cost carbon capture process has prompted the recent development of pressurized oxy-combustion. With a greater combustion pressure the dew point of the flue gas is increased, allowing for effective integration of the latent heat of flue gas moisture into the Rankine cycle. This increases the net plant efficiency and reduces costs. A novel, transformational process, named Staged, Pressurized Oxy-Combustion (SPOC), achieves additional step changes in efficiency and cost reduction by significantly reducing the recycle of flue gas. The research and development activities conducted under Phases I and II of this project (FE0009702)more » include: SPOC power plant cost and performance modeling, CFD-assisted design of pressurized SPOC boilers, theoretical analysis of radiant heat transfer and ash deposition, boiler materials corrosion testing, construction of a 100 kWth POC test facility, and experimental testing. The results of this project have advanced the technology readiness level (TRL) of the SPOC technology from 1 to 5.« less

  7. Numerical modeling of uncertainty and variability in the technology, manufacturing, and economics of crystalline silicon photovoltaics

    NASA Astrophysics Data System (ADS)

    Ristow, Alan H.

    2008-10-01

    Electricity generated from photovoltaics (PV) promises to satisfy the world's ever-growing thirst for energy without significant pollution and greenhouse gas emissions. At present, however, PV is several times too expensive to compete economically with conventional sources of electricity delivered via the power grid. To ensure long-term success, must achieve cost parity with electricity generated by conventional sources of electricity. This requires detailed understanding of the relationship between technology and economics as it pertains to PV devices and systems. The research tasks of this thesis focus on developing and using four types of models in concert to develop a complete picture of how solar cell technology and design choices affect the quantity and cost of energy produced by PV systems. It is shown in this thesis that high-efficiency solar cells can leverage balance-of-systems (BOS) costs to gain an economic advantage over solar cells with low efficiencies. This advantage is quantified and dubbed the "efficiency premium." Solar cell device models are linked to models of manufacturing cost and PV system performance to estimate both PV system cost and performance. These, in turn, are linked to a model of levelized electricity cost to estimate the per-kilowatt-hour cost of electricity produced by the PV system. A numerical PV module manufacturing cost model is developed to facilitate this analysis. The models and methods developed in this thesis are used to propose a roadmap to high-efficiency multicrystalline-silicon PV modules that achieve cost parity with electricity from the grid. The impact of PV system failures on the cost of electricity is also investigated; from this, a methodology is proposed for improving the reliability of PV inverters.

  8. Fluorescent Lamp Replacement Study

    DTIC Science & Technology

    2017-07-01

    friendly products, advances in efficiency, and lower production costs for lamps. The conversion of fluorescent bulbs to LED technology has many benefits ...of 4727 W. An economic analysis was calculated to compare the various lighting technologies that were implemented at ATC and the cost benefits ...the various lighting technologies that were implemented at ATC and the cost benefits of each, a lifecycle comparison was made between the fluorescent

  9. Exploring Opportunities for Efficiency and Joint Provision of Services Using Nonappropriated Funds

    DTIC Science & Technology

    2016-01-01

    analyzed two of them: accounting and employee benefits. RAND assessed the rec- ommendations’ costs , detailed the potential challenges, and identified...Consolidated Service Center: This option would standardize all accounting , including the SGL, cost - center structures, and core feeder and financial...ings of about $100 million would go toward replacing its out- dated accounting system. The analysis considered the costs of developing, deploying

  10. Structures performance, benefit, cost-study

    NASA Technical Reports Server (NTRS)

    Woike, O. G.; Salemme, C.; Stearns, E.; Oritz, P.; Roberts, M. L.; Baughman, J. L.; Johnston, R. P.; Demel, H. F.; Stabrylla, R. G.; Coffinberry, G. A.

    1981-01-01

    New technology concepts and structural analysis development needs which could lead to improved life cycle cost for future high-bypass turbofans were studied. The NASA-GE energy efficient engine technology is used as a base to assess the concept benefits. Recommended programs are identified for attaining these generic structural and other beneficial technologies.

  11. Cost analysis and the practicing radiologist/manager: an introduction to managerial accounting.

    PubMed

    Forman, H P; Yin, D

    1996-06-01

    Cost analysis is inherently one of the most tedious tasks falling on the shoulders of any manager. In today's world, whether in a service business such as radiology or medicine or in a product line such as car manufacturing, accurate cost analysis is critical to all aspects of management: marketing, competitive strategy, quality control, human resource management, accounting (financial), and operations management, to name but a few. This is a topic that we will explore with the intention of giving the radiologist/manager the understanding and the basic skills to use cost analysis efficiently, making sure that major financial decisions are being made with adequate cost information, and showing that cost accounting is really managerial accounting in that it pays little attention to the bottom line of financial statements but places much more emphasis on equipping managers with the information to determine budgets, prices, salaries, and incentives and influences capital budgeting decisions through an understanding of product profitability rather than firm profitability.

  12. An economic framework for preventive care advice.

    PubMed

    Pauly, Mark V; Sloan, Frank A; Sullivan, Sean D

    2014-11-01

    Under the Affordable Care Act, preventive care measures, including vaccinations and screenings, recommended by the Advisory Committee on Immunization Practices and the US Preventive Services Task Force must be covered in full by insurance. These recommendations affect the cost of medical care. Yet neither organization explicitly incorporates measures of efficiency or cost-effectiveness in making its recommendations. To redress this shortcoming, we propose a decision-making framework for these two organizations based on the principles of economic efficiency. Our analysis suggests that routine use of a preventive service should be recommended for full insurance coverage if the service's cost-effectiveness exceeds a socially determined threshold. For less cost-effective services, we suggest that information about effectiveness and cost should be provided to consumers by physicians or government, but the choice of care and insurance coverage for care should be made by individuals. For the least cost-effective services, the two organizations should discourage public and private insurers from covering such services and report their unfavorable cost-effectiveness. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Evaluating ecommerce websites cognitive efficiency: an integrative framework based on data envelopment analysis.

    PubMed

    Lo Storto, Corrado

    2013-11-01

    This paper presents an integrative framework to evaluate ecommerce website efficiency from the user viewpoint using Data Envelopment Analysis (DEA). This framework is inspired by concepts driven from theories of information processing and cognition and considers the website efficiency as a measure of its quality and performance. When the users interact with the website interfaces to perform a task, they are involved in a cognitive effort, sustaining a cognitive cost to search, interpret and process information, and experiencing either a sense of satisfaction or dissatisfaction for that. The amount of ambiguity and uncertainty, and the search (over-)time during navigation that they perceive determine the effort size - and, as a consequence, the cognitive cost amount - they have to bear to perform their task. On the contrary, task performing and result achievement provide the users with cognitive benefits, making interaction with the website potentially attractive, satisfying, and useful. In total, 9 variables are measured, classified in a set of 3 website macro-dimensions (user experience, site navigability and structure). The framework is implemented to compare 52 ecommerce websites that sell products in the information technology and media market. A stepwise regression is performed to assess the influence of cognitive costs and benefits that mostly affect website efficiency. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  14. A study on technical efficiency of a DMU (review of literature)

    NASA Astrophysics Data System (ADS)

    Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Sankar, J. Ravi

    2017-11-01

    In this research paper the concept of technical efficiency (due to Farell) [1] of a decision making unit (DMU) has been introduced and the measure of technical and cost efficiencies are derived. Timmer’s [2] deterministic approach to estimate the Cobb-Douglas production frontier has been proposed. The idea of extension of Timmer’s [2] method to any production frontier which is linear in parameters has been presented here. The estimation of parameters of Cobb-Douglas production frontier by linear programming approach has been discussed in this paper. Mark et al. [3] proposed a non-parametric method to assess efficiency. Nuti et al. [4] investigated the relationships among technical efficiency scores, weighted per capita cost and overall performance Gahe Zing Samuel Yank et al. [5] used Data envelopment analysis to assess technical assessment in banking sectors.

  15. Reviewing the economic efficiency of disaster risk management

    NASA Astrophysics Data System (ADS)

    Mechler, Reinhard

    2013-04-01

    There is a lot of rhetoric suggesting that disaster risk management (DRM) pays, yet surprisingly little in the way of hard facts. Cost-benefit analysis (CBA) is one major tool that can provide quantitative information about the prioritization of disaster risk management (DRM) (and climate adaptation) based on economic principles. Yet, on a global scale, there has been surprisingly little robust evidence on the economic efficiency and benefits of risk management measures. This review shows that for the limited evidence reported the economic case for DRM across a range of hazards is strong and that the benefits of investing in DRM outweigh the costs of doing so, on average, by about four times the cost in terms of avoided and reduced losses. Most studies using a CBA approach focus on structural DRM and most information has been made available on physical flood prevention. There have been some limited studies on preparedness and risk financing. The global evidence base is limited and estimates appear not very solid, and overall, in line with the conclusion of the recent IPCC SREX report, there is limited evidence and medium agreement across the literature. Some of the factors behind the limited robustness are inherent to CBA more widely: these challenges comprise the inability to price intangibles, evaluating strategies rather than single projects, difficulties in assessing softer rather than infrastructure-related options, choices regarding a proper discount rate, lack of accounting for the distribution of benefits and costs and difficulties with assessing nonmarket values such as those related to health, the environment, or public goods. Although techniques exist to address some of these challenges, they are not very likely to easily go away. Other challenges associated specifically with DRM, such as the need and difficulty to undertake risk -based analysis can be overcome, and there have been manuals and reports providing a way forward. In an age of austerity, cost-benefit analysis continues to be an important tool for prioritising efficient DRM measures, yet with a shifting emphasis from infrastructure-based options (hard resilience) to preparedness and systemic interventions (soft resilience), other tools such as cost-effectiveness analysis, multi-criteria analysis and robust decision-making approaches deserve more attention.

  16. Energy analysis and agriculture: an application to US Corn Production

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

    Smil, V.; Nachman, P.; Long, T.V. II

    1983-01-01

    Changes in farming technology have increased the amount and cost of energy used in crop production, raising the question of whether energy efficiency in agriculture has remained constant, decreased, or increased. Despite some studies to the contrary, the authors assert that all essential energy used, both directly and indirectly, in US corn farming has remained constant in relation to crop production during the past two decades. Using a detailed process of energy analysis that takes into account various management and technological changes, they trace and quantify the energy cost of corn production from 1945-1947 and forecast its changes through 1984.more » They conclude that the energy efficiency of corn farming has not declined, and find that future technological and process improvements, led by conservation measures, will likely increase its energy efficiency in the 1980s. 39 references, 33 figures, 88 tables.« less

  17. An experimental strategy validated to design cost-effective culture media based on response surface methodology.

    PubMed

    Navarrete-Bolaños, J L; Téllez-Martínez, M G; Miranda-López, R; Jiménez-Islas, H

    2017-07-03

    For any fermentation process, the production cost depends on several factors, such as the genetics of the microorganism, the process condition, and the culture medium composition. In this work, a guideline for the design of cost-efficient culture media using a sequential approach based on response surface methodology is described. The procedure was applied to analyze and optimize a culture medium of registered trademark and a base culture medium obtained as a result of the screening analysis from different culture media used to grow the same strain according to the literature. During the experiments, the procedure quantitatively identified an appropriate array of micronutrients to obtain a significant yield and find a minimum number of culture medium ingredients without limiting the process efficiency. The resultant culture medium showed an efficiency that compares favorably with the registered trademark medium at a 95% lower cost as well as reduced the number of ingredients in the base culture medium by 60% without limiting the process efficiency. These results demonstrated that, aside from satisfying the qualitative requirements, an optimum quantity of each constituent is needed to obtain a cost-effective culture medium. Study process variables for optimized culture medium and scaling-up production for the optimal values are desirable.

  18. An Analysis of the Efficiency of Sourcing Knowledge-Based Services in the United States Air Force

    DTIC Science & Technology

    2013-05-30

    those cost drivers that are unnecessary in order to cut costs. In 1996 , Coopers and Lybrand identified over 120 mandated cost drivers that contributed...to an 18% price premium for federally procured commodities and services (GAO, 1996 ). The top 10 cost drivers listed in this study (GAO, 1996 ) were... Peterson , 2011). The assessment collected data from 119 organizations over 25 industries to establish the baseline for current and future research

  19. A global overview of health insurance administrative costs: what are the reasons for variations found?

    PubMed

    Mathauer, Inke; Nicolle, Emmanuelle

    2011-10-01

    Administrative costs are an important spending category in total health insurance expenditure. Yet, they have rarely been a topic outside the US and there is no cross-country comparison available. This paper provides a global overview and analysis of administrative costs for social security schemes (SSS) and private health insurance schemes (PHI). The analysis is based on data of the World Health Organization (WHO) National Health Accounts (NHA) and the Organisation for Economic Cooperation and Development (OECD) System of Health Accounts (SHA). These are the only worldwide databases on health expenditure data. Further data was retrieved from a literature search. Administrative costs are presented as a share of total health insurance costs. Data is available for 58 countries. In high-income OECD countries, the average SSS administrative costs are 4.2%. Average PHI administrative costs are about three times higher. The shares are much higher for low- and middle-income countries. However, considerable variations across and within countries over time are revealed. Seven explanatory factors are explored to explain the variations: health financing system aspects, administrative activities undertaken, insurance design aspects, context factors, reporting format, accounting methods, and management and administrative efficiency measures. More detailed reporting of administrative costs would enhance comparability and provide benchmarks. Improved administrative efficiency could free resources to expand coverage. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Ceramic automotive Stirling engine study

    NASA Technical Reports Server (NTRS)

    Musikant, S.; Chiu, W.; Darooka, D.; Mullings, D. M.; Johnson, C. A.

    1985-01-01

    A conceptual design study for a Ceramic Automotive Stirling Engine (CASE) is performed. Year 1990 structural ceramic technology is assumed. Structural and performance analyses of the conceptual design are performed as well as a manufacturing and cost analysis. The general conclusions from this study are that such an engine would be 10-26% more efficient over its performance map than the current metal Automotive Stirling Reference Engine (ASRE). Cost of such a ceramic engine is likely to be somewhat higher than that of the ASRE but engine cost is very sensitive to the ultimate cost of the high purity, ceramic powder raw materials required to fabricate high performance parts. When the design study is projected to the year 2000 technology, substantinal net efficiency improvements, on the order of 25 to 46% over the ASRE, are computed.

  1. Wind-To-Hydrogen Project: Electrolyzer Capital Cost Study

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

    Saur, G.

    This study is being performed as part of the U.S. Department of Energy and Xcel Energy's Wind-to-Hydrogen Project (Wind2H2) at the National Renewable Energy Laboratory. The general aim of the project is to identify areas for improving the production of hydrogen from renewable energy sources. These areas include both technical development and cost analysis of systems that convert renewable energy to hydrogen via water electrolysis. Increased efficiency and reduced cost will bring about greater market penetration for hydrogen production and application. There are different issues for isolated versus grid-connected systems, however, and these issues must be considered. The manner inmore » which hydrogen production is integrated in the larger energy system will determine its cost feasibility and energy efficiency.« less

  2. New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

    PubMed

    Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

    2011-12-01

    School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these findings highlight the higher nontransfer costs for programs delivering cooked meals in schools than for other school feeding modalities. The benchmarks presented here reflect the centralized WFP implementation model, which is not always relevant in terms of government school feeding programs, particularly those procuring within national boundaries using "home-grown" approaches.

  3. Cost-efficiency of specialist hyperacute in-patient rehabilitation services for medically unstable patients with complex rehabilitation needs: a prospective cohort analysis

    PubMed Central

    Turner-Stokes, Lynne; Bavikatte, Ganesh; Williams, Heather; Bill, Alan; Sephton, Keith

    2016-01-01

    Objectives To evaluate functional outcomes, care needs and cost-efficiency of hyperacute (HA) rehabilitation for a cohort of in-patients with complex neurological disability and unstable medical/surgical conditions. Design A multicentre cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database, 2012–2015. Setting Two HA specialist rehabilitation services in England, providing different service models for HA rehabilitation. Participants All patients admitted to each of the units with an admission rehabilitation complexity M score of ≥3 (N=190; mean age 46 (SD16) years; males:females 63:37%). Diagnoses were acquired brain injury (n=166; 87%), spinal cord injury (n=9; 5%), peripheral neurological conditions (n=9; 5%) and other (n=6; 3%). Intervention Specialist in-patient multidisciplinary rehabilitation combined with management and stabilisation of intercurrent medical and surgical problems. Outcome measures Rehabilitation complexity and medical acuity: Rehabilitation Complexity Scale—version 13. Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA). Functional independence: UK Functional Assessment Measure (UK FIM+FAM). Primary outcomes: (1) reduction in dependency and (2) cost-efficiency, measured as the time taken to offset rehabilitation costs by savings in NPCNA-estimated costs of on-going care in the community. Results The mean length of stay was 103 (SD66) days. Some differences were observed between the two units, which were in keeping with the different service models. However, both units showed a significant reduction in dependency and acuity between admission and discharge on all measures (Wilcoxon: p<0.001). For the 180 (95%) patients with complete NPCNA data, the mean episode cost was £77 119 (bootstrapped 95% CI £70 614 to £83 894) and the mean reduction in ‘weekly care costs’ was £462/week (95% CI 349 to 582). The mean time to offset the cost of rehabilitation was 27.6 months (95% CI 13.2 to 43.8). Conclusions Despite its relatively high initial cost, specialist HA rehabilitation can be highly cost-efficient, producing substantial savings in on-going care costs, and relieving pressure in the acute care services. PMID:27609852

  4. Data of cost-optimal solutions and retrofit design methods for school renovation in a warm climate.

    PubMed

    Zacà, Ilaria; Tornese, Giuliano; Baglivo, Cristina; Congedo, Paolo Maria; D'Agostino, Delia

    2016-12-01

    "Efficient Solutions and Cost-Optimal Analysis for Existing School Buildings" (Paolo Maria Congedo, Delia D'Agostino, Cristina Baglivo, Giuliano Tornese, Ilaria Zacà) [1] is the paper that refers to this article. It reports the data related to the establishment of several variants of energy efficient retrofit measures selected for two existing school buildings located in the Mediterranean area. In compliance with the cost-optimal analysis described in the Energy Performance of Buildings Directive and its guidelines (EU, Directive, EU 244,) [2], [3], these data are useful for the integration of renewable energy sources and high performance technical systems for school renovation. The data of cost-efficient high performance solutions are provided in tables that are explained within the following sections. The data focus on the describe school refurbishment sector to which European policies and investments are directed. A methodological approach already used in previous studies about new buildings is followed (Baglivo Cristina, Congedo Paolo Maria, D׳Agostino Delia, Zacà Ilaria, 2015; IlariaZacà, Delia D'Agostino, Paolo Maria Congedo, Cristina Baglivo; Baglivo Cristina, Congedo Paolo Maria, D'Agostino Delia, Zacà Ilaria, 2015; Ilaria Zacà, Delia D'Agostino, Paolo Maria Congedo, Cristina Baglivo, 2015; Paolo Maria Congedo, Cristina Baglivo, IlariaZacà, Delia D'Agostino,2015) [4], [5], [6], [7], [8]. The files give the cost-optimal solutions for a kindergarten (REF1) and a nursery (REF2) school located in Sanarica and Squinzano (province of Lecce Southern Italy). The two reference buildings differ for construction period, materials and systems. The eleven tables provided contain data about the localization of the buildings, geometrical features and thermal properties of the envelope, as well as the energy efficiency measures related to walls, windows, heating, cooling, dhw and renewables. Output values of energy consumption, gas emission and costs are given for a financial and a macro-economic analysis. This data article provides 288 and 96 combinations for REF1 and REF2, respectively. The output values are obtained using the software ProCasaClima 2015v.2.0.

  5. Economic evaluation of infection control activities.

    PubMed

    Seko, T; Tachi, T; Kawashima, N; Maeda, T; Yasuda, M; Noguchi, Y; Teramachi, H

    2017-08-01

    Healthcare-associated infections by drug-resistant bacteria affect a patient's prognosis. Infection control activities at medical institutions in Japan are increasingly focused on the threat from these bacteria. To undertake a full cost analysis that included the costs of consumables and labour required for infection control activities. The cost of infection control activities undertaken by the infection control team (ICT) at Nishimino Kosei Hospital in Japan was surveyed from January 2013 to December 2015. The evaluation index of infection control activities used the meticillin-resistant Staphylococcus aureus detection rate. The cost:effectiveness ratio (CER) of each intervention was calculated. Consumables and labour costs increased over time, as did the ratio of labour cost to total cost over time. However, the CER of interventions was found to have decreased, from ¥164,177 in 2014 to ¥57,989 in 2015. There were increases not only in the amount of consumables, but also in ICT time, suggesting the possibility of improvements in the economic efficiency of infection control. Increasing the amount of consumables and the time input of the ICT could help improve the economic efficiency of infection control. Our research suggests the possibility for improvements in the economic efficiency of infection control. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Cost analysis of plasma-exchange therapy for the treatment of Guillain-Barré syndrome. French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome.

    PubMed

    Espérou, H; Jars-Guincestre, M C; Bolgert, F; Raphaël, J C; Durand-Zaleski, I

    2000-08-01

    To undertake a cost analysis of therapeutic strategies with plasma exchange (PE) for the treatment of patients with Guillain-Barré syndrome. A randomized clinical trial including 556 patients with Guillain-Barré syndrome. We demonstrated that in the group with mild disease (walking possible) two PEs were more effective than none in shortening the time to beginning motor recovery. In the groups with moderate disease (walking impossible) and or severe disease (mechanically ventilated patients) four sessions were more effective than two and no more effective than six in shortening the time to recovery of walking with assistance and for the recovery rate of full muscle strength within 1 year. Data on outcomes and costs was collected. Complete cost data were available on 546 from the 556 patients of the trial. Costs were estimated from the viewpoint of the healthcare system and computed over a 1-year period. Because the analysis of medical outcomes did not show any difference regarding mortality but only on intermediate short-term and long-term outcomes, we carried out a cost minimization analysis. In two groups a dominant strategy appeared, with greater efficacy and lower costs in the two-PE arm for the mild group: 21,353 euros vs. 38,753 euros and in the four-PE arm in the moderate group: 59,480 euros vs. 80,737 euros. In the severe group four PEs were as efficient and somewhat less expensive than six: 57,621 vs. 61,056 euros. The treatment of Guillain-Barré syndrome by PE at the onset of disease appears to have medical justification. The least expensive strategies are either more or equally efficient as more expensive strategies.

  7. Five-year economic evaluation of non-melanoma skin cancer surgery at the Costa del Sol Hospital (2006-2010).

    PubMed

    Aguilar-Bernier, M; González-Carrascosa, M; Padilla-España, L; Rivas-Ruiz, F; Jiménez-Puente, A; de Troya-Martín, M

    2014-03-01

    The cost associated with treatment of non-melanoma skin cancer is expected to rise considerably over the coming decades. This important public health problem is therefore expected to have an enormous economic impact for the various public health services. To estimate the cost of the surgical-care process of non-melanoma skin cancer at the Costa del Sol Hospital and seek areas to improve its efficiency, using the activity-based costing (ABC) method and the tools designed for decision analysis. To compare the costs for hospitalized patients obtained using the ABC method with the data published by the Spanish Ministry of Health, using the diagnosis-related groups (DRG) classification system. Retrospective analysis of the cost of non-melanoma skin cancer surgery at the Costa del Sol Hospital. The total estimated cost from 2006 to 2010 was 3 398 540€. Most of the episodes (47.3%) corresponded to minor outpatient surgery. The costs of the episodes varied greatly according to the type of admission: 423€ (minor outpatient surgery), 1267€ (major outpatient surgery), and 1832€ (inpatient surgery). The average cost of an inpatient episode varied significantly depending on the calculation system used (ABC: 2328€ vs. DRG: 5674€). The ABC cost analysis system favours standardization of the care process for these tumours and the detection of areas to improve efficiency. This would enable more reliable economic studies than those obtained using traditional methods, such as the DRG. © 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.

  8. Locomotion of neutrally buoyant fish with flexible caudal fin.

    PubMed

    Iosilevskii, Gil

    2016-06-21

    Historically, burst-and-coast locomotion strategies have been given two very different explanations. The first one was based on the assumption that the drag of an actively swimming fish is greater than the drag of the same fish in motionless glide. Fish reduce the cost of locomotion by swimming actively during a part of the swimming interval, and gliding through the remaining part. The second one was based on the assumption that muscles perform efficiently only if their contraction rate exceeds a certain threshold. Fish reduce the cost of locomotion by using an efficient contraction rate during a part of the swimming interval, and gliding through the remaining part. In this paper, we suggest yet a third explanation. It is based on the assumption that propulsion efficiency of a swimmer can increase with thrust. Fish reduce the cost of locomotion by alternating high thrust, and hence more efficient, bursts with passive glides. The paper presents a formal analysis of the respective burst-and-coast strategy, shows that the locomotion efficiency can be practically as high as the propulsion efficiency during burst, and shows that the other two explanations can be considered particular cases of the present one. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Is bigger better? An empirical analysis of waste management in New South Wales

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

    Carvalho, Pedro, E-mail: pedrotcc@gmail.com; CESUR – Center for Urban and Regional Systems, Instituto Superior Técnico, University of Lisboa, Av. Rovisco Pais, 1049-001 Lisbon; Marques, Rui Cunha, E-mail: rui.marques@tecnico.ulisboa.pt

    Highlights: • We search for the most efficient cost structure for NSW household waste services. • We found that larger services are no longer efficient. • We found an optimal size for the range 12,000–20,000 inhabitants. • We found significant economies of output density for household waste collection. • We found economies of scope in joint provision of unsorted and recycling services. - Abstract: Across the world, rising demand for municipal solid waste services has seen an ongoing increase in the costs of providing these services. Moreover, municipal waste services have typically been provided through natural or legal monopolies, wheremore » few incentives exist to reduce costs. It is thus vital to examine empirically the cost structure of these services in order to develop effective public policies which can make these services more cost efficient. Accordingly, this paper considers economies of size and economies of output density in the municipal waste collection sector in the New South Wales (NSW) local government system in an effort to identify the optimal size of utilities from the perspective of cost efficiency. Our results show that – as presently constituted – NSW municipal waste services are not efficient in terms of costs, thereby demonstrating that ‘bigger is not better.’ The optimal size of waste utilities is estimated to fall in the range 12,000–20,000 inhabitants. However, significant economies of output density for unsorted (residual) municipal waste collection and recycling waste collection were found, which means it is advantageous to increase the amount of waste collected, but maintaining constant the number of customers and the intervention area.« less

  10. [Cost-effectiveness analysis of interferon beta-1b as treatment for patients with clinically isolated syndrome suggestive of multiple sclerosis in Spain].

    PubMed

    Piñol, C

    2016-05-01

    The BENEFIT study has demonstrated the benefits of early treatment with interferon beta 1b (IFNβ-1b). The objective of this study was to estimate the efficiency of early vs delayed IFNβ-1b treatment in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS) in Spain. A Markov model reflecting the social perspective was developed with time horizons ranging from 2 years to lifetime. A cohort of 1000 patients with CIS, whose health status had been measured on the Expanded Disability Symptom Scale (EDSS), included patients who received early IFNβ-1b treatment and those who did not. Data from the BENEFIT study were used to model EDSS progression and transitions to MS. Costs were estimated from published literature. Patient utilities were derived from EQ-5D data and published data. Mortality was estimated using life tables and EDSS data. Costs (€ at 2013 rates) and outcomes were discounted at 3% per annum. A probabilistic sensitivity analysis was performed. In the base case, both the incremental cost utility ratio (ICUR) and the incremental cost effectiveness ratio (ICER) of IFNβ-1b versus no treatment were dominant (more effective and less costly) from a social perspective. From the perspective of the Spanish Health System, the ICUR was € 40,702/QALY and the ICER was € 13/relapse avoided. Early treatment with IFNβ-1b after a CIS versus delayed treatment is efficient from a social perspective, but it may not be efficient from the perspective of the NHS which does not take non health-related costs into account. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  11. Striving towards efficiency in the Greek hospitals by reviewing case mix classifications.

    PubMed

    Polyzos, Nicholas M

    2002-09-01

    In order to verify the efficiency level of Greek public hospitals, this paper evaluates the most recent indicators. Relevant data were collected from the two following databases: (a) hospitals' utilisation data generally and per clinical speciality [Ministry of Health, Athens, (Data based) 1995]; (b) Patients' and hospitals' characteristics per diagnosis [National Statistical Office, Athens, (Data based) 1993]. As explanatory variables, the study examines supply and demand factors following case mix classifications. Firstly, average length of stay (ALOS) and secondly, cost per case were regressed as dependent variables. The study highlights the extent of variability across hospitals for different groups of patients with the same condition. The results specify the most important factors that affect ALOS and cost pertaining to efficiency. Per speciality analysis shows occupancy, size-type of the hospital, beds and doctors per speciality, access and use of outpatient services, and surgical operations, etc. as the most significant factors. Per disease-diagnosis analysis shows age of over 65 years, gender, residence, marital status, surgical operation and insurance as the most important factors. General cost analysis in all National Health Systems (NHS) hospitals shows that economies of scale appear in: (a) district and/or specialised hospitals of 250-400 beds; (b) regional and/or teaching hospitals of over but near to 400 beds. Consequently, the author determines the 'Greek' Diagnostic Related Groups (DRGs), based on the cost per clinical speciality in the nine basic specialities and on the cost per diagnosis of the top 15 diagnoses. Further to the scientific results, such studies will enhance much necessary discussions on the organisation of service delivery and financing, by following case mix classification. Copyright 2002 Elsevier Science Ireland Ltd.

  12. [Analysis of productivity, quality and cost of first grade laboratories: blood biometry].

    PubMed

    Avila, L; Hernández, P; Cruz, A; Zurita, B; Terres, A M; Cruz, C

    1999-04-01

    Assessment of productivity, quality and production costs and determination of the efficiency of top grade clinical laboratories in Mexico. Ten laboratories were selected from among the total number (52) existing in Mexico City, and the Donabedian model of structure, process and results were applied. Blood count was selected as a tracer. The principal problems found were: inadequate distribution of trained human resources, poor glass material, inadequate analytic process and low productivity. These factors are reflected in the unit costs, which exceed reference laboratory costs by 200%. Only 50% of the laboratories analyzed generate reliable results. Only 20% of the laboratories studied operate efficiently. To solve the problems identified requires integral strategies at different levels. A specific recomendation for the improvement of quality and productivity is an assessment of the cost/benefit of creating a central laboratory and using the remaining sites exclusively for the collection of samples.

  13. Dairy farm cost efficiency in leading milk-producing regions in Poland.

    PubMed

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

    2015-12-01

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

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

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

    Lavee, Doron, E-mail: doron@pareto.co.i

    2010-02-15

    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 clearlymore » 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.« less

  15. Cost-utility analysis of the National truth campaign to prevent youth smoking.

    PubMed

    Holtgrave, David R; Wunderink, Katherine A; Vallone, Donna M; Healton, Cheryl G

    2009-05-01

    In 2005, the American Journal of Public Health published an article that indicated that 22% of the overall decline in youth smoking that occurred between 1999 and 2002 was directly attributable to the truth social marketing campaign launched in 2000. A remaining key question about the truth campaign is whether the economic investment in the program can be justified by the public health outcomes; that question is examined here. Standard methods of cost and cost-utility analysis were employed in accordance with the U.S. Panel on Cost-Effectiveness in Health and Medicine; a societal perspective was employed. During 2000-2002, expenditures totaled just over $324 million to develop, deliver, evaluate, and litigate the truth campaign. The base-case cost-utility analysis result indicates that the campaign was cost saving; it is estimated that the campaign recouped its costs and that just under $1.9 billion in medical costs was averted for society. Sensitivity analysis indicated that the basic determination of cost effectiveness for this campaign is robust to substantial variation in input parameters. This study suggests that the truth campaign not only markedly improved the public's health but did so in an economically efficient manner.

  16. Implementation of a cost-accounting model in a biobank: practical implications.

    PubMed

    Gonzalez-Sanchez, Maria Beatriz; Lopez-Valeiras, Ernesto; García-Montero, Andres C

    2014-01-01

    Given the state of global economy, cost measurement and control have become increasingly relevant over the past years. The scarcity of resources and the need to use these resources more efficiently is making cost information essential in management, even in non-profit public institutions. Biobanks are no exception. However, no empirical experiences on the implementation of cost accounting in biobanks have been published to date. The aim of this paper is to present a step-by-step implementation of a cost-accounting tool for the main production and distribution activities of a real/active biobank, including a comprehensive explanation on how to perform the calculations carried out in this model. Two mathematical models for the analysis of (1) production costs and (2) request costs (order management and sample distribution) have stemmed from the analysis of the results of this implementation, and different theoretical scenarios have been prepared. Global analysis and discussion provides valuable information for internal biobank management and even for strategic decisions at the research and development governmental policies level.

  17. Professional Advanced Research and Analysis

    NASA Technical Reports Server (NTRS)

    Coulman, George A.

    1996-01-01

    Reported here is a summary of studies examining some problems in an energy conversion system. Regenerative fuel cell systems have been suggested for future manned space missions, but to meet the needed specific power requirements substantial improvements in the state-of-the-art technologies are needed. Similar improvements are needed, with emphasis on cost reduction in addition to higher conversion efficiency, for fuel cell systems that have potential for terrestrial applications. Polymer Electrolyte Membrane (PEM) fuel cells have been identified as promising candidates for development that would lead to the desired cost reduction and increased efficiency.

  18. Improving Learning Performance Through Rational Resource Allocation

    NASA Technical Reports Server (NTRS)

    Gratch, J.; Chien, S.; DeJong, G.

    1994-01-01

    This article shows how rational analysis can be used to minimize learning cost for a general class of statistical learning problems. We discuss the factors that influence learning cost and show that the problem of efficient learning can be cast as a resource optimization problem. Solutions found in this way can be significantly more efficient than the best solutions that do not account for these factors. We introduce a heuristic learning algorithm that approximately solves this optimization problem and document its performance improvements on synthetic and real-world problems.

  19. Development of a method for efficient cost-effective screening of Aspergillus niger mutants having increased production of glucoamylase.

    PubMed

    Zhu, Xudong; Arman, Bessembayev; Chu, Ju; Wang, Yonghong; Zhuang, Yingping

    2017-05-01

    To develop an efficient cost-effective screening process to improve production of glucoamylase in Aspergillus niger. The cultivation of A. niger was achieved with well-dispersed morphology in 48-deep-well microtiter plates, which increased the throughput of the samples compared to traditional flask cultivation. There was a close negative correlation between glucoamylase and its pH of the fermentation broth. A novel high-throughput analysis method using Methyl Orange was developed. When compared to the conventional analysis method using 4-nitrophenyl α-D-glucopyranoside as substrate, a correlation coefficient of 0.96 by statistical analysis was obtained. Using this novel screening method, we acquired a strain with an activity of 2.2 × 10 3  U ml -1 , a 70% higher yield of glucoamylase than its parent strain.

  20. High Efficiency Low Global Warming Potential Compressor

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

    Cogswell, Frederick; Verma, Parmesh

    During this project UTRC designed a novel compressor for use with new low Global-Warming-Potential (GWP) refrigerants. Through two design and testing iterations, UTRC advanced the compressor technology from TRL3 to TRL5. The target application was a 5 Tons of Refrigeration (TR) capacity Roof-Top Unit (RTU), although this technology may be applied to other low-capacity systems such as residential. The prototype unit met all design goals at the ARI-A rating condition and requires high efficiency motor to meet high performance targets at the ARI-B condition. This technology may be used in high efficiency units and with seasonal energy efficiency rating (SEER)more » exceeding 20. A preliminary cost analysis estimated that there would be less than $25/kbtuh cost impact to the customer.« less

  1. A cost-effectiveness threshold analysis of a multidisciplinary structured educational intervention in pediatric asthma.

    PubMed

    Rodriguez-Martinez, Carlos E; Sossa-Briceño, Monica P; Castro-Rodriguez, Jose A

    2018-05-01

    Asthma educational interventions have been shown to improve several clinically and economically important outcomes. However, these interventions are costly in themselves and could lead to even higher disease costs. A cost-effectiveness threshold analysis would be helpful in determining the threshold value of the cost of educational interventions, leading to these interventions being cost-effective. The aim of the present study was to perform a cost-effectiveness threshold analysis to determine the level at which the cost of a pediatric asthma educational intervention would be cost-effective and cost-saving. A Markov-type model was developed in order to estimate costs and health outcomes of a simulated cohort of pediatric patients with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a single uncontrolled before-and-after study performed with Colombian asthmatic children. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs). A deterministic threshold sensitivity analysis showed that the asthma educational intervention will be cost-saving to the health system if its cost is under US$513.20. Additionally, the analysis showed that the cost of the intervention would have to be below US$967.40 in order to be cost-effective. This study identified the level at which the cost of a pediatric asthma educational intervention will be cost-effective and cost-saving for the health system in Colombia. Our findings could be a useful aid for decision makers in efficiently allocating limited resources when planning asthma educational interventions for pediatric patients.

  2. Optimizing cost-efficiency in mean exposure assessment - cost functions reconsidered

    PubMed Central

    2011-01-01

    Background Reliable exposure data is a vital concern in medical epidemiology and intervention studies. The present study addresses the needs of the medical researcher to spend monetary resources devoted to exposure assessment with an optimal cost-efficiency, i.e. obtain the best possible statistical performance at a specified budget. A few previous studies have suggested mathematical optimization procedures based on very simple cost models; this study extends the methodology to cover even non-linear cost scenarios. Methods Statistical performance, i.e. efficiency, was assessed in terms of the precision of an exposure mean value, as determined in a hierarchical, nested measurement model with three stages. Total costs were assessed using a corresponding three-stage cost model, allowing costs at each stage to vary non-linearly with the number of measurements according to a power function. Using these models, procedures for identifying the optimally cost-efficient allocation of measurements under a constrained budget were developed, and applied on 225 scenarios combining different sizes of unit costs, cost function exponents, and exposure variance components. Results Explicit mathematical rules for identifying optimal allocation could be developed when cost functions were linear, while non-linear cost functions implied that parts of or the entire optimization procedure had to be carried out using numerical methods. For many of the 225 scenarios, the optimal strategy consisted in measuring on only one occasion from each of as many subjects as allowed by the budget. Significant deviations from this principle occurred if costs for recruiting subjects were large compared to costs for setting up measurement occasions, and, at the same time, the between-subjects to within-subject variance ratio was small. In these cases, non-linearities had a profound influence on the optimal allocation and on the eventual size of the exposure data set. Conclusions The analysis procedures developed in the present study can be used for informed design of exposure assessment strategies, provided that data are available on exposure variability and the costs of collecting and processing data. The present shortage of empirical evidence on costs and appropriate cost functions however impedes general conclusions on optimal exposure measurement strategies in different epidemiologic scenarios. PMID:21600023

  3. Optimizing cost-efficiency in mean exposure assessment--cost functions reconsidered.

    PubMed

    Mathiassen, Svend Erik; Bolin, Kristian

    2011-05-21

    Reliable exposure data is a vital concern in medical epidemiology and intervention studies. The present study addresses the needs of the medical researcher to spend monetary resources devoted to exposure assessment with an optimal cost-efficiency, i.e. obtain the best possible statistical performance at a specified budget. A few previous studies have suggested mathematical optimization procedures based on very simple cost models; this study extends the methodology to cover even non-linear cost scenarios. Statistical performance, i.e. efficiency, was assessed in terms of the precision of an exposure mean value, as determined in a hierarchical, nested measurement model with three stages. Total costs were assessed using a corresponding three-stage cost model, allowing costs at each stage to vary non-linearly with the number of measurements according to a power function. Using these models, procedures for identifying the optimally cost-efficient allocation of measurements under a constrained budget were developed, and applied on 225 scenarios combining different sizes of unit costs, cost function exponents, and exposure variance components. Explicit mathematical rules for identifying optimal allocation could be developed when cost functions were linear, while non-linear cost functions implied that parts of or the entire optimization procedure had to be carried out using numerical methods.For many of the 225 scenarios, the optimal strategy consisted in measuring on only one occasion from each of as many subjects as allowed by the budget. Significant deviations from this principle occurred if costs for recruiting subjects were large compared to costs for setting up measurement occasions, and, at the same time, the between-subjects to within-subject variance ratio was small. In these cases, non-linearities had a profound influence on the optimal allocation and on the eventual size of the exposure data set. The analysis procedures developed in the present study can be used for informed design of exposure assessment strategies, provided that data are available on exposure variability and the costs of collecting and processing data. The present shortage of empirical evidence on costs and appropriate cost functions however impedes general conclusions on optimal exposure measurement strategies in different epidemiologic scenarios.

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

    Desroches, Louis-Benoit; Garbesi, Karina

    It is well established that energy efficiency is most often the lowest cost approach to reducing national energy use and minimizing carbon emissions. National investments in energy efficiency to date have been highly cost-effective. The cumulative impacts (out to 2050) of residential energy efficiency standards are expected to have a benefit-to-cost ratio of 2.71:1. This project examined energy end-uses in the residential, commercial, and in some cases the industrial sectors. The scope is limited to appliances and equipment, and does not include building materials, building envelopes, and system designs. This scope is consistent with the scope of DOE's appliance standardsmore » program, although many products considered here are not currently subject to energy efficiency standards. How much energy could the United States save if the most efficient design options currently feasible were adopted universally? What design features could produce those savings? How would the savings from various technologies compare? With an eye toward identifying promising candidates and strategies for potential energy efficiency standards, the Max Tech and Beyond project aims to answer these questions. The analysis attempts to consolidate, in one document, the energy savings potential and design characteristics of best-on-market products, best-engineered products (i.e., hypothetical products produced using best-on-market components and technologies), and emerging technologies in research & development. As defined here, emerging technologies are fundamentally new and are as yet unproven in the market, although laboratory studies and/or emerging niche applications offer persuasive evidence of major energy-savings potential. The term 'max tech' is used to describe both best-engineered and emerging technologies (whichever appears to offer larger savings). Few best-on-market products currently qualify as max tech, since few apply all available best practices and components. The three primary analyses presented in this report are: Nevertheless, it is important to analyze best-on-market products, since data on truly max tech technologies are limited. (1) an analysis of the cross-cutting strategies most promising for reducing appliance and equipment energy use in the U.S.; (2) a macro-analysis of the U.S. energy-saving potential inherent in promising ultra-efficient appliance technologies; and (3) a product-level analysis of the energy-saving potential.« less

  5. Efficiency assessment of using satellite data for crop area estimation in Ukraine

    NASA Astrophysics Data System (ADS)

    Gallego, Francisco Javier; Kussul, Nataliia; Skakun, Sergii; Kravchenko, Oleksii; Shelestov, Andrii; Kussul, Olga

    2014-06-01

    The knowledge of the crop area is a key element for the estimation of the total crop production of a country and, therefore, the management of agricultural commodities markets. Satellite data and derived products can be effectively used for stratification purposes and a-posteriori correction of area estimates from ground observations. This paper presents the main results and conclusions of the study conducted in 2010 to explore feasibility and efficiency of crop area estimation in Ukraine assisted by optical satellite remote sensing images. The study was carried out on three oblasts in Ukraine with a total area of 78,500 km2. The efficiency of using images acquired by several satellite sensors (MODIS, Landsat-5/TM, AWiFS, LISS-III, and RapidEye) combined with a field survey on a stratified sample of square segments for crop area estimation in Ukraine is assessed. The main criteria used for efficiency analysis are as follows: (i) relative efficiency that shows how much time the error of area estimates can be reduced with satellite images, and (ii) cost-efficiency that shows how much time the costs of ground surveys for crop area estimation can be reduced with satellite images. These criteria are applied to each satellite image type separately, i.e., no integration of images acquired by different sensors is made, to select the optimal dataset. The study found that only MODIS and Landsat-5/TM reached cost-efficiency thresholds while AWiFS, LISS-III, and RapidEye images, due to its high price, were not cost-efficient for crop area estimation in Ukraine at oblast level.

  6. Operational Energy Metrics: Increasing Flexibility While Reducing Vulnerability

    DTIC Science & Technology

    2010-03-01

    procurement decisions with a greater level of fidelity concerning the cost- benefit analysis for systems lifetime cost of energy. Furthermore, it...or we have to RTB, we’re BINGO -fuel48”? As General Ronald Keys, USAF (RET.) stated when discussing energy efficiency and mission effectiveness...of Defense change to fully value the delivered cost of fuel, the sooner joint force commanders will reap the “strategic benefits of reallocating

  7. Eco-efficiency evaluation of a smart window prototype.

    PubMed

    Syrrakou, E; Papaefthimiou, S; Yianoulis, P

    2006-04-15

    An eco-efficiency analysis was conducted using indicators suitably defined to evaluate the performance of an electrochromic window acting as an energy saving component in buildings. Combining the indicators for various parameters (control scenario, expected lifetime, climatic type, purchase cost) significant conclusions are drawn for the development and the potential applications of the device compared to other commercial fenestration products. The reduction of the purchase cost (to 200 euros/m2) and the increase of the lifetime (above 15 years) are the two main targets for achieving both cost and environmental efficiency. An electrochromic device, implemented in cooling dominated areas and operated with an optimum control strategy for the maximum expected lifetime (25 years), can reduce the building energy requirements by 52%. Furthermore, the total energy savings provided will be 33 times more than the energy required for its production while the emission of 615 kg CO2 equivalent per electrochromic glazing unit can be avoided.

  8. An Analysis of the Impact of Multi-Year Procurement on Weapon System Acquisition

    DTIC Science & Technology

    1981-09-01

    contractor~ s accounting system. The cost must be identi- fiable to all cost objectives and allocated to each based on consistent and equitable...ity of the U. S . Defense industry to react in times of crisis. Growing evidence indicates that thsse cost and efficiency problems have been caused, in...politics [84t4]." Increased complexity and expanded technology of today’s defense systems accounts for a large portion of this cost growth (14:4; 85s26

  9. 76 FR 9696 - Equipment Price Forecasting in Energy Conservation Standards Analysis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... for particular efficiency design options, an empirical experience curve fit to the available data may be used to forecast future costs of such design option technologies. If a statistical evaluation indicates a low level of confidence in estimates of the design option cost trend, this method should not be...

  10. Effectiveness of Multimedia Elements in Computer Supported Instruction: Analysis of Personalization Effects, Students' Performances and Costs

    ERIC Educational Resources Information Center

    Zaidel, Mark; Luo, XiaoHui

    2010-01-01

    This study investigates the efficiency of multimedia instruction at the college level by comparing the effectiveness of multimedia elements used in the computer supported learning with the cost of their preparation. Among the various technologies that advance learning, instructors and students generally identify interactive multimedia elements as…

  11. The Implications of the Net Fiscal Benefits Criterion for Cost Sharing in Flood Control Projects.

    DTIC Science & Technology

    controversial areas. First, it is concluded that the net fiscal benefits criterion has important advantages in the determination of what local governments...would be willing to contribute to the cost of flood control projects, but somewhat less applicability to the analysis of economic efficiency benefits and

  12. Treatment strategies for pelvic organ prolapse: a cost-effectiveness analysis.

    PubMed

    Hullfish, Kathie L; Trowbridge, Elisa R; Stukenborg, George J

    2011-05-01

    To compare the relative cost effectiveness of treatment decision alternatives for post-hysterectomy pelvic organ prolapse (POP). A Markov decision analysis model was used to assess and compare the relative cost effectiveness of expectant management, use of a pessary, and surgery for obtaining months of quality-adjusted life over 1 year. Sensitivity analysis was conducted to determine whether the results depended on specific estimates of patient utilities for pessary use, probabilities for complications and other events, and estimated costs. Only two treatment alternatives were found to be efficient choices: initial pessary use and vaginal reconstructive surgery (VRS). Pessary use (including patients that eventually transitioned to surgery) achieved 10.4 quality-adjusted months, at a cost of $10,000 per patient, while VRS obtained 11.4 quality-adjusted months, at $15,000 per patient. Sensitivity analysis demonstrated that these baseline results depended on several key estimates in the model. This analysis indicates that pessary use and VRS are the most cost-effective treatment alternatives for treating post-hysterectomy vaginal prolapse. Additional research is needed to standardize POP outcomes and complications, so that healthcare providers can best utilize cost information in balancing the risks and benefits of their treatment decisions.

  13. Economic appraisal of the public control and prevention strategy against the 2010 West Nile Virus outbreak in Central Macedonia, Greece.

    PubMed

    Kolimenakis, A; Bithas, K; Richardson, C; Latinopoulos, D; Baka, A; Vakali, A; Hadjichristodoulou, C; Mourelatos, S; Kalaitzopoulou, S; Gewehr, S; Michaelakis, A; Koliopoulos, G

    2016-02-01

    The aim of the present paper is to evaluate the economic efficiency of the public control and prevention strategies to tackle the 2010 West Nile Virus (WNV) outbreak in the Region of Central Macedonia, Greece. Efficiency is examined on the basis of the public prevention costs incurred and their potential in justifying the costs arising from health and nuisance impacts in the succeeding years. Economic appraisal of public health management interventions. Prevention and control cost categories including control programmes, contingency planning and blood safety testing, are analyzed based on market prices. A separate cost of illness approach is conducted for the estimation of medical costs and productivity losses from 2010 to 2013 and for the calculation of averted health impacts. The averted mosquito nuisance costs to households are estimated on the basis of a contingent valuation study. Based on these findings, a limited cost-benefit analysis is employed in order to evaluate the economic efficiency of these strategies in 2010-2013. Results indicate that cost of illness and prevention costs fell significantly in the years following the 2010 outbreak, also as a result of the epidemic coming under control. According to the contingent valuation survey, the annual average willingness to pay to eliminate the mosquito problem in the study area ranged between 22 and 27 € per household. Cost-benefit analysis indicates that the aggregate benefit of implementing the previous 3-year strategy creates a net socio-economic benefit in 2013. However the spread of the WNV epidemic and the overall socio-economic consequences, had the various costs not been employed, remain unpredictable and extremely difficult to calculate. The application of a post epidemic strategy appears to be of utmost importance for public health safety. An updated well designed survey is needed for a more precise definition of the optimum prevention policies and levels and for the establishment of the various cost/benefit parameters. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Identifying efficient dairy heifer producers using production costs and data envelopment analysis.

    PubMed

    Heinrichs, A J; Jones, C M; Gray, S M; Heinrichs, P A; Cornelisse, S A; Goodling, R C

    2013-01-01

    During November and December 2011, data were collected from 44 dairy operations in 13 Pennsylvania counties. Researchers visited each farm to collect information regarding management practices and feeding, and costs for labor, health, bedding, and reproduction for replacement heifers from birth until first calving. Costs per heifer were broken up into 4 time periods: birth until weaning, weaning until 6 mo of age, 6 mo of age until breeding age, and heifers from breeding to calving. Milk production records for each herd were obtained from Dairy Herd Improvement. The average number of milking cows on farms in this study was 197.8 ± 280.1, with a range from 38 to 1,708. Total cost averaged $1,808.23 ± $338.62 from birth until freshening. Raising calves from birth to weaning cost $217.49 ± 86.21; raising heifers from weaning age through 6 mo of age cost $247.38 ± 78.89; raising heifers from 6 mo of age until breeding cost $607.02 ± 192.28; and total cost for bred heifers was $736.33 ± 162.86. Feed costs were the largest component of the cost to raise heifers from birth to calving, accounting for nearly 73% of the total. Data envelopment analysis determined that 9 of the 44 farms had no inefficiencies in inputs or outputs. These farms best combined feed and labor investments, spending, on average, $1,137.40 and $140.62/heifer for feed and labor. These heifers calved at 23.7 mo of age and produced 88.42% of the milk produced by older cows. In contrast, the 35 inefficient farms spent $227 more on feed and $78 more on labor per heifer for animals that calved 1.6 mo later and produced only 82% of the milk made by their mature herdmates. Efficiency was attained by herds with the lowest input costs, but herds with higher input costs were also able to be efficient if age at calving was low and milk production was high for heifers compared with the rest of the herd. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. MC-GenomeKey: a multicloud system for the detection and annotation of genomic variants.

    PubMed

    Elshazly, Hatem; Souilmi, Yassine; Tonellato, Peter J; Wall, Dennis P; Abouelhoda, Mohamed

    2017-01-20

    Next Generation Genome sequencing techniques became affordable for massive sequencing efforts devoted to clinical characterization of human diseases. However, the cost of providing cloud-based data analysis of the mounting datasets remains a concerning bottleneck for providing cost-effective clinical services. To address this computational problem, it is important to optimize the variant analysis workflow and the used analysis tools to reduce the overall computational processing time, and concomitantly reduce the processing cost. Furthermore, it is important to capitalize on the use of the recent development in the cloud computing market, which have witnessed more providers competing in terms of products and prices. In this paper, we present a new package called MC-GenomeKey (Multi-Cloud GenomeKey) that efficiently executes the variant analysis workflow for detecting and annotating mutations using cloud resources from different commercial cloud providers. Our package supports Amazon, Google, and Azure clouds, as well as, any other cloud platform based on OpenStack. Our package allows different scenarios of execution with different levels of sophistication, up to the one where a workflow can be executed using a cluster whose nodes come from different clouds. MC-GenomeKey also supports scenarios to exploit the spot instance model of Amazon in combination with the use of other cloud platforms to provide significant cost reduction. To the best of our knowledge, this is the first solution that optimizes the execution of the workflow using computational resources from different cloud providers. MC-GenomeKey provides an efficient multicloud based solution to detect and annotate mutations. The package can run in different commercial cloud platforms, which enables the user to seize the best offers. The package also provides a reliable means to make use of the low-cost spot instance model of Amazon, as it provides an efficient solution to the sudden termination of spot machines as a result of a sudden price increase. The package has a web-interface and it is available for free for academic use.

  16. Evidence-based economic analysis demonstrates that ecosystem service benefits of water hyacinth management greatly exceed research and control costs

    PubMed Central

    Harms, Nathan E.; Magen, Cedric; Liang, Dong; Nesslage, Genevieve M.; McMurray, Anna M.; Cofrancesco, Al F.

    2018-01-01

    Invasive species management can be a victim of its own success when decades of effective control cause memories of past harm to fade and raise questions of whether programs should continue. Economic analysis can be used to assess the efficiency of investing in invasive species control by comparing ecosystem service benefits to program costs, but only if appropriate data exist. We used a case study of water hyacinth (Eichhornia crassipes (Mart.) Solms), a nuisance floating aquatic plant, in Louisiana to demonstrate how comprehensive record-keeping supports economic analysis. Using long-term data sets, we developed empirical and spatio-temporal simulation models of intermediate complexity to project invasive species growth for control and no-control scenarios. For Louisiana, we estimated that peak plant cover would be 76% higher without the substantial growth rate suppression (84% reduction) that appeared due primarily to biological control agents. Our economic analysis revealed that combined biological and herbicide control programs, monitored over an unusually long time period (1975–2013), generated a benefit-cost ratio of about 34:1 derived from the relatively modest costs of $124 million ($2013) compared to the $4.2 billion ($2013) in benefits to anglers, waterfowl hunters, boating-dependent businesses, and water treatment facilities over the 38-year analysis period. This work adds to the literature by: (1) providing evidence of the effectiveness of water hyacinth biological control; (2) demonstrating use of parsimonious spatio-temporal models to estimate benefits of invasive species control; and (3) incorporating activity substitution into economic benefit transfer to avoid overstating benefits. Our study suggests that robust and cost-effective economic analysis is enabled by good record keeping and generalizable models that can demonstrate management effectiveness and promote social efficiency of invasive species control. PMID:29844976

  17. Evidence-based economic analysis demonstrates that ecosystem service benefits of water hyacinth management greatly exceed research and control costs.

    PubMed

    Wainger, Lisa A; Harms, Nathan E; Magen, Cedric; Liang, Dong; Nesslage, Genevieve M; McMurray, Anna M; Cofrancesco, Al F

    2018-01-01

    Invasive species management can be a victim of its own success when decades of effective control cause memories of past harm to fade and raise questions of whether programs should continue. Economic analysis can be used to assess the efficiency of investing in invasive species control by comparing ecosystem service benefits to program costs, but only if appropriate data exist. We used a case study of water hyacinth ( Eichhornia crassipes (Mart.) Solms), a nuisance floating aquatic plant, in Louisiana to demonstrate how comprehensive record-keeping supports economic analysis. Using long-term data sets, we developed empirical and spatio-temporal simulation models of intermediate complexity to project invasive species growth for control and no-control scenarios. For Louisiana, we estimated that peak plant cover would be 76% higher without the substantial growth rate suppression (84% reduction) that appeared due primarily to biological control agents. Our economic analysis revealed that combined biological and herbicide control programs, monitored over an unusually long time period (1975-2013), generated a benefit-cost ratio of about 34:1 derived from the relatively modest costs of $124 million ($2013) compared to the $4.2 billion ($2013) in benefits to anglers, waterfowl hunters, boating-dependent businesses, and water treatment facilities over the 38-year analysis period. This work adds to the literature by: (1) providing evidence of the effectiveness of water hyacinth biological control; (2) demonstrating use of parsimonious spatio-temporal models to estimate benefits of invasive species control; and (3) incorporating activity substitution into economic benefit transfer to avoid overstating benefits. Our study suggests that robust and cost-effective economic analysis is enabled by good record keeping and generalizable models that can demonstrate management effectiveness and promote social efficiency of invasive species control.

  18. Technical support document: Energy conservation standards for consumer products: Dishwashers, clothes washers, and clothes dryers including: Environmental impacts; regulatory impact analysis

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

    Not Available

    1990-12-01

    The Energy Policy and Conservation Act as amended (P.L. 94-163), establishes energy conservation standards for 12 of the 13 types of consumer products specifically covered by the Act. The legislation requires the Department of Energy (DOE) to consider new or amended standards for these and other types of products at specified times. This Technical Support Document presents the methodology, data and results from the analysis of the energy and economic impacts of standards on dishwashers, clothes washers, and clothes dryers. The economic impact analysis is performed in five major areas: An Engineering Analysis, which establishes technical feasibility and product attributesmore » including costs of design options to improve appliance efficiency. A Consumer Analysis at two levels: national aggregate impacts, and impacts on individuals. The national aggregate impacts include forecasts of appliance sales, efficiencies, energy use, and consumer expenditures. The individual impacts are analyzed by Life-Cycle Cost (LCC), Payback Periods, and Cost of Conserved Energy (CCE), which evaluate the savings in operating expenses relative to increases in purchase price; A Manufacturer Analysis, which provides an estimate of manufacturers' response to the proposed standards. Their response is quantified by changes in several measures of financial performance for a firm. An Industry Impact Analysis shows financial and competitive impacts on the appliance industry. A Utility Analysis that measures the impacts of the altered energy-consumption patterns on electric utilities. A Environmental Effects analysis, which estimates changes in emissions of carbon dioxide, sulfur oxides, and nitrogen oxides, due to reduced energy consumption in the home and at the power plant. A Regulatory Impact Analysis collects the results of all the analyses into the net benefits and costs from a national perspective. 47 figs., 171 tabs. (JF)« less

  19. A cost analysis of a smoke alarm installation and fire safety education program.

    PubMed

    Parmer, John E; Corso, Phaedra S; Ballesteros, Michael F

    2006-01-01

    While smoke alarm installation programs can help prevent residential fire injuries, the costs of running these programs are not well understood. We conducted a retrospective cost analysis of a smoke alarm installation program in 12 funded communities across four states. Costs included financial and economic resources needed for training, canvassing, installing, and following-up, within four cost categories: (a) personnel, (b) transportation, (c) facility, and (d) supplies. Local cost per completed home visit averaged 214.54 dollars, with an average local cost per alarm installed of 115.02 dollars. Combined state and local cost per alarm installed across all four states averaged 132.15 dollars. For every 1% increase in alarm installation, costs per alarm decrease by 1.32 dollars. As more smoke alarms are installed, the average installation cost per alarm decreases. By demonstrating effective economies of scale, this study suggests that smoke alarm programs can be implemented efficiently and receive positive economic returns on investment.

  20. Simulation analysis of a novel high efficiency silicon solar cell

    NASA Technical Reports Server (NTRS)

    Mokashi, Anant R.; Daud, T.; Kachare, A. H.

    1985-01-01

    It is recognized that crystalline silicon photovoltaic module efficiency of 15 percent or more is required for cost-effective photovoltaic energy utilization. This level of module efficiency requires large-area encapsulated production cell efficiencies in the range of 18 to 20 percent. Though the theoretical maximum of silicon solar cell efficiency for an idealized case is estimated to be around 30 percent, practical performance of cells to-date are considerably below this limit. This is understood to be largely a consequence of minority carrier losses in the bulk as well as at all surfaces including those under the metal contacts. In this paper a novel device design with special features to reduce bulk and surface recombination losses is evaluated using numerical analysis technique. Details of the numerical model, cell design, and analysis results are presented.

  1. Uncertainty analysis and global sensitivity analysis of techno-economic assessments for biodiesel production.

    PubMed

    Tang, Zhang-Chun; Zhenzhou, Lu; Zhiwen, Liu; Ningcong, Xiao

    2015-01-01

    There are various uncertain parameters in the techno-economic assessments (TEAs) of biodiesel production, including capital cost, interest rate, feedstock price, maintenance rate, biodiesel conversion efficiency, glycerol price and operating cost. However, fewer studies focus on the influence of these parameters on TEAs. This paper investigated the effects of these parameters on the life cycle cost (LCC) and the unit cost (UC) in the TEAs of biodiesel production. The results show that LCC and UC exhibit variations when involving uncertain parameters. Based on the uncertainty analysis, three global sensitivity analysis (GSA) methods are utilized to quantify the contribution of an individual uncertain parameter to LCC and UC. The GSA results reveal that the feedstock price and the interest rate produce considerable effects on the TEAs. These results can provide a useful guide for entrepreneurs when they plan plants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Industrial Technology Modernization Program. Project 80. Increase Efficiency of Card Test/Device Test Areas by the Usage of Improved Material Handling Systems. Revision 1. Phase 2

    DTIC Science & Technology

    1988-03-01

    INDUSTRY ANALYSIS/FINDINGS 132 12 EQUIPMENT/MACHINERY ALTERNATIVES 134 13 MIS REQUIREMENTS/IMPROVEMENTS 135 14 COST BENEFIT ANALYSIS AND PROCEDURE 137 15...SOFTWARE DIAGRAM 14.0-1 COST BENEFIT ANALYSIS METHODOLOGY 138 14.3-1 PROJECT 80 EXPENDITURE SCHEDULE 141 14.4-1 PROJECT 80 CASH FLOWS 142 15.1-1 PROJECT 80...testing, streamlining work flow, and installation of ergonomically designed work cell/work centers. The benefits associated with the implementation of ITM

  3. A Review of Models of Cost and Training Effectiveness Analysis (CTEA). Volume 1. Training Effectiveness Analysis

    DTIC Science & Technology

    1987-10-01

    19 treated in interaction with each other and the hardware and software design. The authors point out some of the inadequacies in HP technologies and...life cycle costs recognition performance on secondary tasks effort/efficiency number of wins ( gaming tasks) number of instructors needed amount of...student interacts with this material in real time via a terminal and display system. The computer performs many functions, such as diagnose student

  4. Breakeven, cost benefit, cost effectiveness, and willingness to pay for web-based versus face-to-face education delivery for health professionals.

    PubMed

    Maloney, Stephen; Haas, Romi; Keating, Jenny L; Molloy, Elizabeth; Jolly, Brian; Sims, Jane; Morgan, Prue; Haines, Terry

    2012-04-02

    The introduction of Web-based education and open universities has seen an increase in access to professional development within the health professional education marketplace. Economic efficiencies of Web-based education and traditional face-to-face educational approaches have not been compared under randomized controlled trial conditions. To compare costs and effects of Web-based and face-to-face short courses in falls prevention education for health professionals. We designed two short courses to improve the clinical performance of health professionals in exercise prescription for falls prevention. One was developed for delivery in face-to-face mode and the other for online learning. Data were collected on learning outcomes including participation, satisfaction, knowledge acquisition, and change in practice, and combined with costs, savings, and benefits, to enable a break-even analysis from the perspective of the provider, cost-effectiveness analysis from the perspective of the health service, and cost-benefit analysis from the perspective of the participant. Face-to-face and Web-based delivery modalities produced comparable outcomes for participation, satisfaction, knowledge acquisition, and change in practice. Break-even analysis identified the Web-based educational approach to be robustly superior to face-to-face education, requiring a lower number of enrollments for the program to reach its break-even point. Cost-effectiveness analyses from the perspective of the health service and cost-benefit analysis from the perspective of the participant favored face-to-face education, although the outcomes were contingent on the sensitivity analysis applied (eg, the fee structure used). The Web-based educational approach was clearly more efficient from the perspective of the education provider. In the presence of relatively equivocal results for comparisons from other stakeholder perspectives, it is likely that providers would prefer to deliver education via a Web-based medium. Australian New Zealand Clinical Trials Registry (ACTRN): 12610000135011; http://www.anzctr.org.au/trial_view.aspx?id=335135 (Archived by WebCite at http://www.webcitation.org/668POww4L).

  5. Breakeven, Cost Benefit, Cost Effectiveness, and Willingness to Pay for Web-Based Versus Face-to-Face Education Delivery for Health Professionals

    PubMed Central

    Haas, Romi; Keating, Jenny L; Molloy, Elizabeth; Jolly, Brian; Sims, Jane; Morgan, Prue; Haines, Terry

    2012-01-01

    Background The introduction of Web-based education and open universities has seen an increase in access to professional development within the health professional education marketplace. Economic efficiencies of Web-based education and traditional face-to-face educational approaches have not been compared under randomized controlled trial conditions. Objective To compare costs and effects of Web-based and face-to-face short courses in falls prevention education for health professionals. Methods We designed two short courses to improve the clinical performance of health professionals in exercise prescription for falls prevention. One was developed for delivery in face-to-face mode and the other for online learning. Data were collected on learning outcomes including participation, satisfaction, knowledge acquisition, and change in practice, and combined with costs, savings, and benefits, to enable a break-even analysis from the perspective of the provider, cost-effectiveness analysis from the perspective of the health service, and cost-benefit analysis from the perspective of the participant. Results Face-to-face and Web-based delivery modalities produced comparable outcomes for participation, satisfaction, knowledge acquisition, and change in practice. Break-even analysis identified the Web-based educational approach to be robustly superior to face-to-face education, requiring a lower number of enrollments for the program to reach its break-even point. Cost-effectiveness analyses from the perspective of the health service and cost-benefit analysis from the perspective of the participant favored face-to-face education, although the outcomes were contingent on the sensitivity analysis applied (eg, the fee structure used). Conclusions The Web-based educational approach was clearly more efficient from the perspective of the education provider. In the presence of relatively equivocal results for comparisons from other stakeholder perspectives, it is likely that providers would prefer to deliver education via a Web-based medium. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12610000135011; http://www.anzctr.org.au/trial_view.aspx?id=335135 (Archived by WebCite at http://www.webcitation.org/668POww4L) PMID:22469659

  6. Cost Analysis of an Office-based Surgical Suite

    PubMed Central

    LaBove, Gabrielle

    2016-01-01

    Introduction: Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead. Methods: A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates. Results: The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy. Conclusions: Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult. PMID:27536482

  7. Interpreting cost of ownership for mix-and-match lithography

    NASA Astrophysics Data System (ADS)

    Levine, Alan L.; Bergendahl, Albert S.

    1994-05-01

    Cost of ownership modeling is a critical and emerging tool that provides significant insight into the ways to optimize device manufacturing costs. The development of a model to deal with a particular application, mix-and-match lithography, was performed in order to determine the level of cost savings and the optimum ways to create these savings. The use of sensitivity analysis with cost of ownership allows the user to make accurate trade-offs between technology and cost. The use and interpretation of the model results are described in this paper. Parameters analyzed include several manufacturing considerations -- depreciation, maintenance, engineering and operator labor, floorspace, resist, consumables and reticles. Inherent in this study is the ability to customize this analysis for a particular operating environment. Results demonstrate the clear advantages of a mix-and-match approach for three different operating environments. These case studies also demonstrate various methods to efficiently optimize cost savings strategies.

  8. Market-Based Higher Education: Does Colorado's Voucher Model Improve Higher Education Access and Efficiency?

    ERIC Educational Resources Information Center

    Hillman, Nicholas W.; Tandberg, David A.; Gross, Jacob P. K.

    2014-01-01

    In 2004, Colorado introduced the nation's first voucher model for financing public higher education. With state appropriations now allocated to students, rather than institutions, state officials expect this model to create cost efficiencies while also expanding college access. Using difference-in-difference regression analysis, we find limited…

  9. On the Use of "Green" Metrics in the Undergraduate Organic Chemistry Lecture and Lab to Assess the Mass Efficiency of Organic Reactions

    ERIC Educational Resources Information Center

    Andraos, John; Sayed, Murtuzaali

    2007-01-01

    A general analysis of reaction mass efficiency and raw material cost is developed using an Excel spread sheet format which can be applied to any chemical transformation. These new methods can be easily incorporated into standard laboratory exercises.

  10. System Evaluation and Economic Analysis of a HTGR Powered High-Temperature Electrolysis Hydrogen Production Plant

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

    Michael G. McKellar; Edwin A. Harvego; Anastasia A. Gandrik

    2010-10-01

    A design for a commercial-scale high-temperature electrolysis (HTE) plant for hydrogen production has been developed. The HTE plant is powered by a high-temperature gas-cooled reactor (HTGR) whose configuration and operating conditions are based on the latest design parameters planned for the Next Generation Nuclear Plant (NGNP). The current HTGR reference design specifies a reactor power of 600 MWt, with a primary system pressure of 7.0 MPa, and reactor inlet and outlet fluid temperatures of 322°C and 750°C, respectively. The power conversion unit will be a Rankine steam cycle with a power conversion efficiency of 40%. The reference hydrogen production plantmore » operates at a system pressure of 5.0 MPa, and utilizes a steam-sweep system to remove the excess oxygen that is evolved on the anode (oxygen) side of the electrolyzer. The overall system thermal-to-hydrogen production efficiency (based on the higher heating value of the produced hydrogen) is 40.4% at a hydrogen production rate of 1.75 kg/s and an oxygen production rate of 13.8 kg/s. An economic analysis of this plant was performed with realistic financial and cost estimating assumptions. The results of the economic analysis demonstrated that the HTE hydrogen production plant driven by a high-temperature helium-cooled nuclear power plant can deliver hydrogen at a cost of $3.67/kg of hydrogen assuming an internal rate of return, IRR, of 12% and a debt to equity ratio of 80%/20%. A second analysis shows that if the power cycle efficiency increases to 44.4%, the hydrogen production efficiency increases to 42.8% and the hydrogen and oxygen production rates are 1.85 kg/s and 14.6 kg/s respectively. At the higher power cycle efficiency and an IRR of 12% the cost of hydrogen production is $3.50/kg.« less

  11. Time-based analysis of total cost of patient episodes: a case study of hip replacement.

    PubMed

    Peltokorpi, Antti; Kujala, Jaakko

    2006-01-01

    Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

  12. CO2 abatement costs of greenhouse gas (GHG) mitigation by different biogas conversion pathways.

    PubMed

    Rehl, T; Müller, J

    2013-01-15

    Biogas will be of increasing importance in the future as a factor in reducing greenhouse gas emissions cost-efficiently by the optimal use of available resources and technologies. The goal of this study was to identify the most ecological and economical use of a given resource (organic waste from residential, commercial and industry sectors) using one specific treatment technology (anaerobic digestion) but applying different energy conversion technologies. Average and marginal abatement costs were calculated based on Life Cycle Cost (LCC) and Life Cycle Assessment (LCA) methodologies. Eight new biogas systems producing electricity, heat, gas or automotive fuel were analyzed in order to identify the most cost-efficient way of reducing GHG emissions. A system using a combined heat and power station (which is connected to waste treatment and digestion operation facilities and located nearby potential residential, commercial or industrial heat users) was found to be the most cost-efficient biogas technology for reducing GHG emissions. Up to € 198 per tonne of CO(2) equivalents can be saved by replacing the "business as usual" systems based on fossil resources with ones based on biogas. Limited gas injection (desulfurized and dried biogas, without compression and upgrading) into the gas grid can also be a viable option with an abatement cost saving of € 72 per tonne of CO(2) equivalents, while a heating plant with a district heating grid or a system based on biogas results in higher abatement costs (€ 267 and € 270 per tonne CO(2) eq). Results from all systems are significantly influenced by whether average or marginal data are used as a reference. Beside that energy efficiency, the reference system that was replaced and the by-products as well as feedstock and investment costs were identified to be parameters with major impacts on abatement costs. The quantitative analysis was completed by a discussion of the role that abatement cost methodology can play in decision-making. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Cost Description and Comparative Cost Efficiency of Post-Exposure Prophylaxis and Canine Mass Vaccination against Rabies in N'Djamena, Chad.

    PubMed

    Mindekem, Rolande; Lechenne, Monique Sarah; Naissengar, Kemdongarti Service; Oussiguéré, Assandi; Kebkiba, Bidjeh; Moto, Daugla Doumagoum; Alfaroukh, Idriss Oumar; Ouedraogo, Laurent Tinoanga; Salifou, Sahidou; Zinsstag, Jakob

    2017-01-01

    Rabies claims approximately 59,000 human lives annually and is a potential risk to 3.3 billion people in over 100 countries worldwide. Despite being fatal in almost 100% of cases, human rabies can be prevented by vaccinating dogs, the most common vector, and the timely administration of post-exposure prophylaxis (PEP) to exposed victims. For the control and prevention of human rabies in N'Djamena, the capital city of Chad, a free mass vaccination campaign for dogs was organized in 2012 and 2013. The campaigns were monitored by parallel studies on the incidence of canine rabies based on diagnostic testing of suspect animals and the incidence of human bite exposure recorded at selected health facilities. Based on the cost description of the campaign and the need for PEP registered in health centers, three cost scenarios were compared: cumulative cost-efficiency of (1) PEP alone, (2) dog mass vaccination and PEP, (3) dog mass vaccination, PEP, and maximal communication between human health and veterinary workers (One Health communication). Assuming ideal One Health communication, the cumulative prospective cost of dog vaccination and PEP break even with the cumulative prospective cost of PEP alone in the 10th year from the start of the calculation (2012). The cost efficiency expressed in cost per human exposure averted is much higher with canine vaccination and One Health communication than with PEP alone. As shown in other studies, our cost-effectiveness analysis highlights that canine vaccination is financially the best option for animal rabies control and rabies prevention in humans. This study also provides evidence of the beneficial effect of One Health communication. Only with close communication between the human and animal health sectors will the decrease in animal rabies incidence be translated into a decline for PEP. An efficiently applied One Health concept would largely reduce the cost of PEP in resource poor countries and should be implemented for zoonosis control in general.

  14. Low-Cost High-Pressure Hydrogen Generator

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

    Cropley, Cecelia C.; Norman, Timothy J.

    Electrolysis of water, particularly in conjunction with renewable energy sources, is potentially a cost-effective and environmentally friendly method of producing hydrogen at dispersed forecourt sites, such as automotive fueling stations. The primary feedstock for an electrolyzer is electricity, which could be produced by renewable sources such as wind or solar that do not produce carbon dioxide or other greenhouse gas emissions. However, state-of-the-art electrolyzer systems are not economically competitive for forecourt hydrogen production due to their high capital and operating costs, particularly the cost of the electricity used by the electrolyzer stack. In this project, Giner Electrochemical Systems, LLC (GES)more » developed a low cost, high efficiency proton-exchange membrane (PEM) electrolysis system for hydrogen production at moderate pressure (300 to 400 psig). The electrolyzer stack operates at differential pressure, with hydrogen produced at moderate pressure while oxygen is evolved at near-atmospheric pressure, reducing the cost of the water feed and oxygen handling subsystems. The project included basic research on catalysts and membranes to improve the efficiency of the electrolysis reaction as well as development of advanced materials and component fabrication methods to reduce the capital cost of the electrolyzer stack and system. The project culminated in delivery of a prototype electrolyzer module to the National Renewable Energy Laboratory for testing at the National Wind Technology Center. Electrolysis cell efficiency of 72% (based on the lower heating value of hydrogen) was demonstrated using an advanced high-strength membrane developed in this project. This membrane would enable the electrolyzer system to exceed the DOE 2012 efficiency target of 69%. GES significantly reduced the capital cost of a PEM electrolyzer stack through development of low cost components and fabrication methods, including a 60% reduction in stack parts count. Economic analysis indicates that hydrogen could be produced for $3.79 per gge at an electricity cost of $0.05/kWh by the lower-cost PEM electrolyzer developed in this project, assuming high-volume production of large-scale electrolyzer systems.« less

  15. Cost Description and Comparative Cost Efficiency of Post-Exposure Prophylaxis and Canine Mass Vaccination against Rabies in N’Djamena, Chad

    PubMed Central

    Mindekem, Rolande; Lechenne, Monique Sarah; Naissengar, Kemdongarti Service; Oussiguéré, Assandi; Kebkiba, Bidjeh; Moto, Daugla Doumagoum; Alfaroukh, Idriss Oumar; Ouedraogo, Laurent Tinoanga; Salifou, Sahidou; Zinsstag, Jakob

    2017-01-01

    Rabies claims approximately 59,000 human lives annually and is a potential risk to 3.3 billion people in over 100 countries worldwide. Despite being fatal in almost 100% of cases, human rabies can be prevented by vaccinating dogs, the most common vector, and the timely administration of post-exposure prophylaxis (PEP) to exposed victims. For the control and prevention of human rabies in N’Djamena, the capital city of Chad, a free mass vaccination campaign for dogs was organized in 2012 and 2013. The campaigns were monitored by parallel studies on the incidence of canine rabies based on diagnostic testing of suspect animals and the incidence of human bite exposure recorded at selected health facilities. Based on the cost description of the campaign and the need for PEP registered in health centers, three cost scenarios were compared: cumulative cost-efficiency of (1) PEP alone, (2) dog mass vaccination and PEP, (3) dog mass vaccination, PEP, and maximal communication between human health and veterinary workers (One Health communication). Assuming ideal One Health communication, the cumulative prospective cost of dog vaccination and PEP break even with the cumulative prospective cost of PEP alone in the 10th year from the start of the calculation (2012). The cost efficiency expressed in cost per human exposure averted is much higher with canine vaccination and One Health communication than with PEP alone. As shown in other studies, our cost-effectiveness analysis highlights that canine vaccination is financially the best option for animal rabies control and rabies prevention in humans. This study also provides evidence of the beneficial effect of One Health communication. Only with close communication between the human and animal health sectors will the decrease in animal rabies incidence be translated into a decline for PEP. An efficiently applied One Health concept would largely reduce the cost of PEP in resource poor countries and should be implemented for zoonosis control in general. PMID:28421186

  16. The Costs of Delivering Integrated HIV and Sexual Reproductive Health Services in Limited Resource Settings

    PubMed Central

    Obure, Carol Dayo; Sweeney, Sedona; Darsamo, Vanessa; Michaels-Igbokwe, Christine; Guinness, Lorna; Terris-Prestholt, Fern; Muketo, Esther; Nhlabatsi, Zelda; Warren, Charlotte E.; Mayhew, Susannah; Watts, Charlotte; Vassall, Anna

    2015-01-01

    Objective To present evidence on the total costs and unit costs of delivering six integrated sexual reproductive health and HIV services in a high and medium HIV prevalence setting, in order to support policy makers and planners scaling up these essential services. Design A retrospective facility based costing study conducted in 40 non-government organization and public health facilities in Kenya and Swaziland. Methods Economic and financial costs were collected retrospectively for the year 2010/11, from each study site with an aim to estimate the cost per visit of six integrated HIV and SRH services. A full cost analysis using a combination of bottom-up and step-down costing methods was conducted from the health provider’s perspective. The main unit of analysis is the economic unit cost per visit for each service. Costs are converted to 2013 International dollars. Results The mean cost per visit for the HIV/SRH services ranged from $Int 14.23 (PNC visit) to $Int 74.21 (HIV treatment visit). We found considerable variation in the unit costs per visit across settings with family planning services exhibiting the least variation ($Int 6.71-52.24) and STI treatment and HIV treatment visits exhibiting the highest variation in unit cost ranging from ($Int 5.44-281.85) and ($Int 0.83-314.95), respectively. Unit costs of visits were driven by fixed costs while variability in visit costs across facilities was explained mainly by technology used and service maturity. Conclusion For all services, variability in unit costs and cost components suggest that potential exists to reduce costs through better use of both human and capital resources, despite the high proportion of expenditure on drugs and medical supplies. Further work is required to explore the key drivers of efficiency and interventions that may facilitate efficiency improvements. PMID:25933414

  17. Energy-Efficiency and Air-Pollutant Emissions-Reduction Opportunities for the Ammonia Industry in China

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

    Ma, Ding; Hasanbeigi, Ali; Chen, Wenying

    As one of the most energy-intensive and polluting industries, ammonia production is responsible for significant carbon dioxide (CO 2) and air-pollutant emissions. Although many energy-efficiency measures have been proposed by the Chinese government to mitigate greenhouse gas emissions and improve air quality, lack of understanding of the cost-effectiveness of such improvements has been a barrier to implementing these measures. Assessing the costs, benefits, and cost-effectiveness of different energy-efficiency measures is essential to advancing this understanding. In this study, a bottom-up energy conservation supply curve model is developed to estimate the potential for energy savings and emissions reductions from 26 energy-efficiencymore » measures that could be applied in China’s ammonia industry. Cost-effective implementation of these measures saves a potential 271.5 petajoules/year for fuel and 5,443 gigawatt-hours/year for electricity, equal to 14% of fuel and 14% of electricity consumed in China’s ammonia industry in 2012. These reductions could mitigate 26.7 million tonnes of CO 2 emissions. This study also quantifies the co-benefits of reducing air-pollutant emissions and water use that would result from saving energy in China’s ammonia industry. This quantitative analysis advances our understanding of the cost-effectiveness of energy-efficiency measures and can be used to augment efforts to reduce energy use and environmental impacts.« less

  18. Determinants of Change in the Cost-effectiveness Threshold.

    PubMed

    Paulden, Mike; O'Mahony, James; McCabe, Christopher

    2017-02-01

    The cost-effectiveness threshold in health care systems with a constrained budget should be determined by the cost-effectiveness of displacing health care services to fund new interventions. Using comparative statics, we review some potential determinants of the threshold, including the budget for health care, the demand for existing health care interventions, the technical efficiency of existing interventions, and the development of new health technologies. We consider the anticipated direction of impact that would affect the threshold following a change in each of these determinants. Where the health care system is technically efficient, an increase in the health care budget unambiguously raises the threshold, whereas an increase in the demand for existing, non-marginal health interventions unambiguously lowers the threshold. Improvements in the technical efficiency of existing interventions may raise or lower the threshold, depending on the cause of the improvement in efficiency, whether the intervention is already funded, and, if so, whether it is marginal. New technologies may also raise or lower the threshold, depending on whether the new technology is a substitute for an existing technology and, again, whether the existing technology is marginal. Our analysis permits health economists and decision makers to assess if and in what direction the threshold may change over time. This matters, as threshold changes impact the cost-effectiveness of interventions that require decisions now but have costs and effects that fall in future periods.

  19. [Determination of cost-effective strategies in colorectal cancer screening].

    PubMed

    Dervaux, B; Eeckhoudt, L; Lebrun, T; Sailly, J C

    1992-01-01

    The object of the article is to implement particular methodologies in order to determine which strategies are cost-effective in the mass screening of colorectal cancer after a positive Hemoccult test. The first approach to be presented consists in proposing a method which enables all the admissible diagnostic strategies to be determined. The second approach enables a minimal cost function to be estimated using an adaptation of "Data Envelopment Analysis". This method proves to be particularly successful in cost-efficiency analysis, when the performance indicators are numerous and hard to aggregate. The results show that there are two cost-effective strategies after a positive Hemoccult test: coloscopy and sigmoidoscopy; they put into question the relevance of double contrast barium enema in the diagnosis of colo-rectal lesions.

  20. Energy Efficiency Appliance Standards: Where do we stand, how far can we go and how do we get there? An analysis across several economies

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

    Letschert, Virginie E.; de la Rue du Can, Stephane; McNeil, Michael A.

    This paper analyses several potential savings scenarios for minimum energy performance standard (MEPS) and comparable programs for governments participating i n the Super-efficient Equipment and Appliance Deployment (SEAD) Initiative, of the Clean Energy Ministerial, which represent over 60% of primary energy consumption in the world. We compare projected energy savings from the main end uses in the residential sector using three energy efficiency scenarios: (1) recent achievements, (2) cost-effective saving potential, and (3) energy efficiency technical potential. The recent achievement scenario (1) evaluates the future impact of MEPS enacted or under development between 2010 and 2012. The cost-effective potential scenariomore » (2) identifies the maximum potential for energy efficiency that results in net benefits to the consumer. The best available technology scenario (3) re presents the full potential of energy efficiency considering best available technologies as candidates for MEPS and incentive programs. We use the Bottom Up Energy Analysis System (BUENAS), developed by Lawrence Berkeley National Laboratory in collaboration with the Collaborative Labelling and Appliances Standards Program (CLASP), to provide a consistent methodology to com pare the different scenarios. This paper focuses on the main end uses in the residential sector. The comparison of the three scenarios for each economy provides possible opportunities for scaling up current policies or implementing additional policies. This comparison across economies reveals country best practices as well as end uses that present the greatest additional potential savings. The paper describes areas where methodologies and additional policy instruments can increase penetration of energy efficient technologies. First , we summarize the barriers and provide remedial policy tools/best practices, such as techno-economic analysis, in response to each barriers that prevent economies from capturing the full cost-effective potentials of MEPS (Scenario 1 to 2). Then, we consider the possible complementary policy options, such as incentive pro grams, to reach the full technical potential of energy efficiency in the residential sector (Scenario 2 to 3).« less

  1. Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries.

    PubMed

    Baji, Petra; García-Goñi, Manuel; Gulácsi, László; Mentzakis, Emmanouil; Paolucci, Francesco

    2016-09-01

    In addition to cost-effectiveness, national guidelines often include other factors in reimbursement decisions. However, weights attached to these are rarely quantified, thus decisions can depend strongly on decision-maker preferences. To explore the preferences of policymakers and healthcare professionals involved in the decision-making process for different efficiency and equity attributes of interventions and to analyse cross-country differences. Discrete choice experiments (DCEs) were carried out in Austria, Hungary, and Norway with policymakers and other professionals working in the health industry (N = 153 respondents). Interventions were described in terms of different efficiency and equity attributes (severity of disease, target age of the population and willingness to subsidise others, potential number of beneficiaries, individual health benefit, and cost-effectiveness). Parameter estimates from the DCE were used to calculate the probability of choosing a healthcare intervention with different characteristics, and to rank different equity and efficiency attributes according to their importance. In all three countries, cost-effectiveness, individual health benefit and severity of the disease were significant and equally important determinants of decisions. All countries show preferences for interventions targeting young and middle aged populations compared to those targeting populations over 60. However, decision-makers in Austria and Hungary show preferences more oriented to efficiency than equity, while those in Norway show equal preferences for equity and efficiency attributes. We find that factors other than cost-effectiveness seem to play an equally important role in decision-making. We also find evidence of cross-country differences in the weight of efficiency and equity attributes.

  2. Financial evaluation of different vaccination strategies for controlling the bluetongue virus serotype 8 epidemic in The Netherlands in 2008.

    PubMed

    Velthuis, Annet G J; Mourits, Monique C M; Saatkamp, Helmut W; de Koeijer, Aline A; Elbers, Armin R W

    2011-05-04

    Bluetongue (BT) is a vector-borne disease of ruminants caused by bluetongue virus that is transmitted by biting midges (Culicoides spp.). In 2006, the introduction of BTV serotype 8 (BTV-8) caused a severe epidemic in Western and Central Europe. The principal effective veterinary measure in response to BT was believed to be vaccination accompanied by other measures such as movement restrictions and surveillance. As the number of vaccine doses available at the start of the vaccination campaign was rather uncertain, the Dutch Ministry of Agriculture, Nature and Food Quality and the Dutch agricultural industry wanted to evaluate several different vaccination strategies. This study aimed to rank eight vaccination strategies based on their efficiency (i.e. net costs in relation to prevented losses or benefits) for controlling the bluetongue virus serotype 8 epidemic in 2008. An economic model was developed that included the Dutch professional cattle, sheep and goat sectors together with the hobby farms. Strategies were evaluated based on the least cost - highest benefit frontier, the benefit-cost ratio and the total net returns. Strategy F, where all adult sheep at professional farms in The Netherlands would be vaccinated was very efficient at lowest costs, whereas strategy D, where additional to all adult sheep at professional farms also all adult cattle in the four Northern provinces would be vaccinated, was also very efficient but at a little higher costs. Strategy C, where all adult sheep and cattle at professional farms in the whole of The Netherlands would be vaccinated was also efficient but again at higher costs. This study demonstrates that a financial analysis differentiates between vaccination strategies and indicates important decision rules based on efficiency.

  3. Financial Evaluation of Different Vaccination Strategies for Controlling the Bluetongue Virus Serotype 8 Epidemic in the Netherlands in 2008

    PubMed Central

    Velthuis, Annet G. J.; Mourits, Monique C. M.; Saatkamp, Helmut W.; de Koeijer, Aline A.; Elbers, Armin R. W.

    2011-01-01

    Background Bluetongue (BT) is a vector-borne disease of ruminants caused by bluetongue virus that is transmitted by biting midges (Culicoides spp.). In 2006, the introduction of BTV serotype 8 (BTV-8) caused a severe epidemic in Western and Central Europe. The principal effective veterinary measure in response to BT was believed to be vaccination accompanied by other measures such as movement restrictions and surveillance. As the number of vaccine doses available at the start of the vaccination campaign was rather uncertain, the Dutch Ministry of Agriculture, Nature and Food Quality and the Dutch agricultural industry wanted to evaluate several different vaccination strategies. This study aimed to rank eight vaccination strategies based on their efficiency (i.e. net costs in relation to prevented losses or benefits) for controlling the bluetongue virus serotype 8 epidemic in 2008. Methodology/Principal Findings An economic model was developed that included the Dutch professional cattle, sheep and goat sectors together with the hobby farms. Strategies were evaluated based on the least cost - highest benefit frontier, the benefit-cost ratio and the total net returns. Strategy F, where all adult sheep at professional farms in the Netherlands would be vaccinated was very efficient at lowest costs, whereas strategy D, where additional to all adult sheep at professional farms also all adult cattle in the four Northern provinces would be vaccinated, was also very efficient but at a little higher costs. Strategy C, where all adult sheep and cattle at professional farms in the whole of the Netherlands would be vaccinated was also efficient but again at higher costs. Conclusions/Significance This study demonstrates that a financial analysis differentiates between vaccination strategies and indicates important decision rules based on efficiency. PMID:21573195

  4. Economic Assessment of Supercritical CO2 Extraction of Waxes as Part of a Maize Stover Biorefinery.

    PubMed

    Attard, Thomas M; McElroy, Con Robert; Hunt, Andrew J

    2015-07-31

    To date limited work has focused on assessing the economic viability of scCO2 extraction to obtain waxes as part of a biorefinery. This work estimates the economic costs for wax extraction from maize stover. The cost of manufacture (COM) for maize stover wax extraction was found to be € 88.89 per kg of wax, with the fixed capital investment (FCI) and utility costs (CUT) contributing significantly to the COM. However, this value is based solely on scCO2 extraction of waxes and does not take into account the downstream processing of the biomass following extraction. The cost of extracting wax from maize stover can be reduced by utilizing pelletized leaves and combusting the residual biomass to generate electricity. This would lead to an overall cost of € 10.87 per kg of wax (based on 27% combustion efficiency for electricity generation) and €4.56 per kg of wax (based on 43% combustion efficiency for electricity generation). A sensitivity analysis study showed that utility costs (cost of electricity) had the greatest effect on the COM.

  5. Economic Assessment of Supercritical CO2 Extraction of Waxes as Part of a Maize Stover Biorefinery

    PubMed Central

    Attard, Thomas M.; McElroy, Con Robert; Hunt, Andrew J.

    2015-01-01

    To date limited work has focused on assessing the economic viability of scCO2 extraction to obtain waxes as part of a biorefinery. This work estimates the economic costs for wax extraction from maize stover. The cost of manufacture (COM) for maize stover wax extraction was found to be €88.89 per kg of wax, with the fixed capital investment (FCI) and utility costs (CUT) contributing significantly to the COM. However, this value is based solely on scCO2 extraction of waxes and does not take into account the downstream processing of the biomass following extraction. The cost of extracting wax from maize stover can be reduced by utilizing pelletized leaves and combusting the residual biomass to generate electricity. This would lead to an overall cost of €10.87 per kg of wax (based on 27% combustion efficiency for electricity generation) and €4.56 per kg of wax (based on 43% combustion efficiency for electricity generation). A sensitivity analysis study showed that utility costs (cost of electricity) had the greatest effect on the COM. PMID:26263976

  6. Demand response-enabled model predictive HVAC load control in buildings using real-time electricity pricing

    NASA Astrophysics Data System (ADS)

    Avci, Mesut

    A practical cost and energy efficient model predictive control (MPC) strategy is proposed for HVAC load control under dynamic real-time electricity pricing. The MPC strategy is built based on a proposed model that jointly minimizes the total energy consumption and hence, cost of electricity for the user, and the deviation of the inside temperature from the consumer's preference. An algorithm that assigns temperature set-points (reference temperatures) to price ranges based on the consumer's discomfort tolerance index is developed. A practical parameter prediction model is also designed for mapping between the HVAC load and the inside temperature. The prediction model and the produced temperature set-points are integrated as inputs into the MPC controller, which is then used to generate signal actions for the AC unit. To investigate and demonstrate the effectiveness of the proposed approach, a simulation based experimental analysis is presented using real-life pricing data. An actual prototype for the proposed HVAC load control strategy is then built and a series of prototype experiments are conducted similar to the simulation studies. The experiments reveal that the MPC strategy can lead to significant reductions in overall energy consumption and cost savings for the consumer. Results suggest that by providing an efficient response strategy for the consumers, the proposed MPC strategy can enable the utility providers to adopt efficient demand management policies using real-time pricing. Finally, a cost-benefit analysis is performed to display the economic feasibility of implementing such a controller as part of a building energy management system, and the payback period is identified considering cost of prototype build and cost savings to help the adoption of this controller in the building HVAC control industry.

  7. Design and Analysis of Cost-Efficient Sensor Deployment for Tracking Small UAS with Agent-Based Modeling.

    PubMed

    Shin, Sangmi; Park, Seongha; Kim, Yongho; Matson, Eric T

    2016-04-22

    Recently, commercial unmanned aerial systems (UAS) have gained popularity. However, these UAS are potential threats to people in terms of safety in public places, such as public parks or stadiums. To reduce such threats, we consider a design, modeling, and evaluation of a cost-efficient sensor system that detects and tracks small UAS. In this research, we focus on discovering the best sensor deployments by simulating different types and numbers of sensors in a designated area, which provide reasonable detection rates at low costs. Also, the system should cover the crowded areas more thoroughly than vacant areas to reduce direct threats to people underneath. This research study utilized the Agent-Based Modeling (ABM) technique to model a system consisting of independent and heterogeneous agents that interact with each other. Our previous work presented the ability to apply ABM to analyze the sensor configurations with two types of radars in terms of cost-efficiency. The results from the ABM simulation provide a list of candidate configurations and deployments that can be referred to for applications in the real world environment.

  8. Design and Analysis of Cost-Efficient Sensor Deployment for Tracking Small UAS with Agent-Based Modeling

    PubMed Central

    Shin, Sangmi; Park, Seongha; Kim, Yongho; Matson, Eric T.

    2016-01-01

    Recently, commercial unmanned aerial systems (UAS) have gained popularity. However, these UAS are potential threats to people in terms of safety in public places, such as public parks or stadiums. To reduce such threats, we consider a design, modeling, and evaluation of a cost-efficient sensor system that detects and tracks small UAS. In this research, we focus on discovering the best sensor deployments by simulating different types and numbers of sensors in a designated area, which provide reasonable detection rates at low costs. Also, the system should cover the crowded areas more thoroughly than vacant areas to reduce direct threats to people underneath. This research study utilized the Agent-Based Modeling (ABM) technique to model a system consisting of independent and heterogeneous agents that interact with each other. Our previous work presented the ability to apply ABM to analyze the sensor configurations with two types of radars in terms of cost-efficiency. The results from the ABM simulation provide a list of candidate configurations and deployments that can be referred to for applications in the real world environment. PMID:27110790

  9. Cost Recommendation under Uncertainty in IQWiG's Efficiency Frontier Framework.

    PubMed

    Corro Ramos, Isaac; Lhachimi, Stefan K; Gerber-Grote, Andreas; Al, Maiwenn J

    2017-02-01

    The National Institute for Quality and Efficiency in Health Care (IQWiG) employs an efficiency frontier (EF) framework to facilitate setting maximum reimbursable prices for new interventions. Probabilistic sensitivity analysis (PSA) is used when yes/no reimbursement decisions are sought based on a fixed threshold. In the IQWiG framework, an additional layer of complexity arises as the EF itself may vary its shape in each PSA iteration, and thus the willingness-to-pay, indicated by the EF segments, may vary. To explore the practical problems arising when, within the EF approach, maximum reimbursable prices for new interventions are sought through PSA. When the EF is varied in a PSA, cost recommendations for new interventions may be determined by the mean or the median of the distances between each intervention's point estimate and each EF. Implications of using these metrics were explored in a simulation study based on the model used by IQWiG to assess the cost-effectiveness of 4 antidepressants. Depending on the metric used, cost recommendations can be contradictory. Recommendations based on the mean can also be inconsistent. Results (median) suggested that costs of duloxetine, venlafaxine, mirtazapine, and bupropion should be decreased by €131, €29, €12, and €99, respectively. These recommendations were implemented and the analysis repeated. New results suggested keeping the costs as they were. The percentage of acceptable PSA outcomes increased 41% on average, and the uncertainty associated to the net health benefit was significantly reduced. The median of the distances between every intervention outcome and every EF is a good proxy for the cost recommendation that would be given should the EF be fixed. Adjusting costs according to the median increased the probability of acceptance and reduced the uncertainty around the net health benefit distribution, resulting in a reduced uncertainty for decision makers.

  10. [Influence of contractual medical association on inpatient service performance].

    PubMed

    Wu, Zhi-jun; Jian, Wei-yan

    2015-06-18

    To study the influence of contractual medical association on inpatient service performance. The data came from "Database of Inpatient Record" administered by Department of Medical Insurance. Using diagnosis related groups (DRG) as the tool of risk-adjustment, the third-tier general hospitals and second-tier general hospitals in medical alliance as the intervention group, and the average level of the same grade local hospitals as the control group, the influence of medical alliance on inpatient service performance was evaluated. The difference in difference (DID) method was used for the data analysis. The assessing indicators included the number of DRG group, case mix index (CMI), the total weight, cost efficiency index and time efficiency index. After the establishment of medical association, compared with the average level of the same grade local hospitals, in the third-tier general hospitals of medical alliance, the growth rate of the total weight had declined, and cost efficiency index had increased, while in the second-tier general hospitals of medical alliance, the CMI value had declined, and the cost efficiency index had increased. Contractual medical association played a role of triage patients, and improved the service levels and management efficiency of the second-tier general hospitals.

  11. Cost analysis of routine immunisation in Zambia.

    PubMed

    Schütte, Carl; Chansa, Collins; Marinda, Edmore; Guthrie, Teresa A; Banda, Stanley; Nombewu, Zipozihle; Motlogelwa, Katlego; Lervik, Marita; Brenzel, Logan; Kinghorn, Anthony

    2015-05-07

    This study aimed to inform planning and funding by providing updated, detailed information on total and unit costs of routine immunisation (RI) in Zambia, a GAVI-eligible lower middle-income country with a population of 13 million. The exercise was part of a multi-country study on costs and financing of routine immunisation (EPIC) that utilized a common, ingredients-based approach to costing. Data on inputs, prices and outputs were collected in a stratified, random sample of 51 facilities in nine districts between December 2012 and March 2013 using a pre-tested questionnaire. Shared inputs were allocated to RI costs on the basis of tracing factors developed for the study. A comprehensive set of costs were analysed to obtain total and unit costs, at facility and above-facility levels. The total annual economic cost of RI was $38.16 million, equivalent to approximately 10% of government health spending. Government contributed 83% of finances. Labour accounted for the lion's share (49%) of total costs followed by vaccines (16%) and travel allowances (12%). Analysis of specific activity costs showed that outreach and facility-based services accounted for half of total economic costs. Costs for managing the program at district, provincial and national levels (above-facility costs) represented 24% of total costs. Average unit costs were $7.18 per dose, $59.32 per infant and $65.89 per DPT3 immunised child, with markedly higher unit costs in rural facilities. Analyses suggest that greater efficiency is associated with higher utilisation levels and urban facility type. Total and unit costs, and government's contribution, were considerably higher than previous Zambian estimates and international benchmarks. These findings have substantial implications for planners, efficiency improvement and sustainable financing, particularly as new vaccines are introduced. Variations in immunisation costs at facility level warrant further statistical analyses. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Integrated analysis of engine structures

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.

    1981-01-01

    The need for light, durable, fuel efficient, cost effective aircraft requires the development of engine structures which are flexible, made from advaced materials (including composites), resist higher temperatures, maintain tighter clearances and have lower maintenance costs. The formal quantification of any or several of these requires integrated computer programs (multilevel and/or interdisciplinary analysis programs interconnected) for engine structural analysis/design. Several integrated analysis computer prorams are under development at Lewis Reseach Center. These programs include: (1) COBSTRAN-Composite Blade Structural Analysis, (2) CODSTRAN-Composite Durability Structural Analysis, (3) CISTRAN-Composite Impact Structural Analysis, (4) STAEBL-StruTailoring of Engine Blades, and (5) ESMOSS-Engine Structures Modeling Software System. Three other related programs, developed under Lewis sponsorship, are described.

  13. [Cost-benefit analysis of a school-based smoking prevention program].

    PubMed

    Hormigo Amaro, Jordi; García-Altés, Anna; López, M José; Bartoll, Xavier; Nebot, Manel; Ariza, Carles

    2009-01-01

    To analyze the efficiency of a school-based smoking prevention program in Barcelona (PASE.bcn program). A cost-benefit analysis was performed. As costs we included those corresponding to the design and implementation of the program. As benefits we considered healthcare costs and the productivity losses avoided. This study was conducted from a societal perspective, and the estimations of costs and benefits related to 2005. Assuming an effectiveness of 1%, the PASE.bcn program would achieve a total benefit of 1,558,311.46euro. The healthcare benefits per prevented smoker were 1997.57euro, and the indirect benefits per prevented smoker were 21,260.80euro. Given the total cost of the school-based program (68,526.03euro), the cost-benefit ratio was 22.74. From a societal perspective, the benefits of school-based tobacco prevention programs, in terms of healthcare costs and productivity losses avoided, are far greater than the costs. These results support universal application of this type of intervention.

  14. User participation in the development of the human/computer interface for control centers

    NASA Technical Reports Server (NTRS)

    Broome, Richard; Quick-Campbell, Marlene; Creegan, James; Dutilly, Robert

    1996-01-01

    Technological advances coupled with the requirements to reduce operations staffing costs led to the demand for efficient, technologically-sophisticated mission operations control centers. The control center under development for the earth observing system (EOS) is considered. The users are involved in the development of a control center in order to ensure that it is cost-efficient and flexible. A number of measures were implemented in the EOS program in order to encourage user involvement in the area of human-computer interface development. The following user participation exercises carried out in relation to the system analysis and design are described: the shadow participation of the programmers during a day of operations; the flight operations personnel interviews; and the analysis of the flight operations team tasks. The user participation in the interface prototype development, the prototype evaluation, and the system implementation are reported on. The involvement of the users early in the development process enables the requirements to be better understood and the cost to be reduced.

  15. Increased energy efficiency of a steel foundry plant by using a cleaner production quick-E-scan methodology

    NASA Astrophysics Data System (ADS)

    Rasmeni, Zelda; Pan, Xiaowei

    2017-07-01

    The Quick-E-Scan methodology is a simple and quick method that is used to achieve operational energy efficiency as opposed to detailed energy audits, which therefore offers a no cost or less cost solutions for energy management programs with a limited budget. The quick-E-scan methodology was used to assesses a steel foundry plant based in Benoni through dividing the foundry into production sections which entailed a review of the current processes and usage patterns of energy within the plant and a detailed analysis of options available for improvement and profitable areas in which energy saving measures may be implemented for an increase energy efficiency which can be presented to management of the company.

  16. A stochastic frontier analysis of technical efficiency of fish cage culture in Peninsular Malaysia.

    PubMed

    Islam, Gazi Md Nurul; Tai, Shzee Yew; Kusairi, Mohd Noh

    2016-01-01

    Cage culture plays an important role in achieving higher output and generating more export earnings in Malaysia. However, the cost of fingerlings, feed and labour have increased substantially for cage culture in the coastal areas in Peninsular Malaysia. This paper uses farm level data gathered from Manjung, Perak and Kota Tinggi, Johor to investigate the technical efficiency of brackish water fish cage culture using the stochastic frontier approach. The technical efficiency was estimated and specifically the factors affecting technical inefficiencies of fish cage culture system in Malaysia was investigated. On average, 37 percent of the sampled fish cage farms are technically efficient. The results suggest very high degrees of technical inefficiency exist among the cage culturists. This implies that great potential exists to increase fish production through improved efficiency in cage culture management in Peninsular Malaysia. The results indicate that farmers obtained grouper fingerlings from other neighboring countries due to scarcity of fingerlings from wild sources. The cost of feeding for grouper (Epinephelus fuscoguttatus) requires relatively higher costs compared to seabass (Lates calcarifer) production in cage farms in the study areas. Initiatives to undertake extension programmes at the farm level are needed to help cage culturists in utilizing their resources more efficiently in order to substantially enhance their fish production.

  17. Energy-efficient sensing in wireless sensor networks using compressed sensing.

    PubMed

    Razzaque, Mohammad Abdur; Dobson, Simon

    2014-02-12

    Sensing of the application environment is the main purpose of a wireless sensor network. Most existing energy management strategies and compression techniques assume that the sensing operation consumes significantly less energy than radio transmission and reception. This assumption does not hold in a number of practical applications. Sensing energy consumption in these applications may be comparable to, or even greater than, that of the radio. In this work, we support this claim by a quantitative analysis of the main operational energy costs of popular sensors, radios and sensor motes. In light of the importance of sensing level energy costs, especially for power hungry sensors, we consider compressed sensing and distributed compressed sensing as potential approaches to provide energy efficient sensing in wireless sensor networks. Numerical experiments investigating the effectiveness of compressed sensing and distributed compressed sensing using real datasets show their potential for efficient utilization of sensing and overall energy costs in wireless sensor networks. It is shown that, for some applications, compressed sensing and distributed compressed sensing can provide greater energy efficiency than transform coding and model-based adaptive sensing in wireless sensor networks.

  18. Using Decision-Analytic Modeling to Isolate Interventions That Are Feasible, Efficient and Optimal: An Application from the Norwegian Cervical Cancer Screening Program.

    PubMed

    Pedersen, Kine; Sørbye, Sveinung Wergeland; Burger, Emily Annika; Lönnberg, Stefan; Kristiansen, Ivar Sønbø

    2015-12-01

    Decision makers often need to simultaneously consider multiple criteria or outcomes when deciding whether to adopt new health interventions. Using decision analysis within the context of cervical cancer screening in Norway, we aimed to aid decision makers in identifying a subset of relevant strategies that are simultaneously efficient, feasible, and optimal. We developed an age-stratified probabilistic decision tree model following a cohort of women attending primary screening through one screening round. We enumerated detected precancers (i.e., cervical intraepithelial neoplasia of grade 2 or more severe (CIN2+)), colposcopies performed, and monetary costs associated with 10 alternative triage algorithms for women with abnormal cytology results. As efficiency metrics, we calculated incremental cost-effectiveness, and harm-benefit, ratios, defined as the additional costs, or the additional number of colposcopies, per additional CIN2+ detected. We estimated capacity requirements and uncertainty surrounding which strategy is optimal according to the decision rule, involving willingness to pay (monetary or resources consumed per added benefit). For ages 25 to 33 years, we eliminated four strategies that did not fall on either efficiency frontier, while one strategy was efficient with respect to both efficiency metrics. Compared with current practice in Norway, two strategies detected more precancers at lower monetary costs, but some required more colposcopies. Similar results were found for women aged 34 to 69 years. Improving the effectiveness and efficiency of cervical cancer screening may necessitate additional resources. Although efficient and feasible, both society and individuals must specify their willingness to accept the additional resources and perceived harms required to increase effectiveness before a strategy can be considered optimal. Copyright © 2015. Published by Elsevier Inc.

  19. Cost comparison of printed circuit heat exchanger to low cost periodic flow regenerator for use as recuperator in a s-CO 2 Brayton cycle

    DOE PAGES

    Hinze, Jacob F.; Nellis, Gregory F.; Anderson, Mark H.

    2017-09-21

    Supercritical Carbon Dioxide (sCO 2) power cycles have the potential to deliver high efficiency at low cost. However, in order for an sCO 2 cycle to reach high efficiency, highly effective recuperators are needed. These recuperative heat exchangers must transfer heat at a rate that is substantially larger than the heat transfer to the cycle itself and can therefore represent a significant portion of the power block costs. Regenerators are proposed as a cost saving alternative to high cost printed circuit recuperators for this application. A regenerator is an indirect heat exchanger which periodically stores and releases heat to themore » working fluid. The simple design of a regenerator can be made more inexpensively compared to current options. The objective of this paper is a detailed evaluation of regenerators as a competing technology for recuperators within an sCO 2 Brayton cycle. The level of the analysis presented here is sufficient to identify issues with the regenerator system in order to direct future work and also to clarify the potential advantage of pursuing this technology. A reduced order model of a regenerator is implemented into a cycle model of an sCO 2 Brayton cycle. An economic analysis investigates the cost savings that is possible by switching from recuperative heat exchangers to switched-bed regenerators. The cost of the regenerators was estimated using the amount of material required if the pressure vessel is sized using ASME Boiler Pressure Vessel Code (BPVC) requirements. The cost of the associated valves is found to be substantial for the regenerator system and is estimated in collaboration with an industrial valve supplier. The result of this analysis suggests that a 21.2% reduction in the contribution to the Levelized Cost of Electricity (LCoE) from the power block can be realized by switching to a regenerator-based system.« less

  20. Cost comparison of printed circuit heat exchanger to low cost periodic flow regenerator for use as recuperator in a s-CO 2 Brayton cycle

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

    Hinze, Jacob F.; Nellis, Gregory F.; Anderson, Mark H.

    Supercritical Carbon Dioxide (sCO 2) power cycles have the potential to deliver high efficiency at low cost. However, in order for an sCO 2 cycle to reach high efficiency, highly effective recuperators are needed. These recuperative heat exchangers must transfer heat at a rate that is substantially larger than the heat transfer to the cycle itself and can therefore represent a significant portion of the power block costs. Regenerators are proposed as a cost saving alternative to high cost printed circuit recuperators for this application. A regenerator is an indirect heat exchanger which periodically stores and releases heat to themore » working fluid. The simple design of a regenerator can be made more inexpensively compared to current options. The objective of this paper is a detailed evaluation of regenerators as a competing technology for recuperators within an sCO 2 Brayton cycle. The level of the analysis presented here is sufficient to identify issues with the regenerator system in order to direct future work and also to clarify the potential advantage of pursuing this technology. A reduced order model of a regenerator is implemented into a cycle model of an sCO 2 Brayton cycle. An economic analysis investigates the cost savings that is possible by switching from recuperative heat exchangers to switched-bed regenerators. The cost of the regenerators was estimated using the amount of material required if the pressure vessel is sized using ASME Boiler Pressure Vessel Code (BPVC) requirements. The cost of the associated valves is found to be substantial for the regenerator system and is estimated in collaboration with an industrial valve supplier. The result of this analysis suggests that a 21.2% reduction in the contribution to the Levelized Cost of Electricity (LCoE) from the power block can be realized by switching to a regenerator-based system.« less

  1. SOSPAC- SOLAR SPACE POWER ANALYSIS CODE

    NASA Technical Reports Server (NTRS)

    Selcuk, M. K.

    1994-01-01

    The Solar Space Power Analysis Code, SOSPAC, was developed to examine the solar thermal and photovoltaic power generation options available for a satellite or spacecraft in low earth orbit. SOSPAC is a preliminary systems analysis tool and enables the engineer to compare the areas, weights, and costs of several candidate electric and thermal power systems. The configurations studied include photovoltaic arrays and parabolic dish systems to produce electricity only, and in various combinations to provide both thermal and electric power. SOSPAC has been used for comparison and parametric studies of proposed power systems for the NASA Space Station. The initial requirements are projected to be about 40 kW of electrical power, and a similar amount of thermal power with temperatures above 1000 degrees Centigrade. For objects in low earth orbit, the aerodynamic drag caused by suitably large photovoltaic arrays is very substantial. Smaller parabolic dishes can provide thermal energy at a collection efficiency of about 80%, but at increased cost. SOSPAC allows an analysis of cost and performance factors of five hybrid power generating systems. Input includes electrical and thermal power requirements, sun and shade durations for the satellite, and unit weight and cost for subsystems and components. Performance equations of the five configurations are derived, and the output tabulates total weights of the power plant assemblies, area of the arrays, efficiencies, and costs. SOSPAC is written in FORTRAN IV for batch execution and has been implemented on an IBM PC computer operating under DOS with a central memory requirement of approximately 60K of 8 bit bytes. This program was developed in 1985.

  2. Efficient Data-Worth Analysis Using a Multilevel Monte Carlo Method Applied in Oil Reservoir Simulations

    NASA Astrophysics Data System (ADS)

    Lu, D.; Ricciuto, D. M.; Evans, K. J.

    2017-12-01

    Data-worth analysis plays an essential role in improving the understanding of the subsurface system, in developing and refining subsurface models, and in supporting rational water resources management. However, data-worth analysis is computationally expensive as it requires quantifying parameter uncertainty, prediction uncertainty, and both current and potential data uncertainties. Assessment of these uncertainties in large-scale stochastic subsurface simulations using standard Monte Carlo (MC) sampling or advanced surrogate modeling is extremely computationally intensive, sometimes even infeasible. In this work, we propose efficient Bayesian analysis of data-worth using a multilevel Monte Carlo (MLMC) method. Compared to the standard MC that requires a significantly large number of high-fidelity model executions to achieve a prescribed accuracy in estimating expectations, the MLMC can substantially reduce the computational cost with the use of multifidelity approximations. As the data-worth analysis involves a great deal of expectation estimations, the cost savings from MLMC in the assessment can be very outstanding. While the proposed MLMC-based data-worth analysis is broadly applicable, we use it to a highly heterogeneous oil reservoir simulation to select an optimal candidate data set that gives the largest uncertainty reduction in predicting mass flow rates at four production wells. The choices made by the MLMC estimation are validated by the actual measurements of the potential data, and consistent with the estimation obtained from the standard MC. But compared to the standard MC, the MLMC greatly reduces the computational costs in the uncertainty reduction estimation, with up to 600 days cost savings when one processor is used.

  3. Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis.

    PubMed

    Pearce, Alison M; Ryan, Fay; Drummond, Frances J; Thomas, Audrey Alforque; Timmons, Aileen; Sharp, Linda

    2016-02-01

    Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland-the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice. A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer's perspective over a 10-year time horizon. Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted. This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.

  4. The cost structure of routine infant immunization services: a systematic analysis of six countries

    PubMed Central

    Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

    2017-01-01

    Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

  5. The cost structure of routine infant immunization services: a systematic analysis of six countries.

    PubMed

    Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

    2017-10-01

    Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  6. High resolution melting analysis is a more sensitive and effective alternative to gel-based platforms in analysis of SSR--an example in citrus.

    PubMed

    Distefano, Gaetano; Caruso, Marco; La Malfa, Stefano; Gentile, Alessandra; Wu, Shu-Biao

    2012-01-01

    High resolution melting curve analysis (HRM) has been used as an efficient, accurate and cost-effective tool to detect single nucleotide polymorphisms (SNPs) or insertions or deletions (INDELs). However, its efficiency, accuracy and applicability to discriminate microsatellite polymorphism have not been extensively assessed. The traditional protocols used for SSR genotyping include PCR amplification of the DNA fragment and the separation of the fragments on electrophoresis-based platform. However, post-PCR handling processes are laborious and costly. Furthermore, SNPs present in the sequences flanking repeat motif cannot be detected by polyacrylamide-gel-electrophoresis based methods. In the present study, we compared the discriminating power of HRM with the traditional electrophoresis-based methods and provided a panel of primers for HRM genotyping in Citrus. The results showed that sixteen SSR markers produced distinct polymorphic melting curves among the Citrus spp investigated through HRM analysis. Among those, 10 showed more genotypes by HRM analysis than capillary electrophoresis owing to the presence of SNPs in the amplicons. For the SSR markers without SNPs present in the flanking region, HRM also gave distinct melting curves which detected same genotypes as were shown in capillary electrophoresis (CE) analysis. Moreover, HRM analysis allowed the discrimination of most of the 15 citrus genotypes and the resulting genetic distance analysis clustered them into three main branches. In conclusion, it has been approved that HRM is not only an efficient and cost-effective alternative of electrophoresis-based method for SSR markers, but also a method to uncover more polymorphisms contributed by SNPs present in SSRs. It was therefore suggested that the panel of SSR markers could be used in a variety of applications in the citrus biodiversity and breeding programs using HRM analysis. Furthermore, we speculate that the HRM analysis can be employed to analyse SSR markers in a wide range of applications in all other species.

  7. Shuttle's 160 hour ground turnaround - A design driver

    NASA Technical Reports Server (NTRS)

    Widick, F.

    1977-01-01

    Turnaround analysis added a new dimension to the Space Program with the advent of the Space Shuttle. The requirement to turn the flight hardware around in 160 working hours from landing to launch was a significant design driver and a useful tool in forcing the integration of flight and ground systems design to permit an efficient ground operation. Although there was concern that time constraints might increase program costs, the result of the analysis was to minimize facility requirements and simplify operations with resultant cost savings.

  8. Net present value analysis: appropriate for public utilities

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

    Davidson, W.N. III

    1980-08-28

    The net-present-value technique widely used by unregulated companies for capital budgeting can also apply to regulated public utilities. Used to decide whether an investment is worthwhile, the NPV technique discounts an investment's initial outlay or cost. The type of project most appropriate for an NPV analysis is that designed to lower costs. Efficiency-improving investments can be adequately evaluated by the NPV method, which in certain cases is easier to use than some of the more complicated revenue-requirement computer models.

  9. Improving the efficiency of selection to Core Medical Training: a study of the use of multiple assessment stations.

    PubMed

    Atkinson, J M; Tullo, E; Mitchison, H; Pearce, M S; Kumar, N

    2012-06-01

    To compare three separate assessment stations used for selection to Core Medical Training (CMT) and to determine the effect of reducing the number from three to two. Quantitative analysis of candidates' assessment station scores, financial analysis of costs of the selection process and quantitative and qualitative surveys of candidates and assessors. The assessment stations used for selection to CMT were reliable and valid for assessing suitability for employment as a CMT trainee. There was no significant difference in candidate ranking if only two assessment stations were used rather than three, i.e. there was no change in the likelihood of receiving a job offer. All of the assessment stations were perceived to have face validity by candidates and assessors. The efficiency of the selection process could be improved without loss of quality if two stations were used rather than three. Using two assessment stations rather than three would appear to improve the efficiency and maintain the quality of the CMT selection process while reducing costs.

  10. In-depth investigation of spin-on doped solar cells with thermally grown oxide passivation

    NASA Astrophysics Data System (ADS)

    Ahmad, Samir Mahmmod; Cheow, Siu Leong; Ludin, Norasikin A.; Sopian, K.; Zaidi, Saleem H.

    Solar cell industrial manufacturing, based largely on proven semiconductor processing technologies supported by significant advancements in automation, has reached a plateau in terms of cost and efficiency. However, solar cell manufacturing cost (dollar/watt) is still substantially higher than fossil fuels. The route to lowering cost may not lie with continuing automation and economies of scale. Alternate fabrication processes with lower cost and environmental-sustainability coupled with self-reliance, simplicity, and affordability may lead to price compatibility with carbon-based fuels. In this paper, a custom-designed formulation of phosphoric acid has been investigated, for n-type doping in p-type substrates, as a function of concentration and drive-in temperature. For post-diffusion surface passivation and anti-reflection, thermally-grown oxide films in 50-150-nm thickness were grown. These fabrication methods facilitate process simplicity, reduced costs, and environmental sustainability by elimination of poisonous chemicals and toxic gases (POCl3, SiH4, NH3). Simultaneous fire-through contact formation process based on screen-printed front surface Ag and back surface through thermally grown oxide films was optimized as a function of the peak temperature in conveyor belt furnace. Highest efficiency solar cells fabricated exhibited efficiency of ∼13%. Analysis of results based on internal quantum efficiency and minority carried measurements reveals three contributing factors: high front surface recombination, low minority carrier lifetime, and higher reflection. Solar cell simulations based on PC1D showed that, with improved passivation, lower reflection, and high lifetimes, efficiency can be enhanced to match with commercially-produced PECVD SiN-coated solar cells.

  11. Dynamic programming on a shared-memory multiprocessor

    NASA Technical Reports Server (NTRS)

    Edmonds, Phil; Chu, Eleanor; George, Alan

    1993-01-01

    Three new algorithms for solving dynamic programming problems on a shared-memory parallel computer are described. All three algorithms attempt to balance work load, while keeping synchronization cost low. In particular, for a multiprocessor having p processors, an analysis of the best algorithm shows that the arithmetic cost is O(n-cubed/6p) and that the synchronization cost is O(absolute value of log sub C n) if p much less than n, where C = (2p-1)/(2p + 1) and n is the size of the problem. The low synchronization cost is important for machines where synchronization is expensive. Analysis and experiments show that the best algorithm is effective in balancing the work load and producing high efficiency.

  12. The Automated Array Assembly Task of the Low-cost Silicon Solar Array Project, Phase 2

    NASA Technical Reports Server (NTRS)

    Coleman, M. G.; Grenon, L.; Pastirik, E. M.; Pryor, R. A.; Sparks, T. G.

    1978-01-01

    An advanced process sequence for manufacturing high efficiency solar cells and modules in a cost-effective manner is discussed. Emphasis is on process simplicity and minimizing consumed materials. The process sequence incorporates texture etching, plasma processes for damage removal and patterning, ion implantation, low pressure silicon nitride deposition, and plated metal. A reliable module design is presented. Specific process step developments are given. A detailed cost analysis was performed to indicate future areas of fruitful cost reduction effort. Recommendations for advanced investigations are included.

  13. The conservation nexus: valuing interdependent water and energy savings in Arizona.

    PubMed

    Bartos, Matthew D; Chester, Mikhail V

    2014-02-18

    Water and energy resources are intrinsically linked, yet they are managed separately--even in the water-scarce American southwest. This study develops a spatially explicit model of water-energy interdependencies in Arizona and assesses the potential for cobeneficial conservation programs. The interdependent benefits of investments in eight conservation strategies are assessed within the context of legislated renewable energy portfolio and energy efficiency standards. The cobenefits of conservation are found to be significant. Water conservation policies have the potential to reduce statewide electricity demand by 0.82-3.1%, satisfying 4.1-16% of the state's mandated energy-efficiency standard. Adoption of energy-efficiency measures and renewable generation portfolios can reduce nonagricultural water demand by 1.9-15%. These conservation cobenefits are typically not included in conservation plans or benefit-cost analyses. Many cobenefits offer negative costs of saved water and energy, indicating that these measures provide water and energy savings at no net cost. Because ranges of costs and savings for water-energy conservation measures are somewhat uncertain, future studies should investigate the cobenefits of individual conservation strategies in detail. Although this study focuses on Arizona, the analysis can be extended elsewhere as renewable portfolio and energy efficiency standards become more common nationally and internationally.

  14. The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy

    PubMed Central

    Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa

    2016-01-01

    Background: Clinical practice protocols should consider both the psychological criteria related to a patient’s satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. Methods: A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Results: Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. Conclusion: The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed. PMID:27303347

  15. The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy.

    PubMed

    Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa

    2016-01-01

    Clinical practice protocols should consider both the psychological criteria related to a patient's satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed.

  16. A demand-side view of risk adjustment.

    PubMed

    Feldman, R; Dowd, B E; Maciejewski, M

    2001-01-01

    This paper analyzes the efficient allocation of consumers to health plans. Specifically, we address the question of why employers that offer multiple health plans often make larger contributions to the premiums of the high-cost plans. Our perspective is that the subsidy for high-cost plans represents a form of demand-side risk adjustment that improves efficiency. Without such subsidies (and in the absence of formal risk adjustment), too few employees would choose the high-cost plans preferred by high-risk workers. We test the theory by estimating a model of the employer premium subsidy, using data from a survey of large public employers in 1994. Our empirical analysis shows that employers are more likely to subsidize high-cost plans when the benefits of risk adjustment are greater. The findings suggest that the premium subsidy can accomplish some of the benefits of formal risk adjustment.

  17. Cost-efficiency analyses for the US of biosimilar filgrastim-sndz, reference filgrastim, pegfilgrastim, and pegfilgrastim with on-body injector in the prophylaxis of chemotherapy-induced (febrile) neutropenia.

    PubMed

    McBride, Ali; Campbell, Kim; Bikkina, Mohan; MacDonald, Karen; Abraham, Ivo; Balu, Sanjeev

    2017-10-01

    Guidelines recommend prophylaxis with granulocyte colony-stimulating factor for chemotherapy-induced (febrile) neutropenia (CIN/FN) based on regimen myelotoxicity and patient-related risk factors. The aim was to conduct a cost-efficiency analysis for the US of the direct acquisition and administration costs of the recently approved biosimilar filgrastim-sndz (Zarxio EP2006) with reference to filgrastim (Neupogen), pegfilgrastim (Neulasta), and a pegfilgrastim injection device (Neulasta Onpro; hereafter pegfilgrastim-injector) for CIN/FN prophylaxis. A cost-efficiency analysis of the prophylaxis of one patient during one chemotherapy cycle under 1-14 days' time horizon was conducted using the unit dose average selling price (ASP) and Current Procedural Terminology (CPT) codes for subcutaneous prophylactic injection under four scenarios: cost of medication only (COSTMED), patient self-administration (SELFADMIN), healthcare provider (HCP) initiating administration followed by self-administration (HCPSTART), and HCP providing full administration (HCPALL). Two case studies were created to illustrate real-world clinical implications. The analyses were replicated using wholesale acquisition cost (WAC). Using ASP + CPT, cost savings achieved with filgrastim-sndz relative to reference filgrastim ranged from $65 (1 day) to $916 (14 days) across all scenarios. Relative to pegfilgrastim, savings with filgrastim-sndz ranged from $834 (14 days) up to $3,666 (1 day) under the COSTMED, SELFADMIN, and HPOSTART scenarios; and from $284 (14 days) up to $3,666 (1 day) under the HPOALL scenario. Similar to the cost-savings compared to pegfilgrastim, filgrastim-sndz achieved savings relative to pegfilgrastim-injector: from $834 (14 days) to $3,666 (1 day) under the COSTMED scenario, from $859 (14 days) to $3,692 (1 day) under SELFADMIN, from $817 (14 days) to $3,649 (1 day) under HPOSTART, and from $267 (14 days) to $3,649 (1 day) under HPOALL. Cost savings of filgrastim-sndz using WAC + CPT were even greater under all scenarios. Prophylaxis with filgrastim-sndz, a biosimilar filgrastim, was associated consistently with significant cost-savings over prophylaxis with reference filgrastim, pegfilgrastim, and pegfilgrastim-injector, and this across various administration scenarios.

  18. An Analysis of the Efficiency of Sourcing Knowledge-based Services in the United States Air Force

    DTIC Science & Technology

    2013-06-01

    costs. In 1996 , Coopers and Lybrand identified over 120 mandated cost drivers that contributed to an 18% price premium for federally procured...commodities and services (GAO, 1996 ). The top 10 cost drivers listed in this study (GAO, 1996 ) were  DoD quality program requirements,  the Truth in...assessment conducted by CAPS Research indicated 22 tenets of strategic sourcing (Monczka & Peterson , 2011). The assessment collected data 42 from 119

  19. Energy efficient engine component development and integration program

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The design of an energy efficient commercial turbofan engine is examined with emphasis on lower fuel consumption and operating costs. Propulsion system performance, emission standards, and noise reduction are also investigated. A detailed design analysis of the engine/aircraft configuration, engine components, and core engine is presented along with an evaluation of the technology and testing involved.

  20. Including quality attributes in efficiency measures consistent with net benefit: creating incentives for evidence based medicine in practice.

    PubMed

    Eckermann, Simon; Coelli, Tim

    2013-01-01

    Evidence based medicine supports net benefit maximising therapies and strategies in processes of health technology assessment (HTA) for reimbursement and subsidy decisions internationally. However, translation of evidence based medicine to practice is impeded by efficiency measures such as cost per case-mix adjusted separation in hospitals, which ignore health effects of care. In this paper we identify a correspondence method that allows quality variables under control of providers to be incorporated in efficiency measures consistent with maximising net benefit. Including effects framed from a disutility bearing (utility reducing) perspective (e.g. mortality, morbidity or reduction in life years) as inputs and minimising quality inclusive costs on the cost-disutility plane is shown to enable efficiency measures consistent with maximising net benefit under a one to one correspondence. The method combines advantages of radial properties with an appropriate objective of maximising net benefit to overcome problems of inappropriate objectives implicit with alternative methods, whether specifying quality variables with utility bearing output (e.g. survival, reduction in morbidity or life years), hyperbolic or exogenous variables. This correspondence approach is illustrated in undertaking efficiency comparison at a clinical activity level for 45 Australian hospitals allowing for their costs and mortality rates per admission. Explicit coverage and comparability conditions of the underlying correspondence method are also shown to provide a robust framework for preventing cost-shifting and cream-skimming incentives, with appropriate qualification of analysis and support for data linkage and risk adjustment where these conditions are not satisfied. Comparison on the cost-disutility plane has previously been shown to have distinct advantages in comparing multiple strategies in HTA, which this paper naturally extends to a robust method and framework for comparing efficiency of health care providers in practice. Consequently, the proposed approach provides a missing link between HTA and practice, to allow active incentives for evidence based net benefit maximisation in practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Can differentiated care models solve the crisis in HIV treatment financing? Analysis of prospects for 38 countries in sub-Saharan Africa.

    PubMed

    Barker, Catherine; Dutta, Arin; Klein, Kate

    2017-07-21

    Rapid scale-up of antiretroviral therapy (ART) in the context of financial and health system constraints has resulted in calls to maximize efficiency in ART service delivery. Adopting differentiated care models (DCMs) for ART could potentially be more cost-efficient and improve outcomes. However, no study comprehensively projects the cost savings across countries. We model the potential reduction in facility-level costs and number of health workers needed when implementing two types of DCMs while attempting to reach 90-90-90 targets in 38 sub-Saharan African countries from 2016 to 2020. We estimated the costs of three service delivery models: (1) undifferentiated care, (2) differentiated care by patient age and stability, and (3) differentiated care by patient age, stability, key vs. general population status, and urban vs. rural location. Frequency of facility visits, type and frequency of laboratory testing, and coverage of community ART support vary by patient subgroup. For each model, we estimated the total costs of antiretroviral drugs, laboratory commodities, and facility-level personnel and overhead. Certain groups under four-criteria differentiation require more intensive inputs. Community-based ART costs were included in the DCMs. We take into account underlying uncertainty in the projected numbers on ART and unit costs. Total five-year facility-based ART costs for undifferentiated care are estimated to be US$23.33 billion (95% confidence interval [CI]: $23.3-$23.5 billion). An estimated 17.5% (95% CI: 17.4%-17.7%) and 16.8% (95% CI: 16.7%-17.0%) could be saved from 2016 to 2020 from implementing the age and stability DCM and four-criteria DCM, respectively, with annual cost savings increasing over time. DCMs decrease the full-time equivalent (FTE) health workforce requirements for ART. An estimated 46.4% (95% CI: 46.1%-46.7%) fewer FTE health workers are needed in 2020 for the age and stability DCM compared with undifferentiated care. Adopting DCMs can result in significant efficiency gains in terms of reduced costs and health workforce needs, even with the costs of scaling up community-based ART support under DCMs. Efficiency gains remained flat with increased differentiation. More evidence is needed on how to translate analyzed efficiency gains into implemented cost reductions at the facility level.

  2. Cost-effectiveness analysis of febuxostat in patients with gout in Spain.

    PubMed

    Perez-Ruiz, F; Díaz-Torné, C; Carcedo, D

    2016-06-01

    Objectives Cost-effectiveness of febuxostat compared with allopurinol in the treatment of hyperuricemia in patients with gout. Methods Costs, clinical outcomes, and QALYs were estimated using a Markov model. Febuxostat 80 mg and 120 mg sequentially, used as first line and second line therapy, was compared with allopurinol 300 mg. Patients switched to the next treatment in the sequence according to a dichotomous response vs no response (target serum urate level < 6 mg/dl outcome) after 3 months of active treatment. A 3% discount rate and 5-year time horizon were applied. National Health System. Results The addition of febuxostat to any therapeutic strategy was an efficient option, with incremental cost-effectiveness ratios (ICER) compared with allopurinol 300 mg ranging from €5268-€9737. Conclusions Febuxostat is a cost-effective treatment in Spain for the management of hyperuricemia in gout patients, with ICERs far below accepted Spanish efficiency thresholds (30 000€/QALY).

  3. Efficient Use of Terrestrial Economic Services: A Case Study in South Korea

    NASA Astrophysics Data System (ADS)

    Nguyen, T. T.; Tenhunen, J.; Hoang, V. N.; Koellner, T.; Shin, H.; Pham, V. D.; Seo, B.

    2012-04-01

    Understanding the linkages between social and ecological systems is crucial for managing potential responses to global change. Agricultural production requires resources, is determined by ecological processes, and results in economic goods and services for society. However, production leads at the same time to both positive and negative externalities. The externalities can be enhanced or mitigated by human behavior in management, which is mainly driven by expectations related to economic gains and losses. Ecological and economic processes are interrelated, and continuously interact in a complex manner. Therefore, understanding potential economic gains and losses in response to global change is a fundamental consideration in order to carry out well-informed decision-making. The International Research and Training Group TERRECO at the University of Bayreuth has intensively investigated ecological systems and processes in forested and agricultural landscapes as well as at regional scale in South Korea. These ongoing efforts provide a unique opportunity to examine the economic gains, losses and trade-offs that may occur with future climate and land-use change. Within this framework, we first investigated the environmental and economic efficiency of rice farms in Kangwon Province of South Korea, since rice is the most important food crop in this country. We then expanded our analysis to include dry farm highland vegetable crops in an intensively farmed region of the country, Haean Catchment. Our main objectives are (1) to categorize different types of farms, (2) determine their economic and environmental efficiency, and (3) to determine the trade-offs that occur in economic and environmental efficiencies under alternative management schemes and alternative climate regimes. Our preliminary analysis for rice farms yielded several important findings. First, both the production cost and environmental pollution by rice farms could be reduced significantly. Improvements in technical efficiency would result in both lower production costs and better environmental performance. Secondly, it is not without cost for farms to move from their current operation to an environmentally efficient operation. On average, this shift would increase production costs by 119%, but benefit water resources by a 69% reduction in eutrophication. It was estimated that the average cost of each kg of aggregate nutrient reduction would cost approximately 1.2 thousand won. These findings have several important policy implications. First, without major policy intervention, rice farms could still improve their economic and environmental performance by being more technically efficient. Training programs for rice farmers that focus on how to manage inputs and how to use the nutrients more efficiently would help farms to consume fewer inputs and cause less eutrophication problems. Second, opportunities exist for policy makers to intervene into the markets to adjust the prices of inputs so that farms, by minimizing their production costs, also improve their environmental performance. Further investigation into such policy options (such as introduction of taxes on fertilizer use, removal of subsidies or provision of incentive schemes) is being conducted.

  4. Comparison of Australian and US Cost-Benefit Approaches to MEPS

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

    McMahon, James E.

    2004-03-12

    The Australian Greenhouse Office contracted with the Collaborative Labeling and Appliance Standards Program (CLASP) for LBNL to compare US and Australian approaches to analyzing costs and benefits of minimum energy performance standards (MEPS). This report compares the approaches for three types of products: household refrigerators and freezers, small electric storage water heaters, and commercial/industrial air conditioners. This report presents the findings of similarities and differences between the approaches of the two countries and suggests changes to consider in the approach taken in Australia. The purpose of the Australian program is to reduce greenhouse gas emissions, while the US program ismore » intended to increase energy efficiency; each program is thus subject to specific constraints. The market and policy contexts are different, with the USA producing most of its own products and conducting pioneering engineering-economic studies to identify maximum energy efficiency levels that are technologically feasible and economically justified. In contrast, Australia imports a large share of its products and adopts MEPS already in place elsewhere. With these differences in circumstances, Australia's analysis approach could be expected to have less analytical detail and still result in MEPS levels that are appropriate for their policy and market context. In practice, the analysis required to meet these different objectives is quite similar. To date, Australia's cost-benefit analysis has served the goals and philosophies of the program well and been highly effective in successfully identifying MEPS that are significantly reducing greenhouse gas emissions while providing economic benefits to consumers. In some cases, however, the experience of the USA--using more extensive data sets and more detailed analysis--suggests possible improvements to Australia's cost-benefit analysis. The principal findings of the comparison are: (1) The Technology and Market Assessments are similar; no changes are recommended. (2) The Australian approach to determining the relationship of price to energy efficiency is based on current market, while the US approach uses prospective estimates. Both approaches may benefit from increased retrospective analysis of impacts of MEPS on appliance and equipment prices. Under some circumstances, Australia may wish to consider analyzing two separate components leading to price impacts: (a) changes in manufacturing costs and (b) markups used to convert from manufacturing costs to consumer price. (3) The Life-Cycle Cost methods are similar, but the USA has statistical surveys that permit a more detailed analysis. Australia uses average values, while the US uses full distributions. If data and resources permit, Australia may benefit from greater depth here as well. If implemented, the changes will provide more information about the benefits and costs of the program, in particular identifying who benefits and who bears net costs so that programs can be designed to offset unintended negative consequences, and may assist the government in convincing affected parties of the justification for some MEPS. However, without a detailed and statistically representative national survey, such an approach may not be practical for Australia at this time. (4) The National Benefits and Costs methods are similar prospective estimates of shipments, costs and energy savings, as well as greenhouse gas emissions. Additional sensitivity studies could further illustrate the ranges in these estimates. Consideration of lower discount rates could lead to more stringent MEPS in some cases. (5) Both the Australian and US analyses of impacts on industry, competition, and trade ultimately depend upon sufficient consultation with industry experts. While the Australian analysis of financial impacts on manufacturers is less detailed than that of the US, the Australian treatment of impacts on market shares imported from different regions of the world is more detailed. No change is recommended. Implementing these changes would increase the depth of analysis, require additional data collection and analysis, and incur associated costs and time. The recommended changes are likely to have incremental rather than dramatic impacts on the substance and implications of the analysis as currently conducted.« less

  5. How to perform a cost-effectiveness analysis with surrogate endpoint: renal denervation in patients with resistant hypertension (DENERHTN) trial as an example.

    PubMed

    Bulsei, Julie; Darlington, Meryl; Durand-Zaleski, Isabelle; Azizi, Michel

    2018-04-01

    Whilst much uncertainty exists as to the efficacy of renal denervation (RDN), the positive results of the DENERHTN study in France confirmed the interest of an economic evaluation in order to assess efficiency of RDN and inform local decision makers about the costs and benefits of this intervention. The uncertainty surrounding both the outcomes and the costs can be described using health economic methods such as the non-parametric bootstrap. Internationally, numerous health economic studies using a cost-effectiveness model to assess the impact of RDN in terms of cost and effectiveness compared to antihypertensive medical treatment have been conducted. The DENERHTN cost-effectiveness study was the first health economic evaluation specifically designed to assess the cost-effectiveness of RDN using individual data. Using the DENERHTN results as an example, we provide here a summary of the principle methods used to perform a cost-effectiveness analysis.

  6. Aneurysm coil embolization: cost per volumetric filling analysis and strategy for cost reduction.

    PubMed

    Wang, Charlie; Ching, Esteban Cheng; Hui, Ferdinand K

    2016-05-01

    One of the primary device expenditures associated with the endovascular treatment of aneurysms is that of detachable coils. Analyzing the cost efficiency of detachable coils is difficult, given the differences in design, implantable volume, and the presence of additives. However, applying a volume per cost metric may provide an index analogous to unit price found in grocery stores. The price information for 509 different coils belonging to 31 different coil lines, available as of September 2013, was obtained through the inventory management system at the study site, and normalized to the price of the least expensive coil. Values were used to calculate the logarithmic ratio of volume over cost. Operator choice among coil sizes can vary the material costs by five-fold in a hypothetical aneurysm. The difference in coil costs as a function of cost per volume of coil can vary tremendously. Using the present pricing algorithms, using the longest available length at a particular helical dimension and system yields improved efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. [Cost-effectiveness analysis of 2 strategies of Helicobacter pylori eradication: results of a prospective and randomized study in primary care].

    PubMed

    Gomollón, F; Valdepérez, J; Garuz, R; Fuentes, J; Barrera, F; Malo, J; Tirado, M; Simón, M A

    2000-06-03

    To analyze cost-effectiveness of two different strategies to treat H. pylori infection in peptic ulcer in the primary care setting. Consecutive patients with endoscopic diagnosis of peptic ulcer were randomized to one of two strategies: a) treatment during 7 days with omeprazole, tetracycline, metronidazole and bismuth subcitrate ("quadruple" therapy) and if failure second-line treatment with omeprazole, amoxycillin and clarithromycin during 7 days (OCA7), and b) initial treatment with OCA7 and if failure treatment with "quadruple therapy". End point was eradication 8 weeks after last treatment dose. Direct and indirect costs were estimated (euros, 1997) and a cost-effectiveness analysis using a decision-tree model was undertaken after real clinical data. 95% confidence intervals are given. After screening 255 patients, 97 were finally included. 48 patients were given strategy a and 49 strategy b. Eradication was obtained (intention-to-treat) in 72.9% (CI 95%: 58.2-84.7) in group a versus 91.8% (CI 95%: 80.4-97.7) (p < 0.05) in group b. Mean cost per case treated was lower in group a (237 versus 268 euros) but cost per case eradicated was lower in group b (320 versus 296 euros). The cost was primarily determined by efficacy. Treatment with OCA7 followed by rescue with "quadruple" therapy if failure is more efficient in our area that the inverse strategy. Efficiency is mostly determined by efficacy.

  8. Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

    PubMed Central

    Alexandrescu, Roxana; Siegert, Richard John; Turner-Stokes, Lynne

    2014-01-01

    Objectives To describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies. Subjects and Setting 186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-Barré Syndrome (n = 118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n = 15 (8.1%) or critical illness neuropathy (n = 32 (17.2%)). Methods Cohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: ‘low’ (NPDS<10), ‘medium’ (NPDS 10–24) and ‘high’ (NPDS ≥25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community. Results The mean rehabilitation length of stay was 72.2 (sd = 66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (£1049 per week (SD £994)), so that overall they were the most cost-efficient to treat. Conclusions Patients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients. PMID:25402491

  9. Urban Land Cover Mapping Accuracy Assessment - A Cost-benefit Analysis Approach

    NASA Astrophysics Data System (ADS)

    Xiao, T.

    2012-12-01

    One of the most important components in urban land cover mapping is mapping accuracy assessment. Many statistical models have been developed to help design simple schemes based on both accuracy and confidence levels. It is intuitive that an increased number of samples increases the accuracy as well as the cost of an assessment. Understanding cost and sampling size is crucial in implementing efficient and effective of field data collection. Few studies have included a cost calculation component as part of the assessment. In this study, a cost-benefit sampling analysis model was created by combining sample size design and sampling cost calculation. The sampling cost included transportation cost, field data collection cost, and laboratory data analysis cost. Simple Random Sampling (SRS) and Modified Systematic Sampling (MSS) methods were used to design sample locations and to extract land cover data in ArcGIS. High resolution land cover data layers of Denver, CO and Sacramento, CA, street networks, and parcel GIS data layers were used in this study to test and verify the model. The relationship between the cost and accuracy was used to determine the effectiveness of each sample method. The results of this study can be applied to other environmental studies that require spatial sampling.

  10. Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany--an application of the efficiency frontier approach.

    PubMed

    Gissel, Christian; Götz, Georg; Mahlich, Jörg; Repp, Holger

    2015-07-30

    The approval of direct-acting antivirals for Interferon-free treatment revolutionized the therapy of chronic Hepatitis C infection. As of August 2014, two treatment regimens for genotype 1 infection received conditional approval in the European Union: Sofosbuvir and Ribavirin for 24 weeks and Sofosbuvir and Simeprevir with or without Ribavirin for 12 weeks. We aim to analyze the cost-effectiveness of both regimens in Germany. We set up a Markov model with a lifetime horizon to simulate immediate treatment success and long-term disease progression for treatment-naive patients. The model analyzes both short-term and long-term costs and benefits from the perspective of the German Statutory Health Insurance. We apply the efficiency frontier method, which was suggested by German Institute for Quality and Efficiency in Health Care for cost-effectiveness analysis in Germany. The efficiency frontier is defined by dual therapy and first generation direct-acting antiviral Boceprevir, yielding a maximum of € 1,447.69 per additional percentage point of sustained virologic response gained. Even without rebates, Sofosbuvir/Simeprevir is very close with € 1,560.13 per additional percentage point. It is both more effective and less expensive than Sofosbuvir/Ribavirin. In addition to higher sustained virologic response rates, new direct-acting antivirals save long-term costs by preventing complications such as liver cirrhosis, hepatocellular carcinoma and ultimately liver transplants, thereby offsetting part of higher drug costs. Our findings are in line with the guidance published by German Society for Gastroenterology, Digestive and Metabolic Diseases, which recommends Sofosbuvir/Simeprevir for Interferon ineligible or intolerant patients.

  11. Cost-effectiveness analysis of stent type in endoscopic treatment of gastric leak after laparoscopic sleeve gastrectomy.

    PubMed

    Cosse, C; Rebibo, L; Brazier, F; Hakim, S; Delcenserie, R; Regimbeau, J M

    2018-04-01

    Gastric leak is the most feared surgical postoperative complication after sleeve gastrectomy. An endoscopic procedure is usually required to treat the leak. No data are available on the cost-effectiveness of different stent types in this procedure. Between April 2005 and July 2016, patients with a confirmed gastric leak undergoing endoscopic treatment using a covered stent (CS) or double-pigtail stent (DPS) were included. The primary objective of the study was to assess overall costs of the stent types after primary sleeve gastrectomy. Secondary objectives were the cost-effectiveness of each stent type expressed as an incremental cost-effectiveness ratio (ICER); the incremental net benefit; the probability of efficiency, defined as the probability of being cost-effective at a threshold of €30 000, and identification of the key drivers of ICER derived from a multivariable analysis. One hundred and twelve patients were enrolled. The overall mean costs of gastric leak were €22 470; the mean(s.d.) cost was €24 916(12 212) in the CS arm and €20 024(3352) in the DPS arm (P = 0·018). DPS was more cost-effective than CS (ICER €4743 per endoscopic procedure avoided), with an incremental net benefit of €25 257 and a 27 per cent probability of efficiency. Key drivers of the ICER were the inpatient ward after diagnosis of gastric leak (surgery versus internal medicine), type of institution (private versus public) and duration of hospital stay per endoscopic procedure. DPS for the treatment of gastric leak is more cost-effective than CS and should be proposed as the standard regimen whenever possible. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  12. A cost effectiveness analysis of maintenance cognitive stimulation therapy (MCST) for people with dementia: examining the influence of cognitive ability and living arrangements.

    PubMed

    Brown, Heather; D'Amico, Francesco; Knapp, Martin; Orrell, Martin; Rehill, Amritpal; Vale, Luke; Robinson, Louise

    2018-03-12

    Identify if cost-effectiveness of Maintenance Cognitive Simulation Therapy (MCST) differs by type of living arrangement and cognitive ability of the person with dementia. Next, a value of information analysis is performed to inform decisions about future research. Incremental cost-effectiveness analysis applying seemingly unrelated regressions using data from a multicentre RCT of MCST versus treatment as usual in a population which had already received 7 weeks of CST for dementia (ISRCTN: 26286067). The findings from the cost-effectiveness analysis are used to inform a value of information analysis. The results are dependent upon how quality adjusted life years (QALYs) are measured. MCST might be cost-effective compared to standard treatment for those who live alone and those with higher levels of cognitive functioning. If a further RCT was to be conducted for this sub-group of the population, value of information analysis suggests a total sample of 48 complete cases for both sub-groups would be required for a two-arm trial. The expected net gain of conducting this future research is £920 million. Preliminary results suggest that MCST may be most cost-efficient for people with dementia who live alone and/or who have higher cognition. Future research in this area is needed.

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

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

    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.more » 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.« less

  14. Inferential ecosystem models, from network data to prediction

    Treesearch

    James S. Clark; Pankaj Agarwal; David M. Bell; Paul G. Flikkema; Alan Gelfand; Xuanlong Nguyen; Eric Ward; Jun Yang

    2011-01-01

    Recent developments suggest that predictive modeling could begin to play a larger role not only for data analysis, but also for data collection. We address the example of efficient wireless sensor networks, where inferential ecosystem models can be used to weigh the value of an observation against the cost of data collection. Transmission costs make observations ‘‘...

  15. Cost analysis of a mini-facet heliostat

    NASA Astrophysics Data System (ADS)

    Hall, Colin; Pratt, Rodney; Farrant, David; Corsi, Clotilde; Pye, John; Coventry, Joe

    2017-06-01

    A significant problem with conventional heliostats is off-axis astigmatism, which increases the spot size at the central receiver, limiting the temperature and efficiency of solar thermal systems. Inspired by low-cost mini-actuators used for car wing mirrors, we examine the economic feasibility of a heliostat with individually adjustable mini-facets to correct astigmatic effects, and we compare three alternative tracking configurations.

  16. Spectrum splitting using multi-layer dielectric meta-surfaces for efficient solar energy harvesting

    NASA Astrophysics Data System (ADS)

    Yao, Yuhan; Liu, He; Wu, Wei

    2014-06-01

    We designed a high-efficiency dispersive mirror based on multi-layer dielectric meta-surfaces. By replacing the secondary mirror of a dome solar concentrator with this dispersive mirror, the solar concentrator can be converted into a spectrum-splitting photovoltaic system with higher energy harvesting efficiency and potentially lower cost. The meta-surfaces are consisted of high-index contrast gratings (HCG). The structures and parameters of the dispersive mirror (i.e. stacked HCG) are optimized based on finite-difference time-domain and rigorous coupled-wave analysis method. Our numerical study shows that the dispersive mirror can direct light with different wavelengths into different angles in the entire solar spectrum, maintaining very low energy loss. Our approach will not only improve the energy harvesting efficiency, but also lower the cost by using single junction cells instead of multi-layer tandem solar cells. Moreover, this approach has the minimal disruption to the existing solar concentrator infrastructures.

  17. Prospects for energy efficiency improvement and reduction of emissions and life cycle costs for natural gas vehicles

    NASA Astrophysics Data System (ADS)

    Kozlov, A. V.; Terenchenko, A. S.; Luksho, V. A.; Karpukhin, K. E.

    2017-01-01

    This work is devoted to the experimental investigation of the possibilities to reduce greenhouse gas emissions and to increase energy efficiency of engines that use natural gas as the main fuel and the analysis of economic efficiency of use of dual fuel engines in vehicles compared to conventional diesel. The results of experimental investigation of a 190 kW dual-fuel engine are presented; it is shown that quantitative and qualitative working process control may ensure thermal efficiency at the same level as that of the diesel engine and in certain conditions 5...8% higher. The prospects for reduction of greenhouse gas emissions have been assessed. The technical and economic evaluation of use of dual fuel engines in heavy-duty vehicles has been performed, taking into account the total life cycle. It is shown that it is possible to reduce life cycle costs by two times.

  18. Social efficiency of hospital care delivery: frontier analysis from the consumer's perspective.

    PubMed

    Bernet, Patrick M; Moises, James; Valdmanis, Vivian Grace

    2011-02-01

    The efficiency of hospital services and patients' access to hospitals are both important health care policy issues. In the past, research has relied on studying these topics separately. In this article, we measure both efficiency and access at the same time using data envelopment analysis (DEA). By including both the technically efficient use of resources, as well as the patients' travel distances, we found increases in social efficiency when patients' travel distances were taken into account. When compared with patients with nonurgent conditions, we found that patients suffering from conditions requiring urgent attention were treated at closer hospitals, increasing the social efficiency. Insurance coverage and hospital ownership were also examined. Our findings corroborated past literature in the hospital and travel distance literature and set out a framework for future research. Perhaps most important, we demonstrate the techniques needed to incorporate broader measures of social costs into studies of hospital efficiency.

  19. Cost analysis as a vitamin A program design and evaluation tool: a case study of the Philippines.

    PubMed

    Fiedler, J L; Dado, D R; Maglalang, H; Juban, N; Capistrano, M; Magpantay, M V

    2000-07-01

    Vitamin A deficiency (VAD) is a serious and widespread public health problem in the Philippines. Initiated in 1993, the Philippines National Vitamin A Supplementation Program (NVASP) is one of the oldest, most mature and comprehensive of its kind. This paper presents a cost-effectiveness and efficiency analysis of the NVASP and of a hypothetical program of vitamin A fortification of wheat flour that was conducted to inform policymakers as to how to modify the program. Employing a proxy effectiveness indicator of VAD--the intake of < 70% of the recommended daily allowance of vitamin A--in a series of simulations using individual child consumption data, the analysis finds that fortification is more efficient in reducing inadequate vitamin A intake (IVAI) compared to the NVASP. Due to the nature of food consumption patterns, however, fortification alone, is not enough. At what is regarded as the maximum politically acceptable fortification level, there will still be 2.2 million (29%) Filipino children aged 12-59 months who will have IVAI. An investigation of the cost and efficiency of geographically targeted supplementation programs reveals that maintaining a universal supplementation program in urban areas and, in rural areas, introducing a targeted program to only the poorest municipalities (where the prevalence of VAD is the highest) will provide a more acceptable public health policy response than fortification alone. Such a policy will reduce incremental direct Government expenditures on vitamin A programs by nearly 20% and will reduce the number of children with IVAI to 900,000 (12%) Filipino children. The paper describes the fortification and supplementation programs, and how their costs were estimated. Lessons for program designers and policymakers in other countries in which vitamin A deficiency constitutes a public health problem are also discussed.

  20. Process and assembly plans for low cost commercial fuselage structure

    NASA Technical Reports Server (NTRS)

    Willden, Kurtis; Metschan, Stephen; Starkey, Val

    1991-01-01

    Cost and weight reduction for a composite structure is a result of selecting design concepts that can be built using efficient low cost manufacturing and assembly processes. Since design and manufacturing are inherently cost dependent, concurrent engineering in the form of a Design-Build Team (DBT) is essential for low cost designs. Detailed cost analysis from DBT designs and hardware verification must be performed to identify the cost drivers and relationships between design and manufacturing processes. Results from the global evaluation are used to quantitatively rank design, identify cost centers for higher ranking design concepts, define and prioritize a list of technical/economic issues and barriers, and identify parameters that control concept response. These results are then used for final design optimization.

  1. Efficient Research Design: Using Value-of-Information Analysis to Estimate the Optimal Mix of Top-down and Bottom-up Costing Approaches in an Economic Evaluation alongside a Clinical Trial.

    PubMed

    Wilson, Edward C F; Mugford, Miranda; Barton, Garry; Shepstone, Lee

    2016-04-01

    In designing economic evaluations alongside clinical trials, analysts are frequently faced with alternative methods of collecting the same data, the extremes being top-down ("gross costing") and bottom-up ("micro-costing") approaches. A priori, bottom-up approaches may be considered superior to top-down approaches but are also more expensive to collect and analyze. In this article, we use value-of-information analysis to estimate the efficient mix of observations on each method in a proposed clinical trial. By assigning a prior bivariate distribution to the 2 data collection processes, the predicted posterior (i.e., preposterior) mean and variance of the superior process can be calculated from proposed samples using either process. This is then used to calculate the preposterior mean and variance of incremental net benefit and hence the expected net gain of sampling. We apply this method to a previously collected data set to estimate the value of conducting a further trial and identifying the optimal mix of observations on drug costs at 2 levels: by individual item (process A) and by drug class (process B). We find that substituting a number of observations on process A for process B leads to a modest £ 35,000 increase in expected net gain of sampling. Drivers of the results are the correlation between the 2 processes and their relative cost. This method has potential use following a pilot study to inform efficient data collection approaches for a subsequent full-scale trial. It provides a formal quantitative approach to inform trialists whether it is efficient to collect resource use data on all patients in a trial or on a subset of patients only or to collect limited data on most and detailed data on a subset. © The Author(s) 2016.

  2. Allocative and implementation efficiency in HIV prevention and treatment for people who inject drugs.

    PubMed

    Benedikt, Clemens; Kelly, Sherrie L; Wilson, David; Wilson, David P

    2016-12-01

    Estimated global new HIV infections among people who inject drugs (PWID) remained stable over the 2010-2015 period and the target of a 50% reduction over this period was missed. To achieve the 2020 UNAIDS target of reducing adult HIV infections by 75% compared to 2010, accelerated action in scaling up HIV programs for PWID is required. In a context of diminishing external support to HIV programs in countries where most HIV-affected PWID live, it is essential that available resources are allocated and used as efficiently as possible. Allocative and implementation efficiency analysis methods were applied. Optima, a dynamic, population-based HIV model with an integrated program and economic analysis framework was applied in eight countries in Eastern Europe and Central Asia (EECA). Mathematical analyses established optimized allocations of resources. An implementation efficiency analysis focused on examining technical efficiency, unit costs, and heterogeneity of service delivery models and practices. Findings from the latest reported data revealed that countries allocated between 4% (Bulgaria) and 40% (Georgia) of total HIV resources to programs targeting PWID - with a median of 13% for the eight countries. When distributing the same amount of HIV funding optimally, between 9% and 25% of available HIV resources would be allocated to PWID programs with a median allocation of 16% and, in addition, antiretroviral therapy would be scaled up including for PWID. As a result of optimized allocations, new HIV infections are projected to decline by 3-28% and AIDS-related deaths by 7-53% in the eight countries. Implementation efficiencies identified involve potential reductions in drug procurement costs, service delivery models, and practices and scale of service delivery influencing cost and outcome. A high level of implementation efficiency was associated with high volumes of PWID clients accessing a drug harm reduction facility. A combination of optimized allocation of resources, improved implementation efficiency and increased investment of non-HIV resources is required to enhance coverage and improve outcomes of programs for PWID. Increasing efficiency of HIV programs for PWID is a key step towards avoiding implicit rationing and ensuring transparent allocation of resources where and how they would have the largest impact on the health of PWID, and thereby ensuring that funding spent on PWID becomes a global best buy in public health. Copyright © 2016. Published by Elsevier B.V.

  3. A Highly Efficient Design Strategy for Regression with Outcome Pooling

    PubMed Central

    Mitchell, Emily M.; Lyles, Robert H.; Manatunga, Amita K.; Perkins, Neil J.; Schisterman, Enrique F.

    2014-01-01

    The potential for research involving biospecimens can be hindered by the prohibitive cost of performing laboratory assays on individual samples. To mitigate this cost, strategies such as randomly selecting a portion of specimens for analysis or randomly pooling specimens prior to performing laboratory assays may be employed. These techniques, while effective in reducing cost, are often accompanied by a considerable loss of statistical efficiency. We propose a novel pooling strategy based on the k-means clustering algorithm to reduce laboratory costs while maintaining a high level of statistical efficiency when predictor variables are measured on all subjects, but the outcome of interest is assessed in pools. We perform simulations motivated by the BioCycle study to compare this k-means pooling strategy with current pooling and selection techniques under simple and multiple linear regression models. While all of the methods considered produce unbiased estimates and confidence intervals with appropriate coverage, pooling under k-means clustering provides the most precise estimates, closely approximating results from the full data and losing minimal precision as the total number of pools decreases. The benefits of k-means clustering evident in the simulation study are then applied to an analysis of the BioCycle dataset. In conclusion, when the number of lab tests is limited by budget, pooling specimens based on k-means clustering prior to performing lab assays can be an effective way to save money with minimal information loss in a regression setting. PMID:25220822

  4. Regulation of suspended particulate matter (SPM) in Indian coal-based thermal power plants

    NASA Astrophysics Data System (ADS)

    Sengupta, Ishita

    Air borne particulate matter, in major Indian cities is at least three times the standard prescribed by the WHO. Coal-based thermal power plants are the major emitters of particulate matter in India. The lack of severe penalty for non-compliance with the standards has worsened the situation and thus calls for an immediate need for investment in technologies to regulate particulate emissions. My dissertation studies the optimal investment decisions in a dynamic framework, for a random sample of forty Indian coal-based power plants to abate particulate emissions. I used Linear Programming to solve the double cost minimization problem for the optimal choices of coal, boiler and pollution-control equipment. A policy analysis is done to choose over various tax policies, which would induce the firms to adopt the energy efficient as well as cost efficient technology. The aim here is to reach the WHO standards. Using the optimal switching point model I show that in a dynamic set up, switching the boiler immediately is always the cost effective option for all the power plants even if there is no policy restriction. The switch to a baghouse depends upon the policy in place. Theoretically, even though an emission tax is considered the most efficient tax, an ash tax or a coal tax can also be considered to be a good substitute especially in countries like India where monitoring costs are very high. As SPM is a local pollutant the analysis here is mainly firm specific.

  5. A highly efficient design strategy for regression with outcome pooling.

    PubMed

    Mitchell, Emily M; Lyles, Robert H; Manatunga, Amita K; Perkins, Neil J; Schisterman, Enrique F

    2014-12-10

    The potential for research involving biospecimens can be hindered by the prohibitive cost of performing laboratory assays on individual samples. To mitigate this cost, strategies such as randomly selecting a portion of specimens for analysis or randomly pooling specimens prior to performing laboratory assays may be employed. These techniques, while effective in reducing cost, are often accompanied by a considerable loss of statistical efficiency. We propose a novel pooling strategy based on the k-means clustering algorithm to reduce laboratory costs while maintaining a high level of statistical efficiency when predictor variables are measured on all subjects, but the outcome of interest is assessed in pools. We perform simulations motivated by the BioCycle study to compare this k-means pooling strategy with current pooling and selection techniques under simple and multiple linear regression models. While all of the methods considered produce unbiased estimates and confidence intervals with appropriate coverage, pooling under k-means clustering provides the most precise estimates, closely approximating results from the full data and losing minimal precision as the total number of pools decreases. The benefits of k-means clustering evident in the simulation study are then applied to an analysis of the BioCycle dataset. In conclusion, when the number of lab tests is limited by budget, pooling specimens based on k-means clustering prior to performing lab assays can be an effective way to save money with minimal information loss in a regression setting. Copyright © 2014 John Wiley & Sons, Ltd.

  6. Pharmacoeconomic Analysis in Saudi Arabia: An Overdue Agenda Item for Action

    PubMed Central

    Al-Jazairi, Abdulrazaq S.; Al-Qadheeb, Nada S.; Ajlan, Aziza

    2011-01-01

    Pharmacoeconomics is a branch of health economics related to the most economical and efficient use of pharmaceuticals. Pharmacoeconomic research identifies, measures and compares the costs and outcomes (clinical, economic and humanistic) of pharmaceutical products and services. Pharmacoeconomic evaluation can play a significant role in the efficient allocation of resources in healthcare systems with constrained budgets. Countries are trying to control the rising costs of health care in their aging population. They are all asking the same question: Is the new drug good value for money; and if so, what is the society willing to pay for it? This article reviews the importance of, and the need for, adaptation of pharmacoeconomic analysis to the conditions in Saudi Arabia. It will shed some light on the important steps for converting the concept into practice, including the need for identifying the willing-to-pay (WTP) or the threshold cutoff, the existence of a real cost for each utility, the nonexistence of an pharmacoeconomic advisory forum, pharmaceutical budget allocation, and the impact of pharmaceutical marketing. It will also provide recommendations for easing any challenges that might jeopardize the conduct of such analysis in Saudi Arabia. PMID:21808106

  7. Business Case Analysis for Replacing the Mazak 30Y Mill-Turn Machine in SM-39. Summary

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

    Booth, Steven Richard; Dinehart, Timothy Grant; Benson, Faith Ann

    2015-03-19

    Business case studies are being looked at to support procurement of new machines and capital equipment in the SM-39 and TA-03-0102 machine shops. The first effort conducted economic analysis of replacing the Mazak 30Y Mill-Turn Machine located in SM-39. To determine the value of switching machinery, a baseline scenario was compared with a future scenario where new machinery was purchased and installed. The conditions under the two scenarios were defined via interviews with subject matter experts in terms of one-time and periodic costs. The results of the analysis were compiled in a life-cycle cost/benefit table. The costs of procuring, installing,more » and maintaining a new machine were balanced against the costs avoided by replacing older machinery. Productivity savings were included as a measure to show the costs avoided by being able to produce parts at a quicker and more efficient pace.« less

  8. Health systems: changes in hospital efficiency and profitability.

    PubMed

    Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

    2016-06-01

    This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital profitability, the results reveal an increase in hospital profitability only 1 year after health system entry, and the estimations suggest that this effect is a transitional phenomenon. Overall, health system entry may serve as an appropriate management instrument for decision makers to increase hospital performance.

  9. Applications of life cycle assessment and cost analysis in health care waste management

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

    Soares, Sebastiao Roberto, E-mail: soares@ens.ufsc.br; Finotti, Alexandra Rodrigues, E-mail: finotti@ens.ufsc.br; Prudencio da Silva, Vamilson, E-mail: vamilson@epagri.sc.gov.br

    Highlights: Black-Right-Pointing-Pointer Three Health Care Waste (HCW) scenarios were assessed through environmental and cost analysis. Black-Right-Pointing-Pointer HCW treatment using microwave oven had the lowest environmental impacts and costs in comparison with autoclave and lime. Black-Right-Pointing-Pointer Lime had the worst environmental and economic results for HCW treatment, in comparison with autoclave and microwave. - Abstract: The establishment of rules to manage Health Care Waste (HCW) is a challenge for the public sector. Regulatory agencies must ensure the safety of waste management alternatives for two very different profiles of generators: (1) hospitals, which concentrate the production of HCW and (2) small establishments, such as clinics, pharmacies and other sources, that generate dispersed quantities of HCW and are scattered throughout the city. To assist in developing sector regulations for the small generators, we evaluated three management scenarios using decision-making tools. They consisted of a disinfection technique (microwave, autoclave and lime) followed by landfilling, where transportation was also included. The microwave, autoclave and lime techniques were tested at the laboratory to establish the operating parameters to ensure their efficiency in disinfection. Using a life cycle assessment (LCA) and cost analysis, the decision-making tools aimed to determine the technique with the best environmental performance. This consisted of evaluating the eco-efficiency of each scenario. Based on the life cycle assessment, microwaving had the lowest environmental impact (12.64 Pt) followed by autoclaving (48.46 Pt). The cost analyses indicated values of USmore » $$ 0.12 kg{sup -1} for the waste treated with microwaves, US$$ 1.10 kg{sup -1} for the waste treated by the autoclave and US$ 1.53 kg{sup -1} for the waste treated with lime. The microwave disinfection presented the best eco-efficiency performance among those studied and provided a feasible alternative to subsidize the formulation of the policy for small generators of HCW.« less

  10. Reuse of disposable laparoscopic instruments: cost analysis*

    PubMed Central

    DesCôteaux, Jean-Gaston; Tye, Lucille; Poulin, Eric C.

    1996-01-01

    Objective To evaluate the cost benefits of reusing disposable laparoscopic instruments. Design A cost-analysis study based on a review of laparoscopic and thoracoscopic procedures performed between August 1990 and January 1994, including analysis of disposable instrument use, purchase records, and reprocessing costs for each instrument. Setting The general surgery department of a 461-bed teaching hospital where disposable laparoscopic instruments are routinely reused according to internally validated reprocessing protocols. Methods Laparoscopic and thoracoscopic interventions performed between August 1990 and January 1994 for which the number and types of disposable laparoscopic instruments were standardized. Main Outcome Measures Reprocessing cost per instrument, the savings realized by reusing disposable laparoscopic instruments and the cost-efficient number of reuses per instrument. Results The cost of reprocessing instruments varied from $2.64 (Can) to $4.66 for each disposable laparoscopic instrument. Purchases of 10 commonly reused disposable laparoscopic instruments totalled $183 279, and the total reprocessing cost was estimated at $35 665 for the study period. Not reusing disposable instruments would have cost $527 575 in instrument purchases for the same period. Disposable laparoscopic instruments were reused 1.7 to 68 times each. Conclusions Under carefully monitored conditions and strict guidelines, reuse of disposable laparoscopic and thoracoscopic instruments can be cost-effective. PMID:8769924

  11. Sizing and economic analysis of stand alone photovoltaic system with hydrogen storage

    NASA Astrophysics Data System (ADS)

    Nordin, N. D.; Rahman, H. A.

    2017-11-01

    This paper proposes a design steps in sizing of standalone photovoltaic system with hydrogen storage using intuitive method. The main advantage of this method is it uses a direct mathematical approach to find system’s size based on daily load consumption and average irradiation data. The keys of system design are to satisfy a pre-determined load requirement and maintain hydrogen storage’s state of charge during low solar irradiation period. To test the effectiveness of the proposed method, a case study is conducted using Kuala Lumpur’s generated meteorological data and rural area’s typical daily load profile of 2.215 kWh. In addition, an economic analysis is performed to appraise the proposed system feasibility. The finding shows that the levelized cost of energy for proposed system is RM 1.98 kWh. However, based on sizing results obtained using a published method with AGM battery as back-up supply, the system cost is lower and more economically viable. The feasibility of PV system with hydrogen storage can be improved if the efficiency of hydrogen storage technologies significantly increases in the future. Hence, a sensitivity analysis is performed to verify the effect of electrolyzer and fuel cell efficiencies towards levelized cost of energy. Efficiencies of electrolyzer and fuel cell available in current market are validated using laboratory’s experimental data. This finding is needed to envisage the applicability of photovoltaic system with hydrogen storage as a future power supply source in Malaysia.

  12. Freely Tunable Broadband Polarization Rotator for Terahertz Waves

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

    Fan, Ren-Hao; Zhou, Yu; Ren, Xiao-Ping

    2014-12-28

    A freely tunable polarization rotator for broadband terahertz waves is demonstrated using a three-rotating-layer metallic grating structure, which can conveniently rotate the polarization of a linearly polarized terahertz wave to any desired direction with nearly perfect conversion efficiency. This low-cost, high-efficiency, and freely tunable device has potential applications as material analysis, wireless communication, and THz imaging.

  13. Predicting internal yellow-poplar log defect features using surface indicators

    Treesearch

    R. Edward Thomas

    2008-01-01

    Determining the defects that are located within the log is crucial to understanding the tree/log resource for efficient processing. However, existing means of doing this non-destructively requires the use of expensive X-ray/CT, MRI, or microwave technology. These methods do not lend themselves to fast, efficient, and cost-effective analysis of logs and tree stems in...

  14. The role of pharmacoeconomics in current Indian healthcare system.

    PubMed

    Ahmad, Akram; Patel, Isha; Parimilakrishnan, Sundararajan; Mohanta, Guru Prasad; Chung, HaeChung; Chang, Jongwha

    2013-01-01

    Phamacoeconomics can aid the policy makers and the healthcare providers in decision making in evaluating the affordability of and access to rational drug use. Efficiency is a key concept of pharmacoeconomics, and various strategies are suggested for buying the greatest amount of benefits for a given resource use. Phamacoeconomic evaluation techniques such as cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utilization analysis, which support identification and quantification of cost of drugs, are conducted in a similar way, but vary in measurement of value of health benefits and outcomes. This article provides a brief overview about pharmacoeconomics, its utility with respect to the Indian pharmaceutical industry, and the expanding insurance system in India. Pharmacoeconomic evidences can be utilized to support decisions on licensing, pricing, reimbursement, and maintenance of formulary procedure of pharmaceuticals. For the insurance companies to give better facility at minimum cost, India must develop the platform for pharmacoeconomics with a validating methodology and appropriate training. The role of clinical pharmacists including PharmD graduates are expected to be more beneficial than the conventional pharmacists, as they will be able to apply the principles of economics in daily basis practice in community and hospital pharmacy.

  15. The role of pharmacoeconomics in current Indian healthcare system

    PubMed Central

    Ahmad, Akram; Patel, Isha; Parimilakrishnan, Sundararajan; Mohanta, Guru Prasad; Chung, HaeChung; Chang, Jongwha

    2013-01-01

    Phamacoeconomics can aid the policy makers and the healthcare providers in decision making in evaluating the affordability of and access to rational drug use. Efficiency is a key concept of pharmacoeconomics, and various strategies are suggested for buying the greatest amount of benefits for a given resource use. Phamacoeconomic evaluation techniques such as cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utilization analysis, which support identification and quantification of cost of drugs, are conducted in a similar way, but vary in measurement of value of health benefits and outcomes. This article provides a brief overview about pharmacoeconomics, its utility with respect to the Indian pharmaceutical industry, and the expanding insurance system in India. Pharmacoeconomic evidences can be utilized to support decisions on licensing, pricing, reimbursement, and maintenance of formulary procedure of pharmaceuticals. For the insurance companies to give better facility at minimum cost, India must develop the platform for pharmacoeconomics with a validating methodology and appropriate training. The role of clinical pharmacists including PharmD graduates are expected to be more beneficial than the conventional pharmacists, as they will be able to apply the principles of economics in daily basis practice in community and hospital pharmacy. PMID:24991597

  16. Development of a cost-effectiveness analysis of leafy green marketing agreement irrigation water provisions.

    PubMed

    Jensen, Helen H; Pouliot, Sébastien; Wang, Tong; Jay-Russell, Michele T

    2014-06-01

    An analysis of the effectiveness of meeting the irrigation water provisions of the Leafy Green Marketing Agreement (LGMA) relative to its costs provides an approach to evaluating the cost-effectiveness of good agricultural practices that uses available data. A case example for lettuce is used to evaluate data requirements and provide a methodological example to determine the cost-effectiveness of the LGMA water quality provision. Both cost and field data on pathogen or indicator bacterial levels are difficult and expensive to obtain prospectively. Therefore, methods to use existing field and experimental data are required. Based on data from current literature and experimental studies, we calculate a cost-efficiency ratio that expresses the reduction in E. coli concentration per dollar expenditure on testing of irrigation water. With appropriate data, the same type of analysis can be extended to soil amendments and other practices and to evaluation of public benefits of practices used in production. Careful use of existing and experimental data can lead to evaluation of an expanded set of practices.

  17. Healthcare payment incentives: a comparative analysis of reforms in Taiwan, South Korea and China.

    PubMed

    Eggleston, Karen; Hsieh, Chee-Ruey

    2004-01-01

    Payment incentives to both consumers and providers have significant consequences for the equity and efficiency of a healthcare system, and have recently come to the fore in health policy reforms. This review first discusses the economic rationale for the apparent international convergence toward payment systems with mixed demand- and supply-side cost sharing. The recent payment reforms undertaken in Taiwan, South Korea and China are then summarised. Available evidence clearly indicates that payment incentives matter, and, in particular, that supply-side cost sharing can improve efficiency without undermining equity. Further study and monitoring of health service quality and risk selection is warranted.

  18. Techno-economic analysis of supercritical carbon dioxide power blocks

    NASA Astrophysics Data System (ADS)

    Meybodi, Mehdi Aghaei; Beath, Andrew; Gwynn-Jones, Stephen; Veeraragavan, Anand; Gurgenci, Hal; Hooman, Kamel

    2017-06-01

    Developing highly efficient power blocks holds the key to enhancing the cost competitiveness of Concentration Solar Thermal (CST) technologies. Supercritical CO2 (sCO2) Brayton cycles have proved promising in providing equivalent or higher cycle efficiency than supercritical or superheated steam cycles at temperatures and scales relevant for Australian CST applications. In this study, a techno-economic methodology is developed using a stochastic approach to determine the ranges for the cost and performance of different components of central receiver power plants utilizing sCO2 power blocks that are necessary to meet the Australian Solar Thermal Initiative (ASTRI) final LCOE target of 12 c/kWh.

  19. Energy Conversion Alternatives Study (ECAS), Westinghouse phase 1. Volume 8: Open-cycle MHD. [energy conversion efficiency and design analysis of electric power plants employing magnetohydrodynamics

    NASA Technical Reports Server (NTRS)

    Hoover, D. Q.

    1976-01-01

    Electric power plant costs and efficiencies are presented for three basic open-cycle MHD systems: (1) direct coal fired system, (2) a system with a separately fired air heater, and (3) a system burning low-Btu gas from an integrated gasifier. Power plant designs were developed corresponding to the basic cases with variation of major parameters for which major system components were sized and costed. Flow diagrams describing each design are presented. A discussion of the limitations of each design is made within the framework of the assumptions made.

  20. Comparative Cost Analysis of Surgical and PrePex Device Male Circumcision in Zimbabwe and Mozambique.

    PubMed

    Schutte, Carl; Tshimanga, M; Mugurungi, Owen; Come, Iotamo; Necochea, Edgar; Mahomed, Mehebub; Xaba, Sinokuthemba; Bossemeyer, Debora; Ferreira, Thais; Macaringue, Lucinda; Chatikobo, Pessanai; Gundididza, Patricia; Hatzold, Karin

    2016-06-01

    The PrePex device has proven to be safe for voluntary medical male circumcision (VMMC) in adults in several African countries. Costing studies were conducted as part of a PrePex/Surgery comparison study in Zimbabwe and a pilot implementation study in Mozambique. The studies calculated per male circumcision unit costs using a cost-analysis approach. Both direct costs (consumable and nonconsumable supplies, device, personnel, associated staff training) and selected indirect costs (capital and support personnel costs) were calculated. The cost comparison in Zimbabwe showed a unit cost per VMMC of $45.50 for PrePex and $53.08 for surgery. The unit cost difference was based on higher personnel and consumable supplies costs for the surgical procedure, which used disposable instrument kits. In Mozambique, the costing analysis estimated a higher unit cost for PrePex circumcision ($40.66) than for surgery ($20.85) because of higher consumable costs, particularly the PrePex device and lower consumable supplies costs for the surgical procedure using reusable instruments. Supplies and direct staff costs contributed 87.2% for PrePex and 65.8% for surgical unit costs in Mozambique. PrePex device male circumcision could potentially be cheaper than surgery in Zimbabwe, especially in settings that lack the infrastructure and personnel required for surgical VMMC, and this might result in programmatic cost savings. In Mozambique, the surgical procedure seems to be less costly compared with PrePex mainly because of higher consumable supplies costs. With reduced device unit costs, PrePex VMMC could become more cost-efficient and considered as complementary for Mozambique's VMMC scale-up program.

  1. Assessing value-for-money in maternal and newborn health

    PubMed Central

    Madaj, Barbara; Kumar, Shubha

    2017-01-01

    Responding to increasing demands to demonstrate value-for-money (VfM) for maternal and newborn health interventions, and in the absence of VfM analysis in peer-reviewed literature, this paper reviews VfM components and methods, critiques their applicability, strengths and weakness and proposes how VfM assessments can be improved. VfM comprises four components: economy, efficiency, effectiveness and cost-effectiveness. Both ‘economy’ and ‘efficiency’ can be assessed with detailed cost analysis utilising costs obtained from programme accounting data or generic cost databases. Before-and-after studies, case–control studies or randomised controlled trials can be used to assess ‘effectiveness’. To assess ‘cost-effectiveness’, cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-benefit analysis (CBA) or social return on investment (SROI) analysis are applicable. Generally, costs can be obtained from programme accounting data or existing generic cost databases. As such ‘economy’ and ‘efficiency’ are relatively easy to assess. However, ‘effectiveness’ and ‘cost-effectiveness’ which require establishment of the counterfactual are more difficult to ascertain. Either a combination of CEA or CUA with tools for assessing other VfM components, or the independent use of CBA or SROI are alternative approaches proposed to strengthen VfM assessments. Cross-cutting themes such as equity, sustainability, scalability and cultural acceptability should also be assessed, as they provide critical contextual information for interpreting VfM assessments. To select an assessment approach, consideration should be given to the purpose, data availability, stakeholders requiring the findings and perspectives of programme beneficiaries. Implementers and researchers should work together to improve the quality of assessments. Standardisation around definitions, methodology and effectiveness measures to be assessed would help. PMID:29081998

  2. Parametric study of prospective early commercial MHD power plants (PSPEC). General Electric Company, task 1: Parametric analysis

    NASA Technical Reports Server (NTRS)

    Marston, C. H.; Alyea, F. N.; Bender, D. J.; Davis, L. K.; Dellinger, T. C.; Hnat, J. G.; Komito, E. H.; Peterson, C. A.; Rogers, D. A.; Roman, A. J.

    1980-01-01

    The performance and cost of moderate technology coal-fired open cycle MHD/steam power plant designs which can be expected to require a shorter development time and have a lower development cost than previously considered mature OCMHD/steam plants were determined. Three base cases were considered: an indirectly-fired high temperature air heater (HTAH) subsystem delivering air at 2700 F, fired by a state of the art atmospheric pressure gasifier, and the HTAH subsystem was deleted and oxygen enrichment was used to obtain requisite MHD combustion temperature. Coal pile to bus bar efficiencies in ease case 1 ranged from 41.4% to 42.9%, and cost of electricity (COE) was highest of the three base cases. For base case 2 the efficiency range was 42.0% to 45.6%, and COE was lowest. For base case 3 the efficiency range was 42.9% to 44.4%, and COE was intermediate. The best parametric cases in bases cases 2 and 3 are recommended for conceptual design. Eventual choice between these approaches is dependent on further evaluation of the tradeoffs among HTAH development risk, O2 plant integration, and further refinements of comparative costs.

  3. Evaluating the Impact of Hospital Efficiency on Wellness in the Military Health System.

    PubMed

    Bastian, Nathaniel D; Kang, Hyojung; Swenson, Eric R; Fulton, Lawrence V; Griffin, Paul M

    2016-08-01

    Like all health care delivery systems, the U.S. Department of Defense Military Health System (MHS) strives to achieve top preventative care and population health outcomes for its members while operating at an efficient level and containing costs. The objective of this study is to understand the overall efficiency performance of military hospitals and investigate the relationship between efficiency and wellness. This study uses data envelopment analysis and stochastic frontier analysis to compare the efficiency of 128 military treatment facilities from the Army, Navy, and Air Force during the period of 2011 to 2013. Fixed effects panel regression is used to determine the association between the hospital efficiency and wellness scores. The results indicate that data envelopment analysis and stochastic frontier analysis efficiency scores are congruent in direction. Both results indicate that the majority of the MHS hospitals and clinics can potentially improve their productive efficiency by managing their input resources better. When comparing the performance of the three military branches of service, Army hospitals as a group outperformed their Navy and Air Force counterparts; thus, best practices from the Army should be shared across service components. The findings also suggest no statistically significant, positive association between efficiency and wellness over time in the MHS. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  4. 2016 Standard Scenarios Report: A U.S. Electricity Sector Outlook

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

    Cole, Wesley; Mai, Trieu; Logan, Jeffrey

    The National Renewable Energy Laboratory is conducting a study sponsored by the Office of Energy Efficiency and Renewable Energy (EERE) that aims to document and implement an annual process designed to identify a realistic and timely set of input assumptions (e.g., technology cost and performance, fuel costs), and a diverse set of potential futures (standard scenarios), initially for electric sector analysis.

  5. Drawing The Red Line: Cost Benefit Analysis on Large Life Rafts

    DTIC Science & Technology

    2013-06-13

    Patterson Air Force Base, Ohio DISTRIBUTION STATEMENT A . APPROVED FOR PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED. The...Anderson, BS, MS Major, USAF June 2013 DISTRIBUTION STATEMENT A . APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. AFIT-ENS-GRP-13-J-1...AMC has set up a Fuel-Efficiency Office (FEO) in order to analyze costs and make decisions that will save money on operational expenses related to

  6. Understanding the Uncertainty of an Effectiveness-Cost Ratio in Educational Resource Allocation: A Bayesian Approach

    ERIC Educational Resources Information Center

    Pan, Yilin

    2016-01-01

    Given the necessity to bridge the gap between what happened and what is likely to happen, this paper aims to explore how to apply Bayesian inference to cost-effectiveness analysis so as to capture the uncertainty of a ratio-type efficiency measure. The first part of the paper summarizes the characteristics of the evaluation data that are commonly…

  7. Identification of high payoff research for more efficient applicator helicopters in agriculture and forestry

    NASA Technical Reports Server (NTRS)

    Waters, K. T.

    1979-01-01

    The results of a study of the uses of helicopters in agriculture and forestry in the United States are discussed. Comparisons with agricultural airplanes are made in terms of costs of aerial application to the growers. An analysis of cost drivers and potential improvements to helicopters that will lower costs is presented. Future trends are discussed, and recommendations for research are outlined. Operational safety hazards and accident records are examined, and problem areas are identified. Areas where research and development are needed to provide opportunities for lowering costs while increasing productivity are analyzed.

  8. The relative efficiency of modular and non-modular networks of different size

    PubMed Central

    Tosh, Colin R.; McNally, Luke

    2015-01-01

    Most biological networks are modular but previous work with small model networks has indicated that modularity does not necessarily lead to increased functional efficiency. Most biological networks are large, however, and here we examine the relative functional efficiency of modular and non-modular neural networks at a range of sizes. We conduct a detailed analysis of efficiency in networks of two size classes: ‘small’ and ‘large’, and a less detailed analysis across a range of network sizes. The former analysis reveals that while the modular network is less efficient than one of the two non-modular networks considered when networks are small, it is usually equally or more efficient than both non-modular networks when networks are large. The latter analysis shows that in networks of small to intermediate size, modular networks are much more efficient that non-modular networks of the same (low) connective density. If connective density must be kept low to reduce energy needs for example, this could promote modularity. We have shown how relative functionality/performance scales with network size, but the precise nature of evolutionary relationship between network size and prevalence of modularity will depend on the costs of connectivity. PMID:25631996

  9. Large-scale implementation of disease control programmes: a cost-effectiveness analysis of long-lasting insecticide-treated bed net distribution channels in a malaria-endemic area of western Kenya-a study protocol.

    PubMed

    Gama, Elvis; Were, Vincent; Ouma, Peter; Desai, Meghna; Niessen, Louis; Buff, Ann M; Kariuki, Simon

    2016-11-21

    Historically, Kenya has used various distribution models for long-lasting insecticide-treated bed nets (LLINs) with variable results in population coverage. The models presently vary widely in scale, target population and strategy. There is limited information to determine the best combination of distribution models, which will lead to sustained high coverage and are operationally efficient and cost-effective. Standardised cost information is needed in combination with programme effectiveness estimates to judge the efficiency of LLIN distribution models and options for improvement in implementing malaria control programmes. The study aims to address the information gap, estimating distribution cost and the effectiveness of different LLIN distribution models, and comparing them in an economic evaluation. Evaluation of cost and coverage will be determined for 5 different distribution models in Busia County, an area of perennial malaria transmission in western Kenya. Cost data will be collected retrospectively from health facilities, the Ministry of Health, donors and distributors. Programme-effectiveness data, defined as the number of people with access to an LLIN per 1000 population, will be collected through triangulation of data from a nationally representative, cross-sectional malaria survey, a cross-sectional survey administered to a subsample of beneficiaries in Busia County and LLIN distributors' records. Descriptive statistics and regression analysis will be used for the evaluation. A cost-effectiveness analysis will be performed from a health-systems perspective, and cost-effectiveness ratios will be calculated using bootstrapping techniques. The study has been evaluated and approved by Kenya Medical Research Institute, Scientific and Ethical Review Unit (SERU number 2997). All participants will provide written informed consent. The findings of this economic evaluation will be disseminated through peer-reviewed publications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Dairy farm cost efficiency.

    PubMed

    Tauer, L W; Mishra, A K

    2006-12-01

    A stochastic cost equation was estimated for US dairy farms using national data from the production year 2000 to determine how farmers might reduce their cost of production. Cost of producing a unit of milk was estimated into separate frontier (efficient) and inefficiency components, with both components estimated as a function of management and causation variables. Variables were entered as impacting the frontier component as well as the efficiency component of the stochastic curve because a priori both components could be impacted. A factor that has an impact on the cost frontier was the number of hours per day the milking facility is used. Using the milking facility for more hours per day decreased frontier costs; however, inefficiency increased with increased hours of milking facility use. Thus, farmers can decrease costs with increased utilization of the milking facility, but only if they are efficient in this strategy. Parlors compared with stanchions used for milking did not decrease frontier costs, but decreased costs because of increased efficiency, as did the use of a nutritionist. Use of rotational grazing decreased frontier costs but also increased inefficiency. Older farmers were less efficient.

  11. Measuring and explaining eco-efficiencies of wastewater treatment plants in China: An uncertainty analysis perspective.

    PubMed

    Dong, Xin; Zhang, Xinyi; Zeng, Siyu

    2017-04-01

    In the context of sustainable development, there has been an increasing requirement for an eco-efficiency assessment of wastewater treatment plants (WWTPs). Data envelopment analysis (DEA), a technique that is widely applied for relative efficiency assessment, is used in combination with the tolerances approach to handle WWTPs' multiple inputs and outputs as well as their uncertainty. The economic cost, energy consumption, contaminant removal, and global warming effect during the treatment processes are integrated to interpret the eco-efficiency of WWTPs. A total of 736 sample plants from across China are assessed, and large sensitivities to variations in inputs and outputs are observed for most samples, with only three WWTPs identified as being stably efficient. Size of plant, overcapacity, climate type, and influent characteristics are proven to have a significant influence on both the mean efficiency and performance sensitivity of WWTPs, while no clear relationships were found between eco-efficiency and technology under the framework of uncertainty analysis. The incorporation of uncertainty quantification and environmental impact consideration has improved the liability and applicability of the assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Modeling Pumped Thermal Energy Storage with Waste Heat Harvesting

    NASA Astrophysics Data System (ADS)

    Abarr, Miles L. Lindsey

    This work introduces a new concept for a utility scale combined energy storage and generation system. The proposed design utilizes a pumped thermal energy storage (PTES) system, which also utilizes waste heat leaving a natural gas peaker plant. This system creates a low cost utility-scale energy storage system by leveraging this dual-functionality. This dissertation first presents a review of previous work in PTES as well as the details of the proposed integrated bottoming and energy storage system. A time-domain system model was developed in Mathworks R2016a Simscape and Simulink software to analyze this system. Validation of both the fluid state model and the thermal energy storage model are provided. The experimental results showed the average error in cumulative fluid energy between simulation and measurement was +/- 0.3% per hour. Comparison to a Finite Element Analysis (FEA) model showed <1% error for bottoming mode heat transfer. The system model was used to conduct sensitivity analysis, baseline performance, and levelized cost of energy of a recently proposed Pumped Thermal Energy Storage and Bottoming System (Bot-PTES) that uses ammonia as the working fluid. This analysis focused on the effects of hot thermal storage utilization, system pressure, and evaporator/condenser size on the system performance. This work presents the estimated performance for a proposed baseline Bot-PTES. Results of this analysis showed that all selected parameters had significant effects on efficiency, with the evaporator/condenser size having the largest effect over the selected ranges. Results for the baseline case showed stand-alone energy storage efficiencies between 51 and 66% for varying power levels and charge states, and a stand-alone bottoming efficiency of 24%. The resulting efficiencies for this case were low compared to competing technologies; however, the dual-functionality of the Bot-PTES enables it to have higher capacity factor, leading to 91-197/MWh levelized cost of energy compared to 262-284/MWh for batteries and $172-254/MWh for Compressed Air Energy Storage.

  13. Residential Energy Efficiency Potential: Texas

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

    Wilson, Eric J

    Energy used by Texas single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  14. Residential Energy Efficiency Potential: Indiana

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

    Wilson, Eric J

    Energy used by Indiana single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  15. Residential Energy Efficiency Potential: Colorado

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

    Wilson, Eric J

    Energy used by Colorado single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  16. New Tool for Benefit-Cost Analysis in Evaluating Transportation Alternatives

    DOT National Transportation Integrated Search

    1997-01-01

    The Intermodal Surface Transportation Efficiency Act (ISTEA) emphasizes assessment of multi-modal alternatives and demand management strategies. In 1995, the Federal Highway Administration (FHWA) developed a corridor sketch planning tool called the S...

  17. Residential Energy Efficiency Potential: Idaho

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

    Wilson, Eric J

    Energy used by Idaho single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  18. Residential Energy Efficiency Potential: Arizona

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

    Wilson, Eric J

    Energy used by Arizona single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  19. "Smaller Schools Are Good"...It Depends!

    ERIC Educational Resources Information Center

    Hill, Franklin

    2001-01-01

    Analyzes three high school sizes: 400-student "Private" school (small), 1,600-student school (medium), and 3,000-plus-student school (extra large). Uses four factors in comparative analysis: Equity, anonymity, program quality, and cost efficiency. (PKP)

  20. Residential Energy Efficiency Potential: Nebraska

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

    Wilson, Eric J

    Energy used by Nebraska single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  1. Residential Energy Efficiency Potential: Michigan

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

    Wilson, Eric J

    Energy used by Michigan single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  2. Residential Energy Efficiency Potential: Vermont

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

    Wilson, Eric J

    Energy used by Vermont single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  3. Residential Energy Efficiency Potential: Wisconsin

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

    Wilson, Eric J

    Energy used by Wisconsin single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  4. Residential Energy Efficiency Potential: Missouri

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

    Wilson, Eric J

    Energy used by Missouri single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  5. Residential Energy Efficiency Potential: Wyoming

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

    Wilson, Eric J

    Energy used by Wyoming single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  6. Residential Energy Efficiency Potential: Virginia

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

    Wilson, Eric J

    Energy used by Virginia single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  7. Residential Energy Efficiency Potential: Washington

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

    Wilson, Eric J

    Energy used by Washington single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  8. Residential Energy Efficiency Potential: Montana

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

    Wilson, Eric J

    Energy used by Montana single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  9. Residential Energy Efficiency Potential: Minnesota

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

    Wilson, Eric J

    Energy used by Minnesota single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  10. Residential Energy Efficiency Potential: Illinois

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

    Wilson, Eric J

    Energy used by Illinois single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  11. Residential Energy Efficiency Potential: Utah

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

    Wilson, Eric J

    Energy used by Utah single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  12. Specialty and full-service hospitals: a comparative cost analysis.

    PubMed

    Carey, Kathleen; Burgess, James F; Young, Gary J

    2008-10-01

    To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

  13. Costing bias in economic evaluations.

    PubMed

    Frappier, Julie; Tremblay, Gabriel; Charny, Mark; Cloutier, L Martin

    2015-01-01

    Determining the cost-effectiveness of healthcare interventions is key to the decision-making process in healthcare. Cost comparisons are used to demonstrate the economic value of treatment options, to evaluate the impact on the insurer budget, and are often used as a key criterion in treatment comparison and comparative effectiveness; however, little guidance is available to researchers for establishing the costing of clinical events and resource utilization. Different costing methods exist, and the choice of underlying assumptions appears to have a significant impact on the results of the costing analysis. This editorial describes the importance of the choice of the costing technique and it's potential impact on the relative cost of treatment options. This editorial also calls for a more efficient approach to healthcare intervention costing in order to ensure the use of consistent costing in the decision-making process.

  14. Economic analysis of biomass power generation schemes under renewable energy initiative with Renewable Portfolio Standards (RPS) in Korea.

    PubMed

    Moon, Ji-Hong; Lee, Jeung-Woo; Lee, Uen-Do

    2011-10-01

    An economic analysis of biomass power generation was conducted. Two key technologies--direct combustion with a steam turbine and gasification with a syngas engine--were mainly examined. In view of the present domestic biomass infrastructure of Korea, a small and distributed power generation system ranging from 0.5 to 5 MW(e) was considered. It was found that gasification with a syngas engine becomes more economically feasible as the plant size decreases. Changes in the economic feasibilities with and without RPS or heat sales were also investigated. A sensitivity analysis of each system was conducted for representative parameters. Regarding the cost of electricity generation, electrical efficiency and fuel cost significantly affect both direct combustion and gasification systems. Regarding the internal rate of return (IRR), the heat sales price becomes important for obtaining a higher IRR, followed by power generation capacity and electrical efficiency. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Development of efficient and cost-effective distributed hydrological modeling tool MWEasyDHM based on open-source MapWindow GIS

    NASA Astrophysics Data System (ADS)

    Lei, Xiaohui; Wang, Yuhui; Liao, Weihong; Jiang, Yunzhong; Tian, Yu; Wang, Hao

    2011-09-01

    Many regions are still threatened with frequent floods and water resource shortage problems in China. Consequently, the task of reproducing and predicting the hydrological process in watersheds is hard and unavoidable for reducing the risks of damage and loss. Thus, it is necessary to develop an efficient and cost-effective hydrological tool in China as many areas should be modeled. Currently, developed hydrological tools such as Mike SHE and ArcSWAT (soil and water assessment tool based on ArcGIS) show significant power in improving the precision of hydrological modeling in China by considering spatial variability both in land cover and in soil type. However, adopting developed commercial tools in such a large developing country comes at a high cost. Commercial modeling tools usually contain large numbers of formulas, complicated data formats, and many preprocessing or postprocessing steps that may make it difficult for the user to carry out simulation, thus lowering the efficiency of the modeling process. Besides, commercial hydrological models usually cannot be modified or improved to be suitable for some special hydrological conditions in China. Some other hydrological models are open source, but integrated into commercial GIS systems. Therefore, by integrating hydrological simulation code EasyDHM, a hydrological simulation tool named MWEasyDHM was developed based on open-source MapWindow GIS, the purpose of which is to establish the first open-source GIS-based distributed hydrological model tool in China by integrating modules of preprocessing, model computation, parameter estimation, result display, and analysis. MWEasyDHM provides users with a friendly manipulating MapWindow GIS interface, selectable multifunctional hydrological processing modules, and, more importantly, an efficient and cost-effective hydrological simulation tool. The general construction of MWEasyDHM consists of four major parts: (1) a general GIS module for hydrological analysis, (2) a preprocessing module for modeling inputs, (3) a model calibration module, and (4) a postprocessing module. The general GIS module for hydrological analysis is developed on the basis of totally open-source GIS software, MapWindow, which contains basic GIS functions. The preprocessing module is made up of three submodules including a DEM-based submodule for hydrological analysis, a submodule for default parameter calculation, and a submodule for the spatial interpolation of meteorological data. The calibration module contains parallel computation, real-time computation, and visualization. The postprocessing module includes model calibration and model results spatial visualization using tabular form and spatial grids. MWEasyDHM makes it possible for efficient modeling and calibration of EasyDHM, and promises further development of cost-effective applications in various watersheds.

  16. Efficient transformer study: Analysis of manufacture and utility data

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

    Burkes, Klaehn; Cordaro, Joe; McIntosh, John

    Distribution transformers convert power from the distribution system voltage to the end-customer voltage, which consists of residences, businesses, distributed generation, campus systems, and manufacturing facilities. Amorphous metal distribution transformers (AMDT) are also more expensive and heavier than conventional silicon steel distribution transformers. This and the difficulty to measure the benefit from energy efficiency and low awareness of the technology have hindered the adoption of AMDT. This report presents the cost savings for installing AMDT and the amount of energy saved based on the improved efficiency.

  17. Regional hospital improves efficiency with co-generation retrofit.

    PubMed

    Knutson, D; Anderson, L

    1999-11-01

    Feasibility analysis of the co-generation retrofit of the Red Deer Regional Hospital pointed to a reasonable payback of capital cost and increased efficiency in operation of the facility. Budget restrictions nearly stopped the project from proceeding. Innovative construction procedures proposed by the Facility Management Group, in particular, Mr Keith Metcalfe, Director of Maintenance, allowed a worthwhile project to reach successful completion. We feel that this model can perhaps be used by similar facilities in the future to achieve their energy efficiency goals.

  18. Efficiency of using construction machines when strengthening foundation soils

    NASA Astrophysics Data System (ADS)

    Turchin, Vadim; Yudina, Ludmila; Ivanova, Tatyana; Zhilkina, Tatyana; Sychugove, Stanislav; Mackevicius, Rimantas; Danutė, Slizyte

    2017-10-01

    The article describes the efficiency of using construction machines when strengthening foundation base soils, as one of the ways to solve the problem of reducing and optimizing costs during construction. The analysis is presented in regard to inspection results of the soil bodies in the pile foundation base of “School of general education No. 5 in the town of Malgobek” of the republic of Ingushetia. Economical efficiency through reducing the duration of construction due to the automation of production is calculated.

  19. Lower HVAC Costs | Efficient Windows Collaborative

    Science.gov Websites

    system. Smaller HVAC systems cost less and as such can offset some of the cost of the efficient windows dehumidification. First cost savings - Smaller HVAC units cost less. If, for example, down-sizing the HVAC system by half a ton saves $275, the cost premium of energy-efficient windows does not present as big an up

  20. Comparing technical efficiency of farms with an automatic milking system and a conventional milking system.

    PubMed

    Steeneveld, W; Tauer, L W; Hogeveen, H; Oude Lansink, A G J M

    2012-12-01

    Changing from a conventional milking system (CMS) to an automatic milking system (AMS) necessitates a new management approach and a corresponding change in labor tasks. Together with labor savings, AMS farms have been found to have higher capital costs, primarily because of higher maintenance costs and depreciation. Therefore, it is hypothesized that AMS farms differ from CMS farms in capital:labor ratio and possibly their technical efficiency, at least during a transition learning period. The current study used actual farm accounting data from dairy farms in the Netherlands with an AMS and a CMS to investigate the empirical substitution of capital for labor in the AMS farms and to determine if the technical efficiency of the AMS farms differed from the CMS farms. The technical efficiency estimates were obtained with data envelopment analysis. The 63 AMS farms and the 337 CMS farms in the data set did not differ in general farm characteristics such as the number of cows, number of hectares, and the amount of milk quota. Farms with AMS have significantly higher capital costs (€12.71 per 100 kg of milk) than CMS farms (€10.10 per 100 kg of milk). Total labor costs and net outputs were not significantly different between AMS and CMS farms. A clear substitution of capital for labor with the adoption of an AMS could not be observed. Although the AMS farms have a slightly lower technical efficiency (0.76) than the CMS farms (0.78), a significant difference in these estimates was not observed. This indicates that the farms were not different in their ability to use inputs (capital, labor, cows, and land) to produce outputs (total farm revenues). The technical efficiency of farms invested in an AMS in 2008 or earlier was not different from the farms invested in 2009 or 2010, indicating that a learning effect during the transition period was not observed. The results indicate that the economic performance of AMS and CMS farms are similar. What these results show is that other than higher capital costs, the use of AMS rather than a CMS does not affect farm efficiency and that the learning costs to use an AMS are not present as measured by any fall in technical efficiency. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  1. Benchmarking undedicated cloud computing providers for analysis of genomic datasets.

    PubMed

    Yazar, Seyhan; Gooden, George E C; Mackey, David A; Hewitt, Alex W

    2014-01-01

    A major bottleneck in biological discovery is now emerging at the computational level. Cloud computing offers a dynamic means whereby small and medium-sized laboratories can rapidly adjust their computational capacity. We benchmarked two established cloud computing services, Amazon Web Services Elastic MapReduce (EMR) on Amazon EC2 instances and Google Compute Engine (GCE), using publicly available genomic datasets (E.coli CC102 strain and a Han Chinese male genome) and a standard bioinformatic pipeline on a Hadoop-based platform. Wall-clock time for complete assembly differed by 52.9% (95% CI: 27.5-78.2) for E.coli and 53.5% (95% CI: 34.4-72.6) for human genome, with GCE being more efficient than EMR. The cost of running this experiment on EMR and GCE differed significantly, with the costs on EMR being 257.3% (95% CI: 211.5-303.1) and 173.9% (95% CI: 134.6-213.1) more expensive for E.coli and human assemblies respectively. Thus, GCE was found to outperform EMR both in terms of cost and wall-clock time. Our findings confirm that cloud computing is an efficient and potentially cost-effective alternative for analysis of large genomic datasets. In addition to releasing our cost-effectiveness comparison, we present available ready-to-use scripts for establishing Hadoop instances with Ganglia monitoring on EC2 or GCE.

  2. Benchmarking Undedicated Cloud Computing Providers for Analysis of Genomic Datasets

    PubMed Central

    Yazar, Seyhan; Gooden, George E. C.; Mackey, David A.; Hewitt, Alex W.

    2014-01-01

    A major bottleneck in biological discovery is now emerging at the computational level. Cloud computing offers a dynamic means whereby small and medium-sized laboratories can rapidly adjust their computational capacity. We benchmarked two established cloud computing services, Amazon Web Services Elastic MapReduce (EMR) on Amazon EC2 instances and Google Compute Engine (GCE), using publicly available genomic datasets (E.coli CC102 strain and a Han Chinese male genome) and a standard bioinformatic pipeline on a Hadoop-based platform. Wall-clock time for complete assembly differed by 52.9% (95% CI: 27.5–78.2) for E.coli and 53.5% (95% CI: 34.4–72.6) for human genome, with GCE being more efficient than EMR. The cost of running this experiment on EMR and GCE differed significantly, with the costs on EMR being 257.3% (95% CI: 211.5–303.1) and 173.9% (95% CI: 134.6–213.1) more expensive for E.coli and human assemblies respectively. Thus, GCE was found to outperform EMR both in terms of cost and wall-clock time. Our findings confirm that cloud computing is an efficient and potentially cost-effective alternative for analysis of large genomic datasets. In addition to releasing our cost-effectiveness comparison, we present available ready-to-use scripts for establishing Hadoop instances with Ganglia monitoring on EC2 or GCE. PMID:25247298

  3. Economical and environmental analysis of thermal and photovoltaic solar energy as source of heat for industrial processes

    NASA Astrophysics Data System (ADS)

    Pérez-Aparicio, Elena; Lillo-Bravo, Isidoro; Moreno-Tejera, Sara; Silva-Pérez, Manuel

    2017-06-01

    Thermal energy for industrial processes can be generated using thermal (ST) or photovoltaic (PV) solar energy. ST energy has traditionally been the most favorable option due to its cost and efficiency. Current costs and efficiencies values make the PV solar energy become an alternative to ST energy as supplier of industrial process heat. The aim of this study is to provide a useful tool to decide in each case which option is economically and environmentally the most suitable alternative. The methodology used to compare ST and PV systems is based on the calculation of the levelized cost of energy (LCOE) and greenhouse gas emissions (GHG) avoided by using renewable technologies instead of conventional sources of energy. In both cases, these calculations depend on costs and efficiencies associated with ST or PV systems and the conversion factor from thermal or electrical energy to GHG. To make these calculations, a series of hypotheses are assumed related to consumer and energy prices, operation, maintenance and replacement costs, lifetime of the system or working temperature of the industrial process. This study applies the methodology at five different sites which have been selected taking into account their radiometric and meteorological characteristics. In the case of ST energy three technologies are taken into account, compound parabolic concentrator (CPC), linear Fresnel collector (LFC) and parabolic trough collector (PTC). The PV option includes two ways of use of generated electricity, an electrical resistance or a combination of an electrical resistance and a heat pump (HP). Current values of costs and efficiencies make ST system remains as the most favorable option. These parameters may vary significantly over time. The evolution of these parameters may convert PV systems into the most favorable option for particular applications.

  4. Energy efficient engine: Flight propulsion system preliminary analysis and design

    NASA Technical Reports Server (NTRS)

    Johnston, R. P.; Beitler, R. S.; Bobinger, R. O.; Broman, C. L.; Gravitt, R. D.; Heineke, H.; Holloway, P. R.; Klem, J. S.; Nash, D. O.; Ortiz, P.

    1980-01-01

    The characteristics of an advanced flight propulsion system (FPS), suitable for introduction in the late 1980's to early 1990's, was more fully defined. It was determined that all goals for efficiency, environmental considerations, and economics could be met or exceeded with the possible exception of NOx emission. In evaluating the FPS, all aspects were considered including component design, performance, weight, initial cost, maintenance cost, engine system integration (including nacelle), and aircraft integration considerations. The current FPS installed specific fuel consumption was reduced 14.2% from that of the CF6-50C reference engine. When integrated into an advanced, subsonic, study transport, the FPS produced a fuel burn savings of 15 to 23% and a direct operating cost reduction of 5 to 12% depending on the mission and study aircraft characteristics relative to the reference engine.

  5. Importance of Economic Evaluation in Health Care: An Indian Perspective.

    PubMed

    Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh

    2016-05-01

    Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. Higher mortgages, lower energy bills: The real economics of buying an energy-efficient home

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

    Mills, E.

    1987-02-01

    To measure the actual costs and benefits of buying an energy- efficient home, it is necessary to employ a cash-flow model that accounts for mortgage interest and other charges associated with the incremental costs of conservation measures. The ability to make payments gradually over the term of a mortgage, energy savings, and tax benefits contribute to increased cost effectiveness. Conversely, financial benefits are reduced by interest payments, insurance, taxes, and various fees linked to the (higher) sale price of an energy-efficient home. Accounting for these factors can yield a strikingly different picture from those given by commonly used ''engineering'' indicators,more » such as simple payback time, internal rate of return, or net present value (NPV), which are based solely on incremental costs and energy savings. This analysis uses actual energy savings data and incremental construction costs to evaluate the mortgage cash flow for 79 of the 144 energy-efficient homes constructed in Minnesota under the Energy-Efficient Housing Demonstration Program (EEHDP) initiated in 1980 by the Minnesota Housing Finance Agency. Using typical lending terms and fees, we find that the mean mortgage-NPV derived from the homeowners' real cash flow (including construction and financing costs) is 20% lower than the standard engineering-NPV of the conservation investment: $7981 versus $9810. For eight homes, the mortgage-NPV becomes negative once we account for the various mortgage-related effects. Sensitivities to interest rates, down payment, loan term, and marginal tax rate are included to illustrate the often large impact of alternative assumptions about these parameters. The most dramatic effect occurs when the loan term is reduced from 30 to 15 years and the mortgage NPV falls to -$925. We also evaluate the favorable Federal Home Administration (FHA) terms actually applied to the EEHDP homes. 8 refs., 4 figs., 3 tabs.« less

  7. [Comparative cost-effectiveness analysis between darunavir/ritonavir and other protease inhibitors in treatment-naive human immunodeficiency syndrome type 1-infected patients in Spain].

    PubMed

    Smets, Erik; Brogan, Anita J; Hill, Andrew; Adriaenssen, Ines; Sawyer, Anthony W; Domingo-Pedrol, Pere; Gostkorzewicz, Joana; Ledesma, Francisco

    2013-01-01

    GESIDA (AIDS Study Group) has proposed preferred regimens of antiretroviral treatment as initial therapy in HIV infected patients. The objective of this analysis is to compare the costs and effectiveness of darunavir/r QD and other ritonavir-boosted (/r) protease inhibitors (PIs) currently recommended in GESIDA guidelines for treatment-naïve patients. A cost-efficacy model compared the boosted PIs recommended as preferred or alternative treatment choices, each used with a nucleoside reverse transcriptase inhibitor backbone. Efficacy was measured by 48-week virological response (viral load < 50 copies/mL) adjusted by baseline viral load and CD4 cell count. To generate efficiency frontiers and cost-efficacy ratios, one-year antiretroviral therapy costs in Spain, and 48-week efficacy values were used. The model estimated that starting treatment with darunavir/r QD was the most cost-effective choice compared with the other preferred PI/r based therapies. The average cost per patient with a virological response was lower for darunavir/r QD (13,420€) than for atazanavir/r QD (14,000€), or lopinavir/r BID (13,815€). Among the preferred PI/r-based therapies, darunavir/r QD also was estimated to be the most efficient option for treatment-naïve patients. Atazanavir/r QD and lopinavir/r BID were found to be «dominated» by darunavir/r) and, consequently, were outside the efficiency frontier of PI/r-based first-line treatment. Given a fixed budget of 10 million euros for PI/r-based first-line therapy, the model estimated that darunavir/r QD would yield more responders (745) than atazanavir/r QD (714), or lopinavir/r BID (724). At the same time, darunavir/r QD would reduce the number of individuals failing treatment (150) compared with atazanavir/r QD (172) and lopinavir/r BID (286). In this model, darunavir/r QD was found to be the most cost-effective choice, among the preferred PI/r-based therapies recommended in the Spanish guidelines for treatment-naïve patients. Copyright © 2012. Published by Elsevier Espana.

  8. NextGen-Airportal Project Technologies: Systems Analysis, Integration, and Evaluation (SAIE)

    NASA Technical Reports Server (NTRS)

    Huang, Alex; Trapani, Andrew; Poage, Jim; Howell, Daniel; Slocum, Douglas

    2012-01-01

    NASA has been conducting Concept & Technology (C&T) research to enable capacity, efficiency, and safety improvements under the Airspace Systems Program, Aeronautics Research Mission Directorate (ARMD). These C&Ts provide various benefits (e.g., improved airport departure/arrival throughputs, fuel saving, and taxi efficiency) with costs and benefits apportioned among various Air Traffic Management (ATM) system stakeholders (e.g., FAA, aircraft operators, or public).

  9. Energy efficient industrialized housing research program

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

    Berg, R.; Brown, G.Z.; Finrow, J.

    1989-01-01

    This is the second volume of a two volume report on energy efficient industrialized housing. Volume II contains support documentation for Volume I. The following items are included: individual trip reports; software bibliography; industry contacts in the US, Denmark, and Japan; Cost comparison of industrialized housing in the US and Denmark; draft of the final report on the systems analysis for Fleetwood Mobile Home Manufacturers. (SM)

  10. Economic Analysis of Waterfront Area Services at Naval Station, Long Beach

    DTIC Science & Technology

    1991-06-01

    the Gradall for waterfront area services, would result in improved responsiveness and timely service. Customer satisfaction and overall customer ...overall cost. Hence, both quality and efficiency will improve leading to greater customer satisfaction . 58 VII. RECOMMENDATIONS FOR ACTION RECOMMENDATION 1...prompting the need for improved efficiency. To ensure adequate future support can be provided to its customers , Naval Station Long Beach (Navsta) is

  11. Reorganization of secondary medical care in the Israeli Defense Forces Medical Corps: A cost-effect analysis.

    PubMed

    Yagil, Yael; Arnon, Ronen; Ezra, Vered; Ashkenazi, Isaac

    2006-12-01

    To increase accessibility and availability of secondary medical care, 10 secondary unit specialist clinics were established side-by-side with five existing regional specialist centers, thus achieving decentralization. The purpose was to analyze the impact of this reorganization on overall consumption of secondary medical care and expenditures. Consumption of secondary medical care was analyzed by using computerized clinic and Medical Corps databases. Functional efficiency and budgetary expenditures were evaluated in four representative unit specialist clinics. The reorganization resulted in an 8% increase in total secondary care consumption over 2.5 years. The establishment of unit specialist clinics did not achieve increased accessibility or availability for military personnel. Functional analysis of representative unit specialist clinics showed diversity in efficiency, differences in physicians' performance, and excess expenditures. The decentralizing reorganization of secondary medical care generated an increase in medical care consumption, possibly because of supply-induced demand. The uniform inefficiency of the unit specialist clinics might have been related to incorrect planning and management. The decentralization of secondary medical care within the Israeli Defense Forces has not proved to be cost-efficient.

  12. Relative potentials of concentrating and two-axis tracking flat-plate photovoltaic arrays for central-station applications

    NASA Technical Reports Server (NTRS)

    Borden, C. S.; Schwartz, D. L.

    1984-01-01

    The purpose of this study is to assess the relative economic potentials of concenrating and two-axis tracking flat-plate photovoltaic arrays for central-station applications in the mid-1990's. Specific objectives of this study are to provide information on concentrator photovoltaic collector probabilistic price and efficiency levels to illustrate critical areas of R&D for concentrator cells and collectors, and to compare concentrator and flat-plate PV price and efficiency alternatives for several locations, based on their implied costs of energy. To deal with the uncertainties surrounding research and development activities in general, a probabilistic assessment of commercially achievable concentrator photovoltaic collector efficiencies and prices (at the factory loading dock) is performed. The results of this projection of concentrator photovoltaic technology are then compared with a previous flat-plate module price analysis (performed early in 1983). To focus this analysis on specific collector alternatives and their implied energy costs for different locations, similar two-axis tracking designs are assumed for both concentrator and flat-plate options.

  13. Energy efficient engine. Volume 1: Component development and integration program

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Technology for achieving lower installed fuel consumption and lower operating costs in future commercial turbofan engines are developed, evaluated, and demonstrated. The four program objectives are: (1) propulsion system analysis; (2) component analysis, design, and development; (3) core design, fabrication, and test; and (4) integrated core/low spoon design, fabrication, and test.

  14. Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients.

    PubMed

    Malet-Larrea, Amaia; Goyenechea, Estíbaliz; Gastelurrutia, Miguel A; Calvo, Begoña; García-Cárdenas, Victoria; Cabases, Juan M; Noain, Aránzazu; Martínez-Martínez, Fernando; Sabater-Hernández, Daniel; Benrimoj, Shalom I

    2017-12-01

    Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis. The economic evaluation was based on a cluster randomized controlled trial. Patients in the intervention group (IG) received the MRF service and the comparison group (CG) received usual care. The analysis was conducted from the national health system (NHS) perspective over 6 months. Direct medical costs were included and expressed in euros at 2014 prices. Health benefits were estimated by assigning a monetary value to the quality-adjusted life years. One-way deterministic sensitivity analysis was undertaken in order to analyse the uncertainty. The analysis included 1403 patients (IG: n = 688 vs CG: n = 715). The cost analysis showed that the MRF saved 97 € per patient in 6 months. Extrapolating data to 1 year and assuming a fee for service of 22 € per patient-month, the estimated savings were 273 € per patient-year. The cost-benefit ratio revealed that for every 1 € invested in MRF, a benefit of 3.3 € to 6.2 € was obtained. The MRF provided health benefits to patients and substantial cost savings to the NHS. Investment in this service would represent an efficient use of healthcare resources.

  15. Reducing electrocoagulation harvesting costs for practical microalgal biodiesel production.

    PubMed

    Dassey, Adam J; Theegala, Chandra S

    2014-01-01

    Electrocoagulation has shown potential to be a primary microalgae harvesting technique for biodiesel production. However, methods to reduce energy and electrode costs are still necessary for practical application. Electrocoagulation tests were conducted on Nannochloris sp. and Dunaliella sp. using perforated aluminium and iron electrodes under various charge densities. Aluminium electrodes were shown to be more efficient than iron electrodes when harvesting both algal species. Despite the lower harvesting efficiency, however, the iron electrodes were more energy and cost efficient. Operational costs of less than $0.03/L oil were achieved when harvesting Nannochloris sp. with iron electrodes at 35% harvest efficiency, whereas aluminium electrodes cost $0.75/L oil with 42% harvesting efficiency. Increasing the harvesting efficiencies for both aluminium and iron electrodes also increased the overall cost per litre of oil, therefore lower harvesting efficiencies with lower energy inputs was recommended. Also, increasing the culturing salinity to 2 ppt sodium chloride for freshwater Nannochloris sp. was determined practical to improve the electrocoagulation energy efficiency despite a 25% reduction in cell growth.

  16. Raising the one-sun conversion efficiency of III-V/Si solar cells to 32.8% for two junctions and 35.9% for three junctions

    NASA Astrophysics Data System (ADS)

    Essig, Stephanie; Allebé, Christophe; Remo, Timothy; Geisz, John F.; Steiner, Myles A.; Horowitz, Kelsey; Barraud, Loris; Ward, J. Scott; Schnabel, Manuel; Descoeudres, Antoine; Young, David L.; Woodhouse, Michael; Despeisse, Matthieu; Ballif, Christophe; Tamboli, Adele

    2017-09-01

    Today's dominant photovoltaic technologies rely on single-junction devices, which are approaching their practical efficiency limit of 25-27%. Therefore, researchers are increasingly turning to multi-junction devices, which consist of two or more stacked subcells, each absorbing a different part of the solar spectrum. Here, we show that dual-junction III-V//Sidevices with mechanically stacked, independently operated III-V and Si cells reach cumulative one-sun efficiencies up to 32.8%. Efficiencies up to 35.9% were achieved when combining a GaInP/GaAs dual-junction cell with a Si single-junction cell. These efficiencies exceed both the theoretical 29.4% efficiency limit of conventional Si technology and the efficiency of the record III-V dual-junction device (32.6%), highlighting the potential of Si-based multi-junction solar cells. However, techno-economic analysis reveals an order-of-magnitude disparity between the costs for III-V//Si tandem cells and conventional Si solar cells, which can be reduced if research advances in low-cost III-V growth techniques and new substrate materials are successful.

  17. Eco-efficiency Analysis of Furniture Product Using Life Cycle Assessment

    NASA Astrophysics Data System (ADS)

    Rinawati, Dyah Ika; Sriyanto; Sari, Diana Puspita; Prayodha, Andana Cantya

    2018-02-01

    Furniture is one of Indonesia's main commodities strategically role in economic growth and employment in Indonesia. In their production process there many wastes resulted, such as such as sawdust, cuttings - pieces of wood, components that do not conform to specifications and the edges of wood from a log. Contrast with requirement of timber for furniture industries, availability of raw material sources decrease because of limited forest areas. Beside that, using electricity and chemical material in furniture production process have impact to environment. This study aim to assess the eco-cost and eco-efficiency ratio of the product so strategic recommendations to improve the eco-efficiency of products can be designed. The results of data processing showed the environmental costs of the furniture production process amount Rp 30.887.84. Eco-efficiency index of furniture products studied was 4,79 with the eco-efficiency ratio of 79,12%. This result means that the measured furniture products already profitable and sustainable, as well as its production process is already fairly efficient. However, improved performance of the production process can still be done to improve the eco-efficiency by minimizing the use of raw materials.

  18. Raising the one-sun conversion efficiency of III–V/Si solar cells to 32.8% for two junctions and 35.9% for three junctions

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

    Essig, Stephanie; Allebé, Christophe; Remo, Timothy

    Today's dominant photovoltaic technologies rely on single-junction devices, which are approaching their practical efficiency limit of 25-27%. Therefore, researchers are increasingly turning to multi-junction devices, which consist of two or more stacked subcells, each absorbing a different part of the solar spectrum. Here, we show that dual-junction III-V//Sidevices with mechanically stacked, independently operated III-V and Si cells reach cumulative one-sun efficiencies up to 32.8%. Efficiencies up to 35.9% were achieved when combining a GaInP/GaAs dual-junction cell with a Si single-junction cell. These efficiencies exceed both the theoretical 29.4% efficiency limit of conventional Si technology and the efficiency of the recordmore » III-V dual-junction device (32.6%), highlighting the potential of Si-based multi-junction solar cells. However, techno-economic analysis reveals an order-of-magnitude disparity between the costs for III-V//Si tandem cells and conventional Si solar cells, which can be reduced if research advances in low-cost III-V growth techniques and new substrate materials are successful.« less

  19. Process-based organization design and hospital efficiency.

    PubMed

    Vera, Antonio; Kuntz, Ludwig

    2007-01-01

    The central idea of process-based organization design is that organizing a firm around core business processes leads to cost reductions and quality improvements. We investigated theoretically and empirically whether the implementation of a process-based organization design is advisable in hospitals. The data came from a database compiled by the Statistical Office of the German federal state of Rheinland-Pfalz and from a written questionnaire, which was sent to the chief executive officers (CEOs) of all 92 hospitals in this federal state. We used data envelopment analysis (DEA) to measure hospital efficiency, and factor analysis and regression analysis to test our hypothesis. Our principal finding is that a high degree of process-based organization has a moderate but significant positive effect on the efficiency of hospitals. The main implication is that hospitals should implement a process-based organization to improve their efficiency. However, to actually achieve positive effects on efficiency, it is of paramount importance to observe some implementation rules, in particular to mobilize physician participation and to create an adequate organizational culture.

  20. Assessing administrative costs of mental health and substance abuse services.

    PubMed

    Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

    2004-05-01

    Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

  1. Choosing options for ultrasound screening in pregnancy and comparing cost effectiveness: a decision analysis approach.

    PubMed

    Roberts, T; Mugford, M; Piercy, J

    1998-09-01

    To compare the cost effectiveness of different programmes of routine antenatal ultrasound screening to detect four key fetal anomalies: serious cardiac anomalies, spina bifida, Down's syndrome and lethal anomalies, using existing evidence. Decision analysis was used based on the best data currently available, including expert opinion from the Royal College of Obstetricians and Gynaecologists, Working Party and secondary data from the literature, to predict the likely outcomes in terms of malformations detected by each screening programme. Results applicable in clinics, hospitals or GP practices delivering antenatal screening. The number of cases with a 'target' malformation correctly detected antenatally. There was substantial overlap between the cost ranges of each screening programme demonstrating considerable uncertainty about the relative economic efficiency of alternative programmes for ultrasound screening. The cheapest, but not the most effective, screening programme consisted of one second trimester ultrasound scan. The cost per target anomaly detected (cost effectiveness) for this programme was in the range 5,000 pound silver-109,000, pound silver but in any 1000 women it will also fail to detect between 3.6 and 4.7 target anomalies. The range of uncertainty in the costs did not allow selection of any one programme as a clear choice for NHS purchasers. The results suggested that the overall allocation of resources for routine ultrasound screening in the UK is not currently economically efficient, but that certain scenarios for ultrasound screening are potentially within the range of cost effectiveness reached by other, possibly competing, screening programmes. The model highlighted the weakness of available evidence and demonstrated the need for more information both about current practice and costs.

  2. Using extreme phenotype sampling to identify the rare causal variants of quantitative traits in association studies.

    PubMed

    Li, Dalin; Lewinger, Juan Pablo; Gauderman, William J; Murcray, Cassandra Elizabeth; Conti, David

    2011-12-01

    Variants identified in recent genome-wide association studies based on the common-disease common-variant hypothesis are far from fully explaining the hereditability of complex traits. Rare variants may, in part, explain some of the missing hereditability. Here, we explored the advantage of the extreme phenotype sampling in rare-variant analysis and refined this design framework for future large-scale association studies on quantitative traits. We first proposed a power calculation approach for a likelihood-based analysis method. We then used this approach to demonstrate the potential advantages of extreme phenotype sampling for rare variants. Next, we discussed how this design can influence future sequencing-based association studies from a cost-efficiency (with the phenotyping cost included) perspective. Moreover, we discussed the potential of a two-stage design with the extreme sample as the first stage and the remaining nonextreme subjects as the second stage. We demonstrated that this two-stage design is a cost-efficient alternative to the one-stage cross-sectional design or traditional two-stage design. We then discussed the analysis strategies for this extreme two-stage design and proposed a corresponding design optimization procedure. To address many practical concerns, for example measurement error or phenotypic heterogeneity at the very extremes, we examined an approach in which individuals with very extreme phenotypes are discarded. We demonstrated that even with a substantial proportion of these extreme individuals discarded, an extreme-based sampling can still be more efficient. Finally, we expanded the current analysis and design framework to accommodate the CMC approach where multiple rare-variants in the same gene region are analyzed jointly. © 2011 Wiley Periodicals, Inc.

  3. Using Extreme Phenotype Sampling to Identify the Rare Causal Variants of Quantitative Traits in Association Studies

    PubMed Central

    Li, Dalin; Lewinger, Juan Pablo; Gauderman, William J.; Murcray, Cassandra Elizabeth; Conti, David

    2014-01-01

    Variants identified in recent genome-wide association studies based on the common-disease common-variant hypothesis are far from fully explaining the hereditability of complex traits. Rare variants may, in part, explain some of the missing hereditability. Here, we explored the advantage of the extreme phenotype sampling in rare-variant analysis and refined this design framework for future large-scale association studies on quantitative traits. We first proposed a power calculation approach for a likelihood-based analysis method. We then used this approach to demonstrate the potential advantages of extreme phenotype sampling for rare variants. Next, we discussed how this design can influence future sequencing-based association studies from a cost-efficiency (with the phenotyping cost included) perspective. Moreover, we discussed the potential of a two-stage design with the extreme sample as the first stage and the remaining nonextreme subjects as the second stage. We demonstrated that this two-stage design is a cost-efficient alternative to the one-stage cross-sectional design or traditional two-stage design. We then discussed the analysis strategies for this extreme two-stage design and proposed a corresponding design optimization procedure. To address many practical concerns, for example measurement error or phenotypic heterogeneity at the very extremes, we examined an approach in which individuals with very extreme phenotypes are discarded. We demonstrated that even with a substantial proportion of these extreme individuals discarded, an extreme-based sampling can still be more efficient. Finally, we expanded the current analysis and design framework to accommodate the CMC approach where multiple rare-variants in the same gene region are analyzed jointly. PMID:21922541

  4. The relationship between effectiveness and costs measured by a risk-adjusted case-mix system: multicentre study of Catalonian population data bases.

    PubMed

    Sicras-Mainar, Antoni; Navarro-Artieda, Ruth; Blanca-Tamayo, Milagrosa; Velasco-Velasco, Soledad; Escribano-Herranz, Esperanza; Llopart-López, Josep Ramon; Violan-Fors, Concepción; Vilaseca-Llobet, Josep Maria; Sánchez-Fontcuberta, Encarna; Benavent-Areu, Jaume; Flor-Serra, Ferran; Aguado-Jodar, Alba; Rodríguez-López, Daniel; Prados-Torres, Alejandra; Estelrich-Bennasar, Jose

    2009-06-25

    The main objective of this study is to measure the relationship between morbidity, direct health care costs and the degree of clinical effectiveness (resolution) of health centres and health professionals by the retrospective application of Adjusted Clinical Groups in a Spanish population setting. The secondary objectives are to determine the factors determining inadequate correlations and the opinion of health professionals on these instruments. We will carry out a multi-centre, retrospective study using patient records from 15 primary health care centres and population data bases. The main measurements will be: general variables (age and sex, centre, service [family medicine, paediatrics], and medical unit), dependent variables (mean number of visits, episodes and direct costs), co-morbidity (Johns Hopkins University Adjusted Clinical Groups Case-Mix System) and effectiveness.The totality of centres/patients will be considered as the standard for comparison. The efficiency index for visits, tests (laboratory, radiology, others), referrals, pharmaceutical prescriptions and total will be calculated as the ratio: observed variables/variables expected by indirect standardization.The model of cost/patient/year will differentiate fixed/semi-fixed (visits) costs of the variables for each patient attended/year (N = 350,000 inhabitants). The mean relative weights of the cost of care will be obtained. The effectiveness will be measured using a set of 50 indicators of process, efficiency and/or health results, and an adjusted synthetic index will be constructed (method: percentile 50).The correlation between the efficiency (relative-weights) and synthetic (by centre and physician) indices will be established using the coefficient of determination. The opinion/degree of acceptance of physicians (N = 1,000) will be measured using a structured questionnaire including various dimensions. multiple regression analysis (procedure: enter), ANCOVA (method: Bonferroni's adjustment) and multilevel analysis will be carried out to correct models. The level of statistical significance will be p < 0.05.

  5. Residential Energy Efficiency Potential: South Dakota

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

    Wilson, Eric J

    2017-11-02

    Energy used by South Dakota single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  6. Residential Energy Efficiency Potential: South Carolina

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

    Wilson, Eric J

    2017-11-02

    Energy used by South Carolina single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  7. Structural design and stress analysis program for advanced composite filament-wound axisymmetric pressure vessels (COMTANK)

    NASA Technical Reports Server (NTRS)

    Knoell, A. C.

    1972-01-01

    Computer program has been specifically developed to handle, in an efficient and cost effective manner, planar wound pressure vessels fabricated of either boron-epoxy or graphite-epoxy advanced composite materials.

  8. Residential Energy Efficiency Potential: Rhode Island

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

    Wilson, Eric J

    Energy used by Rhode Island single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  9. Cost-effectiveness analysis of CNG urban taxi operations.

    DOT National Transportation Integrated Search

    1993-10-01

    Increased emphasis on energy efficiency and air quality has resulted in a number of state and federal initiatives : examining the use of alternative fuels for motor vehicles. Texas' program for alternate fuels includes compressed : natural gas (CNG)....

  10. Monitoring of energy efficiency of technological modes of gas transport using modern gas-turbine equipment

    NASA Astrophysics Data System (ADS)

    Golik, V. V.; Zemenkova, M. Yu; Shipovalov, A. N.; Akulov, K. A.

    2018-05-01

    The paper presents calculations and an example of energy efficiency justification of the regimes of the equipment used. The engineering design of the gas pipeline in the part of monitoring the energy efficiency of a gas compressor unit (GCU) is considered. The results of the GCU characteristics and its components evaluation are described. The evaluation results of the energy efficiency indicators of the gas pipeline are presented. As an example of the result of the analysis, it is proposed to use gas compressor unit GCU-32 "Ladoga" because of its efficiency and cost effectiveness, in comparison with analogues.

  11. Understanding Acquisition Cycle Time: Focusing the Research Problem

    DTIC Science & Technology

    2013-11-01

    Browning, Tyson R., and Steven D. Eppinger. “Modeling Impacts of Process Architecture on Cost and Schedule Risk in Product Development.” IEEE...2009. Clark, Kim, and Steven Wheelwright. Revolutionizing Development: Quantum Leaps in Speed, Efficiency and Quality. New York, NY: The Free Press...1992. Cross, Steven M. Data Analysis and its Impact on Predicting Schedule and Cost Risk. AFIT/GIR/ENC/06M-01. Wright-Patterson AFB OH: AFIT

  12. Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network

    PubMed Central

    Bosch, Julia; Martín-Yuste, Victoria; Rosas, Alba; Faixedas, Maria Teresa; Gómez-Hospital, Joan Antoni; Figueras, Jaume; Curós, Antoni; Cequier, Angel; Goicolea, Javier; Fernández-Ortiz, Antonio; Macaya, Carlos; Tresserras, Ricard; Pellisé, Laura; Sabaté, Manel

    2015-01-01

    Objectives To evaluate the cost-effectiveness of the ST-segment elevation myocardial infarction (STEMI) network of Catalonia (Codi Infart). Design Cost-utility analysis. Setting The analysis was from the Catalonian Autonomous Community in Spain, with a population of about 7.5 million people. Participants Patients with STEMI treated within the autonomous community of Catalonia (Spain) included in the IAM CAT II-IV and Codi Infart registries. Outcome measures Costs included hospitalisation, procedures and additional personnel and were obtained according to the reperfusion strategy. Clinical outcomes were defined as 30-day avoided mortality and quality-adjusted life-years (QALYs), before (N=356) and after network implementation (N=2140). Results A substitution effect and a technology effect were observed; aggregate costs increased by 2.6%. The substitution effect resulted from increased use of primary coronary angioplasty, a relatively expensive procedure and a decrease in fibrinolysis. Primary coronary angioplasty increased from 31% to 89% with the network, and fibrinolysis decreased from 37% to 3%. Rescue coronary angioplasty declined from 11% to 4%, and no reperfusion from 21% to 4%. The technological effect was related to improvements in the percutaneous coronary intervention procedure that increased efficiency, reducing the average length of the hospital stay. Mean costs per patient decreased from €8306 to €7874 for patients with primary coronary angioplasty. Clinical outcomes in patients treated with primary coronary angioplasty did not change significantly, although 30-day mortality decreased from 7.5% to 5.6%. The incremental cost-effectiveness ratio resulted in an extra cost of €4355 per life saved (30-day mortality) and €495 per QALY. Below a cost threshold of €30 000, results were sensitive to variations in costs and outcomes. Conclusions The Catalan STEMI network (Codi Infart) is cost-efficient. Further studies are needed in geopolitical different scenarios. PMID:26656019

  13. The Cost-Effectiveness Analysis of Teleglaucoma Screening Device

    PubMed Central

    Thomas, Sera

    2015-01-01

    Glaucoma is the leading cause of irreversible vision loss and costs the American economy $2.9 billion. Teleglaucoma remotely detects glaucoma improving access to ophthalmic care in rural areas. It helps manage glaucoma more efficiently to preserve vision and reduce healthcare costs. A cost-effectiveness analysis was conducted using healthcare provider or third-party payer perspective within rural Canada. The study population were patients at-risk of glaucoma which includes those with diabetes and/or hypertension, family history of glaucoma, adults older than 50 years, and concurrent ocular conditions in rural Alberta. Markov modelling was used to model glaucoma health states. Effectiveness was measured in Quality-Adjusted Life Years (QALYs) and costs were used in Canadian dollars. Using TreeAge Pro 2009, incremental cost-effectiveness ratios (ICER) were developed in dollars per QALYs. Deterministic and probabilistic sensitivity analyses were performed to assess the factors affecting cost-effectiveness. Teleglaucoma had a 20% increase in ophthalmologist-referral rate; it reduced patient travel times by 61 hours and physician wait times by 30% in comparison to in-person examination (standard of care). Teleglaucoma costs $872 per patient screened which was 80% less than in-person examination. Teleglaucoma had a greater incremental effectiveness providing an additional 0.12 QALY per patient examination. It was more sensitive (86.5%) and less specific (78.6%) than in-person examination. Teleglaucoma was more cost-effective than in-person examination with an ICER of-$27,460/QALY. This indicated that teleglaucoma will save $27, 460 for each additional QALY gained. Long term benefits showed teleglaucoma prevents 24% cases of glaucoma blindness after 30 years. Teleglaucoma demonstrated improved health outcomes, as well as, cost benefits. It increases access to ophthalmic care and improves healthcare service efficiency, specifically in rural areas. Teleglaucoma is more cost-effective than current in-person examination and can improve the quality of life in glaucoma patients. PMID:26382956

  14. The Cost-Effectiveness Analysis of Teleglaucoma Screening Device.

    PubMed

    Thomas, Sera; Hodge, William; Malvankar-Mehta, Monali

    2015-01-01

    Glaucoma is the leading cause of irreversible vision loss and costs the American economy $2.9 billion. Teleglaucoma remotely detects glaucoma improving access to ophthalmic care in rural areas. It helps manage glaucoma more efficiently to preserve vision and reduce healthcare costs. A cost-effectiveness analysis was conducted using healthcare provider or third-party payer perspective within rural Canada. The study population were patients at-risk of glaucoma which includes those with diabetes and/or hypertension, family history of glaucoma, adults older than 50 years, and concurrent ocular conditions in rural Alberta. Markov modelling was used to model glaucoma health states. Effectiveness was measured in Quality-Adjusted Life Years (QALYs) and costs were used in Canadian dollars. Using TreeAge Pro 2009, incremental cost-effectiveness ratios (ICER) were developed in dollars per QALYs. Deterministic and probabilistic sensitivity analyses were performed to assess the factors affecting cost-effectiveness. Teleglaucoma had a 20% increase in ophthalmologist-referral rate; it reduced patient travel times by 61 hours and physician wait times by 30% in comparison to in-person examination (standard of care). Teleglaucoma costs $872 per patient screened which was 80% less than in-person examination. Teleglaucoma had a greater incremental effectiveness providing an additional 0.12 QALY per patient examination. It was more sensitive (86.5%) and less specific (78.6%) than in-person examination. Teleglaucoma was more cost-effective than in-person examination with an ICER of-$27,460/QALY. This indicated that teleglaucoma will save $27, 460 for each additional QALY gained. Long term benefits showed teleglaucoma prevents 24% cases of glaucoma blindness after 30 years. Teleglaucoma demonstrated improved health outcomes, as well as, cost benefits. It increases access to ophthalmic care and improves healthcare service efficiency, specifically in rural areas. Teleglaucoma is more cost-effective than current in-person examination and can improve the quality of life in glaucoma patients.

  15. Usability Tests in Medicine: A Cost-Benefit Analysis for Hospitals Before Acquiring Medical Devices for Theatre.

    PubMed

    Gonser, Phillipp; Fuchsberger, Thomas; Matern, Ulrich

    2017-08-01

    The use of active medical devices in clinical routine should be as safe and efficient as possible. Usability tests (UTs) help improve these aspects of medical devices during their development, but UTs can be of use for hospitals even after a product has been launched. The present pilot study examines the costs and possible benefits of UT for hospitals before buying new medical devices for theatre. Two active medical devices with different complexity were tested in a standardized UT and a cost-benefit analysis was carried out assuming a different device bought at the same price with a higher usability could increase the efficiency of task solving and due to that save valuable theatre time. The cost of the UT amounted up to €19.400. Hospitals could benefit from UTs before buying new devices for theatre by reducing time-consuming operator errors and thereby increase productivity and patient safety. The possible benefits amounted from €23.300 to €1.570.000 (median = €797.000). Not only hospitals could benefit economically from investing in a UT before deciding to buy a medical device, but especially patients would profit from a higher usability by reducing possible operator errors and increase safety and performance of use.

  16. Parametric analysis of closed cycle magnetohydrodynamic (MHD) power plants

    NASA Technical Reports Server (NTRS)

    Owens, W.; Berg, R.; Murthy, R.; Patten, J.

    1981-01-01

    A parametric analysis of closed cycle MHD power plants was performed which studied the technical feasibility, associated capital cost, and cost of electricity for the direct combustion of coal or coal derived fuel. Three reference plants, differing primarily in the method of coal conversion utilized, were defined. Reference Plant 1 used direct coal fired combustion while Reference Plants 2 and 3 employed on site integrated gasifiers. Reference Plant 2 used a pressurized gasifier while Reference Plant 3 used a ""state of the art' atmospheric gasifier. Thirty plant configurations were considered by using parametric variations from the Reference Plants. Parametric variations include the type of coal (Montana Rosebud or Illinois No. 6), clean up systems (hot or cold gas clean up), on or two stage atmospheric or pressurized direct fired coal combustors, and six different gasifier systems. Plant sizes ranged from 100 to 1000 MWe. Overall plant performance was calculated using two methodologies. In one task, the channel performance was assumed and the MHD topping cycle efficiencies were based on the assumed values. A second task involved rigorous calculations of channel performance (enthalpy extraction, isentropic efficiency and generator output) that verified the original (task one) assumptions. Closed cycle MHD capital costs were estimated for the task one plants; task two cost estimates were made for the channel and magnet only.

  17. The Least Costs Hypothesis: A rational analysis approach to the voluntary symbolic control of attention.

    PubMed

    Pauszek, Joseph R; Gibson, Bradley S

    2018-04-30

    Here we propose a rational analysis account of voluntary symbolic attention control-the Least Costs Hypothesis (LCH)-that construes voluntary control as a decision between intentional cue use and unguided search. Consistent with the LCH, the present study showed that this decision is sensitive to variations in cue processing efficiency. In Experiment 1, observers demonstrated a robust preference for using "easy-to-process" arrow cues but not "hard-to-process" spatial word cues to satisfy an easy visual search goal; Experiment 2 showed that this preference persisted even when the temporal costs of cue processing were neutralized. Experiment 3 showed that observers reported this cue type preference outside the context of a speeded task, and Experiment 4 showed empirical measures of this bias to be relatively stable over the course of the task. Together with previous evidence suggesting that observers' decision between intentional cue use and unguided search is also influenced by variations in unguided search efficiency, these findings suggest that voluntary symbolic attention control is mediated by ongoing metacognitive evaluations of demand that are sensitive to perceived variations in the time, effort, and opportunity costs associated with each course of action. Thus, voluntary symbolic attention control is far more complex than previously held. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Integrated power sector efficiency analysis: A case study of Costa Rica

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

    Waddle, D.B.; MacDonald, J.M.

    1990-03-01

    In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results ofmore » the study. 14 refs., 2 figs., 5 tabs.« less

  19. International Experiences with Quantifying the Co-Benefits of Energy-Efficiency and Greenhouse-Gas Mitigation Programs and Policies

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

    Williams, Christopher; Hasanbeigi, Ali; Price, Lynn

    Improving the efficiency of energy production and consumption and switching to lower carbon energy sources can significantly decrease carbon dioxide (CO2) emissions and reduce climate change impacts. A growing body of research has found that these measures can also directly mitigate many non-climate change related human health hazards and environmental damage. Positive impacts of policies and programs that occur in addition to the intended primary policy goal are called co-benefits. Policy analysis relies on forecasting and comparing the costs of policy and program implementation and the benefits that accrue to society from implementation. GHG reduction and energy efficiency policies andmore » programs face political resistance in part because of the difficulty of quantifying their benefits. On the one hand, climate change mitigation policy benefits are often global, long-term, and subject to large uncertainties, and subsidized energy pricing can reduce the direct monetary benefits of energy efficiency policies to below their cost. On the other hand, the co-benefits that accrue from these efforts’ resultant reductions in conventional air pollution (such as improved health, agricultural productivity, reduced damage to infrastructure, and local ecosystem improvements) are generally near term, local, and more certain than climate change mitigation benefits and larger than the monetary value of energy savings. The incorporation of co-benefits into energy efficiency and climate mitigation policy and program analysis therefore might significantly increase the uptake of these policies. Faster policy uptake is especially important in developing countries because ongoing development efforts that do not consider co-benefits may lock in suboptimal technologies and infrastructure and result in high costs in future years. Over the past two decades, studies have repeatedly documented that non-climate change related benefits of energy efficiency and fuel conversion efforts, as a part of GHG mitigation strategies, can be from between 30% to over 100% of the costs of such policies and programs strategies. Policy makers around the world are increasingly interested in including both GHG and non-GHG impacts in analyses of energy efficiency and fuel switching policies and programs and a set of methodologies has matured from the efforts of early moving jurisdictions such as the European Union, the United States, and Japan.« less

  20. Production Functions for Water Delivery Systems: Analysis and Estimation Using Dual Cost Function and Implicit Price Specifications

    NASA Astrophysics Data System (ADS)

    Teeples, Ronald; Glyer, David

    1987-05-01

    Both policy and technical analysis of water delivery systems have been based on cost functions that are inconsistent with or are incomplete representations of the neoclassical production functions of economics. We present a full-featured production function model of water delivery which can be estimated from a multiproduct, dual cost function. The model features implicit prices for own-water inputs and is implemented as a jointly estimated system of input share equations and a translog cost function. Likelihood ratio tests are performed showing that a minimally constrained, full-featured production function is a necessary specification of the water delivery operations in our sample. This, plus the model's highly efficient and economically correct parameter estimates, confirms the usefulness of a production function approach to modeling the economic activities of water delivery systems.

  1. Performance-based contracting in home-care work in The Netherlands: professionalism under pressure?

    PubMed

    Oomkens, Rosanne; Hoogenboom, Marcel; Knijn, Trudie

    2016-07-01

    Our aim was to improve the understanding of the relationships between performance-based contracting, management supportiveness and professionalism in home care. Using path analysis, this article explores the relationships between home-care workers' perceptions of management support, implementation of performance-based contracting (i.e. use of strict time registration rules and cost-efficiency measures) and autonomy and intrinsic job satisfaction. We hypothesised that: use of strict time registration rules and cost-efficiency measures relates to lower levels of autonomy and intrinsic job satisfaction (H1); there is an indirect relationship between use of strict time registration rules and use of cost-efficiency measures and intrinsic job satisfaction via autonomy (H2); higher levels of management support relate to the use of looser time registration rules and less use of cost-efficiency measures (H3); and higher levels of management support relate to higher levels of autonomy and intrinsic job satisfaction (H4). We used data from a cross-sectional survey conducted in 2010 of a sample of Dutch home-care workers (N = 156, response rate = 34%). Overall, our study suggests that the consequences of performance-based contracting for professionalism are ambiguous. More specifically, using strict time registration rules is related to lower levels of autonomy, whereas using cost-efficiency measures does not seem to affect autonomy (H1). Performance-based contracting has no consequences for the level of fulfilment home-care workers find in their job, as neither of the two contracting dimensions measured was directly or indirectly related to intrinsic job satisfaction (H1, H2). The role of managers must be taken into account when studying performance-based contracting, because perceived higher management support is related to managers' less frequent use of both strict time registration rules and of cost-efficiency measures (H3). The insight we gained into the importance of supportive managers for both autonomy and job satisfaction (H4) can help home-care organisations improve the attractiveness of home-care work. © 2015 John Wiley & Sons Ltd.

  2. Efficiencies of Internet-based digital and paper-based scientific surveys and the estimated costs and time for different-sized cohorts.

    PubMed

    Uhlig, Constantin E; Seitz, Berthold; Eter, Nicole; Promesberger, Julia; Busse, Holger

    2014-01-01

    To evaluate the relative efficiencies of five Internet-based digital and three paper-based scientific surveys and to estimate the costs for different-sized cohorts. Invitations to participate in a survey were distributed via e-mail to employees of two university hospitals (E1 and E2) and to members of a medical association (E3), as a link placed in a special text on the municipal homepage regularly read by the administrative employees of two cities (H1 and H2), and paper-based to workers at an automobile enterprise (P1) and college (P2) and senior (P3) students. The main parameters analyzed included the numbers of invited and actual participants, and the time and cost to complete the survey. Statistical analysis was descriptive, except for the Kruskal-Wallis-H-test, which was used to compare the three recruitment methods. Cost efficiencies were compared and extrapolated to different-sized cohorts. The ratios of completely answered questionnaires to distributed questionnaires were between 81.5% (E1) and 97.4% (P2). Between 6.4% (P1) and 57.0% (P2) of the invited participants completely answered the questionnaires. The costs per completely answered questionnaire were $0.57-$1.41 (E1-3), $1.70 and $0.80 for H1 and H2, respectively, and $3.36-$4.21 (P1-3). Based on our results, electronic surveys with 10, 20, 30, or 42 questions would be estimated to be most cost (and time) efficient if more than 101.6-225.9 (128.2-391.7), 139.8-229.2 (93.8-193.6), 165.8-230.6 (68.7-115.7), or 188.2-231.5 (44.4-72.7) participants were required, respectively. The study efficiency depended on the technical modalities of the survey methods and engagement of the participants. Depending on our study design, our results suggest that in similar projects that will certainly have more than two to three hundred required participants, the most efficient way of conducting a questionnaire-based survey is likely via the Internet with a digital questionnaire, specifically via a centralized e-mail.

  3. The Financial Impact of Using TMR in a Private Group Practice

    PubMed Central

    Templeton, Joan; Bernes, Marshall; Ostrowski, Maureen

    1982-01-01

    The installation of a computerized financial system is usually preceded by a cost-benefit analysis showing a positive impact on the facility's financial picture. The administration expects reduction in some operating costs (exclusive of the system and the installation costs) and an improvement in collecting accounts receivable. When California Primary Physicians installed TMR, certain costs were reduced, and the business office did become more efficient. However, because TMR is an integrated medical/financial system, other financial benefits accrued to the practice that billing systems would never be able to provide. This paper discusses the financial impact of TMR on cost reduction, accounts receivable collection, revenue tracking, and program development and marketing.

  4. A comparative technoeconomic analysis of renewable hydrogen production using solar energy

    DOE PAGES

    Shaner, Matthew R.; Atwater, Harry A.; Lewis, Nathan S.; ...

    2016-05-26

    A technoeconomic analysis of photoelectrochemical (PEC) and photovoltaic-electrolytic (PV-E) solar-hydrogen production of 10 000 kg H 2 day -1 (3.65 kilotons per year) was performed to assess the economics of each technology, and to provide a basis for comparison between these technologies as well as within the broader energy landscape. Two PEC systems, differentiated primarily by the extent of solar concentration (unconcentrated and 10× concentrated) and two PV-E systems, differentiated by the degree of grid connectivity (unconnected and grid supplemented), were analyzed. In each case, a base-case system that used established designs and materials was compared to prospective systems thatmore » might be envisioned and developed in the future with the goal of achieving substantially lower overall system costs. With identical overall plant efficiencies of 9.8%, the unconcentrated PEC and non-grid connected PV-E system base-case capital expenses for the rated capacity of 3.65 kilotons H 2 per year were 205 dollars MM (293 dollars per m 2 of solar collection area (m S -2 ), 14.7 W H2,P -1) and 260 dollars MM ($371 m S -2, 18.8 dollars W H2,P -1 ), respectively. The untaxed, plant-gate levelized costs for the hydrogen product (LCH) were $11.4 kg -1 and 12.1 dollars kg -1 for the base-case PEC and PV-E systems, respectively. The 10× concentrated PEC base-case system capital cost was 160 dollars MM (428 dollars m S -2, 11.5 dollars W H2,P -1) and for an efficiency of 20% the LCH was 9.2 kg -1 . Likewise, the grid supplemented base-case PV-E system capital cost was 66 dollars MM (441 dollars m S -2, 11.5 dollars W H2,P -1 ), and with solar-to-hydrogen and grid electrolysis system efficiencies of 9.8% and 61%, respectively, the LCH was 6.1 dollars kg -1 . As a benchmark, a proton-exchange membrane (PEM) based grid-connected electrolysis system was analyzed. Assuming a system efficiency of 61% and a grid electricity cost of $0.07 kWh -1 , the LCH was $5.5 kg -1 . A sensitivity analysis indicated that, relative to the base-case, increases in the system efficiency could effect the greatest cost reductions for all systems, due to the areal dependencies of many of the components. The balance-of-systems (BoS) costs were the largest factor in differentiating the PEC and PV-E systems. No single or combination of technical advancements based on currently demonstrated technology can provide sufficient cost reductions to allow solar hydrogen to directly compete on a levelized cost basis with hydrogen produced from fossil energy. Specifically, a cost of CO 2 greater than ~$800 dollars (ton CO 2 ) -1 was estimated to be necessary for base-case PEC hydrogen to reach price parity with hydrogen derived from steam reforming of methane priced at $12 GJ -1 ($1.39 (kg H 2 ) -1). A comparison with low CO 2 and CO 2 -neutral energy sources indicated that base-case PEC hydrogen is not currently cost-competitive with electrolysis using electricity supplied by nuclear power or from fossil-fuels in conjunction with carbon capture and storage. Solar electricity production and storage using either batteries or PEC hydrogen technologies are currently an order of magnitude greater in cost than electricity prices with no clear advantage to either battery or hydrogen storage as of yet. Significant advances in PEC technology performance and system cost reductions are necessary to enable cost-effective PEC-derived solar hydrogen for use in scalable grid-storage applications as well as for use as a chemical feedstock precursor to CO 2 -neutral high energy-density transportation fuels. Hence such applications are an opportunity for foundational research to contribute to the development of disruptive approaches to solar fuels generation systems that can offer higher performance at much lower cost than is provided by current embodiments of solar fuels generators. Efforts to directly reduce CO 2 photoelectrochemically or electrochemically could potentially produce products with higher value than hydrogen, but many, as yet unmet, challenges include catalytic efficiency and selectivity, and CO 2 mass transport rates and feedstock cost. Major breakthroughs are required to obtain viable economic costs for solar hydrogen production, but the barriers to achieve cost-competitiveness with existing large-scale thermochemical processes for CO 2 reduction are even greater.« less

  5. A comparative technoeconomic analysis of renewable hydrogen production using solar energy

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

    Shaner, Matthew R.; Atwater, Harry A.; Lewis, Nathan S.

    A technoeconomic analysis of photoelectrochemical (PEC) and photovoltaic-electrolytic (PV-E) solar-hydrogen production of 10 000 kg H 2 day -1 (3.65 kilotons per year) was performed to assess the economics of each technology, and to provide a basis for comparison between these technologies as well as within the broader energy landscape. Two PEC systems, differentiated primarily by the extent of solar concentration (unconcentrated and 10× concentrated) and two PV-E systems, differentiated by the degree of grid connectivity (unconnected and grid supplemented), were analyzed. In each case, a base-case system that used established designs and materials was compared to prospective systems thatmore » might be envisioned and developed in the future with the goal of achieving substantially lower overall system costs. With identical overall plant efficiencies of 9.8%, the unconcentrated PEC and non-grid connected PV-E system base-case capital expenses for the rated capacity of 3.65 kilotons H 2 per year were 205 dollars MM (293 dollars per m 2 of solar collection area (m S -2 ), 14.7 W H2,P -1) and 260 dollars MM ($371 m S -2, 18.8 dollars W H2,P -1 ), respectively. The untaxed, plant-gate levelized costs for the hydrogen product (LCH) were $11.4 kg -1 and 12.1 dollars kg -1 for the base-case PEC and PV-E systems, respectively. The 10× concentrated PEC base-case system capital cost was 160 dollars MM (428 dollars m S -2, 11.5 dollars W H2,P -1) and for an efficiency of 20% the LCH was 9.2 kg -1 . Likewise, the grid supplemented base-case PV-E system capital cost was 66 dollars MM (441 dollars m S -2, 11.5 dollars W H2,P -1 ), and with solar-to-hydrogen and grid electrolysis system efficiencies of 9.8% and 61%, respectively, the LCH was 6.1 dollars kg -1 . As a benchmark, a proton-exchange membrane (PEM) based grid-connected electrolysis system was analyzed. Assuming a system efficiency of 61% and a grid electricity cost of $0.07 kWh -1 , the LCH was $5.5 kg -1 . A sensitivity analysis indicated that, relative to the base-case, increases in the system efficiency could effect the greatest cost reductions for all systems, due to the areal dependencies of many of the components. The balance-of-systems (BoS) costs were the largest factor in differentiating the PEC and PV-E systems. No single or combination of technical advancements based on currently demonstrated technology can provide sufficient cost reductions to allow solar hydrogen to directly compete on a levelized cost basis with hydrogen produced from fossil energy. Specifically, a cost of CO 2 greater than ~$800 dollars (ton CO 2 ) -1 was estimated to be necessary for base-case PEC hydrogen to reach price parity with hydrogen derived from steam reforming of methane priced at $12 GJ -1 ($1.39 (kg H 2 ) -1). A comparison with low CO 2 and CO 2 -neutral energy sources indicated that base-case PEC hydrogen is not currently cost-competitive with electrolysis using electricity supplied by nuclear power or from fossil-fuels in conjunction with carbon capture and storage. Solar electricity production and storage using either batteries or PEC hydrogen technologies are currently an order of magnitude greater in cost than electricity prices with no clear advantage to either battery or hydrogen storage as of yet. Significant advances in PEC technology performance and system cost reductions are necessary to enable cost-effective PEC-derived solar hydrogen for use in scalable grid-storage applications as well as for use as a chemical feedstock precursor to CO 2 -neutral high energy-density transportation fuels. Hence such applications are an opportunity for foundational research to contribute to the development of disruptive approaches to solar fuels generation systems that can offer higher performance at much lower cost than is provided by current embodiments of solar fuels generators. Efforts to directly reduce CO 2 photoelectrochemically or electrochemically could potentially produce products with higher value than hydrogen, but many, as yet unmet, challenges include catalytic efficiency and selectivity, and CO 2 mass transport rates and feedstock cost. Major breakthroughs are required to obtain viable economic costs for solar hydrogen production, but the barriers to achieve cost-competitiveness with existing large-scale thermochemical processes for CO 2 reduction are even greater.« less

  6. Process research of non-Czochralski silicon material

    NASA Technical Reports Server (NTRS)

    Campbell, R. B.

    1986-01-01

    Simultaneous diffusion of liquid precursors containing phosphorus and boron into dendritic web silicon to form solar cell structures was investigated. A simultaneous junction formation techniques was developed. It was determined that to produce high quality cells, an annealing cycle (nominal 800 C for 30 min) should follow the diffusion process to anneal quenched-in defects. Two ohm-cm n-base cells were fabricated with efficiencies greater than 15%. A cost analysis indicated that the simultansous diffusion process costs can be as low as 65% of the costs of the sequential diffusion process.

  7. Security in Logistics

    NASA Astrophysics Data System (ADS)

    Cempírek, Václav; Nachtigall, Petr; Široký, Jaromír

    2016-12-01

    This paper deals with security of logistic chains according to incorrect declaration of transported goods, fraudulent transport and forwarding companies and possible threats caused by political influences. The main goal of this paper is to highlight possible logistic costs increase due to these fraudulent threats. An analysis of technological processes will beis provided, and an increase of these transport times considering the possible threatswhich will beis evaluated economic costs-wise. In the conclusion, possible threat of companies'` efficiency in logistics due to the costs`, means of transport and increase in human resources` increase will beare pointed out.

  8. Cost-of-illness studies based on massive data: a prevalence-based, top-down regression approach.

    PubMed

    Stollenwerk, Björn; Welchowski, Thomas; Vogl, Matthias; Stock, Stephanie

    2016-04-01

    Despite the increasing availability of routine data, no analysis method has yet been presented for cost-of-illness (COI) studies based on massive data. We aim, first, to present such a method and, second, to assess the relevance of the associated gain in numerical efficiency. We propose a prevalence-based, top-down regression approach consisting of five steps: aggregating the data; fitting a generalized additive model (GAM); predicting costs via the fitted GAM; comparing predicted costs between prevalent and non-prevalent subjects; and quantifying the stochastic uncertainty via error propagation. To demonstrate the method, it was applied to aggregated data in the context of chronic lung disease to German sickness funds data (from 1999), covering over 7.3 million insured. To assess the gain in numerical efficiency, the computational time of the innovative approach has been compared with corresponding GAMs applied to simulated individual-level data. Furthermore, the probability of model failure was modeled via logistic regression. Applying the innovative method was reasonably fast (19 min). In contrast, regarding patient-level data, computational time increased disproportionately by sample size. Furthermore, using patient-level data was accompanied by a substantial risk of model failure (about 80 % for 6 million subjects). The gain in computational efficiency of the innovative COI method seems to be of practical relevance. Furthermore, it may yield more precise cost estimates.

  9. A Cost-Effectiveness Analysis of Community Health Workers in Mozambique.

    PubMed

    Bowser, Diana; Okunogbe, Adeyemi; Oliveras, Elizabeth; Subramanian, Laura; Morrill, Tyler

    2015-10-01

    Community health worker (CHW) programs are a key strategy for reducing mortality and morbidity. Despite this, there is a gap in the literature on the cost and cost-effectiveness of CHW programs, especially in developing countries. This study assessed the costs of a CHW program in Mozambique over the period 2010-2012. Incremental cost-effectiveness ratios, comparing the change in costs to the change in 3 output measures, as well as gains in efficiency were calculated over the periods 2010-2011 and 2010-2012. The results were reported both excluding and including salaries for CHWs. The results of the study showed total costs of the CHW program increased from US$1.34 million in 2010 to US$1.67 million in 2012. The highest incremental cost-effectiveness ratio was for the cost per beneficiary covered including CHW salaries, estimated at US$47.12 for 2010-2011. The smallest incremental cost-effectiveness ratio was for the cost per household visit not including CHW salaries, estimated at US$0.09 for 2010-2012. Adding CHW salaries would not only have increased total program costs by 362% in 2012 but also led to the largest efficiency gains in program implementation; a 56% gain in cost per output in the long run as compared with the short run after including CHW salaries. Our findings can be used to inform future CHW program policy both in Mozambique and in other countries, as well as provide a set of incremental cost per output measures to be used in benchmarking to other CHW costing analyses. © The Author(s) 2015.

  10. Flux balance analysis indicates that methane is the lowest cost feedstock for microbial cell factories

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

    Comer, Austin D.; Long, Matthew R.; Reed, Jennifer L.

    The low cost of natural gas has driven significant interest in using C 1 carbon sources (e.g. methane, methanol, CO, syngas) as feedstocks for producing liquid transportation fuels and commodity chemicals. Given the large contribution of sugar and lignocellulosic feedstocks to biorefinery operating costs, natural gas and other C 1 sources may provide an economic advantage. To assess the relative costs of these feedstocks, we performed flux balance analysis on genome-scale metabolic models to calculate the maximum theoretical yields of chemical products from methane, methanol, acetate, and glucose. Yield calculations were performed for every metabolite (as a proxy for desiredmore » products) in the genome-scale metabolic models of three organisms: Escherichia coli (bacterium), Saccharomyces cerevisiae (yeast), and Synechococcus sp. PCC 7002 (cyanobacterium). The calculated theoretical yields and current feedstock prices provided inputs to create comparative feedstock cost surfaces. Our analysis shows that, at current market prices, methane feedstock costs are consistently lower than glucose when used as a carbon and energy source for microbial chemical production. Conversely, methanol is costlier than glucose under almost all price scenarios. Acetate feedstock costs could be less than glucose given efficient acetate production from low-cost syngas using nascent biological gas to liquids (BIO-GTL) technologies. Furthermore, our analysis suggests that research should focus on overcoming the technical challenges of methane assimilation and/or yield of acetate via BIO-GTL to take advantage of low-cost natural gas rather than using methanol as a feedstock.« less

  11. Analysis of MRSA-attributed costs of hospitalized patients in Germany.

    PubMed

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

    2014-10-01

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

  12. Flux balance analysis indicates that methane is the lowest cost feedstock for microbial cell factories

    DOE PAGES

    Comer, Austin D.; Long, Matthew R.; Reed, Jennifer L.; ...

    2017-07-10

    The low cost of natural gas has driven significant interest in using C 1 carbon sources (e.g. methane, methanol, CO, syngas) as feedstocks for producing liquid transportation fuels and commodity chemicals. Given the large contribution of sugar and lignocellulosic feedstocks to biorefinery operating costs, natural gas and other C 1 sources may provide an economic advantage. To assess the relative costs of these feedstocks, we performed flux balance analysis on genome-scale metabolic models to calculate the maximum theoretical yields of chemical products from methane, methanol, acetate, and glucose. Yield calculations were performed for every metabolite (as a proxy for desiredmore » products) in the genome-scale metabolic models of three organisms: Escherichia coli (bacterium), Saccharomyces cerevisiae (yeast), and Synechococcus sp. PCC 7002 (cyanobacterium). The calculated theoretical yields and current feedstock prices provided inputs to create comparative feedstock cost surfaces. Our analysis shows that, at current market prices, methane feedstock costs are consistently lower than glucose when used as a carbon and energy source for microbial chemical production. Conversely, methanol is costlier than glucose under almost all price scenarios. Acetate feedstock costs could be less than glucose given efficient acetate production from low-cost syngas using nascent biological gas to liquids (BIO-GTL) technologies. Furthermore, our analysis suggests that research should focus on overcoming the technical challenges of methane assimilation and/or yield of acetate via BIO-GTL to take advantage of low-cost natural gas rather than using methanol as a feedstock.« less

  13. Can home care services achieve cost savings in long-term care for older people?

    PubMed

    Greene, V L; Ondrich, J; Laditka, S

    1998-07-01

    To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

  14. Chapter 8: Whole-Building Retrofit with Consumption Data Analysis Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W.; Agnew, Ken; Goldberg, Mimi

    Whole-building retrofits involve the installation of multiple measures. Whole-building retrofit programs take many forms. With a focus on overall building performance, these programs usually begin with an energy audit to identify cost-effective energy efficiency measures for the home. Measures are then installed, either at no cost to the homeowner or partially paid for by rebates and/or financing. The methods described here may also be applied to evaluation of single-measure retrofit programs. Related methods exist for replace-on-failure programs and for new construction, but are not the subject of this chapter.

  15. A cost and policy analysis comparing immediate sequential cataract surgery and delayed sequential cataract surgery from the physician perspective in the United States.

    PubMed

    Neel, Sean T

    2014-11-01

    A cost analysis was performed to evaluate the effect on physicians in the United States of a transition from delayed sequential cataract surgery to immediate sequential cataract surgery. Financial and efficiency impacts of this change were evaluated to determine whether efficiency gains could offset potential reduced revenue. A cost analysis using Medicare cataract surgery volume estimates, Medicare 2012 physician cataract surgery reimbursement schedules, and estimates of potential additional office visit revenue comparing immediate sequential cataract surgery with delayed sequential cataract surgery for a single specialty ophthalmology practice in West Tennessee. This model should give an indication of the effect on physicians on a national basis. A single specialty ophthalmology practice in West Tennessee was found to have a cataract surgery revenue loss of $126,000, increased revenue from office visits of $34,449 to $106,271 (minimum and maximum offset methods), and a net loss of $19,900 to $91,700 (base case) with the conversion to immediate sequential cataract surgery. Physicians likely stand to lose financially, and this loss cannot be offset by increased patient visits under the current reimbursement system. This may result in physician resistance to converting to immediate sequential cataract surgery, gaming, and supplier-induced demand.

  16. Data processing workflows from low-cost digital survey to various applications: three case studies of Chinese historic architecture

    NASA Astrophysics Data System (ADS)

    Sun, Z.; Cao, Y. K.

    2015-08-01

    The paper focuses on the versatility of data processing workflows ranging from BIM-based survey to structural analysis and reverse modeling. In China nowadays, a large number of historic architecture are in need of restoration, reinforcement and renovation. But the architects are not prepared for the conversion from the booming AEC industry to architectural preservation. As surveyors working with architects in such projects, we have to develop efficient low-cost digital survey workflow robust to various types of architecture, and to process the captured data for architects. Although laser scanning yields high accuracy in architectural heritage documentation and the workflow is quite straightforward, the cost and portability hinder it from being used in projects where budget and efficiency are of prime concern. We integrate Structure from Motion techniques with UAV and total station in data acquisition. The captured data is processed for various purposes illustrated with three case studies: the first one is as-built BIM for a historic building based on registered point clouds according to Ground Control Points; The second one concerns structural analysis for a damaged bridge using Finite Element Analysis software; The last one relates to parametric automated feature extraction from captured point clouds for reverse modeling and fabrication.

  17. How much is new information worth? Evaluating the financial benefit of resolving management uncertainty

    USGS Publications Warehouse

    Maxwell, Sean L.; Rhodes, Jonathan R.; Runge, Michael C.; Possingham, Hugh P.; Ng, Chooi Fei; McDonald Madden, Eve

    2015-01-01

    Conservation decision-makers face a trade-off between spending limited funds on direct management action, or gaining new information in an attempt to improve management performance in the future. Value-of-information analysis can help to resolve this trade-off by evaluating how much management performance could improve if new information was gained. Value-of-information analysis has been used extensively in other disciplines, but there are only a few examples where it has informed conservation planning, none of which have used it to evaluate the financial value of gaining new information. We address this gap by applying value-of-information analysis to the management of a declining koala Phascolarctos cinereuspopulation. Decision-makers responsible for managing this population face uncertainty about survival and fecundity rates, and how habitat cover affects mortality threats. The value of gaining new information about these uncertainties was calculated using a deterministic matrix model of the koala population to find the expected population growth rate if koala mortality threats were optimally managed under alternative model hypotheses, which represented the uncertainties faced by koala managers. Gaining new information about survival and fecundity rates and the effect of habitat cover on mortality threats will do little to improve koala management. Across a range of management budgets, no more than 1·7% of the budget should be spent on resolving these uncertainties. The value of information was low because optimal management decisions were not sensitive to the uncertainties we considered. Decisions were instead driven by a substantial difference in the cost efficiency of management actions. The value of information was up to forty times higher when the cost efficiencies of different koala management actions were similar. Synthesis and applications. This study evaluates the ecological and financial benefits of gaining new information to inform a conservation problem. We also theoretically demonstrate that the value of reducing uncertainty is highest when it is not clear which management action is the most cost efficient. This study will help expand the use of value-of-information analyses in conservation by providing a cost efficiency metric by which to evaluate research or monitoring.

  18. The Cost of Saving Electricity Through Energy Efficiency Programs Funded by Utility Customers: 2009–2015

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

    Hoffman, Ian M.; Goldman, Charles A.; Murphy, Sean

    The average cost to utilities to save a kilowatt-hour (kWh) in the United States is 2.5 cents, according to the most comprehensive assessment to date of the cost performance of energy efficiency programs funded by electricity customers. These costs are similar to those documented earlier. Cost-effective efficiency programs help ensure electricity system reliability at the most affordable cost as part of utility planning and implementation activities for resource adequacy. Building on prior studies, Berkeley Lab analyzed the cost performance of 8,790 electricity efficiency programs between 2009 and 2015 for 116 investor-owned utilities and other program administrators in 41 states. Themore » Berkeley Lab database includes programs representing about three-quarters of total spending on electricity efficiency programs in the United States.« less

  19. Understanding Cost-Effectiveness of Energy Efficiency Programs

    EPA Pesticide Factsheets

    Discusses the five standard tests used to assess the cost-effectiveness of energy efficiency, how states are using these tests, and how the tests can be used to determine the cost-effectiveness of energy efficiency measures.

  20. Impact of Capital and Current Costs Changes of the Incineration Process of the Medical Waste on System Management Cost

    NASA Astrophysics Data System (ADS)

    Jolanta Walery, Maria

    2017-12-01

    The article describes optimization studies aimed at analysing the impact of capital and current costs changes of medical waste incineration on the cost of the system management and its structure. The study was conducted on the example of an analysis of the system of medical waste management in the Podlaskie Province, in north-eastern Poland. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. capital and current costs of medical waste incineration on economic efficiency index (E) and the spatial structure of the system was determined. Optimization studies were conducted for the following cases: with a 25% increase in capital and current costs of incineration process, followed by 50%, 75% and 100% increase. As a result of the calculations, the highest cost of system operation was achieved at the level of 3143.70 PLN/t with the assumption of 100% increase in capital and current costs of incineration process. There was an increase in the economic efficiency index (E) by about 97% in relation to run 1.

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