Economic costs of obesity in Thailand: a retrospective cost-of-illness study.

PubMed

Pitayatienanan, Paiboon; Butchon, Rukmanee; Yothasamut, Jomkwan; Aekplakorn, Wichai; Teerawattananon, Yot; Suksomboon, Naeti; Thavorncharoensap, Montarat

2014-04-02

Over the last decade, the prevalence of obesity (BMI ≥ 25 kg/m2) in Thailand has been rising rapidly and consistently. Estimating the cost of obesity to society is an essential step in setting priorities for research and resource use and helping improve public awareness of the negative economic impacts of obesity. This prevalence-based, cost-of-illness study aims to estimate the economic costs of obesity in Thailand. The estimated costs in this study included health care cost, cost of productivity loss due to premature mortality, and cost of productivity loss due to hospital-related absenteeism. The Obesity-Attributable Fraction (OAF) was used to estimate the extent to which the co-morbidities were attributable to obesity. The health care cost of obesity was further estimated by multiplying the number of patients in each disease category attributable to obesity by the unit cost of treatment. The cost of productivity loss was calculated using the human capital approach. The health care cost attributable to obesity was estimated at 5,584 million baht or 1.5% of national health expenditure. The cost of productivity loss attributable to obesity was estimated at 6,558 million baht - accounting for 54% of the total cost of obesity. The cost of hospital-related absenteeism was estimated at 694 million baht, while the cost of premature mortality was estimated at 5,864 million baht. The total cost of obesity was then estimated at 12,142 million baht (725.3 million US$PPP, 16.74 baht =1 US$PPP accounting for 0.13% of Thailand's Gross Domestic Product (GDP). Obesity imposes a substantial economic burden on Thai society especially in term of health care costs. Large-scale comprehensive interventions focused on improving public awareness of the cost of and problems associated with obesity and promoting a healthy lifestyle should be regarded as a public health priority.

Product line cost estimation: a standard cost approach.

PubMed

Cooper, J C; Suver, J D

1988-04-01

Product line managers often must make decisions based on inaccurate cost information. A method is needed to determine costs more accurately. By using a standard costing model, product line managers can better estimate the cost of intermediate and end products, and hence better estimate the costs of the product line.

Space transfer vehicle concepts and requirements study. Volume 3, book 1: Program cost estimates

NASA Technical Reports Server (NTRS)

Peffley, Al F.

1991-01-01

The Space Transfer Vehicle (STV) Concepts and Requirements Study cost estimate and program planning analysis is presented. The cost estimating technique used to support STV system, subsystem, and component cost analysis is a mixture of parametric cost estimating and selective cost analogy approaches. The parametric cost analysis is aimed at developing cost-effective aerobrake, crew module, tank module, and lander designs with the parametric cost estimates data. This is accomplished using cost as a design parameter in an iterative process with conceptual design input information. The parametric estimating approach segregates costs by major program life cycle phase (development, production, integration, and launch support). These phases are further broken out into major hardware subsystems, software functions, and tasks according to the STV preliminary program work breakdown structure (WBS). The WBS is defined to a low enough level of detail by the study team to highlight STV system cost drivers. This level of cost visibility provided the basis for cost sensitivity analysis against various design approaches aimed at achieving a cost-effective design. The cost approach, methodology, and rationale are described. A chronological record of the interim review material relating to cost analysis is included along with a brief summary of the study contract tasks accomplished during that period of review and the key conclusions or observations identified that relate to STV program cost estimates. The STV life cycle costs are estimated on the proprietary parametric cost model (PCM) with inputs organized by a project WBS. Preliminary life cycle schedules are also included.

Epilepsy in Sweden: health care costs and loss of productivity--a register-based approach.

PubMed

Bolin, Kristian; Lundgren, Anders; Berggren, Fredrik; Källén, Kristina

2012-12-01

The objective was to estimate health care costs and productivity losses due to epilepsy in Sweden and to compare these estimates to previously published estimates. Register data on health care utilisation, pharmaceutical sales, permanent disability and mortality were used to calculate health care costs and costs that accrue due to productivity losses. By linkage of register information, we were able to distinguish pharmaceuticals prescribed against epilepsy from prescriptions that were prompted by other indications. The estimated total cost of epilepsy in Sweden in 2009 was 441 million, which corresponds to an annual per-patient cost of 8,275. Health care accounted for about 16% of the estimated total cost, and drug costs accounted for about 7% of the total cost. The estimated health care cost corresponded to about 0.2% of the total health care cost in Sweden in 2009. Indirect costs were estimated at 370 million, 84% of which was due to sickness absenteeism. Costs resulting from epilepsy-attributable premature deaths or permanent disability to work accounted for about 1% of the total indirect cost in Sweden in 2009. The per-patient cost of epilepsy is substantial. Thus, even though the prevalence of the illness is relatively small, the aggregated cost that epilepsy incurs on society is significant.

48 CFR 1852.216-85 - Estimated cost and award fee.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and Clauses 1852.216-85 Estimated cost and award fee. As prescribed in 1816.406-70(e), insert the following clause: Estimated Cost and Award Fee (SEP 1993) The estimated cost of this contract is $___. The... cost, base fee, and maximum award fee are $___. (End of clause) Alternate I (SEP 1993). As prescribed...

Weight and cost forecasting for advanced manned space vehicles

NASA Technical Reports Server (NTRS)

Williams, Raymond

1989-01-01

A mass and cost estimating computerized methology for predicting advanced manned space vehicle weights and costs was developed. The user friendly methology designated MERCER (Mass Estimating Relationship/Cost Estimating Relationship) organizes the predictive process according to major vehicle subsystem levels. Design, development, test, evaluation, and flight hardware cost forecasting is treated by the study. This methodology consists of a complete set of mass estimating relationships (MERs) which serve as the control components for the model and cost estimating relationships (CERs) which use MER output as input. To develop this model, numerous MER and CER studies were surveyed and modified where required. Additionally, relationships were regressed from raw data to accommodate the methology. The models and formulations which estimated the cost of historical vehicles to within 20 percent of the actual cost were selected. The result of the research, along with components of the MERCER Program, are reported. On the basis of the analysis, the following conclusions were established: (1) The cost of a spacecraft is best estimated by summing the cost of individual subsystems; (2) No one cost equation can be used for forecasting the cost of all spacecraft; (3) Spacecraft cost is highly correlated with its mass; (4) No study surveyed contained sufficient formulations to autonomously forecast the cost and weight of the entire advanced manned vehicle spacecraft program; (5) No user friendly program was found that linked MERs with CERs to produce spacecraft cost; and (6) The group accumulation weight estimation method (summing the estimated weights of the various subsystems) proved to be a useful method for finding total weight and cost of a spacecraft.

Estimating Airline Operating Costs

NASA Technical Reports Server (NTRS)

Maddalon, D. V.

1978-01-01

The factors affecting commercial aircraft operating and delay costs were used to develop an airline operating cost model which includes a method for estimating the labor and material costs of individual airframe maintenance systems. The model permits estimates of aircraft related costs, i.e., aircraft service, landing fees, flight attendants, and control fees. A method for estimating the costs of certain types of airline delay is also described.

Estimating the Costs of Preventive Interventions

ERIC Educational Resources Information Center

Foster, E. Michael; Porter, Michele M.; Ayers, Tim S.; Kaplan, Debra L.; Sandler, Irwin

2007-01-01

The goal of this article is to improve the practice and reporting of cost estimates of prevention programs. It reviews the steps in estimating the costs of an intervention and the principles that should guide estimation. The authors then review prior efforts to estimate intervention costs using a sample of well-known but diverse studies. Finally,…

Manned Mars mission cost estimate

NASA Technical Reports Server (NTRS)

Hamaker, Joseph; Smith, Keith

1986-01-01

The potential costs of several options of a manned Mars mission are examined. A cost estimating methodology based primarily on existing Marshall Space Flight Center (MSFC) parametric cost models is summarized. These models include the MSFC Space Station Cost Model and the MSFC Launch Vehicle Cost Model as well as other modes and techniques. The ground rules and assumptions of the cost estimating methodology are discussed and cost estimates presented for six potential mission options which were studied. The estimated manned Mars mission costs are compared to the cost of the somewhat analogous Apollo Program cost after normalizing the Apollo cost to the environment and ground rules of the manned Mars missions. It is concluded that a manned Mars mission, as currently defined, could be accomplished for under $30 billion in 1985 dollars excluding launch vehicle development and mission operations.

Estimating pharmacy level prescription drug acquisition costs for third-party reimbursement.

PubMed

Kreling, D H; Kirk, K W

1986-07-01

Accurate payment for the acquisition costs of drug products dispensed is an important consideration in a third-party prescription drug program. Two alternative methods of estimating these costs among pharmacies were derived and compared. First, pharmacists were surveyed to determine the purchase discounts offered to them by wholesalers. A 10.00% modal and 11.35% mean discount resulted for 73 responding pharmacists. Second, cost-plus percents derived from gross profit margins of wholesalers were calculated and applied to wholesaler product costs to estimate pharmacy level acquisition costs. Cost-plus percents derived from National Median and Southwestern Region wholesaler figures were 9.27% and 10.10%, respectively. A comparison showed the two methods of estimating acquisition costs would result in similar acquisition cost estimates. Adopting a cost-plus estimating approach is recommended because it avoids potential pricing manipulations by wholesalers and manufacturers that would negate improvements in drug product reimbursement accuracy.

48 CFR 2452.216-70 - Estimated cost, base fee and award fee.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Estimated cost, base fee... Provisions and Clauses 2452.216-70 Estimated cost, base fee and award fee. As prescribed in 2416.406(e)(1), insert the following clause in all cost-plus-award-fee contracts: Estimated Cost, Base Fee and Award Fee...

48 CFR 2452.216-70 - Estimated cost, base fee and award fee.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Estimated cost, base fee... Provisions and Clauses 2452.216-70 Estimated cost, base fee and award fee. As prescribed in 2416.406(e)(1), insert the following clause in all cost-plus-award-fee contracts: Estimated Cost, Base Fee and Award Fee...

Probabilistic estimation of numbers and costs of future landslides in the San Francisco Bay region

USGS Publications Warehouse

Crovelli, R.A.; Coe, J.A.

2009-01-01

We used historical records of damaging landslides triggered by rainstorms and a newly developed Probabilistic Landslide Assessment Cost Estimation System (PLACES) to estimate the numbers and direct costs of future landslides in the 10-county San Francisco Bay region. Historical records of damaging landslides in the region are incomplete. Therefore, our estimates of numbers and costs of future landslides are minimal estimates. The estimated mean annual number of future damaging landslides for the entire 10-county region is about 65. Santa Cruz County has the highest estimated mean annual number of damaging future landslides (about 18), whereas Napa, San Francisco, and Solano Counties have the lowest estimated mean numbers of damaging landslides (about 1 each). The estimated mean annual cost of future landslides in the entire region is about US $14.80 million (year 2000 $). The estimated mean annual cost is highest for San Mateo County ($3.24 million) and lowest for Solano County ($0.18 million). The annual per capita cost for the entire region will be about $2.10. Santa Cruz County will have the highest annual per capita cost at $8.45, whereas San Francisco County will have the lowest per capita cost at $0.31. Normalising costs by dividing by the percentage of land area with slopes equal to or greater than 17% indicates that San Francisco County will have the highest cost per square km ($7,101), whereas Santa Clara County will have the lowest cost per square km ($229). These results indicate that the San Francisco Bay region has one of the highest levels of landslide risk in the United States. Compared with landslide cost estimates from the rest of the world, the risk level in the Bay region seems high, but not exceptionally high.

Cost Estimation and Control for Flight Systems

NASA Technical Reports Server (NTRS)

Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

2002-01-01

Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

Design and Implementation of an Intelligent Cost Estimation Model for Decision Support System Software

DTIC Science & Technology

1990-09-01

following two chapters. 28 V. COCOMO MODEL A. OVERVIEW The COCOMO model which stands for COnstructive COst MOdel was developed by Barry Boehm and is...estimation model which uses an expert system to automate the Intermediate COnstructive Cost Estimation MOdel (COCOMO), developed by Barry W. Boehm and...cost estimation model which uses an expert system to automate the Intermediate COnstructive Cost Estimation MOdel (COCOMO), developed by Barry W

Estimating the costs of VA ambulatory care.

PubMed

Phibbs, Ciaran S; Bhandari, Aman; Yu, Wei; Barnett, Paul G

2003-09-01

This article reports how we matched Common Procedure Terminology (CPT) codes with Medicare payment rates and aggregate Veterans Affairs (VA) budget data to estimate the costs of every VA ambulatory encounter. Converting CPT codes to encounter-level costs was more complex than a simple match of Medicare reimbursements to CPT codes. About 40 percent of the CPT codes used in VA, representing about 20 percent of procedures, did not have a Medicare payment rate and required other cost estimates. Reconciling aggregated estimated costs to the VA budget allocations for outpatient care produced final VA cost estimates that were lower than projected Medicare reimbursements. The methods used to estimate costs for encounters could be replicated for other settings. They are potentially useful for any system that does not generate billing data, when CPT codes are simpler to collect than billing data, or when there is a need to standardize cost estimates across data sources.

Cost and Return on Investment of a Work-Family Intervention in the Extended Care Industry: Evidence From the Work, Family, and Health Network.

PubMed

Dowd, William N; Bray, Jeremy W; Barbosa, Carolina; Brockwood, Krista; Kaiser, David J; Mills, Michael J; Hurtado, David A; Wipfli, Brad

2017-10-01

To estimate the cost and return on investment (ROI) of an intervention targeting work-family conflict (WFC) in the extended care industry. Costs to deliver the intervention during a group-randomized controlled trial were estimated, and data on organizational costs-presenteeism, health care costs, voluntary termination, and sick time-were collected from interviews and administrative data. Generalized linear models were used to estimate the intervention's impact on organizational costs. Combined, these results produced ROI estimates. A cluster-robust confidence interval (CI) was estimated around the ROI estimate. The per-participant cost of the intervention was $767. The ROI was -1.54 (95% CI: -4.31 to 2.18). The intervention was associated with a $668 reduction in health care costs (P < 0.05). This paper builds upon and expands prior ROI estimation methods to a new setting.

Development of a Cost Estimation Process for Human Systems Integration Practitioners During the Analysis of Alternatives

DTIC Science & Technology

2010-12-01

processes. Novice estimators must often use of these complicated cost estimation tools (e.g., ACEIT , SEER-H, SEER-S, PRICE-H, PRICE-S, etc.) until...However, the thesis will leverage the processes embedded in cost estimation tools such as the Automated Cost Estimating Integration Tool ( ACEIT ) and the

The Estimated Annual Cost of Uterine Leiomyomata in the United States

PubMed Central

CARDOZO, Eden R.; CLARK, Andrew D.; BANKS, Nicole K.; HENNE, Melinda B.; STEGMANN, Barbara J.; SEGARS, James H.

2011-01-01

Objective To estimate the total annual societal cost of uterine fibroids in the United States, based on direct and indirect costs, including associated obstetric complications. Study Design A systematic review of the literature was conducted to estimate the number of women seeking treatment for symptomatic fibroids annually, the costs of medical and surgical treatment, work lost and obstetric complications attributable to fibroids. Total annual costs were converted to 2010 U.S. dollars. A sensitivity analysis was performed. Results The estimated annual direct costs (surgery, hospital admissions, outpatient visits, medications) were $4.1 to $9.4 billion. Estimated lost work costs ranged from $1.55 to $17.2 billion annually. Obstetric outcomes attributed to fibroids resulted in a cost of $238 million to $7.76 billion annually. Uterine fibroids were estimated to cost the US $5.9 to $34.4 billion annually. Conclusions Obstetric complications associated with fibroids contributed significantly to their economic burden. Lost work costs may account for the largest proportion of societal costs due to fibroids. PMID:22244472

Innovation in the pharmaceutical industry: New estimates of R&D costs.

PubMed

DiMasi, Joseph A; Grabowski, Henry G; Hansen, Ronald W

2016-05-01

The research and development costs of 106 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug and biologics development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per approved new compound is $1395 million (2013 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 10.5% yields a total pre-approval cost estimate of $2558 million (2013 dollars). When compared to the results of the previous study in this series, total capitalized costs were shown to have increased at an annual rate of 8.5% above general price inflation. Adding an estimate of post-approval R&D costs increases the cost estimate to $2870 million (2013 dollars). Copyright © 2016 Elsevier B.V. All rights reserved.

How to estimate the cost of point-of-care CD4 testing in program settings: an example using the Alere Pima Analyzer in South Africa.

PubMed

Larson, Bruce; Schnippel, Kathryn; Ndibongo, Buyiswa; Long, Lawrence; Fox, Matthew P; Rosen, Sydney

2012-01-01

Integrating POC CD4 testing technologies into HIV counseling and testing (HCT) programs may improve post-HIV testing linkage to care and treatment. As evaluations of these technologies in program settings continue, estimates of the costs of POC CD4 tests to the service provider will be needed and estimates have begun to be reported. Without a consistent and transparent methodology, estimates of the cost per CD4 test using POC technologies are likely to be difficult to compare and may lead to erroneous conclusions about costs and cost-effectiveness. This paper provides a step-by-step approach for estimating the cost per CD4 test from a provider's perspective. As an example, the approach is applied to one specific POC technology, the Pima Analyzer. The costing approach is illustrated with data from a mobile HCT program in Gauteng Province of South Africa. For this program, the cost per test in 2010 was estimated at $23.76 (material costs  = $8.70; labor cost per test  = $7.33; and equipment, insurance, and daily quality control  = $7.72). Labor and equipment costs can vary widely depending on how the program operates and the number of CD4 tests completed over time. Additional costs not included in the above analysis, for on-going training, supervision, and quality control, are likely to increase further the cost per test. The main contribution of this paper is to outline a methodology for estimating the costs of incorporating POC CD4 testing technologies into an HCT program. The details of the program setting matter significantly for the cost estimate, so that such details should be clearly documented to improve the consistency, transparency, and comparability of cost estimates.

Process-based Cost Estimation for Ramjet/Scramjet Engines

NASA Technical Reports Server (NTRS)

Singh, Brijendra; Torres, Felix; Nesman, Miles; Reynolds, John

2003-01-01

Process-based cost estimation plays a key role in effecting cultural change that integrates distributed science, technology and engineering teams to rapidly create innovative and affordable products. Working together, NASA Glenn Research Center and Boeing Canoga Park have developed a methodology of process-based cost estimation bridging the methodologies of high-level parametric models and detailed bottoms-up estimation. The NASA GRC/Boeing CP process-based cost model provides a probabilistic structure of layered cost drivers. High-level inputs characterize mission requirements, system performance, and relevant economic factors. Design alternatives are extracted from a standard, product-specific work breakdown structure to pre-load lower-level cost driver inputs and generate the cost-risk analysis. As product design progresses and matures the lower level more detailed cost drivers can be re-accessed and the projected variation of input values narrowed, thereby generating a progressively more accurate estimate of cost-risk. Incorporated into the process-based cost model are techniques for decision analysis, specifically, the analytic hierarchy process (AHP) and functional utility analysis. Design alternatives may then be evaluated not just on cost-risk, but also user defined performance and schedule criteria. This implementation of full-trade study support contributes significantly to the realization of the integrated development environment. The process-based cost estimation model generates development and manufacturing cost estimates. The development team plans to expand the manufacturing process base from approximately 80 manufacturing processes to over 250 processes. Operation and support cost modeling is also envisioned. Process-based estimation considers the materials, resources, and processes in establishing cost-risk and rather depending on weight as an input, actually estimates weight along with cost and schedule.

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations.

PubMed

Doherty, Kathleen; Essajee, Shaffiq; Penazzato, Martina; Holmes, Charles; Resch, Stephen; Ciaranello, Andrea

2014-05-02

Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow. We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0-13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology. The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates. The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments.

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

Mitigating climate change through afforestation: new cost estimates for the United States

Treesearch

Anne Sofie Elberg Nielsen; Andrew J. Plantinga; Ralph J. Alig

2014-01-01

We provide new cost estimates for carbon sequestration through afforestation in the U.S. We extend existing studies of carbon sequestration costs in several important ways, while ensuring the transparency of our approach. Our costs estimates have five distinguishing features: (1) we estimate costs for each county in the contiguous U.S., (2) we include afforestation of...

Assuring Software Cost Estimates: Is it an Oxymoron?

NASA Technical Reports Server (NTRS)

Hihn, Jarius; Tregre, Grant

2013-01-01

The software industry repeatedly observes cost growth of well over 100% even after decades of cost estimation research and well-known best practices, so "What's the problem?" In this paper we will provide an overview of the current state oj software cost estimation best practice. We then explore whether applying some of the methods used in software assurance might improve the quality of software cost estimates. This paper especially focuses on issues associated with model calibration, estimate review, and the development and documentation of estimates as part alan integrated plan.

Estimating the cost of a smoking employee.

PubMed

Berman, Micah; Crane, Rob; Seiber, Eric; Munur, Mehmet

2014-09-01

We attempted to estimate the excess annual costs that a US private employer may attribute to employing an individual who smokes tobacco as compared to a non-smoking employee. Reviewing and synthesising previous literature estimating certain discrete costs associated with smoking employees, we developed a cost estimation approach that approximates the total of such costs for U.S. employers. We examined absenteeism, presenteesim, smoking breaks, healthcare costs and pension benefits for smokers. Our best estimate of the annual excess cost to employ a smoker is $5816. This estimate should be taken as a general indicator of the extent of excess costs, not as a predictive point value. Employees who smoke impose significant excess costs on private employers. The results of this study may help inform employer decisions about tobacco-related policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pros, Cons, and Alternatives to Weight Based Cost Estimating

NASA Technical Reports Server (NTRS)

Joyner, Claude R.; Lauriem, Jonathan R.; Levack, Daniel H.; Zapata, Edgar

2011-01-01

Many cost estimating tools use weight as a major parameter in projecting the cost. This is often combined with modifying factors such as complexity, technical maturity of design, environment of operation, etc. to increase the fidelity of the estimate. For a set of conceptual designs, all meeting the same requirements, increased weight can be a major driver in increased cost. However, once a design is fixed, increased weight generally decreases cost, while decreased weight generally increases cost - and the relationship is not linear. Alternative approaches to estimating cost without using weight (except perhaps for materials costs) have been attempted to try to produce a tool usable throughout the design process - from concept studies through development. This paper will address the pros and cons of using weight based models for cost estimating, using liquid rocket engines as the example. It will then examine approaches that minimize the impct of weight based cost estimating. The Rocket Engine- Cost Model (RECM) is an attribute based model developed internally by Pratt & Whitney Rocketdyne for NASA. RECM will be presented primarily to show a successful method to use design and programmatic parameters instead of weight to estimate both design and development costs and production costs. An operations model developed by KSC, the Launch and Landing Effects Ground Operations model (LLEGO), will also be discussed.

IUS/TUG orbital operations and mission support study. Volume 5: Cost estimates

NASA Technical Reports Server (NTRS)

1975-01-01

The costing approach, methodology, and rationale utilized for generating cost data for composite IUS and space tug orbital operations are discussed. Summary cost estimates are given along with cost data initially derived for the IUS program and space tug program individually, and cost estimates for each work breakdown structure element.

14 CFR 151.24 - Procedures: Application; information on estimated project costs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... estimated project costs. 151.24 Section 151.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Development Projects § 151.24 Procedures: Application; information on estimated project costs. (a) If any part of the estimated project costs consists of the value of donated land, labor, materials, or equipment...

14 CFR 151.24 - Procedures: Application; information on estimated project costs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... estimated project costs. 151.24 Section 151.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Development Projects § 151.24 Procedures: Application; information on estimated project costs. (a) If any part of the estimated project costs consists of the value of donated land, labor, materials, or equipment...

14 CFR 151.24 - Procedures: Application; information on estimated project costs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... estimated project costs. 151.24 Section 151.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Development Projects § 151.24 Procedures: Application; information on estimated project costs. (a) If any part of the estimated project costs consists of the value of donated land, labor, materials, or equipment...

14 CFR 151.24 - Procedures: Application; information on estimated project costs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... estimated project costs. 151.24 Section 151.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Development Projects § 151.24 Procedures: Application; information on estimated project costs. (a) If any part of the estimated project costs consists of the value of donated land, labor, materials, or equipment...

14 CFR 151.24 - Procedures: Application; information on estimated project costs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... estimated project costs. 151.24 Section 151.24 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Development Projects § 151.24 Procedures: Application; information on estimated project costs. (a) If any part of the estimated project costs consists of the value of donated land, labor, materials, or equipment...

The Sensitivity of Adverse Event Cost Estimates to Diagnostic Coding Error

PubMed Central

Wardle, Gavin; Wodchis, Walter P; Laporte, Audrey; Anderson, Geoffrey M; Baker, Ross G

2012-01-01

Objective To examine the impact of diagnostic coding error on estimates of hospital costs attributable to adverse events. Data Sources Original and reabstracted medical records of 9,670 complex medical and surgical admissions at 11 hospital corporations in Ontario from 2002 to 2004. Patient specific costs, not including physician payments, were retrieved from the Ontario Case Costing Initiative database. Study Design Adverse events were identified among the original and reabstracted records using ICD10-CA (Canadian adaptation of ICD10) codes flagged as postadmission complications. Propensity score matching and multivariate regression analysis were used to estimate the cost of the adverse events and to determine the sensitivity of cost estimates to diagnostic coding error. Principal Findings Estimates of the cost of the adverse events ranged from $16,008 (metabolic derangement) to $30,176 (upper gastrointestinal bleeding). Coding errors caused the total cost attributable to the adverse events to be underestimated by 16 percent. The impact of coding error on adverse event cost estimates was highly variable at the organizational level. Conclusions Estimates of adverse event costs are highly sensitive to coding error. Adverse event costs may be significantly underestimated if the likelihood of error is ignored. PMID:22091908

77 FR 45636 - Food Safety Modernization Act Domestic and Foreign Facility Reinspection, Recall, and Importer...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... of a Supported Direct FDA Work Hour for FY 2013 FDA is required to estimate 100 percent of its costs... operating costs. A. Estimating the Full Cost per Direct Work Hour in FY 2011 In general, the starting point for estimating the full cost per direct work hour is to estimate the cost of a full-time-equivalent...

Using average cost methods to estimate encounter-level costs for medical-surgical stays in the VA.

PubMed

Wagner, Todd H; Chen, Shuo; Barnett, Paul G

2003-09-01

The U.S. Department of Veterans Affairs (VA) maintains discharge abstracts, but these do not include cost information. This article describes the methods the authors used to estimate the costs of VA medical-surgical hospitalizations in fiscal years 1998 to 2000. They estimated a cost regression with 1996 Medicare data restricted to veterans receiving VA care in an earlier year. The regression accounted for approximately 74 percent of the variance in cost-adjusted charges, and it proved to be robust to outliers and the year of input data. The beta coefficients from the cost regression were used to impute costs of VA medical-surgical hospital discharges. The estimated aggregate costs were reconciled with VA budget allocations. In addition to the direct medical costs, their cost estimates include indirect costs and physician services; both of these were allocated in proportion to direct costs. They discuss the method's limitations and application in other health care systems.

Estimates and implications of the costs of compliance with biosafety regulations in developing countries.

PubMed

Falck-Zepeda, Jose; Yorobe, Jose; Husin, Bahagiawati Amir; Manalo, Abraham; Lokollo, Erna; Ramon, Godfrey; Zambrano, Patricia; Sutrisno

2012-01-01

Estimating the cost of compliance with biosafety regulations is important as it helps developers focus their investments in producer development. We provide estimates for the cost of compliance for a set of technologies in Indonesia, the Philippines and other countries. These costs vary from US $100,000 to 1.7 million. These are estimates of regulatory costs and do not include product development or deployment costs. Cost estimates need to be compared with potential gains when the technology is introduced in these countries and the gains in knowledge accumulate during the biosafety assessment process. Although the cost of compliance is important, time delays and uncertainty are even more important and may have an adverse impact on innovations reaching farmers.

Costing the satellite power system

NASA Technical Reports Server (NTRS)

Hazelrigg, G. A., Jr.

1978-01-01

The paper presents a methodology for satellite power system costing, places approximate limits on the accuracy possible in cost estimates made at this time, and outlines the use of probabilistic cost information in support of the decision-making process. Reasons for using probabilistic costing or risk analysis procedures instead of standard deterministic costing procedures are considered. Components of cost, costing estimating relationships, grass roots costing, and risk analysis are discussed. Risk analysis using a Monte Carlo simulation model is used to estimate future costs.

Estimating the Deep Space Network modification costs to prepare for future space missions by using major cost drivers

NASA Technical Reports Server (NTRS)

Remer, Donald S.; Sherif, Josef; Buchanan, Harry R.

1993-01-01

This paper develops a cost model to do long range planning cost estimates for Deep Space Network (DSN) support of future space missions. The paper focuses on the costs required to modify and/or enhance the DSN to prepare for future space missions. The model is a function of eight major mission cost drivers and estimates both the total cost and the annual costs of a similar future space mission. The model is derived from actual cost data from three space missions: Voyager (Uranus), Voyager (Neptune), and Magellan. Estimates derived from the model are tested against actual cost data for two independent missions, Viking and Mariner Jupiter/Saturn (MJS).

Outer planet probe cost estimates: First impressions

NASA Technical Reports Server (NTRS)

Niehoff, J.

1974-01-01

An examination was made of early estimates of outer planetary atmospheric probe cost by comparing the estimates with past planetary projects. Of particular interest is identification of project elements which are likely cost drivers for future probe missions. Data are divided into two parts: first, the description of a cost model developed by SAI for the Planetary Programs Office of NASA, and second, use of this model and its data base to evaluate estimates of probe costs. Several observations are offered in conclusion regarding the credibility of current estimates and specific areas of the outer planet probe concept most vulnerable to cost escalation.

Costs of Alcohol-Involved Crashes, United States, 2010

PubMed Central

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

2013-01-01

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

Estimating age-based antiretroviral therapy costs for HIV-infected children in resource-limited settings based on World Health Organization weight-based dosing recommendations

PubMed Central

2014-01-01

Background Pediatric antiretroviral therapy (ART) has been shown to substantially reduce morbidity and mortality in HIV-infected infants and children. To accurately project program costs, analysts need accurate estimations of antiretroviral drug (ARV) costs for children. However, the costing of pediatric antiretroviral therapy is complicated by weight-based dosing recommendations which change as children grow. Methods We developed a step-by-step methodology for estimating the cost of pediatric ARV regimens for children ages 0–13 years old. The costing approach incorporates weight-based dosing recommendations to provide estimated ARV doses throughout childhood development. Published unit drug costs are then used to calculate average monthly drug costs. We compared our derived monthly ARV costs to published estimates to assess the accuracy of our methodology. Results The estimates of monthly ARV costs are provided for six commonly used first-line pediatric ARV regimens, considering three possible care scenarios. The costs derived in our analysis for children were fairly comparable to or slightly higher than available published ARV drug or regimen estimates. Conclusions The methodology described here can be used to provide an accurate estimation of pediatric ARV regimen costs for cost-effectiveness analysts to project the optimum packages of care for HIV-infected children, as well as for program administrators and budget analysts who wish to assess the feasibility of increasing pediatric ART availability in constrained budget environments. PMID:24885453

A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

NASA Astrophysics Data System (ADS)

Qi, Wei

2017-11-01

Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

Estimating the cost of major ongoing cost plus hardware development programs

NASA Technical Reports Server (NTRS)

Bush, J. C.

1990-01-01

Approaches are developed for forecasting the cost of major hardware development programs while these programs are in the design and development C/D phase. Three approaches are developed: a schedule assessment technique for bottom-line summary cost estimation, a detailed cost estimation approach, and an intermediate cost element analysis procedure. The schedule assessment technique was developed using historical cost/schedule performance data.

40 CFR 144.62 - Cost estimate for plugging and abandonment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Cost estimate for plugging and... Waste Injection Wells § 144.62 Cost estimate for plugging and abandonment. (a) The owner or operator must prepare a written estimate, in current dollars, of the cost of plugging the injection well in...

Estimating Environmental Compliance Costs for Industry (1981)

EPA Pesticide Factsheets

The paper discusses the pros and cons of existing approaches to compliance cost estimation such as ex post survey estimation and ex ante estimation techniques (input cost accounting methods, engineering process models and, econometric models).

Xenia Spacecraft Study Addendum: Spacecraft Cost Estimate

NASA Technical Reports Server (NTRS)

Hill, Spencer; Hopkins, Randall

2009-01-01

This slide presentation reviews the Xenia spacecraft cost estimates as an addendum for the Xenia Spacecraft study. The NASA/Air Force Cost model (NAFCPOM) was used to derive the cost estimates that are expressed in 2009 dollars.

Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

PubMed

Reed, Shelby D; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L; Bowers, Margaret T; Samsa, Gregory P; Paul, Sara; Schulman, Kevin A; Whellan, David J; Riegel, Barbara J

2012-01-01

Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.

Introduction of the TEAM-HF Costing Tool: A User-Friendly Spreadsheet Program to Estimate Costs of Providing Patient-Centered Interventions

PubMed Central

Reed, Shelby D.; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L.; Bowers, Margaret T.; Samsa, Gregory P.; Paul, Sara; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara J.

2011-01-01

Background Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Methods and Results Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers or health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. Conclusions The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions. PMID:22147884

Estimating Software-Development Costs With Greater Accuracy

NASA Technical Reports Server (NTRS)

Baker, Dan; Hihn, Jairus; Lum, Karen

2008-01-01

COCOMOST is a computer program for use in estimating software development costs. The goal in the development of COCOMOST was to increase estimation accuracy in three ways: (1) develop a set of sensitivity software tools that return not only estimates of costs but also the estimation error; (2) using the sensitivity software tools, precisely define the quantities of data needed to adequately tune cost estimation models; and (3) build a repository of software-cost-estimation information that NASA managers can retrieve to improve the estimates of costs of developing software for their project. COCOMOST implements a methodology, called '2cee', in which a unique combination of well-known pre-existing data-mining and software-development- effort-estimation techniques are used to increase the accuracy of estimates. COCOMOST utilizes multiple models to analyze historical data pertaining to software-development projects and performs an exhaustive data-mining search over the space of model parameters to improve the performances of effort-estimation models. Thus, it is possible to both calibrate and generate estimates at the same time. COCOMOST is written in the C language for execution in the UNIX operating system.

Parametric cost estimation for space science missions

NASA Astrophysics Data System (ADS)

Lillie, Charles F.; Thompson, Bruce E.

2008-07-01

Cost estimation for space science missions is critically important in budgeting for successful missions. The process requires consideration of a number of parameters, where many of the values are only known to a limited accuracy. The results of cost estimation are not perfect, but must be calculated and compared with the estimates that the government uses for budgeting purposes. Uncertainties in the input parameters result from evolving requirements for missions that are typically the "first of a kind" with "state-of-the-art" instruments and new spacecraft and payload technologies that make it difficult to base estimates on the cost histories of previous missions. Even the cost of heritage avionics is uncertain due to parts obsolescence and the resulting redesign work. Through experience and use of industry best practices developed in participation with the Aerospace Industries Association (AIA), Northrop Grumman has developed a parametric modeling approach that can provide a reasonably accurate cost range and most probable cost for future space missions. During the initial mission phases, the approach uses mass- and powerbased cost estimating relationships (CER)'s developed with historical data from previous missions. In later mission phases, when the mission requirements are better defined, these estimates are updated with vendor's bids and "bottoms- up", "grass-roots" material and labor cost estimates based on detailed schedules and assigned tasks. In this paper we describe how we develop our CER's for parametric cost estimation and how they can be applied to estimate the costs for future space science missions like those presented to the Astronomy & Astrophysics Decadal Survey Study Committees.

Data Service Provider Cost Estimation Tool

NASA Technical Reports Server (NTRS)

Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel

2011-01-01

The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

Systems engineering and integration: Cost estimation and benefits analysis

NASA Technical Reports Server (NTRS)

Dean, ED; Fridge, Ernie; Hamaker, Joe

1990-01-01

Space Transportation Avionics hardware and software cost has traditionally been estimated in Phase A and B using cost techniques which predict cost as a function of various cost predictive variables such as weight, lines of code, functions to be performed, quantities of test hardware, quantities of flight hardware, design and development heritage, complexity, etc. The output of such analyses has been life cycle costs, economic benefits and related data. The major objectives of Cost Estimation and Benefits analysis are twofold: (1) to play a role in the evaluation of potential new space transportation avionics technologies, and (2) to benefit from emerging technological innovations. Both aspects of cost estimation and technology are discussed here. The role of cost analysis in the evaluation of potential technologies should be one of offering additional quantitative and qualitative information to aid decision-making. The cost analyses process needs to be fully integrated into the design process in such a way that cost trades, optimizations and sensitivities are understood. Current hardware cost models tend to primarily use weights, functional specifications, quantities, design heritage and complexity as metrics to predict cost. Software models mostly use functionality, volume of code, heritage and complexity as cost descriptive variables. Basic research needs to be initiated to develop metrics more responsive to the trades which are required for future launch vehicle avionics systems. These would include cost estimating capabilities that are sensitive to technological innovations such as improved materials and fabrication processes, computer aided design and manufacturing, self checkout and many others. In addition to basic cost estimating improvements, the process must be sensitive to the fact that no cost estimate can be quoted without also quoting a confidence associated with the estimate. In order to achieve this, better cost risk evaluation techniques are needed as well as improved usage of risk data by decision-makers. More and better ways to display and communicate cost and cost risk to management are required.

Efforts to Support Consumer Enrollment Decisions Using Total Cost Estimators: Lessons from the Affordable Care Act’s Marketplaces.

PubMed

Giovannelli, Justin; Curran, Emily

2017-02-01

Issue: Policymakers have sought to improve the shopping experience on the Affordable Care Act’s marketplaces by offering decision support tools that help consumers better understand and compare their health plan options. Cost estimators are one such tool. They are designed to provide consumers a personalized estimate of the total cost--premium, minus subsidy, plus cost-sharing--of their coverage options. Cost estimators were available in most states by the start of the fourth open enrollment period. Goal: To understand the experiences of marketplaces that offer a total cost estimator and the interests and concerns of policymakers from states that are not using them. Methods: Structured interviews with marketplace officials, consumer enrollment assisters, technology vendors, and subject matter experts; analysis of the total cost estimators available on the marketplaces as of October 2016. Key findings and conclusions: Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.

Assessment of transparency of cost estimates in economic evaluations of patient safety programmes.

PubMed

Fukuda, Haruhisa; Imanaka, Yuichi

2009-06-01

Transparency of costing is essential for decision-makers who require information on the efficiency of a health care programme, because effective decisions depend largely on applicability to their settings. The main objectives of this study were to assess published studies for transparency of cost estimates. We first developed criteria with two axes by reviewing publications dealing with economic evaluations and cost accounting studies: clarification of the scope of costing and accuracy of method evaluating costs. We then performed systematic searches of the literature for studies which estimated prevention costs and assessed the transparency and accuracy of costing based on our criteria. Forty studies met the inclusion criteria. Half of the studies reported data for both the quantity and unit price of programmes in regard to prevention costs. Although 30 studies estimated costs of adverse events, 19 of these described the scope of costing only, and just five studies used a micro-costing method. Among 30 studies that estimated 'gross cost savings' and 'net cost savings', there was a huge discrepancy in labels. Even if a cost study was conducted in accordance with existing techniques of economic evaluation which mostly paid attention to internal validity of cost estimates, without adequate explanation of the process of costing, reproducibility cannot be assured and the study may lose its value as scientific information. This study found that there is tremendous room for improvement.

Estimation of optimal educational cost per medical student.

PubMed

Yang, Eunbae B; Lee, Seunghee

2009-09-01

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

Probabilistic Methodology for Estimation of Number and Economic Loss (Cost) of Future Landslides in the San Francisco Bay Region, California

USGS Publications Warehouse

Crovelli, Robert A.; Coe, Jeffrey A.

2008-01-01

The Probabilistic Landslide Assessment Cost Estimation System (PLACES) presented in this report estimates the number and economic loss (cost) of landslides during a specified future time in individual areas, and then calculates the sum of those estimates. The analytic probabilistic methodology is based upon conditional probability theory and laws of expectation and variance. The probabilistic methodology is expressed in the form of a Microsoft Excel computer spreadsheet program. Using historical records, the PLACES spreadsheet is used to estimate the number of future damaging landslides and total damage, as economic loss, from future landslides caused by rainstorms in 10 counties of the San Francisco Bay region in California. Estimates are made for any future 5-year period of time. The estimated total number of future damaging landslides for the entire 10-county region during any future 5-year period of time is about 330. Santa Cruz County has the highest estimated number of damaging landslides (about 90), whereas Napa, San Francisco, and Solano Counties have the lowest estimated number of damaging landslides (5?6 each). Estimated direct costs from future damaging landslides for the entire 10-county region for any future 5-year period are about US $76 million (year 2000 dollars). San Mateo County has the highest estimated costs ($16.62 million), and Solano County has the lowest estimated costs (about $0.90 million). Estimated direct costs are also subdivided into public and private costs.

Estimating airline operating costs

NASA Technical Reports Server (NTRS)

Maddalon, D. V.

1978-01-01

A review was made of the factors affecting commercial aircraft operating and delay costs. From this work, an airline operating cost model was developed which includes a method for estimating the labor and material costs of individual airframe maintenance systems. The model, similar in some respects to the standard Air Transport Association of America (ATA) Direct Operating Cost Model, permits estimates of aircraft-related costs not now included in the standard ATA model (e.g., aircraft service, landing fees, flight attendants, and control fees). A study of the cost of aircraft delay was also made and a method for estimating the cost of certain types of airline delay is described.

The economic burden of child sexual abuse in the United States.

PubMed

Letourneau, Elizabeth J; Brown, Derek S; Fang, Xiangming; Hassan, Ahmed; Mercy, James A

2018-05-01

The present study provides an estimate of the U.S. economic impact of child sexual abuse (CSA). Costs of CSA were measured from the societal perspective and include health care costs, productivity losses, child welfare costs, violence/crime costs, special education costs, and suicide death costs. We separately estimated quality-adjusted life year (QALY) losses. For each category, we used the best available secondary data to develop cost per case estimates. All costs were estimated in U.S. dollars and adjusted to the reference year 2015. Estimating 20 new cases of fatal and 40,387 new substantiated cases of nonfatal CSA that occurred in 2015, the lifetime economic burden of CSA is approximately $9.3 billion, the lifetime cost for victims of fatal CSA per female and male victim is on average $1,128,334 and $1,482,933, respectively, and the average lifetime cost for victims of nonfatal CSA is of $282,734 per female victim. For male victims of nonfatal CSA, there was insufficient information on productivity losses, contributing to a lower average estimated lifetime cost of $74,691 per male victim. If we included QALYs, these costs would increase by approximately $40,000 per victim. With the exception of male productivity losses, all estimates were based on robust, replicable incidence-based costing methods. The availability of accurate, up-to-date estimates should contribute to policy analysis, facilitate comparisons with other public health problems, and support future economic evaluations of CSA-specific policy and practice. In particular, we hope the availability of credible and contemporary estimates will support increased attention to primary prevention of CSA. Copyright © 2018. Published by Elsevier Ltd.

Estimating costs in the economic evaluation of medical technologies.

PubMed

Luce, B R; Elixhauser, A

1990-01-01

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

Estimating the cost of delivering direct nutrition interventions at scale: national and subnational level insights from India.

PubMed

Menon, Purnima; McDonald, Christine M; Chakrabarti, Suman

2016-05-01

India's national nutrition and health programmes are largely designed to provide evidence-based nutrition-specific interventions, but intervention coverage is low due to a combination of implementation challenges, capacity and financing gaps. Global cost estimates for nutrition are available but national and subnational costs are not. We estimated national and subnational costs of delivering recommended nutrition-specific interventions using the Scaling Up Nutrition (SUN) costing approach. We compared costs of delivering the SUN interventions at 100% scale with those of nationally recommended interventions. Target populations (TP) for interventions were estimated using national population and nutrition data. Unit costs (UC) were derived from programmatic data. The cost of delivering an intervention at 100% coverage was calculated as (UC*projected TP). Cost estimates varied; estimates for SUN interventions were lower than estimates for nationally recommended interventions because of differences in choice of intervention, target group or unit cost. US$5.9bn/year are required to deliver a set of nationally recommended nutrition interventions at scale in India, while US$4.2bn are required for the SUN interventions. Cash transfers (49%) and food supplements (40%) contribute most to costs of nationally recommended interventions, while food supplements to prevent and treat malnutrition contribute most to the SUN costs. We conclude that although such costing is useful to generate broad estimates, there is an urgent need for further costing studies on the true unit costs of the delivery of nutrition-specific interventions in different local contexts to be able to project accurate national and subnational budgets for nutrition in India. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Cost-estimating relationships for space programs

NASA Technical Reports Server (NTRS)

Mandell, Humboldt C., Jr.

1992-01-01

Cost-estimating relationships (CERs) are defined and discussed as they relate to the estimation of theoretical costs for space programs. The paper primarily addresses CERs based on analogous relationships between physical and performance parameters to estimate future costs. Analytical estimation principles are reviewed examining the sources of errors in cost models, and the use of CERs is shown to be affected by organizational culture. Two paradigms for cost estimation are set forth: (1) the Rand paradigm for single-culture single-system methods; and (2) the Price paradigms that incorporate a set of cultural variables. For space programs that are potentially subject to even small cultural changes, the Price paradigms are argued to be more effective. The derivation and use of accurate CERs is important for developing effective cost models to analyze the potential of a given space program.

Cost Estimation of Naval Ship Acquisition.

DTIC Science & Technology

1983-12-01

one a 9-sub- system model , the other a single total cost model . The models were developed using the linear least squares regression tech- nique with...to Linear Statistical Models , McGraw-Hill, 1961. 11. Helmer, F. T., Bibliography on Pricing Methodology and Cost Estimating, Dept. of Economics and...SUPPI.EMSaTARY NOTES IS. KWRo" (Cowaft. en tever aide of ..aesep M’ Idab~t 6 Week ONNa.) Cost estimation; Acquisition; Parametric cost estimate; linear

Architects and Design-Phase Cost Estimates: Design Professionals Should Reconsider the Value of Third-Party Estimates

ERIC Educational Resources Information Center

Coakley, John

2010-01-01

Professional cost estimators are widely used by architects during the design phases of a project to provide preliminary cost estimates. These estimates may begin at the conceptual design phase and are prepared at regular intervals through the construction document phase. Estimating professionals are frequently tasked with "selling" the importance…

Cost Estimates for Federal Student Loans: The Market Cost Debate

ERIC Educational Resources Information Center

Delisle, Jason

2008-01-01

In an ongoing debate about the relative costs of the federal government's direct and guaranteed student loan programs, some budget experts and private lenders have argued for the use of "market cost" estimates. They assert that official government cost estimates for federal student loans differ from what private entities would likely charge…

Association between component costs, study methodologies, and foodborne illness-related factors with the cost of nontyphoidal Salmonella illness.

PubMed

McLinden, Taylor; Sargeant, Jan M; Thomas, M Kate; Papadopoulos, Andrew; Fazil, Aamir

2014-09-01

Nontyphoidal Salmonella spp. are one of the most common causes of bacterial foodborne illness. Variability in cost inventories and study methodologies limits the possibility of meaningfully interpreting and comparing cost-of-illness (COI) estimates, reducing their usefulness. However, little is known about the relative effect these factors have on a cost-of-illness estimate. This is important for comparing existing estimates and when designing new cost-of-illness studies. Cost-of-illness estimates, identified through a scoping review, were used to investigate the association between descriptive, component cost, methodological, and foodborne illness-related factors such as chronic sequelae and under-reporting with the cost of nontyphoidal Salmonella spp. illness. The standardized cost of nontyphoidal Salmonella spp. illness from 30 estimates reported in 29 studies ranged from $0.01568 to $41.22 United States dollars (USD)/person/year (2012). The mean cost of nontyphoidal Salmonella spp. illness was $10.37 USD/person/year (2012). The following factors were found to be significant in multiple linear regression (p≤0.05): the number of direct component cost categories included in an estimate (0-4, particularly long-term care costs) and chronic sequelae costs (inclusion/exclusion), which had positive associations with the cost of nontyphoidal Salmonella spp. illness. Factors related to study methodology were not significant. Our findings indicated that study methodology may not be as influential as other factors, such as the number of direct component cost categories included in an estimate and costs incurred due to chronic sequelae. Therefore, these may be the most important factors to consider when designing, interpreting, and comparing cost of foodborne illness studies.

Incorporating indirect costs into a cost-benefit analysis of laparoscopic adjustable gastric banding.

PubMed

Finkelstein, Eric A; Allaire, Benjamin T; Dibonaventura, Marco Dacosta; Burgess, Somali M

2012-01-01

The objective of this study was to estimate the time to breakeven and 5-year net costs of laparoscopic adjustable gastric banding (LAGB) taking both direct and indirect costs and cost savings into account. Estimates of direct cost savings from LAGB were available from the literature. Although longitudinal data on indirect cost savings were not available, these estimates were generated by quantifying the relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and combining these elasticity estimates with estimates of the direct cost savings to generate total savings. These savings were then combined with the direct and indirect costs of the procedure to quantify net savings. By including indirect costs, the time to breakeven was reduced by half a year, from 16 to 14 quarters. After 5 years, net savings in medical expenditures from a gastric banding procedure were estimated to be $4970 (±$3090). Including absenteeism increased savings to $6180 (±$3550). Savings were further increased to $10,960 (±$5864) when both absenteeism and presenteeism estimates were included. This study presented a novel approach for including absenteeism and presenteeism estimates in cost-benefit analyses. Application of the approach to gastric banding among surgery-eligible obese employees revealed that the inclusion of indirect costs and cost savings improves the business case for the procedure. This approach can easily be extended to other populations and treatments. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Government conceptual estimating for contracting and management

NASA Technical Reports Server (NTRS)

Brown, J. A.

1986-01-01

The use of the Aerospace Price Book, a cost index, and conceptual cost estimating for cost-effective design and construction of space facilities is discussed. The price book consists of over 200 commonly used conceptual elements and 100 systems summaries of projects such as launch pads, processing facilities, and air locks. The cost index is composed of three divisions: (1) bid summaries of major Shuttle projects, (2) budget cost data sheets, and (3) cost management summaries; each of these divisions is described. Conceptual estimates of facilities and ground support equipment are required to provide the most probable project cost for budget, funding, and project approval purposes. Similar buildings, systems, and elements already designed are located in the cost index in order to make the best rough order of magnitude conceptual estimates for development of Space Shuttle facilities. An example displaying the applicability of the conceptual cost estimating procedure for the development of the KSC facilities is presented.

Review of hardware cost estimation methods, models and tools applied to early phases of space mission planning

NASA Astrophysics Data System (ADS)

Trivailo, O.; Sippel, M.; Şekercioğlu, Y. A.

2012-08-01

The primary purpose of this paper is to review currently existing cost estimation methods, models, tools and resources applicable to the space sector. While key space sector methods are outlined, a specific focus is placed on hardware cost estimation on a system level, particularly for early mission phases during which specifications and requirements are not yet crystallised, and information is limited. For the space industry, cost engineering within the systems engineering framework is an integral discipline. The cost of any space program now constitutes a stringent design criterion, which must be considered and carefully controlled during the entire program life cycle. A first step to any program budget is a representative cost estimate which usually hinges on a particular estimation approach, or methodology. Therefore appropriate selection of specific cost models, methods and tools is paramount, a difficult task given the highly variable nature, scope as well as scientific and technical requirements applicable to each program. Numerous methods, models and tools exist. However new ways are needed to address very early, pre-Phase 0 cost estimation during the initial program research and establishment phase when system specifications are limited, but the available research budget needs to be established and defined. Due to their specificity, for vehicles such as reusable launchers with a manned capability, a lack of historical data implies that using either the classic heuristic approach such as parametric cost estimation based on underlying CERs, or the analogy approach, is therefore, by definition, limited. This review identifies prominent cost estimation models applied to the space sector, and their underlying cost driving parameters and factors. Strengths, weaknesses, and suitability to specific mission types and classes are also highlighted. Current approaches which strategically amalgamate various cost estimation strategies both for formulation and validation of an estimate, and techniques and/or methods to attain representative and justifiable cost estimates are consequently discussed. Ultimately, the aim of the paper is to establish a baseline for development of a non-commercial, low cost, transparent cost estimation methodology to be applied during very early program research phases at a complete vehicle system level, for largely unprecedented manned launch vehicles in the future. This paper takes the first step to achieving this through the identification, analysis and understanding of established, existing techniques, models, tools and resources relevant within the space sector.

Cost analysis of life sciences experiments and subsystems. [to be carried in the Spacelab

NASA Technical Reports Server (NTRS)

Yakut, M. M.

1975-01-01

Cost estimates for experiments and subsystems flown in the Spacelab were established. Ten experiments were cost analyzed. Estimated cost varied from $650,000 for the hardware development of the SPE water electrolysis experiment to $78,500,000 for the development and operation of a representative life sciences laboratory program. The cost of subsystems for thermal, atmospheric and trace contaminants control of the Spacelab internal atmosphere was also estimated. Subsystem cost estimates were based on the utilization of existing components developed in previous space programs whenever necessary.

Conceptual Cost Estimating

NASA Technical Reports Server (NTRS)

Brown, J. A.

1983-01-01

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

ARSENIC REMOVAL COST ESTIMATING PROGRAM

EPA Science Inventory

The Arsenic Removal Cost Estimating program (Excel) calculates the costs for using adsorptive media and anion exchange treatment systems to remove arsenic from drinking water. The program is an easy-to-use tool to estimate capital and operating costs for three types of arsenic re...

Using Multiple and Logistic Regression to Estimate the Median WillCost and Probability of Cost and Schedule Overrun for Program Managers

DTIC Science & Technology

2017-03-23

PUBLIC RELEASE; DISTRIBUTION UNLIMITED Using Multiple and Logistic Regression to Estimate the Median Will- Cost and Probability of Cost and... Cost and Probability of Cost and Schedule Overrun for Program Managers Ryan C. Trudelle Follow this and additional works at: https://scholar.afit.edu...afit.edu. Recommended Citation Trudelle, Ryan C., "Using Multiple and Logistic Regression to Estimate the Median Will- Cost and Probability of Cost and

The Psychology of Cost Estimating

NASA Technical Reports Server (NTRS)

Price, Andy

2016-01-01

Cost estimation for large (and even not so large) government programs is a challenge. The number and magnitude of cost overruns associated with large Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) programs highlight the difficulties in developing and promulgating accurate cost estimates. These overruns can be the result of inadequate technology readiness or requirements definition, the whims of politicians or government bureaucrats, or even as failures of the cost estimating profession itself. However, there may be another reason for cost overruns that is right in front of us, but only recently have we begun to grasp it: the fact that cost estimators and their customers are human. The last 70+ years of research into human psychology and behavioral economics have yielded amazing findings into how we humans process and use information to make judgments and decisions. What these scientists have uncovered is surprising: humans are often irrational and illogical beings, making decisions based on factors such as emotion and perception, rather than facts and data. These built-in biases to our thinking directly affect how we develop our cost estimates and how those cost estimates are used. We cost estimators can use this knowledge of biases to improve our cost estimates and also to improve how we communicate and work with our customers. By understanding how our customers think, and more importantly, why they think the way they do, we can have more productive relationships and greater influence. By using psychology to our advantage, we can more effectively help the decision maker and our organizations make fact-based decisions.

Reported Energy and Cost Savings from the DOE ESPC Program: FY 2014

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

Slattery, Bob S.

2015-03-01

The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 156 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project. For all 156 projects, theremore » was sufficient information to compare estimated, reported, and guaranteed cost savings. For this group, the total estimated cost savings for the reporting periods addressed were $210.6 million, total reported cost savings were $215.1 million, and total guaranteed cost savings were $204.5 million. This means that on average: ESPC contractors guaranteed 97% of the estimated cost savings; projects reported achieving 102% of the estimated cost savings; and projects reported achieving 105% of the guaranteed cost savings. For 155 of the projects examined, there was sufficient information to compare estimated and reported energy savings. On the basis of site energy, estimated savings for those projects for the previous year totaled 11.938 million MMBtu, and reported savings were 12.138 million MMBtu, 101.7% of the estimated energy savings. On the basis of source energy, total estimated energy savings for the 155 projects were 19.052 million MMBtu, and reported saving were 19.516 million MMBtu, 102.4% of the estimated energy savings.« less

Estimating the cost of epilepsy in Europe: a review with economic modeling.

PubMed

Pugliatti, Maura; Beghi, Ettore; Forsgren, Lars; Ekman, Mattias; Sobocki, Patrik

2007-12-01

Based on available epidemiologic, health economic, and international population statistics literature, the cost of epilepsy in Europe was estimated. Europe was defined as the 25 European Union member countries, Iceland, Norway, and Switzerland. Guidelines for epidemiological studies on epilepsy were used for a case definition. A bottom-up prevalence-based cost-of-illness approach, the societal perspective for including the cost items, and the human capital approach as valuation principle for indirect costs were used. The cost estimates were based on selected studies with common methodology and valuation principles. The estimated prevalence of epilepsy in Europe in 2004 was 4.3-7.8 per 1,000. The estimated total cost of the disease in Europe was euro15.5 billion in 2004, indirect cost being the single most dominant cost category (euro8.6 billion). Direct health care costs were euro2.8 billion, outpatient care comprising the largest part (euro1.3 billion). Direct nonmedical cost was euro4.2 billion. That of antiepileptic drugs was euro400 million. The total cost per case was euro2,000-11,500 and the estimated cost per European inhabitant was euro33. Epilepsy is a relevant socioeconomic burden at individual, family, health services, and societal level in Europe. The greater proportion of such burden is outside the formal health care sector, antiepileptic drugs representing a smaller proportion. Lack of economic data from several European countries and other methodological limitations make this report an initial estimate of the cost of epilepsy in Europe. Prospective incidence cost-of-illness studies from well-defined populations and common methodology are encouraged.

Cost of services provided by the National Breast and Cervical Cancer Early Detection Program.

PubMed

Ekwueme, Donatus U; Subramanian, Sujha; Trogdon, Justin G; Miller, Jacqueline W; Royalty, Janet E; Li, Chunyu; Guy, Gery P; Crouse, Wesley; Thompson, Hope; Gardner, James G

2014-08-15

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the largest cancer screening program for low-income women in the United States. This study updates previous estimates of the costs of delivering preventive cancer screening services in the NBCCEDP. We developed a standardized web-based cost-assessment tool to collect annual activity-based cost data on screening for breast and cervical cancer in the NBCCEDP. Data were collected from 63 of the 66 programs that received funding from the Centers for Disease Control and Prevention during the 2006/2007 fiscal year. We used these data to calculate costs of delivering preventive public health services in the program. We estimated the total cost of all NBCCEDP services to be $296 (standard deviation [SD], $123) per woman served (including the estimated value of in-kind donations, which constituted approximately 15% of this total estimated cost). The estimated cost of screening and diagnostic services was $145 (SD, $38) per women served, which represented 57.7% of the total cost excluding the value of in-kind donations. Including the value of in-kind donations, the weighted mean cost of screening a woman for breast cancer was $110 with an office visit and $88 without, the weighted mean cost of a diagnostic procedure was $401, and the weighted mean cost per breast cancer detected was $35,480. For cervical cancer, the corresponding cost estimates were $61, $21, $415, and $18,995, respectively. These NBCCEDP cost estimates may help policy makers in planning and implementing future costs for various potential changes to the program. © 2014 American Cancer Society.

Taking the Evolutionary Road to Developing an In-House Cost Estimate

NASA Technical Reports Server (NTRS)

Jacintho, David; Esker, Lind; Herman, Frank; Lavaque, Rodolfo; Regardie, Myma

2011-01-01

This slide presentation reviews the process and some of the problems and challenges of developing an In-House Cost Estimate (IHCE). Using as an example the Space Network Ground Segment Sustainment (SGSS) project, the presentation reviews the phases for developing a Cost estimate within the project to estimate government and contractor project costs to support a budget request.

Statistical methods of estimating mining costs

USGS Publications Warehouse

Long, K.R.

2011-01-01

Until it was defunded in 1995, the U.S. Bureau of Mines maintained a Cost Estimating System (CES) for prefeasibility-type economic evaluations of mineral deposits and estimating costs at producing and non-producing mines. This system had a significant role in mineral resource assessments to estimate costs of developing and operating known mineral deposits and predicted undiscovered deposits. For legal reasons, the U.S. Geological Survey cannot update and maintain CES. Instead, statistical tools are under development to estimate mining costs from basic properties of mineral deposits such as tonnage, grade, mineralogy, depth, strip ratio, distance from infrastructure, rock strength, and work index. The first step was to reestimate "Taylor's Rule" which relates operating rate to available ore tonnage. The second step was to estimate statistical models of capital and operating costs for open pit porphyry copper mines with flotation concentrators. For a sample of 27 proposed porphyry copper projects, capital costs can be estimated from three variables: mineral processing rate, strip ratio, and distance from nearest railroad before mine construction began. Of all the variables tested, operating costs were found to be significantly correlated only with strip ratio.

COSTMODL: An automated software development cost estimation tool

NASA Technical Reports Server (NTRS)

Roush, George B.

1991-01-01

The cost of developing computer software continues to consume an increasing portion of many organizations' total budgets, both in the public and private sector. As this trend develops, the capability to produce reliable estimates of the effort and schedule required to develop a candidate software product takes on increasing importance. The COSTMODL program was developed to provide an in-house capability to perform development cost estimates for NASA software projects. COSTMODL is an automated software development cost estimation tool which incorporates five cost estimation algorithms including the latest models for the Ada language and incrementally developed products. The principal characteristic which sets COSTMODL apart from other software cost estimation programs is its capacity to be completely customized to a particular environment. The estimation equations can be recalibrated to reflect the programmer productivity characteristics demonstrated by the user's organization, and the set of significant factors which effect software development costs can be customized to reflect any unique properties of the user's development environment. Careful use of a capability such as COSTMODL can significantly reduce the risk of cost overruns and failed projects.

[Socioeconomic costs of food-borne disease using the cost-of-illness model: applying the QALY method].

PubMed

Shin, Hosung; Lee, Suehyung; Kim, Jong Soo; Kim, Jinsuk; Han, Kyu Hong

2010-07-01

This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 - 76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

Annual national direct and indirect cost estimates of the prevention and treatment of cervical cancer in Brazil

PubMed Central

Novaes, Hillegonda Maria Dutilh; Itria, Alexander; Silva, Gulnar Azevedo e; Sartori, Ana Marli Christovam; Rama, Cristina Helena; de Soárez, Patrícia Coelho

2015-01-01

OBJECTIVE: To estimate the annual direct and indirect costs of the prevention and treatment of cervical cancer in Brazil. METHODS: This cost description study used a "gross-costing" methodology and adopted the health system and societal perspectives. The estimates were grouped into sets of procedures performed in phases of cervical cancer care: the screening, diagnosis and treatment of precancerous lesions and the treatment of cervical cancer. The costs were estimated for the public and private health systems, using data from national health information systems, population surveys, and literature reviews. The cost estimates are presented in 2006 USD. RESULTS: From the societal perspective, the estimated total costs of the prevention and treatment of cervical cancer amounted to USD $1,321,683,034, which was categorized as follows: procedures (USD $213,199,490), visits (USD $325,509,842), transportation (USD $106,521,537) and productivity losses (USD $676,452,166). Indirect costs represented 51% of the total costs, followed by direct medical costs (visits and procedures) at 41% and direct non-medical costs (transportation) at 8%. The public system represented 46% of the total costs, and the private system represented 54%. CONCLUSION: Our national cost estimates of cervical cancer prevention and treatment, indicating the economic importance of cervical cancer screening and care, will be useful in monitoring the effect of the HPV vaccine introduction and are of interest in research and health care management. PMID:26017797

Cost Analysis of an Air Brayton Receiver for a Solar Thermal Electric Power System in Selected Annual Production Volumes

NASA Technical Reports Server (NTRS)

1981-01-01

Pioneer Engineering and Manufacturing Company estimated the cost of manufacturing and Air Brayton Receiver for a Solar Thermal Electric Power System as designed by the AiResearch Division of the Garrett Corporation. Production costs were estimated at annual volumes of 100; 1,000; 5,000; 10,000; 50,000; 100,000 and 1,000,000 units. These costs included direct labor, direct material and manufacturing burden. A make or buy analysis was made of each part of each volume. At high volumes special fabrication concepts were used to reduce operation cycle times. All costs were estimated at an assumed 100% plant capacity. Economic feasibility determined the level of production at which special concepts were to be introduced. Estimated costs were based on the economics of the last half of 1980. Tooling and capital equipment costs were estimated for ach volume. Infrastructure and personnel requirements were also estimated.

16 CFR 305.5 - Determinations of estimated annual energy consumption, estimated annual operating cost, and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... consumption, estimated annual operating cost, and energy efficiency rating, and of water use rate. 305.5... energy efficiency rating, and of water use rate. (a) Procedures for determining the estimated annual energy consumption, the estimated annual operating costs, the energy efficiency ratings, and the efficacy...

48 CFR 1852.216-84 - Estimated cost and incentive fee.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Provisions and Clauses 1852.216-84 Estimated cost and incentive fee. As prescribed in 1816.406-70(d), insert the following clause: Estimated Cost and Incentive Fee (OCT 1996) The target cost of this contract is $___. The target fee of this contract is $___. The total target cost and target fee as contemplated by the...

Implementation of the ANNs ensembles in macro-BIM cost estimates of buildings' floor structural frames

NASA Astrophysics Data System (ADS)

Juszczyk, Michał

2018-04-01

This paper reports some results of the studies on the use of artificial intelligence tools for the purposes of cost estimation based on building information models. A problem of the cost estimates based on the building information models on a macro level supported by the ensembles of artificial neural networks is concisely discussed. In the course of the research a regression model has been built for the purposes of cost estimation of buildings' floor structural frames, as higher level elements. Building information models are supposed to serve as a repository of data used for the purposes of cost estimation. The core of the model is the ensemble of neural networks. The developed model allows the prediction of cost estimates with satisfactory accuracy.

Personal injury recovery cost of pedestrian-vehicle collisions in New South Wales, Australia.

PubMed

Mitchell, Rebecca J; Bambach, Mike R

2016-07-03

There is a need for routine estimates of injury recovery costs from pedestrian collisions using hospital separation records for economic evaluations. To estimate the cost of injury recovery following pedestrian-vehicle collisions using the personal injury recover cost (PIRC) equation using key demographic and injury characteristics. An estimation of the costs of on-road pedestrian-vehicle collisions involving individuals who were injured and hospitalized in New South Wales (NSW), Australia, from 2002 to 2011 using the PIRC equation. The PIRC estimates individual injury recovery costs and does not include costs associated with property damage, vehicle repair, or rescue services. Individual recovery costs associated with severe traumatic brain injury (TBI) were estimated. The injured individual's mean, median, and total injury recovery costs are described for key demographic, injury, and crash characteristics. There were 9,781 pedestrians who were injured, costing an estimated total of $2.4 billion in personal injury recovery costs, an annual cost of $243 million. Males had a total injury recovery cost 1.7 times higher than females. The median injury recovery cost decreased with increasing age. TBI ($248,491) and spinal cord and vertebral column injuries ($264,103) had the highest median injury recovery costs for the body region of the most severe injury. TBI accounted for 22.6% of the total injury recovery costs for the most severe injury sustained. Just over one third of pedestrians sustained 4 or more injuries, with a median cost of $243,992, which was 1.6 times higher than the cost for a pedestrian who sustained a single injury ($153,682). Personal injury recovery costs following pedestrian-vehicle collisions where a pedestrian is injured are substantial in NSW. The PIRC equation enables the economic cost burden of road traffic injury to be calculated using hospital separation data. The PIRC enables comprehensive personal injury recovery costs to be estimated and would aid in economic evaluations of preventive strategies in road safety.

System technology analysis of aeroassisted orbital transfer vehicles: Moderate lift/drag (0.75-1.5). Volume 3: Cost estimates and work breakdown structure/dictionary, phase 1 and 2

NASA Technical Reports Server (NTRS)

1985-01-01

Technology payoffs of representative ground based (Phase 1) and space based (Phase 2) mid lift/drag ratio aeroassisted orbit transfer vehicles (AOTV) were assessed and prioritized. A narrative summary of the cost estimates and work breakdown structure/dictionary for both study phases is presented. Costs were estimated using the Grumman Space Programs Algorithm for Cost Estimating (SPACE) computer program and results are given for four AOTV configurations. The work breakdown structure follows the standard of the joint government/industry Space Systems Cost Analysis Group (SSCAG). A table is provided which shows cost estimates for each work breakdown structure element.

Parametric Cost Deployment

NASA Technical Reports Server (NTRS)

Dean, Edwin B.

1995-01-01

Parametric cost analysis is a mathematical approach to estimating cost. Parametric cost analysis uses non-cost parameters, such as quality characteristics, to estimate the cost to bring forth, sustain, and retire a product. This paper reviews parametric cost analysis and shows how it can be used within the cost deployment process.

Development of cost estimation tools for total occupational safety and health activities and occupational health services: cost estimation from a corporate perspective.

PubMed

Nagata, Tomohisa; Mori, Koji; Aratake, Yutaka; Ide, Hiroshi; Ishida, Hiromi; Nobori, Junichiro; Kojima, Reiko; Odagami, Kiminori; Kato, Anna; Tsutsumi, Akizumi; Matsuda, Shinya

2014-01-01

The aim of the present study was to develop standardized cost estimation tools that provide information to employers about occupational safety and health (OSH) activities for effective and efficient decision making in Japanese companies. We interviewed OSH staff members including full-time professional occupational physicians to list all OSH activities. Using activity-based costing, cost data were obtained from retrospective analyses of occupational safety and health costs over a 1-year period in three manufacturing workplaces and were obtained from retrospective analyses of occupational health services costs in four manufacturing workplaces. We verified the tools additionally in four workplaces including service businesses. We created the OSH and occupational health standardized cost estimation tools. OSH costs consisted of personnel costs, expenses, outsourcing costs and investments for 15 OSH activities. The tools provided accurate, relevant information on OSH activities and occupational health services. The standardized information obtained from our OSH and occupational health cost estimation tools can be used to manage OSH costs, make comparisons of OSH costs between companies and organizations and help occupational health physicians and employers to determine the best course of action.

Cost-estimating for commercial digital printing

NASA Astrophysics Data System (ADS)

Keif, Malcolm G.

2007-01-01

The purpose of this study is to document current cost-estimating practices used in commercial digital printing. A research study was conducted to determine the use of cost-estimating in commercial digital printing companies. This study answers the questions: 1) What methods are currently being used to estimate digital printing? 2) What is the relationship between estimating and pricing digital printing? 3) To what extent, if at all, do digital printers use full-absorption, all-inclusive hourly rates for estimating? Three different digital printing models were identified: 1) Traditional print providers, who supplement their offset presswork with digital printing for short-run color and versioned commercial print; 2) "Low-touch" print providers, who leverage the power of the Internet to streamline business transactions with digital storefronts; 3) Marketing solutions providers, who see printing less as a discrete manufacturing process and more as a component of a complete marketing campaign. Each model approaches estimating differently. Understanding and predicting costs can be extremely beneficial. Establishing a reliable system to estimate those costs can be somewhat challenging though. Unquestionably, cost-estimating digital printing will increase in relevance in the years ahead, as margins tighten and cost knowledge becomes increasingly more critical.

Cost Benefit Analysis: Cost Benefit Analysis for Human Effectiveness Research: Bioacoustic Protection

DTIC Science & Technology

2001-07-21

APPENDIX A. ACRONYMS ACCES Attenuating Custom Communication Earpiece System ACEIT Automated Cost estimating Integrated Tools AFSC Air Force...documented in the ACEIT cost estimating tool developed by Tecolote, Inc. The factor used was 14 percent of PMP. 1.3 System Engineering/ Program...The data source is the ASC Aeronautical Engineering Products Cost Factor Handbook which is documented in the ACEIT cost estimating tool developed

Valuing Non-CO2 GHG Emission Changes in Benefit-Cost ...

EPA Pesticide Factsheets

The climate impacts of greenhouse gas (GHG) emissions impose social costs on society. To date, EPA has not had an approach to estimate the economic benefits of reducing emissions of non-CO2 GHGs (or the costs of increasing them) that is consistent with the methodology underlying the U.S. Government’s current estimates of the social cost of carbon (SCC). A recently published paper presents estimates of the social cost of methane that are consistent with the SCC estimates. The Agency is seeking review of the potential application of these new benefit estimates to benefit cost analysis in relation to current practice in this area. The goal of this project is to improve upon the current treatment of non-CO2 GHG emission impacts in benefit-cost analysis.

An approach to software cost estimation

NASA Technical Reports Server (NTRS)

Mcgarry, F.; Page, J.; Card, D.; Rohleder, M.; Church, V.

1984-01-01

A general procedure for software cost estimation in any environment is outlined. The basic concepts of work and effort estimation are explained, some popular resource estimation models are reviewed, and the accuracy of source estimates is discussed. A software cost prediction procedure based on the experiences of the Software Engineering Laboratory in the flight dynamics area and incorporating management expertise, cost models, and historical data is described. The sources of information and relevant parameters available during each phase of the software life cycle are identified. The methodology suggested incorporates these elements into a customized management tool for software cost prediction. Detailed guidelines for estimation in the flight dynamics environment developed using this methodology are presented.

Taming the Hurricane of Acquisition Cost Growth - Or at Least Predicting It

DTIC Science & Technology

2015-01-01

the practice of generating two different cost estimates dubbed Will Cost and Should Cost. The Should Cost estimate is “based on realistic tech...to predict estimate error in similar future programs. This method is dubbed “macro-stochastic” estimation (Ryan, Schubert Kabban, Jacques...mph Potential Day 1-3 Track Area Tropical Storm Warning OK AR TN AL FL Mexico MS LA TX 30 N 35 N 25 N 95 W 90 W 85 W 80 W True at 30.00N Approx

Cross Service Fixed-Wing Cost Estimation

DTIC Science & Technology

2016-05-17

TRAC-M-TR-16-021 May 2016 Cross Service Fixed-Wing Cost Estimation TRADOC Analysis Center 700 Dyer Road Monterey, California 93943-0692 This study...Service Fixed-Wing Cost Estimation MAJ Jarrod S. Shingleton TRADOC Analysis Center 700 Dyer Road Monterey, California 93943-0692 DISTRIBUTION STATEMENT...Wing Cost Estimation MAJ Jarrod Shingleton 060312 TRADOC Analysis Center, TRAC-MTRY Naval Postgraduate School 700 Dyer Road Bldg 246 Monterey, CA 93943

A Framework of Combining Case-Based Reasoning with a Work Breakdown Structure for Estimating the Cost of Online Course Production Projects

ERIC Educational Resources Information Center

He, Wu

2014-01-01

Currently, a work breakdown structure (WBS) approach is used as the most common cost estimation approach for online course production projects. To improve the practice of cost estimation, this paper proposes a novel framework to estimate the cost for online course production projects using a case-based reasoning (CBR) technique and a WBS. A…

The direct cost of epilepsy in the United States: A systematic review of estimates.

PubMed

Begley, Charles E; Durgin, Tracy L

2015-09-01

To develop estimates of the direct cost of epilepsy in the United States for the general epilepsy population and sub-populations by systematically comparing similarities and differences in types of estimates and estimation methods from recently published studies. Papers published since 1995 were identified by systematic literature search. Information on types of estimates, study designs, data sources, types of epilepsy, and estimation methods was extracted from each study. Annual per person cost estimates from methodologically similar studies were identified, converted to 2013 U.S. dollars, and compared. From 4,104 publications discovered in the literature search, 21 were selected for review. Three were added that were published after the search. Eighteen were identified that reported estimates of average annual direct costs for the general epilepsy population in the United States. For general epilepsy populations (comprising all clinically defined subgroups), total direct healthcare costs per person ranged from $10,192 to $47,862 and epilepsy-specific costs ranged from $1,022 to $19,749. Four recent studies using claims data from large general populations yielded relatively similar epilepsy-specific annual cost estimates ranging from $8,412 to $11,354. Although more difficult to compare, studies examining direct cost differences for epilepsy sub-populations indicated a consistent pattern of markedly higher costs for those with uncontrolled or refractory epilepsy, and for those with comorbidities. This systematic review found that various approaches have been used to estimate the direct costs of epilepsy in the United States. However, recent studies using large claims databases and similar methods allow estimation of the direct cost burden of epilepsy for the general disease population, and show that it is greater for some patient subgroups. Additional research is needed to further understand the broader economic burden of epilepsy and how it varies across subpopulations. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Delay and environmental costs of truck crashes

DOT National Transportation Integrated Search

2013-03-01

This report presents estimates of certain categories of costs of truck- and bus-involved crashes. Crash related costs estimated as part of this study include vehicle delay costs, emission costs, and fuel consumption costs. In addition, this report al...

Developing Analogy Cost Estimates for Space Missions

NASA Technical Reports Server (NTRS)

Shishko, Robert

2004-01-01

The analogy approach in cost estimation combines actual cost data from similar existing systems, activities, or items with adjustments for a new project's technical, physical or programmatic differences to derive a cost estimate for the new system. This method is normally used early in a project cycle when there is insufficient design/cost data to use as a basis for (or insufficient time to perform) a detailed engineering cost estimate. The major limitation of this method is that it relies on the judgment and experience of the analyst/estimator. The analyst must ensure that the best analogy or analogies have been selected, and that appropriate adjustments have been made. While analogy costing is common, there is a dearth of advice in the literature on the 'adjustment methodology', especially for hardware projects. This paper discusses some potential approaches that can improve rigor and repeatability in the analogy costing process.

Commercial Crew Cost Estimating - A Look at Estimating Processes, Challenges and Lessons Learned

NASA Technical Reports Server (NTRS)

Battle, Rick; Cole, Lance

2015-01-01

To support annual PPBE budgets and NASA HQ requests for cost information for commercial crew transportation to the International Space Station (ISS), the NASA ISS ACES team developed system development and per flight cost estimates for the potential providers for each annual PPBE submit from 2009-2014. This paper describes the cost estimating processes used, challenges and lessons learned to develop estimates for this key NASA project that diverted from the traditional procurement approach and used a new way of doing business

Coal supply and cost under technological and environmental uncertainty

NASA Astrophysics Data System (ADS)

Chan, Melissa

This thesis estimates available coal resources, recoverability, mining costs, environmental impacts, and environmental control costs for the United States under technological and environmental uncertainty. It argues for a comprehensive, well-planned research program that will resolve resource uncertainty, and innovate new technologies to improve recovery and environmental performance. A stochastic process and cost (constant 2005) model for longwall, continuous, and surface mines based on current technology and mining practice data was constructed. It estimates production and cost ranges within 5-11 percent of 2006 prices and production rates. The model was applied to the National Coal Resource Assessment. Assuming the cheapest mining method is chosen to extract coal, 250-320 billion tons are recoverable. Two-thirds to all coal resource can be mined at a cost less than 4/mmBTU. If U.S. coal demand substantially increases, as projected by alternate Energy Information Administration (EIA), resources might not last more than 100 years. By scheduling cost to meet EIA projected demand, estimated cost uncertainty increases over time. It costs less than 15/ton to mine in the first 10 years of a 100 year time period, 10-30/ton in the following 50 years, and 15-$90/ton thereafter. Environmental impacts assessed are subsidence from underground mines, surface mine pit area, erosion, acid mine drainage, air pollutant and methane emissions. The analysis reveals that environmental impacts are significant and increasing as coal demand increases. Control technologies recommended to reduce these impacts are backfilling underground mines, surface pit reclamation, substitution of robotic underground mining systems for surface pit mining, soil replacement for erosion, placing barriers between exposed coal and the elements to avoid acid formation, and coalbed methane development to avoid methane emissions during mining. The costs to apply these technologies to meet more stringent environmental regulation scenarios are estimated. The results show that the cost of meeting these regulatory scenarios could increase mining costs two to six times the business as usual cost, which could significantly affect the cost of coal-powered electricity generation. This thesis provides a first estimate of resource availability, mining cost, and environmental impact assessment and cost analysis. Available resource is not completely reported, so the available estimate is lower than actual resource. Mining costs are optimized, so provide a low estimate of potential costs. Environmental impact estimates are on the high end of potential impact that may be incurred because it is assumed that impact is unavoidable. Control costs vary. Estimated cost to control subsidence and surface mine pit impacts are suitable estimates of the cost to reduce land impacts. Erosion control and robotic mining system costs are lower, and methane and acid mine drainage control costs are higher, than they may be in the case that these impacts must be reduced.

The cost of Alzheimer's disease in China and re-estimation of costs worldwide.

PubMed

Jia, Jianping; Wei, Cuibai; Chen, Shuoqi; Li, Fangyu; Tang, Yi; Qin, Wei; Zhao, Lina; Jin, Hongmei; Xu, Hui; Wang, Fen; Zhou, Aihong; Zuo, Xiumei; Wu, Liyong; Han, Ying; Han, Yue; Huang, Liyuan; Wang, Qi; Li, Dan; Chu, Changbiao; Shi, Lu; Gong, Min; Du, Yifeng; Zhang, Jiewen; Zhang, Junjian; Zhou, Chunkui; Lv, Jihui; Lv, Yang; Xie, Haiqun; Ji, Yong; Li, Fang; Yu, Enyan; Luo, Benyan; Wang, Yanjiang; Yang, Shanshan; Qu, Qiumin; Guo, Qihao; Liang, Furu; Zhang, Jintao; Tan, Lan; Shen, Lu; Zhang, Kunnan; Zhang, Jinbiao; Peng, Dantao; Tang, Muni; Lv, Peiyuan; Fang, Boyan; Chu, Lan; Jia, Longfei; Gauthier, Serge

2018-04-01

The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain. We collected data from 3098 patients with AD in 81 representative centers across China and estimated AD costs for individual patient and total patients in China in 2015. Based on this data, we re-estimated the worldwide costs of AD. The annual socioeconomic cost per patient was US $19,144.36, and total costs were US $167.74 billion in 2015. The annual total costs are predicted to reach US $507.49 billion in 2030 and US $1.89 trillion in 2050. Based on our results, the global estimates of costs for dementia were US $957.56 billion in 2015, and will be US $2.54 trillion in 2030, and US $9.12 trillion in 2050, much more than the predictions by the World Alzheimer Report 2015. China bears a heavy burden of AD costs, which greatly change the estimates of AD cost worldwide. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Space Tug Docking Study. Volume 5: Cost Analysis

NASA Technical Reports Server (NTRS)

1976-01-01

The cost methodology, summary cost data, resulting cost estimates by Work Breakdown Structure (WBS), technical characteristics data, program funding schedules and the WBS for the costing are discussed. Cost estimates for two tasks of the study are reported. The first, developed cost estimates for design, development, test and evaluation (DDT&E) and theoretical first unit (TFU) at the component level (Level 7) for all items reported in the data base. Task B developed total subsystem DDT&E costs and funding schedules for the three candidate Rendezvous and Docking Systems: manual, autonomous, and hybrid.

Cost Risk Analysis Based on Perception of the Engineering Process

NASA Technical Reports Server (NTRS)

Dean, Edwin B.; Wood, Darrell A.; Moore, Arlene A.; Bogart, Edward H.

1986-01-01

In most cost estimating applications at the NASA Langley Research Center (LaRC), it is desirable to present predicted cost as a range of possible costs rather than a single predicted cost. A cost risk analysis generates a range of cost for a project and assigns a probability level to each cost value in the range. Constructing a cost risk curve requires a good estimate of the expected cost of a project. It must also include a good estimate of expected variance of the cost. Many cost risk analyses are based upon an expert's knowledge of the cost of similar projects in the past. In a common scenario, a manager or engineer, asked to estimate the cost of a project in his area of expertise, will gather historical cost data from a similar completed project. The cost of the completed project is adjusted using the perceived technical and economic differences between the two projects. This allows errors from at least three sources. The historical cost data may be in error by some unknown amount. The managers' evaluation of the new project and its similarity to the old project may be in error. The factors used to adjust the cost of the old project may not correctly reflect the differences. Some risk analyses are based on untested hypotheses about the form of the statistical distribution that underlies the distribution of possible cost. The usual problem is not just to come up with an estimate of the cost of a project, but to predict the range of values into which the cost may fall and with what level of confidence the prediction is made. Risk analysis techniques that assume the shape of the underlying cost distribution and derive the risk curve from a single estimate plus and minus some amount usually fail to take into account the actual magnitude of the uncertainty in cost due to technical factors in the project itself. This paper addresses a cost risk method that is based on parametric estimates of the technical factors involved in the project being costed. The engineering process parameters are elicited from the engineer/expert on the project and are based on that expert's technical knowledge. These are converted by a parametric cost model into a cost estimate. The method discussed makes no assumptions about the distribution underlying the distribution of possible costs, and is not tied to the analysis of previous projects, except through the expert calibrations performed by the parametric cost analyst.

Cost of Services Provided by the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Ekwueme, Donatus U.; Subramanian, Sujha; Trogdon, Justin G.; Miller, Jacqueline W.; Royalty, Janet E.; Li, Chunyu; Guy, Gery P.; Crouse, Wesley; Thompson, Hope; Gardner, James G.

2015-01-01

BACKGROUND The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the largest cancer screening program for low-income women in the United States. This study updates previous estimates of the costs of delivering preventive cancer screening services in the NBCCEDP. METHODS We developed a standardized web-based cost-assessment tool to collect annual activity-based cost data on screening for breast and cervical cancer in the NBCCEDP. Data were collected from 63 of the 66 programs that received funding from the Centers for Disease Control and Prevention during the 2006/2007 fiscal year. We used these data to calculate costs of delivering preventive public health services in the program. RESULTS We estimated the total cost of all NBCCEDP services to be $296 (standard deviation [SD], $123) per woman served (including the estimated value of in-kind donations, which constituted approximately 15% of this total estimated cost). The estimated cost of screening and diagnostic services was $145 (SD, $38) per women served, which represented 57.7% of the total cost excluding the value of in-kind donations. Including the value of in-kind donations, the weighted mean cost of screening a woman for breast cancer was $110 with an office visit and $88 without, the weighted mean cost of a diagnostic procedure was $401, and the weighted mean cost per breast cancer detected was $35,480. For cervical cancer, the corresponding cost estimates were $61, $21, $415, and $18,995, respectively. CONCLUSIONS These NBCCEDP cost estimates may help policy makers in planning and implementing future costs for various potential changes to the program. PMID:25099904

Constellation Program Life-cycle Cost Analysis Model (LCAM)

NASA Technical Reports Server (NTRS)

Prince, Andy; Rose, Heidi; Wood, James

2008-01-01

The Constellation Program (CxP) is NASA's effort to replace the Space Shuttle, return humans to the moon, and prepare for a human mission to Mars. The major elements of the Constellation Lunar sortie design reference mission architecture are shown. Unlike the Apollo Program of the 1960's, affordability is a major concern of United States policy makers and NASA management. To measure Constellation affordability, a total ownership cost life-cycle parametric cost estimating capability is required. This capability is being developed by the Constellation Systems Engineering and Integration (SE&I) Directorate, and is called the Lifecycle Cost Analysis Model (LCAM). The requirements for LCAM are based on the need to have a parametric estimating capability in order to do top-level program analysis, evaluate design alternatives, and explore options for future systems. By estimating the total cost of ownership within the context of the planned Constellation budget, LCAM can provide Program and NASA management with the cost data necessary to identify the most affordable alternatives. LCAM is also a key component of the Integrated Program Model (IPM), an SE&I developed capability that combines parametric sizing tools with cost, schedule, and risk models to perform program analysis. LCAM is used in the generation of cost estimates for system level trades and analyses. It draws upon the legacy of previous architecture level cost models, such as the Exploration Systems Mission Directorate (ESMD) Architecture Cost Model (ARCOM) developed for Simulation Based Acquisition (SBA), and ATLAS. LCAM is used to support requirements and design trade studies by calculating changes in cost relative to a baseline option cost. Estimated costs are generally low fidelity to accommodate available input data and available cost estimating relationships (CERs). LCAM is capable of interfacing with the Integrated Program Model to provide the cost estimating capability for that suite of tools.

28 CFR 100.16 - Cost estimate submission.

Code of Federal Regulations, 2013 CFR

2013-07-01

... evaluation of the estimated costs. The FBI reserves the right to request additional cost data from carriers... if, as determined by the FBI, all cost data reasonably available to the carrier are either submitted... explain the estimating process are required by the FBI and the carrier refuses to provide necessary data...

28 CFR 100.16 - Cost estimate submission.

Code of Federal Regulations, 2011 CFR

2011-07-01

... evaluation of the estimated costs. The FBI reserves the right to request additional cost data from carriers... if, as determined by the FBI, all cost data reasonably available to the carrier are either submitted... explain the estimating process are required by the FBI and the carrier refuses to provide necessary data...

28 CFR 100.16 - Cost estimate submission.

Code of Federal Regulations, 2012 CFR

2012-07-01

... evaluation of the estimated costs. The FBI reserves the right to request additional cost data from carriers... if, as determined by the FBI, all cost data reasonably available to the carrier are either submitted... explain the estimating process are required by the FBI and the carrier refuses to provide necessary data...

28 CFR 100.16 - Cost estimate submission.

Code of Federal Regulations, 2014 CFR

2014-07-01

... evaluation of the estimated costs. The FBI reserves the right to request additional cost data from carriers... if, as determined by the FBI, all cost data reasonably available to the carrier are either submitted... explain the estimating process are required by the FBI and the carrier refuses to provide necessary data...

Global anthropogenic methane emissions 2005-2030: technical mitigation potentials and costs

NASA Astrophysics Data System (ADS)

Höglund-Isaksson, L.

2012-10-01

This paper presents estimates of current and future global anthropogenic methane emissions, their technical mitigation potential and associated costs for the period 2005 to 2030. The analysis uses the GAINS model framework to estimate emissions, mitigation potentials and costs for all major sources of anthropogenic methane for 83 countries/regions, which are aggregated to produce global estimates. Global emissions are estimated at 323 Mt methane in 2005, with an expected increase to 414 Mt methane in 2030. The technical mitigation potential is estimated at 195 Mt methane in 2030, whereof about 80 percent is found attainable at a marginal cost less than 20 Euro t-1 CO2eq when using a social planner cost perspective. With a private investor cost perspective, the corresponding fraction is only 30 percent. Major uncertainty sources in emission estimates are identified and discussed.

Parametric study of potential early commercial power plants Task 3-A MHD cost analysis

NASA Technical Reports Server (NTRS)

1983-01-01

The development of costs for an MHD Power Plant and the comparison of these costs to a conventional coal fired power plant are reported. The program is divided into three activities: (1) code of accounts review; (2) MHD pulverized coal power plant cost comparison; (3) operating and maintenance cost estimates. The scope of each NASA code of account item was defined to assure that the recently completed Task 3 capital cost estimates are consistent with the code of account scope. Improvement confidence in MHD plant capital cost estimates by identifying comparability with conventional pulverized coal fired (PCF) power plant systems is undertaken. The basis for estimating the MHD plant operating and maintenance costs of electricity is verified.

Reducing Time-dependent Bias in Estimates of the Attributable Cost of Health Care-associated Methicillin-resistant Staphylococcus aureus Infections: A Comparison of Three Estimation Strategies.

PubMed

Nelson, Richard E; Samore, Matthew H; Jones, Makoto; Greene, Tom; Stevens, Vanessa W; Liu, Chuan-Fen; Graves, Nicholas; Evans, Martin F; Rubin, Michael A

2015-09-01

Previous estimates of the excess costs due to health care-associated infection (HAI) have scarcely addressed the issue of time-dependent bias. We examined time-dependent bias by estimating the health care costs attributable to an HAI due to methicillin-resistant Staphylococcus aureus (MRSA) using a unique dataset in the Department of Veterans Affairs (VA) that makes it possible to distinguish between costs that occurred before and after an HAI. In addition, we compare our results to those from 2 other estimation strategies. Using a historical cohort study design to estimate the excess predischarge costs attributable to MRSA HAIs, we conducted 3 analyses: (1) conventional, in which costs for the entire inpatient stay were compared between patients with and without MRSA HAIs; (2) post-HAI, which included only costs that occurred after an infection; and (3) matched, in which costs for the entire inpatient stay were compared between patients with an MRSA HAI and subset of patients without an MRSA HAI who were matched based on the time to infection. In our post-HAI analysis, estimates of the increase in inpatient costs due to MRSA HAI were $12,559 (P<0.0001) and $24,015 (P<0.0001) for variable and total costs, respectively. The excess variable and total cost estimates were 33.7% and 31.5% higher, respectively, when using the conventional methods and 14.6% and 11.8% higher, respectively, when using matched methods. This is the first study to account for time-dependent bias in the estimation of incremental per-patient health care costs attributable to HAI using a unique dataset in the VA. We found that failure to account for this bias can lead to overestimation of these costs. Matching on the timing of infection can reduce this bias substantially.

The friction cost method: a comment.

PubMed

Johannesson, M; Karlsson, G

1997-04-01

The friction cost method has been proposed as an alternative to the human-capital approach of estimating indirect costs. We argue that the friction cost method is based on implausible assumptions not supported by neoclassical economic theory. Furthermore consistently applying the friction cost method would mean that the method should also be applied in the estimation of direct costs, which would mean that the costs of health care programmes are substantially decreased. It is concluded that the friction cost method does not seem to be a useful alternative to the human-capital approach in the estimation of indirect costs.

A model of the costs of community and nosocomial pediatric respiratory syncytial virus infections in Canadian hospitals

PubMed Central

Jacobs, Philip; Lier, Douglas; Gooch, Katherine; Buesch, Katharina; Lorimer, Michelle; Mitchell, Ian

2013-01-01

BACKGROUND: Approximately one in 10 hospitalized patients will acquire a nosocomial infection (NI) after admission to hospital, of which 71% are due to respiratory viruses, including the respiratory syncytial virus (RSV). NIs are concerning and lead to prolonged hospitalizations. The economics of NIs are typically described in generalized terms and specific cost data are lacking. OBJECTIVE: To develop an evidence-based model for predicting the risk and cost of nosocomial RSV infection in pediatric settings. METHODS: A model was developed, from a Canadian perspective, to capture all costs related to an RSV infection hospitalization, including the risk and cost of an NI, diagnostic testing and infection control. All data inputs were derived from published literature. Deterministic sensitivity analyses were performed to evaluate the uncertainty associated with the estimates and to explore the impact of changes to key variables. A probabilistic sensitivity analysis was performed to estimate a confidence interval for the overall cost estimate. RESULTS: The estimated cost of nosocomial RSV infection adds approximately 30.5% to the hospitalization costs for the treatment of community-acquired severe RSV infection. The net benefits of the prevention activities were estimated to be equivalent to 9% of the total RSV-related costs. Changes in the estimated hospital infection transmission rates did not have a significant impact on the base-case estimate. CONCLUSIONS: The risk and cost of nosocomial RSV infection contributes to the overall burden of RSV. The present model, which was developed to estimate this burden, can be adapted to other countries with different disease epidemiology, costs and hospital infection transmission rates. PMID:24421788

Resource costing for multinational neurologic clinical trials: methods and results.

PubMed

Schulman, K; Burke, J; Drummond, M; Davies, L; Carlsson, P; Gruger, J; Harris, A; Lucioni, C; Gisbert, R; Llana, T; Tom, E; Bloom, B; Willke, R; Glick, H

1998-11-01

We present the results of a multinational resource costing study for a prospective economic evaluation of a new medical technology for treatment of subarachnoid hemorrhage within a clinical trial. The study describes a framework for the collection and analysis of international resource cost data that can contribute to a consistent and accurate intercountry estimation of cost. Of the 15 countries that participated in the clinical trial, we collected cost information in the following seven: Australia, France, Germany, the UK, Italy, Spain, and Sweden. The collection of cost data in these countries was structured through the use of worksheets to provide accurate and efficient cost reporting. We converted total average costs to average variable costs and then aggregated the data to develop study unit costs. When unit costs were unavailable, we developed an index table, based on a market-basket approach, to estimate unit costs. To estimate the cost of a given procedure, the market-basket estimation process required that cost information be available for at least one country. When cost information was unavailable in all countries for a given procedure, we estimated costs using a method based on physician-work and practice-expense resource-based relative value units. Finally, we converted study unit costs to a common currency using purchasing power parity measures. Through this costing exercise we developed a set of unit costs for patient services and per diem hospital services. We conclude by discussing the implications of our costing exercise and suggest guidelines to facilitate more effective multinational costing exercises.

Weapon System Requirements: Detailed Systems Engineering Prior to Product Development Positions Programs for Success

DTIC Science & Technology

2016-11-01

systems engineering had better outcomes. For example, the Small Diameter Bomb Increment I program, which delivered within cost and schedule estimates ...its current portfolio. This portfolio has experienced cost growth of 48 percent since first full estimates and average delays in delivering initial...stable design, building and testing of prototypes, and demonstration of mature production processes. • Realistic cost estimate : Sound cost estimates

Massive yet grossly underestimated global costs of invasive insects

PubMed Central

Bradshaw, Corey J. A.; Leroy, Boris; Bellard, Céline; Roiz, David; Albert, Céline; Fournier, Alice; Barbet-Massin, Morgane; Salles, Jean-Michel; Simard, Frédéric; Courchamp, Franck

2016-01-01

Insects have presented human society with some of its greatest development challenges by spreading diseases, consuming crops and damaging infrastructure. Despite the massive human and financial toll of invasive insects, cost estimates of their impacts remain sporadic, spatially incomplete and of questionable quality. Here we compile a comprehensive database of economic costs of invasive insects. Taking all reported goods and service estimates, invasive insects cost a minimum of US$70.0 billion per year globally, while associated health costs exceed US$6.9 billion per year. Total costs rise as the number of estimate increases, although many of the worst costs have already been estimated (especially those related to human health). A lack of dedicated studies, especially for reproducible goods and service estimates, implies gross underestimation of global costs. Global warming as a consequence of climate change, rising human population densities and intensifying international trade will allow these costly insects to spread into new areas, but substantial savings could be achieved by increasing surveillance, containment and public awareness. PMID:27698460

76 FR 36579 - Onsite Consultation Agreements; Extension of the Office of Management and Budget's (OMB) Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-22

.... Estimated Total urden Hours: 222,924. Estimated Cost (Operation and Maintenance): $0. IV. Public... costs) is minimal, collection instruments are clearly understood, and OSHA's estimate of the information... of OSHA's estimate of the burden (time and costs) of the information collection requirements...

Counting the cost: estimating the economic benefit of pedophile treatment programs.

PubMed

Shanahan, M; Donato, R

2001-04-01

The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.

Cost of care of patients with cystic fibrosis in The Netherlands in 1990-1.

PubMed Central

Wildhagen, M. F.; Verheij, J. B.; Verzijl, J. G.; Hilderink, H. B.; Kooij, L.; Tijmstra, T.; ten Kate, L. P.; Gerritsen, J.; Bakker, W.; Habbema, J. D.; Habbema, F.

1996-01-01

BACKGROUND: Research on the cost of care of patients with cystic fibrosis is scarce. The aim of this study was to estimate the costs using age-specific medical consumption from real patient data. METHODS: The age-specific medical consumption of patients with cystic fibrosis in The Netherlands in 1991 was estimated from a survey of medical records and a patient questionnaire. A distinction was made between costs of hospital care, hospital and non-hospital medication, and home care. Costs per year were obtained by multiplying the yearly amount of care and the costs per unit. RESULTS: On average the annual cost of a patient with cystic fibrosis in 1991 was 10,908 pounds (hospital care 42%, medication 37%, home care 20%). The cost of care of cystic fibrosis in The Netherlands, with approximately 1000 patients, is estimated at 10.9 million pounds per year, which is 0.07% of the total health care budget. The cost of care of a patient up to the age of 35 is estimated at 614,587 pounds. When year-to-year survival is taken into account and future costs are discounted to the year of birth with a yearly discount rate of 5%, the cost of care of a patient with cystic fibrosis is estimated at 164,365 pounds for 1991. This estimate will be used in a prospective evaluation of screening for cystic fibrosis carriers. CONCLUSIONS: The cost of care of patients with cystic fibrosis estimated by age-specific medical consumption of real patients is higher than that estimated by non-age-specific medical consumption and/or expert opinions. PMID:8779135

Methodology for Estimating Total Automotive Manufacturing Costs

DOT National Transportation Integrated Search

1983-04-01

A number of methodologies for estimating manufacturing costs have been developed. This report discusses the different approaches and shows that an approach to estimating manufacturing costs in the automobile industry based on surrogate plants is pref...

28 CFR 19.4 - Cost and percentage estimates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... RECOVERY OF MISSING CHILDREN § 19.4 Cost and percentage estimates. It is estimated that this program will... administrative costs. It is DOJ's objective that 50 percent of DOJ penalty mail contain missing children...

The costs of managing genital warts in the UK by devolved nation: England, Scotland, Wales and Northern Ireland.

PubMed

Coles, V A H; Chapman, R; Lanitis, T; Carroll, S M

2016-01-01

Genital warts, 90% of which are caused by human papillomavirus types 6 and 11, are a significant problem in the UK. The cost of managing genital warts was previously estimated at £52.4 million for 2010. The objective of this study was to estimate the cost of genital warts management up to 2012 in the UK and by jurisdiction. Population statistics and the number of reported genital warts cases in genito-urinary medicine clinics were obtained and extrapolated to 2012. Cases of genital warts treated in primary care were estimated from The Health Improvement Network database. The number of visits and therapy required were estimated by genito-urinary medicine experts. Costs were obtained from the appropriate national tariffs. The model estimated there were 220,875 genital warts cases in the UK in 2012, costing £58.44 million (£265/patient). It estimated 157,793 cases in England costing £41.74 million; 7468 cases in Scotland costing £1.90 million; 7095 cases in Wales costing £1.87 million; and 3621 cases in Northern Ireland costing £948,000. The full National Health Service costs for the management of genital warts have never previously been estimated separately for each jurisdiction. Findings reveal a significant economic burden, which is important to quantify when understanding the value of quadrivalent human papilloma virus vaccination. © The Author(s) 2015.

Estimating acreage by double sampling using LANDSAT data

NASA Technical Reports Server (NTRS)

Pont, F.; Horwitz, H.; Kauth, R. (Principal Investigator)

1982-01-01

Double sampling techniques employing LANDSAT data for estimating the acreage of corn and soybeans was investigated and evaluated. The evaluation was based on estimated costs and correlations between two existing procedures having differing cost/variance characteristics, and included consideration of their individual merits when coupled with a fictional 'perfect' procedure of zero bias and variance. Two features of the analysis are: (1) the simultaneous estimation of two or more crops; and (2) the imposition of linear cost constraints among two or more types of resource. A reasonably realistic operational scenario was postulated. The costs were estimated from current experience with the measurement procedures involved, and the correlations were estimated from a set of 39 LACIE-type sample segments located in the U.S. Corn Belt. For a fixed variance of the estimate, double sampling with the two existing LANDSAT measurement procedures can result in a 25% or 50% cost reduction. Double sampling which included the fictional perfect procedure results in a more cost effective combination when it is used with the lower cost/higher variance representative of the existing procedures.

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

Murphy, L.T.; Hickey, M.

This paper summarizes the progress to date by CH2M HILL and the UKAEA in development of a parametric modelling capability for estimating the costs of large nuclear decommissioning projects in the United Kingdom (UK) and Europe. The ability to successfully apply parametric cost estimating techniques will be a key factor to commercial success in the UK and European multi-billion dollar waste management, decommissioning and environmental restoration markets. The most useful parametric models will be those that incorporate individual components representing major elements of work: reactor decommissioning, fuel cycle facility decommissioning, waste management facility decommissioning and environmental restoration. Models must bemore » sufficiently robust to estimate indirect costs and overheads, permit pricing analysis and adjustment, and accommodate the intricacies of international monetary exchange, currency fluctuations and contingency. The development of a parametric cost estimating capability is also a key component in building a forward estimating strategy. The forward estimating strategy will enable the preparation of accurate and cost-effective out-year estimates, even when work scope is poorly defined or as yet indeterminate. Preparation of cost estimates for work outside the organizations current sites, for which detailed measurement is not possible and historical cost data does not exist, will also be facilitated. (authors)« less

NASA Software Cost Estimation Model: An Analogy Based Estimation Model

NASA Technical Reports Server (NTRS)

Hihn, Jairus; Juster, Leora; Menzies, Tim; Mathew, George; Johnson, James

2015-01-01

The cost estimation of software development activities is increasingly critical for large scale integrated projects such as those at DOD and NASA especially as the software systems become larger and more complex. As an example MSL (Mars Scientific Laboratory) developed at the Jet Propulsion Laboratory launched with over 2 million lines of code making it the largest robotic spacecraft ever flown (Based on the size of the software). Software development activities are also notorious for their cost growth, with NASA flight software averaging over 50% cost growth. All across the agency, estimators and analysts are increasingly being tasked to develop reliable cost estimates in support of program planning and execution. While there has been extensive work on improving parametric methods there is very little focus on the use of models based on analogy and clustering algorithms. In this paper we summarize our findings on effort/cost model estimation and model development based on ten years of software effort estimation research using data mining and machine learning methods to develop estimation models based on analogy and clustering. The NASA Software Cost Model performance is evaluated by comparing it to COCOMO II, linear regression, and K-­ nearest neighbor prediction model performance on the same data set.

Valuing productivity costs in a changing macroeconomic environment: the estimation of colorectal cancer productivity costs using the friction cost approach.

PubMed

Hanly, Paul; Koopmanschap, Marc; Sharp, Linda

2016-06-01

The friction cost approach (FCA) has been proposed as an alternative to the human capital approach for productivity cost valuation. However, FCA estimates are context dependent and influenced by extant macroeconomic conditions. We applied the FCA to estimate colorectal cancer labor productivity costs and assessed the impact of a changing macroeconomic environment on these estimates. Data from colorectal cancer survivors (n = 159) derived from a postal survey undertaken in Ireland March 2010 to January 2011 were combined with national wage data, population-level survival data, and occupation-specific friction periods to calculate temporary and permanent disability, and premature mortality costs using the FCA. The effects of changing labor market conditions between 2006 and 2013 on the friction period were modeled in scenario analyses. Costs were valued in 2008 euros. In the base-case, the total FCA per-person productivity cost for incident colorectal cancer patients of working age at diagnosis was €8543. In scenario 1 (a 2.2 % increase in unemployment), the fall in the friction period caused total productivity costs to decrease by up to 18 % compared to base-case estimates. In scenario 2 (a 9.2 % increase in unemployment), the largest decrease in productivity cost was up to 65 %. Adjusting for the vacancy rate reduced the effect of unemployment on the cost results. The friction period used in calculating labor productivity costs greatly affects the derived estimates; this friction period requires reassessment following changes in labor market conditions. The influence of changes in macroeconomic conditions on FCA-derived cost estimates may be substantial.

Estimating comparable English healthcare costs for multiple diseases and unrelated future costs for use in health and public health economic modelling.

PubMed

Briggs, Adam D M; Scarborough, Peter; Wolstenholme, Jane

2018-01-01

Healthcare interventions, and particularly those in public health may affect multiple diseases and significantly prolong life. No consensus currently exists for how to estimate comparable healthcare costs across multiple diseases for use in health and public health cost-effectiveness models. We aim to describe a method for estimating comparable disease specific English healthcare costs as well as future healthcare costs from diseases unrelated to those modelled. We use routine national datasets including programme budgeting data and cost curves from NHS England to estimate annual per person costs for diseases included in the PRIMEtime model as well as age and sex specific costs due to unrelated diseases. The 2013/14 annual cost to NHS England per prevalent case varied between £3,074 for pancreatic cancer and £314 for liver disease. Costs due to unrelated diseases increase with age except for a secondary peak at 30-34 years for women reflecting maternity resource use. The methodology described allows health and public health economic modellers to estimate comparable English healthcare costs for multiple diseases. This facilitates the direct comparison of different health and public health interventions enabling better decision making.

Public Perceptions of Regulatory Costs, Their Uncertainty and Interindividual Distribution.

PubMed

Johnson, Branden B; Finkel, Adam M

2016-06-01

Public perceptions of both risks and regulatory costs shape rational regulatory choices. Despite decades of risk perception studies, this article is the first on regulatory cost perceptions. A survey of 744 U.S. residents probed: (1) How knowledgeable are laypeople about regulatory costs incurred to reduce risks? (2) Do laypeople see official estimates of cost and benefit (lives saved) as accurate? (3) (How) do preferences for hypothetical regulations change when mean-preserving spreads of uncertainty replace certain cost or benefit? and (4) (How) do preferences change when unequal interindividual distributions of hypothetical regulatory costs replace equal distributions? Respondents overestimated costs of regulatory compliance, while assuming agencies underestimate costs. Most assumed agency estimates of benefits are accurate; a third believed both cost and benefit estimates are accurate. Cost and benefit estimates presented without uncertainty were slightly preferred to those surrounded by "narrow uncertainty" (a range of costs or lives entirely within a personally-calibrated zone without clear acceptance or rejection of tradeoffs). Certain estimates were more preferred than "wide uncertainty" (a range of agency estimates extending beyond these personal bounds, thus posing a gamble between favored and unacceptable tradeoffs), particularly for costs as opposed to benefits (but even for costs a quarter of respondents preferred wide uncertainty to certainty). Agency-acknowledged uncertainty in general elicited mixed judgments of honesty and trustworthiness. People preferred egalitarian distributions of regulatory costs, despite skewed actual cost distributions, and preferred progressive cost distributions (the rich pay a greater than proportional share) to regressive ones. Efficient and socially responsive regulations require disclosure of much more information about regulatory costs and risks. © 2016 Society for Risk Analysis.

Economic burden of occupational injury and illness in the United States.

PubMed

Leigh, J Paul

2011-12-01

The allocation of scarce health care resources requires a knowledge of disease costs. Whereas many studies of a variety of diseases are available, few focus on job-related injuries and illnesses. This article provides estimates of the national costs of occupational injury and illness among civilians in the United States for 2007. This study provides estimates of both the incidence of fatal and nonfatal injuries and nonfatal illnesses and the prevalence of fatal diseases as well as both medical and indirect (productivity) costs. To generate the estimates, I combined primary and secondary data sources with parameters from the literature and model assumptions. My primary sources were injury, disease, employment, and inflation data from the U.S. Bureau of Labor Statistics (BLS) and the Centers for Disease Control and Prevention (CDC) as well as costs data from the National Council on Compensation Insurance and the Healthcare Cost and Utilization Project. My secondary sources were the National Academy of Social Insurance, literature estimates of Attributable Fractions (AF) of diseases with occupational components, and national estimates for all health care costs. Critical model assumptions were applied to the underreporting of injuries, wage-replacement rates, and AFs. Total costs were calculated by multiplying the number of cases by the average cost per case. A sensitivity analysis tested for the effects of the most consequential assumptions. Numerous improvements over earlier studies included reliance on BLS data for government workers and ten specific cancer sites rather than only one broad cancer category. The number of fatal and nonfatal injuries in 2007 was estimated to be more than 5,600 and almost 8,559,000, respectively, at a cost of $6 billion and $186 billion. The number of fatal and nonfatal illnesses was estimated at more than 53,000 and nearly 427,000, respectively, with cost estimates of $46 billion and $12 billion. For injuries and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers' compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed. © 2011 Milbank Memorial Fund.

Costs of cervical cancer treatment: population-based estimates from Ontario

PubMed Central

Pendrith, C.; Thind, A.; Zaric, G.S.; Sarma, S.

2016-01-01

Objectives The objectives of the present study were to estimate the overall and specific medical care costs associated with cervical cancer in the first 5 years after diagnosis in Ontario. Methods Incident cases of invasive cervical cancer during 2007–2010 were identified from the Ontario Cancer Registry and linked to administrative databases held at the Institute for Clinical Evaluative Sciences. Mean costs in 2010 Canadian dollars were estimated using the arithmetic mean and estimators that adjust for censored data. Results Mean age of the patients in the study cohort (779 cases) was 49.3 years. The mean overall medical care cost was $39,187 [standard error (se): $1,327] in the 1st year after diagnosis. Costs in year 1 ranged from $34,648 (se: $1,275) for those who survived at least 1 year to $69,142 (se: $4,818) for those who died from cervical cancer within 1 year. At 5 years after diagnosis, the mean overall unadjusted cost was $63,131 (se: $3,131), and the cost adjusted for censoring was $68,745 (se: $2,963). Inpatient hospitalizations and cancer-related care were the two largest components of cancer treatment costs. Conclusions We found that the estimated mean costs that did not account for censoring were consistently undervalued, highlighting the importance of estimates based on censoring-adjusted costs in cervical cancer. Our results are reliable for estimating the economic burden of cervical cancer and the cost-effectiveness of cervical cancer prevention strategies. PMID:27122978

Study of solid rocket motors for a space shuttle booster. Volume 2, book 3: Cost estimating data

NASA Technical Reports Server (NTRS)

Vanderesch, A. H.

1972-01-01

Cost estimating data for the 156 inch diameter, parallel burn solid rocket propellant engine selected for the space shuttle booster are presented. The costing aspects on the baseline motor are initially considered. From the baseline, sufficient data is obtained to provide cost estimates of alternate approaches.

76 FR 28820 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... estimated cost for an in-house attorney is $354 per hour and the estimated cost for an assistant compliance director in the securities industry is $320 per hour. Therefore the estimated total cost of compliance for... developing the required policies and procedures is no longer applicable. \\3\\ The total cost of compliance for...

10 CFR 436.23 - Estimated simple payback time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Methodology and Procedures for Life Cycle Cost Analyses § 436.23 Estimated simple payback time. The estimated simple payback time is the number of years required for the cumulative value of energy or water cost savings less future non-fuel or non-water costs to equal the investment costs of the building energy or...

10 CFR 436.23 - Estimated simple payback time.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Methodology and Procedures for Life Cycle Cost Analyses § 436.23 Estimated simple payback time. The estimated simple payback time is the number of years required for the cumulative value of energy or water cost savings less future non-fuel or non-water costs to equal the investment costs of the building energy or...

10 CFR 436.23 - Estimated simple payback time.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Methodology and Procedures for Life Cycle Cost Analyses § 436.23 Estimated simple payback time. The estimated simple payback time is the number of years required for the cumulative value of energy or water cost savings less future non-fuel or non-water costs to equal the investment costs of the building energy or...

10 CFR 436.23 - Estimated simple payback time.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Methodology and Procedures for Life Cycle Cost Analyses § 436.23 Estimated simple payback time. The estimated simple payback time is the number of years required for the cumulative value of energy or water cost savings less future non-fuel or non-water costs to equal the investment costs of the building energy or...

10 CFR 436.23 - Estimated simple payback time.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Methodology and Procedures for Life Cycle Cost Analyses § 436.23 Estimated simple payback time. The estimated simple payback time is the number of years required for the cumulative value of energy or water cost savings less future non-fuel or non-water costs to equal the investment costs of the building energy or...

The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation

PubMed Central

French, Michael T.; Fang, Hai

2010-01-01

Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than ten years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost of society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. PMID:20071107

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

PubMed

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

2010-04-01

Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Long-range planning cost model for support of future space missions by the deep space network

NASA Technical Reports Server (NTRS)

Sherif, J. S.; Remer, D. S.; Buchanan, H. R.

1990-01-01

A simple model is suggested to do long-range planning cost estimates for Deep Space Network (DSP) support of future space missions. The model estimates total DSN preparation costs and the annual distribution of these costs for long-range budgetary planning. The cost model is based on actual DSN preparation costs from four space missions: Galileo, Voyager (Uranus), Voyager (Neptune), and Magellan. The model was tested against the four projects and gave cost estimates that range from 18 percent above the actual total preparation costs of the projects to 25 percent below. The model was also compared to two other independent projects: Viking and Mariner Jupiter/Saturn (MJS later became Voyager). The model gave cost estimates that range from 2 percent (for Viking) to 10 percent (for MJS) below the actual total preparation costs of these missions.

Standard cost elements for technology programs

NASA Technical Reports Server (NTRS)

Christensen, Carisa B.; Wagenfuehrer, Carl

1992-01-01

The suitable structure for an effective and accurate cost estimate for general purposes is discussed in the context of a NASA technology program. Cost elements are defined for research, management, and facility-construction portions of technology programs. Attention is given to the mechanisms for insuring the viability of spending programs, and the need for program managers is established for effecting timely fund disbursement. Formal, structures, and intuitive techniques are discussed for cost-estimate development, and cost-estimate defensibility can be improved with increased documentation. NASA policies for cash management are examined to demonstrate the importance of the ability to obligate funds and the ability to cost contracted funds. The NASA approach to consistent cost justification is set forth with a list of standard cost-element definitions. The cost elements reflect the three primary concerns of cost estimates: the identification of major assumptions, the specification of secondary analytic assumptions, and the status of program factors.

An activity-based methodology for operations cost analysis

NASA Technical Reports Server (NTRS)

Korsmeyer, David; Bilby, Curt; Frizzell, R. A.

1991-01-01

This report describes an activity-based cost estimation method, proposed for the Space Exploration Initiative (SEI), as an alternative to NASA's traditional mass-based cost estimation method. A case study demonstrates how the activity-based cost estimation technique can be used to identify the operations that have a significant impact on costs over the life cycle of the SEI. The case study yielded an operations cost of $101 billion for the 20-year span of the lunar surface operations for the Option 5a program architecture. In addition, the results indicated that the support and training costs for the missions were the greatest contributors to the annual cost estimates. A cost-sensitivity analysis of the cultural and architectural drivers determined that the length of training and the amount of support associated with the ground support personnel for mission activities are the most significant cost contributors.

Estimation of the cost of large-scale school deworming programmes with benzimidazoles

PubMed Central

Montresor, A.; Gabrielli, A.F.; Engels, D.

2017-01-01

Summary This study estimates the cost of distributing benzimidazole tablets in the context of school deworming programmes: we analysed studies reporting the cost of school deworming from seven countries in four WHO regions. The estimated cost for drug procurement to cover one million children (including customs clearance and international transport) is approximately US$20 000. The estimated financial costs (including the cost of training of personnel, drug transport, social mobilization and monitoring) is, on average, equivalent to US$33 000 per million school-age children with minimal variation in different countries and continents. The estimated economic costs of distribution (including the time spent by teachers, and health personnel at central, provincial and district level) to cover one million children approximately corresponds to US$19 000. This study shows the minimal cost of school deworming activities, but also shows the significant contribution (corresponding to a quarter of the entire cost of the programme) provided by health and education systems in endemic countries even in the case of drug donations and donor support of distribution costs. PMID:19926104

The price of innovation: new estimates of drug development costs.

PubMed

DiMasi, Joseph A; Hansen, Ronald W; Grabowski, Henry G

2003-03-01

The research and development costs of 68 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per new drug is 403 million US dollars (2000 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 11% yields a total pre-approval cost estimate of 802 million US dollars (2000 dollars). When compared to the results of an earlier study with a similar methodology, total capitalized costs were shown to have increased at an annual rate of 7.4% above general price inflation. Copyright 2003 Elsevier Science B.V.

Estimating Development Cost of an Interactive Website Based Cancer Screening Promotion Program

PubMed Central

Lairson, David R.; Chung, Tong Han; Smith, Lisa G.; Springston, Jeffrey K.; Champion, Victoria L.

2015-01-01

Objectives The aim of this study was to estimate the initial development costs for an innovative talk show format tailored intervention delivered via the interactive web, for increasing cancer screening in women 50 to 75 who were non-adherent to screening guidelines for colorectal cancer and/or breast cancer. Methods The cost of the intervention development was estimated from a societal perspective. Micro costing methods plus vendor contract costs were used to estimate cost. Staff logs were used to track personnel time. Non-personnel costs include all additional resources used to produce the intervention. Results Development cost of the interactive web based intervention was $.39 million, of which 77% was direct cost. About 98% of the cost was incurred in personnel time cost, contract cost and overhead cost. Conclusions The new web-based disease prevention medium required substantial investment in health promotion and media specialist time. The development cost was primarily driven by the high level of human capital required. The cost of intervention development is important information for assessing and planning future public and private investments in web-based health promotion interventions. PMID:25749548

Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation.

PubMed

Menzin, Joseph; Marton, Jeno P; Menzin, Jordan A; Willke, Richard J; Woodward, Rebecca M; Federico, Victoria

2012-06-25

Researchers and policy makers have determined that accounting for productivity costs, or "indirect costs," may be as important as including direct medical expenditures when evaluating the societal value of health interventions. These costs are also important when estimating the global burden of disease. The estimation of indirect costs is commonly done on a country-specific basis. However, there are few studies that evaluate indirect costs across countries using a consistent methodology. Using the human capital approach, we developed a model that estimates productivity costs as the present value of lifetime earnings (PVLE) lost due to premature mortality. Applying this methodology, the model estimates productivity costs for 29 selected countries, both developed and emerging. We also provide an illustration of how the inclusion of productivity costs contributes to an analysis of the societal burden of smoking. A sensitivity analysis is undertaken to assess productivity costs on the basis of the friction cost approach. PVLE estimates were higher for certain subpopulations, such as men, younger people, and people in developed countries. In the case study, productivity cost estimates from our model showed that productivity loss was a substantial share of the total cost burden of premature mortality due to smoking, accounting for over 75 % of total lifetime costs in the United States and 67 % of total lifetime costs in Brazil. Productivity costs were much lower using the friction cost approach among those of working age. Our PVLE model is a novel tool allowing researchers to incorporate the value of lost productivity due to premature mortality into economic analyses of treatments for diseases or health interventions. We provide PVLE estimates for a number of emerging and developed countries. Including productivity costs in a health economics study allows for a more comprehensive analysis, and, as demonstrated by our illustration, can have important effects on the results and conclusions.

Cost of Preventing, Managing, and Treating Human Papillomavirus (HPV)-Related Diseases in Sweden before the Introduction of Quadrivalent HPV Vaccination

PubMed Central

Östensson, Ellinor; Fröberg, Maria; Leval, Amy; Hellström, Ann-Cathrin; Bäcklund, Magnus; Zethraeus, Niklas; Andersson, Sonia

2015-01-01

Objective Costs associated with HPV-related diseases such as cervical dysplasia, cervical cancer, and genital warts have not been evaluated in Sweden. These costs must be estimated in order to determine the potential savings if these diseases were eradicated and to assess the combined cost-effectiveness of HPV vaccination and cervical cancer screening. The present study aimed to estimate prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts from a societal perspective in Sweden in 2009, 1 year before the quadrivalent HPV vaccination program was implemented. Methods and Materials Data from the Swedish cervical cancer screening program was used to calculate the costs associated with prevention (cytological cervical cancer screening), management (colposcopy and biopsy following inadequate/abnormal cytological results), and treatment of CIN. Swedish official statistics were used to estimate treatment costs associated with cervical cancer. Published epidemiological data were used to estimate the number of incident, recurrent, and persistent cases of genital warts; a clinical expert panel assessed management and treatment procedures. Estimated visits, procedures, and use of medications were used to calculate the annual cost associated with genital warts. Results From a societal perspective, total estimated costs associated with cervical cancer and genital warts in 2009 were €106.6 million, of which €81.4 million (76%) were direct medical costs. Costs associated with prevention, management, and treatment of CIN were €74 million; screening and management costs for women with normal and inadequate cytology alone accounted for 76% of this sum. The treatment costs associated with incident and prevalent cervical cancer and palliative care were €23 million. Estimated costs for incident, recurrent and persistent cases of genital warts were €9.8 million. Conclusion Prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts are substantial. Defining these costs is important for future cost-effectiveness analyses of the quadrivalent HPV vaccination program in Sweden. PMID:26398189

The Chikungunya Epidemic on La Réunion Island in 2005–2006: A Cost-of-Illness Study

PubMed Central

Soumahoro, Man-Koumba; Boelle, Pierre-Yves; Gaüzere, Bernard-Alex; Atsou, Kokuvi; Pelat, Camille; Lambert, Bruno; La Ruche, Guy; Gastellu-Etchegorry, Marc; Renault, Philippe; Sarazin, Marianne; Yazdanpanah, Yazdan; Flahault, Antoine; Malvy, Denis; Hanslik, Thomas

2011-01-01

Background This study was conducted to assess the impact of chikungunya on health costs during the epidemic that occurred on La Réunion in 2005–2006. Methodology/Principal Findings From data collected from health agencies, the additional costs incurred by chikungunya in terms of consultations, drug consumption and absence from work were determined by a comparison with the expected costs outside the epidemic period. The cost of hospitalization was estimated from data provided by the national hospitalization database for short-term care by considering all hospital stays in which the ICD-10 code A92.0 appeared. A cost-of-illness study was conducted from the perspective of the third-party payer. Direct medical costs per outpatient and inpatient case were evaluated. The costs were estimated in Euros at 2006 values. Additional reimbursements for consultations with general practitioners and drugs were estimated as €12.4 million (range: €7.7 million–€17.1 million) and €5 million (€1.9 million–€8.1 million), respectively, while the cost of hospitalization for chikungunya was estimated to be €8.5 million (€5.8 million–€8.7 million). Productivity costs were estimated as €17.4 million (€6 million–€28.9 million). The medical cost of the chikungunya epidemic was estimated as €43.9 million, 60% due to direct medical costs and 40% to indirect costs (€26.5 million and €17.4 million, respectively). The direct medical cost was assessed as €90 for each outpatient and €2,000 for each inpatient. Conclusions/Significance The medical management of chikungunya during the epidemic on La Réunion Island was associated with an important economic burden. The estimated cost of the reported disease can be used to evaluate the cost/efficacy and cost/benefit ratios for prevention and control programmes of emerging arboviruses. PMID:21695162

Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation

PubMed Central

2012-01-01

Background Researchers and policy makers have determined that accounting for productivity costs, or “indirect costs,” may be as important as including direct medical expenditures when evaluating the societal value of health interventions. These costs are also important when estimating the global burden of disease. The estimation of indirect costs is commonly done on a country-specific basis. However, there are few studies that evaluate indirect costs across countries using a consistent methodology. Methods Using the human capital approach, we developed a model that estimates productivity costs as the present value of lifetime earnings (PVLE) lost due to premature mortality. Applying this methodology, the model estimates productivity costs for 29 selected countries, both developed and emerging. We also provide an illustration of how the inclusion of productivity costs contributes to an analysis of the societal burden of smoking. A sensitivity analysis is undertaken to assess productivity costs on the basis of the friction cost approach. Results PVLE estimates were higher for certain subpopulations, such as men, younger people, and people in developed countries. In the case study, productivity cost estimates from our model showed that productivity loss was a substantial share of the total cost burden of premature mortality due to smoking, accounting for over 75 % of total lifetime costs in the United States and 67 % of total lifetime costs in Brazil. Productivity costs were much lower using the friction cost approach among those of working age. Conclusions Our PVLE model is a novel tool allowing researchers to incorporate the value of lost productivity due to premature mortality into economic analyses of treatments for diseases or health interventions. We provide PVLE estimates for a number of emerging and developed countries. Including productivity costs in a health economics study allows for a more comprehensive analysis, and, as demonstrated by our illustration, can have important effects on the results and conclusions. PMID:22731620

Cost estimation: An expert-opinion approach. [cost analysis of research projects using the Delphi method (forecasting)

NASA Technical Reports Server (NTRS)

Buffalano, C.; Fogleman, S.; Gielecki, M.

1976-01-01

A methodology is outlined which can be used to estimate the costs of research and development projects. The approach uses the Delphi technique a method developed by the Rand Corporation for systematically eliciting and evaluating group judgments in an objective manner. The use of the Delphi allows for the integration of expert opinion into the cost-estimating process in a consistent and rigorous fashion. This approach can also signal potential cost-problem areas. This result can be a useful tool in planning additional cost analysis or in estimating contingency funds. A Monte Carlo approach is also examined.

Space Station Furnace Facility. Volume 3: Program cost estimate

NASA Technical Reports Server (NTRS)

1992-01-01

The approach used to estimate costs for the Space Station Furnace Facility (SSFF) is based on a computer program developed internally at Teledyne Brown Engineering (TBE). The program produces time-phased estimates of cost elements for each hardware component, based on experience with similar components. Engineering estimates of the degree of similarity or difference between the current project and the historical data is then used to adjust the computer-produced cost estimate and to fit it to the current project Work Breakdown Structure (WBS). The SSFF Concept as presented at the Requirements Definition Review (RDR) was used as the base configuration for the cost estimate. This program incorporates data on costs of previous projects and the allocation of those costs to the components of one of three, time-phased, generic WBS's. Input consists of a list of similar components for which cost data exist, number of interfaces with their type and complexity, identification of the extent to which previous designs are applicable, and programmatic data concerning schedules and miscellaneous data (travel, off-site assignments). Output is program cost in labor hours and material dollars, for each component, broken down by generic WBS task and program schedule phase.

The health-related social costs of alcohol in Belgium.

PubMed

Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

2017-12-16

Alcohol is associated with adverse health effects causing a considerable economic impact to society. A reliable estimate of this economic impact for Belgium is lacking. This is the aim of the study. A prevalence-based approach estimating the direct, indirect and intangible costs for the year 2012 was used. Attributional fractions for a series of health effects were derived from literature. The human capital approach was used to estimate indirect costs, while the concept of disability-adjusted life years was used to estimate intangible costs. Sensitivity and scenario analyses were conducted to assess the uncertainty around cost estimates and to evaluate the impact of alternative modelling assumptions. In 2012, total alcohol-attributable direct costs were estimated at €906.1 million, of which the majority were due to hospitalization (€743.7 million, 82%). The indirect costs amounted to €642.6 million, of which 62% was caused by premature mortality. Alcohol was responsible for 157,500 disability-adjusted life years representing €6.3 billion intangible costs. Despite a number of limitations intrinsic to this kind of research, the study can be considered as the most comprehensive analysis thus far of the health-related social costs of alcohol in Belgium.

A practical approach for calculating reliable cost estimates from observational data: application to cost analyses in maternal and child health.

PubMed

Salemi, Jason L; Comins, Meg M; Chandler, Kristen; Mogos, Mulubrhan F; Salihu, Hamisu M

2013-08-01

Comparative effectiveness research (CER) and cost-effectiveness analysis are valuable tools for informing health policy and clinical care decisions. Despite the increased availability of rich observational databases with economic measures, few researchers have the skills needed to conduct valid and reliable cost analyses for CER. The objectives of this paper are to (i) describe a practical approach for calculating cost estimates from hospital charges in discharge data using publicly available hospital cost reports, and (ii) assess the impact of using different methods for cost estimation in maternal and child health (MCH) studies by conducting economic analyses on gestational diabetes (GDM) and pre-pregnancy overweight/obesity. In Florida, we have constructed a clinically enhanced, longitudinal, encounter-level MCH database covering over 2.3 million infants (and their mothers) born alive from 1998 to 2009. Using this as a template, we describe a detailed methodology to use publicly available data to calculate hospital-wide and department-specific cost-to-charge ratios (CCRs), link them to the master database, and convert reported hospital charges to refined cost estimates. We then conduct an economic analysis as a case study on women by GDM and pre-pregnancy body mass index (BMI) status to compare the impact of using different methods on cost estimation. Over 60 % of inpatient charges for birth hospitalizations came from the nursery/labor/delivery units, which have very different cost-to-charge markups (CCR = 0.70) than the commonly substituted hospital average (CCR = 0.29). Using estimated mean, per-person maternal hospitalization costs for women with GDM as an example, unadjusted charges ($US14,696) grossly overestimated actual cost, compared with hospital-wide ($US3,498) and department-level ($US4,986) CCR adjustments. However, the refined cost estimation method, although more accurate, did not alter our conclusions that infant/maternal hospitalization costs were significantly higher for women with GDM than without, and for overweight/obese women than for those in a normal BMI range. Cost estimates, particularly among MCH-related services, vary considerably depending on the adjustment method. Our refined approach will be valuable to researchers interested in incorporating more valid estimates of cost into databases with linked hospital discharge files.

Economic costs attributable to smoking in Hong Kong in 2011: a possible increase from 1998.

PubMed

Chen, Jing; McGhee, Sarah; Lam, Tai Hing

2017-11-15

Reduction in smoking prevalence does not necessarily reduce the costs of smoking as evidence shows in developed countries. We provide up-to-date estimates for direct and indirect costs attributable to smoking in Hong Kong in 2011 and compare with our 1998 estimates. We took a societal perspective to include lives and life years lost, health care costs and time lost from work in the costing. We followed guidelines on estimating costs of active smoking for those aged 35 years or above (35+) and costs due to SHS exposure for 35+, infants aged 12 months and under and children aged 15 and below. All costs are in US$. We estimated that 6154 deaths among 35+ in Hong Kong in 2011 were attributable to active smoking, an increase of 10% from 1998. Besides, 672 deaths were attributable to SHS exposure, i.e. 10% of the total 6826 smoking-attributable deaths. The estimate of productive life lost due to deaths from active smoking by those aged under 65 years in 2011 was $166 million, an increase of about 4% over the estimate in 1998. Our conservative estimate of the annual tobacco-related disease cost in 2011 was $716 million which accounted for 0.3% of GDP. If we added the value of attributable lives lost, the annual cost would be $4.7 billion. Despite the reduction in smoking prevalence, smoking-attributable disease still imposes a substantial economic burden on Hong Kong society. These findings support more stringent and effective tobacco control legislation, polices and measures. Current evidence shows reduction in smoking prevalence does not necessarily reduce the economic costs of smoking. Most studies in developed countries employed a societal perspective, including costs of productivity loss and indirect costs, but not all studies estimated costs associated with second-hand smoking (SHS). The present study estimated the total costs of smoking in Hong Kong including direct and indirect costs attributable to active smoking and to SHS exposure. Our study confirms the pattern of smoking epidemic in developed countries, forewarns the increasing economic burdens from tobacco, and provides East Asian countries with a prediction of their own future costs. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Universal HIV screening of pregnant women in England: cost effectiveness analysis.

PubMed

Postma, M J; Beck, E J; Mandalia, S; Sherr, L; Walters, M D; Houweling, H; Jager, J C

1999-06-19

To estimate the cost effectiveness of universal, voluntary HIV screening of pregnant women in England. Cost effectiveness analysis. Cost estimates of caring for HIV positive children were based on the stage of HIV infection and calculated using data obtained from a London hospital between 1986 and 1996. These were combined with estimates of the health benefits and costs of antenatal screening so that the cost effectiveness of universal, voluntary antenatal screening for HIV infection in England could be estimated. Lifetime, direct costs of medical care of childhood HIV infection; life years gained as a result of the screening programme; net cost per life year gained for different pretest counselling costs; and different prevalence rates of pregnant women who were unaware that they were HIV positive. Estimated direct lifetime medical and social care costs of childhood HIV infection were pound178 300 using a 5% discount rate for time preference (1995-6 prices). In high prevalence areas screening pregnant women for HIV is estimated to be a cost effective intervention with a net cost of less than pound4000 for each life year gained. For areas with comparatively low prevalence rates, cost effectiveness could be less than pound20 000 per life year gained, depending on the number of pregnant women who are unaware that they are infected and local screening costs. Our results confirm recent recommendations that universal, voluntary antenatal HIV screening should be implemented in the London area. Serious consideration of the policy should be given for other areas in England depending on local prevalence and screening costs.

Modular space station phase B extension program cost and schedules. Volume 1: Cost and schedule estimating process and results

NASA Technical Reports Server (NTRS)

Frassinelli, G. J.

1972-01-01

Cost estimates and funding schedules are presented for a given configuration and costing ground rules. Cost methodology is described and the cost evolution from a baseline configuration to a selected configuration is given, emphasizing cases in which cost was a design driver. Programmatic cost avoidance techniques are discussed.

Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario.

PubMed

Yong, J H E; McGowan, T; Redmond-Misner, R; Beca, J; Warde, P; Gutierrez, E; Hoch, J S

2016-06-01

Radiotherapy is a common treatment for many cancers, but up-to-date estimates of the costs of radiotherapy are lacking. In the present study, we estimated the unit costs of intensity-modulated radiotherapy (imrt) and 3-dimensional conformal radiotherapy (3D-crt) in Ontario. An activity-based costing model was developed to estimate the costs of imrt and 3D-crt in prostate cancer. It included the costs of equipment, staff, and supporting infrastructure. The framework was subsequently adapted to estimate the costs of radiotherapy in breast cancer and head-and-neck cancer. We also tested various scenarios by varying the program maturity and the use of volumetric modulated arc therapy (vmat) alongside imrt. From the perspective of the health care system, treating prostate cancer with imrt and 3D-crt respectively cost $12,834 and $12,453 per patient. The cost of radiotherapy ranged from $5,270 to $14,155 and was sensitive to analytic perspective, radiation technique, and disease site. Cases of head-and-neck cancer were the most costly, being driven by treatment complexity and fractions per treatment. Although imrt was more costly than 3D-crt, its cost will likely decline over time as programs mature and vmat is incorporated. Our costing model can be modified to estimate the costs of 3D-crt and imrt for various disease sites and settings. The results demonstrate the important role of capital costs in studies of radiotherapy cost from a health system perspective, which our model can accommodate. In addition, our study established the need for future analyses of imrt cost to consider how vmat affects time consumption.

Cost of improving Access to Psychological Therapies (IAPT) programme: an analysis of cost of session, treatment and recovery in selected Primary Care Trusts in the East of England region.

PubMed

Radhakrishnan, Muralikrishnan; Hammond, Geoffrey; Jones, Peter B; Watson, Alison; McMillan-Shields, Fiona; Lafortune, Louise

2013-01-01

Recent literature on Improving Access to Psychological Therapies (IAPT) has reported on improvements in clinical outcomes, changes in employment status and the concept of recovery attributable to IAPT treatment, but not on the costs of the programme. This article reports the costs associated with a single session, completed course of treatment and recovery for four treatment courses (i.e., remaining in low or high intensity treatment, stepping up or down) in IAPT services in 5 East of England region Primary Care Trusts. Costs were estimated using treatment activity data and gross financial information, along with assumptions about how these financial data could be broken down. The estimated average cost of a high intensity session was £177 and the average cost for a low intensity session was £99. The average cost of treatment was £493 (low intensity), £1416 (high intensity), £699 (stepped down), £1514 (stepped up) and £877 (All). The cost per recovered patient was £1043 (low intensity), £2895 (high intensity), £1653 (stepped down), £2914 (stepped up) and £1766 (All). Sensitivity analysis revealed that the costs are sensitive to cost ratio assumptions, indicating that inaccurate ratios are likely to influence overall estimates. Results indicate the cost per session exceeds previously reported estimates, but cost of treatment is only marginally higher. The current cost estimates are supportive of the originally proposed IAPT model on cost-benefit grounds. The study also provides a framework to estimate costs using financial data, especially when programmes have block contract arrangements. Replication and additional analyses along with evidence-based discussion regarding alternative, cost-effective methods of intervention is recommended. Copyright © 2012 Elsevier Ltd. All rights reserved.

Price Estimation Guidelines

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Aster, R. W.; Firnett, P. J.; Miller, M. A.

1985-01-01

Improved Price Estimation Guidelines, IPEG4, program provides comparatively simple, yet relatively accurate estimate of price of manufactured product. IPEG4 processes user supplied input data to determine estimate of price per unit of production. Input data include equipment cost, space required, labor cost, materials and supplies cost, utility expenses, and production volume on industry wide or process wide basis.

Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: the importance of scale

PubMed Central

Quentin, Wilm; Adu-Sarkodie, Yaw; Terris-Prestholt, Fern; Legood, Rosa; Opoku, Baafuor K; Mayaud, Philippe

2011-01-01

Objectives To estimate the incremental costs of visual inspection with acetic acid (VIA) and cryotherapy at cervical cancer screening facilities in Ghana; to explore determinants of costs through modelling; and to estimate national scale-up and annual programme costs. Methods Resource-use data were collected at four out of six active VIA screening centres, and unit costs were ascertained to estimate the costs per woman of VIA and cryotherapy. Modelling and sensitivity analysis were used to explore the influence of observed differences between screening facilities on estimated costs and to calculate national costs. Results Incremental economic costs per woman screened with VIA ranged from 4.93 US$ to 14.75 US$, and costs of cryotherapy were between 47.26 US$ and 84.48 US$ at surveyed facilities. Under base case assumptions, our model estimated the costs of VIA to be 6.12 US$ per woman and those of cryotherapy to be 27.96 US$. Sensitivity analysis showed that the number of women screened per provider and treated per facility was the most important determinants of costs. National annual programme costs were estimated to be between 0.6 and 4.0 million US$ depending on assumed coverage and adopted screening strategy. Conclusion When choosing between different cervical cancer prevention strategies, the feasibility of increasing uptake to achieve economies of scale should be a major concern. PMID:21214692

Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: the importance of scale.

PubMed

Quentin, Wilm; Adu-Sarkodie, Yaw; Terris-Prestholt, Fern; Legood, Rosa; Opoku, Baafuor K; Mayaud, Philippe

2011-03-01

To estimate the incremental costs of visual inspection with acetic acid (VIA) and cryotherapy at cervical cancer screening facilities in Ghana; to explore determinants of costs through modelling; and to estimate national scale-up and annual programme costs. Resource-use data were collected at four out of six active VIA screening centres, and unit costs were ascertained to estimate the costs per woman of VIA and cryotherapy. Modelling and sensitivity analysis were used to explore the influence of observed differences between screening facilities on estimated costs and to calculate national costs. Incremental economic costs per woman screened with VIA ranged from 4.93 US$ to 14.75 US$, and costs of cryotherapy were between 47.26 US$ and 84.48 US$ at surveyed facilities. Under base case assumptions, our model estimated the costs of VIA to be 6.12 US$ per woman and those of cryotherapy to be 27.96 US$. Sensitivity analysis showed that the number of women screened per provider and treated per facility was the most important determinants of costs. National annual programme costs were estimated to be between 0.6 and 4.0 million US$ depending on assumed coverage and adopted screening strategy.   When choosing between different cervical cancer prevention strategies, the feasibility of increasing uptake to achieve economies of scale should be a major concern. © 2011 Blackwell Publishing Ltd.

The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations

PubMed Central

Mutowo, Mutsa P.; Lorgelly, Paula K.; Laxy, Michael; Mangwiro, John C.; Owen, Alice J.

2016-01-01

Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe. Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models. Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385–1553) mean $1319 (95% CI: 981–1657), was higher than patients with hypertension, $759 (494–1147) mean $914 (95% CI: 825–1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149) for patients with diabetes and $2239 (95% CI: 1589–3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs. Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities. PMID:27403444

Costs And Savings Associated With Community Water Fluoridation In The United States.

PubMed

O'Connell, Joan; Rockell, Jennifer; Ouellet, Judith; Tomar, Scott L; Maas, William

2016-12-01

The most comprehensive study of US community water fluoridation program benefits and costs was published in 2001. This study provides updated estimates using an economic model that includes recent data on program costs, dental caries increments, and dental treatments. In 2013 more than 211 million people had access to fluoridated water through community water systems serving 1,000 or more people. Savings associated with dental caries averted in 2013 as a result of fluoridation were estimated to be $32.19 per capita for this population. Based on 2013 estimated costs ($324 million), net savings (savings minus costs) from fluoridation systems were estimated to be $6,469 million and the estimated return on investment, 20.0. While communities should assess their specific costs for continuing or implementing a fluoridation program, these updated findings indicate that program savings are likely to exceed costs. Project HOPE—The People-to-People Health Foundation, Inc.

The cost-effectiveness of syndromic management in pharmacies in Lima, Peru.

PubMed

Adams, Elisabeth J; Garcia, Patricia J; Garnett, Geoffrey P; Edmunds, W John; Holmes, King K

2003-05-01

Many people with sexually transmitted diseases (STDs) in Lima, Peru, seek treatment in pharmacies. The goal was to assess the cost-effectiveness of training pharmacy workers in syndromic management of STDs. Cost-effectiveness from both the program and societal perspectives was determined on the basis of study costs, societal costs (cost of medicine), and the number of cases adequately managed. The latter was calculated from estimated incidence, proportion of symptomatic patients, proportion seeking treatment in pharmacies, and proportion of cases adequately managed in both comparison and intervention districts. Univariate and multivariate sensitivity analyses were performed. Under base-case assumptions, from the societal perspective the intervention saved an estimated US$1.51 per case adequately managed; from the program perspective, it cost an estimated US$3.67 per case adequately managed. In the sensitivity analyses, the proportion of females with vaginal discharge or pelvic inflammatory disease who seek treatment in pharmacies had the greatest impact on the estimated cost-effectiveness, along with the medication costs under the societal perspective. Training pharmacists in syndromic management of STDs appears to be cost-effective when only program costs are used and cost-saving from the societal perspective. Our methods provide a template for assessing the cost-effectiveness of managing STD syndromes, on the basis of indirect estimates of effectiveness.

Cost estimating methods for advanced space systems

NASA Technical Reports Server (NTRS)

Cyr, Kelley

1988-01-01

Parametric cost estimating methods for space systems in the conceptual design phase are developed. The approach is to identify variables that drive cost such as weight, quantity, development culture, design inheritance, and time. The relationship between weight and cost is examined in detail. A theoretical model of cost is developed and tested statistically against a historical data base of major research and development programs. It is concluded that the technique presented is sound, but that it must be refined in order to produce acceptable cost estimates.

The cost of vision loss in Canada. 1. Methodology.

PubMed

Gordon, Keith D; Cruess, Alan F; Bellan, Lorne; Mitchell, Scott; Pezzullo, M Lynne

2011-08-01

This paper outlines the methodology used to estimate the cost of vision loss in Canada. The results of this study will be presented in a second paper. The cost of vision loss (VL) in Canada was estimated using a prevalence-based approach. This was done by estimating the number of people with VL in a base period (2007) and the costs associated with treating them. The cost estimates included direct health system expenditures on eye conditions that cause VL, as well as other indirect financial costs such as productivity losses. Estimates were also made of the value of the loss of healthy life, measured in Disability Adjusted Life Years or DALY's. To estimate the number of cases of VL in the population, epidemiological data on prevalence rates were applied to population data. The number of cases of VL was stratified by gender, age, ethnicity, severity and cause. The following sources were used for estimating prevalence: Population-based eye studies; Canadian Surveys; Canadian journal articles and research studies; and International Population Based Eye Studies. Direct health costs were obtained primarily from Health Canada and Canadian Institute for Health Information (CIHI) sources, while costs associated with productivity losses were based on employment information compiled by Statistics Canada and on economic theory of productivity loss. Costs related to vision rehabilitation (VR) were obtained from Canadian VR organizations. This study shows that it is possible to estimate the costs for VL for a country in the absence of ongoing local epidemiological studies. Copyright © 2011 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

2009-01-01

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

The costs of turnover in nursing homes.

PubMed

Mukamel, Dana B; Spector, William D; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

2009-10-01

Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. To estimate the net costs associated with turnover of direct care staff in nursing homes. DATA AND SAMPLE: Nine hundred two nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set, Medicare enrollment files, Census, and Area Resource File. We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The instrumental variable estimate of turnover costs was negative and significant (P = 0.039). The marginal cost savings associated with a 10% point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs.

COSTS OF CHILDHOOD ASTHMA DUE TO TRAFFIC-RELATED POLLUTION IN TWO CALIFORNIA COMMUNITIES

PubMed Central

Brandt, Sylvia J.; Perez, Laura; Künzli, Nino; Lurmann, Fred; McConnell, Rob

2015-01-01

Recent research suggests the burden of childhood asthma attributable to air pollution has been underestimated in traditional risk assessments, and there are no estimates of these associated costs. We estimated the yearly childhood asthma-related costs attributable to air pollution for Riverside and Long Beach, California, including: 1) the indirect and direct costs of health care utilization due to asthma exacerbations linked to traffic-related pollution (TRP); and 2) the costs of health care for asthma cases attributable to local TRP exposure. We estimated these costs using estimates from peer-reviewed literature and the authors' analysis of surveys (Medical Expenditure Panel Survey, California Health Interview Survey, National Household Travel Survey, and Health Care Utilization Project). A lower-bound estimate of the asthma burden attributable to air pollution was $18 million yearly. Asthma cases attributable to TRP exposure accounted for almost half of this cost. The cost of bronchitic episodes was a major proportion of both the annual cost of asthma cases attributable to TRP and of pollution-linked exacerbations. Traditional risk assessment methods underestimate both the burden of disease and cost of asthma associated with air pollution, and these costs are borne disproportionately by communities with higher than average TRP. PMID:22267764

Direct and Indirect Costs of Asthma Management in Greece: An Expert Panel Approach.

PubMed

Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Bakakos, Petros; Toumbis, Michalis; Loukides, Stelios; Vassilakopoulos, Theodoros

2017-01-01

Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns. Unit costs from official, published sources were subsequently assigned to resource use to estimate direct medical costs. Indirect costs were estimated as number of work loss days. Cost base year was 2015, and the perspective adopted was that of the National Organization of Health Care Services Provision, as well as the societal. Patients with asthma are mainly managed by pulmonologists (71.4%) and secondarily by general practitioners and internists (28.6%). The annual cost of managing exacerbations was estimated at €273.1, while maintenance costs were estimated at €1,100.2 per year. Total costs of managing asthma per patient per year were estimated at €2,281.8, 64.4% of which represented direct medical costs. Of the direct costs, pharmaceutical treatment was the key driver, accounting for 63.9 and 41.2% of direct and total costs, respectively. Direct non-medical costs (patient travel and waiting time) were estimated at €152.3. Indirect costs accounted for 28.9% of total costs. Asthma is a chronic condition, the management of which constrains the already limited Greek health care resources. The increasing prevalence of the disease raises concerns as it could translate per patient costs into a significant burden for the Greek health care system. Thus, the prevention, self-management, and improved quality of care for asthma should find a place in the health policy agenda in Greece.

Comparing top-down and bottom-up costing approaches for economic evaluation within social welfare.

PubMed

Olsson, Tina M

2011-10-01

This study compares two approaches to the estimation of social welfare intervention costs: one "top-down" and the other "bottom-up" for a group of social welfare clients with severe problem behavior participating in a randomized trial. Intervention costs ranging over a two-year period were compared by intervention category (foster care placement, institutional placement, mentorship services, individual support services and structured support services), estimation method (price, micro costing, average cost) and treatment group (intervention, control). Analyses are based upon 2007 costs for 156 individuals receiving 404 interventions. Overall, both approaches were found to produce reliable estimates of intervention costs at the group level but not at the individual level. As choice of approach can greatly impact the estimate of mean difference, adjustment based on estimation approach should be incorporated into sensitivity analyses. Analysts must take care in assessing the purpose and perspective of the analysis when choosing a costing approach for use within economic evaluation.

Landslide risk in the San Francisco Bay region

USGS Publications Warehouse

Coe, J.A.; Crovelli, R.A.

2008-01-01

We have used historical records of damaging landslides triggered by rainstorms, and a newly developed Probabilistic Landslide Assessment Cost Estimation System (PLACES), to estimate the numbers and direct costs of future landslides in the San Francisco Bay region. The estimated annual cost of future landslides in the entire region is about US $15 million (year 2000 $). The estimated annual cost is highest for San Mateo County ($3.32 million) and lowest for Solano County ($0.18 million). Normalizing costs by dividing by the percentage of land area with slopes equal or greater than about 10° indicates that San Francisco County will have the highest cost per square km ($7,400), whereas Santa Clara County will have the lowest cost per square km ($230). These results indicate that the San Francisco Bay region has one of the highest levels of landslide risk in the United States. Compared to landslide cost estimates from the rest of the world, the risk level in the Bay region seems high, but not exceptionally high.

A risk adjustment approach to estimating the burden of skin disease in the United States.

PubMed

Lim, Henry W; Collins, Scott A B; Resneck, Jack S; Bolognia, Jean; Hodge, Julie A; Rohrer, Thomas A; Van Beek, Marta J; Margolis, David J; Sober, Arthur J; Weinstock, Martin A; Nerenz, David R; Begolka, Wendy Smith; Moyano, Jose V

2018-01-01

Direct insurance claims tabulation and risk adjustment statistical methods can be used to estimate health care costs associated with various diseases. In this third manuscript derived from the new national Burden of Skin Disease Report from the American Academy of Dermatology, a risk adjustment method that was based on modeling the average annual costs of individuals with or without specific diseases, and specifically tailored for 24 skin disease categories, was used to estimate the economic burden of skin disease. The results were compared with the claims tabulation method used in the first 2 parts of this project. The risk adjustment method estimated the direct health care costs of skin diseases to be $46 billion in 2013, approximately $15 billion less than estimates using claims tabulation. For individual skin diseases, the risk adjustment cost estimates ranged from 11% to 297% of those obtained using claims tabulation for the 10 most costly skin disease categories. Although either method may be used for purposes of estimating the costs of skin disease, the choice of method will affect the end result. These findings serve as an important reference for future discussions about the method chosen in health care payment models to estimate both the cost of skin disease and the potential cost impact of care changes. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Overweight and obesity on the island of Ireland: an estimation of costs

PubMed Central

Dee, Anne; Callinan, Aoife; Doherty, Edel; O'Neill, Ciaran; McVeigh, Treasa; Sweeney, Mary Rose; Staines, Anthony; Kearns, Karen; Fitzgerald, Sarah; Sharp, Linda; Kee, Frank; Hughes, John; Balanda, Kevin; Perry, Ivan J

2015-01-01

Objectives The increasing prevalence of overweight and obesity worldwide continues to compromise population health and creates a wider societal cost in terms of productivity loss and premature mortality. Despite extensive international literature on the cost of overweight and obesity, findings are inconsistent between Europe and the USA, and particularly within Europe. Studies vary on issues of focus, specific costs and methods. This study aims to estimate the healthcare and productivity costs of overweight and obesity for the island of Ireland in 2009, using both top-down and bottom-up approaches. Methods Costs were estimated across four categories: healthcare utilisation, drug costs, work absenteeism and premature mortality. Healthcare costs were estimated using Population Attributable Fractions (PAFs). PAFs were applied to national cost data for hospital care and drug prescribing. PAFs were also applied to social welfare and national mortality data to estimate productivity costs due to absenteeism and premature mortality. Results The healthcare costs of overweight and obesity in 2009 were estimated at €437 million for the Republic of Ireland (ROI) and €127.41 million for NI. Productivity loss due to overweight and obesity was up to €865 million for ROI and €362 million for NI. The main drivers of healthcare costs are cardiovascular disease, type II diabetes, colon cancer, stroke and gallbladder disease. In terms of absenteeism, low back pain is the main driver in both jurisdictions, and for productivity loss due to premature mortality the primary driver of cost is coronary heart disease. Conclusions The costs are substantial, and urgent public health action is required in Ireland to address the problem of increasing prevalence of overweight and obesity, which if left unchecked will lead to unsustainable cost escalation within the health service and unacceptable societal costs. PMID:25776042

Helping the Noncompliant Child: An Assessment of Program Costs and Cost-Effectiveness.

PubMed

Honeycutt, Amanda A; Khavjou, Olga A; Jones, Deborah J; Cuellar, Jessica; Forehand, Rex L

2015-02-01

Disruptive behavior disorders (DBD) in children can lead to delinquency in adolescence and antisocial behavior in adulthood. Several evidence-based behavioral parent training (BPT) programs have been created to treat early onset DBD. This paper focuses on one such program, Helping the Noncompliant Child (HNC), and provides detailed cost estimates from a recently completed pilot study for the HNC program. The study also assesses the average cost-effectiveness of the HNC program by combining program cost estimates with data on improvements in child participants' disruptive behavior. The cost and effectiveness estimates are based on implementation of HNC with low-income families. Investigators developed a Microsoft Excel-based costing instrument to collect data from therapists on their time spent delivering the HNC program. The instrument was designed using an activity-based costing approach, where each therapist reported program time by family, by date, and for each skill that the family was working to master. Combining labor and non-labor costs, it is estimated that delivering the HNC program costs an average of $501 per family from a payer perspective. It also costs an average of $13 to improve the Eyberg Child Behavior Inventory intensity score by 1 point for children whose families participated in the HNC pilot program. The cost of delivering the HNC program appears to compare favorably with the costs of similar BPT programs. These cost estimates are the first to be collected systematically and prospectively for HNC. Program managers may use these estimates to plan for the resources needed to fully implement HNC.

Research without billing data. Econometric estimation of patient-specific costs.

PubMed

Barnett, P G

1997-06-01

This article describes a method for computing the cost of care provided to individual patients in health care systems that do not routinely generate billing data, but gather information on patient utilization and total facility costs. Aggregate data on cost and utilization were used to estimate how costs vary with characteristics of patients and facilities of the US Department of Veterans Affairs. A set of cost functions was estimated, taking advantage of the department-level organization of the data. Casemix measures were used to determine the costs of acute hospital and long-term care. Hospitalization for medical conditions cost an average of $5,642 per US Health Care Financing Administration diagnosis-related group weight; surgical hospitalizations cost $11,836. Nursing home care cost $197.33 per day, intermediate care cost $280.66 per day, psychiatric care cost $307.33 per day, and domiciliary care cost $111.84 per day. Outpatient visits cost an average of $90.36. These estimates include the cost of physician services. The econometric method presented here accounts for variation in resource use caused by casemix that is not reflected in length of stay and for the effects of medical education, research, facility size, and wage rates. Data on non-Veteran's Affairs hospital stays suggest that the method accounts for 40% of the variation in acute hospital care costs and is superior to cost estimates based on length of stay or diagnosis-related group weight alone.

The social cost of illegal drug consumption in Spain.

PubMed

García-Altés, Anna; Ollé, Josep Ma; Antoñanzas, Fernando; Colom, Joan

2002-09-01

The objective of this study was to estimate the social cost of the consumption of illegal drugs in Spain. We performed a cost-of-illness study, using a prevalence approximation and a societal perspective. The estimation of costs and consequences referred to 1997. As direct costs we included health-care costs, prevention, continuing education, research, administrative costs, non-governmental organizations and crime-related costs. As indirect costs we included lost productivity associated with mortality and the hospitalization of patients. Estimation of intangible costs was not included. The minimum cost of illegal drug consumption in Spain is 88,800 million pesetas (PTA) (467 million dollars). Seventy-seven per cent of the costs correspond to direct costs. Of those, crime-related costs represent 18%, while the largest part corresponds to the health-care costs (50% of direct costs). From the perspective of the health-care system, the minimum cost of illegal drug consumption is 44,000 million PTA (231 million dollars). The cost of illegal drug consumption represents 0.07% of the Spanish GDP. This gross figure compares with 2250 million PTA (12.5 million dollars) invested in prevention programmes during the same year, and with 12,300 million PTA (68.3 million dollars) spent on specific programmes and resources for the drug addict population. Although there are limitations intrinsic in this type of study and the estimations obtained in the present analysis are likely to be an underestimate of the real cost of this condition, we estimate that illegal drug consumption costs the Spanish economy at least 0.2% of GDP.

Space station systems analysis study. Part 3: Documentation. Volume 5: Cost and schedule data

NASA Technical Reports Server (NTRS)

1977-01-01

Cost estimates for the space station systems analysis were recorded. Space construction base costs and characteristics were cited as well as mission hardware costs and characteristics. Also delineated were cost ground rules, the program schedule, and a detail cost estimate and funding distribution.

Cost Modeling for low-cost planetary missions

NASA Technical Reports Server (NTRS)

Kwan, Eric; Habib-Agahi, Hamid; Rosenberg, Leigh

2005-01-01

This presentation will provide an overview of the JPL parametric cost models used to estimate flight science spacecrafts and instruments. This material will emphasize the cost model approaches to estimate low-cost flight hardware, sensors, and instrumentation, and to perform cost-risk assessments. This presentation will also discuss JPL approaches to perform cost modeling and the methodologies and analyses used to capture low-cost vs. key cost drivers.

Using standardized tools to improve immunization costing data for program planning: the cost of the Colombian Expanded Program on Immunization.

PubMed

Castañeda-Orjuela, Carlos; Romero, Martin; Arce, Patricia; Resch, Stephen; Janusz, Cara B; Toscano, Cristiana M; De la Hoz-Restrepo, Fernando

2013-07-02

The cost of Expanded Programs on Immunization (EPI) is an important aspect of the economic and financial analysis needed for planning purposes. Costs also are needed for cost-effectiveness analysis of introducing new vaccines. We describe a costing tool that improves the speed, accuracy, and availability of EPI costs and that was piloted in Colombia. The ProVac CostVac Tool is a spreadsheet-based tool that estimates overall EPI costs considering program inputs (personnel, cold chain, vaccines, supplies, etc.) at three administrative levels (central, departmental, and municipal) and one service delivery level (health facilities). It uses various costing methods. The tool was evaluated through a pilot exercise in Colombia. In addition to the costs obtained from the central and intermediate administrative levels, a survey of 112 local health facilities was conducted to collect vaccination costs. Total cost of the EPI, cost per dose of vaccine delivered, and cost per fully vaccinated child with the recommended immunization schedule in Colombia in 2009 were estimated. The ProVac CostVac Tool is a novel, user-friendly tool, which allows users to conduct an EPI costing study following guidelines for cost studies. The total costs of the Colombian EPI were estimated at US$ 107.8 million in 2009. The cost for a fully immunized child with the recommended schedule was estimated at US$ 153.62. Vaccines and vaccination supplies accounted for 58% of total costs, personnel for 21%, cold chain for 18%, and transportation for 2%. Most EPI costs are incurred at the central level (62%). The major cost driver at the department and municipal levels is personnel costs. The ProVac CostVac Tool proved to be a comprehensive and useful tool that will allow researchers and health officials to estimate the actual cost for national immunization programs. The present analysis shows that personnel, cold chain, and transportation are important components of EPI and should be carefully estimated in the cost analysis, particularly when evaluating new vaccine introduction. Copyright © 2013 Elsevier Ltd. All rights reserved.

PRELIMINARY COST ESTIMATES OF POLLUTION CONTROL TECHNOLOGIES FOR GEOTHERMAL DEVELOPMENTS

EPA Science Inventory

This report provides preliminary cost estimates of air and water pollution control technologies for geothermal energy conversion facilities. Costs for solid waste disposal are also estimated. The technologies examined include those for control of hydrogen sulfide emissions and fo...

Estimated Costs of Sporadic Gastrointestinal Illness ...

EPA Pesticide Factsheets

BACKGROUND: The ·burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost. attributable disease burden estimates can be useful for environmental management decisions. OBJECTIVES: We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation. METHODS: Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI. RESULTS: Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$1,681) and $1,676 for swimming/wading (range $425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs. CONCLUSIONS: Our estimates suggest gastrointestinal illness attributed to surface water rec

Technology Estimating 2: A Process to Determine the Cost and Schedule of Space Technology Research and Development

NASA Technical Reports Server (NTRS)

Cole, Stuart K.; Wallace, Jon; Schaffer, Mark; May, M. Scott; Greenberg, Marc W.

2014-01-01

As a leader in space technology research and development, NASA is continuing in the development of the Technology Estimating process, initiated in 2012, for estimating the cost and schedule of low maturity technology research and development, where the Technology Readiness Level is less than TRL 6. NASA' s Technology Roadmap areas consist of 14 technology areas. The focus of this continuing Technology Estimating effort included four Technology Areas (TA): TA3 Space Power and Energy Storage, TA4 Robotics, TA8 Instruments, and TA12 Materials, to confine the research to the most abundant data pool. This research report continues the development of technology estimating efforts completed during 2013-2014, and addresses the refinement of parameters selected and recommended for use in the estimating process, where the parameters developed are applicable to Cost Estimating Relationships (CERs) used in the parametric cost estimating analysis. This research addresses the architecture for administration of the Technology Cost and Scheduling Estimating tool, the parameters suggested for computer software adjunct to any technology area, and the identification of gaps in the Technology Estimating process.

Cost estimating methods for advanced space systems

NASA Technical Reports Server (NTRS)

Cyr, Kelley

1994-01-01

NASA is responsible for developing much of the nation's future space technology. Cost estimates for new programs are required early in the planning process so that decisions can be made accurately. Because of the long lead times required to develop space hardware, the cost estimates are frequently required 10 to 15 years before the program delivers hardware. The system design in conceptual phases of a program is usually only vaguely defined and the technology used is so often state-of-the-art or beyond. These factors combine to make cost estimating for conceptual programs very challenging. This paper describes an effort to develop parametric cost estimating methods for space systems in the conceptual design phase. The approach is to identify variables that drive cost such as weight, quantity, development culture, design inheritance and time. The nature of the relationships between the driver variables and cost will be discussed. In particular, the relationship between weight and cost will be examined in detail. A theoretical model of cost will be developed and tested statistically against a historical database of major research and development projects.

The Effect of Infrastructure Sharing in Estimating Operations Cost of Future Space Transportation Systems

NASA Technical Reports Server (NTRS)

Sundaram, Meenakshi

2005-01-01

NASA and the aerospace industry are extremely serious about reducing the cost and improving the performance of launch vehicles both manned or unmanned. In the aerospace industry, sharing infrastructure for manufacturing more than one type spacecraft is becoming a trend to achieve economy of scale. An example is the Boeing Decatur facility where both Delta II and Delta IV launch vehicles are made. The author is not sure how Boeing estimates the costs of each spacecraft made in the same facility. Regardless of how a contractor estimates the cost, NASA in its popular cost estimating tool, NASA Air force Cost Modeling (NAFCOM) has to have a method built in to account for the effect of infrastructure sharing. Since there is no provision in the most recent version of NAFCOM2002 to take care of this, it has been found by the Engineering Cost Community at MSFC that the tool overestimates the manufacturing cost by as much as 30%. Therefore, the objective of this study is to develop a methodology to assess the impact of infrastructure sharing so that better operations cost estimates may be made.

Hospital costs by cost center of inpatient hospitalization for medicare patients undergoing major abdominal surgery.

PubMed

Stey, Anne M; Brook, Robert H; Needleman, Jack; Hall, Bruce L; Zingmond, David S; Lawson, Elise H; Ko, Clifford Y

2015-02-01

This study aims to describe the magnitude of hospital costs among patients undergoing elective colectomy, cholecystectomy, and pancreatectomy, determine whether these costs relate as expected to duration of care, patient case-mix severity and comorbidities, and whether risk-adjusted costs vary significantly by hospital. Correctly estimating the cost of production of surgical care may help decision makers design mechanisms to improve the efficiency of surgical care. Patient data from 202 hospitals in the ACS-NSQIP were linked to Medicare inpatient claims. Patient charges were mapped to cost center cost-to-charge ratios in the Medicare cost reports to estimate costs. The association of patient case-mix severity and comorbidities with cost was analyzed using mixed effects multivariate regression. Cost variation among hospitals was quantified by estimating risk-adjusted hospital cost ratios and 95% confidence intervals from the mixed effects multivariate regression. There were 21,923 patients from 202 hospitals who underwent an elective colectomy (n = 13,945), cholecystectomy (n = 5,569), or pancreatectomy (n = 2,409). Median cost was lowest for cholecystectomy ($15,651) and highest for pancreatectomy ($37,745). Room and board costs accounted for the largest proportion (49%) of costs and were correlated with length of stay, R = 0.89, p < 0.001. The patient case-mix severity and comorbidity variables most associated with cost were American Society of Anesthesiologists (ASA) class IV (estimate 1.72, 95% CI 1.57 to 1.87) and fully dependent functional status (estimate 1.63, 95% CI 1.53 to 1.74). After risk-adjustment, 66 hospitals had significantly lower costs than the average hospital and 57 hospitals had significantly higher costs. The hospital costs estimates appear to be consistent with clinical expectations of hospital resource use and differ significantly among 202 hospitals after risk-adjustment for preoperative patient characteristics and procedure type. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

78 FR 15379 - Agency Information Collection Activities; Submission to OMB for a New Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... form relates to a budget or estimate of the legal fees, costs, and expenses that outside counsel would... estimates of the average number of respondents, burden, and total annual cost appear below. The estimated... cost by multiplying its estimate of the number of respondents (100) by the burden (2 hours) and...

Estimating the social cost of respiratory cancer cases attributable to occupational exposures in France.

PubMed

Serrier, Hassan; Sultan-Taieb, Hélène; Luce, Danièle; Bejean, Sophie

2014-07-01

The objective of this article was to estimate the social cost of respiratory cancer cases attributable to occupational risk factors in France in 2010. According to the attributable fraction method and based on available epidemiological data from the literature, we estimated the number of respiratory cancer cases due to each identified risk factor. We used the cost-of-illness method with a prevalence-based approach. We took into account the direct and indirect costs. We estimated the cost of production losses due to morbidity (absenteeism and presenteeism) and mortality costs (years of production losses) in the market and nonmarket spheres. The social cost of lung, larynx, sinonasal and mesothelioma cancer caused by exposure to asbestos, chromium, diesel engine exhaust, paint, crystalline silica, wood and leather dust in France in 2010 were estimated at between 917 and 2,181 million euros. Between 795 and 2,011 million euros (87-92%) of total costs were due to lung cancer alone. Asbestos was by far the risk factor representing the greatest cost to French society in 2010 at between 531 and 1,538 million euros (58-71%), ahead of diesel engine exhaust, representing an estimated social cost of between 233 and 336 million euros, and crystalline silica (119-229 million euros). Indirect costs represented about 66% of total costs. Our assessment shows the magnitude of the economic impact of occupational respiratory cancers. It allows comparisons between countries and provides valuable information for policy-makers responsible for defining public health priorities.

Comparing NASA and ESA Cost Estimating Methods for Human Missions to Mars

NASA Technical Reports Server (NTRS)

Hunt, Charles D.; vanPelt, Michel O.

2004-01-01

To compare working methodologies between the cost engineering functions in NASA Marshall Space Flight Center (MSFC) and ESA European Space Research and Technology Centre (ESTEC), as well as to set-up cost engineering capabilities for future manned Mars projects and other studies which involve similar subsystem technologies in MSFC and ESTEC, a demonstration cost estimate exercise was organized. This exercise was a direct way of enhancing not only cooperation between agencies but also both agencies commitment to credible cost analyses. Cost engineers in MSFC and ESTEC independently prepared life-cycle cost estimates for a reference human Mars project and subsequently compared the results and estimate methods in detail. As a non-sensitive, public domain reference case for human Mars projects, the Mars Direct concept was chosen. In this paper the results of the exercise are shown; the differences and similarities in estimate methodologies, philosophies, and databases between MSFC and ESTEC, as well as the estimate results for the Mars Direct concept. The most significant differences are explained and possible estimate improvements identified. In addition, the Mars Direct plan and the extensive cost breakdown structure jointly set-up by MSFC and ESTEC for this concept are presented. It was found that NASA applied estimate models mainly based on historic Apollo and Space Shuttle cost data, taking into account the changes in technology since then. ESA used models mostly based on European satellite and launcher cost data, taking into account the higher equipment and testing standards for human space flight. Most of NASA's and ESA s estimates for the Mars Direct case are comparable, but there are some important, consistent differences in the estimates for: 1) Large Structures and Thermal Control subsystems; 2) System Level Management, Engineering, Product Assurance and Assembly, Integration and Test/Verification activities; 3) Mission Control; 4) Space Agency Program Level activities.

Cost of unintended pregnancy in Norway: a role for long-acting reversible contraception

PubMed Central

Henry, Nathaniel; Schlueter, Max; Lowin, Julia; Lekander, Ingrid; Filonenko, Anna; Trussell, James; Skjeldestad, Finn Egil

2015-01-01

Objectives The objective of this study was to quantify the cost burden of unintended pregnancies (UPs) in Norway, and to estimate the proportion of costs due to imperfect contraceptive adherence. Potential cost savings that could arise from increased uptake of long-acting reversible contraception (LARC) were also investigated. Methods An economic model was constructed to estimate the total number of UPs and associated costs in women aged 15–24 years. Adherence-related UP was estimated using ‘perfect use’ and ‘typical use’ contraceptive failure rates. Potential savings from increased use of LARC were projected by comparing current costs to projected costs following a 5% increase in LARC uptake. Results Total costs from UP in women aged 15–24 years were estimated to be 164 million Norwegian Kroner (NOK), of which 81.7% were projected to be due to imperfect contraceptive adherence. A 5% increase in LARC uptake was estimated to generate cost savings of NOK 7.2 million in this group. Conclusions The cost of UP in Norway is substantial, with a large proportion of this cost arising from imperfect contraceptive adherence. Increased LARC uptake may reduce the UP incidence and generate cost savings for both the health care payer and contraceptive user. PMID:25537792

Social Costs of Gambling in the Czech Republic 2012.

PubMed

Winkler, Petr; Bejdová, Markéta; Csémy, Ladislav; Weissová, Aneta

2017-12-01

Evidence about social costs of gambling is scarce and the methodology for their calculation has been a subject to strong criticism. We aimed to estimate social costs of gambling in the Czech Republic 2012. This retrospective, prevalence based cost of illness study builds on the revised methodology of Australian Productivity Commission. Social costs of gambling were estimated by combining epidemiological and economic data. Prevalence data on negative consequences of gambling were taken from existing national epidemiological studies. Economic data were taken from various national and international sources. Consequences of problem and pathological gambling only were taken into account. In 2012, the social costs of gambling in the Czech Republic were estimated to range between 541,619 and 619,608 thousands EUR. While personal and family costs accounted for 63% of all social costs, direct medical costs were estimated to range from 0.25 to 0.28% of all social costs only. This is the first study which estimates social costs of gambling in any of the Central and East European countries. It builds upon the solid evidence about prevalence of gambling related problems in the Czech Republic and satisfactorily reliable economic data. However, there is a number of limitations stemming from assumptions that were made, which suggest that the methodology for the calculation of the social costs of gambling needs further development.

Cost savings through implementation of an integrated home-based record: a case study in Vietnam.

PubMed

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

2018-03-01

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

The economic burden of cancer care in Canada: a population-based cost study

PubMed Central

de Oliveira, Claire; Weir, Sharada; Rangrej, Jagadish; Krahn, Murray D.; Mittmann, Nicole; Hoch, Jeffrey S.; Chan, Kelvin K.W.; Peacock, Stuart

2018-01-01

Background: Resource and cost issues are a growing concern in health care. Thus, it is important to have an accurate estimate of the economic burden of care. Previous work has estimated the economic burden of cancer care for Canada; however, there is some concern this estimate is too low. The objective of this analysis was to provide a comprehensive revised estimate of this burden. Methods: We used a case-control prevalence-based approach to estimate direct annual cancer costs from 2005 to 2012. We used patient-level administrative health care data from Ontario to correctly attribute health care costs to cancer. We employed the net cost method (cost difference between patients with cancer and control subjects without cancer) to account for costs directly and indirectly related to cancer and its sequelae. Using average patient-level cost estimates from Ontario, we applied proportions from national health expenditures data to obtain the economic burden of cancer care for Canada. All costs were adjusted to 2015 Canadian dollars. Results: Costs of cancer care rose steadily over our analysis period, from $2.9 billion in 2005 to $7.5 billion in 2012, mostly owing to the increase in costs of hospital-based care. Most expenditures for health care services increased over time, with chemotherapy and radiation therapy expenditures accounting for the largest increases over the study period. Our cost estimates were larger than those in the Economic Burden of Illness in Canada 2005-2008 report for every year except 2005 and 2006. Interpretation: The economic burden of cancer care in Canada is substantial. Further research is needed to understand how the economic burden of cancer compares to that of other diseases. PMID:29301745

Treatment Costs of Breast Cancer Among Younger Women Aged 19-44 Years Enrolled in Medicaid.

PubMed

Ekwueme, Donatus U; Allaire, Benjamin T; Guy, Gery P; Arnold, Sarah; Trogdon, Justin G

2016-02-01

A few studies have examined the costs of breast cancer treatment in a Medicaid population at the state level. However, no study has estimated medical costs for breast cancer treatment at the national level for women aged 19-44 years enrolled in Medicaid. A sample of 5,542 younger women aged 19-44 years enrolled in fee-for-service Medicaid with diagnosis codes for breast cancer in 2007 were compared with 4.3 million women aged 19-44 years enrolled in fee-for-service Medicaid without breast cancer. Nonlinear regression methods estimated prevalent treatment costs for younger women with breast cancer compared with those without breast cancer. Individual medical costs were estimated by race/ethnicity and by type of services. Analyses were conducted in 2013 and all medical treatment costs were adjusted to 2012 U.S. dollars. The estimated monthly direct medical costs for breast cancer treatment among younger women enrolled in Medicaid was $5,711 (95% CI=$5,039, $6,383) per woman. The estimated monthly cost for outpatient services was $4,058 (95% CI=$3,575, $4,541), for inpatient services was $1,003 (95% CI=$708, $1,298), and for prescription drugs was $539 (95% CI=$431, $647). By race/ethnicity, non-Hispanic white women had the highest monthly total medical costs, followed by Hispanic women and non-Hispanic women of other race. Cost estimates demonstrate the substantial medical costs associated with breast cancer treatment for younger Medicaid beneficiaries. As the Medicaid program continues to evolve, the treatment cost estimates could serve as important inputs in decision making regarding planning for treatment of invasive breast cancer in this population. Published by Elsevier Inc.

The social costs of dangerous products: an empirical investigation.

PubMed

Shapiro, Sidney; Ruttenberg, Ruth; Leigh, Paul

2009-01-01

Defective consumer products impose significant costs on consumers and third parties when they cause fatalities and injuries. This Article develops a novel approach to measuring the true extent of such costs, which may not be accurately captured under current methods of estimating the cost of dangerous products. Current analysis rests on a narrowly defined set of costs, excluding certain types of costs. The cost-of-injury estimates utilized in this Article address this omission by quantifying and incorporating these costs to provide a more complete picture of the true impact of defective consumer products. The new estimates help to gauge the true value of the civil liability system.

Comparing Methods for Estimating Direct Costs of Adverse Drug Events.

PubMed

Gyllensten, Hanna; Jönsson, Anna K; Hakkarainen, Katja M; Svensson, Staffan; Hägg, Staffan; Rehnberg, Clas

2017-12-01

To estimate how direct health care costs resulting from adverse drug events (ADEs) and cost distribution are affected by methodological decisions regarding identification of ADEs, assigning relevant resource use to ADEs, and estimating costs for the assigned resources. ADEs were identified from medical records and diagnostic codes for a random sample of 4970 Swedish adults during a 3-month study period in 2008 and were assessed for causality. Results were compared for five cost evaluation methods, including different methods for identifying ADEs, assigning resource use to ADEs, and for estimating costs for the assigned resources (resource use method, proportion of registered cost method, unit cost method, diagnostic code method, and main diagnosis method). Different levels of causality for ADEs and ADEs' contribution to health care resource use were considered. Using the five methods, the maximum estimated overall direct health care costs resulting from ADEs ranged from Sk10,000 (Sk = Swedish krona; ~€1,500 in 2016 values) using the diagnostic code method to more than Sk3,000,000 (~€414,000) using the unit cost method in our study population. The most conservative definitions for ADEs' contribution to health care resource use and the causality of ADEs resulted in average costs per patient ranging from Sk0 using the diagnostic code method to Sk4066 (~€500) using the unit cost method. The estimated costs resulting from ADEs varied considerably depending on the methodological choices. The results indicate that costs for ADEs need to be identified through medical record review and by using detailed unit cost data. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A Methodology for Developing Army Acquisition Strategies for an Uncertain Future

DTIC Science & Technology

2007-01-01

manuscript for publication. Acronyms ABP Assumption-Based Planning ACEIT Automated Cost Estimating Integrated Tool ACR Armored Cavalry Regiment ACTD...decisions. For example, they employ the Automated Cost Estimating Integrated Tools ( ACEIT ) to simplify life cycle cost estimates; other tools are

Estimating the costs of human space exploration

NASA Technical Reports Server (NTRS)

Mandell, Humboldt C., Jr.

1994-01-01

The plan for NASA's new exploration initiative has the following strategic themes: (1) incremental, logical evolutionary development; (2) economic viability; and (3) excellence in management. The cost estimation process is involved with all of these themes and they are completely dependent upon the engineering cost estimator for success. The purpose is to articulate the issues associated with beginning this major new government initiative, to show how NASA intends to resolve them, and finally to demonstrate the vital importance of a leadership role by the cost estimation community.

What Would It Cost to Coach Every New Principal? An Estimate Using Statewide Personnel Data

ERIC Educational Resources Information Center

Lochmiller, Chad R.

2014-01-01

In this paper, I use Levin and McEwan's (2001) cost feasibility approach and personnel data obtained from the Superintendent of Public Instruction to estimate the cost of providing coaching support to every newly hired principal in Washington State. Based on this descriptive analysis, I estimate that the cost to provide leadership coaching to…

New cost estimates for carbon sequestration through afforestation in the United States

Treesearch

Anne Sofie Elburg Nielsen; Andrew J. Plantinga; Ralph J. Alig

2014-01-01

This report provides new cost estimates for carbon sequestration through afforestation in the United States. We extend existing studies of carbon sequestration costs in several important ways, while ensuring the transparency of our approach. We clearly identify all components of our cost estimates so that other researchers can reconstruct our results as well as use our...

Cost estimators for construction of forest roads in the central Appalachians

Treesearch

Deborah, A. Layton; Chris O. LeDoux; Curt C. Hassler; Curt C. Hassler

1992-01-01

Regression equations were developed for estimating the total cost of road construction in the central Appalachian region. Estimators include methods for predicting total costs for roads constructed using hourly rental methods and roads built on a total-job bid basis. Results show that total-job bid roads cost up to five times as much as roads built than when equipment...

Economic Burden of Occupational Injury and Illness in the United States

PubMed Central

Leigh, J Paul

2011-01-01

Context The allocation of scarce health care resources requires a knowledge of disease costs. Whereas many studies of a variety of diseases are available, few focus on job-related injuries and illnesses. This article provides estimates of the national costs of occupational injury and illness among civilians in the United States for 2007. Methods This study provides estimates of both the incidence of fatal and nonfatal injuries and nonfatal illnesses and the prevalence of fatal diseases as well as both medical and indirect (productivity) costs. To generate the estimates, I combined primary and secondary data sources with parameters from the literature and model assumptions. My primary sources were injury, disease, employment, and inflation data from the U.S. Bureau of Labor Statistics (BLS) and the Centers for Disease Control and Prevention (CDC) as well as costs data from the National Council on Compensation Insurance and the Healthcare Cost and Utilization Project. My secondary sources were the National Academy of Social Insurance, literature estimates of Attributable Fractions (AF) of diseases with occupational components, and national estimates for all health care costs. Critical model assumptions were applied to the underreporting of injuries, wage-replacement rates, and AFs. Total costs were calculated by multiplying the number of cases by the average cost per case. A sensitivity analysis tested for the effects of the most consequential assumptions. Numerous improvements over earlier studies included reliance on BLS data for government workers and ten specific cancer sites rather than only one broad cancer category. Findings The number of fatal and nonfatal injuries in 2007 was estimated to be more than 5,600 and almost 8,559,000, respectively, at a cost of $6 billion and $186 billion. The number of fatal and nonfatal illnesses was estimated at more than 53,000 and nearly 427,000, respectively, with cost estimates of $46 billion and $12 billion. For injuries and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. Conclusions The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers’ compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed. PMID:22188353

Cost estimation using ministerial regulation of public work no. 11/2013 in construction projects

NASA Astrophysics Data System (ADS)

Arumsari, Putri; Juliastuti; Khalifah Al'farisi, Muhammad

2017-12-01

One of the first tasks in starting a construction project is to estimate the total cost of building a project. In Indonesia there are several standards that are used to calculate the cost estimation of a project. One of the standards used in based on the Ministerial Regulation of Public Work No. 11/2013. However in a construction project, contractor often has their own cost estimation based on their own calculation. This research aimed to compare the construction project total cost using calculation based on the Ministerial Regulation of Public Work No. 11/2013 against the contractor’s calculation. Two projects were used as case study to compare the results. The projects were a 4 storey building located in Pantai Indah Kapuk area (West Jakarta) and a warehouse located in Sentul (West Java) which was built by 2 different contractors. The cost estimation from both contractors’ calculation were compared to the one based on the Ministerial Regulation of Public Work No. 11/2013. It is found that there were differences between the two calculation around 1.80 % - 3.03% in total cost, in which the cost estimation based on Ministerial Regulation was higher than the contractors’ calculations.

A U.K. cost-benefit analysis of circles of support and accountability interventions.

PubMed

Elliott, Ian A; Beech, Anthony R

2013-06-01

Circles of Support and Accountability (CoSA) aim to augment sex offender risk management at the point of community reentry by facilitating "Circles" of volunteers who provide support, guidance, and advice, while ensuring that the offender remains accountable for their actions. In this study, the authors provide (a) a rapid evidence assessment of the effectiveness of CoSA in reducing reoffending, and (b) a U.K. cost-benefit analysis for CoSA when compared to the criminal justice costs of reoffending. From the study analysis, the average cost of a "Circle" was estimated to be £11,303 per annum and appears to produce a 50% reduction in reoffending (sexual and nonsexual), as the estimated cost of reoffending was estimated to be £147,161 per offender, per annum. Based on a hypothetical cohort of 100 offenders--50 of whom receive CoSA and 50 of whom do not--investment in CoSA appears to provide a cost saving of £23,494 and a benefit-cost ratio of 1.04. Accounting for estimates that the full extent of the cost to society may be 5 to 10 times the tangible costs substantially increases estimated cost savings related to CoSA.

Latest NASA Instrument Cost Model (NICM): Version VI

NASA Technical Reports Server (NTRS)

Mrozinski, Joe; Habib-Agahi, Hamid; Fox, George; Ball, Gary

2014-01-01

The NASA Instrument Cost Model, NICM, is a suite of tools which allow for probabilistic cost estimation of NASA's space-flight instruments at both the system and subsystem level. NICM also includes the ability to perform cost by analogy as well as joint confidence level (JCL) analysis. The latest version of NICM, Version VI, was released in Spring 2014. This paper will focus on the new features released with NICM VI, which include: 1) The NICM-E cost estimating relationship, which is applicable for instruments flying on Explorer-like class missions; 2) The new cluster analysis ability which, alongside the results of the parametric cost estimation for the user's instrument, also provides a visualization of the user's instrument's similarity to previously flown instruments; and 3) includes new cost estimating relationships for in-situ instruments.

Reducing Contingency through Sampling at the Luckey FUSRAP Site - 13186

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

Frothingham, David; Barker, Michelle; Buechi, Steve

2013-07-01

Typically, the greatest risk in developing accurate cost estimates for the remediation of hazardous, toxic, and radioactive waste sites is the uncertainty in the estimated volume of contaminated media requiring remediation. Efforts to address this risk in the remediation cost estimate can result in large cost contingencies that are often considered unacceptable when budgeting for site cleanups. Such was the case for the Luckey Formerly Utilized Sites Remedial Action Program (FUSRAP) site near Luckey, Ohio, which had significant uncertainty surrounding the estimated volume of site soils contaminated with radium, uranium, thorium, beryllium, and lead. Funding provided by the American Recoverymore » and Reinvestment Act (ARRA) allowed the U.S. Army Corps of Engineers (USACE) to conduct additional environmental sampling and analysis at the Luckey Site between November 2009 and April 2010, with the objective to further delineate the horizontal and vertical extent of contaminated soils in order to reduce the uncertainty in the soil volume estimate. Investigative work included radiological, geophysical, and topographic field surveys, subsurface borings, and soil sampling. Results from the investigative sampling were used in conjunction with Argonne National Laboratory's Bayesian Approaches for Adaptive Spatial Sampling (BAASS) software to update the contaminated soil volume estimate for the site. This updated volume estimate was then used to update the project cost-to-complete estimate using the USACE Cost and Schedule Risk Analysis process, which develops cost contingencies based on project risks. An investment of $1.1 M of ARRA funds for additional investigative work resulted in a reduction of 135,000 in-situ cubic meters (177,000 in-situ cubic yards) in the estimated base volume estimate. This refinement of the estimated soil volume resulted in a $64.3 M reduction in the estimated project cost-to-complete, through a reduction in the uncertainty in the contaminated soil volume estimate and the associated contingency costs. (authors)« less

Production cost analysis of Euphorbia lathyris. Final report

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

Mendel, D.A.; Schooley, F.A.; Dickenson, R.L.

1979-08-01

The purpose of SRI's study was to estimate the costs of producing Euphorbia in commercial quantities in five regions of the United States, which include both irrigated and nonirrigated areas. The study assumed that a uniform crop yield could be achieved in the five regions by varying the quantities of production inputs. Therefore, the production costs estimates, which are based on fourth quarter 1978 dollars, include both fixed and variable costs for each region. Doane's Machinery Custom Rates for 1978 were used to estimate all variable costs except materials, which were estimated separately. Custom rates are determined by members ofmore » the Doane Countywide Farm Panel, a group of farmers specifically selected to represent the various sizes and types of commercial farms found throughout the country. The rates reported are the most recent rates the panel members had either paid, charged, or known for certain a second party had paid or charged. Custom rates for any particular operation include equipment operating costs (fuel, lubrication, and repairs), equipment ownership costs (depreciation, taxes, interest), as well as a labor charge for the operator. Custom rates are regionally specific and thereby assist the accuracy of this analysis. Fixed costs include land, management, and transportation of the plant material to a conversion facility. When appropriate, fixed costs were regionally specific. Changes in total production costs over future time periods were not addressed. The total estimated production costs of Euphorbia in each region were compared with production costs for corn and alfalfa in the same regions. Finally, the effects on yield and costs of changes in the production inputs were estimated.« less

Social Cost of Substance Abuse in Russia.

PubMed

Potapchik, Elena; Popovich, Larisa

2014-09-01

To summarize results of studies that estimate the social costs of alcohol, tobacco, and illicit drug abuse in Russia. The purpose of these studies was to inform policymakers about the real economic burden of risky behaviors and to provide conditions for evidence-based and well-informed decision making in this area. The cost-of-illness method was applied to estimate the social cost of substance abuse. The intangible cost was not included in estimation. A prevalence-based approach was applied to estimate the tangible cost. For the estimation of direct costs, a top-down method was used. Indirect costs were estimated using two methods: the human capital and the friction cost. In 2008, the social cost of substance abuse in Russia comprised 677.2 billion rubles if the friction cost method is applied and 1965.9 billion rubles if the human capital method is used. The social cost of substance abuse is defined to the greatest extent by alcohol consumption, comprising about 45% of the economic burden. Illicit drug use comprises about 30% of the economic burden and tobacco consumption 25%. The results of economic studies demonstrated that psychoactive substances impose a considerable economic burden on society. Analysis of the substance abuse social cost pattern shows that the main losses that society bears because of these behavioral risk factors fall outside the health care system and lay in other sectors of the economy such as social care, law enforcement, and productivity losses. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2016-01-01

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

Cost of chronic disease in California: estimates at the county level.

PubMed

Brown, Paul M; Gonzalez, Mariaelena; Dhaul, Ritem Sandhu

2015-01-01

An estimated 39% of people in California suffer from at least one chronic condition or disease. While the increased coverage provided by the Affordable Care Act will result in greater access to primary health care, coordinated strategies are needed to prevent chronic conditions. To identify cost-effective strategies, local health departments and other agencies need accurate information on the costs of chronic conditions in their region. To present a methodology for estimating the cost of chronic conditions for counties. Estimates of the attributable cost of 6 chronic conditions-arthritis, asthma, cancer, cardiovascular disease, diabetes, and depression-from the Centers for Disease Control and Prevention's Chronic Disease Cost Calculator were combined with prevalence rates from the various sources and census data for California counties to estimate the number of cases and costs of each condition. The estimates were adjusted for differences in prices using Medicare geographical adjusters. An estimated $98 billion is currently spent on treating chronic conditions in California. There is significant variation between counties in the percentage of total health care expenditure due to chronic conditions and county size, ranging from a low 32% to a high of 63%. The variations between counties result from differing rates of chronic conditions across age, ethnicity, and gender. Information on the cost of chronic conditions is important for planning prevention and control efforts. This study demonstrates a method for providing local health departments with estimates of the scope of the problems in their region. Combining the cost estimates with information on current prevention strategies can identify gaps in prevention activities and the prevention measures that promise the greatest return on investment for each county.

The direct and indirect costs of managing chronic obstructive pulmonary disease in Greece.

PubMed

Souliotis, Kyriakos; Kousoulakou, Hara; Hillas, Georgios; Tzanakis, Nikos; Toumbis, Michalis; Vassilakopoulos, Theodoros

2017-01-01

COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece. A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs). In addition, absenteeism and caregiver's costs were recorded in order to quantify indirect COPD costs. The total costs of managing COPD per patient per year were estimated at €4,730, with direct (medical and nonmedical) and indirect costs accounting for 62.5% and 37.5%, respectively. COPD exacerbations were responsible for 32% of total costs (€1,512). Key exacerbation-related cost drivers were hospitalization (€830) and intensive care unit (ICU) admission costs (€454), jointly accounting for 85% of total exacerbation costs. Annual maintenance phase costs were estimated at €835, with pharmaceutical treatment accounting for 77% (€639.9). Patient time costs were estimated at €146 per year. The average number of sick days per year was estimated at 16.9, resulting in productivity losses of €968. Caregiver's costs were estimated at €806 per year. The management of COPD in Greece is associated with intensive resource use and significant economic burden. Exacerbations and productivity losses are the key cost drivers. Cost containment policies should focus on prioritizing treatments that increase patient compliance as these can lead to reduction of exacerbations, longer maintenance phases, and thus lower costs.

Space tug economic analysis study. Volume 3: Cost estimates

NASA Technical Reports Server (NTRS)

1972-01-01

Cost estimates for the space tug operation are presented. The subjects discussed are: (1) research and development costs, (2) investment costs, (3) operations costs, and (4) funding requirements. The emphasis is placed on the single stage tug configuration using various types of liquid propellants.

Predicting Costs of Eastern National Forest Wildernesses.

ERIC Educational Resources Information Center

Guldin, Richard W.

1981-01-01

A method for estimating the total direct social costs for proposed wilderness areas is presented. A cost framework is constructed and equations are developed for cost components. To illustrate the study's method, social costs are estimated for a proposed wilderness area in New England. (Author/JN)

Cost and cost-effectiveness of nationwide school-based helminth control in Uganda

PubMed Central

BROOKER, SIMON; KABATEREINE, NARCIS B; FLEMING, FIONA; DEVLIN, NANCY

2009-01-01

Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with districts officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated and an incremental cost effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$ 0.54 and the cost-effectiveness was US$ 3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children which received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$ 0.41-0.91) and cost per anaemia case averted (US$ 1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. PMID:18024966

KSC Construction Cost Index

NASA Technical Reports Server (NTRS)

Brown, J. A.

1983-01-01

Kennedy Space Center cost Index aids in conceptual design cost estimates. Report discusses development of KSC Cost Index since January 1974. Index since January 1974. Index provides management, design engineers, and estimators an up-to-data reference for local labor and material process. Also provides mount and rate of change in these costs used to predict future construction costs.

Manual of phosphoric acid fuel cell power plant cost model and computer program

NASA Technical Reports Server (NTRS)

Lu, C. Y.; Alkasab, K. A.

1984-01-01

Cost analysis of phosphoric acid fuel cell power plant includes two parts: a method for estimation of system capital costs, and an economic analysis which determines the levelized annual cost of operating the system used in the capital cost estimation. A FORTRAN computer has been developed for this cost analysis.

An evaluation of contractor projected and actual costs

NASA Technical Reports Server (NTRS)

Kwiatkowski, K. A.; Buffalano, C.

1974-01-01

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

Actual and estimated costs of disposable materials used during surgical procedures.

PubMed

Toyabe, Shin-Ichi; Cao, Pengyu; Kurashima, Sachiko; Nakayama, Yukiko; Ishii, Yuko; Hosoyama, Noriko; Akazawa, Kouhei

2005-07-01

It is difficult to estimate precisely the costs of disposable materials used during surgical operations. To evaluate the actual costs of disposable materials, we calculated the actual costs of disposable materials used in 59 operations by taking account of costs of all disposable materials used for each operation. The costs of the disposable materials varied significantly from operation to operation (US$ 38-4230 per operation), and the median [25-percentile and 75-percentile] of the sum total of disposable material costs of a single operation was found to be US$ 686 [205 and 993]. Multiple regression analysis with a stepwise regression method showed that costs of disposable materials significantly correlated only with operation time (p<0.001). Based on the results, we propose a simple method for estimating costs of disposable materials by measuring operation time, and we found that the method gives reliable results. Since costs of disposable materials used during surgical operations are considerable, precise estimation of the costs is essential for hospital cost accounting. Our method should be useful for planning hospital administration strategies.

The Role of Inflation and Price Escalation Adjustments in Properly Estimating Program Costs: F-35 Case Study

DTIC Science & Technology

2016-04-30

costs of new defense systems. An inappropriate price index can introduce errors in both development of cost estimating relationships ( CERs ) and in...indexes derived from CERs . These indexes isolate changes in price due to factors other than changes in quality over time. We develop a “Baseline” CER ...The hedonic index application has commonalities with cost estimating relationships ( CERs ), which also model system costs as a function of quality

Selected Tether Applications Cost Model

NASA Technical Reports Server (NTRS)

Keeley, Michael G.

1988-01-01

Diverse cost-estimating techniques and data combined into single program. Selected Tether Applications Cost Model (STACOM 1.0) is interactive accounting software tool providing means for combining several independent cost-estimating programs into fully-integrated mathematical model capable of assessing costs, analyzing benefits, providing file-handling utilities, and putting out information in text and graphical forms to screen, printer, or plotter. Program based on Lotus 1-2-3, version 2.0. Developed to provide clear, concise traceability and visibility into methodology and rationale for estimating costs and benefits of operations of Space Station tether deployer system.

Cost-Effectiveness of Routine Screening for Critical Congenital Heart Disease in US Newborns

PubMed Central

Peterson, Cora; Grosse, Scott D.; Oster, Matthew E.; Olney, Richard S.; Cassell, Cynthia H.

2015-01-01

OBJECTIVES Clinical evidence indicates newborn critical congenital heart disease (CCHD) screening through pulse oximetry is lifesaving. In 2011, CCHD was added to the US Recommended Uniform Screening Panel for newborns. Several states have implemented or are considering screening mandates. This study aimed to estimate the cost-effectiveness of routine screening among US newborns unsuspected of having CCHD. METHODS We developed a cohort model with a time horizon of infancy to estimate the inpatient medical costs and health benefits of CCHD screening. Model inputs were derived from new estimates of hospital screening costs and inpatient care for infants with late-detected CCHD, defined as no diagnosis at the birth hospital. We estimated the number of newborns with CCHD detected at birth hospitals and life-years saved with routine screening compared with no screening. RESULTS Screening was estimated to incur an additional cost of $6.28 per newborn, with incremental costs of $20 862 per newborn with CCHD detected at birth hospitals and $40 385 per life-year gained (2011 US dollars). We estimated 1189 more newborns with CCHD would be identified at birth hospitals and 20 infant deaths averted annually with screening. Another 1975 false-positive results not associated with CCHD were estimated to occur, although these results had a minimal impact on total estimated costs. CONCLUSIONS This study provides the first US cost-effectiveness analysis of CCHD screening in the United States could be reasonably cost-effective. We anticipate data from states that have recently approved or initiated CCHD screening will become available over the next few years to refine these projections. PMID:23918890

A Comparison of Ambulatory Surgery Center Production Costs and Medicare Payments: Evidence on Colonoscopy and Endoscopy.

PubMed

Mitchell, Jean M; Carey, Kathleen

2016-02-01

Ambulatory surgery centers (ASCs) are freestanding facilities that specialize in surgical and diagnostic procedures that do not require an overnight stay. While it is generally assumed that ASCs are less costly than hospital outpatient surgery departments, there is sparse empirical evidence regarding their relative production costs. To estimate ASC production costs using financial and claims records for procedures performed by surgery centers that specialize in gastroenterology procedures (colonoscopy and endoscopy). We estimate production costs in ASCs that specialize in gastroenterology procedures using financial cost and patient discharge data from Pennsylvania for the time period 2004-2013. We focus on the 2 primary procedures (colonoscopies and endoscopies) performed at each ASC. We use our estimates to predict average costs for each procedure and then compare predicted costs to Medicare ACS payments for these procedures. Comparisons of the costs of each procedure with 2013 national Medicare ASC payment rates suggest that Medicare payments exceed production costs for both colonoscopy and endoscopy. This study demonstrated that it is feasible to estimate production costs for procedures performed in freestanding surgery centers. The procedure-specific cost estimates can then be compared with ASC payment rates to ascertain if payments are aligned with costs. This approach can serve as an evaluation template for CMS and private insurers who are concerned that ASC facility payments for specific procedures may be excessive.

Proceedings of Symposium on Cost Estimating for Water Supply Planning Studies Held at Tampa, Florida on 14-16 March 1983.

DTIC Science & Technology

1983-09-01

Science, Art, or Witchcraft ?" which summarizes the state of the art and describes some important issues in planning level estimates in water resources...REPORT: AD#: P1o 902 TITLE:Panning Level Cost Estimating--Science, Art, or Witchcraft . P01 903 Planning Water Supply Projects: The Systems Estimate...OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 PLANNING LEVEL COST ESTIMATING--SCIENCE, ART, OR WITCHCRAFT by * PLANNING WATER

Mars Rover/Sample Return - Phase A cost estimation

NASA Technical Reports Server (NTRS)

Stancati, Michael L.; Spadoni, Daniel J.

1990-01-01

This paper presents a preliminary cost estimate for the design and development of the Mars Rover/Sample Return (MRSR) mission. The estimate was generated using a modeling tool specifically built to provide useful cost estimates from design parameters of the type and fidelity usually available during early phases of mission design. The model approach and its application to MRSR are described.

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

ERIC Educational Resources Information Center

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

2009-01-01

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

Estimation of the cost of using chemical protective clothing

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

Schwope, A.D.; Renard, E.R.

1993-01-01

The U.S. Environmental Protection Agency, either directly or through its Superfund contractors, is a major user of chemical protective clothing. The purpose of the study was to develop estimates for the cost of using this clothing. These estimates can be used to guide purchase decisions and use practices. For example, economic guidelines would assist in decisions pertinent to single-use versus reusable clothing. Eight cost elements were considered: (1) purchase cost, (2) the number of times an item is used, (3) the number of items used per day, (4) cost of decontamination, (5) cost of inspection, (6) cost of maintenance, (7)more » cost of storage, and (8) cost of disposal. Estimates or assumed inputs for each of these elements were developed based on labor costs, fixed costs, and recurring costs. The cost elements were combined into an economic (mathematical) model having the single output of cost/use. By comparing cost/use for various use scenarios, conclusions are readily reached as to the optimum economics for purchase, use, and reuse of the clothing. In general, clothing should be considered disposable if its purchase cost is less than its average cost/use per use for the anticipated number of times it will be reused.« less

Cost and Cost-Effectiveness Assessments of Newborn Screening for Critical Congenital Heart Disease Using Pulse Oximetry: A Review.

PubMed

Grosse, Scott D; Peterson, Cora; Abouk, Rahi; Glidewell, Jill; Oster, Matthew E

2017-01-01

Screening newborns for critical congenital heart disease (CCHD) using pulse oximetry is recommended to allow for the prompt diagnosis and prevention of life-threatening crises. The present review summarizes and critiques six previously published estimates of the costs or cost-effectiveness of CCHD screening from the United Kingdom, United States, and China. Several elements that affect CCHD screening costs were assessed in varying numbers of studies, including screening staff time, instrumentation, and consumables, as well as costs of diagnosis and treatment. A previous US study that used conservative assumptions suggested that CCHD screening is likely to be considered cost-effective from the healthcare sector perspective. Newly available estimates of avoided infant CCHD deaths in several US states that implemented mandatory CCHD screening policies during 2011-2013 suggest a substantially larger reduction in deaths than was projected in the previous US cost-effectiveness analysis. Taking into account these new estimates, we estimate that cost per life-year gained could be as low as USD 12,000. However, that estimate does not take into account future costs of health care and education for surviving children with CCHD nor the costs incurred by health departments to support and monitor CCHD screening policies and programs.

Cost and Cost-Effectiveness Assessments of Newborn Screening for Critical Congenital Heart Disease Using Pulse Oximetry: A Review

PubMed Central

Grosse, Scott D.; Peterson, Cora; Abouk, Rahi; Glidewell, Jill; Oster, Matthew E.

2018-01-01

Screening newborns for critical congenital heart disease (CCHD) using pulse oximetry is recommended to allow for the prompt diagnosis and prevention of life-threatening crises. The present review summarizes and critiques six previously published estimates of the costs or cost-effectiveness of CCHD screening from the United Kingdom, United States, and China. Several elements that affect CCHD screening costs were assessed in varying numbers of studies, including screening staff time, instrumentation, and consumables, as well as costs of diagnosis and treatment. A previous US study that used conservative assumptions suggested that CCHD screening is likely to be considered cost-effective from the healthcare sector perspective. Newly available estimates of avoided infant CCHD deaths in several US states that implemented mandatory CCHD screening policies during 2011–2013 suggest a substantially larger reduction in deaths than was projected in the previous US cost-effectiveness analysis. Taking into account these new estimates, we estimate that cost per life-year gained could be as low as USD 12,000. However, that estimate does not take into account future costs of health care and education for surviving children with CCHD nor the costs incurred by health departments to support and monitor CCHD screening policies and programs. PMID:29376140

The costs of turnover in nursing homes

PubMed Central

Mukamel, Dana B.; Spector, William D.; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

2009-01-01

Background Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. Objectives To estimate the net costs associated with turnover of direct care staff in nursing homes. Data and sample 902 nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set (MDS), Medicare enrollment files, Census and Area Resource File (ARF). Research Design We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable (IV) limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. Results The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The IV estimate of turnover costs was negative and significant (p=0.039). The marginal cost savings associated with a 10 percentage point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. Conclusion The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs. PMID:19648834

The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study

PubMed Central

2012-01-01

Background Health inequalities have been extensively documented, internationally and in New Zealand. The cost of reducing health inequities is often perceived as high; however, recent international studies suggest the cost of “doing nothing” is itself significant. This study aimed to develop a preliminary estimate of the economic cost of health inequities between Māori (indigenous) and non-Māori children in New Zealand. Methods Standard quantitative epidemiological methods and “cost of illness” methodology were employed, within a Kaupapa Māori theoretical framework. Data were obtained from national data collections held by the New Zealand Health Information Service and other health sector agencies. Results Preliminary estimates suggest child health inequities between Māori and non-Māori in New Zealand are cost-saving to the health sector. However the societal costs are significant. A conservative “base case” scenario estimate is over $NZ62 million per year, while alternative costing methods yield larger costs of nearly $NZ200 million per annum. The total cost estimate is highly sensitive to the costing method used and Value of Statistical Life applied, as the cost of potentially avoidable deaths of Māori children is the major contributor to this estimate. Conclusions This preliminary study suggests that health sector spending is skewed towards non-Māori children despite evidence of greater Māori need. Persistent child health inequities result in significant societal economic costs. Eliminating child health inequities, particularly in primary care access, could result in significant economic benefits for New Zealand. However, there are conceptual, ethical and methodological challenges in estimating the economic cost of child health inequities. Re-thinking of traditional economic frameworks and development of more appropriate methodologies is required. PMID:22640030

The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study.

PubMed

Mills, Clair; Reid, Papaarangi; Vaithianathan, Rhema

2012-05-28

Health inequalities have been extensively documented, internationally and in New Zealand. The cost of reducing health inequities is often perceived as high; however, recent international studies suggest the cost of "doing nothing" is itself significant. This study aimed to develop a preliminary estimate of the economic cost of health inequities between Māori (indigenous) and non-Māori children in New Zealand. Standard quantitative epidemiological methods and "cost of illness" methodology were employed, within a Kaupapa Māori theoretical framework. Data were obtained from national data collections held by the New Zealand Health Information Service and other health sector agencies. Preliminary estimates suggest child health inequities between Māori and non-Māori in New Zealand are cost-saving to the health sector. However the societal costs are significant. A conservative "base case" scenario estimate is over $NZ62 million per year, while alternative costing methods yield larger costs of nearly $NZ200 million per annum. The total cost estimate is highly sensitive to the costing method used and Value of Statistical Life applied, as the cost of potentially avoidable deaths of Māori children is the major contributor to this estimate. This preliminary study suggests that health sector spending is skewed towards non-Māori children despite evidence of greater Māori need. Persistent child health inequities result in significant societal economic costs. Eliminating child health inequities, particularly in primary care access, could result in significant economic benefits for New Zealand. However, there are conceptual, ethical and methodological challenges in estimating the economic cost of child health inequities. Re-thinking of traditional economic frameworks and development of more appropriate methodologies is required.

Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: testing theBrain Trauma Foundation guidelines for the treatment of severe traumatic brain injury.

PubMed

Faul, Mark; Wald, Marlena M; Rutland-Brown, Wesley; Sullivent, Ernest E; Sattin, Richard W

2007-12-01

A decade after promulgation of treatment guidelines by the Brain Trauma Foundation (BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury (TBI) patients. These studies have reported both cost savings and reduced mortality. We projected the results of previous studies of BTF guideline adoption to estimate the impact of widespread adoption across the United States. We used surveillance systems and national surveys to estimate the number of severely injured TBI patients and compared the lifetime costs of BTF adoption to the current state of treatment. After examining the health outcomes and costs, we estimated that a substantial savings in annual medical costs ($262 million), annual rehabilitation costs ($43 million) and lifetime societal costs ($3.84 billion) would be achieved if treatment guidelines were used more routinely. Implementation costs were estimated to be $61 million. The net savings were primarily because of better health outcomes and a decreased burden on lifetime social support systems. We also estimate that mortality would be reduced by 3,607 lives if the guidelines were followed. Widespread adoption of the BTF guidelines for the treatment of severe TBI would result in substantial savings in costs and lives. The majority of cost savings are societal costs. Further validation work to identify the most effective aspects of the BTF guidelines is warranted.

48 CFR 1852.216-84 - Estimated cost and incentive fee.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the following clause: Estimated Cost and Incentive Fee (OCT 1996) The target cost of this contract is $___. The target fee of this contract is $___. The total target cost and target fee as contemplated by the...

Proposed Reliability/Cost Model

NASA Technical Reports Server (NTRS)

Delionback, L. M.

1982-01-01

New technique estimates cost of improvement in reliability for complex system. Model format/approach is dependent upon use of subsystem cost-estimating relationships (CER's) in devising cost-effective policy. Proposed methodology should have application in broad range of engineering management decisions.

Economic burden made celiac disease an expensive and challenging condition for Iranian patients.

PubMed

Pourhoseingholi, Mohamad Amin; Rostami-Nejad, Mohammad; Barzegar, Farnoush; Rostami, Kamran; Volta, Umberto; Sadeghi, Amir; Honarkar, Zahra; Salehi, Niloofar; Asadzadeh-Aghdaei, Hamid; Baghestani, Ahmad Reza; Zali, Mohammad Reza

2017-01-01

The aim of this study was to estimate the economic burden of celiac disease (CD) in Iran. The assessment of burden of CD has become an important primary or secondary outcome measure in clinical and epidemiologic studies. Information regarding medical costs and gluten free diet (GFD) costs were gathered using questionnaire and checklists offered to the selected patients with CD. The data included the direct medical cost (including Doctor Visit, hospitalization, clinical test examinations, endoscopies, etc.), GFD cost and loss productivity cost (as the indirect cost) for CD patient were estimated. The factors used for cost estimation included frequency of health resource utilization and gluten free diet basket. Purchasing Power Parity Dollar (PPP$) was used in order to make inter-country comparisons. Total of 213 celiac patients entered to this study. The mean (standard deviation) of total cost per patient per year was 3377 (1853) PPP$. This total cost including direct medical cost, GFD costs and loss productivity cost per patients per year. Also the mean and standard deviation of medical cost and GFD cost were 195 (128) PPP$ and 932 (734) PPP$ respectively. The total costs of CD were significantly higher for male. Also GFD cost and total cost were higher for unmarried patients. In conclusion, our estimation of CD economic burden is indicating that CD patients face substantial expense that might not be affordable for a good number of these patients. The estimated economic burden may put these patients at high risk for dietary neglect resulting in increasing the risk of long term complications.

Cost of schizophrenia in England.

PubMed

Mangalore, Roshni; Knapp, Martin

2007-03-01

Despite the wide-ranging financial and social burdens associated with schizophrenia, there have been few cost-of-illness studies of this illness in the UK. To provide up-to-date, prevalence based estimate of all costs associated with schizophrenia for England. A bottom-up approach was adopted. Separate cost estimates were made for people living in private households, institutions, prisons and for those who are homeless. The costs included related to: health and social care, informal care, private expenditures, lost productivity, premature mortality, criminal justice services and other public expenditures such as those by the social security system. Data came from many sources, including the UK-SCAP (Schizophrenia Care and Assessment Program) survey, Psychiatric Morbidity Surveys, Department of Health and government publications. The estimated total societal cost of schizophrenia was 6.7 billion pounds in 2004/05. The direct cost of treatment and care that falls on the public purse was about 2 billion pounds; the burden of indirect costs to the society was huge, amounting to nearly 4.7 billion pounds. Cost of informal care and private expenditures borne by families was 615 million pounds. The cost of lost productivity due to unemployment, absence from work and premature mortality of patients was 3.4 billion pounds. The cost of lost productivity of carers was 32 million pounds. Estimated cost to the criminal justice system was about 1 million pounds. It is estimated that about 570 million pounds will be paid out in benefit payments and the cost of administration associated with this is about 14 million pounds. It is difficult to compare estimates from previous cost-of-illness studies due to differences in the methods, scope of analyses and the range of costs covered. Costs estimated in this study are detailed, cover a comprehensive list of relevant items and allow for different levels of disaggregation. The main limitation of the study is that data came from a variety of secondary sources and some official data publicly available was not the latest. Schizophrenia continues to be a high cost illness because of the range of health needs that people have. Despite the shifting balance of care away from hospital-based care, the health care costs of treating and supporting people with schizophrenia remain high. Decision-makers need to recognise the breadth of economic impacts, well beyond the health system as conventionally defined. For example, as nearly 80% of schizophrenia patients remain unemployed, the cost of lost productivity is especially large. Better measurement of criminal justice services costs, private expenditures borne by families and valuation of lost quality of life could improve the estimates further.

[Economic impact of overactive bladder symptoms in Japan].

PubMed

Inoue, Sachie; Kobayashi, Makoto; Sugaya, Kimio

2008-11-01

Overactive bladder (OAB) is characterized by involuntary contractions of the detrusor muscles of the bladder. The primary symptoms of OAB include urinary urgency and frequency, with or without urge incontinence. Despite the growing awareness of OAB as a chronic medical condition, little is known about the disease's economic burden. Therefore, in the present study, the costs associated with the management of OAB symptoms in Japan were estimated, and the potential cost saving by increasing the rate of physician visits in OAB population was analyzed. To estimate the costs of OAB symptoms in Japan, we collected a variety of epidemiologic and economic literatures about OAB or urinary incontinence published by June, 2007. Three types of costs were considered in this estimation: 1. OAB treatment cost (pharmacological treatment cost, diagnostic cost and cost for physician visits), 2. direct cost (OAB-related cost [urinary tract infections, skin infections and fractures] and incontinence care cost [costs of pads, diapers and cleaning]), and 3. indirect cost (work loss due to absence from work and decrease in productivity). The analysis was conducted on community dwelling Japanese persons aged > or = 40 years, and assumed that OAB patients visited a hospital or a clinic once every four weeks. For the estimation of pharmacological treatment cost, four anticholinergic drugs (immediate-release oxybutynin (Pollakisu), propiverine (BUP-4), extended-release tolterodine (Detrusitol) and solifenacin (Vesicare)) were referred. Potential cost saving was estimated on the assumption that the hospital visit rate would increase from the current 22.7% to 35% and 50%, respectively. The number of persons with OAB symptoms and OAB patients was estimated at 8.6 million (4.6 million men, 4.0 million women) and 2.0 million (1.7 million men, 0.3 million women), respectively. The annual cost for OAB was estimated to be 956.2 billion yen (112,000 yen per one person with OAB symptoms). This cost included 180.9 billion yen (19%) for OAB treatment cost (including medication of 159.1 billion yen), 62 billion yen (6%) for OAB-related cost, 28.7 billion yen (3%) for incontinence care cost and 684.6 billion yen (72%) for work loss. Therefore, the cost for work loss accounted for the majority of OAB cost. The potential annual cost saving was estimated at 92.7 billion yen and 205.8 billion yen for the assumed hospital visit rate of 35% and 50%, respectively, and 88,000 yen per newly visiting OAB patient. It was revealed that the economic impact imposed by OAB was enormous. It might be possible to reduce the cost for OAB by appropriate treatment for OAB population.

Integrated HIV testing, malaria, and diarrhea prevention campaign in Kenya: modeled health impact and cost-effectiveness.

PubMed

Kahn, James G; Muraguri, Nicholas; Harris, Brian; Lugada, Eric; Clasen, Thomas; Grabowsky, Mark; Mermin, Jonathan; Shariff, Shahnaaz

2012-01-01

Efficiently delivered interventions to reduce HIV, malaria, and diarrhea are essential to accelerating global health efforts. A 2008 community integrated prevention campaign in Western Province, Kenya, reached 47,000 individuals over 7 days, providing HIV testing and counseling, water filters, insecticide-treated bed nets, condoms, and for HIV-infected individuals cotrimoxazole prophylaxis and referral for ongoing care. We modeled the potential cost-effectiveness of a scaled-up integrated prevention campaign. We estimated averted deaths and disability-adjusted life years (DALYs) based on published data on baseline mortality and morbidity and on the protective effect of interventions, including antiretroviral therapy. We incorporate a previously estimated scaled-up campaign cost. We used published costs of medical care to estimate savings from averted illness (for all three diseases) and the added costs of initiating treatment earlier in the course of HIV disease. Per 1000 participants, projected reductions in cases of diarrhea, malaria, and HIV infection avert an estimated 16.3 deaths, 359 DALYs and $85,113 in medical care costs. Earlier care for HIV-infected persons adds an estimated 82 DALYs averted (to a total of 442), at a cost of $37,097 (reducing total averted costs to $48,015). Accounting for the estimated campaign cost of $32,000, the campaign saves an estimated $16,015 per 1000 participants. In multivariate sensitivity analyses, 83% of simulations result in net savings, and 93% in a cost per DALY averted of less than $20. A mass, rapidly implemented campaign for HIV testing, safe water, and malaria control appears economically attractive.

The economic feasibility of producing sweet sorghum as an ethanol feedstock in Mississippi

NASA Astrophysics Data System (ADS)

Linton, Joseph Andrew

This study examines the feasibility of producing sweet sorghum as an ethanol feedstock in Mississippi. An enterprise budgeting system is used along with estimates of transportation costs to estimate farmers' breakeven costs for producing and delivering sweet sorghum biomass. This breakeven cost for the farmer, along with breakeven costs for the producer based on wholesale ethanol price, production costs, and transportation and marketing costs for the refined ethanol, is used to estimate the amounts that farmers and ethanol producers would be willing to accept (WTA) and willing to pay (WTP), respectively, for sweet sorghum biomass. These WTA and WTP estimates are analyzed by varying key factors in the biomass and ethanol production processes. Deterministic and stochastic models are used to estimate profits for sweet sorghum and competing crops in two representative counties in Mississippi, with sweet sorghum consistently yielding negative per-acre profits in both counties.

Cost benefits of advanced software: A review of methodology used at Kennedy Space Center

NASA Technical Reports Server (NTRS)

Joglekar, Prafulla N.

1993-01-01

To assist rational investments in advanced software, a formal, explicit, and multi-perspective cost-benefit analysis methodology is proposed. The methodology can be implemented through a six-stage process which is described and explained. The current practice of cost-benefit analysis at KSC is reviewed in the light of this methodology. The review finds that there is a vicious circle operating. Unsound methods lead to unreliable cost-benefit estimates. Unreliable estimates convince management that cost-benefit studies should not be taken seriously. Then, given external demands for cost-benefit estimates, management encourages software enginees to somehow come up with the numbers for their projects. Lacking the expertise needed to do a proper study, courageous software engineers with vested interests use ad hoc and unsound methods to generate some estimates. In turn, these estimates are unreliable, and the cycle continues. The proposed methodology should help KSC to break out of this cycle.

Estimating patient time costs associated with colorectal cancer care.

PubMed

Yabroff, K Robin; Warren, Joan L; Knopf, Kevin; Davis, William W; Brown, Martin L

2005-07-01

Nonmedical costs of care, such as patient time associated with travel to, waiting for, and seeking medical care, are rarely measured systematically with population-based data. The purpose of this study was to estimate patient time costs associated with colorectal cancer care. We identified categories of key medical services for colorectal cancer care and then estimated patient time associated with each service category using data from national surveys. To estimate average service frequencies for each service category, we used a nested case control design and SEER-Medicare data. Estimates were calculated by phase of care for cases and controls, using data from 1995 to 1998. Average service frequencies were then combined with estimates of patient time for each category of service, and the value of patient time assigned. Net patient time costs were calculated for each service category, summarized by phase of care, and compared with previously reported net direct costs of colorectal cancer care. Net patient time costs for the 3 phases of colorectal cancer care averaged dollar 4592 (95% confidence interval [CI] dollar 4427-4757) over the 12 months of the initial phase, dollar 2788 (95% CI dollar 2614-2963) over the 12 months of the terminal phase, and dollar 25 (95% CI: dollar 23-26) per month in the continuing phase of care. Hospitalizations accounted for more than two thirds of these estimates. Patient time costs were 19.3% of direct medical costs in the initial phase, 15.8% in the continuing phase, and 36.8% in the terminal phase of care. Patient time costs are an important component of the costs of colorectal cancer care. Application of this method to other tumor sites and inclusion of other components of the costs of medical care will be important in delineating the economic burden of cancer in the United States.

State-Level Estimates of Cancer-Related Absenteeism Costs

PubMed Central

Tangka, Florence K.; Trogdon, Justin G.; Nwaise, Isaac; Ekwueme, Donatus U.; Guy, Gery P.; Orenstein, Diane

2016-01-01

Background Cancer is one of the top five most costly diseases in the United States and leads to substantial work loss. Nevertheless, limited state-level estimates of cancer absenteeism costs have been published. Methods In analyses of data from the 2004–2008 Medical Expenditure Panel Survey, the 2004 National Nursing Home Survey, the U.S. Census Bureau for 2008, and the 2009 Current Population Survey, we used regression modeling to estimate annual state-level absenteeism costs attributable to cancer from 2004 to 2008. Results We estimated that the state-level median number of days of absenteeism per year among employed cancer patients was 6.1 days and that annual state-level cancer absenteeism costs ranged from $14.9 million to $915.9 million (median = $115.9 million) across states in 2010 dollars. Absenteeism costs are approximately 6.5% of the costs of premature cancer mortality. Conclusions The results from this study suggest that lost productivity attributable to cancer is a substantial cost to employees and employers and contributes to estimates of the overall impact of cancer in a state population. PMID:23969498

State-level estimates of cancer-related absenteeism costs.

PubMed

Tangka, Florence K; Trogdon, Justin G; Nwaise, Isaac; Ekwueme, Donatus U; Guy, Gery P; Orenstein, Diane

2013-09-01

Cancer is one of the top five most costly diseases in the United States and leads to substantial work loss. Nevertheless, limited state-level estimates of cancer absenteeism costs have been published. In analyses of data from the 2004-2008 Medical Expenditure Panel Survey, the 2004 National Nursing Home Survey, the U.S. Census Bureau for 2008, and the 2009 Current Population Survey, we used regression modeling to estimate annual state-level absenteeism costs attributable to cancer from 2004 to 2008. We estimated that the state-level median number of days of absenteeism per year among employed cancer patients was 6.1 days and that annual state-level cancer absenteeism costs ranged from $14.9 million to $915.9 million (median = $115.9 million) across states in 2010 dollars. Absenteeism costs are approximately 6.5% of the costs of premature cancer mortality. The results from this study suggest that lost productivity attributable to cancer is a substantial cost to employees and employers and contributes to estimates of the overall impact of cancer in a state population.

PHENIX Work Breakdown Structure. Cost and schedule review copy

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

Not Available

1994-02-01

The Work Breakdown Structure (WBS) Book begins with this Overview section, which contains the high-level summary cost estimate, the cost profile, and the global construction schedule. The summary cost estimate shows the total US cost and the cost in terms of PHENIX construction funds for building the PHENIX detector. All costs in the WBS book are shown in FY 1993 dollars. Also shown are the institutional and foreign contributions, the level of pre-operations funding, and the cost of deferred items. Pie charts are presented at PHENIX WBS level 1 and 2 that show this information. The PHENIX construction funds aremore » shown broken down to PHENIX WBS level 3 items per fiscal year, and the resulting profile is compared to the RHIC target profile. An accumulated difference of the two profiles is also shown. The PHENIX global construction schedule is presented at the end of the Overview section. Following the Overview are sections for each subsystem. Each subsystem section begins with a summary cost estimate, cost profile, and critical path. The total level 3 cost is broken down into fixed costs (M&S), engineering costs (EDIA) and labor costs. Costs are further broken down in terms of PHENIX construction funds, institutional and foreign contributions, pre-operations funding, and deferred items. Also shown is the contingency at level 3 and the level 4 breakdown of the total cost. The cost profile in fiscal years is shown at level 3. The subsystem summaries are followed by the full cost estimate and schedule sheets for that subsystem. These detailed sheets are typically carried down to level 7 or 8. The cost estimate shows Total, M&S, EDIA, and Labor breakdowns, as well as contingency, for each WBS entry.« less

Cost of individual peer counselling for the promotion of exclusive breastfeeding in Uganda

PubMed Central

2011-01-01

Background Exclusive breastfeeding (EBF) for 6 months is the recommended form of infant feeding. Support of mothers through individual peer counselling has been proved to be effective in increasing exclusive breastfeeding prevalence. We present a costing study of an individual peer support intervention in Uganda, whose objective was to raise exclusive breastfeeding rates at 3 months of age. Methods We costed the peer support intervention, which was offered to 406 breastfeeding mothers in Uganda. The average number of counselling visits was about 6 per woman. Annual financial and economic costs were collected in 2005-2008. Estimates were made of total project costs, average costs per mother counselled and average costs per peer counselling visit. Alternative intervention packages were explored in the sensitivity analysis. We also estimated the resources required to fund the scale up to district level, of a breastfeeding intervention programme within a public health sector model. Results Annual project costs were estimated to be US$56,308. The largest cost component was peer supporter supervision, which accounted for over 50% of total project costs. The cost per mother counselled was US$139 and the cost per visit was US$26. The cost per week of EBF was estimated to be US$15 at 12 weeks post partum. We estimated that implementing an alternative package modelled on routine public health sector programmes can potentially reduce costs by over 60%. Based on the calculated average costs and annual births, scaling up modelled costs to district level would cost the public sector an additional US$1,813,000. Conclusion Exclusive breastfeeding promotion in sub-Saharan Africa is feasible and can be implemented at a sustainable cost. The results of this study can be incorporated in cost effectiveness analyses of exclusive breastfeeding promotion programmes in sub-Saharan Africa. PMID:21714877

Implementation Costs for Educational Technology Systems. Issue Trak: A CEFPI Brief on Educational Facility Issues.

ERIC Educational Resources Information Center

Meeks, Glenn E.; Fisher, Ricki; Loveless, Warren

Personnel involved in planning or developing schools lack the costing tools that will enable them to determine educational technology costs. This report presents an overview of the technology costing process and the general costs used in estimating educational technology systems on a macro-budget basis, along with simple cost estimates for…

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

ERIC Educational Resources Information Center

Phelps, Richard P.

2000-01-01

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

Satellite Power Systems (SPS) space transportation cost analysis and evaluation

NASA Technical Reports Server (NTRS)

1980-01-01

A picture of Space Power Systems space transportation costs at the present time is given with respect to accuracy as stated, reasonableness of the methods used, assumptions made, and uncertainty associated with the estimates. The approach used consists of examining space transportation costs from several perspectives to perform a variety of sensitivity analyses or reviews and examine the findings in terms of internal consistency and external comparison with analogous systems. These approaches are summarized as a theoretical and historical review including a review of stated and unstated assumptions used to derive the costs, and a performance or technical review. These reviews cover the overall transportation program as well as the individual vehicles proposed. The review of overall cost assumptions is the principal means used for estimating the cost uncertainty derived. The cost estimates used as the best current estimate are included.

Using Top‐down and Bottom‐up Costing Approaches in LMICs: The Case for Using Both to Assess the Incremental Costs of New Technologies at Scale

PubMed Central

Sinanovic, Edina; Ramma, Lebogang; Foster, Nicola; Berrie, Leigh; Stevens, Wendy; Molapo, Sebaka; Marokane, Puleng; McCarthy, Kerrigan; Churchyard, Gavin; Vassall, Anna

2016-01-01

Abstract Purpose Estimating the incremental costs of scaling‐up novel technologies in low‐income and middle‐income countries is a methodologically challenging and substantial empirical undertaking, in the absence of routine cost data collection. We demonstrate a best practice pragmatic approach to estimate the incremental costs of new technologies in low‐income and middle‐income countries, using the example of costing the scale‐up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa. Materials and methods We estimate costs, by applying two distinct approaches of bottom‐up and top‐down costing, together with an assessment of processes and capacity. Results The unit costs measured using the different methods of bottom‐up and top‐down costing, respectively, are $US16.9 and $US33.5 for Xpert MTB/RIF, and $US6.3 and $US8.5 for microscopy. The incremental cost of Xpert MTB/RIF is estimated to be between $US14.7 and $US17.7. While the average cost of Xpert MTB/RIF was higher than previous studies using standard methods, the incremental cost of Xpert MTB/RIF was found to be lower. Conclusion Costs estimates are highly dependent on the method used, so an approach, which clearly identifies resource‐use data collected from a bottom‐up or top‐down perspective, together with capacity measurement, is recommended as a pragmatic approach to capture true incremental cost where routine cost data are scarce. PMID:26763594

Using Top-down and Bottom-up Costing Approaches in LMICs: The Case for Using Both to Assess the Incremental Costs of New Technologies at Scale.

PubMed

Cunnama, Lucy; Sinanovic, Edina; Ramma, Lebogang; Foster, Nicola; Berrie, Leigh; Stevens, Wendy; Molapo, Sebaka; Marokane, Puleng; McCarthy, Kerrigan; Churchyard, Gavin; Vassall, Anna

2016-02-01

Estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking, in the absence of routine cost data collection. We demonstrate a best practice pragmatic approach to estimate the incremental costs of new technologies in low-income and middle-income countries, using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa. We estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the different methods of bottom-up and top-down costing, respectively, are $US16.9 and $US33.5 for Xpert MTB/RIF, and $US6.3 and $US8.5 for microscopy. The incremental cost of Xpert MTB/RIF is estimated to be between $US14.7 and $US17.7. While the average cost of Xpert MTB/RIF was higher than previous studies using standard methods, the incremental cost of Xpert MTB/RIF was found to be lower. Costs estimates are highly dependent on the method used, so an approach, which clearly identifies resource-use data collected from a bottom-up or top-down perspective, together with capacity measurement, is recommended as a pragmatic approach to capture true incremental cost where routine cost data are scarce. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives.

PubMed

Zempsky, William T; Zehrer, Cindy L; Lyle, Christopher T; Hedbloom, Edwin C

2005-09-01

Our objective was to review and assess the treatment of low-tension wounds and evaluate the cost-effectiveness of wound closure methods. We used a health economic model to estimate cost/closure of adhesive wound closure strips, tissue adhesives and sutures. The model incorporated cost-driving variables: application time, costs and the likelihood and costs of dehiscence and infection. The model was populated with variable estimates derived from the literature. Cost estimates and cosmetic results were compared. Parameter values were estimated using national healthcare and labour statistics. Sensitivity analyses were used to verify the results. Our analysis suggests that adhesive wound closure strips had the lowest average cost per laceration ($7.54), the lowest cost per infected laceration ($53.40) and the lowest cost per laceration with dehiscence ($25.40). The costs for sutures were $24.11, $69.91 and $41.91, respectively; the costs for tissue adhesives were $28.77, $74.68 and $46.68, respectively. The cosmetic outcome for all three treatments was equivalent. We conclude adhesive wound closure strips were both a cost-saving and a cost-effective alternative to sutures and tissue adhesives in the closure of low-tension lacerations.

A non-stationary cost-benefit based bivariate extreme flood estimation approach

NASA Astrophysics Data System (ADS)

Qi, Wei; Liu, Junguo

2018-02-01

Cost-benefit analysis and flood frequency analysis have been integrated into a comprehensive framework to estimate cost effective design values. However, previous cost-benefit based extreme flood estimation is based on stationary assumptions and analyze dependent flood variables separately. A Non-Stationary Cost-Benefit based bivariate design flood estimation (NSCOBE) approach is developed in this study to investigate influence of non-stationarities in both the dependence of flood variables and the marginal distributions on extreme flood estimation. The dependence is modeled utilizing copula functions. Previous design flood selection criteria are not suitable for NSCOBE since they ignore time changing dependence of flood variables. Therefore, a risk calculation approach is proposed based on non-stationarities in both marginal probability distributions and copula functions. A case study with 54-year observed data is utilized to illustrate the application of NSCOBE. Results show NSCOBE can effectively integrate non-stationarities in both copula functions and marginal distributions into cost-benefit based design flood estimation. It is also found that there is a trade-off between maximum probability of exceedance calculated from copula functions and marginal distributions. This study for the first time provides a new approach towards a better understanding of influence of non-stationarities in both copula functions and marginal distributions on extreme flood estimation, and could be beneficial to cost-benefit based non-stationary bivariate design flood estimation across the world.

Total costs of injury from accidents in the home and during education, sports and leisure activities: estimates for Norway with assessment of uncertainty.

PubMed

Veisten, Knut; Nossum, Ase; Akhtar, Juned

2009-07-01

Injury accidents occurring in the home, during educational, sports or leisure activities were estimated from samples of hospital data, combined with fatality data from vital statistics. Uncertainty of estimated figures was assessed in simulation-based analysis. Total economic costs to society from injuries and fatalities due to such accidents were estimated at approximately NOK 150 billion per year. The estimated costs reveal the scale of the public health problem and lead to arguments for the establishment of a proper injury register for the identification of preventive measures to reduce the costs to society.

Smoking, healthcare cost, and loss of productivity in Sweden 2001.

PubMed

Bolin, Kristian; Lindgren, Björn

2007-01-01

Objectives were (a) to estimate healthcare cost and productivity losses due to smoking in Sweden 2001 and (b) to compare the results with studies for Sweden 1980, Canada 1991, Germany 1996, and the USA 1998. Published estimates on relative risks and Swedish smoking patterns were used to calculate attributable risks for smokers and former smokers. These were applied to cost estimates for smoking-related diseases based on data from public Swedish registers. The estimated total cost for Sweden 2001 was US 804 million dollars; COPD and cancer of the lung accounted for 43%. Healthcare cost accounted for 26% of the total cost. The estimated costs per smoker were US 3,200 dollars in the USA 1998; 1,600 in Canada 1991; 1,100 in Germany 1996; 600 in Sweden 2001; and 300 in Sweden 1980 (all in 2001 US dollar prices). To reduce the prevalence of smoking is an issue worthwhile pursuing in its own right. In order to reduce the cost of smoking, however, policy-makers should also explore and influence the factors that determine the cost per smoker. Sweden seems to have been more successful than comparable countries in pursuing both these objectives.

A stump-to-truck cost estimating program for cable logging young-growth Douglas-fir

Treesearch

Chris B. LeDoux

1989-01-01

WCOST is a computer program designed to estimate the stump-to-truck logging cost of cable logging young-growth Douglas-fir. The program uses data from stand inventory, cruise data, and the logging plan for the tract in question to produce detailed stump-to-truck cost estimates for specific proposed timber sales. These estimates are then used, in combination with...

M-X Environmental Technical Report. Economic Model.

DTIC Science & Technology

1980-12-22

TABLE PAGE C-4. Estimated off base school facility costs. 147 C-5. Estimated development costs to other public facilities. 148 C-6. Estimated utility... development costs. 149 C-7. Estimated non-residential building development . 151 E-1. Adjustments to baseline population projections to account for...the fringes of the rural deployment areas themselves. These metropolitan areas potentially would experience significant indirect employment growth as a

Key Aspects of the Federal Direct Loan Program's Cost Estimates: Department of Education. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Calbom, Linda M.; Ashby, Cornelia M.

Because of concerns about the Department of Education's reliance on estimates to project costs of the William D. Ford Federal Direct Loan Program (FDLP) and a lack of historical information on which to base those estimates, Congress asked the General Accounting Office (GAO) to review how the department develops its cost estimates for the program,…

Cost comparisons of raising a child from birth to 17 years among samples of abused, delinquent, violent, and homicidal youth using victimization and justice system estimates.

PubMed

Zagar, Agata Karolina; Zagar, Robert John; Bartikowski, Boris; Busch, Kenneth G

2009-02-01

Data from youth studied by Zagar and colleagues were randomly sampled to create groups of controls and abused, delinquent, violent, and homicidal youth (n=30 in each). Estimated costs of raising a nondelinquent youth from birth to 17 yr. were compared with the average costs incurred by other youth in each group. Estimates of living expenses, direct and indirect costs of victimization, and criminal justice system expenditures were summed. Groups differed significantly on total expenses, victimization costs, and criminal justice expenditures. Mean total costs for a homicidal youth were estimated at $3,935,433, while those for a control youth were $150,754. Abused, delinquent, and violent youth had average total expenses roughly double the total mean costs of controls. Prevention of dropout, alcoholism, addiction, career delinquency, or homicide justifies interception and empirical treatment on a cost-benefit basis, but also based on the severe personal costs to the victims and to the youth themselves.

Fairbanks North Star borough rural roads upgrade inventory and cost estimation software user guide : version I.

DOT National Transportation Integrated Search

2013-04-01

The Rural Road Upgrade Inventory and Cost Estimation Software is designed by the AUTC : research team to help the Fairbanks North Star Borough (FNSB) estimate the cost of upgrading : rural roads located in the Borough's Service Areas. The Software pe...

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

Van Wie, N.H.

An overview of the UCC-ND system for computer-aided cost estimating is provided. The program is generally utilized in the preparation of construction cost estimates for projects costing $25,000,000 or more. The advantages of the system to the manager and the estimator are discussed, and examples of the product are provided. 19 figures, 1 table.

40 CFR 144.62 - Cost estimate for plugging and abandonment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... must revise the plugging and abandonment cost estimate whenever a change in the plugging and... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Cost estimate for plugging and abandonment. 144.62 Section 144.62 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER...

75 FR 52033 - Rigging Equipment for Material Handling; Extension of the Office of Management and Budget's (OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

.... Estimated Total Burden Hours: 51,815. Estimated Cost (Operation and Maintenance): $0. IV. Public... desired format, reporting burden (time and costs) is minimal, collection instruments are clearly...; The accuracy of OSHA's estimate of the burden (time and costs) of the information collection...

75 FR 65033 - Manlifts; Extension of the Office of Management and Budget's (OMB) Approval of Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-21

.... Estimated Cost (Operation and Maintenance): $0. IV. Public Participation--Submission of Comments on This... costs) is minimal, collection instruments are clearly understood, and OSHA's estimate of the information... of OSHA's estimate of the burden (time and costs) of the information collection requirements...

Improving The Discipline of Cost Estimation and Analysis

NASA Technical Reports Server (NTRS)

Piland, William M.; Pine, David J.; Wilson, Delano M.

2000-01-01

The need to improve the quality and accuracy of cost estimates of proposed new aerospace systems has been widely recognized. The industry has done the best job of maintaining related capability with improvements in estimation methods and giving appropriate priority to the hiring and training of qualified analysts. Some parts of Government, and National Aeronautics and Space Administration (NASA) in particular, continue to need major improvements in this area. Recently, NASA recognized that its cost estimation and analysis capabilities had eroded to the point that the ability to provide timely, reliable estimates was impacting the confidence in planning many program activities. As a result, this year the Agency established a lead role for cost estimation and analysis. The Independent Program Assessment Office located at the Langley Research Center was given this responsibility. This paper presents the plans for the newly established role. Described is how the Independent Program Assessment Office, working with all NASA Centers, NASA Headquarters, other Government agencies, and industry, is focused on creating cost estimation and analysis as a professional discipline that will be recognized equally with the technical disciplines needed to design new space and aeronautics activities. Investments in selected, new analysis tools, creating advanced training opportunities for analysts, and developing career paths for future analysts engaged in the discipline are all elements of the plan. Plans also include increasing the human resources available to conduct independent cost analysis of Agency programs during their formulation, to improve near-term capability to conduct economic cost-benefit assessments, to support NASA management's decision process, and to provide cost analysis results emphasizing "full-cost" and "full-life cycle" considerations. The Agency cost analysis improvement plan has been approved for implementation starting this calendar year. Adequate financial and human resources are being made available to accomplish the goals of this important effort, and all indications are that NASA's cost estimation and analysis core competencies will be substantially improved within the foreseeable future.

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

Not Available

The Work Breakdown Structure (WBS) Book begins with this Overview section, which contains the high-level summary cost estimate, the cost profile, and the global construction schedule. The summary cost estimate shows the total US cost and the cost in terms of PHENIX construction funds for building the PHENIX detector. All costs in the WBS book are shown in FY 1993 dollars. Also shown are the institutional and foreign contributions, the level of pre-operations funding, and the cost of deferred items. Pie charts are presented at PHENIX WBS level 1 and 2 that show this information. The PHENIX construction funds aremore » shown broken down to PHENIX WBS level 3 items per fiscal year, and the resulting profile is compared to the RHIC target profile. An accumulated difference of the two profiles is also shown. The PHENIX global construction schedule is presented at the end of the Overview section. Following the Overview are sections for each subsystem. Each subsystem section begins with a summary cost estimate, cost profile, and critical path. The total level 3 cost is broken down into fixed costs (M&S), engineering costs (EDIA) and labor costs. Costs are further broken down in terms of PHENIX construction funds, institutional and foreign contributions, pre-operations funding, and deferred items. Also shown is the contingency at level 3 and the level 4 breakdown of the total cost. The cost profile in fiscal years is shown at level 3. The subsystem summaries are followed by the full cost estimate and schedule sheets for that subsystem. These detailed sheets are typically carried down to level 7 or 8. The cost estimate Total, M&S, EDIA, and Labor breakdowns, as well as contingency, for each WBS entry.« less

Yarding cost for the Koller K300 cable yarder: results from field trials and simulations

Treesearch

Neil K. Huyler; Chris B. LeDoux

1997-01-01

This paper describes results from field studies and simulation that can be used to estimate the yarding cost for the Koller K300 cable yarder. Yarding costs can be estimated for clearcuts and light and heavy thinnings in eastern hardwoods. Yarding costs can be estimated with a handheld calculator, or the data can be incorporated into stump-to-mill desktop PC and...

Societal costs of traffic crashes and crime in Michigan : 2011 update.

DOT National Transportation Integrated Search

2011-06-01

"Cost estimates, including both monetary and nonmonetary quality-of-life costs specific to Michigan, were : estimated for overall traffic crashes and index crimes by experts in the field of economics of traffic crashes : and crimes. These cost estima...

Notification: Preliminary Research: Review of Independent Government Cost Estimates and Indirect Costs for EPA’s Interagency Agreements

EPA Pesticide Factsheets

Project #OA-FY14-0130, February 11, 2014. The EPA OIG plans to begin preliminary research of the independent government cost estimates and indirect costs for the EPA's funds-in interagency agreements.

An estimating rule for deep space station control room equipment energy costs

NASA Technical Reports Server (NTRS)

Younger, H. C.

1980-01-01

A rule is described which can be used to estimate power costs for new equipment under development, helping to reduce life-cycle costs and energy consumption by justifying design alternatives that are more costly, but more efficient.

Overweight and obesity on the island of Ireland: an estimation of costs.

PubMed

Dee, Anne; Callinan, Aoife; Doherty, Edel; O'Neill, Ciaran; McVeigh, Treasa; Sweeney, Mary Rose; Staines, Anthony; Kearns, Karen; Fitzgerald, Sarah; Sharp, Linda; Kee, Frank; Hughes, John; Balanda, Kevin; Perry, Ivan J

2015-03-16

The increasing prevalence of overweight and obesity worldwide continues to compromise population health and creates a wider societal cost in terms of productivity loss and premature mortality. Despite extensive international literature on the cost of overweight and obesity, findings are inconsistent between Europe and the USA, and particularly within Europe. Studies vary on issues of focus, specific costs and methods. This study aims to estimate the healthcare and productivity costs of overweight and obesity for the island of Ireland in 2009, using both top-down and bottom-up approaches. Costs were estimated across four categories: healthcare utilisation, drug costs, work absenteeism and premature mortality. Healthcare costs were estimated using Population Attributable Fractions (PAFs). PAFs were applied to national cost data for hospital care and drug prescribing. PAFs were also applied to social welfare and national mortality data to estimate productivity costs due to absenteeism and premature mortality. The healthcare costs of overweight and obesity in 2009 were estimated at €437 million for the Republic of Ireland (ROI) and €127.41 million for NI. Productivity loss due to overweight and obesity was up to €865 million for ROI and €362 million for NI. The main drivers of healthcare costs are cardiovascular disease, type II diabetes, colon cancer, stroke and gallbladder disease. In terms of absenteeism, low back pain is the main driver in both jurisdictions, and for productivity loss due to premature mortality the primary driver of cost is coronary heart disease. The costs are substantial, and urgent public health action is required in Ireland to address the problem of increasing prevalence of overweight and obesity, which if left unchecked will lead to unsustainable cost escalation within the health service and unacceptable societal costs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Estimating the Medical Care Costs of Obesity in the United States: Systematic Review, Meta-Analysis, and Empirical Analysis.

PubMed

Kim, David D; Basu, Anirban

2016-01-01

The prevalence of adult obesity exceeds 30% in the United States, posing a significant public health concern as well as a substantial financial burden. Although the impact of obesity on medical spending is undeniably significant, the estimated magnitude of the cost of obesity has varied considerably, perhaps driven by different study methodologies. To document variations in study design and methodology in existing literature and to understand the impact of those variations on the estimated costs of obesity. We conducted a systematic review of the twelve recently published articles that reported costs of obesity and performed a meta-analysis to generate a pooled estimate across those studies. Also, we performed an original analysis to understand the impact of different age groups, statistical models, and confounder adjustment on the magnitude of estimated costs using the nationally representative Medical Expenditure Panel Surveys from 2008-2010. We found significant variations among cost estimates in the existing literature. The meta-analysis found that the annual medical spending attributable to an obese individual was $1901 ($1239-$2582) in 2014 USD, accounting for $149.4 billion at the national level. The two most significant drivers of variability in the cost estimates were age groups and adjustment for obesity-related comorbid conditions. It would be important to acknowledge variations in the magnitude of the medical cost of obesity driven by different study design and methodology. Researchers and policy-makers need to be cautious on determining appropriate cost estimates according to their scientific and political questions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Using computerised patient-level costing data for setting DRG weights: the Victorian (Australia) cost weight studies.

PubMed

Jackson, T

2001-05-01

Casemix-funding systems for hospital inpatient care require a set of resource weights which will not inadvertently distort patterns of patient care. Few health systems have very good sources of cost information, and specific studies to derive empirical cost relativities are themselves costly. This paper reports a 5 year program of research into the use of data from hospital management information systems (clinical costing systems) to estimate resource relativities for inpatient hospital care used in Victoria's DRG-based payment system. The paper briefly describes international approaches to cost weight estimation. It describes the architecture of clinical costing systems, and contrasts process and job costing approaches to cost estimation. Techniques of data validation and reliability testing developed in the conduct of four of the first five of the Victorian Cost Weight Studies (1993-1998) are described. Improvement in sampling, data validity and reliability are documented over the course of the research program, the advantages of patient-level data are highlighted. The usefulness of these byproduct data for estimation of relative resource weights and other policy applications may be an important factor in hospital and health system decisions to invest in clinical costing technology.

48 CFR 434.001 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... total acquisition costs (for information technology, life cycle costs) are estimated to be $50 million or more, or (b) The system, regardless of estimated acquisition or life cycle costs, has been...

48 CFR 434.001 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... total acquisition costs (for information technology, life cycle costs) are estimated to be $50 million or more, or (b) The system, regardless of estimated acquisition or life cycle costs, has been...

48 CFR 434.001 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... total acquisition costs (for information technology, life cycle costs) are estimated to be $50 million or more, or (b) The system, regardless of estimated acquisition or life cycle costs, has been...

48 CFR 434.001 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... total acquisition costs (for information technology, life cycle costs) are estimated to be $50 million or more, or (b) The system, regardless of estimated acquisition or life cycle costs, has been...

Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study.

PubMed

Toscano, Cristiana M; Sugita, Tatiana H; Rosa, Michelle Q M; Pedrosa, Hermelinda C; Rosa, Roger Dos S; Bahia, Luciana R

2018-01-08

The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP) (1 Int$ = 1.748 BRL). We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13%) was for inpatient, and Int$ 333.5 million (87%) for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients. Although we have various reasons to believe that the hospital costs are underestimated, the estimated DFD burden is significant. As such, public health preventive strategies to reduce DFD related morbidity and mortality and costs are of utmost importance.

Costs of Crashes to Government, United States, 2008

PubMed Central

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

2011-01-01

We estimated how much the Federal government and state/local government pay for different kinds of crashes in the United States. Government costs include reductions in an array of public services (emergency, incident management, vocational rehabilitation, coroner court processing of liability litigation), medical payments, social safety net assistance to the injured and their families, and taxes foregone because victims miss work. Government also pays when its employees crash while working and covers fringe benefits for crash-involved employees and their benefit-eligible dependents in non-work hours. We estimated government shares of crash costs by component. We applied those estimates to existing US Department of Transportation estimates of crash costs to society and employers. Government pays an estimated $35 billion annually because of crashes, an estimated 12.6% of the economic cost of crashes (Federal 7.1%, State/local 5.5%). Government bears a higher percentage of the monetary costs of injury crashes than fatal crashes or crashes involving property damage only. Government is increasingly recovering the medical cost of crashes from auto insurers. Nevertheless, medical costs and income and sales tax losses account for 75% of government's crash costs. For State/local government to break even on a 100%-State funded investment in road safety, the intervention would need to have an unrealistically high benefit-cost ratio of 34. Government invests in medical treatment of illness to save lives and improve quality of life. Curing a child's leukemia, for example, is not less costly than leaving that leukemia untreated. Safety should not be held to a different standard. PMID:22105409

Cost estimating methods for advanced space systems

NASA Technical Reports Server (NTRS)

Cyr, Kelley

1988-01-01

The development of parametric cost estimating methods for advanced space systems in the conceptual design phase is discussed. The process of identifying variables which drive cost and the relationship between weight and cost are discussed. A theoretical model of cost is developed and tested using a historical data base of research and development projects.

A Cost Analysis of Colonoscopy using Microcosting and Time-and-motion Techniques

PubMed Central

Ness, Reid M.; Stiles, Renée A.; Shintani, Ayumi K.; Dittus, Robert S.

2007-01-01

Background The cost of an individual colonoscopy is an important determinant of the overall cost and cost-effectiveness of colorectal cancer screening. Published cost estimates vary widely and typically report institutional costs derived from gross-costing methods. Objective Perform a cost analysis of colonoscopy using micro-costing and time-and-motion techniques to determine the total societal cost of colonoscopy, which includes direct health care costs as well as direct non-health care costs and costs related to patients’ time. The design is prospective cohort. The participants were 276 contacted, eligible patients who underwent colonoscopy between July 2001 and June 2002, at either a Veterans’ Affairs Medical Center or a University Hospital in the Southeastern United States. Major results The median direct health care cost for colonoscopy was $379 (25%, 75%; $343, $433). The median direct non-health care and patient time costs were $226 (25%, 75%; $187, $323) and $274 (25%, 75%; $186, $368), respectively. The median total societal cost of colonoscopy was $923 (25%, 75%; $805, $1047). The median direct health care, direct non-health care, patient time costs, and total costs at the VA were $391, $288, $274, and $958, respectively; analogous costs at the University Hospital were $376, $189, $368, and $905, respectively. Conclusion Microcosting techniques and time-and-motion studies can produce accurate, detailed cost estimates for complex medical interventions. Cost estimates that inform health policy decisions or cost-effectiveness analyses should use total costs from the societal perspective. Societal cost estimates, which include patient and caregiver time costs, may affect colonoscopy screening rates. PMID:17665271

Demonstration of line transect methodologies to estimate urban gray squirrel density

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

Hein, E.W.

1997-11-01

Because studies estimating density of gray squirrels (Sciurus carolinensis) have been labor intensive and costly, I demonstrate the use of line transect surveys to estimate gray squirrel density and determine the costs of conducting surveys to achieve precise estimates. Density estimates are based on four transacts that were surveyed five times from 30 June to 9 July 1994. Using the program DISTANCE, I estimated there were 4.7 (95% Cl = 1.86-11.92) gray squirrels/ha on the Clemson University campus. Eleven additional surveys would have decreased the percent coefficient of variation from 30% to 20% and would have cost approximately $114. Estimatingmore » urban gray squirrel density using line transect surveys is cost effective and can provide unbiased estimates of density, provided that none of the assumptions of distance sampling theory are violated.« less

The Program Cost of a Brief Video Intervention Shown in Sexually Transmitted Disease Clinic Waiting Rooms.

PubMed

Gift, Thomas L; OʼDonnell, Lydia N; Rietmeijer, Cornelis A; Malotte, Kevin C; Klausner, Jeffrey D; Margolis, Andrew D; Borkowf, Craig B; Kent, Charlotte K; Warner, Lee

2016-01-01

Patients in sexually transmitted disease (STD) clinic waiting rooms represent a potential audience for delivering health messages via video-based interventions. A controlled trial at 3 sites found that patients exposed to one intervention, Safe in the City, had a significantly lower incidence of STDs compared with patients in the control condition. An evaluation of the intervention's cost could help determine whether such interventions are programmatically viable. The cost of producing the Safe in the City intervention was estimated using study records, including logs, calendars, and contract invoices. Production costs were divided by the 1650 digital video kits initially fabricated to get an estimated cost per digital video. Clinic costs for showing the video in waiting rooms included staff time costs for equipment operation and hardware depreciation and were estimated for the 21-month study observation period retrospectively. The intervention cost an estimated $416,966 to develop, equaling $253 per digital video disk produced. Per-site costs to show the video intervention were estimated to be $2699 during the randomized trial. The cost of producing and implementing Safe in the City intervention suggests that similar interventions could potentially be produced and made available to end users at a price that would both cover production costs and be low enough that the end users could afford them.

Cost effectiveness of the Oregon quitline "free patch initiative".

PubMed

Fellows, Jeffrey L; Bush, Terry; McAfee, Tim; Dickerson, John

2007-12-01

We estimated the cost effectiveness of the Oregon tobacco quitline's "free patch initiative" compared to the pre-initiative programme. Using quitline utilisation and cost data from the state, intervention providers and patients, we estimated annual programme use and costs for media promotions and intervention services. We also estimated annual quitline registration calls and the number of quitters and life years saved for the pre-initiative and free patch initiative programmes. Service utilisation and 30-day abstinence at six months were obtained from 959 quitline callers. We compared the cost effectiveness of the free patch initiative (media and intervention costs) to the pre-initiative service offered to insured and uninsured callers. We conducted sensitivity analyses on key programme costs and outcomes by estimating a best case and worst case scenario for each intervention strategy. Compared to the pre-intervention programme, the free patch initiative doubled registered calls, increased quitting fourfold and reduced total costs per quit by $2688. We estimated annual paid media costs were $215 per registered tobacco user for the pre-initiative programme and less than $4 per caller during the free patch initiative. Compared to the pre-initiative programme, incremental quitline promotion and intervention costs for the free patch initiative were $86 (range $22-$353) per life year saved. Compared to the pre-initiative programme, the free patch initiative was a highly cost effective strategy for increasing quitting in the population.

Estimating two indirect logging costs caused by accelerated erosion.

Treesearch

Glen O. Klock

1976-01-01

In forest areas where high soil erosion potential exists, a comparative yarding cost estimate, including the indirect costs determined by methods proposed here, shows that the total cost of using "advanced" logging methods may be less than that of "traditional" systems.

Cost-benefit analysis simulation of a hospital-based violence intervention program.

PubMed

Purtle, Jonathan; Rich, Linda J; Bloom, Sandra L; Rich, John A; Corbin, Theodore J

2015-02-01

Violent injury is a major cause of disability, premature mortality, and health disparities worldwide. Hospital-based violence intervention programs (HVIPs) show promise in preventing violent injury. Little is known, however, about how the impact of HVIPs may translate into monetary figures. To conduct a cost-benefit analysis simulation to estimate the savings an HVIP might produce in healthcare, criminal justice, and lost productivity costs over 5 years in a hypothetical population of 180 violently injured patients, 90 of whom received HVIP intervention and 90 of whom did not. Primary data from 2012, analyzed in 2013, on annual HVIP costs/number of clients served and secondary data sources were used to estimate the cost, number, and type of violent reinjury incidents (fatal/nonfatal, resulting in hospitalization/not resulting in hospitalization) and violent perpetration incidents (aggravated assault/homicide) that this population might experience over 5 years. Four different models were constructed and three different estimates of HVIP effect size (20%, 25%, and 30%) were used to calculate a range of estimates for HVIP net savings and cost-benefit ratios from different payer perspectives. All benefits were discounted at 5% to adjust for their net present value. Estimates of HVIP cost savings at the base effect estimate of 25% ranged from $82,765 (narrowest model) to $4,055,873 (broadest model). HVIPs are likely to produce cost savings. This study provides a systematic framework for the economic evaluation of HVIPs and estimates of HVIP cost savings and cost-benefit ratios that may be useful in informing public policy decisions. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Cost of Universal Health Care in India: A Model Based Estimate

PubMed Central

Prinja, Shankar; Bahuguna, Pankaj; Pinto, Andrew D.; Sharma, Atul; Bharaj, Gursimer; Kumar, Vishal; Tripathy, Jaya Prasad; Kaur, Manmeet; Kumar, Rajesh

2012-01-01

Introduction As high out-of-pocket healthcare expenses pose heavy financial burden on the families, Government of India is considering a variety of financing and delivery options to universalize health care services. Hence, an estimate of the cost of delivering universal health care services is needed. Methods We developed a model to estimate recurrent and annual costs for providing health services through a mix of public and private providers in Chandigarh located in northern India. Necessary health services required to deliver good quality care were defined by the Indian Public Health Standards. National Sample Survey data was utilized to estimate disease burden. In addition, morbidity and treatment data was collected from two secondary and two tertiary care hospitals. The unit cost of treatment was estimated from the published literature. For diseases where data on treatment cost was not available, we collected data on standard treatment protocols and cost of care from local health providers. Results We estimate that the cost of universal health care delivery through the existing mix of public and private health institutions would be INR 1713 (USD 38, 95%CI USD 18–73) per person per annum in India. This cost would be 24% higher, if branded drugs are used. Extrapolation of these costs to entire country indicates that Indian government needs to spend 3.8% (2.1%–6.8%) of the GDP for universalizing health care services. Conclusion The cost of universal health care delivered through a combination of public and private providers is estimated to be INR 1713 per capita per year in India. Important issues such as delivery strategy for ensuring quality, reducing inequities in access, and managing the growth of health care demand need be explored. PMID:22299038

The cost of asthma in Kuwait.

PubMed

Khadadah, Mousa

2013-01-01

To evaluate the direct costs of treating asthma in Kuwait. Population figures were obtained from the 2005 census and projected to 2008. Treatment profiles were obtained from the Asthma Insights and Reality for the Gulf and Near East (AIRGNE) study. Asthma prevalence and unit cost estimates were based on results from a Delphi technique. These estimates were applied to the total Kuwaiti population aged 5 years and over to obtain the number of people diagnosed with asthma. The estimates from the Delphi exercise and the AIRGNE results were used to determine the number of asthma patients managed in government facilities. Direct drug costs were provided by the Ministry of Health. Treatment costs (Kuwaiti dinars, KD) were also calculated using the Delphi exercise and the AIRGNE data. The prevalence of asthma was estimated to be 15% of adults and 18% of children (93,923 adults; 70,158 children). Of these, 84,530 (90%) adults and 58,932 (84.0%) children were estimated to be using government healthcare facilities. Inpatient visits accounted for the largest portion of total direct costs (43%), followed by emergency room visits (29%), outpatient visits (21%) and medications (7%). The annual cost of treatment, excluding medications, was KD 29,946,776 (USD 107,076,063) for adults and KD 24,295,439 (USD 86,869,450) for children. Including medications, the total annual direct cost of asthma treatment was estimated to be over KD 58 million (USD 207 million). Asthma costs Kuwait a huge sum of money, though the estimates were conservative because only Kuwaiti nationals were included. Given the high medical expenditures associated with emergency room and inpatient visits, relative to lower medication costs, efforts should be focused on improving asthma control rather than reducing expenditure on procurement of medication. Copyright © 2012 S. Karger AG, Basel.

Variability in Costs across Hospital Wards. A Study of Chinese Hospitals

PubMed Central

Adam, Taghreed; Evans, David B.; Ying, Bian; Murray, Christopher J. L.

2014-01-01

Introduction Analysts estimating the costs or cost-effectiveness of health interventions requiring hospitalization often cut corners because they lack data and the costs of undertaking full step-down costing studies are high. They sometimes use the costs taken from a single hospital, sometimes use simple rules of thumb for allocating total hospital costs between general inpatient care and the outpatient department, and sometimes use the average cost of an inpatient bed-day instead of a ward-specific cost. Purpose In this paper we explore for the first time the extent and the causes of variation in ward-specific costs across hospitals, using data from China. We then use the resulting model to show how ward-specific costs for hospitals outside the data set could be estimated using information on the determinants identified in the paper. Methodology Ward-specific costs estimated using step-down costing methods from 41 hospitals in 12 provinces of China were used. We used seemingly unrelated regressions to identify the determinants of variability in the ratio of the costs of specific wards to that of the outpatient department, and explain how this can be used to generate ward-specific unit costs. Findings Ward-specific unit costs varied considerably across hospitals, ranging from 1 to 24 times the unit cost in the outpatient department — average unit costs are not a good proxy for costs at specialty wards in general. The most important sources of variability were the number of staff and the level of capacity utilization. Practice Implications More careful hospital costing studies are clearly needed. In the meantime, we have shown that in China it is possible to estimate ward-specific unit costs taking into account key determinants of variability in costs across wards. This might well be a better alternative than using simple rules of thumb or using estimates from a single study. PMID:24874566

Life Cycle Cost Analysis of Shuttle-Derived Launch Vehicles, Volume 1

NASA Technical Reports Server (NTRS)

1982-01-01

The design, performance, and programmatic definition of shuttle derived launch vehicles (SDLV) established by two different contractors were assessed and the relative life cycle costs of space transportation systems using the shuttle alone were compared with costs for a mix of shuttles and SDLV's. The ground rules and assumptions used in the evaluation are summarized and the work breakdown structure is included. Approaches used in deriving SDLV costs, including calibration factors and historical data are described. Both SDLV cost estimates and SDLV/STS cost comparisons are summarized. Standard formats are used to report comprehensive SDLV life cycle estimates. Hardware cost estimates (below subsystem level) obtained using the RCA PRICE 84 cost model are included along with other supporting data.

40 CFR 264.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

40 CFR 265.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... comply with § 265.145. For owners or operators using the financial test or corporate guarantee, the post... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Cost estimate for post-closure care..., STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 265.144 Cost estimate for post-closure care. (a...

40 CFR 265.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... comply with § 265.145. For owners or operators using the financial test or corporate guarantee, the post... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Cost estimate for post-closure care..., STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 265.144 Cost estimate for post-closure care. (a...

40 CFR 265.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... comply with § 265.145. For owners or operators using the financial test or corporate guarantee, the post... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Cost estimate for post-closure care..., STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 265.144 Cost estimate for post-closure care. (a...

40 CFR 265.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... comply with § 265.145. For owners or operators using the financial test or corporate guarantee, the post... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Cost estimate for post-closure care..., STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 265.144 Cost estimate for post-closure care. (a...

40 CFR 265.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2014 CFR

2014-07-01

... comply with § 265.145. For owners or operators using the financial test or corporate guarantee, the post... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Cost estimate for post-closure care..., STORAGE, AND DISPOSAL FACILITIES Financial Requirements § 265.144 Cost estimate for post-closure care. (a...

40 CFR 264.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

40 CFR 264.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

40 CFR 264.144 - Cost estimate for post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 264.145. For owners or operators using the financial test or corporate guarantee, the post-closure... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Cost estimate for post-closure care... FACILITIES Financial Requirements § 264.144 Cost estimate for post-closure care. (a) The owner or operator of...

78 FR 26088 - Agency Information Collection Activities: Submission to OMB for a New Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... form relates to a budget or estimate of the legal fees, costs, and expenses that outside counsel would... average number of respondents, burden, and total annual cost appear below. The estimated number of... and the representations and certifications form. The NCUA estimated the total annual cost by...

A Cost Estimation Tool for Charter Schools

ERIC Educational Resources Information Center

Hayes, Cheryl D.; Keller, Eric

2009-01-01

To align their financing strategies and fundraising efforts with their fiscal needs, charter school leaders need to know how much funding they need and what that funding will support. This cost estimation tool offers a simple set of worksheets to help start-up charter school operators identify and estimate the range of costs and timing of…

Computer software to estimate timber harvesting system production, cost, and revenue

Treesearch

Dr. John E. Baumgras; Dr. Chris B. LeDoux

1992-01-01

Large variations in timber harvesting cost and revenue can result from the differences between harvesting systems, the variable attributes of harvesting sites and timber stands, or changing product markets. Consequently, system and site specific estimates of production rates and costs are required to improve estimates of harvesting revenue. This paper describes...

76 FR 65217 - Inorganic Arsenic Standard; Extension of the Office of Management and Budget's (OMB) Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

.... Estimated Cost (Operation and Maintenance): $54,197 IV. Public Participation--Submission of Comments on This... costs) is minimal, collection instruments are clearly understood, and OSHA's estimate of the information... accuracy of OSHA's estimate of the burden (time and costs) of the information collection requirements...

Estimating the cost of caring for people with cancer at the end of life: A modelling study

PubMed Central

Round, Jeff; Jones, Louise; Morris, Steve

2015-01-01

Background: People with advanced cancer require a range of health, social and informal care during the final phases of life. The cost of providing care to this group as they approach the end of their lives is unknown, but represents a significant cost to health and social care systems, charities patients and their families. Aim: In this study, we estimate the direct and indirect costs for lung, breast, colorectal and prostate cancer patients at the end of life (from the start of strong opioids to death) in England and Wales. Methods: We use a modelling-based approach to estimate the costs of care. Data are estimated from the literature and publicly available data sets. Probabilistic sensitivity analysis is used to reflect uncertainty in model estimates. Results: Total estimated costs for treating people with these four cancers at the end of life are £641 million. Breast and prostate cancer patients have the highest expected cost per person at £12,663 (95% credible interval (CI): £1249–£38,712) and £14,859 (95% CI: £1391–£46,424), respectively. Lung cancer has the highest expected total cost (£226m). The value of informal care giving accounts for approximately one-third of all costs. Conclusion: The cost to society of providing care to people at the end of their lives is significant. Much of this cost is borne by informal care givers. The cost to formal care services of replacing this care with paid care giving would be significant and demand for care will increase as the demographic profile of the population ages. PMID:26199134

Estimated community costs of an outbreak of campylobacteriosis resulting from contamination of a public water supply in Darfield, New Zealand.

PubMed

Sheerin, Ian; Bartholomew, Nadia; Brunton, Cheryl

2014-03-28

To estimate the economic costs to the community of an outbreak of campylobacteriosis in August 2012 resulting from contamination of a public water supply in Darfield, New Zealand. Probable incidence of waterborne disease was estimated. Reported cases were scrutinised to identify symptoms, duration, hospital admissions and those in the paid workforce. Extra public health and local authority costs were calculated. Estimated time off work was multiplied by the average wage to obtain a conservative estimate of lost production. Sensitivity analysis was used to estimate unreported cases and their associated costs. There were 138 cases of confirmed or probable campylobacter, of whom 46 sought a medical consultation. Taking into account the usual pyramid of non-notified cases, estimates of the population infected range between approximately 828 and 1987. The dominant societal cost is lost production from time off paid work. Forty-six per cent were in the paid workforce, indicating a total estimated economic cost of at least $714,527 but it could have been as high as $1.26 million, depending on estimates of unreported cases. The likely cause of the Darfield outbreak was faecal contamination of the water supply, which with a multi-barrier approach would have been entirely preventable. The results provide economic evidence to support upgrading of water supplies to provide safe water and prevent waterborne disease.

Rule-Based Flight Software Cost Estimation

NASA Technical Reports Server (NTRS)

Stukes, Sherry A.; Spagnuolo, John N. Jr.

2015-01-01

This paper discusses the fundamental process for the computation of Flight Software (FSW) cost estimates. This process has been incorporated in a rule-based expert system [1] that can be used for Independent Cost Estimates (ICEs), Proposals, and for the validation of Cost Analysis Data Requirements (CADRe) submissions. A high-level directed graph (referred to here as a decision graph) illustrates the steps taken in the production of these estimated costs and serves as a basis of design for the expert system described in this paper. Detailed discussions are subsequently given elaborating upon the methodology, tools, charts, and caveats related to the various nodes of the graph. We present general principles for the estimation of FSW using SEER-SEM as an illustration of these principles when appropriate. Since Source Lines of Code (SLOC) is a major cost driver, a discussion of various SLOC data sources for the preparation of the estimates is given together with an explanation of how contractor SLOC estimates compare with the SLOC estimates used by JPL. Obtaining consistency in code counting will be presented as well as factors used in reconciling SLOC estimates from different code counters. When sufficient data is obtained, a mapping into the JPL Work Breakdown Structure (WBS) from the SEER-SEM output is illustrated. For across the board FSW estimates, as was done for the NASA Discovery Mission proposal estimates performed at JPL, a comparative high-level summary sheet for all missions with the SLOC, data description, brief mission description and the most relevant SEER-SEM parameter values is given to illustrate an encapsulation of the used and calculated data involved in the estimates. The rule-based expert system described provides the user with inputs useful or sufficient to run generic cost estimation programs. This system's incarnation is achieved via the C Language Integrated Production System (CLIPS) and will be addressed at the end of this paper.

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association.

PubMed

Dunbar, Sandra B; Khavjou, Olga A; Bakas, Tamilyn; Hunt, Gail; Kirch, Rebecca A; Leib, Alyssa R; Morrison, R Sean; Poehler, Diana C; Roger, Veronique L; Whitsel, Laurie P

2018-05-08

In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035. We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers' wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant. The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs attributable to CVD. The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers. © 2018 American Heart Association, Inc.

Spacecraft platform cost estimating relationships

NASA Technical Reports Server (NTRS)

Gruhl, W. M.

1972-01-01

The three main cost areas of unmanned satellite development are discussed. The areas are identified as: (1) the spacecraft platform (SCP), (2) the payload or experiments, and (3) the postlaunch ground equipment and operations. The SCP normally accounts for over half of the total project cost and accurate estimates of SCP costs are required early in project planning as a basis for determining total project budget requirements. The development of single formula SCP cost estimating relationships (CER) from readily available data by statistical linear regression analysis is described. The advantages of single formula CER are presented.

LANDSAT D user data processing study

NASA Technical Reports Server (NTRS)

1976-01-01

The major expected users of the LANDSAT D system and a preliminary system design of their required facilities are investigated. This system design will then be costed in order to provide an estimate of the incremental user costs necessitated by LANDSAT D. One major use of these cost estimates is as part of an overall economic cost/benefit argument being developed for the LANDSAT D system. The implication of this motive is key; the system design (and corresponding cost estimates) must be a credible one, but not necessarily an optimum one.

Cost of stroke in Australia from a societal perspective: results from the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Dewey, H M; Thrift, A G; Mihalopoulos, C; Carter, R; Macdonell, R A; McNeil, J J; Donnan, G A

2001-10-01

Accurate information about resource use and costs of stroke is necessary for informed health service planning. The purpose of this study was to determine the patterns of resource use among stroke patients and to estimate the total costs (direct service use and indirect production losses) of stroke (excluding SAH) in Australia for 1997. An incidence-based cost-of-illness model was developed, incorporating data obtained from the North East Melbourne Stroke Incidence Study (NEMESIS). The costs of stroke during the first year after stroke and the present value of total lifetime costs of stroke were estimated. The total first-year costs of all first-ever-in-a lifetime strokes (SAH excluded) that occurred in Australia during 1997 were estimated to be A$555 million (US$420 million), and the present value of lifetime costs was estimated to be A$1.3 billion (US$985 million). The average cost per case during the first 12 months and over a lifetime was A$18 956 (US$14 361) and A$44 428 (US$33 658), respectively. The most important categories of cost during the first year were acute hospitalization (A$154 million), inpatient rehabilitation (A$150 million), and nursing home care (A$63 million). The present value of lifetime indirect costs was estimated to be A$34 million. Similar to other studies, hospital and nursing home costs contributed most to the total cost of stroke (excluding SAH) in Australia. Inpatient rehabilitation accounts for approximately 27% of total first-year costs. Given the magnitude of these costs, investigation of the cost-effectiveness of rehabilitation services should become a priority in this community.

Oil and gas pipeline construction cost analysis and developing regression models for cost estimation

NASA Astrophysics Data System (ADS)

Thaduri, Ravi Kiran

In this study, cost data for 180 pipelines and 136 compressor stations have been analyzed. On the basis of the distribution analysis, regression models have been developed. Material, Labor, ROW and miscellaneous costs make up the total cost of a pipeline construction. The pipelines are analyzed based on different pipeline lengths, diameter, location, pipeline volume and year of completion. In a pipeline construction, labor costs dominate the total costs with a share of about 40%. Multiple non-linear regression models are developed to estimate the component costs of pipelines for various cross-sectional areas, lengths and locations. The Compressor stations are analyzed based on the capacity, year of completion and location. Unlike the pipeline costs, material costs dominate the total costs in the construction of compressor station, with an average share of about 50.6%. Land costs have very little influence on the total costs. Similar regression models are developed to estimate the component costs of compressor station for various capacities and locations.

On a Formal Tool for Reasoning About Flight Software Cost Analysis

NASA Technical Reports Server (NTRS)

Spagnuolo, John N., Jr.; Stukes, Sherry A.

2013-01-01

A report focuses on the development of flight software (FSW) cost estimates for 16 Discovery-class missions at JPL. The techniques and procedures developed enabled streamlining of the FSW analysis process, and provided instantaneous confirmation that the data and processes used for these estimates were consistent across all missions. The research provides direction as to how to build a prototype rule-based system for FSW cost estimation that would provide (1) FSW cost estimates, (2) explanation of how the estimates were arrived at, (3) mapping of costs, (4) mathematical trend charts with explanations of why the trends are what they are, (5) tables with ancillary FSW data of interest to analysts, (6) a facility for expert modification/enhancement of the rules, and (7) a basis for conceptually convenient expansion into more complex, useful, and general rule-based systems.

The socioeconomic costs of mental illness in Spain.

PubMed

Oliva-Moreno, Juan; López-Bastida, Julio; Montejo-González, Angel Luis; Osuna-Guerrero, Rubén; Duque-González, Beatriz

2009-10-01

Mental illness affects a large number of people in the world, seriously impairing their quality of life and resulting in high socioeconomic costs for health care systems and society. Our aim is to estimate the socioeconomic impact of mental illness in Spain for the year 2002, including health care resources, informal care and loss of labour productivity. A prevalence-based approach was used to estimate direct medical costs, direct non-medical costs, and loss of labour productivity. The total costs of mental illness have been estimated at 7,019 million euros. Direct medical costs represented 39.6% of the total costs and 7.3% of total public healthcare expenditure in Spain. Informal care costs represented 17.7% of the total costs. Loss of labour productivity accounted for 42.7% of total costs. In conclusion, the costs of mental illness in Spain make a considerable economic impact from a societal perspective.

The Cost of Relapse in Schizophrenia.

PubMed

Pennington, Mark; McCrone, Paul

2017-09-01

Schizophrenia is a chronic and debilitating mental illness characterised by periods of relapse that require resource intensive management. Quantifying the cost of relapse is central to the evaluation of the cost effectiveness of treating schizophrenia. We aimed to undertake a comprehensive search of the available literature on the cost of relapse. We performed a search on multiple databases (MEDLINE, Embase, PsycINFO and Health Management Information Consortium) for any study reporting a cost of relapse or data from which such a cost could be calculated. Costs are reported in 2015 international dollars. We found 16 studies reporting costs associated with relapse over a defined period of time and identified a cost associated with hospitalisation for relapse in 43 studies. Eight clinical decision analyses also provided cost estimates. Studies from the US report excess costs of relapse of $6033-$32,753 (2015 Purchasing Power Parity dollars [PPP$]) over periods of 12-15 months. European studies report excess costs of $8665-$18,676 (2015 PPP$) over periods of 6-12 months. Estimates of the cost of hospitalisation for relapse are more diverse, and associated with marked differences in typical length of stay across jurisdictions. Wide ranges in the estimated cost of relapse may reflect differences in sample section and relapse definition as well as practice styles and differences in resource costs. Selection of the most appropriate cost estimate should be guided by the definition of relapse and the analysis setting.

Costs of providing infusion therapy for patients with inflammatory bowel disease in a hospital-based infusion center setting.

PubMed

Afzali, Anita; Ogden, Kristine; Friedman, Michael L; Chao, Jingdong; Wang, Anthony

2017-04-01

Inflammatory bowel disease (IBD) (e.g. ulcerative colitis [UC] and Crohn's disease [CD]) severely impacts patient quality-of-life. Moderate-to-severe disease is often treated with biologics requiring infusion therapy, adding incremental costs beyond drug costs. This study evaluates US hospital-based infusion services costs for treatment of UC or CD patients receiving infliximab or vedolizumab therapy. A model was developed, estimating annual costs of providing monitored infusions using an activity-based costing framework approach. Multiple sources (published literature, treatment product inserts) informed base-case model input estimates. The total modeled per patient infusion therapy costs in Year 1 with infliximab and vedolizumab was $38,782 and $41,320, respectively, and Year 2+, $49,897 and $36,197, respectively. Drug acquisition cost was the largest total costs driver (90-93%), followed by costs associated with hospital-based infusion provision: labor (53-56%, non-drug costs), allocated overhead (23%, non-drug costs), non-labor (23%, non-drug costs), and laboratory (7-10%, non-drug costs). Limitations included reliance on published estimates, base-case cost estimates infusion drug, and supplies, not accounting for volume pricing, assumption of a small hospital infusion center, and that, given the model adopts the hospital perspective, costs to the patient were not included in infusion administration cost base-case estimates. This model is an early step towards a framework to fully analyze infusion therapies' associated costs. Given the lack of published data, it would be beneficial for hospital administrators to assess total costs and trade-offs with alternative means of providing biologic therapies. This analysis highlights the value to hospital administrators of assessing cost associated with infusion patient mix to make more informed resource allocation decisions. As the landscape for reimbursement changes, tools for evaluating the costs of infusion therapy may help hospital administrators make informed choices and weigh trade-offs associated with providing infusion services for IBD patients.

The Economic Costs of Substance Abuse Treatment: Updated Estimates and Cost Bands for Program Assessment and Reimbursement

PubMed Central

French, Michael T.; Popovici, Ioana; Tapsell, Lauren

2008-01-01

Federal, State, and local government agencies require current and accurate cost information for publicly funded substance abuse treatment programs to guide program assessments and reimbursement decisions. The Center for Substance Abuse Treatment (CSAT) published a list of modality-specific cost bands for this purpose in 2002. However, the upper and lower values in these ranges are so wide that they offer little practical guidance for funding agencies. Thus, the dual purpose of this investigation was to assemble the most current and comprehensive set of economic cost estimates from the readily-available literature and then use these estimates to develop updated modality-specific cost bands for more reasonable reimbursement policies. Although cost estimates were scant for some modalities, the recommended cost bands are based on the best available economic research, and we believe these new ranges will be more useful and pertinent for all stakeholders of publicly-funded substance abuse treatment. PMID:18294803

Occupational disease and workers' compensation: coverage, costs, and consequences.

PubMed

Leigh, J Paul; Robbins, John A

2004-01-01

Most of the costs of occupational disease are not covered by workers' compensation. First, the authors estimated the deaths and costs for all occupational disease in 1999, using epidemiological studies. Among the greatest contributors were job-related cancer, chronic respiratory disease, and circulatory disease. Second, the authors estimated the number of workers' compensation cases, costs, and deaths for 1999, using data from up to 16 states representing all regions of the country. Unlike the epidemiological studies that emphasized fatal diseases, the workers' compensation estimates emphasized nonfatal diseases and conditions like tendonitis and hernia. Comparisons of the epidemiological and workers' compensation estimates suggest that in 1999, workers' compensation missed roughly 46,000 to 93,000 deaths and 8 billion US dollars to 23 billion US dollars in medical costs. These deaths and costs represented substantial cost shifting from workers' compensation systems to individual workers, their families, private medical insurance, and taxpayers (through Medicare and Medicaid). Designing policies to reduce the cost shifting and its associated inefficiency will be challenging.

Occupational Disease and Workers’ Compensation: Coverage, Costs, and Consequences

PubMed Central

Leigh, J Paul; Robbins, John A

2004-01-01

Most of the costs of occupational disease are not covered by workers’ compensation. First, the authors estimated the deaths and costs for all occupational disease in 1999, using epidemiological studies. Among the greatest contributors were job-related cancer, chronic respiratory disease, and circulatory disease. Second, the authors estimated the number of workers’ compensation cases, costs, and deaths for 1999, using data from up to 16 states representing all regions of the country. Unlike the epidemiological studies that emphasized fatal diseases, the workers’ compensation estimates emphasized nonfatal diseases and conditions like tendonitis and hernia. Comparisons of the epidemiological and workers’ compensation estimates suggest that in 1999, workers’ compensation missed roughly 46,000 to 93,000 deaths and $8 billion to $23 billion in medical costs. These deaths and costs represented substantial cost shifting from workers’ compensation systems to individual workers, their families, private medical insurance, and taxpayers (through Medicare and Medicaid). Designing policies to reduce the cost shifting and its associated inefficiency will be challenging. PMID:15595947

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.

Comprehensive investigation into historical pipeline construction costs and engineering economic analysis of Alaska in-state gas pipeline

NASA Astrophysics Data System (ADS)

Rui, Zhenhua

This study analyzes historical cost data of 412 pipelines and 220 compressor stations. On the basis of this analysis, the study also evaluates the feasibility of an Alaska in-state gas pipeline using Monte Carlo simulation techniques. Analysis of pipeline construction costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary by diameter, length, volume, year, and location. Overall average learning rates for pipeline material and labor costs are 6.1% and 12.4%, respectively. Overall average cost shares for pipeline material, labor, miscellaneous, and right of way (ROW) are 31%, 40%, 23%, and 7%, respectively. Regression models are developed to estimate pipeline component costs for different lengths, cross-sectional areas, and locations. An analysis of inaccuracy in pipeline cost estimation demonstrates that the cost estimation of pipeline cost components is biased except for in the case of total costs. Overall overrun rates for pipeline material, labor, miscellaneous, ROW, and total costs are 4.9%, 22.4%, -0.9%, 9.1%, and 6.5%, respectively, and project size, capacity, diameter, location, and year of completion have different degrees of impacts on cost overruns of pipeline cost components. Analysis of compressor station costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary in terms of capacity, year, and location. Average learning rates for compressor station material and labor costs are 12.1% and 7.48%, respectively. Overall average cost shares of material, labor, miscellaneous, and ROW are 50.6%, 27.2%, 21.5%, and 0.8%, respectively. Regression models are developed to estimate compressor station component costs in different capacities and locations. An investigation into inaccuracies in compressor station cost estimation demonstrates that the cost estimation for compressor stations is biased except for in the case of material costs. Overall average overrun rates for compressor station material, labor, miscellaneous, land, and total costs are 3%, 60%, 2%, -14%, and 11%, respectively, and cost overruns for cost components are influenced by location and year of completion to different degrees. Monte Carlo models are developed and simulated to evaluate the feasibility of an Alaska in-state gas pipeline by assigning triangular distribution of the values of economic parameters. Simulated results show that the construction of an Alaska in-state natural gas pipeline is feasible at three scenarios: 500 million cubic feet per day (mmcfd), 750 mmcfd, and 1000 mmcfd.

Improving the Discipline of Cost Estimation and Analysis

NASA Technical Reports Server (NTRS)

Piland, William M.; Pine, David J.; Wilson, Delano M.

2000-01-01

The need to improve the quality and accuracy of cost estimates of proposed new aerospace systems has been widely recognized. The industry has done the best job of maintaining related capability with improvements in estimation methods and giving appropriate priority to the hiring and training of qualified analysts. Some parts of Government, and National Aeronautics and Space Administration (NASA) in particular, continue to need major improvements in this area. Recently, NASA recognized that its cost estimation and analysis capabilities had eroded to the point that the ability to provide timely, reliable estimates was impacting the confidence in planning man), program activities. As a result, this year the Agency established a lead role for cost estimation and analysis. The Independent Program Assessment Office located at the Langley Research Center was given this responsibility.

ESTIMATING TREATMENT EFFECTS ON HEALTHCARE COSTS UNDER EXOGENEITY: IS THERE A ‘MAGIC BULLET’?

PubMed Central

Polsky, Daniel; Manning, Willard G.

2011-01-01

Methods for estimating average treatment effects, under the assumption of no unmeasured confounders, include regression models; propensity score adjustments using stratification, weighting, or matching; and doubly robust estimators (a combination of both). Researchers continue to debate about the best estimator for outcomes such as health care cost data, as they are usually characterized by an asymmetric distribution and heterogeneous treatment effects,. Challenges in finding the right specifications for regression models are well documented in the literature. Propensity score estimators are proposed as alternatives to overcoming these challenges. Using simulations, we find that in moderate size samples (n= 5000), balancing on propensity scores that are estimated from saturated specifications can balance the covariate means across treatment arms but fails to balance higher-order moments and covariances amongst covariates. Therefore, unlike regression model, even if a formal model for outcomes is not required, propensity score estimators can be inefficient at best and biased at worst for health care cost data. Our simulation study, designed to take a ‘proof by contradiction’ approach, proves that no one estimator can be considered the best under all data generating processes for outcomes such as costs. The inverse-propensity weighted estimator is most likely to be unbiased under alternate data generating processes but is prone to bias under misspecification of the propensity score model and is inefficient compared to an unbiased regression estimator. Our results show that there are no ‘magic bullets’ when it comes to estimating treatment effects in health care costs. Care should be taken before naively applying any one estimator to estimate average treatment effects in these data. We illustrate the performance of alternative methods in a cost dataset on breast cancer treatment. PMID:22199462

Medical costs and quality-adjusted life years associated with smoking: a systematic review.

PubMed

Feirman, Shari P; Glasser, Allison M; Teplitskaya, Lyubov; Holtgrave, David R; Abrams, David B; Niaura, Raymond S; Villanti, Andrea C

2016-07-27

Estimated medical costs ("T") and QALYs ("Q") associated with smoking are frequently used in cost-utility analyses of tobacco control interventions. The goal of this study was to understand how researchers have addressed the methodological challenges involved in estimating these parameters. Data were collected as part of a systematic review of tobacco modeling studies. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Studies were eligible for the current analysis if they were U.S.-based, provided an estimate for Q, and used a societal perspective and lifetime analytic horizon to estimate T. We identified common methods and frequently cited sources used to obtain these estimates. Across all 18 studies included in this review, 50 % cited a 1992 source to estimate the medical costs associated with smoking and 56 % cited a 1996 study to derive the estimate for QALYs saved by quitting or preventing smoking. Approaches for estimating T varied dramatically among the studies included in this review. T was valued as a positive number, negative number and $0; five studies did not include estimates for T in their analyses. The most commonly cited source for Q based its estimate on the Health Utilities Index (HUI). Several papers also cited sources that based their estimates for Q on the Quality of Well-Being Scale and the EuroQol five dimensions questionnaire (EQ-5D). Current estimates of the lifetime medical care costs and the QALYs associated with smoking are dated and do not reflect the latest evidence on the health effects of smoking, nor the current costs and benefits of smoking cessation and prevention. Given these limitations, we recommend that researchers conducting economic evaluations of tobacco control interventions perform extensive sensitivity analyses around these parameter estimates.

A Framework for Automating Cost Estimates in Assembly Processes

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

Calton, T.L.; Peters, R.R.

1998-12-09

When a product concept emerges, the manufacturing engineer is asked to sketch out a production strategy and estimate its cost. The engineer is given an initial product design, along with a schedule of expected production volumes. The engineer then determines the best approach to manufacturing the product, comparing a variey of alternative production strategies. The engineer must consider capital cost, operating cost, lead-time, and other issues in an attempt to maximize pro$ts. After making these basic choices and sketching the design of overall production, the engineer produces estimates of the required capital, operating costs, and production capacity. 177is process maymore » iterate as the product design is refined in order to improve its pe~ormance or manufacturability. The focus of this paper is on the development of computer tools to aid manufacturing engineers in their decision-making processes. This computer sof~are tool provides aj?amework in which accurate cost estimates can be seamlessly derivedfiom design requirements at the start of any engineering project. Z+e result is faster cycle times through first-pass success; lower ll~e cycie cost due to requirements-driven design and accurate cost estimates derived early in the process.« less

Productivity cost calculations in health economic evaluations: correcting for compensation mechanisms and multiplier effects.

PubMed

Krol, Marieke; Brouwer, Werner B F; Severens, Johan L; Kaper, Janneke; Evers, Silvia M A A

2012-12-01

Productivity costs related to paid work are commonly calculated in economic evaluations of health technologies by multiplying the relevant number of work days lost with a wage rate estimate. It has been argued that actual productivity costs may either be lower or higher than current estimates due to compensation mechanisms and/or multiplier effects (related to team dependency and problems with finding good substitutes in cases of absenteeism). Empirical evidence on such mechanisms and their impact on productivity costs is scarce, however. This study aims to increase knowledge on how diminished productivity is compensated within firms. Moreover, it aims to explore how compensation and multiplier effects potentially affect productivity cost estimates. Absenteeism and compensation mechanisms were measured in a randomized trial among Dutch citizens examining the cost-effectiveness of reimbursement for smoking cessation treatment. Multiplier effects were extracted from published literature. Productivity costs were calculated applying the Friction Cost Approach. Regular estimates were subsequently adjusted for (i) compensation during regular working hours, (ii) job dependent multipliers and (iii) both compensation and multiplier effects. A total of 187 respondents included in the trial were useful for inclusion in this study, based on being in paid employment, having experienced absenteeism in the preceding six months and completing the questionnaire on absenteeism and compensation mechanisms. Over half of these respondents stated that their absenteeism was compensated during normal working hours by themselves or colleagues. Only counting productivity costs not compensated in regular working hours reduced the traditional estimate by 57%. Correcting for multiplier effects increased regular estimates by a quarter. Combining both impacts decreased traditional estimates by 29%. To conclude, large amounts of lost production are compensated in normal hours. Productivity costs estimates are strongly influenced by adjustment for compensation mechanisms and multiplier effects. The validity of such adjustments needs further examination, however. Copyright © 2012 Elsevier Ltd. All rights reserved.

National Costs Of The Medical Liability System

PubMed Central

Mello, Michelle M.; Chandra, Amitabh; Gawande, Atul A.; Studdert, David M.

2011-01-01

Concerns about reducing the rate of growth of health expenditures have reignited interest in medical liability reforms and their potential to save money by reducing the practice of defensive medicine. It is not easy to estimate the costs of the medical liability system, however. This article identifies the various components of liability system costs, generates national estimates for each component, and discusses the level of evidence available to support the estimates. Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending. PMID:20820010

Planetary spacecraft cost modeling utilizing labor estimating relationships

NASA Technical Reports Server (NTRS)

Williams, Raymond

1990-01-01

A basic computerized technology is presented for estimating labor hours and cost of unmanned planetary and lunar programs. The user friendly methodology designated Labor Estimating Relationship/Cost Estimating Relationship (LERCER) organizes the forecasting process according to vehicle subsystem levels. The level of input variables required by the model in predicting cost is consistent with pre-Phase A type mission analysis. Twenty one program categories were used in the modeling. To develop the model, numerous LER and CER studies were surveyed and modified when required. The result of the research along with components of the LERCER program are reported.

Highway Cost Index Estimator Tool

DOT National Transportation Integrated Search

2017-10-01

To plan and program highway construction projects, the Texas Department of Transportation requires accurate construction cost data. However, due to the number of, and uncertainty of, variables that affect highway construction costs, estimating future...

Harvesting systems and costs for southern pine in the 1980s

Treesearch

Frederick W. Cubbage; James E. Granskog

1981-01-01

Timber harvesting systems and their costs are a major concern for the forest products industries. In this paper, harvest costs per cord are estimated, using computer simulation, for current southern pine harvesting systems. The estimations represent a range of mechanization levels. The sensitivity of systems to factors affecting harvest costs - machine costs, fuel...

Economic Costs of Alcohol and Drug Abuse in Texas: 1997 Update.

ERIC Educational Resources Information Center

Liu, Liang Y.

This report provides an update of the costs of alcohol and drug abuse for 1997. The 1997 costs were estimated by multiplying the percent changes in various socioeconomic factors from 1989 to 1997 by the cost estimates. The adverse health and social consequences of substance abuse extensively increased costs to the state. The total economic costs…

The Cost of Blindness in the Republic of Ireland 2010-2020.

PubMed

Green, D; Ducorroy, G; McElnea, E; Naughton, A; Skelly, A; O'Neill, C; Kenny, D; Keegan, D

2016-01-01

Aims. To estimate the prevalence of blindness in the Republic of Ireland and the associated financial and total economic cost between 2010 and 2020. Methods. Estimates for the prevalence of blindness in the Republic of Ireland were based on blindness registration data from the National Council for the Blind of Ireland. Estimates for the financial and total economic cost of blindness were based on the sum of direct and indirect healthcare and nonhealthcare costs. Results. We estimate that there were 12,995 blind individuals in Ireland in 2010 and in 2020 there will be 17,997. We estimate that the financial and total economic costs of blindness in the Republic of Ireland in 2010 were €276.6 million and €809 million, respectively, and will increase in 2020 to €367 million and €1.1 billion, respectively. Conclusions. Here, ninety-eight percent of the cost of blindness is borne by the Departments of Social Protection and Finance and not by the Department of Health as might initially be expected. Cost of illness studies should play a role in public policy making as they help to quantify the indirect or "hidden" costs of disability and so help to reveal the true cost of illness.

The Cost of Blindness in the Republic of Ireland 2010–2020

PubMed Central

Green, D.; Ducorroy, G.; McElnea, E.; Naughton, A.; Skelly, A.; O'Neill, C.; Kenny, D.; Keegan, D.

2016-01-01

Aims. To estimate the prevalence of blindness in the Republic of Ireland and the associated financial and total economic cost between 2010 and 2020. Methods. Estimates for the prevalence of blindness in the Republic of Ireland were based on blindness registration data from the National Council for the Blind of Ireland. Estimates for the financial and total economic cost of blindness were based on the sum of direct and indirect healthcare and nonhealthcare costs. Results. We estimate that there were 12,995 blind individuals in Ireland in 2010 and in 2020 there will be 17,997. We estimate that the financial and total economic costs of blindness in the Republic of Ireland in 2010 were €276.6 million and €809 million, respectively, and will increase in 2020 to €367 million and €1.1 billion, respectively. Conclusions. Here, ninety-eight percent of the cost of blindness is borne by the Departments of Social Protection and Finance and not by the Department of Health as might initially be expected. Cost of illness studies should play a role in public policy making as they help to quantify the indirect or “hidden” costs of disability and so help to reveal the true cost of illness. PMID:26981276

Remote Minehunting System (RMS)

DTIC Science & Technology

2015-12-01

1449.4 1449.4 744.6 Confidence Level Confidence Level of cost estimate for current APB: 50% The Independent Cost Estimate to support the RMS Nunn...which the Derpartment has been successful. It is difficult to calculate mathematically the precise confidence levels associated with life-cycle cost...Baseline (TY $M) Initial PAUC Production Estimate Changes PAUC Development Estimate Econ Qty Sch Eng Est Oth Spt Total 12.957 -0.752 3.262 2.950 0.454

Cost-to-Complete Estimates and Financial Reporting for the Management of the Iraq Relief and Reconstruction Fund

DTIC Science & Technology

2005-07-26

Audit Report Cost-to-Complete Estimates and Financial Reporting for the Management of the Iraq Relief and Reconstruction...Complete Estimates and Financial Reporting for the Management of the Iraq Relief and Reconstruction Fund 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...RECONSTRUCTION MANAGEMENT OFFICE DIRECTOR, PROJECT AND CONTRACTING OFFICE SUBJECT: Cost-to-Complete Estimates and Financial Reporting for the Management of

Regional economic activity and absenteeism: a new approach to estimating the indirect costs of employee productivity loss.

PubMed

Bankert, Brian; Coberley, Carter; Pope, James E; Wells, Aaron

2015-02-01

This paper presents a new approach to estimating the indirect costs of health-related absenteeism. Productivity losses related to employee absenteeism have negative business implications for employers and these losses effectively deprive the business of an expected level of employee labor. The approach herein quantifies absenteeism cost using an output per labor hour-based method and extends employer-level results to the region. This new approach was applied to the employed population of 3 health insurance carriers. The economic cost of absenteeism was estimated to be $6.8 million, $0.8 million, and $0.7 million on average for the 3 employers; regional losses were roughly twice the magnitude of employer-specific losses. The new approach suggests that costs related to absenteeism for high output per labor hour industries exceed similar estimates derived from application of the human capital approach. The materially higher costs under the new approach emphasize the importance of accurately estimating productivity losses.

Early‐Stage Capital Cost Estimation of Biorefinery Processes: A Comparative Study of Heuristic Techniques

PubMed Central

Couturier, Jean‐Luc; Kokossis, Antonis; Dubois, Jean‐Luc

2016-01-01

Abstract Biorefineries offer a promising alternative to fossil‐based processing industries and have undergone rapid development in recent years. Limited financial resources and stringent company budgets necessitate quick capital estimation of pioneering biorefinery projects at the early stages of their conception to screen process alternatives, decide on project viability, and allocate resources to the most promising cases. Biorefineries are capital‐intensive projects that involve state‐of‐the‐art technologies for which there is no prior experience or sufficient historical data. This work reviews existing rapid cost estimation practices, which can be used by researchers with no previous cost estimating experience. It also comprises a comparative study of six cost methods on three well‐documented biorefinery processes to evaluate their accuracy and precision. The results illustrate discrepancies among the methods because their extrapolation on biorefinery data often violates inherent assumptions. This study recommends the most appropriate rapid cost methods and urges the development of an improved early‐stage capital cost estimation tool suitable for biorefinery processes. PMID:27484398

Taking ART to Scale: Determinants of the Cost and Cost-Effectiveness of Antiretroviral Therapy in 45 Clinical Sites in Zambia

PubMed Central

Marseille, Elliot; Giganti, Mark J.; Mwango, Albert; Chisembele-Taylor, Angela; Mulenga, Lloyd; Over, Mead; Kahn, James G.; Stringer, Jeffrey S. A.

2012-01-01

Background We estimated the unit costs and cost-effectiveness of a government ART program in 45 sites in Zambia supported by the Centre for Infectious Disease Research Zambia (CIDRZ). Methods We estimated per person-year costs at the facility level, and support costs incurred above the facility level and used multiple regression to estimate variation in these costs. To estimate ART effectiveness, we compared mortality in this Zambian population to that of a cohort of rural Ugandan HIV patients receiving co-trimoxazole (CTX) prophylaxis. We used micro-costing techniques to estimate incremental unit costs, and calculated cost-effectiveness ratios with a computer model which projected results to 10 years. Results The program cost $69.7 million for 125,436 person-years of ART, or $556 per ART-year. Compared to CTX prophylaxis alone, the program averted 33.3 deaths or 244.5 disability adjusted life-years (DALYs) per 100 person-years of ART. In the base-case analysis, the net cost per DALY averted was $833 compared to CTX alone. More than two-thirds of the variation in average incremental total and on-site cost per patient-year of treatment is explained by eight determinants, including the complexity of the patient-case load, the degree of adherence among the patients, and institutional characteristics including, experience, scale, scope, setting and sector. Conclusions and Significance The 45 sites exhibited substantial variation in unit costs and cost-effectiveness and are in the mid-range of cost-effectiveness when compared to other ART programs studied in southern Africa. Early treatment initiation, large scale, and hospital setting, are associated with statistically significantly lower costs, while others (rural location, private sector) are associated with shifting cost from on- to off-site. This study shows that ART programs can be significantly less costly or more cost-effective when they exploit economies of scale and scope, and initiate patients at higher CD4 counts. PMID:23284843

Taking ART to scale: determinants of the cost and cost-effectiveness of antiretroviral therapy in 45 clinical sites in Zambia.

PubMed

Marseille, Elliot; Giganti, Mark J; Mwango, Albert; Chisembele-Taylor, Angela; Mulenga, Lloyd; Over, Mead; Kahn, James G; Stringer, Jeffrey S A

2012-01-01

We estimated the unit costs and cost-effectiveness of a government ART program in 45 sites in Zambia supported by the Centre for Infectious Disease Research Zambia (CIDRZ). We estimated per person-year costs at the facility level, and support costs incurred above the facility level and used multiple regression to estimate variation in these costs. To estimate ART effectiveness, we compared mortality in this Zambian population to that of a cohort of rural Ugandan HIV patients receiving co-trimoxazole (CTX) prophylaxis. We used micro-costing techniques to estimate incremental unit costs, and calculated cost-effectiveness ratios with a computer model which projected results to 10 years. The program cost $69.7 million for 125,436 person-years of ART, or $556 per ART-year. Compared to CTX prophylaxis alone, the program averted 33.3 deaths or 244.5 disability adjusted life-years (DALYs) per 100 person-years of ART. In the base-case analysis, the net cost per DALY averted was $833 compared to CTX alone. More than two-thirds of the variation in average incremental total and on-site cost per patient-year of treatment is explained by eight determinants, including the complexity of the patient-case load, the degree of adherence among the patients, and institutional characteristics including, experience, scale, scope, setting and sector. The 45 sites exhibited substantial variation in unit costs and cost-effectiveness and are in the mid-range of cost-effectiveness when compared to other ART programs studied in southern Africa. Early treatment initiation, large scale, and hospital setting, are associated with statistically significantly lower costs, while others (rural location, private sector) are associated with shifting cost from on- to off-site. This study shows that ART programs can be significantly less costly or more cost-effective when they exploit economies of scale and scope, and initiate patients at higher CD4 counts.

Costs of HIV/AIDS outpatient services delivered through Zambian public health facilities.

PubMed

Bratt, John H; Torpey, Kwasi; Kabaso, Mushota; Gondwe, Yebo

2011-01-01

To present evidence on unit and total costs of outpatient HIV/AIDS services in ZPCT-supported facilities in Zambia; specifically, to measure unit costs of selected outpatient HIV/AIDS services, and to estimate total annual costs of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) in Zambia. Cost data from 2008 were collected in 12 ZPCT-supported facilities (hospitals and health centres) in four provinces. Costs of all resources used to produce ART, PMTCT and CT visits were included, using the perspective of the provider. All shared costs were distributed to clinic visits using appropriate allocation variables. Estimates of annual costs of HIV/AIDS services were made using ZPCT and Ministry of Health data on numbers of persons receiving services in 2009. Unit costs of visits were driven by costs of drugs, laboratory tests and clinical labour, while variability in visit costs across facilities was explained mainly by differences in utilization. First-year costs of ART per client ranged from US$278 to US$523 depending on drug regimen and facility type; costs of a complete course of antenatal care (ANC) including PMTCT were approximately US$114. Annual costs of ART provided in ZPCT-supported facilities were estimated at US$14.7-$40.1 million depending on regimen, and annual costs of antenatal care including PMTCT were estimated at US$16 million. In Zambia as a whole, the respective estimates were US$41.0-114.2 million for ART and US$57.7 million for ANC including PMTCT. Consistent with the literature, total costs of services were dominated by drugs, laboratory tests and clinical labour. For each visit type, variability across facilities in total costs and cost components suggests that some potential exists to reduce costs through greater harmonization of care protocols and more intensive use of fixed resources. Improving facility-level information on the costs of resources used to produce services should be emphasized as an element of health systems strengthening. © 2010 Blackwell Publishing Ltd.

Systematic review of incremental non-vaccine cost estimates used in cost-effectiveness analysis on the introduction of rotavirus and pneumococcal vaccines.

PubMed

De la Hoz-Restrepo, Fernando; Castañeda-Orjuela, Carlos; Paternina, Angel; Alvis-Guzman, Nelson

2013-07-02

To review the approaches used in the cost-effectiveness analysis (CEAs) literature to estimate the cost of expanded program on immunization (EPI) activities, other than vaccine purchase, for rotavirus and pneumococcal vaccines. A systematic review in PubMed and NHS EED databases of rotavirus and pneumococcal vaccines CEAs was done. Selected articles were read and information on how EPI costs were calculated was extracted. EPI costing approaches were classified according to the method or assumption used for estimation. Seventy-nine studies that evaluated cost effectiveness of rotavirus (n=43) or pneumococcal (n=36) vaccines were identified. In general, there are few details on how EPI costs other than vaccine procurement were estimated. While 30 studies used some measurement of that cost, only one study on pneumococcal vaccine used a primary cost evaluation (bottom-up costing analysis) and one study used a costing tool. Twenty-seven studies (17 on rotavirus and 10 on pneumococcal vaccine) assumed the non-vaccine costs. Five studies made no reference to additional costs. Fourteen studies (9 rotavirus and 5 pneumococcal) did not consider any additional EPI cost beyond vaccine procurement. For rotavirus studies, the median for non-vaccine cost per dose was US$0.74 in developing countries and US$6.39 in developed countries. For pneumococcal vaccines, the median for non-vaccine cost per dose was US$1.27 in developing countries and US$8.71 in developed countries. Many pneumococcal (52.8%) and rotavirus (60.4%) cost-effectiveness analyses did not consider additional EPI costs or used poorly supported assumptions. Ignoring EPI costs in addition to those for vaccine procurement in CEA analysis of new vaccines may lead to significant errors in the estimations of ICERs since several factors like personnel, cold chain, or social mobilization can be substantially affected by the introduction of new vaccines. Copyright © 2013 Elsevier Ltd. All rights reserved.

The social cost of rheumatoid arthritis in Italy: the results of an estimation exercise.

PubMed

Turchetti, G; Bellelli, S; Mosca, M

2014-03-14

The objective of this study is to estimate the mean annual social cost per adult person and the total social cost of rheumatoid arthritis (RA) in Italy. A literature review was performed by searching primary economic studies on adults in order to collect cost data of RA in Italy in the last decade. The review results were merged with data of institutional sources for estimating - following the methodological steps of the cost of illness analysis - the social cost of RA in Italy. The mean annual social cost of RA was € 13,595 per adult patient in Italy. Affecting 259,795 persons, RA determines a social cost of € 3.5 billions in Italy. Non-medical direct cost and indirect cost represent the main cost items (48% and 31%) of the total social cost of RA in Italy. Based on these results, it appears evident that the assessment of the economic burden of RA solely based on direct medical costs evaluation gives a limited view of the phenomenon.

Estimation of the costs of cervical cancer screening, diagnosis and treatment in rural Shanxi Province, China: a micro-costing study

PubMed Central

2012-01-01

Background Cost estimation is a central feature of health economic analyses. The aim of this study was to use a micro-costing approach and a societal perspective to estimate aggregated costs associated with cervical cancer screening, diagnosis and treatment in rural China. Methods We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 2008–9. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion. Results Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, self-sampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64,$7.49,$7.95,$3.90 and $5.76, respectively. Screening costs were robust to screening volume (<5% variation if 2,000 women screened annually), but costs of colposcopy/biopsy tripled at the lower volume. Direct medical costs of Loop Excision, Cold-Knife Conization and Simple and Radical Hysterectomy varied from $61–544, depending on the procedure and whether conducted at county or prefecture level. Direct non-medical expenditure varied from $0.68–$3.09 for screening/diagnosis and $83–$494 for pre-cancer/cancer treatment. Conclusions Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower-volume situations, which is a key consideration for the scale-up phase of new programs. The study’s findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China. PMID:22624619

The Costs of an Enhanced Employee Assistance Program (EAP) Intervention.

ERIC Educational Resources Information Center

French, Michael T.; Dunlap, Laura J.; Zarkin, Gary A.; Karuntzos, Georgia T.

1998-01-01

This study estimates the economic costs of an enhanced Employee Assistance Program (EAP) intervention at a large midwestern EAP that serves 90 worksites. Results specify developmental and implementation costs and provide benchmark cost estimated for other EAPs that may be considering enhanced services. (SLD)

The effect of bovine somatotropin on the cost of producing milk: Estimates using propensity scores.

PubMed

Tauer, Loren W

2016-04-01

Annual farm-level data from New York dairy farms from the years 1994 through 2013 were used to estimate the cost effect from bovine somatotropin (bST) using propensity score matching. Cost of production was computed using the whole-farm method, which subtracts sales of crops and animals from total costs under the assumption that the cost of producing those products is equal to their sales values. For a farm to be included in this data set, milk receipts on that farm must have comprised 85% or more of total receipts, indicating that these farms are primarily milk producers. Farm use of bST, where 25% or more of the herd was treated, ranged annually from 25 to 47% of the farms. The average cost effect from the use of bST was estimated to be a reduction of $2.67 per 100 kg of milk produced in 2013 dollars, although annual cost reduction estimates ranged from statistical zero to $3.42 in nominal dollars. Nearest neighbor matching techniques generated a similar estimate of $2.78 in 2013 dollars. These cost reductions estimated from the use of bST represented a cost savings of 5.5% per kilogram of milk produced. Herd-level production increase per cow from the use of bST over 20 yr averaged 1,160 kg. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

[Methodologies for estimating the indirect costs of traffic accidents].

PubMed

Carozzi, Soledad; Elorza, María Eugenia; Moscoso, Nebel Silvana; Ripari, Nadia Vanina

2017-01-01

Traffic accidents generate multiple costs to society, including those associated with the loss of productivity. However, there is no consensus about the most appropriate methodology for estimating those costs. The aim of this study was to review methods for estimating indirect costs applied in crash cost studies. A thematic review of the literature was carried out between 1995 and 2012 in PubMed with the terms cost of illness, indirect cost, road traffic injuries, productivity loss. For the assessment of costs we used the the human capital method, on the basis of the wage-income lost during the time of treatment and recovery of patients and caregivers. In the case of premature death or total disability, the discount rate was applied to obtain the present value of lost future earnings. The computed years arose by subtracting to life expectancy at birth the average age of those affected who are not incorporated into the economically active life. The interest in minimizing the problem is reflected in the evolution of the implemented methodologies. We expect that this review is useful to estimate efficiently the real indirect costs of traffic accidents.

Development of regional stump-to-mill logging cost estimators

Treesearch

Chris B. LeDoux; John E. Baumgras

1989-01-01

Planning logging operations requires estimating the logging costs for the sale or tract being harvested. Decisions need to be made on equipment selection and its application to terrain. In this paper a methodology is described that has been developed and implemented to solve the problem of accurately estimating logging costs by region. The methodology blends field time...

39 CFR 3050.30 - Information needed to estimate the cost of the universal service obligation. [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Information needed to estimate the cost of the universal service obligation. [Reserved] 3050.30 Section 3050.30 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.30 Information needed to estimate the cost of the universal service...

COST OF PRIMARY HEALTH CARE IN PAKISTAN.

PubMed

Malik, Muhammad Ashar; Gul, Wahid; Iqbal, Saleem Perwaiz; Abrejo, Farina

2015-01-01

Detailed cost analysis is an important tool for review of health policy and reforms. We provide an estimate of cost of service and its detailed breakup on out-door patient visits (OPV) to basic health units (BHU) in Pakistan. Six BHUs were randomly selected from each of the five districts in Khyber Pukhtonkhawa (KPK) and two agencies in Federally Administered Tribal Areas (FATA) of Pakistan for this study. Actual expenditure data and utilization data in the year 2005-06 of 42 BHUs was collected from selected district health offices in KPK and FATA. Costs were estimated for outpatient visits to BHUs. Perspective on cost estimates was district-based health planning and management of BHUs. Average recurring cost was PKR.245 (USD 4.1) per OPV to BHU. Staff salaries constituted 90% of recurrent cost. On the average there were 16 OPV per day to the BHUs. CONCLUDION: Recurrent cost per OPV has doubled from the previous estimates of cost of OPV in Baluchistan. The estimated recurrent cost was six times higher than average consultation charges with the private general practitioner (GP) in the country (i.e., PKR 50/ GP consultation). Performance of majority of the BHUs was much lower than the performance target (50 patients per day) set in the sixth five-year plan of the government of Pakistan. The Government of Pakistan may use these analyses to revisit the performance target, staffinL and location of BHUs.

The direct and indirect costs of both overweight and obesity: a systematic review

PubMed Central

2014-01-01

Background The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included. Methods A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies. Results Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs. Conclusion A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons. PMID:24739239

The direct and indirect costs of both overweight and obesity: a systematic review.

PubMed

Dee, Anne; Kearns, Karen; O'Neill, Ciaran; Sharp, Linda; Staines, Anthony; O'Dwyer, Victoria; Fitzgerald, Sarah; Perry, Ivan J

2014-04-16

The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included. A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies. Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs. A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons.

The economic burden of a Salmonella Thompson outbreak caused by smoked salmon in the Netherlands, 2012-2013.

PubMed

Suijkerbuijk, Anita W M; Bouwknegt, Martijn; Mangen, Marie-Josee J; de Wit, G Ardine; van Pelt, Wilfrid; Bijkerk, Paul; Friesema, Ingrid H M

2017-04-01

In 2012, the Netherlands experienced the most extensive food-related outbreak of Salmonella ever recorded. It was caused by smoked salmon contaminated with Salmonella Thompson during processing. In total, 1149 cases of salmonellosis were laboratory confirmed and reported to RIVM. Twenty percent of cases was hospitalised and four cases were reported to be fatal. The purpose of this study was to estimate total costs of the Salmonella Thompson outbreak. Data from a case-control study were used to estimate the cost-of-illness of reported cases (i.e. healthcare costs, patient costs and production losses). Outbreak control costs were estimated based on interviews with staff from health authorities. Using the Dutch foodborne disease burden and cost-of-illness model, we estimated the number of underestimated cases and the associated cost-of-illness. The estimated number of cases, including reported and underestimated cases was 21 123. Adjusted for underestimation, the total cost-of-illness would be €6.8 million (95% CI €2.5-€16.7 million) with productivity losses being the main cost driver. Adding outbreak control costs, the total outbreak costs are estimated at €7.5 million. In the Netherlands, measures are taken to reduce salmonella concentrations in food, but detection of contamination during food processing remains difficult. As shown, Salmonella outbreaks have the potential for a relatively high disease and economic burden for society. Early warning and close cooperation between the industry, health authorities and laboratories is essential for rapid detection, control of outbreaks, and to reduce disease and economic burden. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Estimating the long-term costs of ischemic and hemorrhagic stroke for Australia: new evidence derived from the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Cadilhac, Dominique A; Carter, Rob; Thrift, Amanda G; Dewey, Helen M

2009-03-01

Stroke is associated with considerable societal costs. Cost-of-illness studies have been undertaken to estimate lifetime costs; most incorporating data up to 12 months after stroke. Costs of stroke, incorporating data collected up to 12 months, have previously been reported from the North East Melbourne Stroke Incidence Study (NEMESIS). NEMESIS now has patient-level resource use data for 5 years. We aimed to recalculate the long-term resource utilization of first-ever stroke patients and compare these to previous estimates obtained using data collected to 12 months. Population structure, life expectancy, and unit prices within the original cost-of-illness models were updated from 1997 to 2004. New Australian stroke survival and recurrence data up to 10 years were incorporated, as well as cross-sectional resource utilization data at 3, 4, and 5 years from NEMESIS. To enable comparisons, 1997 costs were inflated to 2004 prices and discounting was standardized. In 2004, 27 291 ischemic stroke (IS) and 4291 intracerebral hemorrhagic stroke (ICH) first-ever events were estimated. Average annual resource use after 12 months was AU$6022 for IS and AU$3977 for ICH. This is greater than the 1997 estimates for IS (AU$4848) and less than those for ICH (previously AU$10 692). The recalculated average lifetime costs per first-ever case differed for IS (AU$57 106 versus AU$52 855 [1997]), but differed more for ICH (AU$49 995 versus AU$92 308 [1997]). Basing lifetime cost estimates on short-term data overestimated the costs for ICH and underestimated those for IS. Patterns of resource use varied by stroke subtype and, overall, the societal cost impact was large.

Cost-effectiveness of a motivational intervention for alcohol-involved youth in a hospital emergency department.

PubMed

Neighbors, Charles J; Barnett, Nancy P; Rohsenow, Damaris J; Colby, Suzanne M; Monti, Peter M

2010-05-01

Brief interventions in the emergency department targeting risk-taking youth show promise to reduce alcohol-related injury. This study models the cost-effectiveness of a motivational interviewing-based intervention relative to brief advice to stop alcohol-related risk behaviors (standard care). Average cost-effectiveness ratios were compared between conditions. In addition, a cost-utility analysis examined the incremental cost of motivational interviewing per quality-adjusted life year gained. Microcosting methods were used to estimate marginal costs of motivational interviewing and standard care as well as two methods of patient screening: standard emergency-department staff questioning and proactive outreach by counseling staff. Average cost-effectiveness ratios were computed for drinking and driving, injuries, vehicular citations, and negative social consequences. Using estimates of the marginal effect of motivational interviewing in reducing drinking and driving, estimates of traffic fatality risk from drinking-and-driving youth, and national life tables, the societal costs per quality-adjusted life year saved by motivational interviewing relative to standard care were also estimated. Alcohol-attributable traffic fatality risks were estimated using national databases. Intervention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening. The cost-effectiveness ratios for motivational interviewing were more favorable than standard care across all study outcomes and better for men than women. The societal cost per quality-adjusted life year of motivational interviewing was $8,795. Sensitivity analyses indicated that results were robust in terms of variability in parameter estimates. This brief intervention represents a good societal investment compared with other commonly adopted medical interventions.

The Cost of Ménière's Disease: A Novel Multisource Approach.

PubMed

Tyrrell, Jessica; Whinney, David J; Taylor, Timothy

2016-01-01

To estimate the annual cost of Ménière's disease and the cost per person in the UK population and to investigate the direct and indirect costs of the condition. The authors utilized a multidata approach to provide the first estimate of the cost of Ménière's. Data from the UK Biobank (a study of 500,000 individuals collected between 2007 and 2012), the Hospital Episode Statistics (data on all hospital admissions in England from 2008 to 2012) and the UK Ménière's Society (2014) were used to estimate the cost of Ménière's. Cases were self-reported in the UK Biobank and UK Ménière's Society, within the Hospital Episode Statistics cases were clinician diagnosed. The authors estimated the direct and indirect costs of the condition, using count data to represent numbers of individuals reporting specific treatments, operations etc. and basic statistical analyses (χ tests, linear and logistic regression) to compare cases and controls in the UK Biobank. Ménière's was estimated to cost between £541.30 million and £608.70 million annually (equivalent to US $829.9 to $934.2 million), equating to £3,341 to £3,757 ($5112 to $5748) per person per annum. The indirect costs were substantial, with loss of earnings contributing to over £400 million per annum. For the first time, the authors were able to estimate the economic burden of Ménière's disease. In the UK, the annual cost of this condition is substantial. Further research is required to develop cost-effective treatments and management strategies for Ménière's to reduce the economic burden of the disease. These findings should be interpreted with caution due to the uncertainties inherent in the analysis.

Cost collection and analysis for health economic evaluation.

PubMed

Smith, Kristine A; Rudmik, Luke

2013-08-01

To improve the understanding of common health care cost collection, estimation, analysis, and reporting methodologies. Ovid MEDLINE (1947 to December 2012), Cochrane Central register of Controlled Trials, Database of Systematic Reviews, Health Technology Assessment, and National Health Service Economic Evaluation Database. This article discusses the following cost collection methods: defining relevant resources, quantification of consumed resources, and resource valuation. It outlines the recommendations for cost reporting in economic evaluations and reviews the techniques on how to handle cost data uncertainty. Last, it discusses the controversial topics of future costs and patient productivity losses. Health care cost collection and estimation can be challenging, and an organized approach is required to optimize accuracy of economic evaluation outcomes. Understanding health care cost collection and estimation techniques will improve both critical appraisal and development of future economic evaluations.

Economic cost of primary prevention of cardiovascular diseases in Tanzania

PubMed Central

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

2015-01-01

Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)’s CVD medical preventive guidelines are implemented in Tanzania. In addition, we estimate and explore the cost to patients of receiving these services. Cost data were collected in four health facilities located in both urban and rural settings. Providers’ costs were identified and measured using ingredients approach to costing and resource valuation followed the opportunity cost method. Unit costs were estimated using activity-based and step-down costing methodologies. The patient costs were obtained through a structured questionnaire. The unit cost of providing CVD medical primary prevention services ranged from US$30–41 to US$52–71 per patient per year at the health centre and hospital levels, respectively. Employing the WHO’s absolute risk approach guidelines will substantially increase these costs. The annual patient cost of receiving these services as currently practised was estimated to be US$118 and US$127 for urban and rural patients, respectively. Providers’ costs were estimated from two main viewpoints: ‘what is’, that is the current practice, and ‘what if’, reflecting a WHO guidelines scenario. The higher cost of implementing the WHO guidelines suggests the need for further evaluation of whether these added costs are reasonable relative to the added benefits. We also found considerably higher patient costs, implying that distributive and equity implications of access to care require more consideration. Facility location surfaced as the main explanatory variable for both direct and indirect patient costs in the regression analysis; further research on the influence of other provider characteristics on these costs is important. PMID:25113027

The cost of diabetes in Latin America and the Caribbean in 2015: Evidence for decision and policy makers.

PubMed

Barcelo, Alberto; Arredondo, Armando; Gordillo-Tobar, Amparo; Segovia, Johanna; Qiang, Anthony

2017-12-01

The financial implications of the increase in the prevalence of diabetes in middle-income countries represents one of the main challenges to health system financing and to the society as a whole. The objective of this study was to estimate the economic cost of diabetes in Latin America and the Caribbean (LAC) in 2015. The study used a prevalence-based approach to estimate the direct and indirect costs related to diabetes in 29 LAC countries in 2015. Direct costs included health care expenditures such as medications (insulin and oral hypoglycemic agents), tests, consultations, hospitalizations, emergency visits and treating complications. Two different scenarios (S1 and S2) were used to analyze direct cost. S1 assumed conservative estimates while S2 assumed broader coverage of medication and services. Indirect costs included lost resources due to premature mortality, temporary and permanent disabilities. In 2015 over 41 million adults (20 years of age and more) were estimated to have Diabetes Mellitus in LAC. The total indirect cost attributed to Diabetes was US$ 57.1 billion, of which US$ 27.5 billion was due to premature mortality, US$16.2 billion to permanent disability, and US$ 13.3 billion to temporary disability. The total direct cost was estimated between US$ 45 and US$ 66 billion, of which the highest estimated cost was due to treatment of complications (US$ 1 616 to US$ 26 billion). Other estimates indicated the cost of insulin between US$ 6 and US$ 11 billion; oral medication US$ 4 to US$ 6 billion; consultations between US$ 5 and US$ 6 billion; hospitalization US$ 10 billion; emergency visits US$ 1 billion; test and laboratory exams between US$ 1 and US$ 3 million. The total cost of diabetes in 2015 in LAC was estimated to be between US$ 102 and US$ 123 billion. On average, the annual cost of treating one case of diabetes mellitus (DM) in LAC was estimated between US$ 1088 and US$ 1818. Per capita National Health Expenditures averaged US$ 1061 in LAC. Diabetes represented a major economic burden to the countries of Latin America and the Caribbean in 2015. The estimates presented here are key information for decision-making that can be used in the formulation of policies and programs to achieve greater efficiency and effectiveness in the use of resources for diabetes prevention in the 29 countries of LAC.

The cost of diabetes in Latin America and the Caribbean in 2015: Evidence for decision and policy makers

PubMed Central

Barcelo, Alberto; Arredondo, Armando; Gordillo–Tobar, Amparo; Segovia, Johanna; Qiang, Anthony

2017-01-01

BACKGROUND The financial implications of the increase in the prevalence of diabetes in middle–income countries represents one of the main challenges to health system financing and to the society as a whole. The objective of this study was to estimate the economic cost of diabetes in Latin America and the Caribbean (LAC) in 2015. METHODS The study used a prevalence–based approach to estimate the direct and indirect costs related to diabetes in 29 LAC countries in 2015. Direct costs included health care expenditures such as medications (insulin and oral hypoglycemic agents), tests, consultations, hospitalizations, emergency visits and treating complications. Two different scenarios (S1 and S2) were used to analyze direct cost. S1 assumed conservative estimates while S2 assumed broader coverage of medication and services. Indirect costs included lost resources due to premature mortality, temporary and permanent disabilities. RESULTS In 2015 over 41 million adults (20 years of age and more) were estimated to have Diabetes Mellitus in LAC. The total indirect cost attributed to Diabetes was US$ 57.1 billion, of which US$ 27.5 billion was due to premature mortality, US$16.2 billion to permanent disability, and US$ 13.3 billion to temporary disability. The total direct cost was estimated between US$ 45 and US$ 66 billion, of which the highest estimated cost was due to treatment of complications (US$ 1 616 to US$ 26 billion). Other estimates indicated the cost of insulin between US$ 6 and US$ 11 billion; oral medication US$ 4 to US$ 6 billion; consultations between US$ 5 and US$ 6 billion; hospitalization US$ 10 billion; emergency visits US$ 1 billion; test and laboratory exams between US$ 1 and US$ 3 million. The total cost of diabetes in 2015 in LAC was estimated to be between US$ 102 and US$ 123 billion. On average, the annual cost of treating one case of diabetes mellitus (DM) in LAC was estimated between US$ 1088 and US$ 1818. Per capita National Health Expenditures averaged US$ 1061 in LAC. CONCLUSIONS Diabetes represented a major economic burden to the countries of Latin America and the Caribbean in 2015. The estimates presented here are key information for decision–making that can be used in the formulation of policies and programs to achieve greater efficiency and effectiveness in the use of resources for diabetes prevention in the 29 countries of LAC. PMID:29163935

Valuing the Economic Costs of Allergic Rhinitis, Acute Bronchitis, and Asthma from Exposure to Indoor Dampness and Mold in the US

PubMed Central

2016-01-01

Two foundational methods for estimating the total economic burden of disease are cost of illness (COI) and willingness to pay (WTP). WTP measures the full cost to society, but WTP estimates are difficult to compute and rarely available. COI methods are more often used but less likely to reflect full costs. This paper attempts to estimate the full economic cost (2014$) of illnesses resulting from exposure to dampness and mold using COI methods and WTP where the data is available. A limited sensitivity analysis of alternative methods and assumptions demonstrates a wide potential range of estimates. In the final estimates, the total annual cost to society attributable to dampness and mold is estimated to be $3.7 (2.3–4.7) billion for allergic rhinitis, $1.9 (1.1–2.3) billion for acute bronchitis, $15.1 (9.4–20.6) billion for asthma morbidity, and $1.7 (0.4–4.5) billion for asthma mortality. The corresponding costs from all causes, not limited to dampness and mold, using the same approach would be $24.8 billion for allergic rhinitis, $13.5 billion for acute bronchitis, $94.5 billion for asthma morbidity, and $10.8 billion for asthma mortality. PMID:27313630

Cost Estimating Relationships for U.S. Navy Ships

DTIC Science & Technology

1983-09-01

ORGANIZATION NAME AND ADDRESS Institute for Defense Analyses iBOl North Beauregard Street Alexandria, Virginia 22311 10. PROGRAM ELEMENT, PROJECT ...linear CER also is displayed. In addi- tion. Table S-1 displays the total observed cost, the total estimated cost, and the percent difference...report provided by program year a total end cost for each ship by hull number including outfitting and post delivery costs. This end cost does not

Health care and lost productivity costs of overweight and obesity in New Zealand.

PubMed

Lal, Anita; Moodie, Marj; Ashton, Toni; Siahpush, Mohammad; Swinburn, Boyd

2012-12-01

To estimate the costs of health care and lost productivity attributable to overweight and obesity in New Zealand (NZ) in 2006. A prevalence-based approach to costing was used in which costs were calculated for all cases of disease in the year 2006. Population attributable fractions (PAFs) were calculated based on the relative risks obtained from large cohort studies and the prevalence of overweight and obesity. For each disease, the PAF was multiplied by the total health care cost. The costs of lost productivity associated with premature mortality were estimated using both the Human Capital approach (HCA) and Friction Cost approach (FCA). Health care costs attributable to overweight and obesity were estimated to be NZ$686m or 4.5% of New Zealand's total health care expenditure in 2006. The costs of lost productivity using the FCA were estimated to be NZ$98m and NZ$225m using the HCA. The combined costs of health care and lost productivity using the FCA were $784m and $911m using the HCA. The cost burden of overweight and obesity in NZ is considerable. Policies and interventions are urgently needed to reduce the prevalence of obesity thereby decreasing these substantial costs. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

A novel methodology for estimating upper limits of major cost drivers for profitable conceptual launch system architectures

NASA Astrophysics Data System (ADS)

Rhodes, Russel E.; Byrd, Raymond J.

1998-01-01

This paper presents a ``back of the envelope'' technique for fast, timely, on-the-spot, assessment of affordability (profitability) of commercial space transportation architectural concepts. The tool presented here is not intended to replace conventional, detailed costing methodology. The process described enables ``quick look'' estimations and assumptions to effectively determine whether an initial concept (with its attendant cost estimating line items) provides focus for major leapfrog improvement. The Cost Charts Users Guide provides a generic sample tutorial, building an approximate understanding of the basic launch system cost factors and their representative magnitudes. This process will enable the user to develop a net ``cost (and price) per payload-mass unit to orbit'' incorporating a variety of significant cost drivers, supplemental to basic vehicle cost estimates. If acquisition cost and recurring cost factors (as a function of cost per payload-mass unit to orbit) do not meet the predetermined system-profitability goal, the concept in question will be clearly seen as non-competitive. Multiple analytical approaches, and applications of a variety of interrelated assumptions, can be examined in a quick, (on-the-spot) cost approximation analysis as this tool has inherent flexibility. The technique will allow determination of concept conformance to system objectives.

Software for Estimating Costs of Testing Rocket Engines

NASA Technical Reports Server (NTRS)

Hines, Merlon M.

2004-01-01

A high-level parametric mathematical model for estimating the costs of testing rocket engines and components at Stennis Space Center has been implemented as a Microsoft Excel program that generates multiple spreadsheets. The model and the program are both denoted, simply, the Cost Estimating Model (CEM). The inputs to the CEM are the parameters that describe particular tests, including test types (component or engine test), numbers and duration of tests, thrust levels, and other parameters. The CEM estimates anticipated total project costs for a specific test. Estimates are broken down into testing categories based on a work-breakdown structure and a cost-element structure. A notable historical assumption incorporated into the CEM is that total labor times depend mainly on thrust levels. As a result of a recent modification of the CEM to increase the accuracy of predicted labor times, the dependence of labor time on thrust level is now embodied in third- and fourth-order polynomials.

Software for Estimating Costs of Testing Rocket Engines

NASA Technical Reports Server (NTRS)

Hines, Merion M.

2002-01-01

A high-level parametric mathematical model for estimating the costs of testing rocket engines and components at Stennis Space Center has been implemented as a Microsoft Excel program that generates multiple spreadsheets. The model and the program are both denoted, simply, the Cost Estimating Model (CEM). The inputs to the CEM are the parameters that describe particular tests, including test types (component or engine test), numbers and duration of tests, thrust levels, and other parameters. The CEM estimates anticipated total project costs for a specific test. Estimates are broken down into testing categories based on a work-breakdown structure and a cost-element structure. A notable historical assumption incorporated into the CEM is that total labor times depend mainly on thrust levels. As a result of a recent modification of the CEM to increase the accuracy of predicted labor times, the dependence of labor time on thrust level is now embodied in third- and fourth-order polynomials.

Software for Estimating Costs of Testing Rocket Engines

NASA Technical Reports Server (NTRS)

Hines, Merlon M.

2003-01-01

A high-level parametric mathematical model for estimating the costs of testing rocket engines and components at Stennis Space Center has been implemented as a Microsoft Excel program that generates multiple spreadsheets. The model and the program are both denoted, simply, the Cost Estimating Model (CEM). The inputs to the CEM are the parameters that describe particular tests, including test types (component or engine test), numbers and duration of tests, thrust levels, and other parameters. The CEM estimates anticipated total project costs for a specific test. Estimates are broken down into testing categories based on a work-breakdown structure and a cost-element structure. A notable historical assumption incorporated into the CEM is that total labor times depend mainly on thrust levels. As a result of a recent modification of the CEM to increase the accuracy of predicted labor times, the dependence of labor time on thrust level is now embodied in third- and fourth-order polynomials.

Hazardous materials incident costs : estimating the costs of the March 25, 2004, tanker truck crash in Bridgeport, Connecticut

DOT National Transportation Integrated Search

2004-08-01

Significant variations in the reporting of hazardous materials incident costs are illustrated using a case study of the March 2004 crash of a fuel tanker truck on Interstate 95 in Bridgeport, Connecticut. Three separate cost estimates are presented, ...

Utility-Scale Energy Technology Capacity Factors | Energy Analysis | NREL

Science.gov Websites

Transparent Cost Database Button This chart indicates the range of recent capacity factor estimates for utility-scale technology cost and performance estimates, please visit the Transparent Cost Database website for NREL's information regarding vehicles, biofuels, and electricity generation. Capital Cost

Analysis of Schedule Determination in Software Program Development and Software Development Estimation Models

DTIC Science & Technology

1988-09-01

20 SLIM . . . . .e & . . . . . . . . . . . . 24 SoftCost-R . . . . . . . . . . . . . . . 26 SPQR /20 . . . . . . . . . . .*. . . . . 28...PRICB-8 . . . . . . . . . . .. . 83 softCost-R ............. 84 SPQR /20 . . . . . . . . . . . . 0 . 84 System-3 . . . . . . . . . . . . . . 85 Summry...128 Appendix G: SoftCost-R Input Values . . . . . . . . . . 129 Appendix H: SoftCost-R Resources Estimate . . . . . . . 131 Appendix I: SPQR

The Cost of CAI: A Matter of Assumptions.

ERIC Educational Resources Information Center

Kearsley, Greg P.

Cost estimates for Computer Assisted Instruction (CAI) depend crucially upon the particular assumptions made about the components of the system to be included in the costs, the expected lifetime of the system and courseware, and the anticipated student utilization of the system/courseware. The cost estimates of three currently operational systems…

Cost Allocation Issues in Interlibrary Systems.

ERIC Educational Resources Information Center

Alexander, Ernest R.

1985-01-01

In comparing methods of allocating service transaction costs among member libraries of interlibrary systems, questions of how costs are to be estimated, and what cost elements are to be included are critical. Different approaches of estimation yield varying results. Actual distribution of units accounts for greatest variance in allocations. (CDD)

Comparability of methods assigning monetary costs to diets: derivation from household till receipts versus cost database estimation using 4-day food diaries.

PubMed

Timmins, K A; Morris, M A; Hulme, C; Edwards, K L; Clarke, G P; Cade, J E

2013-10-01

Diet cost could influence dietary patterns, with potential health consequences. Assigning a monetary cost to diet is challenging, and there are contrasting methods in the literature. This study compares two methods-a food cost database linked to 4-day diet diaries and an individual cost calculated from household till receipts. The Diet and Nutrition Tool for Evaluation (DANTE) had supermarket prices (cost per 100 g) added to its food composition table. Agreement between diet costs calculated using DANTE from food diaries and expenditure recorded using food purchase till receipts for 325 individuals was assessed using correlation and Bland Altman (BA) plots. The mean difference between the methods' estimates was £0.10. The BA showed 95% limits of agreement of £2.88 and -£3.08. Excluding the highest 5% of diet cost values from each collection method reduced the mean difference to £0.02, with limits of agreement ranging from £2.31 to -£2.35. Agreement between the methods was stronger for males and for adults. Diet cost estimates using a food price database with 4-day food diaries are comparable to recorded expenditure from household till receipts at the population or group level. At the individual level, however, estimates differed by as much as £3.00 per day. The methods agreed less when estimating diet costs of children, females or those with more expensive diets.

Cost-Conscious of Anesthesia Physicians: An awareness survey.

PubMed

Hakimoglu, Sedat; Hancı, Volkan; Karcıoglu, Murat; Tuzcu, Kasım; Davarcı, Isıl; Kiraz, Hasan Ali; Turhanoglu, Selim

2015-01-01

Increasing competitive pressure and health performance system in the hospitals result in pressure to reduce the resources allocated. The aim of this study was to evaluate the anesthesiology and intensive care physicians awareness of the cost of the materials used and to determine the factors that influence it. This survey was conducted between September 2012 and September 2013 after the approval of the local ethics committee. Overall 149 anesthetists were included in the study. Participants were asked to estimate the cost of 30 products used by anesthesiology and intensive care units. One hundred forty nine doctors, 45% female and 55% male, participated in this study. Of the total 30 questions the averages of cost estimations were 5.8% accurate estimation, 35.13% underestimation and 59.16% overestimation. When the participants were divided into the different groups of institution, duration of working in this profession and sex, there were no statistically significant differences regarding accurate estimation. However, there was statistically significant difference in underestimation. In underestimation, there was no significant difference between 16-20 year group and >20 year group but these two groups have more price overestimation than the other groups (p=0.031). Furthermore, when all the participants were evaluated there were no significant difference between age-accurate cost estimation and profession time-accurate cost estimation. Anesthesiology and intensive care physicians in this survey have an insufficient awareness of the cost of the drugs and materials that they use. The institution and experience are not effective factors for accurate estimate. Programs for improving the health workers knowledge creating awareness of cost should be planned in order to use the resources more efficiently and cost effectively.

Cost of fetal alcohol spectrum disorder diagnosis in Canada.

PubMed

Popova, Svetlana; Lange, Shannon; Burd, Larry; Chudley, Albert E; Clarren, Sterling K; Rehm, Jürgen

2013-01-01

Fetal Alcohol Spectrum Disorder (FASD) is underdiagnosed in Canada. The diagnosis of FASD is not simple and currently, the recommendation is that a comprehensive, multidisciplinary assessment of the individual be done. The purpose of this study was to estimate the annual cost of FASD diagnosis on Canadian society. The diagnostic process breakdown was based on recommendations from the Fetal Alcohol Spectrum Disorder Canadian Guidelines for Diagnosis. The per person cost of diagnosis was calculated based on the number of hours (estimated based on expert opinion) required by each specialist involved in the diagnostic process. The average rate per hour for each respective specialist was estimated based on hourly costs across Canada. Based on the existing clinical capacity of all FASD multidisciplinary clinics in Canada, obtained from the 2005 and 2011 surveys conducted by the Canada Northwest FASD Research Network, the number of FASD cases diagnosed per year in Canada was estimated. The per person cost of FASD diagnosis was then applied to the number of cases diagnosed per year in Canada in order to calculated the overall annual cost. Using the most conservative approach, it was estimated that an FASD evaluation requires 32 to 47 hours for one individual to be screened, referred, admitted, and diagnosed with an FASD diagnosis, which results in a total cost of $3,110 to $4,570 per person. The total cost of FASD diagnostic services in Canada ranges from $3.6 to $5.2 million (lower estimate), up to $5.0 to $7.3 million (upper estimate) per year. As a result of using the most conservative approach, the cost of FASD diagnostic services presented in the current study is most likely underestimated. The reasons for this likelihood and the limitations of the study are discussed.

[Hospital production cost of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression].

PubMed

Etcheverrigaray, F; Bulteau, S; Machon, L O; Riche, V P; Mauduit, N; Tricot, R; Sellal, O; Sauvaget, A

2015-08-01

Repetitive transcranial magnetic stimulation (rTMS) is an effective and well-tolerated treatment in resistant depression with mild to moderate intensity. This indication has not yet been approved in France. The cost and medico-economic value of rTMS in psychiatry remains unknown. The aim of this preliminary study was to assess rTMS cost production analysis as an in-hospital treatment for depression. The methodology, derived from analytical accounts, was validated by a multidisciplinary task force (clinicians, public health doctors, pharmacists, administrative officials and health economist). It was pragmatic, based on official and institutional documentary sources and from field practice. It included equipment, staff, and structure costs, to get an estimate as close to reality as possible. First, we estimated the production cost of rTMS session, based on our annual activity. We then estimated the cost of a cure, which includes 15 sessions. A sensitivity analysis was also performed. The hospital production cost of a cure for treating depression was estimated at € 1932.94 (€ 503.55 for equipment, € 1082.75 for the staff, and € 346.65 for structural expenses). This cost-estimate has resulted from an innovative, pragmatic, and cooperative approach. It is slightly higher but more comprehensive than the costs estimated by the few international studies. However, it is limited due to structure-specific problems and activity. This work could be repeated in other circumstances in order to obtain a more general estimate, potentially helpful for determining an official price for the French health care system. Moreover, budgetary constraints and public health choices should be taken into consideration. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Economic Burden of Thalassemia Major in Iran, 2015.

PubMed

Esmaeilzadeh, Firooz; Azarkeivan, Azita; Emamgholipour, Sara; Akbari Sari, Ali; Yaseri, Mehdi; Ahmadi, Batoul; Ghaffari, Mohtasham

2016-01-01

Major Thalassemia is an autosomal recessive disease with complications, mortality and serious pathology. Today, the life expectancy of patients with major thalassemia has increased along with therapeutic advances. Therefore, they need lifelong care, and caring for them would incur many costs. Being aware of the patients' costs can be effective for controlling and managing the costs and providing efficient treatments for the care of patients. Hence, this study was conducted to estimate the economic burden of the patients with major thalassemia. Totally, 198 patients with major thalassemia were randomly selected from among the patients with major thalassemia in Tehran, Iran in 2015. The economic burden of the patients was estimated from a social perspective and through a bottom-up, prevalence-based approach. The average annual cost per patient was estimated $ 8321.8 regardless of the cost of lost welfare. Of this amount, $ 7286.8 was related to direct medical costs, $ 461.4 to direct non-medical costs, and $ 573.5 to indirect costs. In addition, the annual cost per patient was estimated $ 1360.5 due to the distress caused by the disease CONCLUSIONS: Considering the high costs of the treatment of patients with major thalassemia, adopting new policies to reduce the costs that patients have to pay seems necessary. In addition, making new decisions regarding thalassemia screening, even with higher costs than the usual screening costs, can be useful since the costs of treatment are high.

Cost and price estimate of Brayton and Stirling engines in selected production volumes

NASA Technical Reports Server (NTRS)

Fortgang, H. R.; Mayers, H. F.

1980-01-01

The methods used to determine the production costs and required selling price of Brayton and Stirling engines modified for use in solar power conversion units are presented. Each engine part, component and assembly was examined and evaluated to determine the costs of its material and the method of manufacture based on specific annual production volumes. Cost estimates are presented for both the Stirling and Brayton engines in annual production volumes of 1,000, 25,000, 100,000 and 400,000. At annual production volumes above 50,000 units, the costs of both engines are similar, although the Stirling engine costs are somewhat lower. It is concluded that modifications to both the Brayton and Stirling engine designs could reduce the estimated costs.

Modeling the cost of influenza: the impact of missing costs of unreported complications and sick leave

PubMed Central

2010-01-01

Background Estimating the economic impact of influenza is complicated because the disease may have non-specific symptoms, and many patients with influenza are registered with other diagnoses. Furthermore, in some countries like Norway, employees can be on paid sick leave for a specified number of days without a doctor's certificate ("self-reported sick leave") and these sick leaves are not registered. Both problems result in gaps in the existing literature: costs associated with influenza-related illness and self-reported sick leave are rarely included. The aim of this study was to improve estimates of total influenza-related health-care costs and productivity losses by estimating these missing costs. Methods Using Norwegian data, the weekly numbers of influenza-attributable hospital admissions and certified sick leaves registered with other diagnoses were estimated from influenza-like illness surveillance data using quasi-Poisson regression. The number of self-reported sick leaves was estimated using a Monte-Carlo simulation model of illness recovery curves based on the number of certified sick leaves. A probabilistic sensitivity analysis was conducted on the economic outcomes. Results During the 1998/99 through 2005/06 influenza seasons, the models estimated an annual average of 2700 excess influenza-associated hospitalizations in Norway, of which 16% were registered as influenza, 51% as pneumonia and 33% were registered with other diagnoses. The direct cost of seasonal influenza totaled US$22 million annually, including costs of pharmaceuticals and outpatient services. The annual average number of working days lost was predicted at 793 000, resulting in an estimated productivity loss of US$231 million. Self-reported sick leave accounted for approximately one-third of the total indirect cost. During a pandemic, the total cost could rise to over US$800 million. Conclusions Influenza places a considerable burden on patients and society with indirect costs greatly exceeding direct costs. The cost of influenza-attributable complications and the cost of self-reported sick leave represent a considerable part of the economic burden of influenza. PMID:21106057

The Economic Burden of Vision Loss and Eye Disorders among the United States Population Younger than 40 Years

PubMed Central

Wittenborn, John S.; Zhang, Xinzhi; Feagan, Charles W.; Crouse, Wesley L.; Shrestha, Sundar; Kemper, Alex R.; Hoerger, Thomas J.; Saaddine, Jinan B.

2017-01-01

Objective To estimate the economic burden of vision loss and eye disorders in the United States population younger than 40 years in 2012. Design Econometric and statistical analysis of survey, commercial claims, and census data. Participants The United States population younger than 40 years in 2012. Methods We categorized costs based on consensus guidelines. We estimated medical costs attributable to diagnosed eye-related disorders, undiagnosed vision loss, and medical vision aids using Medical Expenditure Panel Survey and MarketScan data. The prevalence of vision impairment and blindness were estimated using National Health and Nutrition Examination Survey data. We estimated costs from lost productivity using Survey of Income and Program Participation. We estimated costs of informal care, low vision aids, special education, school screening, government spending, and transfer payments based on published estimates and federal budgets. We estimated quality-adjusted life years (QALYs) lost based on published utility values. Main Outcome Measures Costs and QALYs lost in 2012. Results The economic burden of vision loss and eye disorders among the United States population younger than 40 years was $27.5 billion in 2012 (95% confidence interval, $21.5–$37.2 billion), including $5.9 billion for children and $21.6 billion for adults 18 to 39 years of age. Direct costs were $14.5 billion, including $7.3 billion in medical costs for diagnosed disorders, $4.9 billion in refraction correction, $0.5 billion in medical costs for undiagnosed vision loss, and $1.8 billion in other direct costs. Indirect costs were $13 billion, primarily because of $12.2 billion in productivity losses. In addition, vision loss cost society 215 000 QALYs. Conclusions We found a substantial burden resulting from vision loss and eye disorders in the United States population younger than 40 years, a population excluded from previous studies. Monetizing quality-of-life losses at $50 000 per QALY would add $10.8 billion in additional costs, indicating a total economic burden of $38.2 billion. Relative to previously reported estimates for the population 40 years of age and older, more than one third of the total cost of vision loss and eye disorders may be incurred by persons younger than 40 years. PMID:23631946

Rock bed thermal storage: Concepts and costs

NASA Astrophysics Data System (ADS)

Allen, Kenneth; von Backström, Theodor; Joubert, Eugene; Gauché, Paul

2016-05-01

Thermal storage enables concentrating solar power (CSP) plants to provide baseload or dispatchable power. Currently CSP plants use two-tank molten salt thermal storage, with estimated capital costs of about 22-30 /kWhth. In the interests of reducing CSP costs, alternative storage concepts have been proposed. In particular, packed rock beds with air as the heat transfer fluid offer the potential of lower cost storage because of the low cost and abundance of rock. Two rock bed storage concepts which have been formulated for use at temperatures up to at least 600 °C are presented and a brief analysis and cost estimate is given. The cost estimate shows that both concepts are capable of capital costs less than 15 /kWhth at scales larger than 1000 MWhth. Depending on the design and the costs of scaling containment, capital costs as low as 5-8 /kWhth may be possible. These costs are between a half and a third of current molten salt costs.

The worldwide costs of dementia 2015 and comparisons with 2010.

PubMed

Wimo, Anders; Guerchet, Maëlenn; Ali, Gemma-Claire; Wu, Yu-Tzu; Prina, A Matthew; Winblad, Bengt; Jönsson, Linus; Liu, Zhaorui; Prince, Martin

2017-01-01

In 2010, Alzheimer's Disease International presented estimates of the global cost of illness (COI) of dementia. Since then, new studies have been conducted, and the number of people with dementia has increased. Here, we present an update of the global cost estimates. This is a societal, prevalence-based global COI study. The worldwide costs of dementia were estimated at United States (US) $818 billion in 2015, an increase of 35% since 2010; 86% of the costs occur in high-income countries. Costs of informal care and the direct costs of social care still contribute similar proportions of total costs, whereas the costs in the medical sector are much lower. The threshold of US $1 trillion will be crossed by 2018. Worldwide costs of dementia are enormous and still inequitably distributed. The increase in costs arises from increases in numbers of people with dementia and in increases in per person costs. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

PubMed Central

Pataky, Reka; Bremner, Karen E.; Rangrej, Jagadish; Chan, Kelvin K.W.; Cheung, Winson Y.; Hoch, Jeffrey S.; Peacock, Stuart; Krahn, Murray D.

2017-01-01

Background: Costing studies are useful to measure the economic burden of cancer. Comparing costs between healthcare systems can inform evaluation, development or modification of cancer care policies. Objectives: To estimate and compare cancer costs in British Columbia and Ontario from the payers' perspectives. Methods: Using linked cancer registry and administrative data, and standardized costing methodology and analyses, we estimated costs for 21 cancer sites by phase of care to determine potential differences between provinces. Results: Overall, costs were higher in Ontario. Costs were highest in the initial post-diagnosis and pre-death phases and lowest in the pre-diagnosis and continuing phases, and generally higher for brain cancer and multiple myeloma, and lower for melanoma. Hospitalization was the major cost category. Costs for physician services and diagnostic tests differed the most between provinces. Conclusions: The standardization of data and costing methodology is challenging, but it enables interprovincial and international comparative costing analyses. PMID:28277207

Construction cost estimation of spherical storage tanks: artificial neural networks and hybrid regression—GA algorithms

NASA Astrophysics Data System (ADS)

Arabzadeh, Vida; Niaki, S. T. A.; Arabzadeh, Vahid

2017-10-01

One of the most important processes in the early stages of construction projects is to estimate the cost involved. This process involves a wide range of uncertainties, which make it a challenging task. Because of unknown issues, using the experience of the experts or looking for similar cases are the conventional methods to deal with cost estimation. The current study presents data-driven methods for cost estimation based on the application of artificial neural network (ANN) and regression models. The learning algorithms of the ANN are the Levenberg-Marquardt and the Bayesian regulated. Moreover, regression models are hybridized with a genetic algorithm to obtain better estimates of the coefficients. The methods are applied in a real case, where the input parameters of the models are assigned based on the key issues involved in a spherical tank construction. The results reveal that while a high correlation between the estimated cost and the real cost exists; both ANNs could perform better than the hybridized regression models. In addition, the ANN with the Levenberg-Marquardt learning algorithm (LMNN) obtains a better estimation than the ANN with the Bayesian-regulated learning algorithm (BRNN). The correlation between real data and estimated values is over 90%, while the mean square error is achieved around 0.4. The proposed LMNN model can be effective to reduce uncertainty and complexity in the early stages of the construction project.

Estimating the Life Cycle Cost of Space Systems

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2015-01-01

A space system's Life Cycle Cost (LCC) includes design and development, launch and emplacement, and operations and maintenance. Each of these cost factors is usually estimated separately. NASA uses three different parametric models for the design and development cost of crewed space systems; the commercial PRICE-H space hardware cost model, the NASA-Air Force Cost Model (NAFCOM), and the Advanced Missions Cost Model (AMCM). System mass is an important parameter in all three models. System mass also determines the launch and emplacement cost, which directly depends on the cost per kilogram to launch mass to Low Earth Orbit (LEO). The launch and emplacement cost is the cost to launch to LEO the system itself and also the rockets, propellant, and lander needed to emplace it. The ratio of the total launch mass to payload mass depends on the mission scenario and destination. The operations and maintenance costs include any material and spares provided, the ground control crew, and sustaining engineering. The Mission Operations Cost Model (MOCM) estimates these costs as a percentage of the system development cost per year.

Environmental Liabilities: DoD Training Range Cleanup Cost Estimates Are Likely Understated

DTIC Science & Technology

2001-04-01

1Federal accounting standards define environmental cleanup costs as...report will not be complete or accurate. Federal financial accounting standards have required that DOD report a liability for the estimated cost of...within the range is better than any other amount. SFFAS No. 6, Accounting for Property, Plant, and Equipment, further defines cleanup costs as costs for

The Development of a Methodology for Estimating the Cost of Air Force On-the-Job Training.

ERIC Educational Resources Information Center

Samers, Bernard N.; And Others

The Air Force uses a standardized costing methodology for resident technical training schools (TTS); no comparable methodology exists for computing the cost of on-the-job training (OJT). This study evaluates three alternative survey methodologies and a number of cost models for estimating the cost of OJT for airmen training in the Administrative…

Incremental costs associated with myocardial infarction and stroke in patients with type 2 diabetes mellitus: an overview for economic modeling.

PubMed

Brennan, Victoria K; Colosia, Ann D; Copley-Merriman, Catherine; Mauskopf, Josephine; Hass, Bastian; Palencia, Roberto

2014-07-01

To identify cost estimates related to myocardial infarction (MI) or stroke in patients with type 2 diabetes mellitus (T2DM) for use in economic models. A systematic literature review was conducted. Electronic databases and conference abstracts were screened against inclusion criteria, which included studies performed in patients who had T2DM before experiencing an MI or stroke. Primary cost studies and economic models were included. Costs were converted to 2012 pounds sterling. Fifty-four studies were identified: 13 primary cost studies and 41 economic evaluations using secondary sources for complication costs. Primary studies provided costs from 10 countries. Estimates for a fatal event ranged from £2482-£5222 for MI and from £4900-£6694 for stroke. Costs for the year a non-fatal event occurred ranged from £5071-£29,249 for MI and from £5171-£38,732 for stroke. Annual follow-up costs ranged from £945-£1616 for an MI and from £4704-£12,926 for a stroke. Economic evaluations from 12 countries were identified, and costs of complications showed similar variability to the primary studies. The costs identified within primary studies varied between and within countries. Many studies used costs estimated in studies not specific to patients with T2DM. Data gaps included a detailed breakdown of resource use, which affected the ability to compare data across countries. In the development of economic models for patients with T2DM, the use of accurate estimates of costs associated with MI and stroke is important. When country-specific costs are not available, clear justification for the choice of estimates should be provided.

Direct medical costs associated with atopic diseases among young children in Thailand.

PubMed

Ngamphaiboon, Jarungchit; Kongnakorn, Thitima; Detzel, Patrick; Sirisomboonwong, Krittawan; Wasiak, Radek

2012-01-01

Allergic diseases are the most common childhood illness in Thailand. Their prevalence has been rising over time, with several studies having revealed substantial economic burden. However, no such study had yet been conducted for Thailand. The aim of this study was to estimate direct medical costs associated with atopic diseases among children aged 0-5 years in Thailand. A cost-of-illness model was constructed to estimate the total direct medical costs of atopic diseases comprising atopic dermatitis, chronic rhinitis, asthma (i.e., recurrent wheeze), and cow's milk allergy. The model employed a prevalence-based approach, considering a total number of atopic cases in 2010. Direct medical costs were estimated using a bottom-up analysis with the estimation of the quantity of healthcare resource use and the unit costs. Epidemiological data were obtained from literature and Thai surveys, whereas treatment unit costs were from either a hospital database or Thai standard cost list. Expert opinion informed type, frequency, and quantity of medical resources utilized. Key limitations included lack of data-driven evidences on severity distribution for this particular age group, indirect costs, and medical resource use associated with each condition. Total direct cost was estimated to be THB 27.8 billion (US$899 million). Treatments contributed largest to the total costs (46%), followed by inpatient care (37%), outpatient care (12%), and monitoring and labs (5%). Costs per treated patient were highest in cow's milk allergy (THB 64,383; US$2077), followed by rhinitis (THB 12,669; US$409), asthma (THB 9633; US$312), and atopic dermatitis (THB 5432; US$175). Atopic diseases in young children are associated with substantial burden in direct medical costs to Thailand. These costs can be diminished through nutritional intervention recognized to effectively decrease the incidence of atopic diseases.

Assessment of costs and benefits of flexible and alternative fuel use in the US transportation sector

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

None

1993-01-01

The primary objective of this report is to provide estimates of volumes and development costs of known nonassociated gas reserves in selected, potentially important supplier nations, using a standard set of costing algorithms and conventions. Estimates of undeveloped nonassociated gas reserves and the cost of drilling development wells, production equipment, gas processing facilities, and pipeline construction are made at the individual field level. A discounted cash-flow model of production, investment, and expenses is used to estimate the present value cost of developing each field on a per-thousand-cubic-foot (Mcf) basis. These gas resource cost estimates for individual accumulations (that is, fieldsmore » or groups of fields) then were aggregated into country-specific price-quantity curves. These curves represent the cost of developing and transporting natural gas to an export point suitable for tanker shipments or to a junction with a transmission line. The additional costs of LNG or methanol conversion are not included. A brief summary of the cost of conversion to methanol and transportation to the United States is contained in Appendix D: Implications of Gas Development Costs for Methanol Conversion.« less

Estimating the Proportion of Childhood Cancer Cases and Costs Attributable to the Environment in California.

PubMed

Nelson, Lauren; Valle, Jhaqueline; King, Galatea; Mills, Paul K; Richardson, Maxwell J; Roberts, Eric M; Smith, Daniel; English, Paul

2017-05-01

To estimate the proportion of cases and costs of the most common cancers among children aged 0 to 14 years (leukemia, lymphoma, and brain or central nervous system tumors) that were attributable to preventable environmental pollution in California in 2013. We conducted a literature review to identify preventable environmental hazards associated with childhood cancer. We combined risk estimates with California-specific exposure prevalence estimates to calculate hazard-specific environmental attributable fractions (EAFs). We combined hazard-specific EAFs to estimate EAFs for each cancer and calculated an overall EAF. Estimated economic costs included annual (indirect and direct medical) and lifetime costs. Hazards associated with childhood cancer risks included tobacco smoke, residential exposures, and parental occupational exposures. Estimated EAFs for leukemia, lymphoma, and brain or central nervous system cancer were 21.3% (range = 11.7%-30.9%), 16.1% (range = 15.0%-17.2%), and 2.0% (range = 1.7%-2.2%), respectively. The combined EAF was 15.1% (range = 9.4%-20.7%), representing $18.6 million (range = $11.6 to $25.5 million) in annual costs and $31 million in lifetime costs. Reducing environmental hazards and exposures in California could substantially reduce the human burden of childhood cancer and result in significant annual and lifetime savings.

Simplified Life-Cycle Cost Estimation

NASA Technical Reports Server (NTRS)

Remer, D. S.; Lorden, G.; Eisenberger, I.

1983-01-01

Simple method for life-cycle cost (LCC) estimation avoids pitfalls inherent in formulations requiring separate estimates of inflation and interest rates. Method depends for validity observation that interest and inflation rates closely track each other.

NASA Air Force Cost Model (NAFCOM): Capabilities and Results

NASA Technical Reports Server (NTRS)

McAfee, Julie; Culver, George; Naderi, Mahmoud

2011-01-01

NAFCOM is a parametric estimating tool for space hardware. Uses cost estimating relationships (CERs) which correlate historical costs to mission characteristics to predict new project costs. It is based on historical NASA and Air Force space projects. It is intended to be used in the very early phases of a development project. NAFCOM can be used at the subsystem or component levels and estimates development and production costs. NAFCOM is applicable to various types of missions (crewed spacecraft, uncrewed spacecraft, and launch vehicles). There are two versions of the model: a government version that is restricted and a contractor releasable version.

Bread Basket: a gaming model for estimating home-energy costs

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

Not Available

An instructional manual for answering the twenty variables on COLORADO ENERGY's computerized program estimating home energy costs. The program will generate home-energy cost estimates based on individual household data, such as total square footage, number of windows and doors, number and variety of appliances, heating system design, etc., and will print out detailed costs, showing the percentages of the total household budget that energy costs will amount to over a twenty-year span. Using the program, homeowners and policymakers alike can predict the effects of rising energy prices on total spending by Colorado households.

Costs of rearing children in agricultural economies: an alternative estimation approach and findings from rural Bangladesh.

PubMed

Khan, M M; Magnani, R J; Mock, N B; Saadat, Y S

1993-03-01

There are changes in child costs during demographic transition. This study examines household time allocation from 66 agricultural households in 3 villages in Tangail District in rural north central Bangladesh in 1984-85 (371 days). Component and total child-rearing costs are estimated in alternative ways. Conventional "opportunity wage" measures are considered overestimated. The methodological shortcomings of direct cost accounting procedures and consumer demand methods in computing time cost and monetary cost of child rearing are pointed out. In this study's alternative computation, age standardized equivalent costs are generated. Child food consumption costs were generated from a large national survey conducted in 1983. Nonfood expenditures were estimated by food to nonfood expenditure ratios taken from the aforementioned survey. For estimating breast-feeding costs, an estimate was produced based on the assumption that costs for infant food consumption were a fixed proportion of food costs for older children. Land ownership groups were set up to reflect socioeconomic status: 1) landless households, 2) marginal farm households with 1 acre or .4 hectares of land, 3) middle income households with 1-2 acres of land, 4) upper middle income households with 2-4 acres of land, and 5) upper income or rich households with over 4 acres of land. The nonmarket wage rate for hired household help was used to determine the value of cooking, fetching water, and household cleaning and repairing. The results confirm the low costs of child rearing in high fertility societies. Productive nonmarket activities are effective in subsidizing the costs of children. The addition of a child into households already with children has a low impact on time costs of children; "this economies of scale effect is estimated ... at 20%." The highest relative costs were found in the lowest income households, and the lowest costs were in the highest income households. 5% of total household income is devoted to child rearing in the lowest income households compared to 1% of income in the highest income households. The implications are that fertility decline is more directly related to structural changes in the economy, satisfaction of existing demand for family planning, and the producing additional demand for fertility control.

Space Programs: Nasa’s Independent Cost Estimating Capability Needs Improvement

DTIC Science & Technology

1992-11-01

AD--A2?t59 263 DTJC 93-01281 I I !:ig’ i ~I1 V:II oz ’~ -A e•, 2.JQ For United States NTISAO General Accounting Office Wto faB Washington, D.C...advisory committee’s recommendation to strengthen NASA’s independent cost estimating capability. Congress and the executive branch need accurate cost ...estimates in deciding whether to undertake or continue space programs which often cost millions or even billions of dollars. In December 1990, the

Index cost estimate based BIM method - Computational example for sports fields

NASA Astrophysics Data System (ADS)

Zima, Krzysztof

2017-07-01

The paper presents an example ofcost estimation in the early phase of the project. The fragment of relative database containing solution, descriptions, geometry of construction object and unit cost of sports facilities was shown. The Index Cost Estimate Based BIM method calculationswith use of Case Based Reasoning were presented, too. The article presentslocal and global similarity measurement and example of BIM based quantity takeoff process. The outcome of cost calculations based on CBR method was presented as a final result of calculations.

Lives Saved Tool (LiST) costing: a module to examine costs and prioritize interventions.

PubMed

Bollinger, Lori A; Sanders, Rachel; Winfrey, William; Adesina, Adebiyi

2017-11-07

Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST) has been used widely to calculate the impact of maternal, neonatal and child health (MNCH) interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different resource allocation strategies. It can be a useful tool for countries as they seek to identify the best investments for scarce resources. The purpose of the LiST model is to provide a tool to make resource allocation decisions in a strategic planning process through prioritizing interventions based on resulting impact on maternal and child mortality and morbidity.

The Cost of Smoking in California.

PubMed

Max, Wendy; Sung, Hai-Yen; Shi, Yanling; Stark, Brad

2016-05-01

The economic impact of smoking, including healthcare costs and the value of lost productivity due to illness and mortality, was estimated for California for 2009. Smoking-attributable healthcare costs were estimated using a series of econometric models that estimate expenditures for hospital care, ambulatory care, prescriptions, home health care, and nursing home care. Lost productivity due to illness was estimated using an econometric model predicting how smoking status affects the number of days lost from work or other activities. The value of lives lost from premature mortality due to smoking was estimated using an epidemiological approach. Almost 4 million Californians still smoke, including 146 000 adolescents. The cost of smoking in 2009 totaled $18.1 billion, including $9.8 billion in healthcare costs, $1.4 billion in lost productivity from illness, and $6.8 billion in lost productivity from premature mortality. This amounts to $487 per California resident and $4603 per smoker. Costs were greater for men than for women. Hospital costs comprised 44% of healthcare costs. Despite extensive efforts at tobacco control in California, healthcare and lost productivity costs attributable to smoking remain high. Compared to costs for 1999, the total cost was 15% greater in 2009. However, after adjusting for inflation, real costs have fallen by 13% over the past decade, indicating that efforts have been successful in reducing the economic burden of smoking in the state. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparing Costs of Traditional and Specialty Probation for People With Serious Mental Illness.

PubMed

Skeem, Jennifer L; Montoya, Lina; Manchak, Sarah M

2018-05-15

Specialty mental health probation reduces the likelihood of rearrest for people with mental illness, who are overrepresented in the justice system. This study tested whether specialty probation was associated with lower costs than traditional probation during the two years after placement in probation. A longitudinal, matched study compared costs of behavioral health care and criminal justice contacts among 359 probationers with mental illness at prototypic specialty or traditional agencies. Compared with traditional officers, specialty officers supervised smaller caseloads, established better relationships with supervisees, and participated more in treatment. Participants and officers were interviewed, and administrative databases were integrated to capture service use and criminal justice contacts. Unit costs were attached to these data to estimate costs incurred by each participant over two years. Cost differences were estimated by using machine-learning algorithms combined with targeted maximum-likelihood estimation (TMLE), a double-robust estimator that accounts for associations between confounders and both treatment assignment and outcomes. Specialty probation cost $11,826 (p<.001) less per participant than traditional probation, with overall savings of about 51%. Specialty and traditional probation did not differ in criminal justice costs because the additional costs for supervision of specialty caseloads were offset by reduced recidivism. However, for behavioral health care, specialty probation cost an estimated $14,049 (p<.001) less per client than traditional probation. Greater outpatient costs were more than offset by reduced emergency, inpatient, and residential costs. Well-implemented specialty probation yielded substantial savings-and should be considered in justice reform efforts for people with mental illness.

The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.

PubMed

Michaelidis, Constantinos I; Fine, Michael J; Lin, Chyongchiou Jeng; Linder, Jeffrey A; Nowalk, Mary Patricia; Shields, Ryan K; Zimmerman, Richard K; Smith, Kenneth J

2016-11-08

Ambulatory antibiotic prescribing contributes to the development of antibiotic resistance and increases societal costs. Here, we estimate the hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States. In an exploratory analysis, we used published data to develop point and range estimates for the hidden societal cost of antibiotic resistance (SCAR) attributable to each ambulatory antibiotic prescription in the United States. We developed four estimation methods that focused on the antibiotic-resistance attributable costs of hospitalization, second-line inpatient antibiotic use, second-line outpatient antibiotic use, and antibiotic stewardship, then summed the estimates across all methods. The total SCAR attributable to each ambulatory antibiotic prescription was estimated to be $13 (range: $3-$95). The greatest contributor to the total SCAR was the cost of hospitalization ($9; 69 % of the total SCAR). The costs of second-line inpatient antibiotic use ($1; 8 % of the total SCAR), second-line outpatient antibiotic use ($2; 15 % of the total SCAR) and antibiotic stewardship ($1; 8 %). This apperars to be an error.; of the total SCAR) were modest contributors to the total SCAR. Assuming an average antibiotic cost of $20, the total SCAR attributable to each ambulatory antibiotic prescription would increase antibiotic costs by 65 % (range: 15-475 %) if incorporated into antibiotic costs paid by patients or payers. Each ambulatory antibiotic prescription is associated with a hidden SCAR that substantially increases the cost of an antibiotic prescription in the United States. This finding raises concerns regarding the magnitude of misalignment between individual and societal antibiotic costs.

Application of Boosting Regression Trees to Preliminary Cost Estimation in Building Construction Projects

PubMed Central

2015-01-01

Among the recent data mining techniques available, the boosting approach has attracted a great deal of attention because of its effective learning algorithm and strong boundaries in terms of its generalization performance. However, the boosting approach has yet to be used in regression problems within the construction domain, including cost estimations, but has been actively utilized in other domains. Therefore, a boosting regression tree (BRT) is applied to cost estimations at the early stage of a construction project to examine the applicability of the boosting approach to a regression problem within the construction domain. To evaluate the performance of the BRT model, its performance was compared with that of a neural network (NN) model, which has been proven to have a high performance in cost estimation domains. The BRT model has shown results similar to those of NN model using 234 actual cost datasets of a building construction project. In addition, the BRT model can provide additional information such as the importance plot and structure model, which can support estimators in comprehending the decision making process. Consequently, the boosting approach has potential applicability in preliminary cost estimations in a building construction project. PMID:26339227

Application of Boosting Regression Trees to Preliminary Cost Estimation in Building Construction Projects.

PubMed

Shin, Yoonseok

2015-01-01

Among the recent data mining techniques available, the boosting approach has attracted a great deal of attention because of its effective learning algorithm and strong boundaries in terms of its generalization performance. However, the boosting approach has yet to be used in regression problems within the construction domain, including cost estimations, but has been actively utilized in other domains. Therefore, a boosting regression tree (BRT) is applied to cost estimations at the early stage of a construction project to examine the applicability of the boosting approach to a regression problem within the construction domain. To evaluate the performance of the BRT model, its performance was compared with that of a neural network (NN) model, which has been proven to have a high performance in cost estimation domains. The BRT model has shown results similar to those of NN model using 234 actual cost datasets of a building construction project. In addition, the BRT model can provide additional information such as the importance plot and structure model, which can support estimators in comprehending the decision making process. Consequently, the boosting approach has potential applicability in preliminary cost estimations in a building construction project.

Economic impact of malignant mesothelioma in Italy: an estimate of the public and social costs.

PubMed

Buresti, Giuliana; Colonna, Fabrizio; Corfiati, Marisa; Valenti, Antonio; Persechino, Benedetta; Marinaccio, Alessandro; Rondinone, Bruna Maria; Iavicoli, Sergio

2017-10-27

Despite their considerable interest for public health policies and for occupational disease management and assessment, the economic costs of asbestos-related diseases (ARDs) for society have not been fully estimated or even frequently discussed. The aim of this study was to estimate the economic burden of mesothelioma in Italy by assessing the overall societal cost of the disease, applying an econometric model. We analyzed two main cost groups, public and social. The first includes expenditure borne by the State and other public bodies (medical care costs, insurance, tax and benefits), while the latter uses the human capital approach to measure the loss of productivity suffered by the economy as a whole. We provide an estimate of euro 33,000 per patient for medical care costs and euro 25,000 for insurance and compensation; tax and benefits seem to roughly compensate. We estimated a loss of more than euro 200,000 per patient, in terms of loss of production. This study offers a practical approach for estimating the economic impact of mesothelioma, and provides empirical evidence of the huge economic burden linked to this disease, with its high etiologic fraction.

Costs of large truck- and bus-involved crashes.

DOT National Transportation Integrated Search

2000-12-01

This study provides comprehensive, economically sophisticated estimates of the costs of highway crashes involving large trucks and buses by severity. Based on the latest data available, the estimated cost of police-reported crashes involving trucks w...

CUECost workbook development documentation

EPA Science Inventory

This is a user's manual for the Coal Utility Environmental Cost (CUECost) workbook to estimate installed capital and annualized costs. The CUECost workbook produces rough-order-of-magnitude (ROM) cost estimates (+/-30% accuracy) of the installed capital and annualized operating c...

Aircraft ground damage and the use of predictive models to estimate costs

NASA Astrophysics Data System (ADS)

Kromphardt, Benjamin D.

Aircraft are frequently involved in ground damage incidents, and repair costs are often accepted as part of doing business. The Flight Safety Foundation (FSF) estimates ground damage to cost operators $5-10 billion annually. Incident reports, documents from manufacturers or regulatory agencies, and other resources were examined to better understand the problem of ground damage in aviation. Major contributing factors were explained, and two versions of a computer-based model were developed to project costs and show what is possible. One objective was to determine if the models could match the FSF's estimate. Another objective was to better understand cost savings that could be realized by efforts to further mitigate the occurrence of ground incidents. Model effectiveness was limited by access to official data, and assumptions were used if data was not available. However, the models were determined to sufficiently estimate the costs of ground incidents.

Estimating the indirect costs associated with the expected number of cancer cases in Mexico by 2020.

PubMed

Gutiérrez-Delgado, Cristina; Armas-Texta, Daniel; Reynoso-Noverón, Nancy; Meneses-García, Abelardo; Mohar-Betancourt, Alejandro

2016-04-01

To estimate the indirect costs generated by adults with cancer in Mexico from 2002-2020. Using information from national sources and the national cancer incidence from GLOBOCAN, we estimated income lost due to premature death (ILPD), short-term benefits (STBs), disability pensions (DPs), and opportunity costs for the carer (OCCs) generated by patients with cancer. Amounts were reported in Mexican pesos. We estimated 23 359 deaths and 216 679 new cases of cancer by 2020, which would be associated with a total indirect cost of 20.15 billion Mexican pesos. Men are expected to generate 54.9% of these costs. ILPD is expected to comprise the highest percentage of the cost (60%), followed by OCCs (22%), STBs (17%) and DPs (1%). From an economic perspective, the results emphasize the need to strengthen preventive interventions and early detection of cancer among adults to reduce its effect on the productivity of Mexico.

United States Marine Corps (USMC) Single Channel Ground and Airborne Radio System (SINCGARS) rechargeable battery trade-off study. Technical report, June-September 1992

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

Allard, S.M.; Albert, N.F.

1992-09-18

Cost estimates for USMC SINCGARS usage of BB-5590/U Lithium Sulfur Dioxide (LiSO[sub 2]) Batteries, BA-590/U Sealed Lead-Acid Batteries, and BB-490/U Nickel-Cadmium (Ni-Cad) Batteries. Estimates encompass battery costs, charger costs as applicable, and disposal costs. Annual battery-related costs were estimated for USMC usage of mix of LiSO[sub 2] and Ni-Cad batteries ranging from 100% use of LiSO[sub 2] batteries to 100% use of Ni-Cad batteries; and for mix of LiSO[sub 2] and Lead-Acid batteries over the same range. Estimated hourly battery-related costs are $2.66 per hour for LiSO[sub 2] batteries $0.34 for Ni-Cad batteries, and $0.30 for Lead-Acid batteries. Disposal relatedmore » regulations and related documents are discussed and included in Appendices.« less

Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India

PubMed Central

2010-01-01

Background Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. Methods Based on data from a representative sample of 128 public-funded HIV prevention programs of 14 types in Andhra Pradesh, we have recently reported the number of HIV infections averted by each type of HIV prevention intervention and their cost. Using estimates of the age of onset of HIV infection, we used standard methods to calculate the cost per Disability Adjusted Life Year (DALY) saved as a measure of cost-effectiveness of each type of HIV prevention intervention. Results The point estimates of the cost per DALY saved were less than US $50 for blood banks, men who have sex with men programmes, voluntary counselling and testing centres, prevention of parent to child transmission clinics, sexually transmitted infection clinics, and women sex worker programmes; between US $50 and 100 for truckers and migrant labourer programmes; more than US $100 and up to US $410 for composite, street children, condom promotion, prisoners and workplace programmes and mass media campaign for the general public. The uncertainty range around these estimates was very wide for several interventions, with the ratio of the high to the low estimates infinite for five interventions. Conclusions The point estimates for the cost per DALY saved from the averted HIV infections for all interventions was much lower than the per capita gross domestic product in this Indian state. While these indicative cost-effectiveness estimates can inform HIV control planning currently, the wide uncertainty range around estimates for several interventions suggest the need for more firm data for estimating cost-effectiveness of HIV prevention interventions in India. PMID:20459755

Using Microsimulation to Estimate the Future Health and Economic Costs of Salmonellosis under Climate Change in Central Queensland, Australia.

PubMed

Stephen, Dimity Maree; Barnett, Adrian Gerard

2017-12-11

The incidence of salmonellosis, a costly foodborne disease, is rising in Australia. Salmonellosis increases during high temperatures and rainfall, and future incidence is likely to rise under climate change. Allocating funding to preventative strategies would be best informed by accurate estimates of salmonellosis costs under climate change and by knowing which population subgroups will be most affected. We used microsimulation models to estimate the health and economic costs of salmonellosis in Central Queensland under climate change between 2016 and 2036 to inform preventative strategies. We projected the entire population of Central Queensland to 2036 by simulating births, deaths, and migration, and salmonellosis and two resultant conditions, reactive arthritis and postinfectious irritable bowel syndrome. We estimated salmonellosis risks and costs under baseline conditions and under projected climate conditions for Queensland under the A1FI emissions scenario using composite projections from 6 global climate models (warm with reduced rainfall). We estimated the resulting costs based on direct medical expenditures combined with the value of lost quality-adjusted life years (QALYs) based on willingness-to-pay. Estimated costs of salmonellosis between 2016 and 2036 increased from 456.0 QALYs (95% CI: 440.3, 473.1) and AUD29,900,000 million (95% CI: AUD28,900,000, AUD31,600,000), assuming no climate change, to 485.9 QALYs (95% CI: 469.6, 503.5) and AUD31,900,000 (95% CI: AUD30,800,000, AUD33,000,000) under the climate change scenario. We applied a microsimulation approach to estimate the costs of salmonellosis and its sequelae in Queensland during 2016-2036 under baseline conditions and according to climate change projections. This novel application of microsimulation models demonstrates the models' potential utility to researchers for examining complex interactions between weather and disease to estimate future costs. https://doi.org/10.1289/EHP1370.

Using Microsimulation to Estimate the Future Health and Economic Costs of Salmonellosis under Climate Change in Central Queensland, Australia

PubMed Central

2017-01-01

Background: The incidence of salmonellosis, a costly foodborne disease, is rising in Australia. Salmonellosis increases during high temperatures and rainfall, and future incidence is likely to rise under climate change. Allocating funding to preventative strategies would be best informed by accurate estimates of salmonellosis costs under climate change and by knowing which population subgroups will be most affected. Objective: We used microsimulation models to estimate the health and economic costs of salmonellosis in Central Queensland under climate change between 2016 and 2036 to inform preventative strategies. Methods: We projected the entire population of Central Queensland to 2036 by simulating births, deaths, and migration, and salmonellosis and two resultant conditions, reactive arthritis and postinfectious irritable bowel syndrome. We estimated salmonellosis risks and costs under baseline conditions and under projected climate conditions for Queensland under the A1FI emissions scenario using composite projections from 6 global climate models (warm with reduced rainfall). We estimated the resulting costs based on direct medical expenditures combined with the value of lost quality-adjusted life years (QALYs) based on willingness-to-pay. Results: Estimated costs of salmonellosis between 2016 and 2036 increased from 456.0 QALYs (95% CI: 440.3, 473.1) and AUD29,900,000 million (95% CI: AUD28,900,000, AUD31,600,000), assuming no climate change, to 485.9 QALYs (95% CI: 469.6, 503.5) and AUD31,900,000 (95% CI: AUD30,800,000, AUD33,000,000) under the climate change scenario. Conclusion: We applied a microsimulation approach to estimate the costs of salmonellosis and its sequelae in Queensland during 2016–2036 under baseline conditions and according to climate change projections. This novel application of microsimulation models demonstrates the models’ potential utility to researchers for examining complex interactions between weather and disease to estimate future costs. https://doi.org/10.1289/EHP1370 PMID:29233795

Magnetohydrodynamics MHD Engineering Test Facility ETF 200 MWe power plant. Conceptual Design Engineering Report CDER. Volume 3: Costs and schedules

NASA Astrophysics Data System (ADS)

1981-09-01

The estimated plant capital cost for a coal fired 200 MWE electric generating plant with open cycle magnetohydrodynamics is divided into principal accounts based on Federal Energy Regulatory Commision account structure. Each principal account is defined and its estimated cost subdivided into identifiable and major equipment systems. The cost data sources for compiling the estimates, cost parameters, allotments, assumptions, and contingencies, are discussed. Uncertainties associated with developing the costs are quantified to show the confidence level acquired. Guidelines established in preparing the estimated costs are included. Based on an overall milestone schedule related to conventional power plant scheduling experience and starting procurement of MHD components during the preliminary design phase there is a 6 1/2-year construction period. The duration of the project from start to commercial operation is 79 months. The engineering phase of the project is 4 1/2 years; the construction duration following the start of the man power block is 37 months.

Magnetohydrodynamics MHD Engineering Test Facility ETF 200 MWe power plant. Conceptual Design Engineering Report CDER. Volume 3: Costs and schedules

NASA Technical Reports Server (NTRS)

1981-01-01

The estimated plant capital cost for a coal fired 200 MWE electric generating plant with open cycle magnetohydrodynamics is divided into principal accounts based on Federal Energy Regulatory Commision account structure. Each principal account is defined and its estimated cost subdivided into identifiable and major equipment systems. The cost data sources for compiling the estimates, cost parameters, allotments, assumptions, and contingencies, are discussed. Uncertainties associated with developing the costs are quantified to show the confidence level acquired. Guidelines established in preparing the estimated costs are included. Based on an overall milestone schedule related to conventional power plant scheduling experience and starting procurement of MHD components during the preliminary design phase there is a 6 1/2-year construction period. The duration of the project from start to commercial operation is 79 months. The engineering phase of the project is 4 1/2 years; the construction duration following the start of the man power block is 37 months.

Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods.

PubMed

Nunes, Sheila Elke Araujo; Minamisava, Ruth; Vieira, Maria Aparecida da Silva; Itria, Alexander; Pessoa, Vicente Porfirio; Andrade, Ana Lúcia Sampaio Sgambatti de; Toscano, Cristiana Maria

2017-01-01

To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective. Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test. Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (p<0.001) or record review (p=0.006). Brazilian Public Unified Health System costs estimated via different costing methods differ significantly, with gross-costing yielding lower cost estimates. Given costs estimated by different micro-costing methods are similar and costing methods based on therapeutic guidelines are easier to apply and less expensive, this method may be a valuable alternative for estimation of hospitalization costs of bacterial community-acquired pneumonia in children. Determinar e comparar custos hospitalares no tratamento da pneumonia bacteriana adquirida na comunidade por diferentes metodologias de custeio, na perspectiva do Sistema Único de Saúde. Estudo de custo, com coleta de dados primários de uma amostra de 59 crianças com 28 dias a 35 meses de idade hospitalizadas por pneumonia bacteriana. Foram considerados custos diretos médicos e não médicos. Três metodologias de custeio foram utilizadas: microcusteio por revisão de prontuários, microcusteio considerando diretriz terapêutica e macrocusteio por ressarcimento do Sistema Único de Saúde. Os custos estimados pelas diferentes metodologias foram comparados utilizando o teste de Friedman. Os custos hospitalares de crianças com pneumonia grave foram R$ 780,70 ($Int. 858.7) por revisão de prontuários, R$ 641,90 ($Int. 706.90) por diretriz terapêutica e R$ 594,80 ($Int. 654.28) por ressarcimento do Sistema Único de Saúde, respectivamente. A utilização de metodologias de microcusteio (revisão de prontuários e diretriz) resultou em estimativas de custos equivalentes (p=0,405), enquanto o custo estimado por ressarcimento foi significativamente menor do que aqueles estimados por diretriz (p<0,001) e por revisão de prontuário (p=0,006), sendo, assim, significativamente diferentes. Na perspectiva do Sistema Único de Saúde, existe diferença significativa nos custos estimados quando se utilizam diferentes metodologias, sendo a estimativa por ressarcimento a que resulta em valores menores. Considerando que não há diferença nos valores de custos estimados por diferentes metodologias de microcusteio, a metodologia de custeio por diretriz, de mais fácil e rápida execução, é uma alternativa válida para estimativa de custos de hospitalização por pneumonias bacterianas em crianças.

Methodological Considerations in Social Cost Studies of Addictive Substances: A Systematic Literature Review.

PubMed

Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

2016-01-01

Alcohol, tobacco, illicit drugs, and psychoactive pharmaceuticals' use is associated with a higher likelihood of developing several diseases and injuries and, as a consequence, considerable health-care expenditures. There is yet a lack of consistent methodologies to estimate the economic impact of addictive substances to society. The aim was to assess the methodological approaches applied in social cost studies estimating the economic impact of alcohol, tobacco, illicit drugs, and psychoactive pharmaceuticals. A systematic literature review through the electronic databases, Medline (PubMed) and Web of Science, was performed. Studies in English published from 1997 examining the social costs of the addictive substances alcohol, tobacco, illicit drugs, and psychoactive pharmaceuticals were eligible for inclusion. Twelve social cost studies met the inclusion criteria. In all studies, the direct and indirect costs were measured, but the intangible costs were seldom taken into account. A wide variety in cost items included across studies was observed. Sensitivity analyses to address the uncertainty around certain cost estimates were conducted in eight studies considered in the review. Differences in cost items included in cost-of-illness studies limit the comparison across studies. It is clear that it is difficult to deal with all consequences of substance use in cost-of-illness studies. Future social cost studies should be based on sound methodological principles in order to result in more reliable cost estimates of the economic burden of substance use.

Estimating Power Outage Cost based on a Survey for Industrial Customers

NASA Astrophysics Data System (ADS)

Yoshida, Yoshikuni; Matsuhashi, Ryuji

A survey was conducted on power outage cost for industrial customers. 5139 factories, which are designated energy management factories in Japan, answered their power consumption and the loss of production value due to the power outage in an hour in summer weekday. The median of unit cost of power outage of whole sectors is estimated as 672 yen/kWh. The sector of services for amusement and hobbies and the sector of manufacture of information and communication electronics equipment relatively have higher unit cost of power outage. Direct damage cost from power outage in whole sectors reaches 77 billion yen. Then utilizing input-output analysis, we estimated indirect damage cost that is caused by the repercussion of production halt. Indirect damage cost in whole sectors reaches 91 billion yen. The sector of wholesale and retail trade has the largest direct damage cost. The sector of manufacture of transportation equipment has the largest indirect damage cost.

Definition and preliminary design of the Laser Atmospheric Wind Sounder (LAWS) phase 1. Volume 3: Program cost estimates

NASA Technical Reports Server (NTRS)

1990-01-01

Cost estimates for phase C/D of the laser atmospheric wind sounder (LAWS) program are presented. This information provides a framework for cost, budget, and program planning estimates for LAWS. Volume 3 is divided into three sections. Section 1 details the approach taken to produce the cost figures, including the assumptions regarding the schedule for phase C/D and the methodology and rationale for costing the various work breakdown structure (WBS) elements. Section 2 shows a breakdown of the cost by WBS element, with the cost divided in non-recurring and recurring expenditures. Note that throughout this volume the cost is given in 1990 dollars, with bottom line totals also expressed in 1988 dollars (1 dollar(88) = 0.93 1 dollar(90)). Section 3 shows a breakdown of the cost by year. The WBS and WBS dictionary are included as an attachment to this report.

The economic cost of inadequate sleep.

PubMed

Hillman, David; Mitchell, Scott; Streatfeild, Jared; Burns, Chloe; Bruck, Dorothy; Pezzullo, Lynne

2018-06-04

To estimate the economic cost (financial and nonfinancial) of inadequate sleep in Australia for the 2016-2017 financial year and relate this to likely costs in similar economies. Analysis was undertaken using prevalence, financial, and nonfinancial cost data derived from national surveys and databases. Costs considered included the following: (1) financial costs associated with health care, informal care provided outside healthcare sector, productivity losses, nonmedical work and vehicle accident costs, deadweight loss through inefficiencies relating to lost taxation revenue and welfare payments; and (2) nonfinancial costs of loss of well-being. They were expressed in US dollars ($). The estimated overall cost of inadequate sleep in Australia in 2016-2017 (population: 24.8 million) was $45.21 billion. The financial cost component was $17.88 billion, comprised of as follows: direct health costs of $160 million for sleep disorders and $1.08 billion for associated conditions; productivity losses of $12.19 billion ($5.22 billion reduced employment, $0.61 billion premature death, $1.73 billion absenteeism, and $4.63 billion presenteeism); nonmedical accident costs of $2.48 billion; informal care costs of $0.41 billion; and deadweight loss of $1.56 billion. The nonfinancial cost of reduced well-being was $27.33 billion. The financial and nonfinancial costs associated with inadequate sleep are substantial. The estimated total financial cost of $17.88 billion represents 1.55 per cent of Australian gross domestic product. The estimated nonfinancial cost of $27.33 billion represents 4.6 per cent of the total Australian burden of disease for the year. These costs warrant substantial investment in preventive health measures to address the issue through education and regulation.

Cost-of-illness studies in heart failure: a systematic review 2004-2016.

PubMed

Lesyuk, Wladimir; Kriza, Christine; Kolominsky-Rabas, Peter

2018-05-02

Heart failure is a major and growing medical and economic problem worldwide as 1-2% of the healthcare budget are spent for heart failure. The prevalence of heart failure has increased over the past decades and it is expected that there will be further raise due to the higher proportion of elderly in the western societies. In this context cost-of-illness studies can significantly contribute to a better understanding of the drivers and problems which lead to the increasing costs in heart failure. The aim of this study was to perform a systematic review of published cost-of-illness studies related to heart failure to highlight the increasing cost impact of heart failure. A systematic review was conducted from 2004 to 2016 to identify cost-of-illness studies related to heart failure, searching PubMed (Medline), Cochrane, Science Direct (Embase), Scopus and CRD York Database. Of the total of 16 studies identified, 11 studies reported prevalence-based estimates, 2 studies focused on incidence-based data and 3 articles presented both types of cost data. A large variation concerning cost components and estimates can be noted. Only three studies estimated indirect costs. Most of the included studies have shown that the costs for hospital admission are the most expensive cost element. Estimates for annual prevalence-based costs for heart failure patients range from $868 for South Korea to $25,532 for Germany. The lifetime costs for heart failure patients have been estimated to $126.819 per patient. Our review highlights the considerable and growing economic burden of heart failure on the health care systems. The cost-of-illness studies included in this review show large variations in methodology used and the cost results vary consequently. High quality data from cost-of-illness studies with a robust methodology applied can inform policy makers about the major cost drivers of heart failure and can be used as the basis of further economic evaluations.

Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

PubMed

Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

2015-05-28

Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya.

PubMed

Shretta, Rima; Johnson, Brittany; Smith, Lisa; Doumbia, Seydou; de Savigny, Don; Anupindi, Ravi; Yadav, Prashant

2015-02-05

Studies have shown that supply chain costs are a significant proportion of total programme costs. Nevertheless, the costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya. A micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. Data from document reviews and semi-structured interviews were used to identify cost inputs and estimate actual costs. Sampling was purposive to isolate key variables of interest. Survey guides were developed and administered electronically. Data were extracted into Microsoft Excel, and the supply chain cost per unit of ACT and RDT distributed by function and level of system was calculated. In Benin, supply chain costs added USD 0.2011 to the initial acquisition cost of ACT and USD 0.3375 to RDTs (normalized to USD 1). In Kenya, they added USD 0.2443 to the acquisition cost of ACT and USD 0.1895 to RDTs (normalized to USD 1). Total supply chain costs accounted for more than 30% of the initial acquisition cost of the products in some cases and these costs were highly sensitive to product volumes. The major cost drivers were found to be labour, transport, and utilities with health facilities carrying the majority of the cost per unit of product. Accurate cost estimates are needed to ensure adequate resources are available for supply chain activities. Product volumes should be considered when costing supply chain functions rather than dollar value. Further work is needed to develop extrapolative costing models that can be applied at country level without extensive micro-costing exercises. This will allow other countries to generate more accurate estimates in the future.

Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

PubMed Central

Temperley, Matilda; Mueller, Dirk H; Njagi, J Kiambo; Akhwale, Willis; Clarke, Siân E; Jukes, Matthew CH; Estambale, Benson BA; Brooker, Simon

2008-01-01

Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT) as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly). Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child) whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year). The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This study provides the first evidence that IPT administered by teachers is a cost-effective school-based malaria intervention and merits investigation in other settings. PMID:18826594

Costs of illness of multiple sclerosis in Sweden: a population-based register study of people of working age.

PubMed

Gyllensten, Hanna; Wiberg, Michael; Alexanderson, Kristina; Norlund, Anders; Friberg, Emilie; Hillert, Jan; Ernstsson, Olivia; Tinghög, Petter

2018-04-01

Multiple sclerosis (MS) causes work disability and healthcare resource use, but little is known about the distribution of the associated costs to society. We estimated the cost of illness (COI) of working-aged individuals with MS, from the societal perspective, overall and in different groups. A population-based study was conducted, using data linked from several nationwide registers, on 14,077 individuals with MS, aged 20-64 years and living in Sweden. Prevalence-based direct and indirect costs in 2010 were calculated, including costs for prescription drug use, specialized healthcare, sick leave, and disability pension. The estimated COI of all the MS patients were SEK 3950 million, of which 75% were indirect costs. MS was the main diagnosis for resource use, causing 38% of healthcare costs and 67% of indirect costs. The distribution of costs was skewed, in which less than 25% of the patients accounted for half the total COI. Indirect costs contributed to approximately 75% of the estimated overall COI of MS patients of working age in Sweden. MS was the main diagnosis for more than half of the estimated COI in this patient group. Further studies are needed to gain knowledge on development of costs over time during the MS disease course.

Production cost analysis of Euphorbia lathyris. Final report

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

Mendel, D.A.

1979-08-01

The purpose of this study is to estimate costs of production for Euphorbia lathyris (hereafter referred to as Euphorbia) in commercial-scale quantities. Selection of five US locations for analysis was based on assumed climatic and cultivation requirements. The five areas are: nonirrigated areas (Southeast Kansas and Central Oklahoma, Northeast Louisiana and Central Mississippi, Southern Illinois), and irrigated areas: (San Joaquin Valley and the Imperial Valley, California and Yuma, Arizona). Cost estimates are tailored to reflect each region's requirements and capabilities. Variable costs for inputs such as cultivation, planting, fertilization, pesticide application, and harvesting include material costs, equipment ownership, operating costs,more » and labor. Fixed costs include land, management, and transportation of the plant material to a conversion facility. Euphorbia crop production costs, on the average, range between $215 per acre in nonirrigated areas to $500 per acre in irrigated areas. Extraction costs for conversion of Euphorbia plant material to oil are estimated at $33.76 per barrel of oil, assuming a plant capacity of 3000 dry ST/D. Estimated Euphorbia crop production costs are competitive with those of corn. Alfalfa production costs per acre are less than those of Euphorbia in the Kansas/Oklahoma and Southern Illinois site, but greater in the irrigated regions. This disparity is accounted for largely by differences in productivity and irrigation requirements.« less

Costs of childhood asthma due to traffic-related pollution in two California communities.

PubMed

Brandt, Sylvia J; Perez, Laura; Künzli, Nino; Lurmann, Fred; McConnell, Rob

2012-08-01

Recent research suggests the burden of childhood asthma that is attributable to air pollution has been underestimated in traditional risk assessments, and there are no estimates of these associated costs. We aimed to estimate the yearly childhood asthma-related costs attributable to air pollution for Riverside and Long Beach, CA, USA, including: 1) the indirect and direct costs of healthcare utilisation due to asthma exacerbations linked with traffic-related pollution (TRP); and 2) the costs of health care for asthma cases attributable to local TRP exposure. We calculated costs using estimates from peer-reviewed literature and the authors' analysis of surveys (Medical Expenditure Panel Survey, California Health Interview Survey, National Household Travel Survey, and Health Care Utilization Project). A lower-bound estimate of the asthma burden attributable to air pollution was US$18 million yearly. Asthma cases attributable to TRP exposure accounted for almost half of this cost. The cost of bronchitic episodes was a major proportion of both the annual cost of asthma cases attributable to TRP and of pollution-linked exacerbations. Traditional risk assessment methods underestimate both the burden of disease and cost of asthma associated with air pollution, and these costs are borne disproportionately by communities with higher than average TRP.

Cost-effectiveness analysis of salt reduction policies to reduce coronary heart disease in Syria, 2010-2020.

PubMed

Wilcox, Meredith L; Mason, Helen; Fouad, Fouad M; Rastam, Samer; al Ali, Radwan; Page, Timothy F; Capewell, Simon; O'Flaherty, Martin; Maziak, Wasim

2015-01-01

This study presents a cost-effectiveness analysis of salt reduction policies to lower coronary heart disease in Syria. Costs and benefits of a health promotion campaign about salt reduction (HP); labeling of salt content on packaged foods (L); reformulation of salt content within packaged foods (R); and combinations of the three were estimated over a 10-year time frame. Policies were deemed cost-effective if their cost-effectiveness ratios were below the region's established threshold of $38,997 purchasing power parity (PPP). Sensitivity analysis was conducted to account for the uncertainty in the reduction of salt intake. HP, L, and R+HP+L were cost-saving using the best estimates. The remaining policies were cost-effective (CERs: R=$5,453 PPP/LYG; R+HP=$2,201 PPP/LYG; R+L=$2,125 PPP/LYG). R+HP+L provided the largest benefit with net savings using the best and maximum estimates, while R+L was cost-effective with the lowest marginal cost using the minimum estimates. This study demonstrated that all policies were cost-saving or cost effective, with the combination of reformulation plus labeling and a comprehensive policy involving all three approaches being the most promising salt reduction strategies to reduce CHD mortality in Syria.

Controlling for endogeneity in attributable costs of vancomycin-resistant enterococci from a Canadian hospital.

PubMed

Lloyd-Smith, Patrick

2017-12-01

Decisions regarding the optimal provision of infection prevention and control resources depend on accurate estimates of the attributable costs of health care-associated infections. This is challenging given the skewed nature of health care cost data and the endogeneity of health care-associated infections. The objective of this study is to determine the hospital costs attributable to vancomycin-resistant enterococci (VRE) while accounting for endogeneity. This study builds on an attributable cost model conducted by a retrospective cohort study including 1,292 patients admitted to an urban hospital in Vancouver, Canada. Attributable hospital costs were estimated with multivariate generalized linear models (GLMs). To account for endogeneity, a control function approach was used. The analysis sample included 217 patients with health care-associated VRE. In the standard GLM, the costs attributable to VRE are $17,949 (SEM, $2,993). However, accounting for endogeneity, the attributable costs were estimated to range from $14,706 (SEM, $7,612) to $42,101 (SEM, $15,533). Across all model specifications, attributable costs are 76% higher on average when controlling for endogeneity. VRE was independently associated with increased hospital costs, and controlling for endogeneity lead to higher attributable cost estimates. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Cost-of-illness studies of atrial fibrillation: methodological considerations.

PubMed

Becker, Christian

2014-10-01

Atrial fibrillation (AF) is the most common heart rhythm arrhythmia, which has considerable economic consequences. This study aims to identify the current cost-of-illness estimates of AF; a focus was put on describing the studies' methodology. A literature review was conducted. Twenty-eight cost-of-illness studies were identified. Cost-of-illness estimates exist for health insurance members, hospital and primary care populations. In addition, the cost of stroke in AF patients and the costs of post-operative AF were calculated. The methods used were heterogeneous, mostly studies calculated excess costs. The identified annual excess costs varied, even among studies from the USA (∼US$1900 to ∼US$19,000). While pointing toward considerable costs, the cost-of-illness studies' relevance could be improved by focusing on subpopulations and treatment mixes. As possible starting points for subsequent economic studies, the methodology of cost-of-illness studies should be taken into account using methods, allowing stakeholders to find suitable studies and validate estimates.

78 FR 29751 - Agency Information Collection Activities: Proposed Collections; Request for Comment on Two...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

...) of CAA and 40 CFR Part 1042, Subpart D). Estimated number of respondents: 200 (total, including..., depending on the program. Total estimated burden: 3,012 hours per year. Burden is defined at 5 CFR 1320.03(b) Total estimated cost: Estimated total annual costs: $200,000 (per year), includes an estimated $65,155...

Global cost of child survival: estimates from country-level validation

PubMed Central

van Ekdom, Liselore; Scherpbier, Robert W; Niessen, Louis W

2011-01-01

Abstract Objective To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4) as estimated by the World Health Organization (WHO) in 2007 by using the latest country-provided data and new assumptions. Methods After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV). Findings Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53% increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$]) for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15%). New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16%). Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80%) for 2010–2015. Conclusion Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12% increase in total health expenditure) would be needed between 2010 and 2015. Given resource constraints, countries will need to prioritize health activities within their national resource envelope. PMID:21479091

Warfighter Information Network-Tactical Increment 2 (WIN-T Inc 2)

DTIC Science & Technology

2015-12-01

Company- level . Using equipment mounted on combat platforms, WIN-T Inc 2 delivers a mobile capability that reduces reliance on fixed infrastructure...Cost Estimate Reference Army Cost Position (ACP) dated April 28, 2015 Confidence Level Confidence Level of cost estimate for current APB: 50% The...Development Estimate Changes PAUC Production Estimate Econ Qty Sch Eng Est Oth Spt Total 2.064 -0.055 -0.063 0.016 0.000 0.093 0.000 0.200 0.191 2.255

How low can you go? The impact of reduced benefits and increased cost sharing.

PubMed

Lee, Jason S; Tollen, Laura

2002-01-01

Amid escalating health care costs and a managed care backlash, employers are considering traditional cost control methods from the pre-managed care era. We use an actuarial model to estimate the premium-reducing effects of two such methods: increasing employee cost sharing and reducing benefits. Starting from a baseline plan with rich benefits and low cost sharing, estimated premium savings as a result of eliminating five specific benefits were about 22 percent. The same level of savings was also achieved by increasing cost sharing from a 15 dollars copayment with no deductible to 20 percent coinsurance and a 250 dollars deductible. Further increases in cost sharing produced estimated savings of up to 50 percent. We discuss possible market- and individual-level effects of the proliferation of plans with high cost sharing and low benefits.

External costs of risky health behaviors associated with leading actual causes of death in the U.S.: a review of the evidence and implications for future research.

PubMed

Zohrabian, Armineh; Philipson, Tomas J

2010-06-01

This paper reviews the evidence on external costs of risky behaviors in the U.S. and provides a framework for estimating them. External costs arise when a person does not bear all the costs of his or her behavior. They provide one of the strongest rationales for government interventions. Although the earlier estimates of external costs no longer have policy relevance, they demonstrated that the existence of external costs was an empirical question. We recommend that the estimates of external costs be updated as insurance structures, environments, and knowledge about these behaviors change. The general aspects of external costs may apply to countries other than the U.S. after taking into account differences in institutional, policy and epidemiological characteristics.

Cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya.

PubMed

McPake, Barbara; Edoka, Ijeoma; Witter, Sophie; Kielmann, Karina; Taegtmeyer, Miriam; Dieleman, Marjolein; Vaughan, Kelsey; Gama, Elvis; Kok, Maryse; Datiko, Daniel; Otiso, Lillian; Ahmed, Rukhsana; Squires, Neil; Suraratdecha, Chutima; Cometto, Giorgio

2015-09-01

To assess the cost-effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Incremental cost-effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. Life years gained were estimated based on coverage of reproductive, maternal, neonatal and child health services. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. For Indonesia, coverage of health service interventions was estimated from routine data. We used the Lives Saved Tool to estimate the number of lives saved from changes in reproductive, maternal, neonatal and child health-service coverage. Gross domestic product per capita was used as the reference willingness-to-pay threshold value. The estimated incremental cost per life year gained was 82 international dollars ($)in Kenya, $999 in Ethiopia and $3396 in Indonesia. The results were most sensitive to uncertainty in the estimates of life-years gained. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective. Community-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. Community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness.

The costs of hepatitis A infections in South Korea

PubMed Central

Kim, Kyohyun; Jeong, Baek-Geun; Ki, Moran; Park, Mira; Park, Jin Kyung; Choi, Bo Youl; Yoo, Weon-Seob

2014-01-01

OBJECTIVES: The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies. METHODS: We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008. RESULTS: There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case). Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group. CONCLUSIONS: This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate. PMID:25139060

Cost of abortions in Zambia: A comparison of safe abortion and post abortion care.

PubMed

Parmar, Divya; Leone, Tiziana; Coast, Ernestina; Murray, Susan Fairley; Hukin, Eleanor; Vwalika, Bellington

2017-02-01

Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion.

A simplified economic filter for open-pit mining and heap-leach recovery of copper in the United States

USGS Publications Warehouse

Long, Keith R.; Singer, Donald A.

2001-01-01

Determining the economic viability of mineral deposits of various sizes and grades is a critical task in all phases of mineral supply, from land-use management to mine development. This study evaluates two simple tools for estimating the economic viability of porphyry copper deposits mined by open-pit, heap-leach methods when only limited information on these deposits is available. These two methods are useful for evaluating deposits that either (1) are undiscovered deposits predicted by a mineral resource assessment, or (2) have been discovered but for which little data has been collected or released. The first tool uses ordinary least-squared regression analysis of cost and operating data from selected deposits to estimate a predictive relationship between mining rate, itself estimated from deposit size, and capital and operating costs. The second method uses cost models developed by the U.S. Bureau of Mines (Camm, 1991) updated using appropriate cost indices. We find that the cost model method works best for estimating capital costs and the empirical model works best for estimating operating costs for mines to be developed in the United States.

Estimating the Cost of Providing Foundational Public Health Services.

PubMed

Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

2017-12-28

To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

Estimating costs of pressure area management based on a survey of ulcer care in one Irish hospital.

PubMed

Gethin, G; Jordan-O'Brien, J; Moore, Z

2005-04-01

Pressure ulceration remains a significant cause of morbidity for patients and has a real economic impact on the health sector. Studies to date have estimated the cost of management but have not always given a breakdown of how these figures were calculated. There are no published studies that have estimated the cost of management of pressure ulcers in Ireland. A two-part study was therefore undertaken. Part one determined the prevalence of pressure ulcers in a 626-bed Irish acute hospital. Part two set out to derive a best estimate of the cost of managing pressure ulcers in Ireland. The European Pressure UlcerAdvisory Panel (EPUAP) minimum data set tool was used to complete the prevalence survey. Tissue viability nurses trained in the data-collection tool collected the data. A cost was obtained for all items of care for the management of one patient with three grade IV pressure ulcers over a five-month period. Of the patients, 2.5% had pressure ulcers. It cost Euros 119,000 to successfully treat one patient. We estimate that it costs Euros 250,000,000 per annum to manage pressure ulcers across all care settings in Ireland.

Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

PubMed Central

Alouki, Koffi; Delisle, Hélène; Besançon, Stéphane; Baldé, Naby; Sidibé-Traoré, Assa; Drabo, Joseph; Djrolo, François; Mbanya, Jean-Claude; Halimi, Serge

2015-01-01

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularly patients with complications. METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin, Burkina Faso, Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines, published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications. RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes (in the public sector) would amount to 21%-34% of the country’s gross national income per capita, 26%-47% in the presence of retinopathy, and above 70% for nephropathy, the most expensive complication. CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders. PMID:26617974

Costs of subcutaneous and intravenous administration of trastuzumab for patients with HER2-positive breast cancer.

PubMed

Olsen, Jens; Jensen, Kenneth Forsstrøm; Olesen, Daniel Sloth; Knoop, Ann

2018-05-01

Trastuzumab is available in an intravenous (iv.) and a subcutaneous (sc.) formulation. The objective of this study was to estimate the costs of administration of iv. and sc. trastuzumab treatment. Via interviews, we identified all the activities associated with iv. and sc. administration. The outcome was time estimates. To estimate the administration costs, the time estimates were valued by average gross wages.  The iv. administration takes longer time as infusion time is longer (25 or 85 min). The iv. administration is associated with higher cost for 17 cycles; €971 (€1858 vs €887). sc. administration is associated with lower administration costs. Switching patients from iv. to sc. would make it possible to treat more patients without increasing the personnel resources.

Investment opportunity : the FPL low-cost solar dry kiln

Treesearch

George B. Harpole

1988-01-01

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

Estimating Resource Costs of Levy Campaigns in Five Ohio School Districts

ERIC Educational Resources Information Center

Ingle, W. Kyle; Petroff, Ruth Ann; Johnson, Paul A.

2011-01-01

Using Levin and McEwan's (2001) "ingredients method," this study identified the major activities and associated costs of school levy campaigns in five districts. The ingredients were divided into one of five cost categories--human resources, facilities, fees, marketing, and supplies. As to overall costs of the campaigns, estimates ranged…

Parametric CERs (Cost Estimate Relationships) for Replenishment Repair Parts (Selected U.S. Army Helicopters and Combat Vehicles)

DTIC Science & Technology

1989-07-31

Information System (OSMIS). The long-range objective is to develop methods to determine total operating and support (O&S) costs within life-cycle cost...objective was to assess the feasibility of developing cost estimating relationships (CERs) based on data from the Army Operating and Support Management

The cost of an Ebola case.

PubMed

Bartsch, Sarah M; Gorham, Katrin; Lee, Bruce Y

2015-02-01

As the most recent outbreak of Ebola virus disease (EVD) in West Africa continues to grow since its initial recognition as a Public Health Emergency of International Concern, an unanswered question is what is the cost of a case of Ebola? Understanding this cost will help decision makers better understand the impact of each case of EVD, benchmark this against that of other diseases, prioritize which cases may require response, and begin to estimate the cost of Ebola outbreaks. To date, the scientific literature has not characterized this cost per case. Therefore, we developed a mathematical model to estimate the cost of an EVD case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Our model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5929 to $18 929, varying by age and country. Therefore, as of 10 December 2014, the estimated total societal costs of all reported EVD cases in these three countries range from $82 to potentially over $356 million.

The cost of long-term follow-up of high-risk infants for research studies.

PubMed

Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y

2015-10-01

Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Costs of occupational injuries in agriculture.

PubMed Central

Leigh, J. P.; McCurdy, S. A.; Schenker, M. B.

2001-01-01

OBJECTIVE: This study was conducted to estimate the costs of job-related injuries in agriculture in the United States for 1992. METHODS: The authors reviewed data from national surveys to assess the incidence of fatal and non-fatal farm injuries. Numerical adjustments were made for weaknesses in the most reliable data sets. For example, the Bureau of Labor Statistics (BLS) Annual Survey estimate of non-fatal injuries is adjusted upward by a factor of 4.7 to reflect the BLS undercount of farm injuries. To assess costs, the authors used the human capital method that allocates costs to direct categories such as medical expenses, as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Cost data were drawn from the Health Care Financing Administration and the National Council on Compensation Insurance. RESULTS: Eight hundred forty-one (841) deaths and 512,539 non-fatal injuries are estimated for 1992. The non-fatal injuries include 281,896 that led to at least one full day of work loss. Agricultural occupational injuries cost an estimated $4.57 billion (range $3.14 billion to $13.99 billion) in 1992. On a per person basis, farming contributes roughly 30% more than the national average to occupational injury costs. Direct costs are estimated to be $1.66 billion and indirect costs, $2.93 billion. CONCLUSIONS: The costs of farm injuries are on a par with the costs of hepatitis C. This high cost is in sharp contrast to the limited public attention and economic resources devoted to prevention and amelioration of farm injuries. Agricultural occupational injuries are an underappreciated contributor to the overall national burden of health and medical costs. PMID:12034913

Costs of occupational injuries in agriculture.

PubMed

Leigh, J P; McCurdy, S A; Schenker, M B

2001-01-01

This study was conducted to estimate the costs of job-related injuries in agriculture in the United States for 1992. The authors reviewed data from national surveys to assess the incidence of fatal and non-fatal farm injuries. Numerical adjustments were made for weaknesses in the most reliable data sets. For example, the Bureau of Labor Statistics (BLS) Annual Survey estimate of non-fatal injuries is adjusted upward by a factor of 4.7 to reflect the BLS undercount of farm injuries. To assess costs, the authors used the human capital method that allocates costs to direct categories such as medical expenses, as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Cost data were drawn from the Health Care Financing Administration and the National Council on Compensation Insurance. Eight hundred forty-one (841) deaths and 512,539 non-fatal injuries are estimated for 1992. The non-fatal injuries include 281,896 that led to at least one full day of work loss. Agricultural occupational injuries cost an estimated $4.57 billion (range $3.14 billion to $13.99 billion) in 1992. On a per person basis, farming contributes roughly 30% more than the national average to occupational injury costs. Direct costs are estimated to be $1.66 billion and indirect costs, $2.93 billion. The costs of farm injuries are on a par with the costs of hepatitis C. This high cost is in sharp contrast to the limited public attention and economic resources devoted to prevention and amelioration of farm injuries. Agricultural occupational injuries are an underappreciated contributor to the overall national burden of health and medical costs.

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

PubMed Central

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

2017-01-01

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

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

PubMed

Chang, Chongwon; Lee, Seung Mi; Choi, Byoung Whui; Song, Jong Hwa; Song, Hee; Jung, Sujin; Bai, Yoon Kyeong; Park, Haedong; Jeung, Seungwon; Suh, Dong Churl

2017-01-01

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

An overall estimation of losses caused by diseases in the Brazilian fish farms.

PubMed

Tavares-Dias, Marcos; Martins, Maurício Laterça

2017-12-01

Parasitic and infectious diseases are common in finfish, but are difficult to accurately estimate the economic impacts on the production in a country with large dimensions like Brazil. The aim of this study was to estimate the costs caused by economic losses of finfish due to mortality by diseases in Brazil. A model for estimating the costs related to parasitic and bacterial diseases in farmed fish and an estimative of these economic impacts are presented. We used official data of production and mortality of finfish for rough estimation of economic losses. The losses herein presented are related to direct and indirect economic costs for freshwater farmed fish, which were estimated in US$ 84 million per year. Finally, it was possible to establish by the first time an estimative of overall losses in finfish production in Brazil using data available from production. Therefore, this current estimative must help researchers and policy makers to approximate the economic costs of diseases for fish farming industry, as well as for developing of public policies on the control measures of diseases and priority research lines.

An Investment Case to Prevent the Reintroduction of Malaria in Sri Lanka

PubMed Central

Shretta, Rima; Baral, Ranju; Avanceña, Anton L. V.; Fox, Katie; Dannoruwa, Asoka Premasiri; Jayanetti, Ravindra; Jeyakumaran, Arumainayagam; Hasantha, Rasike; Peris, Lalanthika; Premaratne, Risintha

2017-01-01

Sri Lanka has made remarkable gains in reducing the burden of malaria, recording no locally transmitted malaria cases since November 2012 and zero deaths since 2007. The country was recently certified as malaria free by World Health Organization in September 2016. Sri Lanka, however, continues to face a risk of resurgence due to persistent receptivity and vulnerability to malaria transmission. Maintaining the gains will require continued financing to the malaria program to maintain the activities aimed at preventing reintroduction. This article presents an investment case for malaria in Sri Lanka by estimating the costs and benefits of sustaining investments to prevent the reintroduction of the disease. An ingredient-based approach was used to estimate the cost of the existing program. The cost of potential resurgence was estimated using a hypothetical scenario in which resurgence assumed to occur, if all prevention of reintroduction activities were halted. These estimates were used to compute a benefit–cost ratio and a return on investment. The total economic cost of the malaria program in 2014 was estimated at U.S. dollars (USD) 0.57 per capita per year with a financial cost of USD0.37 per capita. The cost of potential malaria resurgence was, however, much higher estimated at 13 times the cost of maintaining existing activities or 21 times based on financial costs alone. This evidence suggests a substantial return on investment providing a compelling argument for advocacy for continued prioritization of funding for the prevention of reintroduction of malaria in Sri Lanka. PMID:28115673

The Cost of Penicillin Allergy Evaluation.

PubMed

Blumenthal, Kimberly G; Li, Yu; Banerji, Aleena; Yun, Brian J; Long, Aidan A; Walensky, Rochelle P

2017-09-22

Unverified penicillin allergy leads to adverse downstream clinical and economic sequelae. Penicillin allergy evaluation can be used to identify true, IgE-mediated allergy. To estimate the cost of penicillin allergy evaluation using time-driven activity-based costing (TDABC). We implemented TDABC throughout the care pathway for 30 outpatients presenting for penicillin allergy evaluation. The base-case evaluation included penicillin skin testing and a 1-step amoxicillin drug challenge, performed by an allergist. We varied assumptions about the provider type, clinical setting, procedure type, and personnel timing. The base-case penicillin allergy evaluation costs $220 in 2016 US dollars: $98 for personnel, $119 for consumables, and $3 for space. In sensitivity analyses, lower cost estimates were achieved when only a drug challenge was performed (ie, no skin test, $84) and a nurse practitioner provider was used ($170). Adjusting for the probability of anaphylaxis did not result in a changed estimate ($220); although other analyses led to modest changes in the TDABC estimate ($214-$246), higher estimates were identified with changing to a low-demand practice setting ($268), a 50% increase in personnel times ($269), and including clinician documentation time ($288). In a least/most costly scenario analyses, the lowest TDABC estimate was $40 and the highest was $537. Using TDABC, penicillin allergy evaluation costs $220; even with varied assumptions adjusting for operational challenges, clinical setting, and expanded testing, penicillin allergy evaluation still costs only about $540. This modest investment may be offset for patients treated with costly alternative antibiotics that also may result in adverse consequences. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Estimating the Cost of a Bachelor's Degree: An Institutional Cost Analysis.

ERIC Educational Resources Information Center

To, Duc-Le

The cost of a bachelor's degree was estimated and compared for different types of institutions. The objective was to develop a single index to show how much each type of institution spends on producing a bachelor's degree graduate, and to use trend data to show how these costs will change over time. The basic concept associated with the cost of a…

Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030.

PubMed

Antonelli, Jodi A; Maalouf, Naim M; Pearle, Margaret S; Lotan, Yair

2014-10-01

The prevalence of urolithiasis and its risk factors such as obesity and diabetes have increased over time. Determine the future cost and prevalence of kidney stones using current and projected estimates for stones, obesity, diabetes, and population rates. The stone prevalence in 2000 was estimated from the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010. The cost per percentage prevalence of stones in 2000, calculated using Urologic Diseases in America Project data, was used to estimate the annual cost of stones in 2030, adjusting for inflation and increases in population, stone prevalence, obesity and diabetes rates. The primary outcome was prevalence and cost of stones in 2030. The secondary outcomes were the impact of obesity and diabetes on these values, calculated using odds ratios for stones by body mass index and diabetes status. The annual cost of stone disease in 2000, adjusted for inflation to 2014 US dollars, was approximately $2.81 billion. After accounting for increases in population and stone prevalence from 2000, the estimated cost of stones in 2007 in 2014 US dollars was $3.79 billion. Future population growth alone would increase the cost of stone disease by $780 million in 2030. Based on projected estimates for 2030, obesity will independently increase stone prevalence by 0.36%, with an annual cost increase of $157 million. Diabetes will independently increase stone prevalence by 0.72%, associated with a cost increase of $308 million annually by 2030. NHANES data, however, capture patient self-assessment rather than medical diagnosis, which is a potential bias. The rising prevalence of obesity and diabetes, together with population growth, is projected to contribute to dramatic increases in the cost of urolithiasis, with an additional $1.24 billion/yr estimated by 2030. Obesity, diabetes, and population rates will contribute to an estimated $1.24 billion/yr increase in the cost of kidney stones by 2030. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Estimates and predictors of health care costs of esophageal adenocarcinoma: a population-based cohort study.

PubMed

Thein, Hla-Hla; Jembere, Nathaniel; Thavorn, Kednapa; Chan, Kelvin K W; Coyte, Peter C; de Oliveira, Claire; Hur, Chin; Earle, Craig C

2018-06-27

Esophageal adenocarcinoma (EAC) incidence is increasing rapidly. Esophageal cancer has the second lowest 5-year survival rate of people diagnosed with cancer in Canada. Given the poor survival and the potential for further increases in incidence, phase-specific cost estimates constitute an important input for economic evaluation of prevention, screening, and treatment interventions. The study aims to estimate phase-specific net direct medical costs of care attributable to EAC, costs stratified by cancer stage and treatment, and predictors of total net costs of care for EAC. A population-based retrospective cohort study was conducted using Ontario Cancer Registry-linked administrative health data from 2003 to 2011. The mean net costs of EAC care per 30 patient-days (2016 CAD) were estimated from the payer perspective using phase of care approach and generalized estimating equations. Predictors of net cost by phase of care were based on a generalized estimating equations model with a logarithmic link and gamma distribution adjusting for sociodemographic and clinical factors. The mean net costs of EAC care per 30 patient-days were $1016 (95% CI, $955-$1078) in the initial phase, $669 (95% CI, $594-$743) in the continuing care phase, and $8678 (95% CI, $8217-$9139) in the terminal phase. Overall, stage IV at diagnosis and surgery plus radiotherapy for EAC incurred the highest cost, particularly in the terminal phase. Strong predictors of higher net costs were receipt of chemotherapy plus radiotherapy, surgery plus chemotherapy, radiotherapy alone, surgery alone, and chemotherapy alone in the initial and continuing care phases, stage III-IV disease and patients diagnosed with EAC later in a calendar year (2007-2011) in the initial and terminal phases, comorbidity in the continuing care phase, and older age at diagnosis (70-74 years), and geographic region in the terminal phase. Costs of care vary by phase of care, stage at diagnosis, and type of treatment for EAC. These cost estimates provide information to guide future resource allocation decisions, and clinical and policy interventions to reduce the burden of EAC.

The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a systematic literature review and cost calculation for England.

PubMed

Mahon, James; Lifschitz, Carlos; Ludwig, Thomas; Thapar, Nikhil; Glanville, Julie; Miqdady, Mohamad; Saps, Miguel; Quak, Seng Hock; Lenoir Wijnkoop, Irene; Edwards, Mary; Wood, Hannah; Szajewska, Hania

2017-11-14

To estimate the cost of functional gastrointestinal disorders (FGIDs) and related signs and symptoms in infants to the third party payer and to parents. To estimate the cost of illness (COI) of infant FGIDs, a two-stage process was applied: a systematic literature review and a COI calculation. As no pertinent papers were found in the systematic literature review, a 'de novo' analysis was performed. For the latter, the potential costs for the third party payer (the National Health Service (NHS) in England) and for parents/carers for the treatment of FGIDs in infants were calculated, by using publicly available data. In constructing the calculation, estimates and assumptions (where necessary) were chosen to provide a lower bound (minimum) of the potential overall cost. In doing so, the interpretation of the calculation is that the true COI can be no lower than that estimated. Our calculation estimated that the total costs of treating FGIDs in infants in England were at least £72.3 million per year in 2014/2015 of which £49.1 million was NHS expenditure on prescriptions, community care and hospital treatment. Parents incurred £23.2 million in costs through purchase of over the counter remedies. The total cost presented here is likely to be a significant underestimate as only lower bound estimates were used where applicable, and for example, costs of alternative therapies, inpatient treatments or diagnostic tests, and time off work by parents could not be adequately estimated and were omitted from the calculation. The number and kind of prescribed products and products sold over the counter to treat FGIDs suggest that there are gaps between treatment guidelines, which emphasise parental reassurance and nutritional advice, and their implementation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a systematic literature review and cost calculation for England

PubMed Central

Mahon, James; Lifschitz, Carlos; Ludwig, Thomas; Thapar, Nikhil; Glanville, Julie; Miqdady, Mohamad; Saps, Miguel; Quak, Seng Hock; Lenoir Wijnkoop, Irene; Wood, Hannah; Szajewska, Hania

2017-01-01

Objectives To estimate the cost of functional gastrointestinal disorders (FGIDs) and related signs and symptoms in infants to the third party payer and to parents. Study design To estimate the cost of illness (COI) of infant FGIDs, a two-stage process was applied: a systematic literature review and a COI calculation. As no pertinent papers were found in the systematic literature review, a ‘de novo’ analysis was performed. For the latter, the potential costs for the third party payer (the National Health Service (NHS) in England) and for parents/carers for the treatment of FGIDs in infants were calculated, by using publicly available data. In constructing the calculation, estimates and assumptions (where necessary) were chosen to provide a lower bound (minimum) of the potential overall cost. In doing so, the interpretation of the calculation is that the true COI can be no lower than that estimated. Results Our calculation estimated that the total costs of treating FGIDs in infants in England were at least £72.3 million per year in 2014/2015 of which £49.1 million was NHS expenditure on prescriptions, community care and hospital treatment. Parents incurred £23.2 million in costs through purchase of over the counter remedies. Conclusions The total cost presented here is likely to be a significant underestimate as only lower bound estimates were used where applicable, and for example, costs of alternative therapies, inpatient treatments or diagnostic tests, and time off work by parents could not be adequately estimated and were omitted from the calculation. The number and kind of prescribed products and products sold over the counter to treat FGIDs suggest that there are gaps between treatment guidelines, which emphasise parental reassurance and nutritional advice, and their implementation. PMID:29138194

Treatment of dissociative disorders and reported changes in inpatient and outpatient cost estimates.

PubMed

Myrick, Amie C; Webermann, Aliya R; Langeland, Willemien; Putnam, Frank W; Brand, Bethany L

2017-01-01

Background: Interpersonal trauma and trauma-related disorders cost society billions of dollars each year. Because of chronic and severe trauma histories, dissociative disorder (DD) patients spend many years in the mental health system, yet there is limited knowledge about the economic burden associated with DDs. Objective: The current study sought to determine how receiving specialized treatment would relate to estimated costs of inpatient and outpatient mental health services. Method: Patients' and individual therapists' reports of inpatient hospitalization days and outpatient treatment sessions were converted into US dollars. DD patients and their clinicians reported on use of inpatient and outpatient services four times over 30 months as part of a larger, naturalistic, international DD treatment study. The baseline sample included 292 clinicians and 280 patients; at the 30-month follow-up, 135 clinicians and 111 patients. Missing data were replaced in analyses to maintain adequate statistical power. The substantial attrition rate (>50%) should be considered in interpreting findings. Results: Longitudinal and cross-sectional analyses of cost estimates based on patient reported inpatient hospitalization significantly decreased over time. Longitudinal cost estimates based on clinician-reported outpatient services also significantly decreased over time. Cross-sectional cost estimates based on patient and clinician reported inpatient hospitalization were significantly lower for patients in later stages of treatment compared to those struggling with safety and stabilization. Cross-sectional cost estimates based on clinician-reported outpatient services were significantly lower for patients in later stages of treatment compared to those in early stages. Conclusions: This pattern of longitudinal and cross-sectional reductions in inpatient and outpatient costs, as reported by both patients and therapists, suggests that DD treatment may be associated with reduced inpatient and outpatient costs over time. Although these preliminary results show decreased mental health care utilization and associated estimated costs, it is not clear whether it was treatment that caused these important changes.

Voluntary medical male circumcision: a qualitative study exploring the challenges of costing demand creation in eastern and southern Africa.

PubMed

Bertrand, Jane T; Njeuhmeli, Emmanuel; Forsythe, Steven; Mattison, Sarah K; Mahler, Hally; Hankins, Catherine A

2011-01-01

This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to "trigger the decision" among eligible men. Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and southern Africa.

Voluntary Medical Male Circumcision: A Qualitative Study Exploring the Challenges of Costing Demand Creation in Eastern and Southern Africa

PubMed Central

Bertrand, Jane T.; Njeuhmeli, Emmanuel; Forsythe, Steven; Mattison, Sarah K.; Mahler, Hally; Hankins, Catherine A.

2011-01-01

Background This paper proposes an approach to estimating the costs of demand creation for voluntary medical male circumcision (VMMC) scale-up in 13 countries of eastern and southern Africa. It addresses two key questions: (1) what are the elements of a standardized package for demand creation? And (2) what challenges exist and must be taken into account in estimating the costs of demand creation? Methods and Findings We conducted a key informant study on VMMC demand creation using purposive sampling to recruit seven people who provide technical assistance to government programs and manage budgets for VMMC demand creation. Key informants provided their views on the important elements of VMMC demand creation and the most effective funding allocations across different types of communication approaches (e.g., mass media, small media, outreach/mobilization). The key finding was the wide range of views, suggesting that a standard package of core demand creation elements would not be universally applicable. This underscored the importance of tailoring demand creation strategies and estimates to specific country contexts before estimating costs. The key informant interviews, supplemented by the researchers' field experience, identified these issues to be addressed in future costing exercises: variations in the cost of VMMC demand creation activities by country and program, decisions about the quality and comprehensiveness of programming, and lack of data on critical elements needed to “trigger the decision” among eligible men. Conclusions Based on this study's findings, we propose a seven-step methodological approach to estimate the cost of VMMC scale-up in a priority country, based on our key assumptions. However, further work is needed to better understand core components of a demand creation package and how to cost them. Notwithstanding the methodological challenges, estimating the cost of demand creation remains an essential element in deriving estimates of the total costs for VMMC scale-up in eastern and southern Africa. PMID:22140450

Treatment of dissociative disorders and reported changes in inpatient and outpatient cost estimates

PubMed Central

Myrick, Amie C.; Webermann, Aliya R.; Langeland, Willemien; Putnam, Frank W.; Brand, Bethany L.

2017-01-01

ABSTRACT Background: Interpersonal trauma and trauma-related disorders cost society billions of dollars each year. Because of chronic and severe trauma histories, dissociative disorder (DD) patients spend many years in the mental health system, yet there is limited knowledge about the economic burden associated with DDs. Objective: The current study sought to determine how receiving specialized treatment would relate to estimated costs of inpatient and outpatient mental health services. Method: Patients’ and individual therapists’ reports of inpatient hospitalization days and outpatient treatment sessions were converted into US dollars. DD patients and their clinicians reported on use of inpatient and outpatient services four times over 30 months as part of a larger, naturalistic, international DD treatment study. The baseline sample included 292 clinicians and 280 patients; at the 30-month follow-up, 135 clinicians and 111 patients. Missing data were replaced in analyses to maintain adequate statistical power. The substantial attrition rate (>50%) should be considered in interpreting findings. Results: Longitudinal and cross-sectional analyses of cost estimates based on patient reported inpatient hospitalization significantly decreased over time. Longitudinal cost estimates based on clinician-reported outpatient services also significantly decreased over time. Cross-sectional cost estimates based on patient and clinician reported inpatient hospitalization were significantly lower for patients in later stages of treatment compared to those struggling with safety and stabilization. Cross-sectional cost estimates based on clinician-reported outpatient services were significantly lower for patients in later stages of treatment compared to those in early stages. Conclusions: This pattern of longitudinal and cross-sectional reductions in inpatient and outpatient costs, as reported by both patients and therapists, suggests that DD treatment may be associated with reduced inpatient and outpatient costs over time. Although these preliminary results show decreased mental health care utilization and associated estimated costs, it is not clear whether it was treatment that caused these important changes. PMID:29038681

Cost-effectiveness of lobectomy versus genetic testing (Afirma®) for indeterminate thyroid nodules: Considering the costs of surveillance.

PubMed

Balentine, Courtney J; Vanness, David J; Schneider, David F

2018-01-01

We evaluated whether diagnostic thyroidectomy for indeterminate thyroid nodules would be more cost-effective than genetic testing after including the costs of long-term surveillance. We used a Markov decision model to estimate the cost-effectiveness of thyroid lobectomy versus genetic testing (Afirma®) for evaluation of indeterminate (Bethesda 3-4) thyroid nodules. The base case was a 40-year-old woman with a 1-cm indeterminate nodule. Probabilities and estimates of utilities were obtained from the literature. Cost estimates were based on Medicare reimbursements with a 3% discount rate for costs and quality-adjusted life-years. During a 5-year period after the diagnosis of indeterminate thyroid nodules, lobectomy was less costly and more effective than Afirma® (lobectomy: $6,100; 4.50 quality-adjusted life- years vs Afirma®: $9,400; 4.47 quality-adjusted life-years). Only in 253 of 10,000 simulations (2.5%) did Afirma® show a net benefit at a cost-effectiveness threshold of $100,000 per quality- adjusted life-years. There was only a 0.3% probability of Afirma® being cost saving and a 14.9% probability of improving quality-adjusted life-years. Our base case estimate suggests that diagnostic lobectomy dominates genetic testing as a strategy for ruling out malignancy of indeterminate thyroid nodules. These results, however, were highly sensitive to estimates of utilities after lobectomy and living under surveillance after Afirma®. Published by Elsevier Inc.

Estimating the effect of hospital closure on areawide inpatient hospital costs: a preliminary model and application.

PubMed Central

Shepard, D S

1983-01-01

A preliminary model is developed for estimating the extent of savings, if any, likely to result from discontinuing a specific inpatient service. By examining the sources of referral to the discontinued service, the model estimates potential demand and how cases will be redistributed among remaining hospitals. This redistribution determines average cost per day in hospitals that receive these cases, relative to average cost per day of the discontinued service. The outflow rate, which measures the proportion of cases not absorbed in other acute care hospitals, is estimated as 30 percent for the average discontinuation. The marginal cost ratio, which relates marginal costs of cases absorbed in surrounding hospitals to the average costs in those hospitals, is estimated as 87 percent in the base case. The model was applied to the discontinuation of all inpatient services in the 75-bed Chelsea Memorial Hospital, near Boston, Massachusetts, using 1976 data. As the precise value of key parameters is uncertain, sensitivity analysis was used to explore a range of values. The most likely result is a small increase ($120,000) in the area's annual inpatient hospital costs, because many patients are referred to more costly teaching hospitals. A similar situation may arise with other urban closures. For service discontinuations to generate savings, recipient hospitals must be low in costs, the outflow rate must be large, and the marginal cost ratio must be low. PMID:6668181

Informal care for stroke survivors: results from the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Dewey, H M; Thrift, A G; Mihalopoulos, C; Carter, R; Macdonell, R A L; McNeil, J J; Donnan, G A

2002-04-01

Informal caregivers play an important role in the lives of stroke patients, but the cost of providing this care has not been estimated. The purpose of this study was to determine the nature and amount of informal care provided to stroke patients and to estimate the economic cost of that care. The primary caregivers of stroke patients registered in the North East Melbourne Stroke Incidence Study (NEMESIS) were interviewed at 3, 6, and 12 months after stroke, and the nature and amount of informal care provided were documented. The opportunity and replacement costs of informal care for all first-ever-in-a-lifetime strokes (excluding subarachnoid hemorrhages) that occurred in 1997 in Australia were estimated. Among 3-month stroke survivors, 74% required assistance with activities of daily living and received informal care from family or friends. Two thirds of primary caregivers were women, and most primary caregivers (>90%) provided care during family or leisure time. Total first-year caregiver time costs for all first-ever-in-a-lifetime strokes were estimated to be A$21.7 million (opportunity cost approach) or A$42.5 million (replacement cost approach), and the present values of lifetime caregiver time costs were estimated to be A$171.4 million (opportunity cost approach) or A$331.8 million (replacement cost approach). Informal care for stroke survivors represents a significant hidden cost to Australian society. Because our community is rapidly aging, this informal care burden may increase significantly in the future.

Lunar base scenario cost estimates: Lunar base systems study task 6.1

NASA Technical Reports Server (NTRS)

1988-01-01

The projected development and production costs of each of the Lunar Base's systems are described and unit costs are estimated for transporting the systems to the lunar surface and for setting up the system.

COST ESTIMATING EQUATIONS FOR BEST MANAGEMENT PRACTICES

EPA Science Inventory

This paper describes the development of an interactive internet-based cost-estimating tool for commonly used urban storm runoff best management practices (BMP), including: retention and detention ponds, grassed swales, and constructed wetlands. The paper presents the cost data, c...

Estimating dietary costs of low-income women in California: a comparison of 2 approaches.

PubMed

Aaron, Grant J; Keim, Nancy L; Drewnowski, Adam; Townsend, Marilyn S

2013-04-01

Currently, no simplified approach to estimating food costs exists for a large, nationally representative sample. The objective was to compare 2 approaches for estimating individual daily diet costs in a population of low-income women in California. Cost estimates based on time-intensive method 1 (three 24-h recalls and associated food prices on receipts) were compared with estimates made by using less intensive method 2 [a food-frequency questionnaire (FFQ) and store prices]. Low-income participants (n = 121) of USDA nutrition programs were recruited. Mean daily diet costs, both unadjusted and adjusted for energy, were compared by using Pearson correlation coefficients and the Bland-Altman 95% limits of agreement between methods. Energy and nutrient intakes derived by the 2 methods were comparable; where differences occurred, the FFQ (method 2) provided higher nutrient values than did the 24-h recall (method 1). The crude daily diet cost was $6.32 by the 24-h recall method and $5.93 by the FFQ method (P = 0.221). The energy-adjusted diet cost was $6.65 by the 24-h recall method and $5.98 by the FFQ method (P < 0.001). Although the agreement between methods was weaker than expected, both approaches may be useful. Additional research is needed to further refine a large national survey approach (method 2) to estimate daily dietary costs with the use of this minimal time-intensive method for the participant and moderate time-intensive method for the researcher.

Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System.

PubMed

Tseng, Phillip; Kaplan, Robert S; Richman, Barak D; Shah, Mahek A; Schulman, Kevin A

2018-02-20

Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. This study used time-driven activity-based costing. Interviews were conducted with 27 health system administrators and 34 physicians in 2016 and 2017 to construct a process map charting the path of an insurance claim through the revenue cycle management process. These data were used to calculate the cost for each major billing and insurance-related activity and were aggregated to estimate the health system's total cost of processing an insurance claim. Estimated time required to perform billing and insurance-related activities, based on interviews with management personnel and physicians. Estimated billing and insurance-related costs for 5 types of patient encounters: primary care visits, discharged emergency department visits, general medicine inpatient stays, ambulatory surgical procedures, and inpatient surgical procedures. Estimated processing time and total costs for billing and insurance-related activities were 13 minutes and $20.49 for a primary care visit, 32 minutes and $61.54 for a discharged emergency department visit, 73 minutes and $124.26 for a general inpatient stay, 75 minutes and $170.40 for an ambulatory surgical procedure, and 100 minutes and $215.10 for an inpatient surgical procedure. Of these totals, time and costs for activities carried out by physicians were estimated at a median of 3 minutes or $6.36 for a primary care visit, 3 minutes or $10.97 for an emergency department visit, 5 minutes or $13.29 for a general inpatient stay, 15 minutes or $51.20 for an ambulatory surgical procedure, and 15 minutes or $51.20 for an inpatient surgical procedure. Of professional revenue, professional billing costs were estimated to represent 14.5% for primary care visits, 25.2% for emergency department visits, 8.0% for general medicine inpatient stays, 13.4% for ambulatory surgical procedures, and 3.1% for inpatient surgical procedures. In a time-driven activity-based costing study in a large academic health care system with a certified electronic health record system, the estimated costs of billing and insurance-related activities ranged from $20 for a primary care visit to $215 for an inpatient surgical procedure. Knowledge of how specific billing and insurance-related activities contribute to administrative costs may help inform policy solutions to reduce these expenses.

77 FR 15004 - Updating of Employer Identification Numbers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

... the IRS, including whether the information will have practical utility; The accuracy of the estimated... techniques or other forms of information technology; and Estimates of capital or start-up costs and costs of... respondents are persons that have an EIN. Estimated total annual reporting burden: 403,177 hours. Estimated...

The evaluation of cost-of-illness due to use of cost-of-illness-based chemicals.

PubMed

Hong, Jiyeon; Lee, Yongjin; Lee, Geonwoo; Lee, Hanseul; Yang, Jiyeon

2015-01-01

This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

Occupational injury and illness in the United States. Estimates of costs, morbidity, and mortality.

PubMed

Leigh, J P; Markowitz, S B; Fahs, M; Shin, C; Landrigan, P J

1997-07-28

To estimate the annual incidence, the mortality and the direct and indirect costs associated with occupational injuries and illnesses in the United States in 1992. Aggregation and analysis of national and large regional data sets collected by the Bureau of Labor Statistics, the National Council on Compensation Insurance, the National Center for Health Statistics, the Health Care Financing Administration, and other governmental bureaus and private firms. To assess incidence of and mortality from occupational injuries and illnesses, we reviewed data from national surveys and applied an attributable risk proportion method. To assess costs, we used the human capital method that decomposes costs into direct categories such as medical and insurance administration expenses as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Some cost estimates were drawn from the literature while others were generated within this study. Total costs were calculated by multiplying average costs by the number of injuries and illnesses in each diagnostic category. Approximately 6500 job-related deaths from injury, 13.2 million nonfatal injuries, 60,300 deaths from disease, and 862,200 illnesses are estimated to occur annually in the civilian American workforce. The total direct ($65 billion) plus indirect ($106 billion) costs were estimated to be $171 billion. Injuries cost $145 billion and illnesses $26 billion. These estimates are likely to be low, because they ignore costs associated with pain and suffering as well as those of within-home care provided by family members, and because the numbers of occupational injuries and illnesses are likely to be undercounted. The costs of occupational injuries and illnesses are high, in sharp contrast to the limited public attention and societal resources devoted to their prevention and amelioration. Occupational injuries and illnesses are an insufficiently appreciated contributor to the total burden of health care costs in the United States.

U.S. Balance-of-Station Cost Drivers and Sensitivities (Presentation)

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

Maples, B.

2012-10-01

With balance-of-system (BOS) costs contributing up to 70% of the installed capital cost, it is fundamental to understanding the BOS costs for offshore wind projects as well as potential cost trends for larger offshore turbines. NREL developed a BOS model using project cost estimates developed by GL Garrad Hassan. Aspects of BOS covered include engineering and permitting, ports and staging, transportation and installation, vessels, foundations, and electrical. The data introduce new scaling relationships for each BOS component to estimate cost as a function of turbine parameters and size, project parameters and size, and soil type. Based on the new BOSmore » model, an analysis to understand the non‐turbine costs has been conducted. This analysis establishes a more robust baseline cost estimate, identifies the largest cost components of offshore wind project BOS, and explores the sensitivity of the levelized cost of energy to permutations in each BOS cost element. This presentation shows results from the model that illustrates the potential impact of turbine size and project size on the cost of energy from U.S. offshore wind plants.« less

Benefit-cost estimation for alternative drinking water maximum contaminant levels

NASA Astrophysics Data System (ADS)

Gurian, Patrick L.; Small, Mitchell J.; Lockwood, John R.; Schervish, Mark J.

2001-08-01

A simulation model for estimating compliance behavior and resulting costs at U.S. Community Water Suppliers is developed and applied to the evaluation of a more stringent maximum contaminant level (MCL) for arsenic. Probability distributions of source water arsenic concentrations are simulated using a statistical model conditioned on system location (state) and source water type (surface water or groundwater). This model is fit to two recent national surveys of source waters, then applied with the model explanatory variables for the population of U.S. Community Water Suppliers. Existing treatment types and arsenic removal efficiencies are also simulated. Utilities with finished water arsenic concentrations above the proposed MCL are assumed to select the least cost option compatible with their existing treatment from among 21 available compliance strategies and processes for meeting the standard. Estimated costs and arsenic exposure reductions at individual suppliers are aggregated to estimate the national compliance cost, arsenic exposure reduction, and resulting bladder cancer risk reduction. Uncertainties in the estimates are characterized based on uncertainties in the occurrence model parameters, existing treatment types, treatment removal efficiencies, costs, and the bladder cancer dose-response function for arsenic.

Early-Stage Capital Cost Estimation of Biorefinery Processes: A Comparative Study of Heuristic Techniques.

PubMed

Tsagkari, Mirela; Couturier, Jean-Luc; Kokossis, Antonis; Dubois, Jean-Luc

2016-09-08

Biorefineries offer a promising alternative to fossil-based processing industries and have undergone rapid development in recent years. Limited financial resources and stringent company budgets necessitate quick capital estimation of pioneering biorefinery projects at the early stages of their conception to screen process alternatives, decide on project viability, and allocate resources to the most promising cases. Biorefineries are capital-intensive projects that involve state-of-the-art technologies for which there is no prior experience or sufficient historical data. This work reviews existing rapid cost estimation practices, which can be used by researchers with no previous cost estimating experience. It also comprises a comparative study of six cost methods on three well-documented biorefinery processes to evaluate their accuracy and precision. The results illustrate discrepancies among the methods because their extrapolation on biorefinery data often violates inherent assumptions. This study recommends the most appropriate rapid cost methods and urges the development of an improved early-stage capital cost estimation tool suitable for biorefinery processes. © 2015 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.