[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.

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.

Coal gasification systems engineering and analysis. Appendix E: Cost estimation and economic evaluation methodology

NASA Technical Reports Server (NTRS)

1980-01-01

The cost estimation and economic evaluation methodologies presented are consistent with industry practice for assessing capital investment requirements and operating costs of coal conversion systems. All values stated are based on January, 1980 dollars with appropriate recognition of the time value of money. Evaluation of project economic feasibility can be considered a two step process (subject to considerable refinement). First, the costs of the project must be quantified and second, the price at which the product can be manufacturd must be determined. These two major categories are discussed. The summary of methodology is divided into five parts: (1) systems costs, (2)instant plant costs, (3) annual operating costs, (4) escalation and discounting process, and (5) product pricing.

Life-Cycle Cost/Benefit Assessment of Expedite Departure Path (EDP)

NASA Technical Reports Server (NTRS)

Wang, Jianzhong Jay; Chang, Paul; Datta, Koushik

2005-01-01

This report presents a life-cycle cost/benefit assessment (LCCBA) of Expedite Departure Path (EDP), an air traffic control Decision Support Tool (DST) currently under development at NASA. This assessment is an update of a previous study performed by bd Systems, Inc. (bd) during FY01, with the following revisions: The life-cycle cost assessment methodology developed by bd for the previous study was refined and calibrated using Free Flight Phase 1 (FFP1) cost information for Traffic Management Advisor (TMA, or TMA-SC in the FAA's terminology). Adjustments were also made to the site selection and deployment scheduling methodology to include airspace complexity as a factor. This technique was also applied to the benefit extrapolation methodology to better estimate potential benefits for other years, and at other sites. This study employed a new benefit estimating methodology because bd s previous single year potential benefit assessment of EDP used unrealistic assumptions that resulted in optimistic estimates. This methodology uses an air traffic simulation approach to reasonably predict the impacts from the implementation of EDP. The results of the costs and benefits analyses were then integrated into a life-cycle cost/benefit assessment.

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.

Costs of Addressing Heroin Addiction in Malaysia and 32 Comparable Countries Worldwide

PubMed Central

Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Luekens, Craig; Ng, Nora; Schottenfeld, Richard

2012-01-01

Objective Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide. Data Sources/Study Setting Micro-costing methodology developed and data collected during randomized controlled trial (RCT) involving 126 patients (July 2003–May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 countries with data collected from publicly available sources. Study Design Fixed, variable, and societal cost components of Malaysian RCT micro-costed and analytical framework created and employed for gross-costing in 32 countries selected by three criteria relative to Malaysia: major heroin problem, geographic proximity, and comparable gross domestic product (GDP) per capita. Principal Findings Medication, and urine and blood testing accounted for the greatest percentage of total costs for both naltrexone (29–53 percent) and buprenorphine (33–72 percent) interventions. In 13 countries, buprenorphine treatment could be provided for under $2,000 per patient. For all countries except United Kingdom and Singapore, incremental costs per person were below $1,000 when comparing buprenorphine to naltrexone. An estimated 100 percent of opiate users in Cambodia and Lao People's Democratic Republic could be treated for $8 and $30 million, respectively. Conclusions Buprenorphine treatment can be provided at low cost in countries across the world. This study's new costing methodologies provide tools for health systems worldwide to determine the feasibility and cost of similar interventions. PMID:22091732

Costs of addressing heroin addiction in Malaysia and 32 comparable countries worldwide.

PubMed

Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Luekens, Craig; Ng, Nora; Schottenfeld, Richard

2012-04-01

Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide. Micro-costing methodology developed and data collected during randomized controlled trial (RCT) involving 126 patients (July 2003-May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 countries with data collected from publicly available sources. Fixed, variable, and societal cost components of Malaysian RCT micro-costed and analytical framework created and employed for gross-costing in 32 countries selected by three criteria relative to Malaysia: major heroin problem, geographic proximity, and comparable gross domestic product (GDP) per capita. Medication, and urine and blood testing accounted for the greatest percentage of total costs for both naltrexone (29-53 percent) and buprenorphine (33-72 percent) interventions. In 13 countries, buprenorphine treatment could be provided for under $2,000 per patient. For all countries except United Kingdom and Singapore, incremental costs per person were below $1,000 when comparing buprenorphine to naltrexone. An estimated 100 percent of opiate users in Cambodia and Lao People's Democratic Republic could be treated for $8 and $30 million, respectively. Buprenorphine treatment can be provided at low cost in countries across the world. This study's new costing methodologies provide tools for health systems worldwide to determine the feasibility and cost of similar interventions. © Health Research and Educational Trust.

Costing for the Future: Exploring Cost Estimation With Unmanned Autonomous Systems

DTIC Science & Technology

2016-04-30

account for how cost estimating for autonomy is different than current methodologies and to suggest ways it can be addressed through the integration and...The Development stage involves refining the system requirements, creating a solution description , and building a system. 3. The Operational Test...parameter describes the extent to which efficient fabrication methodologies and processes are used, and the automation of labor-intensive operations

Evaluation of Methodology for Estimating the Cost of Air Force On-The-Job Training. Final Report.

ERIC Educational Resources Information Center

Samers, Bernard N.; And Others

Described is the final phase of a study directed at the development of an on-the-job training (OJT) costing methodology. Utilizing a modification of survey techniques tested and evaluated during the previous phase, estimates were obtained for the cost of OJT for airman training from the l-level (unskilled to the 3-level (semiskilled) in five…

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.

Highway User Benefit Analysis System Research Project #128

DOT National Transportation Integrated Search

2000-10-01

In this research, a methodology for estimating road user costs of various competing alternatives was developed. Also, software was developed to calculate the road user cost, perform economic analysis and update cost tables. The methodology is based o...

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

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.

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...

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.

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.

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 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

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.

A quality-based cost model for new electronic systems and products

NASA Astrophysics Data System (ADS)

Shina, Sammy G.; Saigal, Anil

1998-04-01

This article outlines a method for developing a quality-based cost model for the design of new electronic systems and products. The model incorporates a methodology for determining a cost-effective design margin allocation for electronic products and systems and its impact on manufacturing quality and cost. A spreadsheet-based cost estimating tool was developed to help implement this methodology in order for the system design engineers to quickly estimate the effect of design decisions and tradeoffs on the quality and cost of new products. The tool was developed with automatic spreadsheet connectivity to current process capability and with provisions to consider the impact of capital equipment and tooling purchases to reduce the product cost.

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

Measuring the costs of outreach motivational interviewing for smoking cessation and relapse prevention among low-income pregnant women

PubMed Central

Ruger, Jennifer Prah; Emmons, Karen M; Kearney, Margaret H; Weinstein, Milton C

2009-01-01

Background Economic theory provides the philosophical foundation for valuing costs in judging medical and public health interventions. When evaluating smoking cessation interventions, accurate data on costs are essential for understanding resource consumption. Smoking cessation interventions, for which prior data on resource costs are typically not available, present special challenges. We develop a micro-costing methodology for estimating the real resource costs of outreach motivational interviewing (MI) for smoking cessation and relapse prevention among low-income pregnant women and report results from a randomized controlled trial (RCT) employing the methodology. Methodological standards in cost analysis are necessary for comparison and uniformity in analysis across interventions. Estimating the costs of outreach programs is critical for understanding the economics of reaching underserved and hard-to-reach populations. Methods Randomized controlled trial (1997-2000) collecting primary cost data for intervention. A sample of 302 low-income pregnant women was recruited from multiple obstetrical sites in the Boston metropolitan area. MI delivered by outreach health nurses vs. usual care (UC), with economic costs as the main outcome measures. Results The total cost of the MI intervention for 156 participants was $48,672 or $312 per participant. The total cost of $311.8 per participant for the MI intervention compared with a cost of $4.82 per participant for usual care, a difference of $307 ([CI], $289.2 to $322.8). The total fixed costs of the MI were $3,930 and the total variable costs of the MI were $44,710. The total expected program costs for delivering MI to 500 participants would be 147,430, assuming no economies of scale in program delivery. The main cost components of outreach MI were intervention delivery, travel time, scheduling, and training. Conclusion Grounded in economic theory, this methodology systematically identifies and measures resource utilization, using a process tracking system and calculates both component-specific and total costs of outreach MI. The methodology could help improve collection of accurate data on costs and estimates of the real resource costs of interventions alongside clinical trials and improve the validity and reliability of estimates of resource costs for interventions targeted at underserved and hard-to-reach populations. PMID:19775455

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.

Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

PubMed

Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

2016-12-01

Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic costs of different acute hand and wrist injuries varied greatly depending on the study methodology, however, by any standards, these injuries should be considered a substantial burden on the individual and society. Further research using standardised methodologies could provide guidance to relevant policy makers on how to best distribute limited resources by identifying the major disorders and exposures resulting in the largest burden. Copyright © 2016 Elsevier Ltd. All rights reserved.

Major weapon system environmental life-cycle cost estimating for Conservation, Cleanup, Compliance and Pollution Prevention (C3P2)

NASA Technical Reports Server (NTRS)

Hammond, Wesley; Thurston, Marland; Hood, Christopher

1995-01-01

The Titan 4 Space Launch Vehicle Program is one of many major weapon system programs that have modified acquisition plans and operational procedures to meet new, stringent environmental rules and regulations. The Environmental Protection Agency (EPA) and the Department of Defense (DOD) mandate to reduce the use of ozone depleting chemicals (ODC's) is just one of the regulatory changes that has affected the program. In the last few years, public environmental awareness, coupled with stricter environmental regulations, has created the need for DOD to produce environmental life-cycle cost estimates (ELCCE) for every major weapon system acquisition program. The environmental impact of the weapon system must be assessed and budgeted, considering all costs, from cradle to grave. The Office of the Secretary of Defense (OSD) has proposed that organizations consider Conservation, Cleanup, Compliance and Pollution Prevention (C(sup 3)P(sup 2)) issues associated with each acquisition program to assess life-cycle impacts and costs. The Air Force selected the Titan 4 system as the pilot program for estimating life-cycle environmental costs. The estimating task required participants to develop an ELCCE methodology, collect data to test the methodology and produce a credible cost estimate within the DOD C(sup 3)P(sup 2) definition. The estimating methodology included using the Program Office weapon system description and work breakdown structure together with operational site and manufacturing plant visits to identify environmental cost drivers. The results of the Titan IV ELCCE process are discussed and expanded to demonstrate how they can be applied to satisfy any life-cycle environmental cost estimating requirement.

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.

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.

High School Students' Accuracy in Estimating the Cost of College: A Proposed Methodological Approach and Differences among Racial/Ethnic Groups and College Financial-Related Factors

ERIC Educational Resources Information Center

Nienhusser, H. Kenny; Oshio, Toko

2017-01-01

High school students' accuracy in estimating the cost of college (AECC) was examined by utilizing a new methodological approach, the absolute-deviation-continuous construct. This study used the High School Longitudinal Study of 2009 (HSLS:09) data and examined 10,530 11th grade students in order to measure their AECC for 4-year public and private…

Software Size Estimation Using Expert Estimation: A Fuzzy Logic Approach

ERIC Educational Resources Information Center

Stevenson, Glenn A.

2012-01-01

For decades software managers have been using formal methodologies such as the Constructive Cost Model and Function Points to estimate the effort of software projects during the early stages of project development. While some research shows these methodologies to be effective, many software managers feel that they are overly complicated to use and…

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.

The economic burden of physical inactivity: a systematic review and critical appraisal.

PubMed

Ding, Ding; Kolbe-Alexander, Tracy; Nguyen, Binh; Katzmarzyk, Peter T; Pratt, Michael; Lawson, Kenny D

2017-10-01

To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English. Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors. © 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 economic burden of patient safety targets in acute care: a systematic review

PubMed Central

Mittmann, Nicole; Koo, Marika; Daneman, Nick; McDonald, Andrew; Baker, Michael; Matlow, Anne; Krahn, Murray; Shojania, Kaveh G; Etchells, Edward

2012-01-01

Background Our objective was to determine the quality of literature in costing of the economic burden of patient safety. Methods We selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: “costs and cost analysis,” “cost-effectiveness,” “cost,” and “financial management, hospital.” We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76). The quality of each costing study per patient safety target was also evaluated. Results We screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39%) reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22,414. Conclusion There are wide variations in the estimates of economic burden due to differences in study methods and methodologic quality. Greater attention to methodologic standards for economic evaluations in patient safety is needed. PMID:23097615

Accounting for the drug life cycle and future drug prices in cost-effectiveness analysis.

PubMed

Hoyle, Martin

2011-01-01

Economic evaluations of health technologies typically assume constant real drug prices and model only the cohort of patients currently eligible for treatment. It has recently been suggested that, in the UK, we should assume that real drug prices decrease at 4% per annum and, in New Zealand, that real drug prices decrease at 2% per annum and at patent expiry the drug price falls. It has also recently been suggested that we should model multiple future incident cohorts. In this article, the cost effectiveness of drugs is modelled based on these ideas. Algebraic expressions are developed to capture all costs and benefits over the entire life cycle of a new drug. The lifetime of a new drug in the UK, a key model parameter, is estimated as 33 years, based on the historical lifetime of drugs in England over the last 27 years. Under the proposed methodology, cost effectiveness is calculated for seven new drugs recently appraised in the UK. Cost effectiveness as assessed in the future is also estimated. Whilst the article is framed in mathematics, the findings and recommendations are also explained in non-mathematical language. The 'life-cycle correction factor' is introduced, which is used to convert estimates of cost effectiveness as traditionally calculated into estimates under the proposed methodology. Under the proposed methodology, all seven drugs appear far more cost effective in the UK than published. For example, the incremental cost-effectiveness ratio decreases by 46%, from £61, 900 to £33, 500 per QALY, for cinacalcet versus best supportive care for end-stage renal disease, and by 45%, from £31,100 to £17,000 per QALY, for imatinib versus interferon-α for chronic myeloid leukaemia. Assuming real drug prices decrease over time, the chance that a drug is publicly funded increases over time, and is greater when modelling multiple cohorts than with a single cohort. Using the methodology (compared with traditional methodology) all drugs in the UK and New Zealand are predicted to be more cost effective. It is suggested that the willingness-to-pay threshold should be reduced in the UK and New Zealand. The ranking of cost effectiveness will change with drugs assessed as relatively more cost effective and medical devices and surgical procedures relatively less cost effective than previously thought. The methodology is very simple to implement. It is suggested that the model should be parameterized for other countries.

[Methodology for estimating total direct costs of comprehensive care for non-communicable diseases].

PubMed

Castillo, Nancy; Malo, Miguel; Villacres, Nilda; Chauca, José; Cornetero, Víctor; de Flores, Karin Roedel; Tapia, Rafaela; Ríos, Raúl

2017-01-01

RESUMEN Diseases like diabetes mellitus (DM) and hypertension (HT) generate high costs and are the most common cause of mortality in the Americas. In the case of Peru, given demographic and epidemiological changes, particularly the alarming increase in overweight and obesity, the burden of these diseases is constantly increasing, resulting in the need to budget more financial resources to the health services. The total care costs of these diseases and their complications represent a financial burden that should be considered very carefully by health institutions when they draft their budgets. With this aim, the Pan American Health Organization has assisted the Ministry of Health (MINSA) with a study to estimate these costs. This article graphically describes the methodology developed to estimate the direct costs of comprehensive care for DM and HT to the health services of MINSA and regional governments.

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.

The Joint Confidence Level Paradox: A History of Denial

NASA Technical Reports Server (NTRS)

Butts, Glenn; Linton, Kent

2009-01-01

This paper is intended to provide a reliable methodology for those tasked with generating price tags on construction (C0F) and research and development (R&D) activities in the NASA performance world. This document consists of a collection of cost-related engineering detail and project fulfillment information from early agency days to the present. Accurate historical detail is the first place to start when determining improved methodologies for future cost and schedule estimating. This paper contains a beneficial proposed cost estimating method for arriving at more reliable numbers for future submits. When comparing current cost and schedule methods with earlier cost and schedule approaches, it became apparent that NASA's organizational performance paradigm has morphed. Mission fulfillment speed has slowed and cost calculating factors have increased in 21st Century space exploration.

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.

The costs of nurse turnover, part 2: application of the Nursing Turnover Cost Calculation Methodology.

PubMed

Jones, Cheryl Bland

2005-01-01

This is the second article in a 2-part series focusing on nurse turnover and its costs. Part 1 (December 2004) described nurse turnover costs within the context of human capital theory, and using human resource accounting methods, presented the updated Nursing Turnover Cost Calculation Methodology. Part 2 presents an application of this method in an acute care setting and the estimated costs of nurse turnover that were derived. Administrators and researchers can use these methods and cost information to build a business case for nurse retention.

Top Level Space Cost Methodology (TLSCM)

DTIC Science & Technology

1997-12-02

Software 7 6. ACEIT . 7 C. Ground Rules and Assumptions 7 D. Typical Life Cycle Cost Distribution 7 E. Methodologies 7 1. Cost/budget Threshold 9 2. Analogy...which is based on real-time Air Force and space programs. Ref.(25:2- 8, 2-9) 6. ACEIT : Automated Cost Estimating Integrated Tools( ACEIT ), Tecolote...Research, Inc. There is a way to use the ACEIT cost program to get a print-out of an expanded WBS. Therefore, find someone that has ACEIT experience and

Using Data Envelopment Analysis to Improve Estimates of Higher Education Institution's Per-Student Education Costs

ERIC Educational Resources Information Center

Salerno, Carlo

2006-01-01

This paper puts forth a data envelopment analysis (DEA) approach to estimating higher education institutions' per-student education costs (PSCs) in an effort to redress a number of methodological problems endemic to such estimations, particularly the allocation of shared expenditures between education and other institutional activities. An example…

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.

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.

Estimating breeding proportions and testing hypotheses about costs of reproduction with capture-recapture data

USGS Publications Warehouse

Nichols, James D.; Hines, James E.; Pollock, Kenneth H.; Hinz, Robert L.; Link, William A.

1994-01-01

The proportion of animals in a population that breeds is an important determinant of population growth rate. Usual estimates of this quantity from field sampling data assume that the probability of appearing in the capture or count statistic is the same for animals that do and do not breed. A similar assumption is required by most existing methods used to test ecologically interesting hypotheses about reproductive costs using field sampling data. However, in many field sampling situations breeding and nonbreeding animals are likely to exhibit different probabilities of being seen or caught. In this paper, we propose the use of multistate capture-recapture models for these estimation and testing problems. This methodology permits a formal test of the hypothesis of equal capture/sighting probabilities for breeding and nonbreeding individuals. Two estimators of breeding proportion (and associated standard errors) are presented, one for the case of equal capture probabilities and one for the case of unequal capture probabilities. The multistate modeling framework also yields formal tests of hypotheses about reproductive costs to future reproduction or survival or both fitness components. The general methodology is illustrated using capture-recapture data on female meadow voles, Microtus pennsylvanicus. Resulting estimates of the proportion of reproductively active females showed strong seasonal variation, as expected, with low breeding proportions in midwinter. We found no evidence of reproductive costs extracted in subsequent survival or reproduction. We believe that this methodological framework has wide application to problems in animal ecology concerning breeding proportions and phenotypic reproductive costs.

Estimating the Full Cost of Family-Financed Time Inputs to Education.

ERIC Educational Resources Information Center

Levine, Victor

This paper presents a methodology for estimating the full cost of parental time allocated to child-care activities at home. Building upon the human capital hypothesis, a model is developed in which the cost of an hour diverted from labor market activity is seen as consisting of three components: 1) direct wages foregone; 2) investments in…

A method for the analysis of the benefits and costs for aeronautical research and technology

NASA Technical Reports Server (NTRS)

Williams, L. J.; Hoy, H. H.; Anderson, J. L.

1978-01-01

A relatively simple, consistent, and reasonable methodology for performing cost-benefit analyses which can be used to guide, justify, and explain investments in aeronautical research and technology is presented. The elements of this methodology (labeled ABC-ART for the Analysis of the Benefits and Costs of Aeronautical Research and Technology) include estimation of aircraft markets; manufacturer costs and return on investment versus aircraft price; airline costs and return on investment versus aircraft price and passenger yield; and potential system benefits--fuel savings, cost savings, and noise reduction. The application of this methodology is explained using the introduction of an advanced turboprop powered transport aircraft in the medium range market in 1978 as an example.

Product pricing in the Solar Array Manufacturing Industry - An executive summary of SAMICS

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.

1978-01-01

Capabilities, methodology, and a description of input data to the Solar Array Manufacturing Industry Costing Standards (SAMICS) are presented. SAMICS were developed to provide a standardized procedure and data base for comparing manufacturing processes of Low-cost Solar Array (LSA) subcontractors, guide the setting of research priorities, and assess the progress of LSA toward its hundred-fold cost reduction goal. SAMICS can be used to estimate the manufacturing costs and product prices and determine the impact of inflation, taxes, and interest rates, but it is limited by its ignoring the effects of the market supply and demand and an assumption that all factories operate in a production line mode. The SAMICS methodology defines the industry structure, hypothetical supplier companies, and manufacturing processes and maintains a body of standardized data which is used to compute the final product price. The input data includes the product description, the process characteristics, the equipment cost factors, and production data for the preparation of detailed cost estimates. Activities validating that SAMICS produced realistic price estimates and cost breakdowns are described.

Economic Effects of Increased Control Zone Sizes in Conflict Resolution

NASA Technical Reports Server (NTRS)

Datta, Koushik

1998-01-01

A methodology for estimating the economic effects of different control zone sizes used in conflict resolutions between aircraft is presented in this paper. The methodology is based on estimating the difference in flight times of aircraft with and without the control zone, and converting the difference into a direct operating cost. Using this methodology the effects of increased lateral and vertical control zone sizes are evaluated.

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.

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

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.

VALIDATION OF A METHOD FOR ESTIMATING POLLUTION EMISSION RATES FROM AREA SOURCES USING OPEN-PATH FTIR SEPCTROSCOPY AND DISPERSION MODELING TECHNIQUES

EPA Science Inventory

The paper describes a methodology developed to estimate emissions factors for a variety of different area sources in a rapid, accurate, and cost effective manner. he methodology involves using an open-path Fourier transform infrared (FTIR) spectrometer to measure concentrations o...

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.

A model for estimating the cost impact of schedule perturbations on aerospace research and development programs

NASA Technical Reports Server (NTRS)

Bishop, D. F.

1972-01-01

The problem of determining the cost impact attributable to perturbations in an aerospace R and D program schedule is discussed in terms of the diminishing availability of funds. The methodology from which a model is presented for updating R and D cost estimates as a function of perturbations in program time is presented.

Systems cost/performance analysis (study 2.3). Volume 2: Systems cost/performance model. [unmanned automated payload programs and program planning

NASA Technical Reports Server (NTRS)

Campbell, B. H.

1974-01-01

A methodology which was developed for balanced designing of spacecraft subsystems and interrelates cost, performance, safety, and schedule considerations was refined. The methodology consists of a two-step process: the first step is one of selecting all hardware designs which satisfy the given performance and safety requirements, the second step is one of estimating the cost and schedule required to design, build, and operate each spacecraft design. Using this methodology to develop a systems cost/performance model allows the user of such a model to establish specific designs and the related costs and schedule. The user is able to determine the sensitivity of design, costs, and schedules to changes in requirements. The resulting systems cost performance model is described and implemented as a digital computer program.

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.

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.

Space system operations and support cost analysis using Markov chains

NASA Technical Reports Server (NTRS)

Unal, Resit; Dean, Edwin B.; Moore, Arlene A.; Fairbairn, Robert E.

1990-01-01

This paper evaluates the use of Markov chain process in probabilistic life cycle cost analysis and suggests further uses of the process as a design aid tool. A methodology is developed for estimating operations and support cost and expected life for reusable space transportation systems. Application of the methodology is demonstrated for the case of a hypothetical space transportation vehicle. A sensitivity analysis is carried out to explore the effects of uncertainty in key model inputs.

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.

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.

Preliminary estimates of the direct costs associated with endemic diseases of livestock in Great Britain.

PubMed

Bennett, R; Christiansen, K; Clifton-Hadley, R

1999-04-09

Many 'economic' studies of livestock diseases in Great Britain have been carried out over time. Most studies have considered just one or two diseases and used a different methodology and valuation base from other studies, hampering any comparative assessment of the economic impact of diseases. A standardized methodology was applied to the estimation of the direct costs to livestock production of some 30 endemic diseases/conditions of farm animals in Great Britain. This involved identification of the livestock populations at risk, estimation of the annual incidence of each disease in these populations, identification of the range and incidence of physical effects of each disease on production, valuation of the physical effects of each disease and estimation of the financial value of output losses/resource wastage due to a disease and the costs of specific treatment and prevention measures. The wider economic impacts of disease (such as the implications for human health, animal welfare and markets) were not included in the assessments. Using this standardized methodology with common financial values, a simple spreadsheet model was constructed for each disease. Given the paucity of appropriate disease data for economic assessment, 'low' and 'high' values were used to reflect uncertainties surrounding key disease parameters. Preliminary estimates of the value of disease output losses/resource wastage, treatment and prevention costs are presented for each disease. Despite the limitations of the spreadsheet models and of the estimates derived from them, we conclude that the models represent a useful start in developing a system for the comparative economic assessment of livestock diseases in Great Britain.

JEDI Methodology | Jobs and Economic Development Impact Models | NREL

Science.gov Websites

Methodology JEDI Methodology The intent of the Jobs and Economic Development Impact (JEDI) models costs) to demonstrate the employment and economic impacts that will likely result during the estimate of overall economic impacts from specific scenarios. Please see Limitations of JEDI Models for

Costs of Chronic Diseases at the State Level: The Chronic Disease Cost Calculator

PubMed Central

Murphy, Louise B.; Khavjou, Olga A.; Li, Rui; Maylahn, Christopher M.; Tangka, Florence K.; Nurmagambetov, Tursynbek A.; Ekwueme, Donatus U.; Nwaise, Isaac; Chapman, Daniel P.; Orenstein, Diane

2015-01-01

Introduction Many studies have estimated national chronic disease costs, but state-level estimates are limited. The Centers for Disease Control and Prevention developed the Chronic Disease Cost Calculator (CDCC), which estimates state-level costs for arthritis, asthma, cancer, congestive heart failure, coronary heart disease, hypertension, stroke, other heart diseases, depression, and diabetes. Methods Using publicly available and restricted secondary data from multiple national data sets from 2004 through 2008, disease-attributable annual per-person medical and absenteeism costs were estimated. Total state medical and absenteeism costs were derived by multiplying per person costs from regressions by the number of people in the state treated for each disease. Medical costs were estimated for all payers and separately for Medicaid, Medicare, and private insurers. Projected medical costs for all payers (2010 through 2020) were calculated using medical costs and projected state population counts. Results Median state-specific medical costs ranged from $410 million (asthma) to $1.8 billion (diabetes); median absenteeism costs ranged from $5 million (congestive heart failure) to $217 million (arthritis). Conclusion CDCC provides methodologically rigorous chronic disease cost estimates. These estimates highlight possible areas of cost savings achievable through targeted prevention efforts or research into new interventions and treatments. PMID:26334712

An effective and optimal quality control approach for green energy manufacturing using design of experiments framework and evolutionary algorithm

NASA Astrophysics Data System (ADS)

Saavedra, Juan Alejandro

Quality Control (QC) and Quality Assurance (QA) strategies vary significantly across industries in the manufacturing sector depending on the product being built. Such strategies range from simple statistical analysis and process controls, decision-making process of reworking, repairing, or scraping defective product. This study proposes an optimal QC methodology in order to include rework stations during the manufacturing process by identifying the amount and location of these workstations. The factors that are considered to optimize these stations are cost, cycle time, reworkability and rework benefit. The goal is to minimize the cost and cycle time of the process, but increase the reworkability and rework benefit. The specific objectives of this study are: (1) to propose a cost estimation model that includes energy consumption, and (2) to propose an optimal QC methodology to identify quantity and location of rework workstations. The cost estimation model includes energy consumption as part of the product direct cost. The cost estimation model developed allows the user to calculate product direct cost as the quality sigma level of the process changes. This provides a benefit because a complete cost estimation calculation does not need to be performed every time the processes yield changes. This cost estimation model is then used for the QC strategy optimization process. In order to propose a methodology that provides an optimal QC strategy, the possible factors that affect QC were evaluated. A screening Design of Experiments (DOE) was performed on seven initial factors and identified 3 significant factors. It reflected that one response variable was not required for the optimization process. A full factorial DOE was estimated in order to verify the significant factors obtained previously. The QC strategy optimization is performed through a Genetic Algorithm (GA) which allows the evaluation of several solutions in order to obtain feasible optimal solutions. The GA evaluates possible solutions based on cost, cycle time, reworkability and rework benefit. Finally it provides several possible solutions because this is a multi-objective optimization problem. The solutions are presented as chromosomes that clearly state the amount and location of the rework stations. The user analyzes these solutions in order to select one by deciding which of the four factors considered is most important depending on the product being manufactured or the company's objective. The major contribution of this study is to provide the user with a methodology used to identify an effective and optimal QC strategy that incorporates the number and location of rework substations in order to minimize direct product cost, and cycle time, and maximize reworkability, and rework benefit.

Weapon System Costing Methodology for Aircraft Airframes and Basic Structures. Volume I. Technical Volume

DTIC Science & Technology

1975-06-01

the Air Force Flight Dynamics Laboratory for use in conceptual and preliminary designs pauses of weapon system development. The methods are a...trade study method provides ai\\ iterative capability stemming from a direct interface with design synthesis programs. A detailed cost data base ;ind...system for data expmjsion is provided. The methods are designed for ease in changing cost estimating relationships and estimating coefficients

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.

Social costs of road crashes: An international analysis.

PubMed

Wijnen, Wim; Stipdonk, Henk

2016-09-01

This paper provides an international overview of the most recent estimates of the social costs of road crashes: total costs, value per casualty and breakdown in cost components. The analysis is based on publications about the national costs of road crashes of 17 countries, of which ten high income countries (HICs) and seven low and middle income countries (LMICs). Costs are expressed as a proportion of the gross domestic product (GDP). Differences between countries are described and explained. These are partly a consequence of differences in the road safety level, but there are also methodological explanations. Countries may or may not correct for underreporting of road crashes, they may or may not use the internationally recommended willingness to pay (WTP)-method for estimating human costs, and there are methodological differences regarding the calculation of some other cost components. The analysis shows that the social costs of road crashes in HICs range from 0.5% to 6.0% of the GDP with an average of 2.7%. Excluding countries that do not use a WTP- method for estimating human costs and countries that do not correct for underreporting, results in average costs of 3.3% of GDP. For LMICs that do correct for underreporting the share in GDP ranges from 1.1% to 2.9%. However, none of the LMICs included has performed a WTP study of the human costs. A major part of the costs is related to injuries: an average share of 50% for both HICs and LMICs. The average share of fatalities in the costs is 23% and 30% respectively. Prevention of injuries is thus important to bring down the socio-economic burden of road crashes. The paper shows that there are methodological differences between countries regarding cost components that are taken into account and regarding the methods used to estimate specific cost components. In order to be able to make sound comparisons of the costs of road crashes across countries, (further) harmonization of cost studies is recommended. This can be achieved by updating and improving international guidelines and applying them in future cost studies. The information regarding some cost components, particularly human costs and property damage, is poor and more research into these cost components is recommended. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic feasibility study for new technological alternatives in wastewater treatment processes: a review.

PubMed

Molinos-Senante, María; Hernández-Sancho, Francesc; Sala-Garrido, Ramón

2012-01-01

The concept of sustainability involves the integration of economic, environmental, and social aspects and this also applies in the field of wastewater treatment. Economic feasibility studies are a key tool for selecting the most appropriate option from a set of technological proposals. Moreover, these studies are needed to assess the viability of transferring new technologies from pilot-scale to full-scale. In traditional economic feasibility studies, the benefits that have no market price, such as environmental benefits, are not considered and are therefore underestimated. To overcome this limitation, we propose a new methodology to assess the economic viability of wastewater treatment technologies that considers internal and external impacts. The estimation of the costs is based on the use of cost functions. To quantify the environmental benefits from wastewater treatment, the distance function methodology is proposed to estimate the shadow price of each pollutant removed in the wastewater treatment. The application of this methodological approach by decision makers enables the calculation of the true costs and benefits associated with each alternative technology. The proposed methodology is presented as a useful tool to support decision making.

IVF cycle cost estimation using Activity Based Costing and Monte Carlo simulation.

PubMed

Cassettari, Lucia; Mosca, Marco; Mosca, Roberto; Rolando, Fabio; Costa, Mauro; Pisaturo, Valerio

2016-03-01

The Authors present a new methodological approach in stochastic regime to determine the actual costs of an healthcare process. The paper specifically shows the application of the methodology for the determination of the cost of an Assisted reproductive technology (ART) treatment in Italy. The reason of this research comes from the fact that deterministic regime is inadequate to implement an accurate estimate of the cost of this particular treatment. In fact the durations of the different activities involved are unfixed and described by means of frequency distributions. Hence the need to determine in addition to the mean value of the cost, the interval within which it is intended to vary with a known confidence level. Consequently the cost obtained for each type of cycle investigated (in vitro fertilization and embryo transfer with or without intracytoplasmic sperm injection), shows tolerance intervals around the mean value sufficiently restricted as to make the data obtained statistically robust and therefore usable also as reference for any benchmark with other Countries. It should be noted that under a methodological point of view the approach was rigorous. In fact it was used both the technique of Activity Based Costing for determining the cost of individual activities of the process both the Monte Carlo simulation, with control of experimental error, for the construction of the tolerance intervals on the final result.

Assessing the costs attributed to project delay during project pre-construction stages

DOT National Transportation Integrated Search

2016-03-01

This project for the Texas Department of Transportation (TxDOT) developed a simple but sound : methodology for estimating the cost of delaying most types of highway projects. Researchers considered the : cost of delays during the pre-construction pha...

Assessing the costs attributed to project delay during project pre-construction stages.

DOT National Transportation Integrated Search

2016-03-01

This project for the Texas Department of Transportation (TxDOT) developed a simple but sound : methodology for estimating the cost of delaying most types of highway projects. Researchers considered the : cost of delays during the pre-construction pha...

10 CFR 436.10 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Cycle Cost Analyses § 436.10 Purpose. This subpart establishes a methodology and procedures for estimating and comparing the life cycle costs of Federal buildings, for determining the life cycle cost effectiveness of energy conservation measures and water conservation measures, and for rank ordering life cycle...

Cost analysis of carbon dioxide concentrators

NASA Technical Reports Server (NTRS)

Yakut, M. M.

1973-01-01

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

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.

Estimating Teacher Turnover Costs: A Case Study

ERIC Educational Resources Information Center

Levy, Abigail Jurist; Joy, Lois; Ellis, Pamela; Jablonski, Erica; Karelitz, Tzur M.

2012-01-01

High teacher turnover in large U.S. cities is a critical issue for schools and districts, and the students they serve; but surprisingly little work has been done to develop methodologies and standards that districts and schools can use to make reliable estimates of turnover costs. Even less is known about how to detect variations in turnover costs…

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.

Incorporating ITS into corridor planning : Seattle case study

DOT National Transportation Integrated Search

1999-08-01

The goals of this study were to develop a methodology for incorporating Intelligent Transportation Systems (ITS) into the transportation planning process and apply the methodology to estimate ITS costs and benefits for one case study. A major result ...

Incorporating ITS into corridor planning : Seattle case study

DOT National Transportation Integrated Search

1999-06-01

The goals of this study were to develop a methodology for incorporating Intelligent Transportation Systems (ITS) into the transportation planning process and apply the methodology to estimate ITS costs and benefits for one case study. A major result ...

Costs of Educational Media Systems. A Series II Occasional Paper from ERIC at Stanford.

ERIC Educational Resources Information Center

Sovereign, Michael G.

Investigating the costs of instructional media systems necessitated that those systems be identified and analyzed, and that a methodology be formulated for estimating their costs, with reference to their area of operation: local, city, metropolitan, state, or regional school areas. Costs are broken down into cost per student per year, according to…

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

[Direct costs of medical care for patients with type 2 diabetes mellitus in Mexico micro-costing analysis].

PubMed

Rodríguez Bolaños, Rosibel de Los Ángeles; Reynales Shigematsu, Luz Myriam; Jiménez Ruíz, Jorge Alberto; Juárez Márquezy, Sergio Arturo; Hernández Ávila, Mauricio

2010-12-01

Estimate the direct cost of medical care incurred by the Mexican Social Security Institute (IMSS, Instituto Mexicano del Seguro Social) for patients with type 2 diabetes mellitus (DM2). The clinical files of 497 patients who were treated in secondary and tertiary medical care units in 2002-2004 were reviewed. Costs were quantified using a disease costing approach (DCA) from the provider's perspective, a micro-costing technique, and a bottom-up methodology. Average annual costs by diagnosis, complication, and total cost were estimated. Total IMSS DM2 annual costs were US$452 064 988, or 3.1% of operating expenses. The annual average cost per patient was US$3 193.75, with US$2 740.34 per patient without complications and US$3 550.17 per patient with complications. Hospitalization and intensive care bed-days generated the greatest expenses. The high cost of providing medical care to patients with DM2 and its complications represents an economic burden that health institutions should consider in their budgets to enable them to offer quality service that is both adequate and timely. Using the micro-costing methodology allows an approximation to real data on utilization and management of the disease.

IDC Reengineering Phase 2 & 3 Rough Order of Magnitude (ROM) Cost Estimate Summary (Leveraged NDC Case).

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

Harris, James M.; Prescott, Ryan; Dawson, Jericah M.

2014-11-01

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, based on leveraging a fully funded, Sandia executed NDC Modernization project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOTmore » intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.« less

Tug fleet and ground operations schedules and controls. Volume 3: Program cost estimates

NASA Technical Reports Server (NTRS)

1975-01-01

Cost data for the tug DDT&E and operations phases are presented. Option 6 is the recommended option selected from seven options considered and was used as the basis for ground processing estimates. Option 6 provides for processing the tug in a factory clean environment in the low bay area of VAB with subsequent cleaning to visibly clean. The basis and results of the trade study to select Option 6 processing plan is included. Cost estimating methodology, a work breakdown structure, and a dictionary of WBS definitions is also provided.

Cost analysis of carbon dioxide concentrators

NASA Technical Reports Server (NTRS)

Yakut, M. M.

1972-01-01

A methodology is developed to predict the relevant contributions of the more intangible cost elements encountered in the development of flight-qualified hardware and is used to predict the costs of three carbon dioxide concentration systems. The cost and performance data from Gemini, Skylab, and other programs are utilized as a basis for establishing the cost estimating relationships. The concentration systems analyzed are the molecular sieves C02 concentrator, the hydrogen-depolarized concentrator, and the regenerable solid desiccant concentrator. Besides the cost estimates for each system, their comparative criteria including relative characteristics, operational differences, and development status are considered.

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.

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

Applying risk adjusted cost-effectiveness (RAC-E) analysis to hospitals: estimating the costs and consequences of variation in clinical practice.

PubMed

Karnon, Jonathan; Caffrey, Orla; Pham, Clarabelle; Grieve, Richard; Ben-Tovim, David; Hakendorf, Paul; Crotty, Maria

2013-06-01

Cost-effectiveness analysis is well established for pharmaceuticals and medical technologies but not for evaluating variations in clinical practice. This paper describes a novel methodology--risk adjusted cost-effectiveness (RAC-E)--that facilitates the comparative evaluation of applied clinical practice processes. In this application, risk adjustment is undertaken with a multivariate matching algorithm that balances the baseline characteristics of patients attending different settings (e.g., hospitals). Linked, routinely collected data are used to analyse patient-level costs and outcomes over a 2-year period, as well as to extrapolate costs and survival over patient lifetimes. The study reports the relative cost-effectiveness of alternative forms of clinical practice, including a full representation of the statistical uncertainty around the mean estimates. The methodology is illustrated by a case study that evaluates the relative cost-effectiveness of services for patients presenting with acute chest pain across the four main public hospitals in South Australia. The evaluation finds that services provided at two hospitals were dominated, and of the remaining services, the more effective hospital gained life years at a low mean additional cost and had an 80% probability of being the most cost-effective hospital at realistic cost-effectiveness thresholds. Potential determinants of the estimated variation in costs and effects were identified, although more detailed analyses to identify specific areas of variation in clinical practice are required to inform improvements at the less cost-effective institutions. Copyright © 2012 John Wiley & Sons, Ltd.

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.

A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.

PubMed

Lungu, Elena R; Manti, Orlando J; Levine, Mitchell A H; Clark, Douglas A; Potashnik, Tanya M; McKinley, Carol I

2017-09-01

Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

An integrative cross-design synthesis approach to estimate the cost of illness: an applied case to the cost of depression in Catalonia.

PubMed

Bendeck, Murielle; Serrano-Blanco, Antoni; García-Alonso, Carlos; Bonet, Pere; Jordà, Esther; Sabes-Figuera, Ramon; Salvador-Carulla, Luis

2013-04-01

Cost of illness (COI) studies are carried out under conditions of uncertainty and with incomplete information. There are concerns regarding their generalisability, accuracy and usability in evidence-informed care. A hybrid methodology is used to estimate the regional costs of depression in Catalonia (Spain) following an integrative approach. The cross-design synthesis included nominal groups and quantitative analysis of both top-down and bottom-up studies, and incorporated primary and secondary data from different sources of information in Catalonia. Sensitivity analysis used probabilistic Monte Carlo simulation modelling. A dissemination strategy was planned, including a standard form adapted from cost-effectiveness studies to summarise methods and results. The method used allows for a comprehensive estimate of the cost of depression in Catalonia. Health officers and decision-makers concluded that this methodology provided useful information and knowledge for evidence-informed planning in mental health. The mix of methods, combined with a simulation model, contributed to a reduction in data gaps and, in conditions of uncertainty, supplied more complete information on the costs of depression in Catalonia. This approach to COI should be differentiated from other COI designs to allow like-with-like comparisons. A consensus on COI typology, procedures and dissemination is needed.

Physician awareness of drug cost: a systematic review.

PubMed

Allan, G Michael; Lexchin, Joel; Wiebe, Natasha

2007-09-01

Pharmaceutical costs are the fastest-growing health-care expense in most developed countries. Higher drug costs have been shown to negatively impact patient outcomes. Studies suggest that doctors have a poor understanding of pharmaceutical costs, but the data are variable and there is no consistent pattern in awareness. We designed this systematic review to investigate doctors' knowledge of the relative and absolute costs of medications and to determine the factors that influence awareness. Our search strategy included The Cochrane Library, EconoLit, EMBASE, and MEDLINE as well as reference lists and contact with authors who had published two or more articles on the topic or who had published within 10 y of the commencement of our review. Studies were included if: either doctors, trainees (interns or residents), or medical students were surveyed; there were more than ten survey respondents; cost of pharmaceuticals was estimated; results were expressed quantitatively; there was a clear description of how authors defined "accurate estimates"; and there was a description of how the true cost was determined. Two authors reviewed each article for eligibility and extracted data independently. Cost accuracy outcomes were summarized, but data were not combined in meta-analysis because of extensive heterogeneity. Qualitative data related to physicians and drug costs were also extracted. The final analysis included 24 articles. Cost accuracy was low; 31% of estimates were within 20% or 25% of the true cost, and fewer than 50% were accurate by any definition of cost accuracy. Methodological weaknesses were common, and studies of low methodological quality showed better cost awareness. The most important factor influencing the pattern and accuracy of estimation was the true cost of therapy. High-cost drugs were estimated more accurately than inexpensive ones (74% versus 31%, Chi-square p < 0.001). Doctors consistently overestimated the cost of inexpensive products and underestimated the cost of expensive ones (binomial test, 89/101, p < 0.001). When asked, doctors indicated that they want cost information and feel it would improve their prescribing but that it is not accessible. Doctors' ignorance of costs, combined with their tendency to underestimate the price of expensive drugs and overestimate the price of inexpensive ones, demonstrate a lack of appreciation of the large difference in cost between inexpensive and expensive drugs. This discrepancy in turn could have profound implications for overall drug expenditures. Much more focus is required in the education of physicians about costs and the access to cost information. Future research should focus on the accessibility and reliability of medical cost information and whether the provision of this information is used by doctors and makes a difference to physician prescribing. Additionally, future work should strive for higher methodological standards to avoid the biases we found in the current literature, including attention to the method of assessing accuracy that allows larger absolute estimation ranges for expensive drugs.

42 CFR 495.204 - Incentive payments to qualifying MA organizations for qualifying MA-EPs and qualifying MA...

Code of Federal Regulations, 2013 CFR

2013-10-01

... methodological proposal for estimating the portion of each qualifying MA EP's salary or revenue attributable to... enrollees of the MA organization in the payment year. The methodological proposal— (i) Must be approved by... account for the MA-enrollee related Part B practice costs of the qualifying MA EP. (iii) Methodological...

42 CFR 495.204 - Incentive payments to qualifying MA organizations for qualifying MA-EPs and qualifying MA...

Code of Federal Regulations, 2014 CFR

2014-10-01

... methodological proposal for estimating the portion of each qualifying MA EP's salary or revenue attributable to... enrollees of the MA organization in the payment year. The methodological proposal— (i) Must be approved by... account for the MA-enrollee related Part B practice costs of the qualifying MA EP. (iii) Methodological...

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

EPA Science Inventory

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...

Predicting Cost/Reliability/Maintainability of Advanced General Aviation Avionics Equipment

NASA Technical Reports Server (NTRS)

Davis, M. R.; Kamins, M.; Mooz, W. E.

1978-01-01

A methodology is provided for assisting NASA in estimating the cost, reliability, and maintenance (CRM) requirements for general avionics equipment operating in the 1980's. Practical problems of predicting these factors are examined. The usefulness and short comings of different approaches for modeling coast and reliability estimates are discussed together with special problems caused by the lack of historical data on the cost of maintaining general aviation avionics. Suggestions are offered on how NASA might proceed in assessing cost reliability CRM implications in the absence of reliable generalized predictive models.

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.

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

Code of Federal Regulations, 2012 CFR

2012-04-01

... bills directly to the utility company, then the development's monthly operating cost per occupied unit... Authority and its affected developments. c. As an example of estimating development operating costs from PHA... divided by 270, the product of 22.5 and 12, to give a cost per unit month of $222. C. Accrual The monthly...

Space Station Freedom operations costs

NASA Technical Reports Server (NTRS)

Accola, Anne L.; Williams, Gregory J.

1988-01-01

Measures to reduce the operation costs of the Space Station which can be implemented in the design and development stages are discussed. Operational functions are described in the context of an overall operations concept. The provisions for operations cost responsibilities among the partners in the Space Station program are presented. Cost estimating methodologies and the way in which operations costs affect the design and development process are examined.

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.

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.

Methodological Approaches for Estimating the Benefits and Costs of Smart Grid Demonstration Projects

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

Lee, Russell

This report presents a comprehensive framework for estimating the benefits and costs of Smart Grid projects and a step-by-step approach for making these estimates. The framework identifies the basic categories of benefits, the beneficiaries of these benefits, and the Smart Grid functionalities that lead to different benefits and proposes ways to estimate these benefits, including their monetization. The report covers cost-effectiveness evaluation, uncertainty, and issues in estimating baseline conditions against which a project would be compared. The report also suggests metrics suitable for describing principal characteristics of a modern Smart Grid to which a project can contribute. This first sectionmore » of the report presents background information on the motivation for the report and its purpose. Section 2 introduces the methodological framework, focusing on the definition of benefits and a sequential, logical process for estimating them. Beginning with the Smart Grid technologies and functions of a project, it maps these functions to the benefits they produce. Section 3 provides a hypothetical example to illustrate the approach. Section 4 describes each of the 10 steps in the approach. Section 5 covers issues related to estimating benefits of the Smart Grid. Section 6 summarizes the next steps. The methods developed in this study will help improve future estimates - both retrospective and prospective - of the benefits of Smart Grid investments. These benefits, including those to consumers, society in general, and utilities, can then be weighed against the investments. Such methods would be useful in total resource cost tests and in societal versions of such tests. As such, the report will be of interest not only to electric utilities, but also to a broad constituency of stakeholders. Significant aspects of the methodology were used by the U.S. Department of Energy (DOE) to develop its methods for estimating the benefits and costs of its renewable and distributed systems integration demonstration projects as well as its Smart Grid Investment Grant projects and demonstration projects funded under the American Recovery and Reinvestment Act (ARRA). The goal of this report, which was cofunded by the Electric Power Research Institute (EPRI) and DOE, is to present a comprehensive set of methods for estimating the benefits and costs of Smart Grid projects. By publishing this report, EPRI seeks to contribute to the development of methods that will establish the benefits associated with investments in Smart Grid technologies. EPRI does not endorse the contents of this report or make any representations as to the accuracy and appropriateness of its contents. The purpose of this report is to present a methodological framework that will provide a standardized approach for estimating the benefits and costs of Smart Grid demonstration projects. The framework also has broader application to larger projects, such as those funded under the ARRA. Moreover, with additional development, it will provide the means for extrapolating the results of pilots and trials to at-scale investments in Smart Grid technologies. The framework was developed by a panel whose members provided a broad range of expertise.« less

Risk-based economic decision analysis of remediation options at a PCE-contaminated site.

PubMed

Lemming, Gitte; Friis-Hansen, Peter; Bjerg, Poul L

2010-05-01

Remediation methods for contaminated sites cover a wide range of technical solutions with different remedial efficiencies and costs. Additionally, they may vary in their secondary impacts on the environment i.e. the potential impacts generated due to emissions and resource use caused by the remediation activities. More attention is increasingly being given to these secondary environmental impacts when evaluating remediation options. This paper presents a methodology for an integrated economic decision analysis which combines assessments of remediation costs, health risk costs and potential environmental costs. The health risks costs are associated with the residual contamination left at the site and its migration to groundwater used for drinking water. A probabilistic exposure model using first- and second-order reliability methods (FORM/SORM) is used to estimate the contaminant concentrations at a downstream groundwater well. Potential environmental impacts on the local, regional and global scales due to the site remediation activities are evaluated using life cycle assessments (LCA). The potential impacts on health and environment are converted to monetary units using a simplified cost model. A case study based upon the developed methodology is presented in which the following remediation scenarios are analyzed and compared: (a) no action, (b) excavation and off-site treatment of soil, (c) soil vapor extraction and (d) thermally enhanced soil vapor extraction by electrical heating of the soil. Ultimately, the developed methodology facilitates societal cost estimations of remediation scenarios which can be used for internal ranking of the analyzed options. Despite the inherent uncertainties of placing a value on health and environmental impacts, the presented methodology is believed to be valuable in supporting decisions on remedial interventions. Copyright 2010 Elsevier Ltd. All rights reserved.

Wastewater Treatment Costs and Outlays in Organic Petrochemicals: Standards Versus Taxes With Methodology Suggestions for Marginal Cost Pricing and Analysis

NASA Astrophysics Data System (ADS)

Thompson, Russell G.; Singleton, F. D., Jr.

1986-04-01

With the methodology recommended by Baumol and Oates, comparable estimates of wastewater treatment costs and industry outlays are developed for effluent standard and effluent tax instruments for pollution abatement in five hypothetical organic petrochemicals (olefins) plants. The computational method uses a nonlinear simulation model for wastewater treatment to estimate the system state inputs for linear programming cost estimation, following a practice developed in a National Science Foundation (Research Applied to National Needs) study at the University of Houston and used to estimate Houston Ship Channel pollution abatement costs for the National Commission on Water Quality. Focusing on best practical and best available technology standards, with effluent taxes adjusted to give nearly equal pollution discharges, shows that average daily treatment costs (and the confidence intervals for treatment cost) would always be less for the effluent tax than for the effluent standard approach. However, industry's total outlay for these treatment costs, plus effluent taxes, would always be greater for the effluent tax approach than the total treatment costs would be for the effluent standard approach. Thus the practical necessity of showing smaller outlays as a prerequisite for a policy change toward efficiency dictates the need to link the economics at the microlevel with that at the macrolevel. Aggregation of the plants into a programming modeling basis for individual sectors and for the economy would provide a sound basis for effective policy reform, because the opportunity costs of the salient regulatory policies would be captured. Then, the government's policymakers would have the informational insights necessary to legislate more efficient environmental policies in light of the wealth distribution effects.

Software Cost Estimation Using a Decision Graph Process: A Knowledge Engineering Approach

NASA Technical Reports Server (NTRS)

Stukes, Sherry; Spagnuolo, John, Jr.

2011-01-01

This paper is not a description per se of the efforts by two software cost analysts. Rather, it is an outline of the methodology used for FSW cost analysis presented in a form that would serve as a foundation upon which others may gain insight into how to perform FSW cost analyses for their own problems at hand.

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.

Development of hybrid lifecycle cost estimating tool (HLCET) for manufacturing influenced design tradeoff

NASA Astrophysics Data System (ADS)

Sirirojvisuth, Apinut

In complex aerospace system design, making an effective design decision requires multidisciplinary knowledge from both product and process perspectives. Integrating manufacturing considerations into the design process is most valuable during the early design stages since designers have more freedom to integrate new ideas when changes are relatively inexpensive in terms of time and effort. Several metrics related to manufacturability are cost, time, and manufacturing readiness level (MRL). Yet, there is a lack of structured methodology that quantifies how changes in the design decisions impact these metrics. As a result, a new set of integrated cost analysis tools are proposed in this study to quantify the impacts. Equally important is the capability to integrate this new cost tool into the existing design methodologies without sacrificing agility and flexibility required during the early design phases. To demonstrate the applicability of this concept, a ModelCenter environment is used to develop software architecture that represents Integrated Product and Process Development (IPPD) methodology used in several aerospace systems designs. The environment seamlessly integrates product and process analysis tools and makes effective transition from one design phase to the other while retaining knowledge gained a priori. Then, an advanced cost estimating tool called Hybrid Lifecycle Cost Estimating Tool (HLCET), a hybrid combination of weight-, process-, and activity-based estimating techniques, is integrated with the design framework. A new weight-based lifecycle cost model is created based on Tailored Cost Model (TCM) equations [3]. This lifecycle cost tool estimates the program cost based on vehicle component weights and programmatic assumptions. Additional high fidelity cost tools like process-based and activity-based cost analysis methods can be used to modify the baseline TCM result as more knowledge is accumulated over design iterations. Therefore, with this concept, the additional manufacturing knowledge can be used to identify a more accurate lifecycle cost and facilitate higher fidelity tradeoffs during conceptual and preliminary design. Advanced Composite Cost Estimating Model (ACCEM) is employed as a process-based cost component to replace the original TCM result of the composite part production cost. The reason for the replacement is that TCM estimates production costs from part weights as a result of subtractive manufacturing of metallic origin such as casting, forging, and machining processes. A complexity factor can sometimes be adjusted to reflect different types of metal and machine settings. The TCM assumption, however, gives erroneous results when applied to additive processes like those of composite manufacturing. Another innovative aspect of this research is the introduction of a work measurement technique called Maynard Operation Sequence Technique (MOST) to be used, similarly to Activity-Based Costing (ABC) approach, to estimate manufacturing time of a part by virtue of breaking down the operations occurred during its production. ABC allows a realistic determination of cost incurred in each activity, as opposed to using a traditional method of time estimation by analogy or using response surface equations from historical process data. The MOST concept provides a tailored study of an individual process typically required for a new, innovative design. Nevertheless, the MOST idea has some challenges, one of which is its requirement to build a new process from ground up. The process development requires a Subject Matter Expertise (SME) in manufacturing method of the particular design. The SME must have also a comprehensive understanding of the MOST system so that the correct parameters are chosen. In practice, these knowledge requirements may demand people from outside of the design discipline and a priori training of MOST. To relieve the constraint, this study includes an entirely new sub-system architecture that comprises 1) a knowledge-based system to provide the required knowledge during the process selection; and 2) a new user-interface to guide the parameter selection when building the process using MOST. Also included in this study is the demonstration of how the HLCET and its constituents can be integrated with a Georgia Tech' Integrated Product and Process Development (IPPD) methodology. The applicability of this work will be shown through a complex aerospace design example to gain insights into how manufacturing knowledge helps make better design decisions during the early stages. The setup process is explained with an example of its utility demonstrated in a hypothetical fighter aircraft wing redesign. The evaluation of the system effectiveness against existing methodologies is illustrated to conclude the thesis.

An economic toolkit for identifying the cost of emergency medical services (EMS) systems: detailed methodology of the EMS Cost Analysis Project (EMSCAP).

PubMed

Lerner, E Brooke; Garrison, Herbert G; Nichol, Graham; Maio, Ronald F; Lookman, Hunaid A; Sheahan, William D; Franz, Timothy R; Austad, James D; Ginster, Aaron M; Spaite, Daniel W

2012-02-01

Calculating the cost of an emergency medical services (EMS) system using a standardized method is important for determining the value of EMS. This article describes the development of a methodology for calculating the cost of an EMS system to its community. This includes a tool for calculating the cost of EMS (the "cost workbook") and detailed directions for determining cost (the "cost guide"). The 12-step process that was developed is consistent with current theories of health economics, applicable to prehospital care, flexible enough to be used in varying sizes and types of EMS systems, and comprehensive enough to provide meaningful conclusions. It was developed by an expert panel (the EMS Cost Analysis Project [EMSCAP] investigator team) in an iterative process that included pilot testing the process in three diverse communities. The iterative process allowed ongoing modification of the toolkit during the development phase, based upon direct, practical, ongoing interaction with the EMS systems that were using the toolkit. The resulting methodology estimates EMS system costs within a user-defined community, allowing either the number of patients treated or the estimated number of lives saved by EMS to be assessed in light of the cost of those efforts. Much controversy exists about the cost of EMS and whether the resources spent for this purpose are justified. However, the existence of a validated toolkit that provides a standardized process will allow meaningful assessments and comparisons to be made and will supply objective information to inform EMS and community officials who are tasked with determining the utilization of scarce societal resources. © 2012 by the Society for Academic Emergency Medicine.

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.

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.

Remedial Action Assessment System: A computer-based methodology for conducting feasibility studies

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

White, M.K.; Buelt, J.L.; Stottlemyre, J.A.

1991-02-01

Because of the complexity and number of potential waste sites facing the US Department of Energy (DOE) for potential cleanup, DOE is supporting the development of a computer-based methodology to streamline the remedial investigation/feasibility study process. The Remedial Action Assessment System (RAAS), can be used for screening, linking, and evaluating established technology processes in support of conducting feasibility studies. It is also intended to do the same in support of corrective measures studies. The user interface employs menus, windows, help features, and graphical information while RAAS is in operation. Object-oriented programming is used to link unit processes into sets ofmore » compatible processes that form appropriate remedial alternatives. Once the remedial alternatives are formed, the RAAS methodology can evaluate them in terms of effectiveness, implementability, and cost. RAAS will access a user-selected risk assessment code to determine the reduction of risk after remedial action by each recommended alternative. The methodology will also help determine the implementability of the remedial alternatives at a site and access cost estimating tools to provide estimates of capital, operating, and maintenance costs. This paper presents the characteristics of two RAAS prototypes currently being developed. These include the RAAS Technology Information System, which accesses graphical, tabular and textual information about technologies, and the main RAAS methodology, which screens, links, and evaluates remedial technologies. 4 refs., 3 figs., 1 tab.« less

Physician Awareness of Drug Cost: A Systematic Review

PubMed Central

Allan, G. Michael; Lexchin, Joel; Wiebe, Natasha

2007-01-01

Background Pharmaceutical costs are the fastest-growing health-care expense in most developed countries. Higher drug costs have been shown to negatively impact patient outcomes. Studies suggest that doctors have a poor understanding of pharmaceutical costs, but the data are variable and there is no consistent pattern in awareness. We designed this systematic review to investigate doctors' knowledge of the relative and absolute costs of medications and to determine the factors that influence awareness. Methods and Findings Our search strategy included The Cochrane Library, EconoLit, EMBASE, and MEDLINE as well as reference lists and contact with authors who had published two or more articles on the topic or who had published within 10 y of the commencement of our review. Studies were included if: either doctors, trainees (interns or residents), or medical students were surveyed; there were more than ten survey respondents; cost of pharmaceuticals was estimated; results were expressed quantitatively; there was a clear description of how authors defined “accurate estimates”; and there was a description of how the true cost was determined. Two authors reviewed each article for eligibility and extracted data independently. Cost accuracy outcomes were summarized, but data were not combined in meta-analysis because of extensive heterogeneity. Qualitative data related to physicians and drug costs were also extracted. The final analysis included 24 articles. Cost accuracy was low; 31% of estimates were within 20% or 25% of the true cost, and fewer than 50% were accurate by any definition of cost accuracy. Methodological weaknesses were common, and studies of low methodological quality showed better cost awareness. The most important factor influencing the pattern and accuracy of estimation was the true cost of therapy. High-cost drugs were estimated more accurately than inexpensive ones (74% versus 31%, Chi-square p < 0.001). Doctors consistently overestimated the cost of inexpensive products and underestimated the cost of expensive ones (binomial test, 89/101, p < 0.001). When asked, doctors indicated that they want cost information and feel it would improve their prescribing but that it is not accessible. Conclusions Doctors' ignorance of costs, combined with their tendency to underestimate the price of expensive drugs and overestimate the price of inexpensive ones, demonstrate a lack of appreciation of the large difference in cost between inexpensive and expensive drugs. This discrepancy in turn could have profound implications for overall drug expenditures. Much more focus is required in the education of physicians about costs and the access to cost information. Future research should focus on the accessibility and reliability of medical cost information and whether the provision of this information is used by doctors and makes a difference to physician prescribing. Additionally, future work should strive for higher methodological standards to avoid the biases we found in the current literature, including attention to the method of assessing accuracy that allows larger absolute estimation ranges for expensive drugs. PMID:17896856

Documentation of the analysis of the benefits and costs of aeronautical research and technology models, volume 1

NASA Technical Reports Server (NTRS)

Bobick, J. C.; Braun, R. L.; Denny, R. E.

1979-01-01

The analysis of the benefits and costs of aeronautical research and technology (ABC-ART) models are documented. These models were developed by NASA for use in analyzing the economic feasibility of applying advanced aeronautical technology to future civil aircraft. The methodology is composed of three major modules: fleet accounting module, airframe manufacturing module, and air carrier module. The fleet accounting module is used to estimate the number of new aircraft required as a function of time to meet demand. This estimation is based primarily upon the expected retirement age of existing aircraft and the expected change in revenue passenger miles demanded. Fuel consumption estimates are also generated by this module. The airframe manufacturer module is used to analyze the feasibility of the manufacturing the new aircraft demanded. The module includes logic for production scheduling and estimating manufacturing costs. For a series of aircraft selling prices, a cash flow analysis is performed and a rate of return on investment is calculated. The air carrier module provides a tool for analyzing the financial feasibility of an airline purchasing and operating the new aircraft. This module includes a methodology for computing the air carrier direct and indirect operating costs, performing a cash flow analysis, and estimating the internal rate of return on investment for a set of aircraft purchase prices.

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.

The economic burden of diabetes in India: a review of the literature.

PubMed

Yesudian, Charles A K; Grepstad, Mari; Visintin, Erica; Ferrario, Alessandra

2014-12-02

Diabetes and its complications are a major cause of morbidity and mortality in India, and the prevalence of type 2 diabetes is on the rise. This calls for an assessment of the economic burden of the disease. To conduct a critical review of the literature on cost of illness studies of diabetes and its complications in India. A comprehensive literature review addressing the study objective was conducted. An extraction table and a scoring system to assess the quality of the studies reviewed were developed. A total of nineteen articles from different regions of India met the study inclusion criteria. The third party payer perspective was the most common study design (17 articles) while fewer articles (n =2) reported on costs from a health system or societal perspective. All the articles included direct costs and only a few (n =4) provided estimates for indirect costs based on income loss for patients and carers. Drug costs proved to be a significant cost component in several studies (n =12). While middle and high-income groups had higher expenditure in absolute terms, costs constituted a higher proportion of income for the poor. The economic burden was highest among urban groups. The overall quality of the studies is low due to a number of methodological weaknesses. The most frequent epidemiological approach employed was the prevalence-based one (n =18) while costs were mainly estimated using a bottom up approach (n =15). The body of literature on the costs of diabetes and its complications in India provides a fragmented picture that has mostly concentrated on the direct costs borne by individuals rather than the healthcare system. There is a need to develop a robust methodology to perform methodologically rigorous and transparent cost of illness studies to inform policy decisions.

Strategic Methodologies in Public Health Cost Analyses.

PubMed

Whittington, Melanie; Atherly, Adam; VanRaemdonck, Lisa; Lampe, Sarah

The National Research Agenda for Public Health Services and Systems Research states the need for research to determine the cost of delivering public health services in order to assist the public health system in communicating financial needs to decision makers, partners, and health reform leaders. The objective of this analysis is to compare 2 cost estimation methodologies, public health manager estimates of employee time spent and activity logs completed by public health workers, to understand to what degree manager surveys could be used in lieu of more time-consuming and burdensome activity logs. Employees recorded their time spent on communicable disease surveillance for a 2-week period using an activity log. Managers then estimated time spent by each employee on a manager survey. Robust and ordinary least squares regression was used to measure the agreement between the time estimated by the manager and the time recorded by the employee. The 2 outcomes for this study included time recorded by the employee on the activity log and time estimated by the manager on the manager survey. This study was conducted in local health departments in Colorado. Forty-one Colorado local health departments (82%) agreed to participate. Seven of the 8 models showed that managers underestimate their employees' time, especially for activities on which an employee spent little time. Manager surveys can best estimate time for time-intensive activities, such as total time spent on a core service or broad public health activity, and yet are less precise when estimating discrete activities. When Public Health Services and Systems Research researchers and health departments are conducting studies to determine the cost of public health services, there are many situations in which managers can closely approximate the time required and produce a relatively precise approximation of cost without as much time investment by practitioners.

A normative price for energy from an electricity generation system: An Owner-dependent Methodology for Energy Generation (system) Assessment (OMEGA). Volume 2: Derivation of system energy price equations

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Mcmaster, K. M.

1981-01-01

The methodology presented is a derivation of the utility owned solar electric systems model. The net present value of the system is determined by consideration of all financial benefits and costs including a specified return on investment. Life cycle costs, life cycle revenues, and residual system values are obtained. Break-even values of system parameters are estimated by setting the net present value to zero.

Is Military Advertising Effective? An Estimation Methodology and Applications to Recruiting in the 1980’s and 90s

DTIC Science & Technology

2003-01-01

This report documents research findings from a RAND project titled The Relative Cost Effectiveness of Military Advertising , the goal of which was to...develop and apply a methodology for assessing the cost effectiveness of the services’ advertising programs and to provide guidance for a more...examines issues related to the effectiveness of recruiting advertising during the 1980s and 1990s. It describes the policy context, summarizes the current

Reference Model 5 (RM5): Oscillating Surge Wave Energy Converter

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

Yu, Y. H.; Jenne, D. S.; Thresher, R.

This report is an addendum to SAND2013-9040: Methodology for Design and Economic Analysis of Marine Energy Conversion (MEC) Technologies. This report describes an Oscillating Water Column Wave Energy Converter (OSWEC) reference model design in a complementary manner to Reference Models 1-4 contained in the above report. A conceptual design for a taut moored oscillating surge wave energy converter was developed. The design had an annual electrical power of 108 kilowatts (kW), rated power of 360 kW, and intended deployment at water depths between 50 m and 100 m. The study includes structural analysis, power output estimation, a hydraulic power conversionmore » chain system, and mooring designs. The results were used to estimate device capital cost and annual operation and maintenance costs. The device performance and costs were used for the economic analysis, following the methodology presented in SAND2013-9040 that included costs for designing, manufacturing, deploying, and operating commercial-scale MEC arrays up to 100 devices. The levelized cost of energy estimated for the Reference Model 5 OSWEC, presented in this report, was for a single device and arrays of 10, 50, and 100 units, and it enabled the economic analysis to account for cost reductions associated with economies of scale. The baseline commercial levelized cost of energy estimate for the Reference Model 5 device in an array comprised of 10 units is $1.44/kilowatt-hour (kWh), and the value drops to approximately $0.69/kWh for an array of 100 units.« less

On the Estimation of the Cost-Effectiveness Threshold: Why, What, How?

PubMed

Vallejo-Torres, Laura; García-Lorenzo, Borja; Castilla, Iván; Valcárcel-Nazco, Cristina; García-Pérez, Lidia; Linertová, Renata; Polentinos-Castro, Elena; Serrano-Aguilar, Pedro

2016-01-01

Many health care systems claim to incorporate the cost-effectiveness criterion in their investment decisions. Information on the system's willingness to pay per effectiveness unit, normally measured as quality-adjusted life-years (QALYs), however, is not available in most countries. This is partly because of the controversy that remains around the use of a cost-effectiveness threshold, about what the threshold ought to represent, and about the appropriate methodology to arrive at a threshold value. The aim of this article was to identify and critically appraise the conceptual perspectives and methodologies used to date to estimate the cost-effectiveness threshold. We provided an in-depth discussion of different conceptual views and undertook a systematic review of empirical analyses. Identified studies were categorized into the two main conceptual perspectives that argue that the threshold should reflect 1) the value that society places on a QALY and 2) the opportunity cost of investment to the system given budget constraints. These studies showed different underpinning assumptions, strengths, and limitations, which are highlighted and discussed. Furthermore, this review allowed us to compare the cost-effectiveness threshold estimates derived from different types of studies. We found that thresholds based on society's valuation of a QALY are generally larger than thresholds resulting from estimating the opportunity cost to the health care system. This implies that some interventions with positive social net benefits, as informed by individuals' preferences, might not be an appropriate use of resources under fixed budget constraints. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

COST OF SELECTIVE CATALYTIC REDUCTION (SCR) APPLICATION FOR NOX CONTROL ON COAL-FIRED BOILERS

EPA Science Inventory

The report provides a methodology for estimating budgetary costs associated with retrofit applications of selective catalytic reduction (SCR) technology on coal-fired boilers. SCR is a postcombustion nitrogen oxides (NOx) control technology capable of providing NOx reductions >90...

A Methodology for Assessing and Ranking Ballistic Missile Defense Technologies Using a System Performance Index

DTIC Science & Technology

2002-07-29

suggestions, and guidance concerning the technology assessment process. References 1. Using ACEIT for Total Ownership Cost Modeling and Analysis...2001 World Population Data Sheet, Population Reference Bureau, Washington, DC List of Acronyms ACEIT – Automated Cost Estimating Integrated

Congestion Mitigation and Air Quality (CMAQ) Improvement Program: Cost-Effectiveness Tables Development and Methodology

DOT National Transportation Integrated Search

2015-05-01

This document presents summary and detailed findings from a research effort to develop estimates of the cost-effectiveness of a range of project types funded under the Congestion Mitigation and Air Quality (CMAQ) Improvement Program. In this study, c...

A Resource Paper on the Relative Cost of Special Education.

ERIC Educational Resources Information Center

Osher, Trina; And Others

This resource paper describes two recent studies and one report on special education costs and the methodology used in their analyses. Each study and its data source are summarized with a short discussion on the quality of the data and its usefulness and limitations in generating reliable cost estimates for special education. The paper summarizes…

Exploring the Sensitivity of Education Costs to Racial Composition of Schools and Race-Neutral Alternative Measures: A Cost Function Application to Missouri

ERIC Educational Resources Information Center

Baker, Bruce D.

2011-01-01

This article applies the education cost function methodology in order to estimate additional costs associated with black student concentration and with alternative, race-neutral measures of urban poverty. Recent research highlights the continued importance of the role of race in educational outcomes, and how the intersection of peer group effects…

Improved Methodology for Developing Cost Uncertainty Models for Naval Vessels

DTIC Science & Technology

2008-09-01

Growth: Last 700 Years (From: Deegan , 2007b) ................13 Figure 3. Business Rules to Consider: Choosing an acceptable cost risk point...requires an understanding of consequence (From: Deegan , 2007b)...............16 Figure 4. Basic Steps in Estimating Probable Systems Cost (From: Book...her guidance and assistance in the development of this thesis. Additionally, I thank Mr. Chris Deegan , the former Director of Cost Engineering and

Stand-alone flat-plate photovoltaic power systems: System sizing and life-cycle costing methodology for Federal agencies

NASA Technical Reports Server (NTRS)

Borden, C. S.; Volkmer, K.; Cochrane, E. H.; Lawson, A. C.

1984-01-01

A simple methodology to estimate photovoltaic system size and life-cycle costs in stand-alone applications is presented. It is designed to assist engineers at Government agencies in determining the feasibility of using small stand-alone photovoltaic systems to supply ac or dc power to the load. Photovoltaic system design considerations are presented as well as the equations for sizing the flat-plate array and the battery storage to meet the required load. Cost effectiveness of a candidate photovoltaic system is based on comparison with the life-cycle cost of alternative systems. Examples of alternative systems addressed are batteries, diesel generators, the utility grid, and other renewable energy systems.

Pesticide Environmental Accounting: a method for assessing the external costs of individual pesticide applications.

PubMed

Leach, A W; Mumford, J D

2008-01-01

The Pesticide Environmental Accounting (PEA) tool provides a monetary estimate of environmental and health impacts per hectare-application for any pesticide. The model combines the Environmental Impact Quotient method and a methodology for absolute estimates of external pesticide costs in UK, USA and Germany. For many countries resources are not available for intensive assessments of external pesticide costs. The model converts external costs of a pesticide in the UK, USA and Germany to Mediterranean countries. Economic and policy applications include estimating impacts of pesticide reduction policies or benefits from technologies replacing pesticides, such as sterile insect technique. The system integrates disparate data and approaches into a single logical method. The assumptions in the system provide transparency and consistency but at the cost of some specificity and precision, a reasonable trade-off for a method that provides both comparative estimates of pesticide impacts and area-based assessments of absolute impacts.

Estimating and validating ground-based timber harvesting production through computer simulation

Treesearch

Jingxin Wang; Chris B. LeDoux

2003-01-01

Estimating ground-based timber harvesting systems production with an object oriented methodology was investigated. The estimation model developed generates stands of trees, simulates chain saw, drive-to-tree feller-buncher, swing-to-tree single-grip harvester felling, and grapple skidder and forwarder extraction activities, and analyzes costs and productivity. It also...

Reference Model 6 (RM6): Oscillating Wave Energy Converter.

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

Bull, Diana L; Smith, Chris; Jenne, Dale Scott

This report is an addendum to SAND2013-9040: Methodology for Design and Economic Analysis of Marine Energy Conversion (MEC) Technologies. This report describes an Oscillating Water Column Wave Energy Converter reference model design in a complementary manner to Reference Models 1-4 contained in the above report. In this report, a conceptual design for an Oscillating Water Column Wave Energy Converter (WEC) device appropriate for the modeled reference resource site was identified, and a detailed backward bent duct buoy (BBDB) device design was developed using a combination of numerical modeling tools and scaled physical models. Our team used the methodology in SAND2013-9040more » for the economic analysis that included costs for designing, manufacturing, deploying, and operating commercial-scale MEC arrays, up to 100 devices. The methodology was applied to identify key cost drivers and to estimate levelized cost of energy (LCOE) for this RM6 Oscillating Water Column device in dollars per kilowatt-hour ($/kWh). Although many costs were difficult to estimate at this time due to the lack of operational experience, the main contribution of this work was to disseminate a detailed set of methodologies and models that allow for an initial cost analysis of this emerging technology. This project is sponsored by the U.S. Department of Energy's (DOE) Wind and Water Power Technologies Program Office (WWPTO), within the Office of Energy Efficiency & Renewable Energy (EERE). Sandia National Laboratories, the lead in this effort, collaborated with partners from National Laboratories, industry, and universities to design and test this reference model.« less

Comparison of sampling methodologies for nutrient monitoring in streams: uncertainties, costs and implications for mitigation

NASA Astrophysics Data System (ADS)

Audet, J.; Martinsen, L.; Hasler, B.; de Jonge, H.; Karydi, E.; Ovesen, N. B.; Kronvang, B.

2014-07-01

Eutrophication of aquatic ecosystems caused by excess concentrations of nitrogen and phosphorus may have harmful consequences for biodiversity and poses a health risk to humans via the water supplies. Reduction of nitrogen and phosphorus losses to aquatic ecosystems involves implementation of costly measures, and reliable monitoring methods are therefore essential to select appropriate mitigation strategies and to evaluate their effects. Here, we compare the performances and costs of three methodologies for the monitoring of nutrients in rivers: grab sampling, time-proportional sampling and passive sampling using flow proportional samplers. Assuming time-proportional sampling to be the best estimate of the "true" nutrient load, our results showed that the risk of obtaining wrong total nutrient load estimates by passive samplers is high despite similar costs as the time-proportional sampling. Our conclusion is that for passive samplers to provide a reliable monitoring alternative, further development is needed. Grab sampling was the cheapest of the three methods and was more precise and accurate than passive sampling. We conclude that although monitoring employing time-proportional sampling is costly, its reliability precludes unnecessarily high implementation expenses.

Comparison of sampling methodologies for nutrient monitoring in streams: uncertainties, costs and implications for mitigation

NASA Astrophysics Data System (ADS)

Audet, J.; Martinsen, L.; Hasler, B.; de Jonge, H.; Karydi, E.; Ovesen, N. B.; Kronvang, B.

2014-11-01

Eutrophication of aquatic ecosystems caused by excess concentrations of nitrogen and phosphorus may have harmful consequences for biodiversity and poses a health risk to humans via water supplies. Reduction of nitrogen and phosphorus losses to aquatic ecosystems involves implementation of costly measures, and reliable monitoring methods are therefore essential to select appropriate mitigation strategies and to evaluate their effects. Here, we compare the performances and costs of three methodologies for the monitoring of nutrients in rivers: grab sampling; time-proportional sampling; and passive sampling using flow-proportional samplers. Assuming hourly time-proportional sampling to be the best estimate of the "true" nutrient load, our results showed that the risk of obtaining wrong total nutrient load estimates by passive samplers is high despite similar costs as the time-proportional sampling. Our conclusion is that for passive samplers to provide a reliable monitoring alternative, further development is needed. Grab sampling was the cheapest of the three methods and was more precise and accurate than passive sampling. We conclude that although monitoring employing time-proportional sampling is costly, its reliability precludes unnecessarily high implementation expenses.

Bigger is Better, but at What Cost? Estimating the Economic Value of Incremental Data Assets.

PubMed

Dalessandro, Brian; Perlich, Claudia; Raeder, Troy

2014-06-01

Many firms depend on third-party vendors to supply data for commercial predictive modeling applications. An issue that has received very little attention in the prior research literature is the estimation of a fair price for purchased data. In this work we present a methodology for estimating the economic value of adding incremental data to predictive modeling applications and present two cases studies. The methodology starts with estimating the effect that incremental data has on model performance in terms of common classification evaluation metrics. This effect is then translated into economic units, which gives an expected economic value that the firm might realize with the acquisition of a particular data asset. With this estimate a firm can then set a data acquisition price that targets a particular return on investment. This article presents the methodology in full detail and illustrates it in the context of two marketing case studies.

Estimating the value of a Country's built assets: investment-based exposure modelling for global risk assessment

NASA Astrophysics Data System (ADS)

Daniell, James; Pomonis, Antonios; Gunasekera, Rashmin; Ishizawa, Oscar; Gaspari, Maria; Lu, Xijie; Aubrecht, Christoph; Ungar, Joachim

2017-04-01

In order to quantify disaster risk, there is a demand and need for determining consistent and reliable economic value of built assets at national or sub national level exposed to natural hazards. The value of the built stock in the context of a city or a country is critical for risk modelling applications as it allows for the upper bound in potential losses to be established. Under the World Bank probabilistic disaster risk assessment - Country Disaster Risk Profiles (CDRP) Program and rapid post-disaster loss analyses in CATDAT, key methodologies have been developed that quantify the asset exposure of a country. In this study, we assess the complementary methods determining value of building stock through capital investment data vs aggregated ground up values based on built area and unit cost of construction analyses. Different approaches to modelling exposure around the world, have resulted in estimated values of built assets of some countries differing by order(s) of magnitude. Using the aforementioned methodology of comparing investment data based capital stock and bottom-up unit cost of construction values per square meter of assets; a suitable range of capital stock estimates for built assets have been created. A blind test format was undertaken to compare the two types of approaches from top-down (investment) and bottom-up (construction cost per unit), In many cases, census data, demographic, engineering and construction cost data are key for bottom-up calculations from previous years. Similarly for the top-down investment approach, distributed GFCF (Gross Fixed Capital Formation) data is also required. Over the past few years, numerous studies have been undertaken through the World Bank Caribbean and Central America disaster risk assessment program adopting this methodology initially developed by Gunasekera et al. (2015). The range of values of the building stock is tested for around 15 countries. In addition, three types of costs - Reconstruction cost (building back to the standard required by building codes); Replacement cost (gross capital stock) and Book value (net capital stock - depreciated value of assets) are discussed and the differences in methodologies assessed. We then examine historical costs (reconstruction and replacement) and losses (book value) of natural disasters versus this upper bound of capital stock in various locations to examine the impact of a reasonable capital stock estimate. It is found that some historic loss estimates in publications are not reasonable given the value of assets at the time of the event. This has applications for quantitative disaster risk assessment and development of country disaster risk profiles, economic analyses and benchmarking upper loss limits of built assets damaged due to natural hazards.

COST OF SELECTIVE CATALYTIC REDUCTION (SCR) APPLICATION FOR NOX CONTROL ON COAL-FIRED BOILERS

EPA Science Inventory

The report provides a methodology for estimating budgetary costs associ-ated with retrofit applications of selec-tive catalytic reduction (SCR) technology on coal-fired boilers. SCR is a post-combustion nitrogen oxides (NOX) con-trol technology capable of providing NOX reductions...

A Survey of Cost Estimating Methodologies for Distributed Spacecraft Missions

NASA Technical Reports Server (NTRS)

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

2016-01-01

Satellite constellations and Distributed Spacecraft Mission (DSM) architectures offer unique benefits to Earth observation scientists and unique challenges to cost estimators. The Cost and Risk (CR) module of the Tradespace Analysis Tool for Constellations (TAT-C) being developed by NASA Goddard seeks to address some of these challenges by providing a new approach to cost modeling, which aggregates existing Cost Estimating Relationships (CER) from respected sources, cost estimating best practices, and data from existing and proposed satellite designs. Cost estimation through this tool is approached from two perspectives: parametric cost estimating relationships and analogous cost estimation techniques. The dual approach utilized within the TAT-C CR module is intended to address prevailing concerns regarding early design stage cost estimates, and offer increased transparency and fidelity by offering two preliminary perspectives on mission cost. This work outlines the existing cost model, details assumptions built into the model, and explains what measures have been taken to address the particular challenges of constellation cost estimating. The risk estimation portion of the TAT-C CR module is still in development and will be presented in future work. The cost estimate produced by the CR module is not intended to be an exact mission valuation, but rather a comparative tool to assist in the exploration of the constellation design tradespace. Previous work has noted that estimating the cost of satellite constellations is difficult given that no comprehensive model for constellation cost estimation has yet been developed, and as such, quantitative assessment of multiple spacecraft missions has many remaining areas of uncertainty. By incorporating well-established CERs with preliminary approaches to approaching these uncertainties, the CR module offers more complete approach to constellation costing than has previously been available to mission architects or Earth scientists seeking to leverage the capabilities of multiple spacecraft working in support of a common goal.

Empirical cost models for estimating power and energy consumption in database servers

NASA Astrophysics Data System (ADS)

Valdivia Garcia, Harold Dwight

The explosive growth in the size of data centers, coupled with the widespread use of virtualization technology has brought power and energy consumption as major concerns for data center administrators. Provisioning decisions must take into consideration not only target application performance but also the power demands and total energy consumption incurred by the hardware and software to be deployed at the data center. Failure to do so will result in damaged equipment, power outages, and inefficient operation. Since database servers comprise one of the most popular and important server applications deployed in such facilities, it becomes necessary to have accurate cost models that can predict the power and energy demands that each database workloads will impose in the system. In this work we present an empirical methodology to estimate the power and energy cost of database operations. Our methodology uses multiple-linear regression to derive accurate cost models that depend only on readily available statistics such as selectivity factors, tuple size, numbers columns and relational cardinality. Moreover, our method does not need measurement of individual hardware components, but rather total power and energy consumption measured at a server. We have implemented our methodology, and ran experiments with several server configurations. Our experiments indicate that we can predict power and energy more accurately than alternative methods found in the literature.

Economic Evaluation of Adolescent Addiction Programs: Methodological Challenges and Recommendations

PubMed Central

Homer, Jenny F.; Drummond, Michael F.; French, Michael T.

2008-01-01

This paper identifies and describes several methodological challenges encountered in economic evaluations of substance abuse interventions for adolescents. Topics include study design, the choice of perspective, the estimation of costs and outcomes, and the generalizability of results. Recommendations are offered for confronting these challenges using examples from adolescent addiction research. PMID:19027640

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.

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 of Equity Estimation in Fuel and Energy Sector Companies Based on CAPM

NASA Astrophysics Data System (ADS)

Kozieł, Diana; Pawłowski, Stanisław; Kustra, Arkadiusz

2018-03-01

The article presents cost of equity estimation of capital groups from the fuel and energy sector, listed at the Warsaw Stock Exchange, based on the Capital Asset Pricing Model (CAPM). The objective of the article was to perform a valuation of equity with the application of CAPM, based on actual financial data and stock exchange data and to carry out a sensitivity analysis of such cost, depending on the financing structure of the entity. The objective of the article formulated in this manner has determined its' structure. It focuses on presentation of substantive analyses related to the core of equity and methods of estimating its' costs, with special attention given to the CAPM. In the practical section, estimation of cost was performed according to the CAPM methodology, based on the example of leading fuel and energy companies, such as Tauron GE and PGE. Simultaneously, sensitivity analysis of such cost was performed depending on the structure of financing the company's operation.

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

PubMed

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

2011-11-01

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

Continued investigation of solid propulsion economics. Task 1B: Large solid rocket motor case fabrication methods - Supplement process complexity factor cost technique

NASA Technical Reports Server (NTRS)

Baird, J.

1967-01-01

This supplement to Task lB-Large Solid Rocket Motor Case Fabrication Methods supplies additional supporting cost data and discusses in detail the methodology that was applied to the task. For the case elements studied, the cost was found to be directly proportional to the Process Complexity Factor (PCF). The PCF was obtained for each element by identifying unit processes that are common to the elements and their alternative manufacturing routes, by assigning a weight to each unit process, and by summing the weighted counts. In three instances of actual manufacture, the actual cost per pound equaled the cost estimate based on PCF per pound, but this supplement, recognizes that the methodology is of limited, rather than general, application.

Cooperative Catalog Conversion Study. Final Report.

ERIC Educational Resources Information Center

Peat, Marwick, Mitchell and Co., Washington, DC.

Cost estimates provided by cataloging vendors during January 1981 are analyzed to identify the costs of catalog conversion options and alternatives to the card catalog for six Minnesota regional library systems. Following an executive summary of the study is a discussion of its background, scope, objectives, data gathering methodology, and…

The importance of operations, risk, and cost assessment to space transfer systems design

NASA Technical Reports Server (NTRS)

Ball, J. M.; Komerska, R. J.; Rowell, L. F.

1992-01-01

This paper examines several methodologies which contribute to comprehensive subsystem cost estimation. The example of a space-based lunar space transfer vehicle (STV) design is used to illustrate how including both primary and secondary factors into cost affects the decision of whether to use aerobraking or propulsion for earth orbit capture upon lunar return. The expected dominant cost factor in this decision is earth-to-orbit launch cost driven by STV mass. However, to quantify other significant cost factors, this cost comparison included a risk analysis to identify development and testing costs, a Taguchi design of experiments to determine a minimum mass aerobrake design, and a detailed operations analysis. As a result, the predicted cost advantage of aerobraking, while still positive, was subsequently reduced by about 30 percent compared to the simpler mass-based cost estimates.

Comparing methodologies for the allocation of overhead and capital costs to hospital services.

PubMed

Tan, Siok Swan; van Ineveld, Bastianus Martinus; Redekop, William Ken; Hakkaart-van Roijen, Leona

2009-06-01

Typically, little consideration is given to the allocation of indirect costs (overheads and capital) to hospital services, compared to the allocation of direct costs. Weighted service allocation is believed to provide the most accurate indirect cost estimation, but the method is time consuming. To determine whether hourly rate, inpatient day, and marginal mark-up allocation are reliable alternatives for weighted service allocation. The cost approaches were compared independently for appendectomy, hip replacement, cataract, and stroke in representative general hospitals in The Netherlands for 2005. Hourly rate allocation and inpatient day allocation produce estimates that are not significantly different from weighted service allocation. Hourly rate allocation may be a strong alternative to weighted service allocation for hospital services with a relatively short inpatient stay. The use of inpatient day allocation would likely most closely reflect the indirect cost estimates obtained by the weighted service method.

Methodology for conceptual remote sensing spacecraft technology: insertion analysis balancing performance, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David A.; Duclos, Donald P.; Barrera, Mark J.; Mosher, Todd J.; Lao, Norman Y.

1997-12-01

Emerging technologies and micro-instrumentation are changing the way remote sensing spacecraft missions are developed and implemented. Government agencies responsible for procuring space systems are increasingly requesting analyses to estimate cost, performance and design impacts of advanced technology insertion for both state-of-the-art systems as well as systems to be built 5 to 10 years in the future. Numerous spacecraft technology development programs are being sponsored by Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) agencies with the goal of enhancing spacecraft performance, reducing mass, and reducing cost. However, it is often the case that technology studies, in the interest of maximizing subsystem-level performance and/or mass reduction, do not anticipate synergistic system-level effects. Furthermore, even though technical risks are often identified as one of the largest cost drivers for space systems, many cost/design processes and models ignore effects of cost risk in the interest of quick estimates. To address these issues, the Aerospace Corporation developed a concept analysis methodology and associated software tools. These tools, collectively referred to as the concept analysis and design evaluation toolkit (CADET), facilitate system architecture studies and space system conceptual designs focusing on design heritage, technology selection, and associated effects on cost, risk and performance at the system and subsystem level. CADET allows: (1) quick response to technical design and cost questions; (2) assessment of the cost and performance impacts of existing and new designs/technologies; and (3) estimation of cost uncertainties and risks. These capabilities aid mission designers in determining the configuration of remote sensing missions that meet essential requirements in a cost- effective manner. This paper discuses the development of CADET modules and their application to several remote sensing satellite mission concepts.

Evaluation of freeway motorist assist program : final report, September 30, 2009.

DOT National Transportation Integrated Search

2010-02-01

This evaluation of the Motorist Assist (MA) program in St. Louis estimated that MA has an annual benefit-cost ratio (B/C) of 38.25:1 using 2009 dollars. This estimate was based on nationally accepted AASHTO methodology and was based on 1082 secondary...

Project resource reallocation algorithm

NASA Technical Reports Server (NTRS)

Myers, J. E.

1981-01-01

A methodology for adjusting baseline cost estimates according to project schedule changes is described. An algorithm which performs a linear expansion or contraction of the baseline project resource distribution in proportion to the project schedule expansion or contraction is presented. Input to the algorithm consists of the deck of cards (PACE input data) prepared for the baseline project schedule as well as a specification of the nature of the baseline schedule change. Output of the algorithm is a new deck of cards with all work breakdown structure block and element of cost estimates redistributed for the new project schedule. This new deck can be processed through PACE to produce a detailed cost estimate for the new schedule.

Cost-effectiveness analyses of hepatitis A vaccine: a systematic review to explore the effect of methodological quality on the economic attractiveness of vaccination strategies.

PubMed

Anonychuk, Andrea M; Tricco, Andrea C; Bauch, Chris T; Pham, Ba'; Gilca, Vladimir; Duval, Bernard; John-Baptiste, Ava; Woo, Gloria; Krahn, Murray

2008-01-01

Hepatitis A vaccines have been available for more than a decade. Because the burden of hepatitis A virus has fallen in developed countries, the appropriate role of vaccination programmes, especially universal vaccination strategies, remains unclear. Cost-effectiveness analysis is a useful method of relating the costs of vaccination to its benefits, and may inform policy. This article systematically reviews the evidence on the cost effectiveness of hepatitis A vaccination in varying populations, and explores the effects of methodological quality and key modelling issues on the cost-effectiveness ratios.Cost-effectiveness/cost-utility studies of hepatitis A vaccine were identified via a series of literature searches (MEDLINE, EMBASE, HSTAR and SSCI). Citations and full-text articles were reviewed independently by two reviewers. Reference searching, author searches and expert consultation ensured literature saturation. Incremental cost-effectiveness ratios (ICERs) were abstracted for base-case analyses, converted to $US, year 2005 values, and categorised to reflect various levels of cost effectiveness. Quality of reporting, methodological issues and key modelling issues were assessed using frameworks published in the literature.Thirty-one cost-effectiveness studies (including 12 cost-utility analyses) were included from full-text article review (n = 58) and citation screening (n = 570). These studies evaluated universal mass vaccination (n = 14), targeted vaccination (n = 17) and vaccination of susceptibles (i.e. individuals initially screened for antibody and, if susceptible, vaccinated) [n = 13]. For universal vaccination, 50% of the ICERs were <$US20 000 per QALY or life-year gained. Analyses evaluating vaccination in children, particularly in high incidence areas, produced the most attractive ICERs. For targeted vaccination, cost effectiveness was highly dependent on the risk of infection.Incidence, vaccine cost and discount rate were the most influential parameters in sensitivity analyses. Overall, analyses that evaluated the combined hepatitis A/hepatitis B vaccine, adjusted incidence for under-reporting, included societal costs and that came from studies of higher methodological quality tended to have more attractive cost-effectiveness ratios. Methodological quality varied across studies. Major methodological flaws included inappropriate model type, comparator, incidence estimate and inclusion/exclusion of costs.

Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis.

PubMed

Thavorn, Kednapa; Kugathasan, Howsikan; Tan, Darrell H S; Moqueet, Nasheed; Baral, Stefan D; Skidmore, Becky; MacFadden, Derek; Simkin, Anna; Mishra, Sharmistha

2018-03-15

Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations. We aim to estimate the incremental cost per health outcome of PrEP compared with placebo, no PrEP, or other HIV prevention strategies; assess the methodological variability in, and quality of, economic evaluations of PrEP; estimate the incremental cost per health outcome of different PrEP implementation strategies; and quantify the potential sources of heterogeneity in outcomes. We will systematically search electronic databases (MEDLINE, Embase) and the gray literature. We will include economic evaluation studies that assess both costs and health outcomes of PrEP in HIV-uninfected individuals, without restricting language or year of publication. Two reviewers will independently screen studies using predefined inclusion criteria, extract data, and assess methodological quality using the Philips checklist, Second Panel on the Cost-effectiveness of Health and Medicines, and the International Society for Pharmacoeconomics and Outcomes Research recommendations. Outcomes of interest include incremental costs and outcomes in natural units or utilities, cost-effectiveness ratios, and net monetary benefit. We will perform descriptive and quantitative syntheses using sensitivity analyses of outcomes by population subgroups, HIV epidemic settings, study designs, baseline intervention contexts, key parameter inputs and assumptions, type of outcomes, economic perspectives, and willingness to pay values. Findings will guide future economic evaluation of PrEP strategies in terms of methodological and knowledge gaps, and will inform decisions on the efficient integration of PrEP into public health programs across epidemiologic and health system contexts. PROSPERO CRD42016038440 .

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

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

Heeter, Jenny; Barbose, Galen; Bird, Lori

2014-03-12

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

Cost of Quality Evaluation Methodologies Handbook

DTIC Science & Technology

1988-07-28

policy. 2. Use multiple vendors for major procurements. 3. Establish a formal vendor qualification process. 4. Conduct joint quality planning; agree...and from which extrapolations and inter- polations may be extracted for estimating purposes. COST OF QUALITY - The costs of all efforts expended to...PRODUCIBILITY - The relative ease of producing an item or system which is governed by the characteristics and features of a design that enable

Benefit-cost analysis of addiction treatment: methodological guidelines and empirical application using the DATCAP and ASI.

PubMed

French, Michael T; Salomé, Helena J; Sindelar, Jody L; McLellan, A Thomas

2002-04-01

To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment. A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines. Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit-cost analysis and a sensitivity analysis of the estimates. The DATCAP was administered at three outpatient drug-free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7-months postadmission. The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit-cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se. This study used previously validated, research-proven instruments and methods to perform a practical benefit-cost analysis of real-world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.

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.

Estimation of the laser cutting operating cost by support vector regression methodology

NASA Astrophysics Data System (ADS)

Jović, Srđan; Radović, Aleksandar; Šarkoćević, Živče; Petković, Dalibor; Alizamir, Meysam

2016-09-01

Laser cutting is a popular manufacturing process utilized to cut various types of materials economically. The operating cost is affected by laser power, cutting speed, assist gas pressure, nozzle diameter and focus point position as well as the workpiece material. In this article, the process factors investigated were: laser power, cutting speed, air pressure and focal point position. The aim of this work is to relate the operating cost to the process parameters mentioned above. CO2 laser cutting of stainless steel of medical grade AISI316L has been investigated. The main goal was to analyze the operating cost through the laser power, cutting speed, air pressure, focal point position and material thickness. Since the laser operating cost is a complex, non-linear task, soft computing optimization algorithms can be used. Intelligent soft computing scheme support vector regression (SVR) was implemented. The performance of the proposed estimator was confirmed with the simulation results. The SVR results are then compared with artificial neural network and genetic programing. According to the results, a greater improvement in estimation accuracy can be achieved through the SVR compared to other soft computing methodologies. The new optimization methods benefit from the soft computing capabilities of global optimization and multiobjective optimization rather than choosing a starting point by trial and error and combining multiple criteria into a single criterion.

Nudging Waste Diversion at Western State Colorado University: Application of Behavioral Insights

ERIC Educational Resources Information Center

McCoy, Kimberly; Oliver, Justin J.; Borden, D. Scott; Cohn, Scott I.

2018-01-01

Purpose: This paper aims to test a nudge, or intervention, designed through behavioral insights at a university campus to discover cost-effective means for increasing recycling participation and methods for estimating waste removal cost savings. Design/methodology/approach: A series of studies were conducted demonstrating the effectiveness of…

Compile-time estimation of communication costs in multicomputers

NASA Technical Reports Server (NTRS)

Gupta, Manish; Banerjee, Prithviraj

1991-01-01

An important problem facing numerous research projects on parallelizing compilers for distributed memory machines is that of automatically determining a suitable data partitioning scheme for a program. Any strategy for automatic data partitioning needs a mechanism for estimating the performance of a program under a given partitioning scheme, the most crucial part of which involves determining the communication costs incurred by the program. A methodology is described for estimating the communication costs at compile-time as functions of the numbers of processors over which various arrays are distributed. A strategy is described along with its theoretical basis, for making program transformations that expose opportunities for combining of messages, leading to considerable savings in the communication costs. For certain loops with regular dependences, the compiler can detect the possibility of pipelining, and thus estimate communication costs more accurately than it could otherwise. These results are of great significance to any parallelization system supporting numeric applications on multicomputers. In particular, they lay down a framework for effective synthesis of communication on multicomputers from sequential program references.

The cost of power outages in the business and public sectors in Israel: Revealed preference vs. subjective evaluation

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

Beenstock, M.; Goldin, E.; Haitovsky, Y.

1997-05-01

The economic cost of power outages is a central parameter in the cost-benefit analysis of electric power reliability and the design of electric power systems. The authors present a new methodology for estimating the cost of power outages in the business and public sections and illustrate with data for Israel. The methodology is based on the principle of revealed preference, the cost of an outage may be inferred from the actions taken by consumers to mitigate losses induced by unsupplied electricity. If outages impose costs on businesses, managers are likely to invest in back-up power to mitigate the losses thatmore » are incurred when electricity is not supplied. Investment in back-up generators may then be used to impute the mitigated and unmitigated damage from outages. 12 refs., 3 figs., 7 tabs.« less

Global mortality consequences of climate change accounting for adaptation costs and benefits

NASA Astrophysics Data System (ADS)

Rising, J. A.; Jina, A.; Carleton, T.; Hsiang, S. M.; Greenstone, M.

2017-12-01

Empirically-based and plausibly causal estimates of the damages of climate change are greatly needed to inform rapidly developing global and local climate policies. To accurately reflect the costs of climate change, it is essential to estimate how much populations will adapt to a changing climate, yet adaptation remains one of the least understood aspects of social responses to climate. In this paper, we develop and implement a novel methodology to estimate climate impacts on mortality rates. We assemble comprehensive sub-national panel data in 41 countries that account for 56% of the world's population, and combine them with high resolution daily climate data to flexibly estimate the causal effect of temperature on mortality. We find the impacts of temperature on mortality have a U-shaped response; both hot days and cold days cause excess mortality. However, this average response obscures substantial heterogeneity, as populations are differentially adapted to extreme temperatures. Our empirical model allows us to extrapolate response functions across the entire globe, as well as across time, using a range of economic, population, and climate change scenarios. We also develop a methodology to capture not only the benefits of adaptation, but also its costs. We combine these innovations to produce the first causal, micro-founded, global, empirically-derived climate damage function for human health. We project that by 2100, business-as-usual climate change is likely to incur mortality-only costs that amount to approximately 5% of global GDP for 5°C degrees of warming above pre-industrial levels. On average across model runs, we estimate that the upper bound on adaptation costs amounts to 55% of the total damages.

Controlling air pollution from passenger ferries: cost-effectiveness of seven technological options.

PubMed

Farrell, Alexander E; Corbett, James J; Winebrake, James J

2002-12-01

Continued interest in improving air quality in the United States along with renewed interest in the expansion of urban passenger ferry service has created concern about air pollution from ferry vessels. This paper presents a methodology for estimating the air pollution emissions from passenger ferries and the costs of emissions control strategies. The methodology is used to estimate the emissions and costs of retrofitting or re-powering ferries with seven technological options (combinations of propulsion and emission control systems) onto three vessels currently in service in San Francisco Bay. The technologies include improved engine design, cleaner fuels (including natural gas), and exhaust gas cleanup devices. The three vessels span a range of ages and technologies, from a 25-year-old monohull to a modern, high-speed catamaran built only four years ago. By looking at a range of technologies, vessel designs, and service conditions, a sense of the broader implications of controlling emissions from passenger ferries across a range of vessels and service profiles is provided. Tier 2-certified engines are the most cost-effective choice, but all options are cost-effective relative to other emission control strategies already in place in the transportation system.

A new methodology for modeling of direct landslide costs for transportation infrastructures

NASA Astrophysics Data System (ADS)

Klose, Martin; Terhorst, Birgit

2014-05-01

The world's transportation infrastructure is at risk of landslides in many areas across the globe. A safe and affordable operation of traffic routes are the two main criteria for transportation planning in landslide-prone areas. The right balancing of these often conflicting priorities requires, amongst others, profound knowledge of the direct costs of landslide damage. These costs include capital investments for landslide repair and mitigation as well as operational expenditures for first response and maintenance works. This contribution presents a new methodology for ex post assessment of direct landslide costs for transportation infrastructures. The methodology includes tools to compile, model, and extrapolate landslide losses on different spatial scales over time. A landslide susceptibility model enables regional cost extrapolation by means of a cost figure obtained from local cost compilation for representative case study areas. On local level, cost survey is closely linked with cost modeling, a toolset for cost estimation based on landslide databases. Cost modeling uses Landslide Disaster Management Process Models (LDMMs) and cost modules to simulate and monetize cost factors for certain types of landslide damage. The landslide susceptibility model provides a regional exposure index and updates the cost figure to a cost index which describes the costs per km of traffic route at risk of landslides. Both indexes enable the regionalization of local landslide losses. The methodology is applied and tested in a cost assessment for highways in the Lower Saxon Uplands, NW Germany, in the period 1980 to 2010. The basis of this research is a regional subset of a landslide database for the Federal Republic of Germany. In the 7,000 km² large Lower Saxon Uplands, 77 km of highway are located in potential landslide hazard area. Annual average costs of 52k per km of highway at risk of landslides are identified as cost index for a local case study area in this region. The cost extrapolation for the Lower Saxon Uplands results in annual average costs for highways of 4.02mn. This test application as well as a validation of selected modeling tools verifies the functionality of this methodology.

A cost effective and operational methodology for wall to wall Above Ground Biomass (AGB) and carbon stocks estimation and mapping: Nepal REDD+

NASA Astrophysics Data System (ADS)

Gilani, H., Sr.; Ganguly, S.; Zhang, G.; Koju, U. A.; Murthy, M. S. R.; Nemani, R. R.; Manandhar, U.; Thapa, G. J.

2015-12-01

Nepal is a landlocked country with 39% forest cover of the total land area (147,181 km2). Under the Forest Carbon Partnership Facility (FCPF) and implemented by the World Bank (WB), Nepal chosen as one of four countries best suitable for results-based payment system for Reducing Emissions from Deforestation and Forest Degradation (REDD and REDD+) scheme. At the national level Landsat based, from 1990 to 2000 the forest area has declined by 2%, i.e. by 1467 km2, whereas from 2000 to 2010 it has declined only by 0.12% i.e. 176 km2. A cost effective monitoring and evaluation system for REDD+ requires a balanced approach of remote sensing and ground measurements. This paper provides, for Nepal a cost effective and operational 30 m Above Ground Biomass (AGB) estimation and mapping methodology using freely available satellite data integrated with field inventory. Leaf Area Index (LAI) generated based on propose methodology by Ganguly et al. (2012) using Landsat-8 the OLI cloud free images. To generate tree canopy height map, a density scatter graph between the Geoscience Laser Altimeter System (GLAS) on the Ice, Cloud, and Land Elevation Satellite (ICESat) estimated maximum height and Landsat LAI nearest to the center coordinates of the GLAS shots show a moderate but significant exponential correlation (31.211*LAI0.4593, R2= 0.33, RMSE=13.25 m). From the field well distributed circular (750m2 and 500m2), 1124 field plots (0.001% representation of forest cover) measured which were used for estimation AGB (ton/ha) using Sharma et al. (1990) proposed equations for all tree species of Nepal. A satisfactory linear relationship (AGB = 8.7018*Hmax-101.24, R2=0.67, RMSE=7.2 ton/ha) achieved between maximum canopy height (Hmax) and AGB (ton/ha). This cost effective and operational methodology is replicable, over 5-10 years with minimum ground samples through integration of satellite images. Developed AGB used to produce optimum fuel wood scenarios using population and road accessibility datasets.

A normative price for energy from an electricity generation system: An Owner-dependent Methodology for Energy Generation (system) Assessment (OMEGA). Volume 1: Summary

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.; Mcmaster, K. M.

1981-01-01

The utility owned solar electric system methodology is generalized and updated. The net present value of the system is determined by consideration of all financial benefits and costs (including a specified return on investment). Life cycle costs, life cycle revenues, and residual system values are obtained. Break even values of system parameters are estimated by setting the net present value to zero. While the model was designed for photovoltaic generators with a possible thermal energy byproduct, it applicability is not limited to such systems. The resulting owner-dependent methodology for energy generation system assessment consists of a few equations that can be evaluated without the aid of a high-speed computer.

Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

PubMed

Prada, Sergio I

2017-12-01

The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of methodology transparency, which is important, because lack of transparency hinders states from learning from each other. Ultimately, the federal government needs to evaluate and improve its DUR program.

RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME I - INTRODUCTION AND METHODOLOGY

EPA Science Inventory

The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

Cost of epilepsy: a systematic review.

PubMed

Strzelczyk, Adam; Reese, Jens Peter; Dodel, Richard; Hamer, Hajo M

2008-01-01

The objective of this review was to overview published cost-of-illness (COI) studies of epilepsy and their methodological approaches. Epilepsy imposes a substantial burden on individuals and society as a whole. The mean prevalence of epilepsy is estimated at 0.52% in Europe, 0.68% in the US, and peaks up to 1.5% in developing countries. Estimation of the economic burden of epilepsy is of pivotal relevance to enable a rational distribution of healthcare resources. This is especially so with the introduction of the newer antiepileptic drugs (AEDs), the marketing of vagal-nerve stimulators and the resurgence of new surgical treatment options, which have the potential to considerably increase the costs of treating epilepsy.A systematic literature review was performed to identify studies that evaluated direct and indirect costs of epilepsy. Using a standardized assessment form, information on the study design, methodological framework and data sources were extracted from each publication and systematically reported. We identified 22 studies worldwide on costs of epilepsy. The majority of the studies reflected the costs of epilepsy in Europe (three studies each for the UK and Italy, one study each for Germany, the Netherlands, Switzerland, France and the EU) and the US (four studies), but studies were also available from India (two), Hong Kong, Oman, Burundi, Chile and Mexico. The studies utilized different frameworks to evaluate costs. All used a bottom-up approach; however, only 12 studies (55%) evaluated direct as well as indirect costs. The range for the mean annual direct costs lay between 40 International Dollar purchasing power parities (PPP-$) in rural Burundi and PPP-$4748 (adjusted to 2006 values) in a German epilepsy centre. Recent studies suggest AEDs are becoming the main contributor to direct costs. The mean indirect costs ranged between 12% and 85% of the total annual costs. Epilepsy is a cost-intensive disorder. A reliable comparison of the different COI studies in epilepsy is not easily feasible, as the evaluated studies show substantial methodological differences with respect to their patient selection criteria, diagnostic stratifications and evaluated costs. Therefore, there is an urgent need for studies that evaluate direct and indirect costs in a standardized fashion.

Effects of Special Use Airspace on Economic Benefits of Direct Flights

NASA Technical Reports Server (NTRS)

Datta, Koushik; Barrington, Craig; Foster, John D. (Technical Monitor)

1996-01-01

A methodology for estimating the economic effects of Special Use Airspace (SUA) on direct route flights is presented in this paper. The methodology is based on evaluating operating costs of aircraft and analyzing the different ground-track distances traveled by flights under different air traffic scenarios. Using this methodology the following objectives are evaluated: optimistic bias of studies that assume accessible SUAs the maximum economic benefit of dynamic use of SUAs and the marginal economic benefit of the dynamic use of individual SUAs.

A Model for Oil-Gas Pipelines Cost Prediction Based on a Data Mining Process

NASA Astrophysics Data System (ADS)

Batzias, Fragiskos A.; Spanidis, Phillip-Mark P.

2009-08-01

This paper addresses the problems associated with the cost estimation of oil/gas pipelines during the elaboration of feasibility assessments. Techno-economic parameters, i.e., cost, length and diameter, are critical for such studies at the preliminary design stage. A methodology for the development of a cost prediction model based on Data Mining (DM) process is proposed. The design and implementation of a Knowledge Base (KB), maintaining data collected from various disciplines of the pipeline industry, are presented. The formulation of a cost prediction equation is demonstrated by applying multiple regression analysis using data sets extracted from the KB. Following the methodology proposed, a learning context is inductively developed as background pipeline data are acquired, grouped and stored in the KB, and through a linear regression model provide statistically substantial results, useful for project managers or decision makers.

The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs.

PubMed

Eisenhauer, Philipp; Heckman, James J; Vytlacil, Edward

2015-04-01

The literature on treatment effects focuses on gross benefits from program participation. We extend this literature by developing conditions under which it is possible to identify parameters measuring the cost and net surplus from program participation. Using the generalized Roy model, we nonparametrically identify the cost, benefit, and net surplus of selection into treatment without requiring the analyst to have direct information on the cost. We apply our methodology to estimate the gross benefit and net surplus of attending college.

The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs*

PubMed Central

Eisenhauer, Philipp; Heckman, James J.; Vytlacil, Edward

2015-01-01

The literature on treatment effects focuses on gross benefits from program participation. We extend this literature by developing conditions under which it is possible to identify parameters measuring the cost and net surplus from program participation. Using the generalized Roy model, we nonparametrically identify the cost, benefit, and net surplus of selection into treatment without requiring the analyst to have direct information on the cost. We apply our methodology to estimate the gross benefit and net surplus of attending college. PMID:26709315

Automobile Industry Retail Price Equivalent and Indirect Cost ...

EPA Pesticide Factsheets

This report develops a modified multiplier, referred to as an indirect cost (IC) multiplier, which specifically evaluates the components of indirect costs that are likely to be affected by vehicle modifications associated with environmental regulation. A range of IC multipliers are developed that 1) account for differences in the technical complexity of required vehicle modifications and 2) adjust over time as new technologies become assimilated into the automotive production process. To develop an improved methodology for estimating indirect costs of new environmental regulations on automobile manufacturers.

Rapid Cost Assessment of Space Mission Concepts through Application of Complexity Indices

NASA Technical Reports Server (NTRS)

Peterson, Craig; Cutts, James; Balint, Tibor; Hall, James B.

2008-01-01

In 2005, the Solar System Exploration Strategic Roadmap Conmrittee (chartered by NASA to develop the roadmap for Solar System Exploration Missions for the coming decades) found itself posed with the difficult problem of sorting through several mission concepts and determining their relative costs. While detailed mission studies are the normal approach to costing, neither the budget nor schedule allotted to the conmrittee could support such studies. Members of the Jet Propulsion Laboratory (JPL) supporting the conmrittee were given the challenge of developing a semi-quantitative approach that could provide the relative costs of these missions, without requiring an in depth study of the missions. In response to this challenge, a rapid cost assessment methodology based on a set of mission cost/complexity indexes was developed. This methodology also underwent two separate validations, one comparing its results when applied to historical missions, and another comparing its estimates against those of veteran space mission managers. Remarkably good agreement was achieved, suggesting that this approach provides an effective early indication of space mission costs.

Evaluation of solar thermal power plants using economic and performance simulations

NASA Technical Reports Server (NTRS)

El-Gabawali, N.

1980-01-01

An energy cost analysis is presented for central receiver power plants with thermal storage and point focusing power plants with electrical storage. The present approach is based on optimizing the size of the plant to give the minimum energy cost (in mills/kWe hr) of an annual plant energy production. The optimization is done by considering the trade-off between the collector field size and the storage capacity for a given engine size. The energy cost is determined by the plant cost and performance. The performance is estimated by simulating the behavior of the plant under typical weather conditions. Plant capital and operational costs are estimated based on the size and performance of different components. This methodology is translated into computer programs for automatic and consistent evaluation.

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.

Estimation of under-reporting in epidemics using approximations.

PubMed

Gamado, Kokouvi; Streftaris, George; Zachary, Stan

2017-06-01

Under-reporting in epidemics, when it is ignored, leads to under-estimation of the infection rate and therefore of the reproduction number. In the case of stochastic models with temporal data, a usual approach for dealing with such issues is to apply data augmentation techniques through Bayesian methodology. Departing from earlier literature approaches implemented using reversible jump Markov chain Monte Carlo (RJMCMC) techniques, we make use of approximations to obtain faster estimation with simple MCMC. Comparisons among the methods developed here, and with the RJMCMC approach, are carried out and highlight that approximation-based methodology offers useful alternative inference tools for large epidemics, with a good trade-off between time cost and accuracy.

Cost estimate for a proposed GDF Suez LNG testing program

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

Blanchat, Thomas K.; Brady, Patrick Dennis; Jernigan, Dann A.

2014-02-01

At the request of GDF Suez, a Rough Order of Magnitude (ROM) cost estimate was prepared for the design, construction, testing, and data analysis for an experimental series of large-scale (Liquefied Natural Gas) LNG spills on land and water that would result in the largest pool fires and vapor dispersion events ever conducted. Due to the expected cost of this large, multi-year program, the authors utilized Sandia's structured cost estimating methodology. This methodology insures that the efforts identified can be performed for the cost proposed at a plus or minus 30 percent confidence. The scale of the LNG spill, fire,more » and vapor dispersion tests proposed by GDF could produce hazard distances and testing safety issues that need to be fully explored. Based on our evaluations, Sandia can utilize much of our existing fire testing infrastructure for the large fire tests and some small dispersion tests (with some modifications) in Albuquerque, but we propose to develop a new dispersion testing site at our remote test area in Nevada because of the large hazard distances. While this might impact some testing logistics, the safety aspects warrant this approach. In addition, we have included a proposal to study cryogenic liquid spills on water and subsequent vaporization in the presence of waves. Sandia is working with DOE on applications that provide infrastructure pertinent to wave production. We present an approach to conduct repeatable wave/spill interaction testing that could utilize such infrastructure.« less

Allocation of Federal Airport and Airway Costs for FY 1985.

DTIC Science & Technology

1986-12-01

100 GLOSSARY OF FAA TERMS...................107 APPENDIX A RAMSEY PRICING..................1 ’I"P LIST OF TABLES AND FIGURES Title...Methodology .. ....... 26 Figure 2.3.1 Estimation and Allocation of operating Site Costs................28 Table 2.3.2.1 Econometric Results for FAA...Based on Ramsey Pricing ............. 39 Table 2.3.5.1 Allocation of TRACON O&M Costs Based on Ramsey Pricing. ............ 41 Table 2.3.6.1

Improved Methodology for Developing Cost Uncertainty Models for Naval Vessels

DTIC Science & Technology

2009-04-22

Deegan , 2007). Risk cannot be assessed with a point estimate, as it represents a single value that serves as a best guess for the parameter to be...or stakeholders ( Deegan & Fields, 2007). This paper analyzes the current NAVSEA 05C Cruiser (CG(X)) probabilistic cost model including data...provided by Mr. Chris Deegan and his CG(X) analysts. The CG(X) model encompasses all factors considered for cost of the entire program, including

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.

A methodology for estimating health benefits of electricity generation using renewable technologies.

PubMed

Partridge, Ian; Gamkhar, Shama

2012-02-01

At Copenhagen, the developed countries agreed to provide up to $100 bn per year to finance climate change mitigation and adaptation by developing countries. Projects aimed at cutting greenhouse gas (GHG) emissions will need to be evaluated against dual criteria: from the viewpoint of the developed countries they must cut emissions of GHGs at reasonable cost, while host countries will assess their contribution to development, or simply their overall economic benefits. Co-benefits of some types of project will also be of interest to host countries: for example some projects will contribute to reducing air pollution, thus improving the health of the local population. This paper uses a simple damage function methodology to quantify some of the health co-benefits of replacing coal-fired generation with wind or small hydro in China. We estimate the monetary value of these co-benefits and find that it is probably small compared to the added costs. We have not made a full cost-benefit analysis of renewable energy in China as some likely co-benefits are omitted from our calculations. Our results are subject to considerable uncertainty however, after careful consideration of their likely accuracy and comparisons with other studies, we believe that they provide a good first cut estimate of co-benefits and are sufficiently robust to stand as a guide for policy makers. In addition to these empirical results, a key contribution made by the paper is to demonstrate a simple and reasonably accurate methodology for health benefits estimation that applies the most recent academic research in the field to the solution of an increasingly important problem. Copyright © 2011 Elsevier Ltd. All rights reserved.

Benefits estimates of highway capital improvements with uncertain parameters.

DOT National Transportation Integrated Search

2006-01-01

This report warrants consideration in the development of goals, performance measures, and standard cost-benefit methodology required of transportation agencies by the Virginia 2006 Appropriations Act. The Virginia Department of Transportation has beg...

Indicators of Student Flow Rates in Honduras: An Assessment of an Alternative Methodology, with Two Methodologies for Estimating Student Flow Rates. BRIDGES Research Report No. 6.

ERIC Educational Resources Information Center

Cuadra, Ernesto; Crouch, Luis

Student promotion, repetition, and dropout rates constitute the basic data needed to forecast future enrollment and new resources. Information on student flow is significantly related to policy formulation aimed at improving internal efficiency, because dropping out and grade repetition increase per pupil cost, block access to eligible school-age…

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.

Capital cost expenditure of high temperature latent and sensible thermal energy storage systems

NASA Astrophysics Data System (ADS)

Jacob, Rhys; Saman, Wasim; Bruno, Frank

2017-06-01

In the following study cost estimates have been undertaken for an encapsulated phase change material (EPCM) packed bed, a packed bed thermocline and a traditional two-tank molten salt system. The effect of various heat transfer fluids (air and molten salt), system configuration (cascade vs one PCM, and direct vs indirect) and temperature difference (ΔT = 100-500 °C) on the cost estimate of the system was also investigated. Lastly, the storage system boundary was expanded to include heat exchangers, pumps and fans, and heat tracing so that a thorough cost comparison could be undertaken. The results presented in this paper provide a methodology to quickly compare various systems and configurations while providing design limits for the studied technologies.

Integrated cost-effectiveness analysis of agri-environmental measures for water quality.

PubMed

Balana, Bedru B; Jackson-Blake, Leah; Martin-Ortega, Julia; Dunn, Sarah

2015-09-15

This paper presents an application of integrated methodological approach for identifying cost-effective combinations of agri-environmental measures to achieve water quality targets. The methodological approach involves linking hydro-chemical modelling with economic costs of mitigation measures. The utility of the approach was explored for the River Dee catchment in North East Scotland, examining the cost-effectiveness of mitigation measures for nitrogen (N) and phosphorus (P) pollutants. In-stream nitrate concentration was modelled using the STREAM-N and phosphorus using INCA-P model. Both models were first run for baseline conditions and then their effectiveness for changes in land management was simulated. Costs were based on farm income foregone, capital and operational expenditures. The costs and effects data were integrated using 'Risk Solver Platform' optimization in excel to produce the most cost-effective combination of measures by which target nutrient reductions could be attained at a minimum economic cost. The analysis identified different combination of measures as most cost-effective for the two pollutants. An important aspect of this paper is integration of model-based effectiveness estimates with economic cost of measures for cost-effectiveness analysis of land and water management options. The methodological approach developed is not limited to the two pollutants and the selected agri-environmental measures considered in the paper; the approach can be adapted to the cost-effectiveness analysis of any catchment-scale environmental management options. Copyright © 2015 Elsevier Ltd. All rights reserved.

Methodology for cost analysis of film-based and filmless portable chest systems

NASA Astrophysics Data System (ADS)

Melson, David L.; Gauvain, Karen M.; Beardslee, Brian M.; Kraitsik, Michael J.; Burton, Larry; Blaine, G. James; Brink, Gary S.

1996-05-01

Many studies analyzing the costs of film-based and filmless radiology have focused on multi- modality, hospital-wide solutions. Yet due to the enormous cost of converting an entire large radiology department or hospital to a filmless environment all at once, institutions often choose to eliminate film one area at a time. Narrowing the focus of cost-analysis may be useful in making such decisions. This presentation will outline a methodology for analyzing the cost per exam of film-based and filmless solutions for providing portable chest exams to Intensive Care Units (ICUs). The methodology, unlike most in the literature, is based on parallel data collection from existing filmless and film-based ICUs, and is currently being utilized at our institution. Direct costs, taken from the perspective of the hospital, for portable computed radiography chest exams in one filmless and two film-based ICUs are identified. The major cost components are labor, equipment, materials, and storage. Methods for gathering and analyzing each of the cost components are discussed, including FTE-based and time-based labor analysis, incorporation of equipment depreciation, lease, and maintenance costs, and estimation of materials costs. Extrapolation of data from three ICUs to model hypothetical, hospital-wide film-based and filmless ICU imaging systems is described. Performance of sensitivity analysis on the filmless model to assess the impact of anticipated reductions in specific labor, equipment, and archiving costs is detailed. A number of indirect costs, which are not explicitly included in the analysis, are identified and discussed.

Report summary Prevalence and monetary costs of dementia in Canada (2016): a report by the Alzheimer Society of Canada.

PubMed

2016-10-01

Dementia prevalence estimates vary among population-based studies, depending on the definitions of dementia, methodologies and data sources and types of costs they use. A common approach is needed to avoid confusion and increase public and stakeholder confidence in the estimates. Since 1994, five major studies have yielded widely differing estimates of dementia prevalence and monetary costs of dementia in Canada. These studies variously estimated the prevalence of dementia for the year 2011 as low as 340 170 and as high as 747 000. The main reason for this difference was that mild cognitive impairment (MCI) was not consistently included in the projections. The estimated monetary costs of dementia for the same year also varied, from $910 million to $33 billion. This discrepancy is largely due to three factors: (1) the lack of agreed-upon methods for estimating financial costs; (2) the unavailability of prevalence estimates for the various stages of dementia (mild, moderate and severe), which directly affect the amount of money spent; and (3) the absence of tools to measure direct, indirect and intangible costs more accurately. Given the increasing challenges of dementia in Canada and around the globe, reconciling these differences is critical for developing standards to generate reliable information for public consumption and to shape public policy and service development.

Regression to fuzziness method for estimation of remaining useful life in power plant components

NASA Astrophysics Data System (ADS)

Alamaniotis, Miltiadis; Grelle, Austin; Tsoukalas, Lefteri H.

2014-10-01

Mitigation of severe accidents in power plants requires the reliable operation of all systems and the on-time replacement of mechanical components. Therefore, the continuous surveillance of power systems is a crucial concern for the overall safety, cost control, and on-time maintenance of a power plant. In this paper a methodology called regression to fuzziness is presented that estimates the remaining useful life (RUL) of power plant components. The RUL is defined as the difference between the time that a measurement was taken and the estimated failure time of that component. The methodology aims to compensate for a potential lack of historical data by modeling an expert's operational experience and expertise applied to the system. It initially identifies critical degradation parameters and their associated value range. Once completed, the operator's experience is modeled through fuzzy sets which span the entire parameter range. This model is then synergistically used with linear regression and a component's failure point to estimate the RUL. The proposed methodology is tested on estimating the RUL of a turbine (the basic electrical generating component of a power plant) in three different cases. Results demonstrate the benefits of the methodology for components for which operational data is not readily available and emphasize the significance of the selection of fuzzy sets and the effect of knowledge representation on the predicted output. To verify the effectiveness of the methodology, it was benchmarked against the data-based simple linear regression model used for predictions which was shown to perform equal or worse than the presented methodology. Furthermore, methodology comparison highlighted the improvement in estimation offered by the adoption of appropriate of fuzzy sets for parameter representation.

Spatial allocation of market and nonmarket values in wildland fire management: A case study

Treesearch

John W. Benoit; Armando González-Cabán; Francis M. Fujioka; Shyh-Chin Chen; José J. Sanchez

2013-01-01

We developed a methodology to evaluate the efficacy of fuel treatments by estimating their costs and potential costs/losses with and without treatments in the San Jacinto Ranger District of the San Bernardino National Forest, California. This district is a typical southern California forest complex containing a large amount of high-valued real estate. We chose four...

Three Essays in Energy Economics and Industrial Organization, with Applications to Electricity and Distribution Networks

NASA Astrophysics Data System (ADS)

Dimitropoulos, Dimitrios

Electricity industries are experiencing upward cost pressures in many parts of the world. Chapter 1 of this thesis studies the production technology of electricity distributors. Although production and cost functions are mathematical duals, practitioners typically estimate only one or the other. This chapter proposes an approach for joint estimation of production and costs. Combining such quantity and price data has the effect of adding statistical information without introducing additional parameters into the model. We define a GMM estimator that produces internally consistent parameter estimates for both the production function and the cost function. We consider a multi-output framework, and show how to account for the presence of certain types of simultaneity and measurement error. The methodology is applied to data on 73 Ontario distributors for the period 2002-2012. As expected, the joint model results in a substantial improvement in the precision of parameter estimates. Chapter 2 focuses on productivity trends in electricity distribution. We apply two methodologies for estimating productivity growth . an index based approach, and an econometric cost based approach . to our data on the 73 Ontario distributors for the period 2002 to 2012. The resulting productivity growth estimates are approximately 1% per year, suggesting a reversal of the positive estimates that have generally been reported in previous periods. We implement flexible semi-parametric variants to assess the robustness of these conclusions and discuss the use of such statistical analyses for calibrating productivity and relative efficiencies within a price-cap framework. In chapter 3, I turn to the historically important problem of vertical contractual relations. While the existing literature has established that resale price maintenance is sufficient to coordinate the distribution network of a manufacturer, this chapter asks whether such vertical restraints are necessary. Specifically, I study the vertical contracting problem between an upstream manufacturer and its downstream distributors in a setting where spot market contracts fail, but resale price maintenance cannot be appealed to due to legal prohibition. I show that a bonus scheme based on retail revenues is sufficient to provide incentives to decentralized retailers to elicit the correct levels of both price and service.

Three Essays in Energy Economics and Industrial Organization, with Applications to Electricity and Distribution Networks

NASA Astrophysics Data System (ADS)

Dimitropoulos, Dimitrios

Electricity industries are experiencing upward cost pressures in many parts of the world. Chapter 1 of this thesis studies the production technology of electricity distributors. Although production and cost functions are mathematical duals, practitioners typically estimate only one or the other. This chapter proposes an approach for joint estimation of production and costs. Combining such quantity and price data has the effect of adding statistical information without introducing additional parameters into the model. We define a GMM estimator that produces internally consistent parameter estimates for both the production function and the cost function. We consider a multi-output framework, and show how to account for the presence of certain types of simultaneity and measurement error. The methodology is applied to data on 73 Ontario distributors for the period 2002-2012. As expected, the joint model results in a substantial improvement in the precision of parameter estimates. Chapter 2 focuses on productivity trends in electricity distribution. We apply two methodologies for estimating productivity growth---an index based approach, and an econometric cost based approach---to our data on the 73 Ontario distributors for the period 2002 to 2012. The resulting productivity growth estimates are approximately -1% per year, suggesting a reversal of the positive estimates that have generally been reported in previous periods. We implement flexible semi-parametric variants to assess the robustness of these conclusions and discuss the use of such statistical analyses for calibrating productivity and relative efficiencies within a price-cap framework. In chapter 3, I turn to the historically important problem of vertical contractual relations. While the existing literature has established that resale price maintenance is sufficient to coordinate the distribution network of a manufacturer, this chapter asks whether such vertical restraints are necessary. Specifically, I study the vertical contracting problem between an upstream manufacturer and its downstream distributors in a setting where spot market contracts fail, but resale price maintenance cannot be appealed to due to legal prohibition. I show that a bonus scheme based on retail revenues is sufficient to provide incentives to decentralized retailers to elicit the correct levels of both price and service.

Estimating the cost of cervical cancer screening in five developing countries

PubMed Central

Goldhaber-Fiebert, Jeremy D; Goldie, Sue J

2006-01-01

Background Cost-effectiveness analyses (CEAs) can provide useful information to policymakers concerned with the broad allocation of resources as well as to local decision makers choosing between different options for reducing the burden from a single disease. For the latter, it is important to use country-specific data when possible and to represent cost differences between countries that might make one strategy more or less attractive than another strategy locally. As part of a CEA of cervical cancer screening in five developing countries, we supplemented limited primary cost data by developing other estimation techniques for direct medical and non-medical costs associated with alternative screening approaches using one of three initial screening tests: simple visual screening, HPV DNA testing, and cervical cytology. Here, we report estimation methods and results for three cost areas in which data were lacking. Methods To supplement direct medical costs, including staff, supplies, and equipment depreciation using country-specific data, we used alternative techniques to quantify cervical cytology and HPV DNA laboratory sample processing costs. We used a detailed quantity and price approach whose face validity was compared to an adaptation of a US laboratory estimation methodology. This methodology was also used to project annual sample processing capacities for each laboratory type. The cost of sample transport from the clinic to the laboratory was estimated using spatial models. A plausible range of the cost of patient time spent seeking and receiving screening was estimated using only formal sector employment and wages as well as using both formal and informal sector participation and country-specific minimum wages. Data sources included primary data from country-specific studies, international databases, international prices, and expert opinion. Costs were standardized to year 2000 international dollars using inflation adjustment and purchasing power parity. Results Cervical cytology laboratory processing costs were I$1.57–3.37 using the quantity and price method compared to I$1.58–3.02 from the face validation method. HPV DNA processing costs were I$6.07–6.59. Rural laboratory transport costs for cytology were I$0.12–0.64 and I$0.14–0.74 for HPV DNA laboratories. Under assumptions of lower resource efficiency, these estimates increased to I$0.42–0.83 and I$0.54–1.06. Estimates of the value of an hour of patient time using only formal sector participation were I$0.07–4.16, increasing to I$0.30–4.80 when informal and unpaid labor was also included. The value of patient time for traveling, waiting, and attending a screening visit was I$0.68–17.74. With the total cost of screening for cytology and HPV DNA testing ranging from I$4.85–40.54 and I$11.30–48.77 respectively, the cost of the laboratory transport, processing, and patient time accounted for 26–66% and 33–65% of the total costs. From a payer perspective, laboratory transport and processing accounted for 18–48% and 25–60% of total direct medical costs of I$4.11–19.96 and I$10.57–28.18 respectively. Conclusion Cost estimates of laboratory processing, sample transport, and patient time account for a significant proportion of total cervical cancer screening costs in five developing countries and provide important inputs for CEAs of alternative screening modalities. PMID:16887041

Estimating parameters with pre-specified accuracies in distributed parameter systems using optimal experiment design

NASA Astrophysics Data System (ADS)

Potters, M. G.; Bombois, X.; Mansoori, M.; Hof, Paul M. J. Van den

2016-08-01

Estimation of physical parameters in dynamical systems driven by linear partial differential equations is an important problem. In this paper, we introduce the least costly experiment design framework for these systems. It enables parameter estimation with an accuracy that is specified by the experimenter prior to the identification experiment, while at the same time minimising the cost of the experiment. We show how to adapt the classical framework for these systems and take into account scaling and stability issues. We also introduce a progressive subdivision algorithm that further generalises the experiment design framework in the sense that it returns the lowest cost by finding the optimal input signal, and optimal sensor and actuator locations. Our methodology is then applied to a relevant problem in heat transfer studies: estimation of conductivity and diffusivity parameters in front-face experiments. We find good correspondence between numerical and theoretical results.

Accounting for the move to ambulatory patient groups.

PubMed

Boyagian, H R; Dessingue, R F

1998-07-01

This article focuses on the cost accounting challenge an ambulatory patient group (APG)-like-based prospective payment system presents to providers and the issues associated with that challenge. In particular, how can costs be identified, how can the differences in costs be associated with alternative settings, and how do costs identified through a detailed resource costing methodology compare to estimates using alternative measures? The results presented suggest that decisions made based on current measures of ambulatory cost (i.e., charge-based measures) need to be reexamined. These decisions could include which services to provide, what setting is appropriate, and where marketshare opportunities exist.

Market frictions: A unified model of search costs and switching costs

PubMed Central

Wilson, Chris M.

2012-01-01

It is well known that search costs and switching costs can create market power by constraining the ability of consumers to change suppliers. While previous research has examined each cost in isolation, this paper demonstrates the benefits of examining the two types of friction in unison. The paper shows how subtle distinctions between the two costs can provide important differences in their effects upon consumer behaviour, competition and welfare. In addition, the paper also illustrates a simple empirical methodology for estimating separate measures of both costs, while demonstrating a potential bias that can arise if only one cost is considered. PMID:25550674

The costs of nurse turnover: part 1: an economic perspective.

PubMed

Jones, Cheryl Bland

2004-12-01

Nurse turnover is costly for healthcare organizations. Administrators and nurse executives need a reliable estimate of nurse turnover costs and the origins of those costs if they are to develop effective measures of reducing nurse turnover and its costs. However, determining how to best capture and quantify nurse turnover costs can be challenging. Part 1 of this series conceptualizes nurse turnover via human capital theory and presents an update of a previously developed method for determining the costs of nurse turnover, the Nursing Turnover Cost Calculation Method. Part 2 (January 2005) presents a recent application of the methodology in an acute care hospital.

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

Estimating the opportunity costs of bed‐days

PubMed Central

Robotham, Julie V.; Deeny, Sarah R.; Edmunds, W. John; Jit, Mark

2017-01-01

Abstract Opportunity costs of bed‐days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second‐best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed‐days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed‐days in terms of health forgone for the second‐best patient, but expressed monetarily. This alternative approach effectively re‐connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed‐days. PMID:29105894

Step-by-step guideline for disease-specific costing studies in low- and middle-income countries: a mixed methodology

PubMed Central

Hendriks, Marleen E.; Kundu, Piyali; Boers, Alexander C.; Bolarinwa, Oladimeji A.; te Pas, Mark J.; Akande, Tanimola M.; Agbede, Kayode; Gomez, Gabriella B.; Redekop, William K.; Schultsz, Constance; Tan, Siok Swan

2014-01-01

Background Disease-specific costing studies can be used as input into cost-effectiveness analyses and provide important information for efficient resource allocation. However, limited data availability and limited expertise constrain such studies in low- and middle-income countries (LMICs). Objective To describe a step-by-step guideline for conducting disease-specific costing studies in LMICs where data availability is limited and to illustrate how the guideline was applied in a costing study of cardiovascular disease prevention care in rural Nigeria. Design The step-by-step guideline provides practical recommendations on methods and data requirements for six sequential steps: 1) definition of the study perspective, 2) characterization of the unit of analysis, 3) identification of cost items, 4) measurement of cost items, 5) valuation of cost items, and 6) uncertainty analyses. Results We discuss the necessary tradeoffs between the accuracy of estimates and data availability constraints at each step and illustrate how a mixed methodology of accurate bottom-up micro-costing and more feasible approaches can be used to make optimal use of all available data. An illustrative example from Nigeria is provided. Conclusions An innovative, user-friendly guideline for disease-specific costing in LMICs is presented, using a mixed methodology to account for limited data availability. The illustrative example showed that the step-by-step guideline can be used by healthcare professionals in LMICs to conduct feasible and accurate disease-specific cost analyses. PMID:24685170

Airport Capacity Investment Handbook

DOT National Transportation Integrated Search

1978-12-01

This handbook provides a methodology for estimating the benefits and costs of capacity-related investments in airports in the United States. The procedures are laid out in a series of worksheets. The user provides certain basic information such as ex...

[Cost at the first level of care].

PubMed

Villarreal-Ríos, E; Montalvo-Almaguer, G; Salinas-Martínez, M; Guzmán-Padilla, J E; Tovar-Castillo, N H; Garza-Elizondo, M E

1996-01-01

To estimate the unit cost of 15 causes of demand for primary care per health clinic in an institutional (social security) health care system, and to determine the average cost at the state level. The cost of 80% of clinic visits was estimated in 35 of 40 clinics in the social security health care system in the state of Nuevo Leon, Mexico. The methodology for fixed costs consisted of: departmentalization, inputs, cost, weights and construction of matrices. Variable costs were estimated for standard patients by type of health care sought and with the consensus of experts; the sum of fixed and variable costs gave the unit cost. A computerized model was employed for data processing. A large variation in unit cost was observed between health clinics studied for all causes of demand, in both metropolitan and non-metropolitan areas. Prenatal care ($92.26) and diarrhea ($93.76) were the least expensive while diabetes ($240.42) and hypertension ($312.54) were the most expensive. Non-metropolitan costs were higher than metropolitan costs (p < 0.05); controlling for number of physician's offices showed that this was determined by medical units with only one physician's office. Knowledge of unit costs is a tool that, when used by medical administrators, allows adequate health care planning and efficient allocation of health resources.

CRUSER News. Issue 23, January 2013

DTIC Science & Technology

2013-01-01

Ricardo Martins, José Pinto, Laboratório de Sistemas e Tecnologias Subaquáticas, Engineering Faculty, Porto University Portugal has one of the largest...Total Ownership Cost ( TOC ) by Dr. Dan Nussbaum, Professor in the Operations Research Dept at NPS, danussba@nps.edu According to the methodology section of...paradigm shift in UAV cost estimation The purpose in this part of the project is to provide a TOC that reflects the end-to-end costs associated with ISR

Analyzing the requirements for mass production of small wind turbine generators

NASA Astrophysics Data System (ADS)

Anuskiewicz, T.; Asmussen, J.; Frankenfield, O.

Mass producibility of small wind turbine generators to give manufacturers design and cost data for profitable production operations is discussed. A 15 kW wind turbine generator for production in annual volumes from 1,000 to 50,000 units is discussed. Methodology to cost the systems effectively is explained. The process estimate sequence followed is outlined with emphasis on the process estimate sheets compiled for each component and subsystem. These data enabled analysts to develop cost breakdown profiles crucial in manufacturing decision-making. The appraisal also led to various design recommendations including replacement of aluminum towers with cost effective carbon steel towers. Extensive cost information is supplied in tables covering subassemblies, capital requirements, and levelized energy costs. The physical layout of the plant is depicted to guide manufacturers in taking advantage of the growing business opportunity now offered in conjunction with the national need for energy development.

Costs and cost-effectiveness of periviable care.

PubMed

Caughey, Aaron B; Burchfield, David J

2014-02-01

With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

The determination of operational and support requirements and costs during the conceptual design of space systems

NASA Technical Reports Server (NTRS)

Ebeling, Charles; Beasley, Kenneth D.

1992-01-01

The first year of research to provide NASA support in predicting operational and support parameters and costs of proposed space systems is reported. Some of the specific research objectives were (1) to develop a methodology for deriving reliability and maintainability parameters and, based upon their estimates, determine the operational capability and support costs, and (2) to identify data sources and establish an initial data base to implement the methodology. Implementation of the methodology is accomplished through the development of a comprehensive computer model. While the model appears to work reasonably well when applied to aircraft systems, it was not accurate when used for space systems. The model is dynamic and should be updated as new data become available. It is particularly important to integrate the current aircraft data base with data obtained from the Space Shuttle and other space systems since subsystems unique to a space vehicle require data not available from aircraft. This research only addressed the major subsystems on the vehicle.

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.

Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association.

PubMed

Heidenreich, Paul A; Albert, Nancy M; Allen, Larry A; Bluemke, David A; Butler, Javed; Fonarow, Gregg C; Ikonomidis, John S; Khavjou, Olga; Konstam, Marvin A; Maddox, Thomas M; Nichol, Graham; Pham, Michael; Piña, Ileana L; Trogdon, Justin G

2013-05-01

Heart failure (HF) is an important contributor to both the burden and cost of national healthcare expenditures, with more older Americans hospitalized for HF than for any other medical condition. With the aging of the population, the impact of HF is expected to increase substantially. We estimated future costs of HF by adapting a methodology developed by the American Heart Association to project the epidemiology and future costs of HF from 2012 to 2030 without double counting the costs attributed to comorbid conditions. The model assumes that HF prevalence will remain constant by age, sex, and race/ethnicity and that rising costs and technological innovation will continue at the same rate. By 2030, >8 million people in the United States (1 in every 33) will have HF. Between 2012 and 2030, real (2010$) total direct medical costs of HF are projected to increase from $21 billion to $53 billion. Total costs, including indirect costs for HF, are estimated to increase from $31 billion in 2012 to $70 billion in 2030. If one assumes all costs of cardiac care for HF patients are attributable to HF (no cost attribution to comorbid conditions), the 2030 projected cost estimates of treating patients with HF will be 3-fold higher ($160 billion in direct costs). The estimated prevalence and cost of care for HF will increase markedly because of aging of the population. Strategies to prevent HF and improve the efficiency of care are needed.

Forecasting the Impact of Heart Failure in the United States

PubMed Central

Heidenreich, Paul A.; Albert, Nancy M.; Allen, Larry A.; Bluemke, David A.; Butler, Javed; Fonarow, Gregg C.; Ikonomidis, John S.; Khavjou, Olga; Konstam, Marvin A.; Maddox, Thomas M.; Nichol, Graham; Pham, Michael; Piña, Ileana L.; Trogdon, Justin G.

2013-01-01

Background Heart failure (HF) is an important contributor to both the burden and cost of national healthcare expenditures, with more older Americans hospitalized for HF than for any other medical condition. With the aging of the population, the impact of HF is expected to increase substantially. Methods and Results We estimated future costs of HF by adapting a methodology developed by the American Heart Association to project the epidemiology and future costs of HF from 2012 to 2030 without double counting the costs attributed to comorbid conditions. The model assumes that HF prevalence will remain constant by age, sex, and race/ethnicity and that rising costs and technological innovation will continue at the same rate. By 2030, >8 million people in the United States (1 in every 33) will have HF. Between 2012 and 2030, real (2010$) total direct medical costs of HF are projected to increase from $21 billion to $53 billion. Total costs, including indirect costs for HF, are estimated to increase from $31 billion in 2012 to $70 billion in 2030. If one assumes all costs of cardiac care for HF patients are attributable to HF (no cost attribution to comorbid conditions), the 2030 projected cost estimates of treating patients with HF will be 3-fold higher ($160 billion in direct costs). Conclusions The estimated prevalence and cost of care for HF will increase markedly because of aging of the population. Strategies to prevent HF and improve the efficiency of care are needed. PMID:23616602

Which cost of alcohol? What should we compare it against?

PubMed

Bhattacharya, Aveek

2017-04-01

This paper explores and develops issues raised by recent debates about the cost of alcohol to England and Wales. It advances two arguments. First, that the commonly used estimates for alcohol harm in England and Wales are outdated, not fully reliable and in need of revisiting. These estimates rely on data that are between 4 and 12 years out of date and sensitive to questionable assumptions and methodological judgements. Secondly, it argues that policymakers, academics and non-governmental organizations should be more careful in their use of these numbers. In particular, it is imperative that the numbers quoted fit the argument advanced. To help guide such appropriate usage, the different types of cost of alcohol are surveyed, alongside some thoughts on the questions they help us to answer and what they imply for policy. For example, comprehensive estimates of the total social cost of alcohol provide an indication of the scale of the problem, but have limited policy relevance. External cost estimates represent a 'lowest common denominator' approach acceptable to most, but require additional assumptions to guide action. Narrower perspectives, such as fiscal, economic or health costs, may be relevant in specific contexts. However, optimal policy should take a holistic view of all the relevant costs and benefits. Similarly, focusing solely on tangible costs may be less controversial, but will result in an under-estimate of the relevant costs of alcohol. © 2016 Society for the Study of Addiction.

Overview of causes and costs of injuries in Massachusetts: a methodology for analysis of state data.

PubMed Central

Schuster, M; Cohen, B B; Rodgers, C G; Walker, D K; Friedman, D J; Ozonoff, V V

1995-01-01

Massachusetts has developed the first State profile of the causes and costs of injury based on the national study, "Cost of Injury in the United States: A Report to Congress." Incidence of fatal injuries is based on Massachusetts data; nonfatal hospitalized injuries, on Massachusetts age and sex rates and U.S. cause data; and nonhospitalized injuries, on U.S. rates applied to Massachusetts census data. Lifetime costs per injured person are based on national data adjusted for higher personal health care expenditures and for higher mean annual earnings in Massachusetts. The estimated total lifetime cost for the 1.4 million injuries that occurred in 1989 is $4.4 billion--$1.7 billion for health care and $2.7 billion for lost earnings. Injuries attributed to motor vehicles and falls account for more than half of the total cost. The other cause categories are poisonings, fire-burns, firearms, drowings-near drownings, and other. For every person who dies from an injury, 17 people are hospitalized, and an estimated 535 people require outpatient treatment, consultation, or restricted activity. Development of a State-based cost report can be useful in monitoring the contribution of injuries to health status and in planning effective injury prevention strategies in a community-based health care system. The methodology described in this paper can be replicated by other States through accessing their State-specific mortality and hospital discharge data bases. PMID:7610211

Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies

PubMed Central

Prada, Sergio I.

2017-01-01

Background The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug–drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. Objectives To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. Method For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. Discussion In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. Conclusion There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of methodology transparency, which is important, because lack of transparency hinders states from learning from each other. Ultimately, the federal government needs to evaluate and improve its DUR program. PMID:29403573

Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

PubMed Central

2010-01-01

Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage. PMID:20236531

Estimate of potential benefit for Europe of fitting Autonomous Emergency Braking (AEB) systems for pedestrian protection to passenger cars.

PubMed

Edwards, Mervyn; Nathanson, Andrew; Wisch, Marcus

2014-01-01

The objective of the current study was to estimate the benefit for Europe of fitting precrash braking systems to cars that detect pedestrians and autonomously brake the car to prevent or lower the speed of the impact with the pedestrian. The analysis was divided into 2 main parts: (1) Develop and apply methodology to estimate benefit for Great Britain and Germany; (2) scale Great Britain and German results to give an indicative estimate for Europe (EU27). The calculation methodology developed to estimate the benefit was based on 2 main steps: 1. Calculate the change in the impact speed distribution curve for pedestrian casualties hit by the fronts of cars assuming pedestrian autonomous emergency braking (AEB) system fitment. 2. From this, calculate the change in the number of fatally, seriously, and slightly injured casualties by using the relationship between risk of injury and the casualty impact speed distribution to sum the resulting risks for each individual casualty. The methodology was applied to Great Britain and German data for 3 types of pedestrian AEB systems representative of (1) currently available systems; (2) future systems with improved performance, which are expected to be available in the next 2-3 years; and (3) reference limit system, which has the best performance currently thought to be technically feasible. Nominal benefits estimated for Great Britain ranged from £119 million to £385 million annually and for Germany from €63 million to €216 million annually depending on the type of AEB system assumed fitted. Sensitivity calculations showed that the benefit estimated could vary from about half to twice the nominal estimate, depending on factors such as whether or not the system would function at night and the road friction assumed. Based on scaling of estimates made for Great Britain and Germany, the nominal benefit of implementing pedestrian AEB systems on all cars in Europe was estimated to range from about €1 billion per year for current generation AEB systems to about €3.5 billion for a reference limit system (i.e., best performance thought technically feasible at present). Dividing these values by the number of new passenger cars registered in Europe per year gives an indication that the cost of a system per car should be less than ∼€80 to ∼€280 for it to be cost effective. The potential benefit of fitting AEB systems to cars in Europe for pedestrian protection has been estimated and the results interpreted to indicate the upper limit of cost for a system to allow it to be cost effective.

[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.

A performance-oriented power transformer design methodology using multi-objective evolutionary optimization

PubMed Central

Adly, Amr A.; Abd-El-Hafiz, Salwa K.

2014-01-01

Transformers are regarded as crucial components in power systems. Due to market globalization, power transformer manufacturers are facing an increasingly competitive environment that mandates the adoption of design strategies yielding better performance at lower costs. In this paper, a power transformer design methodology using multi-objective evolutionary optimization is proposed. Using this methodology, which is tailored to be target performance design-oriented, quick rough estimation of transformer design specifics may be inferred. Testing of the suggested approach revealed significant qualitative and quantitative match with measured design and performance values. Details of the proposed methodology as well as sample design results are reported in the paper. PMID:26257939

A performance-oriented power transformer design methodology using multi-objective evolutionary optimization.

PubMed

Adly, Amr A; Abd-El-Hafiz, Salwa K

2015-05-01

Transformers are regarded as crucial components in power systems. Due to market globalization, power transformer manufacturers are facing an increasingly competitive environment that mandates the adoption of design strategies yielding better performance at lower costs. In this paper, a power transformer design methodology using multi-objective evolutionary optimization is proposed. Using this methodology, which is tailored to be target performance design-oriented, quick rough estimation of transformer design specifics may be inferred. Testing of the suggested approach revealed significant qualitative and quantitative match with measured design and performance values. Details of the proposed methodology as well as sample design results are reported in the paper.

Different approaches to valuing the lost productivity of patients with migraine.

PubMed

Lofland, J H; Locklear, J C; Frick, K D

2001-01-01

To calculate and compare the human capital approach (HCA) and friction cost approach (FCA) methods for estimating the cost of lost productivity of migraineurs after the initiation of sumatriptan from a US societal perspective. Secondary, retrospective analysis to a prospective observational study. A mixed-model managed care organisation in western Pennsylvania, USA. Patients with migraine using sumatriptan therapy. Patient-reported questionnaires collected at baseline, 3 and 6 months after initiation of sumatriptan therapy. The cost of lost productivity estimated with the HCA and FCA methods. Of the 178 patients who completed the study, 51% were full-time employees, 13% were part-time, 18% were not working and 17% changed work status. Twenty-four percent reported a clerical or administrative position. From the HCA, the estimated total cost of lost productivity for 6 months following the initiation of sumatriptan was $US117905 (1996 values). From the FCA, the six-month estimated total cost of lost productivity ranged from $US28329 to $US117905 (1996 values). This was the first study to retrospectively estimate lost productivity of patients with migraine using the FCA methodology. Our results demonstrate that depending on the assumptions and illustrations employed, the FCA can yield lost productivity estimates that vary greatly as a percentage of the HCA estimate. Prospective investigations are needed to better determine the components and the nature of the lost productivity for chronic episodic diseases such as migraine headache.

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

PubMed

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

2013-03-01

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

Global Impact Estimation of ISO 50001 Energy Management System for Industrial and Service Sectors

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

Aghajanzadeh, Arian; Therkelsen, Peter L.; Rao, Prakash

A methodology has been developed to determine the impacts of ISO 50001 Energy Management System (EnMS) at a region or country level. The impacts of ISO 50001 EnMS include energy, CO2 emissions, and cost savings. This internationally recognized and transparent methodology has been embodied in a user friendly Microsoft Excel® based tool called ISO 50001 Impact Estimator Tool (IET 50001). However, the tool inputs are critical in order to get accurate and defensible results. This report is intended to document the data sources used and assumptions made to calculate the global impact of ISO 50001 EnMS.

Analysis of travel-time reliability for freight corridors connecting the Pacific Northwest.

DOT National Transportation Integrated Search

2012-11-01

A new methodology and algorithms were developed to combine diverse data sources and to estimate the impacts of recurrent and non-recurrent : congestion on freight movements reliability and delays, costs, and emissions. The results suggest that tra...

Cost-benefit analysis in occupational health: a comparison of intervention scenarios for occupational asthma and rhinitis among bakery workers.

PubMed

Meijster, Tim; van Duuren-Stuurman, Birgit; Heederik, Dick; Houba, Remko; Koningsveld, Ernst; Warren, Nicholas; Tielemans, Erik

2011-10-01

Use of cost-benefit analysis in occupational health increases insight into the intervention strategy that maximises the cost-benefit ratio. This study presents a methodological framework identifying the most important elements of a cost-benefit analysis for occupational health settings. One of the main aims of the methodology is to evaluate cost-benefit ratios for different stakeholders (employers, employees and society). The developed methodology was applied to two intervention strategies focused on reducing respiratory diseases. A cost-benefit framework was developed and used to set up a calculation spreadsheet containing the inputs and algorithms required to calculate the costs and benefits for all cost elements. Inputs from a large variety of sources were used to calculate total costs, total benefits, net costs and the benefit-to-costs ratio for both intervention scenarios. Implementation of a covenant intervention program resulted in a net benefit of €16 848 546 over 20 years for a population of 10 000 workers. Implementation was cost-effective for all stakeholders. For a health surveillance scenario, total benefits resulting from a decreased disease burden were estimated to be €44 659 352. The costs of the interventions could not be calculated. This study provides important insights for developing effective intervention strategies in the field of occupational medicine. Use of a model based approach enables investigation of those parameters most likely to impact on the effectiveness and costs of interventions for work related diseases. Our case study highlights the importance of considering different perspectives (of employers, society and employees) in assessing and sharing the costs and benefits of interventions.

Global Economic Impact of Dental Diseases.

PubMed

Listl, S; Galloway, J; Mossey, P A; Marcenes, W

2015-10-01

Reporting the economic burden of oral diseases is important to evaluate the societal relevance of preventing and addressing oral diseases. In addition to treatment costs, there are indirect costs to consider, mainly in terms of productivity losses due to absenteeism from work. The purpose of the present study was to estimate the direct and indirect costs of dental diseases worldwide to approximate the global economic impact. Estimation of direct treatment costs was based on a systematic approach. For estimation of indirect costs, an approach suggested by the World Health Organization's Commission on Macroeconomics and Health was employed, which factored in 2010 values of gross domestic product per capita as provided by the International Monetary Fund and oral burden of disease estimates from the 2010 Global Burden of Disease Study. Direct treatment costs due to dental diseases worldwide were estimated at US$298 billion yearly, corresponding to an average of 4.6% of global health expenditure. Indirect costs due to dental diseases worldwide amounted to US$144 billion yearly, corresponding to economic losses within the range of the 10 most frequent global causes of death. Within the limitations of currently available data sources and methodologies, these findings suggest that the global economic impact of dental diseases amounted to US$442 billion in 2010. Improvements in population oral health may imply substantial economic benefits not only in terms of reduced treatment costs but also because of fewer productivity losses in the labor market. © International & American Associations for Dental Research 2015.

Is herpes zoster vaccination likely to be cost-effective in Canada?

PubMed

Peden, Alexander D; Strobel, Stephenson B; Forget, Evelyn L

2014-05-30

To synthesize the current literature detailing the cost-effectiveness of the herpes zoster (HZ) vaccine, and to provide Canadian policy-makers with cost-effectiveness measurements in a Canadian context. This article builds on an existing systematic review of the HZ vaccine that offers a quality assessment of 11 recent articles. We first replicated this study, and then two assessors reviewed the articles and extracted information on vaccine effectiveness, cost of HZ, other modelling assumptions and QALY estimates. Then we transformed the results into a format useful for Canadian policy decisions. Results expressed in different currencies from different years were converted into 2012 Canadian dollars using Bank of Canada exchange rates and a Consumer Price Index deflator. Modelling assumptions that varied between studies were synthesized. We tabled the results for comparability. The Szucs systematic review presented a thorough methodological assessment of the relevant literature. However, the various studies presented results in a variety of currencies, and based their analyses on disparate methodological assumptions. Most of the current literature uses Markov chain models to estimate HZ prevalence. Cost assumptions, discount rate assumptions, assumptions about vaccine efficacy and waning and epidemiological assumptions drove variation in the outcomes. This article transforms the results into a table easily understood by policy-makers. The majority of the current literature shows that HZ vaccination is cost-effective at the price of $100,000 per QALY. Few studies showed that vaccination cost-effectiveness was higher than this threshold, and only under conservative assumptions. Cost-effectiveness was sensitive to vaccine price and discount rate.

Micro-costing studies in the health and medical literature: protocol for a systematic review

PubMed Central

2014-01-01

Background Micro-costing is a cost estimation method that allows for precise assessment of the economic costs of health interventions. It has been demonstrated to be particularly useful for estimating the costs of new interventions, for interventions with large variability across providers, and for estimating the true costs to the health system and to society. However, existing guidelines for economic evaluations do not provide sufficient detail of the methods and techniques to use when conducting micro-costing analyses. Therefore, the purpose of this study is to review the current literature on micro-costing studies of health and medical interventions, strategies, and programs to assess the variation in micro-costing methodology and the quality of existing studies. This will inform current practice in conducting and reporting micro-costing studies and lead to greater standardization in methodology in the future. Methods/Design We will perform a systematic review of the current literature on micro-costing studies of health and medical interventions, strategies, and programs. Using rigorously designed search strategies, we will search Ovid MEDLINE, EconLit, BIOSIS Previews, Embase, Scopus, and the National Health Service Economic Evaluation Database (NHS EED) to identify relevant English-language articles. These searches will be supplemented by a review of the references of relevant articles identified. Two members of the review team will independently extract detailed information on the design and characteristics of each included article using a standardized data collection form. A third reviewer will be consulted to resolve discrepancies. We will use checklists that have been developed for critical appraisal of health economics studies to evaluate the quality and potential risk of bias of included studies. Discussion This systematic review will provide useful information to help standardize the methods and techniques for conducting and reporting micro-costing studies in research, which can improve the quality and transparency of future studies and enhance comparability and interpretation of findings. In the long run, these efforts will facilitate clinical and health policy decision-making about resource allocation. Trial registration Systematic review registration: PROSPERO CRD42014007453. PMID:24887208

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

Quantifying tobacco related health care expenditures in the Republic of the Marshall Islands: a case study in determining health costs in a developing US associated island nation.

PubMed

Palafox, N A; Ou, A C; Haberle, H; Chen, T H

2001-01-01

This case study examines the advantages, disadvantages, and utility of three research methods to measure the medical costs of tobacco use in the Republic of the Marshall Islands (RMI). The authors used the morbidity-based models, models based on the difference in utilization of medical facilities between smokers and non-smokers, and models of inter-country comparisons. In the RMI, morbidity models would have a propensity to grossly under-estimate the medical costs of tobacco use. Models that measure the difference in medical service utilization between smokers and non-smokers can be confounded by cultural factors and by the level of health care that is provided. The RMI population structure affected the sampling methods. The external validity of the survey instrument may be increased through measuring more parameters with greater precision. Inter-country comparisons may be used to approximate and set upper and lower limits of costs for past medical costs, and may be the only method to determine future health care costs from tobacco use. Determining medical costs of tobacco use in an US Associated island nation with an under-developed health care infrastructure has not been previously attempted. There were significant methodological challenges that were encountered. Health, economic, cultural, and research environments in the RMI are unique and require innovative methods to determine medical costs associated with tobacco use. Direct application of the methodologies utilized in the United States to determine medical costs of tobacco use may grossly under-estimate the medical cost of tobacco use in the RMI. The research challenges can be addressed.

Life sciences payload definition and integration study. Volume 4: Appendix, costs, and data management requirements of the dedicated 30-day laboratory. [carry-on laboratory for Spacelab

NASA Technical Reports Server (NTRS)

1974-01-01

The results of the updated 30-day life sciences dedicated laboratory scheduling and costing activities are documented, and the 'low cost' methodology used to establish individual equipment item costs is explained in terms of its allowances for equipment that is commerical off-the-shelf, modified commercial, and laboratory prototype; a method which significantly lowers program costs. The costs generated include estimates for non-recurring development, recurring production, and recurring operations costs. A cost for a biomedical emphasis laboratory and a Delta cost to provide a bioscience and technology laboratory were also generated. All cost reported are commensurate with the design and schedule definitions available.

Landslide Risk: Economic Valuation in The North-Eastern Zone of Medellin City

NASA Astrophysics Data System (ADS)

Vega, Johnny Alexander; Hidalgo, César Augusto; Johana Marín, Nini

2017-10-01

Natural disasters of a geodynamic nature can cause enormous economic and human losses. The economic costs of a landslide disaster include relocation of communities and physical repair of urban infrastructure. However, when performing a quantitative risk analysis, generally, the indirect economic consequences of such an event are not taken into account. A probabilistic approach methodology that considers several scenarios of hazard and vulnerability to measure the magnitude of the landslide and to quantify the economic costs is proposed. With this approach, it is possible to carry out a quantitative evaluation of the risk by landslides, allowing the calculation of the economic losses before a potential disaster in an objective, standardized and reproducible way, taking into account the uncertainty of the building costs in the study zone. The possibility of comparing different scenarios facilitates the urban planning process, the optimization of interventions to reduce risk to acceptable levels and an assessment of economic losses according to the magnitude of the damage. For the development and explanation of the proposed methodology, a simple case study is presented, located in north-eastern zone of the city of Medellín. This area has particular geomorphological characteristics, and it is also characterized by the presence of several buildings in bad structural conditions. The proposed methodology permits to obtain an estimative of the probable economic losses by earthquake-induced landslides, taking into account the uncertainty of the building costs in the study zone. The obtained estimative shows that the structural intervention of the buildings produces a reduction the order of 21 % in the total landslide risk.

Advanced Machine Learning Emulators of Radiative Transfer Models

NASA Astrophysics Data System (ADS)

Camps-Valls, G.; Verrelst, J.; Martino, L.; Vicent, J.

2017-12-01

Physically-based model inversion methodologies are based on physical laws and established cause-effect relationships. A plethora of remote sensing applications rely on the physical inversion of a Radiative Transfer Model (RTM), which lead to physically meaningful bio-geo-physical parameter estimates. The process is however computationally expensive, needs expert knowledge for both the selection of the RTM, its parametrization and the the look-up table generation, as well as its inversion. Mimicking complex codes with statistical nonlinear machine learning algorithms has become the natural alternative very recently. Emulators are statistical constructs able to approximate the RTM, although at a fraction of the computational cost, providing an estimation of uncertainty, and estimations of the gradient or finite integral forms. We review the field and recent advances of emulation of RTMs with machine learning models. We posit Gaussian processes (GPs) as the proper framework to tackle the problem. Furthermore, we introduce an automatic methodology to construct emulators for costly RTMs. The Automatic Gaussian Process Emulator (AGAPE) methodology combines the interpolation capabilities of GPs with the accurate design of an acquisition function that favours sampling in low density regions and flatness of the interpolation function. We illustrate the good capabilities of our emulators in toy examples, leaf and canopy levels PROSPECT and PROSAIL RTMs, and for the construction of an optimal look-up-table for atmospheric correction based on MODTRAN5.

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.

Estimating the opportunity costs of bed-days.

PubMed

Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark

2018-03-01

Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.

Estimation of the diagnostic threshold accounting for decision costs and sampling uncertainty.

PubMed

Skaltsa, Konstantina; Jover, Lluís; Carrasco, Josep Lluís

2010-10-01

Medical diagnostic tests are used to classify subjects as non-diseased or diseased. The classification rule usually consists of classifying subjects using the values of a continuous marker that is dichotomised by means of a threshold. Here, the optimum threshold estimate is found by minimising a cost function that accounts for both decision costs and sampling uncertainty. The cost function is optimised either analytically in a normal distribution setting or empirically in a free-distribution setting when the underlying probability distributions of diseased and non-diseased subjects are unknown. Inference of the threshold estimates is based on approximate analytically standard errors and bootstrap-based approaches. The performance of the proposed methodology is assessed by means of a simulation study, and the sample size required for a given confidence interval precision and sample size ratio is also calculated. Finally, a case example based on previously published data concerning the diagnosis of Alzheimer's patients is provided in order to illustrate the procedure.

Comparative Lifecycle Energy Analysis: Theory and Practice.

ERIC Educational Resources Information Center

Morris, Jeffrey; Canzoneri, Diana

1992-01-01

Explores the position that more energy is conserved through recycling secondary materials than is generated from municipal solid waste incineration. Discusses one component of a lifecycle analysis--a comparison of energy requirements for manufacturing competing products. Includes methodological issues, energy cost estimates, and difficulties…

The cost of pressure ulcers in the United Kingdom.

PubMed

Dealey, C; Posnett, J; Walker, A

2012-06-01

To provide an estimate of the costs of treating pressure ulcers in the UK at August 2011 prices, as a means of highlighting the importance of pressure ulcer prevention. Resource use was derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice, with prices reflecting costs to the health and social care system in the UK. This approach was used to estimate treatment costs per episode of care and per patient for ulcers of different severity and level of complications. The cost of treating a pressure ulcer varies from £1,214 (category 1) to £14,108 (category IV). Costs increase with ulcer severity because the time to heal is longer and the incidence of complications is higher in more severe cases. Pressure ulcers represent a significant cost burden in the UK, both to patients and to health-care providers. Without concerted effort, this cost is likely to increase in the future as the population ages. The estimates reported here provide a basis for assessment of the cost-effectiveness of measures to reduce the incidence of hospital-acquired ulcers. Heron Evidence Development Ltd. was funded for this work by Mölnlycke Health Care (UK). The authors have no other conflicts of interest to declare.

A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations.

PubMed

Achana, Felix; Petrou, Stavros; Khan, Kamran; Gaye, Amadou; Modi, Neena

2018-01-01

A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.

A Study about Kalman Filters Applied to Embedded Sensors

PubMed Central

Valade, Aurélien; Acco, Pascal; Grabolosa, Pierre; Fourniols, Jean-Yves

2017-01-01

Over the last decade, smart sensors have grown in complexity and can now handle multiple measurement sources. This work establishes a methodology to achieve better estimates of physical values by processing raw measurements within a sensor using multi-physical models and Kalman filters for data fusion. A driving constraint being production cost and power consumption, this methodology focuses on algorithmic complexity while meeting real-time constraints and improving both precision and reliability despite low power processors limitations. Consequently, processing time available for other tasks is maximized. The known problem of estimating a 2D orientation using an inertial measurement unit with automatic gyroscope bias compensation will be used to illustrate the proposed methodology applied to a low power STM32L053 microcontroller. This application shows promising results with a processing time of 1.18 ms at 32 MHz with a 3.8% CPU usage due to the computation at a 26 Hz measurement and estimation rate. PMID:29206187

An Estimation of Private Household Costs to Receive Free Oral Cholera Vaccine in Odisha, India.

PubMed

Mogasale, Vittal; Kar, Shantanu K; Kim, Jong-Hoon; Mogasale, Vijayalaxmi V; Kerketta, Anna S; Patnaik, Bikash; Rath, Shyam Bandhu; Puri, Mahesh K; You, Young Ae; Khuntia, Hemant K; Maskery, Brian; Wierzba, Thomas F; Sah, Binod

2015-01-01

Service provider costs for vaccine delivery have been well documented; however, vaccine recipients' costs have drawn less attention. This research explores the private household out-of-pocket and opportunity costs incurred to receive free oral cholera vaccine during a mass vaccination campaign in rural Odisha, India. Following a government-driven oral cholera mass vaccination campaign targeting population over one year of age, a questionnaire-based cross-sectional survey was conducted to estimate private household costs among vaccine recipients. The questionnaire captured travel costs as well as time and wage loss for self and accompanying persons. The productivity loss was estimated using three methods: self-reported, government defined minimum daily wages and gross domestic product per capita in Odisha. On average, families were located 282.7 (SD = 254.5) meters from the nearest vaccination booths. Most family members either walked or bicycled to the vaccination sites and spent on average 26.5 minutes on travel and 15.7 minutes on waiting. Depending upon the methodology, the estimated productivity loss due to potential foregone income ranged from $0.15 to $0.29 per dose of cholera vaccine received. The private household cost of receiving oral cholera vaccine constituted 24.6% to 38.0% of overall vaccine delivery costs. The private household costs resulting from productivity loss for receiving a free oral cholera vaccine is a substantial proportion of overall vaccine delivery cost and may influence vaccine uptake. Policy makers and program managers need to recognize the importance of private costs and consider how to balance programmatic delivery costs with private household costs to receive vaccines.

Integrating risk assessment and life cycle assessment: a case study of insulation.

PubMed

Nishioka, Yurika; Levy, Jonathan I; Norris, Gregory A; Wilson, Andrew; Hofstetter, Patrick; Spengler, John D

2002-10-01

Increasing residential insulation can decrease energy consumption and provide public health benefits, given changes in emissions from fuel combustion, but also has cost implications and ancillary risks and benefits. Risk assessment or life cycle assessment can be used to calculate the net impacts and determine whether more stringent energy codes or other conservation policies would be warranted, but few analyses have combined the critical elements of both methodologies In this article, we present the first portion of a combined analysis, with the goal of estimating the net public health impacts of increasing residential insulation for new housing from current practice to the latest International Energy Conservation Code (IECC 2000). We model state-by-state residential energy savings and evaluate particulate matter less than 2.5 microm in diameter (PM2.5), NOx, and SO2 emission reductions. We use past dispersion modeling results to estimate reductions in exposure, and we apply concentration-response functions for premature mortality and selected morbidity outcomes using current epidemiological knowledge of effects of PM2.5 (primary and secondary). We find that an insulation policy shift would save 3 x 10(14) British thermal units or BTU (3 x 10(17) J) over a 10-year period, resulting in reduced emissions of 1,000 tons of PM2.5, 30,000 tons of NOx, and 40,000 tons of SO2. These emission reductions yield an estimated 60 fewer fatalities during this period, with the geographic distribution of health benefits differing from the distribution of energy savings because of differences in energy sources, population patterns, and meteorology. We discuss the methodology to be used to integrate life cycle calculations, which can ultimately yield estimates that can be compared with costs to determine the influence of external costs on benefit-cost calculations.

Modelling the effects and economics of managed realignment on the cycling and storage of nutrients, carbon and sediments in the Blackwater estuary UK

NASA Astrophysics Data System (ADS)

Shepherd, D.; Burgess, D.; Jickells, T.; Andrews, J.; Cave, R.; Turner, R. K.; Aldridge, J.; Parker, E. R.; Young, E.

2007-07-01

A hydrodynamic model is developed for the Blackwater estuary (UK) and used to estimate nitrate removal by denitrification. Using the model, sediment analysis and estimates of sedimentation rates, we estimate changes in estuarine denitrification and intertidal carbon and nutrient storage and associated value of habitat created under a scenario of extensive managed realignment. We then use this information, together with engineering and land costs, to conduct a cost benefit analysis of the managed realignment. This demonstrates that over a 50-100 year timescale the value of the habitat created and carbon buried is sufficient to make the large scale managed realignment cost effective. The analysis reveals that carbon and nutrient storage plus habitat creation represent major and quantifiable benefits of realignment. The methodology described here can be readily transferred to other coastal systems.

Performance analysis of complex repairable industrial systems using PSO and fuzzy confidence interval based methodology.

PubMed

Garg, Harish

2013-03-01

The main objective of the present paper is to propose a methodology for analyzing the behavior of the complex repairable industrial systems. In real-life situations, it is difficult to find the most optimal design policies for MTBF (mean time between failures), MTTR (mean time to repair) and related costs by utilizing available resources and uncertain data. For this, the availability-cost optimization model has been constructed for determining the optimal design parameters for improving the system design efficiency. The uncertainties in the data related to each component of the system are estimated with the help of fuzzy and statistical methodology in the form of the triangular fuzzy numbers. Using these data, the various reliability parameters, which affects the system performance, are obtained in the form of the fuzzy membership function by the proposed confidence interval based fuzzy Lambda-Tau (CIBFLT) methodology. The computed results by CIBFLT are compared with the existing fuzzy Lambda-Tau methodology. Sensitivity analysis on the system MTBF has also been addressed. The methodology has been illustrated through a case study of washing unit, the main part of the paper industry. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

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 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

Direct cost of pars plana vitrectomy for the treatment of macular hole, epiretinal membrane and vitreomacular traction: a bottom-up approach.

PubMed

Nicod, Elena; Jackson, Timothy L; Grimaccia, Federico; Angelis, Aris; Costen, Marc; Haynes, Richard; Hughes, Edward; Pringle, Edward; Zambarakji, Hadi; Kanavos, Panos

2016-11-01

The direct cost to the National Health Service (NHS) in England of pars plana vitrectomy (PPV) is unknown since a bottom-up costing exercise has not been undertaken. Healthcare resource group (HRG) costing relies on a top-down approach. We aimed to quantify the direct cost of intermediate complexity PPV. Five NHS vitreoretinal units prospectively recorded all consumables, equipment and staff salaries during PPV undertaken for vitreomacular traction, epiretinal membrane and macular hole. Out-of-surgery costs between admission and discharge were estimated using a representative accounting method. The average patient time in theatre for 57 PPVs was 72 min. The average in-surgery cost for staff was £297, consumables £619, and equipment £82 (total £997). The average out-of-surgery costs were £260, including nursing and medical staff, other consumables, eye drops and hospitalisation. The total cost was therefore £1634, including 30 % overheads. This cost estimate was an under-estimate because it did not include out-of-theatre consumables or equipment. The average reimbursed HRG tariff was £1701. The cost of undertaking PPV of intermediate complexity is likely to be higher than the reimbursed tariff, except for hospitals with high throughput, where amortisation costs benefit from economies of scale. Although this research was set in England, the methodology may provide a useful template for other countries.

Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association.

PubMed

Heidenreich, Paul A; Trogdon, Justin G; Khavjou, Olga A; Butler, Javed; Dracup, Kathleen; Ezekowitz, Michael D; Finkelstein, Eric Andrew; Hong, Yuling; Johnston, S Claiborne; Khera, Amit; Lloyd-Jones, Donald M; Nelson, Sue A; Nichol, Graham; Orenstein, Diane; Wilson, Peter W F; Woo, Y Joseph

2011-03-01

Cardiovascular disease (CVD) is the leading cause of death in the United States and is responsible for 17% of national health expenditures. As the population ages, these costs are expected to increase substantially. To prepare for future cardiovascular care needs, the American Heart Association developed methodology to project future costs of care for hypertension, coronary heart disease, heart failure, stroke, and all other CVD from 2010 to 2030. This methodology avoided double counting of costs for patients with multiple cardiovascular conditions. By 2030, 40.5% of the US population is projected to have some form of CVD. Between 2010 and 2030, real (2008$) total direct medical costs of CVD are projected to triple, from $273 billion to $818 billion. Real indirect costs (due to lost productivity) for all CVD are estimated to increase from $172 billion in 2010 to $276 billion in 2030, an increase of 61%. These findings indicate CVD prevalence and costs are projected to increase substantially. Effective prevention strategies are needed if we are to limit the growing burden of CVD.

Screening for Chlamydia trachomatis: a systematic review of the economic evaluations and modelling

PubMed Central

Roberts, T E; Robinson, S; Barton, P; Bryan, S; Low, N

2006-01-01

Objective To review systematically and critically, evidence used to derive estimates of costs and cost effectiveness of chlamydia screening. Methods Systematic review. A search of 11 electronic bibliographic databases from the earliest date available to August 2004 using keywords including chlamydia, pelvic inflammatory disease, economic evaluation, and cost. We included studies of chlamydia screening in males and/or females over 14 years, including studies of diagnostic tests, contact tracing, and treatment as part of a screening programme. Outcomes included cases of chlamydia identified and major outcomes averted. We assessed methodological quality and the modelling approach used. Results Of 713 identified papers we included 57 formal economic evaluations and two cost studies. Most studies found chlamydia screening to be cost effective, partner notification to be an effective adjunct, and testing with nucleic acid amplification tests, and treatment with azithromycin to be cost effective. Methodological problems limited the validity of these findings: most studies used static models that are inappropriate for infectious diseases; restricted outcomes were used as a basis for policy recommendations; and high estimates of the probability of chlamydia associated complications might have overestimated cost effectiveness. Two high quality dynamic modelling studies found opportunistic screening to be cost effective but poor reporting or uncertainty about complication rates make interpretation difficult. Conclusion The inappropriate use of static models to study interventions to prevent a communicable disease means that uncertainty remains about whether chlamydia screening programmes are cost effective or not. The results of this review can be used by health service managers in the allocation of resources, and health economists and other researchers who are considering further research in this area. PMID:16731666

Preventing the Wernicke-Korsakoff syndrome in Australia: cost-effectiveness of thiamin-supplementation alternatives.

PubMed

Connelly, L; Price, J

1996-04-01

Alcoholic Wernicke's encephalopathy has been commonplace in Australia for many years and, as this syndrome is attributed to a deficiency in the diet, it should be preventable. This study employs conventional cost-effectiveness methodology to compare the economic efficiency of several thiamin-supplementation alternatives that have been proposed for the prevention of Wernicke's encephalopathy. A series of rankings of these measures is derived from an estimated cost per case averted for each of the alternatives studied. These rankings identify the least cost-effective thiamin-supplementation alternative as that of enriching bread-making flour with thiamin.

A Framework for Preliminary Design of Aircraft Structures Based on Process Information. Part 1

NASA Technical Reports Server (NTRS)

Rais-Rohani, Masoud

1998-01-01

This report discusses the general framework and development of a computational tool for preliminary design of aircraft structures based on process information. The described methodology is suitable for multidisciplinary design optimization (MDO) activities associated with integrated product and process development (IPPD). The framework consists of three parts: (1) product and process definitions; (2) engineering synthesis, and (3) optimization. The product and process definitions are part of input information provided by the design team. The backbone of the system is its ability to analyze a given structural design for performance as well as manufacturability and cost assessment. The system uses a database on material systems and manufacturing processes. Based on the identified set of design variables and an objective function, the system is capable of performing optimization subject to manufacturability, cost, and performance constraints. The accuracy of the manufacturability measures and cost models discussed here depend largely on the available data on specific methods of manufacture and assembly and associated labor requirements. As such, our focus in this research has been on the methodology itself and not so much on its accurate implementation in an industrial setting. A three-tier approach is presented for an IPPD-MDO based design of aircraft structures. The variable-complexity cost estimation methodology and an approach for integrating manufacturing cost assessment into design process are also discussed. This report is presented in two parts. In the first part, the design methodology is presented, and the computational design tool is described. In the second part, a prototype model of the preliminary design Tool for Aircraft Structures based on Process Information (TASPI) is described. Part two also contains an example problem that applies the methodology described here for evaluation of six different design concepts for a wing spar.

A time-driven, activity-based costing methodology for determining the costs of red blood cell transfusion in patients with beta thalassaemia major.

PubMed

Burns, K E; Haysom, H E; Higgins, A M; Waters, N; Tahiri, R; Rushford, K; Dunstan, T; Saxby, K; Kaplan, Z; Chunilal, S; McQuilten, Z K; Wood, E M

2018-04-10

To describe the methodology to estimate the total cost of administration of a single unit of red blood cells (RBC) in adults with beta thalassaemia major in an Australian specialist haemoglobinopathy centre. Beta thalassaemia major is a genetic disorder of haemoglobin associated with multiple end-organ complications and typically requiring lifelong RBC transfusion therapy. New therapeutic agents are becoming available based on advances in understanding of the disorder and its consequences. Assessment of the true total cost of transfusion, incorporating both product and activity costs, is required in order to evaluate the benefits and costs of these new therapies. We describe the bottom-up, time-driven, activity-based costing methodology used to develop process maps to provide a step-by-step outline of the entire transfusion pathway. Detailed flowcharts for each process are described. Direct observations and timing of the process maps document all activities, resources, staff, equipment and consumables in detail. The analysis will include costs associated with performing these processes, including resources and consumables. Sensitivity analyses will be performed to determine the impact of different staffing levels, timings and probabilities associated with performing different tasks. Thirty-one process maps have been developed, with over 600 individual activities requiring multiple timings. These will be used for future detailed cost analyses. Detailed process maps using bottom-up, time-driven, activity-based costing for determining the cost of RBC transfusion in thalassaemia major have been developed. These could be adapted for wider use to understand and compare the costs and complexities of transfusion in other settings. © 2018 British Blood Transfusion Society.

Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials

PubMed Central

Oppong, Raymond; Nicholls, Elaine; Whitehurst, David G. T.; Hill, Susan; Hammond, Alison; Hay, Elaine M.; Dziedzic, Krysia

2015-01-01

Objectives. Evidence regarding the cost-effectiveness of joint protection and hand exercises for the management of hand OA is not well established. The primary aim of this study is to assess the cost-effectiveness (cost-utility) of these management options. In addition, given the absence of consensus regarding the conduct of economic evaluation alongside factorial trials, we compare different analytical methodologies. Methods. A trial-based economic evaluation to assess the cost-utility of joint protection only, hand exercises only and joint protection plus hand exercises compared with leaflet and advice was undertaken over a 12 month period from a UK National Health Service perspective. Patient-level mean costs and mean quality-adjusted life years (QALYs) were calculated for each trial arm. Incremental cost-effectiveness ratios (ICERs) were estimated and cost-effectiveness acceptability curves were constructed. The base case analysis used a within-the-table analysis methodology. Two further methods were explored: the at-the-margins approach and a regression-based approach with or without an interaction term. Results. Mean costs (QALYs) were £58.46 (s.d. 0.662) for leaflet and advice, £92.12 (s.d. 0.659) for joint protection, £64.51 (s.d. 0.681) for hand exercises and £112.38 (s.d. 0.658) for joint protection plus hand exercises. In the base case, hand exercises were the cost-effective option, with an ICER of £318 per QALY gained. Hand exercises remained the most cost-effective management strategy when adopting alternative methodological approaches. Conclusion. This is the first trial evaluating the cost-effectiveness of occupational therapy-supported approaches to self-management for hand OA. Our findings showed that hand exercises were the most cost-effective option. PMID:25339642

The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study.

PubMed

Sleed, Michelle; Eccleston, Christopher; Beecham, Jennifer; Knapp, Martin; Jordan, Abbie

2005-12-15

Chronic pain in adulthood is one of the most costly conditions in modern western society. However, very little is known about the costs of chronic pain in adolescence. This preliminary study explored methods for collecting economic-related data for this population and estimated the cost-of-illness of adolescent chronic pain in the United Kingdom. The client service receipt inventory was specifically adapted for use with parents of adolescent chronic pain patients to collect economic-related data (CSRI-Pain). This method was compared and discussed in relation to other widely used methods. The CSRI-Pain was sent to 52 families of adolescents with chronic pain to complete as a self-report retrospective questionnaire. These data were linked with unit costs to estimate the total care cost package for each family. The economic impact of adolescent chronic pain was found to be high. The mean cost per adolescent experiencing chronic pain was approximately 8,000 pounds per year, including direct and indirect costs. The adolescents attending a specialised pain management unit, who had predominantly non-inflammatory pain, accrued significantly higher costs, than those attending rheumatology outpatient clinics, who had mostly inflammatory diagnoses. Extrapolating the mean total cost to estimated UK prevalence data of adolescent chronic pain demonstrates a cost-of-illness to UK society of approximately 3,840 million pounds in one year. The implications of the study are discussed.

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.

Decision Making Methodology to Mitigate Damage From Glacial Lake Outburst Floods From Imja Lake in Nepal

NASA Astrophysics Data System (ADS)

McKinney, D. C.; Cuellar, A. D.

2015-12-01

Climate change has accelerated glacial retreat in high altitude glaciated regions of Nepal leading to the growth and formation of glacier lakes. Glacial lake outburst floods (GLOF) are sudden events triggered by an earthquake, moraine failure or other shock that causes a sudden outflow of water. These floods are catastrophic because of their sudden onset, the difficulty predicting them, and enormous quantity of water and debris rapidly flooding downstream areas. Imja Lake in the Himalaya of Nepal has experienced accelerated growth since it first appeared in the 1960s. Communities threatened by a flood from Imja Lake have advocated for projects to adapt to the increasing threat of a GLOF. Nonetheless, discussions surrounding projects for Imja have not included a rigorous analysis of the potential consequences of a flood, probability of an event, or costs of mitigation projects in part because this information is unknown or uncertain. This work presents a demonstration of a decision making methodology developed to rationally analyze the risks posed by Imja Lake and the various adaptation projects proposed using available information. In this work the authors use decision analysis, data envelopement analysis (DEA), and sensitivity analysis to assess proposed adaptation measures that would mitigate damage in downstream communities from a GLOF. We use an existing hydrodynamic model of the at-risk area to determine how adaptation projects will affect downstream flooding and estimate fatalities using an empirical method developed for dam failures. The DEA methodology allows us to estimate the value of a statistical life implied by each project given the cost of the project and number of lives saved to determine which project is the most efficient. In contrast the decision analysis methodology requires fatalities to be assigned a cost but allows the inclusion of uncertainty in the decision making process. We compare the output of these two methodologies and determine the sensitivity of the conclusions to changes in uncertain input parameters including project cost, value of a statistical life, and time to a GLOF event.

Estimating the cost of blood: past, present, and future directions.

PubMed

Shander, Aryeh; Hofmann, Axel; Gombotz, Hans; Theusinger, Oliver M; Spahn, Donat R

2007-06-01

Understanding the costs associated with blood products requires sophisticated knowledge about transfusion medicine and is attracting the attention of clinical and administrative healthcare sectors worldwide. To improve outcomes, blood usage must be optimized and expenditures controlled so that resources may be channeled toward other diagnostic, therapeutic, and technological initiatives. Estimating blood costs, however, is a complex undertaking, surpassing simple supply versus demand economics. Shrinking donor availability and application of a precautionary principle to minimize transfusion risks are factors that continue to drive the cost of blood products upward. Recognizing that historical accounting attempts to determine blood costs have varied in scope, perspective, and methodology, new approaches have been initiated to identify all potential cost elements related to blood and blood product administration. Activities are also under way to tie these elements together in a comprehensive and practical model that will be applicable to all single-donor blood products without regard to practice type (e.g., academic, private, multi- or single-center clinic). These initiatives, their rationale, importance, and future directions are described.

Modelling the energy costs of the wastewater treatment process: The influence of the aging factor.

PubMed

Castellet-Viciano, Lledó; Hernández-Chover, Vicent; Hernández-Sancho, Francesc

2018-06-01

Wastewater treatment plants (WWTPs) are aging and its effects on the process are more evident as time goes by. Due to the deterioration of the facilities, the efficiency of the treatment process decreases gradually. Within this framework, this paper proves the increase in the energy consumption of the WWTPs with time, and finds differences among facilities size. Accordingly, the paper aims to develop a dynamic energy cost function capable of predicting the energy cost of the process in the future. The time variable is used to introduce the aging effects on the energy cost estimation in order to increase the accuracy of the estimation. For this purpose, the evolution of energy costs will be assessed and modelled for a group of WWTPs using the methodology of cost functions. The results will be useful for the managers of the facilities in the decision making process. Copyright © 2017 Elsevier B.V. All rights reserved.

A cost-construction model to assess the total cost of an anesthesiology residency program.

PubMed

Franzini, L; Berry, J M

1999-01-01

Although the total costs of graduate medical education are difficult to quantify, this information may be of great importance for health policy and planning over the next decade. This study describes the total costs associated with the residency program at the University of Texas--Houston Department of Anesthesiology during the 1996-1997 academic year. The authors used cost-construction methodology, which computes the cost of teaching from information on program description, resident enrollment, faculty and resident salaries and benefits, and overhead. Surveys of faculty and residents were conducted to determine the time spent in teaching activities; access to institutional and departmental financial records was obtained to quantify associated costs. The model was then developed and examined for a range of assumptions concerning resident productivity, replacement costs, and the cost allocation of activities jointly producing clinical care and education. The cost of resident training (cost of didactic teaching, direct clinical supervision, teaching-related preparation and administration, plus the support of the teaching program) was estimated at $75,070 per resident per year. This cost was less than the estimated replacement value of the teaching and clinical services provided by residents, $103,436 per resident per year. Sensitivity analysis, with different assumptions regarding resident replacement cost and reimbursement rates, varied the cost estimates but generally identified the anesthesiology residency program as a financial asset. In most scenarios, the value of the teaching and clinical services provided by residents exceeded the cost of the resources used in the educational program.

Peer Review of March 2013 LDV Rebound Report By Small ...

EPA Pesticide Factsheets

The regulatory option of encouraging the adoption of advanced technologies for improving vehicle efficiency can result in significant fuel savings and GHG emissions benefits. At the same time, it is possible that some of these benefits might be offset by additional driving that is encouraged by the reduced costs of operating more efficient vehicles. This so called “rebound effect”, the increased driving that results from an improvement in the energy efficiency of a vehicle, must be determined in order to reliably estimate the overall benefits of GHG regulations for light-duty vehicles. Dr. Ken Small, an Economist at the Department of Economics, University of California at Irvine, with contributions by Dr. Kent Hymel, Department of Economics, California State University at Northridge, have developed a methodology to estimate the rebound effect for light-duty vehicles in the U.S. Specifically, rebound is estimated as the change in vehicle miles traveled (VMT) with respect to the change in per mile fuel costs that can occur, for example, when vehicle operating efficiency is improved. The model analyzes aggregate personal motor-vehicle travel within a simultaneous model of aggregate VMT, fleet size, fuel efficiency, and congestion formation. To use the peer review process to help assure that the methodologies considered by the U.S. EPA for estimating VMT rebound have been thoroughly examined.

A less field-intensive robust design for estimating demographic parameters with Mark-resight data

USGS Publications Warehouse

McClintock, B.T.; White, Gary C.

2009-01-01

The robust design has become popular among animal ecologists as a means for estimating population abundance and related demographic parameters with mark-recapture data. However, two drawbacks of traditional mark-recapture are financial cost and repeated disturbance to animals. Mark-resight methodology may in many circumstances be a less expensive and less invasive alternative to mark-recapture, but the models developed to date for these data have overwhelmingly concentrated only on the estimation of abundance. Here we introduce a mark-resight model analogous to that used in mark-recapture for the simultaneous estimation of abundance, apparent survival, and transition probabilities between observable and unobservable states. The model may be implemented using standard statistical computing software, but it has also been incorporated into the freeware package Program MARK. We illustrate the use of our model with mainland New Zealand Robin (Petroica australis) data collected to ascertain whether this methodology may be a reliable alternative for monitoring endangered populations of a closely related species inhabiting the Chatham Islands. We found this method to be a viable alternative to traditional mark-recapture when cost or disturbance to species is of particular concern in long-term population monitoring programs. ?? 2009 by the Ecological Society of America.

Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing.

PubMed

French, Katy E; Guzman, Alexis B; Rubio, Augustin C; Frenzel, John C; Feeley, Thomas W

2016-09-01

With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. Copyright © 2015 Elsevier Inc. All rights reserved.

Value Based Care and Bundled Payments: Anesthesia Care Costs for Outpatient Oncology Surgery Using Time-Driven Activity-Based Costing

PubMed Central

French, Katy E.; Guzman, Alexis B.; Rubio, Augustin C.; Frenzel, John C.; Feeley, Thomas W

2015-01-01

Background With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Methods Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Results Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13-28% across the 11 procedures. Conclusions TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. PMID:27637823

A validated methodology for determination of laboratory instrument computer interface efficacy

NASA Astrophysics Data System (ADS)

1984-12-01

This report is intended to provide a methodology for determining when, and for which instruments, direct interfacing of laboratory instrument and laboratory computers is beneficial. This methodology has been developed to assist the Tri-Service Medical Information Systems Program Office in making future decisions regarding laboratory instrument interfaces. We have calculated the time savings required to reach a break-even point for a range of instrument interface prices and corresponding average annual costs. The break-even analyses used empirical data to estimate the number of data points run per day that are required to meet the break-even point. The results indicate, for example, that at a purchase price of $3,000, an instrument interface will be cost-effective if the instrument is utilized for at least 154 data points per day if operated in the continuous mode, or 216 points per day if operated in the discrete mode. Although this model can help to ensure that instrument interfaces are cost effective, additional information should be considered in making the interface decisions. A reduction in results transcription errors may be a major benefit of instrument interfacing.

Earth Sciences Data and Information System (ESDIS) program planning and evaluation methodology development

NASA Technical Reports Server (NTRS)

Dickinson, William B.

1995-01-01

An Earth Sciences Data and Information System (ESDIS) Project Management Plan (PMP) is prepared. An ESDIS Project Systems Engineering Management Plan (SEMP) consistent with the developed PMP is also prepared. ESDIS and related EOS program requirements developments, management and analysis processes are evaluated. Opportunities to improve the effectiveness of these processes and program/project responsiveness to requirements are identified. Overall ESDIS cost estimation processes are evaluated, and recommendations to improve cost estimating and modeling techniques are developed. ESDIS schedules and scheduling tools are evaluated. Risk assessment, risk mitigation strategies and approaches, and use of risk information in management decision-making are addressed.

Fast and low-cost method for VBES bathymetry generation in coastal areas

NASA Astrophysics Data System (ADS)

Sánchez-Carnero, N.; Aceña, S.; Rodríguez-Pérez, D.; Couñago, E.; Fraile, P.; Freire, J.

2012-12-01

Sea floor topography is key information in coastal area management. Nowadays, LiDAR and multibeam technologies provide accurate bathymetries in those areas; however these methodologies are yet too expensive for small customers (fishermen associations, small research groups) willing to keep a periodic surveillance of environmental resources. In this paper, we analyse a simple methodology for vertical beam echosounder (VBES) bathymetric data acquisition and postprocessing, using low-cost means and free customizable tools such as ECOSONS and gvSIG (that is compared with industry standard ArcGIS). Echosounder data was filtered, resampled and, interpolated (using kriging or radial basis functions). Moreover, the presented methodology includes two data correction processes: Monte Carlo simulation, used to reduce GPS errors, and manually applied bathymetric line transformations, both improving the obtained results. As an example, we present the bathymetry of the Ría de Cedeira (Galicia, NW Spain), a good testbed area for coastal bathymetry methodologies given its extension and rich topography. The statistical analysis, performed by direct ground-truthing, rendered an upper bound of 1.7 m error, at 95% confidence level, and 0.7 m r.m.s. (cross-validation provided 30 cm and 25 cm, respectively). The methodology presented is fast and easy to implement, accurate outside transects (accuracy can be estimated), and can be used as a low-cost periodical monitoring method.

Traumatic brain injury: methodological approaches to estimate health and economic outcomes.

PubMed

Lu, Juan; Roe, Cecilie; Aas, Eline; Lapane, Kate L; Niemeier, Janet; Arango-Lasprilla, Juan Carlos; Andelic, Nada

2013-12-01

The effort to standardize the methodology and adherence to recommended principles for all economic evaluations has been emphasized in medical literature. The objective of this review is to examine whether economic evaluations in traumatic brain injury (TBI) research have been compliant with existing guidelines. Medline search was performed between January 1, 1995 and August 11, 2012. All original TBI-related full economic evaluations were included in the study. Two authors independently rated each study's methodology and data presentation to determine compliance to the 10 methodological principles recommended by Blackmore et al. Descriptive analysis was used to summarize the data. Inter-rater reliability was assessed with Kappa statistics. A total of 28 studies met the inclusion criteria. Eighteen of these studies described cost-effectiveness, seven cost-benefit, and three cost-utility analyses. The results showed a rapid growth in the number of published articles on the economic impact of TBI since 2000 and an improvement in their methodological quality. However, overall compliance with recommended methodological principles of TBI-related economic evaluation has been deficient. On average, about six of the 10 criteria were followed in these publications, and only two articles met all 10 criteria. These findings call for an increased awareness of the methodological standards that should be followed by investigators both in performance of economic evaluation and in reviews of evaluation reports prior to publication. The results also suggest that all economic evaluations should be made by following the guidelines within a conceptual framework, in order to facilitate evidence-based practices in the field of TBI.

Hospital consolidation and costs: another look at the evidence.

PubMed

Dranove, David; Lindrooth, Richard

2003-11-01

We investigate whether pairwise hospital consolidation leads to cost savings. We use a unified empirical methodology to assess both systems and mergers. Our comparison group for each consolidation consists of 10 'pseudo-mergers' chosen based on propensity scores. Cost function estimates reveal that consolidation into systems does not generate savings, even after 4 years. Mergers in which hospitals consolidate financial reporting and licenses generate savings of approximately 14%: 2, 3, and 4 years after merger. The system consolidation and merger results are very robust to changes in the specification and the sample.

Estimating the harms and costs of cannabis-attributable collisions in the Canadian provinces.

PubMed

Wettlaufer, Ashley; Florica, Roxana O; Asbridge, Mark; Beirness, Douglas; Brubacher, Jeffrey; Callaghan, Russell; Fischer, Benedikt; Gmel, Gerrit; Imtiaz, Sameer; Mann, Robert E; McKiernan, Anna; Rehm, Jürgen

2017-04-01

In 2012, 10% of Canadians used cannabis and just under half of those who use cannabis were estimated to have driven under the influence of cannabis. Substantial evidence has accumulated to indicate that driving after cannabis use increases collision risk significantly; however, little is known about the extent and costs associated with cannabis-related traffic collisions. This study quantifies the costs of cannabis-related traffic collisions in the Canadian provinces. Province and age specific cannabis-attributable fractions (CAFs) were calculated for traffic collisions of varying severity. The CAFs were applied to traffic collision data in order to estimate the total number of persons involved in cannabis-attributable fatal, injury and property damage only collisions. Social cost values, based on willingness-to-pay and direct costs, were applied to estimate the costs associated with cannabis-related traffic collisions. The 95% confidence intervals were calculated using Monte Carlo methodology. Cannabis-attributable traffic collisions were estimated to have caused 75 deaths (95% CI: 0-213), 4407 injuries (95% CI: 20-11,549) and 7794 people (95% CI: 3107-13,086) were involved in property damage only collisions in Canada in 2012, totalling $1,094,972,062 (95% CI: 37,069,392-2,934,108,175) with costs being highest among younger people. The cannabis-attributable driving harms and costs are substantial. The harm and cost of cannabis-related collisions is an important factor to consider as Canada looks to legalize and regulate the sale of cannabis. This analysis provides evidence to help inform Canadian policy to reduce the human and economic costs of drug-impaired driving. Copyright © 2017 Canadian Centre on Substance Abuse. Published by Elsevier B.V. All rights reserved.

Integrating the Clearance in NPP Residual Material Management

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

Garcia-Bermejo, R.; Lamela, B.

Previous Experiences in decommissioning projects are being used to optimize the residual material management in NPP, metallic scrap usually. The approach is based in the availability of a materials Clearance MARSSIM-based methodology developed and licensed in Spain. A typical project includes the integration of segregation, decontamination, clearance, quality control and quality assurance activities. The design is based in the clearance methodology features translating them into standard operational procedures. In terms of ecological taxes and final disposal costs, significant amounts of money could be saved with this type of approaches. The last clearance project managed a total amount of 405 tonsmore » scrap metal and a similar amount of other residual materials occupying a volume of 1500 m{sup 3}. After less than a year of field works 251 tons were finally recycled in a non-licensed smelting facility. The balance was disposed as LILW. In the planning phase the estimated cost savings were 4.5 Meuro. However, today a VLLW option is available in European countries so, the estimated cost savings are reduced to 1.2 Meuro. In conclusion: the application of materials clearance in NPP decommissioning lessons learnt to the NPP residual material management is an interesting management option. This practice is currently going on in Spanish NPP and, in a preliminary view, is consistent with the new MARSAME Draft. An interesting parameter is the cost of 1 m3 of recyclable scrap. The above estimates are very project specific because in the segregation process other residual materials were involved. If the effect of this other materials is removed the estimated Unit Cost were in this project around 1700 euro/m{sup 3}, this figure is clearly below the above VLLW disposal cost of 2600 euro. In a future project it appears feasible to descend to 839 euro/m{sup 3} and if it became routine values and is used in big Decommissioning projects, around 600 euro/m{sup 3} or below possibly could be achieved. A rough economical analysis permits to estimate a saving around 2000 US$ to 13000 US$ per cubic meter of steel scrap according the variability of materials and disposal costs. Many learnt lessons of this practice were used as a feed back in the planning of characterization activities for decommissioning a Spanish NPP and today are considered as a significant reference in our Decommissioning engineering approaches.« less

Projecting effects of improvements in passive safety of the New Zealand light vehicle fleet.

PubMed

Keall, Michael; Newstead, Stuart; Jones, Wayne

2007-09-01

In the year 2000, as part of the process for setting New Zealand road safety targets, a projection was made for a reduction in social cost of 15.5 percent associated with improvements in crashworthiness, which is a measure of the occupant protection of the light passenger vehicle fleet. Since that document was produced, new estimates of crashworthiness have become available, allowing for a more accurate projection. The objective of this paper is to describe a methodology for projecting changes in casualty rates associated with passive safety features and to apply this methodology to produce a new prediction. The shape of the age distribution of the New Zealand light passenger vehicle fleet was projected to 2010. Projected improvements in crashworthiness and associated reductions in social cost were also modeled based on historical trends. These projections of changes in the vehicle fleet age distribution and of improvements in crashworthiness together provided a basis for estimating the future performance of the fleet in terms of secondary safety. A large social cost reduction of about 22 percent for 2010 compared to the year 2000 was predicted due to the expected huge impact of improvements in passive vehicle features on road trauma in New Zealand. Countries experiencing improvements in their vehicle fleets can also expect significant reductions in road injury compared to a less crashworthy passenger fleet. Such road safety gains can be analyzed using some of the methodology described here.

Direct costs of osteoporosis and hip fracture: an analysis for the Mexican Social Insurance Health Care System.

PubMed

Carlos, Fernando; Clark, Patricia; Maciel, Humberto; Tamayo, Juan A

2009-01-01

To compare costs of diagnosis and annual treatment of osteoporosis and hip fracture between the Instituto Nacional de Rehabilitación (INR) and the protocol used by the Seguro Popular de Salud (SPSS). Direct costs gathered in a prospective study with real cases at the INR are presented, and then this data is re-analyzed with the methodology and protocol for the SPSS to estimate the costs of those cases if treated with the SPSS protocol. Important differences were found in the cost of hip fracture: the SPSS estimates ($37,363.73 MXN) almost double the INR cost ($20,286.86 MXN ). This discrepancy was caused by the different types of surgeries the INR and SPSS protocols call for (the SPSS assumes that all hip fractures will necessitate a hip replacement) and the cost of subsequent hospitalization. A prospective study at the SPSS is needed to validate these results. Important differences were found between treatment of the same osteoporosis related problems at the INR and SPSS. We recommend revising the SPSS protocol to include less costly surgical treatments.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

NASA Astrophysics Data System (ADS)

Gates, W. R.

1983-02-01

Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (R&D) is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), depending on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

NASA Technical Reports Server (NTRS)

Gates, W. R.

1983-01-01

Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (R&D) is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), depending on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

Potential and Limitations of an Improved Method to Produce Dynamometric Wheels

PubMed Central

García de Jalón, Javier

2018-01-01

A new methodology for the estimation of tyre-contact forces is presented. The new procedure is an evolution of a previous method based on harmonic elimination techniques developed with the aim of producing low cost dynamometric wheels. While the original method required stress measurement in many rim radial lines and the fulfillment of some rigid conditions of symmetry, the new methodology described in this article significantly reduces the number of required measurement points and greatly relaxes symmetry constraints. This can be done without compromising the estimation error level. The reduction of the number of measuring radial lines increases the ripple of demodulated signals due to non-eliminated higher order harmonics. Therefore, it is necessary to adapt the calibration procedure to this new scenario. A new calibration procedure that takes into account angular position of the wheel is completely described. This new methodology is tested on a standard commercial five-spoke car wheel. Obtained results are qualitatively compared to those derived from the application of former methodology leading to the conclusion that the new method is both simpler and more robust due to the reduction in the number of measuring points, while contact forces’ estimation error remains at an acceptable level. PMID:29439427

[Economic and epidemiologic aspects of generalized anxiety disorder: a review of the literature].

PubMed

Albarracin, G; Rovira, J; Carreras, L; Rejas, J

2008-01-01

The objective is to assess the prevalence and treatment patterns of generalized anxiety disorder (GAD) in Spain as well as the cost associated to this disorder in different countries. A search in the literature of health and economics databases was conducted. In regards to the 32 references selected, 6 studies had data on the prevalence of GAD and 3 on treatment patterns in Spain and 11 studies on the costs associated to the disease on an international level. The remaining 20 studies were of general interest for methodological or contextual reasons. GAD is a mental disorder with high prevalence. According to some authors, it is probably underdiagnosed. No appropriate long term treatment is available. High health care and social costs are associated to GAD. The frequent presence of comorbidity, different definitions and methodologies used in the studies limits the comparability and synthesis of the results. It also makes it difficult to obtain valid estimations of prevalence and costs.

[Cost of a health care system for dependent older adults in Chile, 2012-2020].

PubMed

Matus-López, Mauricio; Pedraza, Camilo Cid

2014-07-01

To estimate the relative and absolute costs of a home-based health care system for dependent older adults in Chile and to consider the methodological factors to take into account in estimates for other models in other countries. Sex- and age-specific prevalence rates were used, based on microdata from the National Dependency Survey (ENDPM 2009), and three scenarios were projected for 2012 - 2020. The beneficiary population and the demand were estimated for 12 home-based health care programs. The characteristics of the programs (number of hours and type of care) were based on expert opinions, adjusted through a literature review. Public and private system wages/hours were used. Overall, 20.3% of people over 65 years of age would be beneficiaries of the system; 21.7% of all women and 18.4% of all men, for a total of 336 874 people in 2012. The annual cost of the system is 1.214 billion dollars for 2012, equivalent to 0.45% of GDP (gross domestic product). This figure could increase by between 32.1% and 33.1% by 2020. The cost of an initial system for dependent older adults in Chile is relatively low in comparison to the models seen in industrialized countries. In terms of methodology, it is particularly important for there to be prior discussion of the desired model to be implemented and the financial capacity to achieve this. Furthermore, the option of using expert opinions as the basis for the evaluation is validated, although it is recommended that this be expanded.

Using the Delphi technique in economic evaluation: time to revisit the oracle?

PubMed

Simoens, S

2006-12-01

Although the Delphi technique has been commonly used as a data source in medical and health services research, its application in economic evaluation of medicines has been more limited. The aim of this study was to describe the methodology of the Delphi technique, to present a case for using the technique in economic evaluation, and to provide recommendations to improve such use. The literature was accessed through MEDLINE focusing on studies discussing the methodology of the Delphi technique and economic evaluations of medicines using the Delphi technique. The Delphi technique can be used to provide estimates of health care resources required and to modify such estimates when making inter-country comparisons. The Delphi technique can also contribute to mapping the treatment process under investigation, to identifying the appropriate comparator to be used, and to ensuring that the economic evaluation estimates cost-effectiveness rather than cost-efficacy. Ideally, economic evaluations of medicines should be based on real-patient data. In the absence of such data, evaluations need to incorporate the best evidence available by employing approaches such as the Delphi technique. Evaluations based on this approach should state the limitations, and explore the impact of the associated uncertainty in the results.

Parts and Components Reliability Assessment: A Cost Effective Approach

NASA Technical Reports Server (NTRS)

Lee, Lydia

2009-01-01

System reliability assessment is a methodology which incorporates reliability analyses performed at parts and components level such as Reliability Prediction, Failure Modes and Effects Analysis (FMEA) and Fault Tree Analysis (FTA) to assess risks, perform design tradeoffs, and therefore, to ensure effective productivity and/or mission success. The system reliability is used to optimize the product design to accommodate today?s mandated budget, manpower, and schedule constraints. Stand ard based reliability assessment is an effective approach consisting of reliability predictions together with other reliability analyses for electronic, electrical, and electro-mechanical (EEE) complex parts and components of large systems based on failure rate estimates published by the United States (U.S.) military or commercial standards and handbooks. Many of these standards are globally accepted and recognized. The reliability assessment is especially useful during the initial stages when the system design is still in the development and hard failure data is not yet available or manufacturers are not contractually obliged by their customers to publish the reliability estimates/predictions for their parts and components. This paper presents a methodology to assess system reliability using parts and components reliability estimates to ensure effective productivity and/or mission success in an efficient manner, low cost, and tight schedule.

A reliability-based cost effective fail-safe design procedure

NASA Technical Reports Server (NTRS)

Hanagud, S.; Uppaluri, B.

1976-01-01

The authors have developed a methodology for cost-effective fatigue design of structures subject to random fatigue loading. A stochastic model for fatigue crack propagation under random loading has been discussed. Fracture mechanics is then used to estimate the parameters of the model and the residual strength of structures with cracks. The stochastic model and residual strength variations have been used to develop procedures for estimating the probability of failure and its changes with inspection frequency. This information on reliability is then used to construct an objective function in terms of either a total weight function or cost function. A procedure for selecting the design variables, subject to constraints, by optimizing the objective function has been illustrated by examples. In particular, optimum design of stiffened panel has been discussed.

Variability of cost-effectiveness estimates for pharmaceuticals in Western Europe: lessons for inferring generalizability.

PubMed

Barbieri, Marco; Drummond, Michael; Willke, Richard; Chancellor, Jeremy; Jolain, Bruno; Towse, Adrian

2005-01-01

It has long been suggested that, whereas the results of clinical studies of pharmaceuticals are generalizable from one jurisdiction to another, the results of economic evaluations are location dependent. There has been, however, little study of the causes of variation, whether differences in study results among countries are systematic, or whether they are important for decision making. A literature search was conducted to identify economic evaluations of pharmaceuticals conducted in two or more European countries. The studies identified were then classified by methodological type and analyzed to assess their level of variability and to identify the main causes of variation. Assessments were also made of the extent to which differences in study results among countries were systematic and whether they would lead to a different decision, assuming a range of values of the threshold willingness-to-pay for a life-year or quality-adjusted life-year (QALY). In total 46 intercountry drug comparisons were identified, 29 in multicountry studies and 17 in comparable single country studies that were considered to be sufficiently similar in terms of methodology. The type of study (i.e., trial-based or modeling study) had some impact on variability, but the most important factor was the extent of variation across countries in effectiveness, resource use or unit costs, allowed by the researcher's chosen methodology. There were few systematic differences in study results among countries, so a decision maker in country B, on seeing a recent economic evaluation of a new drug in country A, would have little basis on which to predict whether the drug, if evaluated, would be more or less cost-effective in his or her country. Given the extent of variation in cost-effectiveness estimates among countries, the importance of this for decision making depends on decision makers' thresholds in willingness-to-pay for a QALY or life-year. If a cost-effectiveness threshold (i.e., willingness-to-pay) for a life-year or QALY of dollar 50,000 were assumed, the same conclusion regarding cost-effectiveness would be reached in most cases. This review shows that cost-effectiveness results for pharmaceuticals vary from country to country in Western Europe and that these variations are not systematic. In addition, constraints imposed by analysts may reduce apparent variability in the estimates. The lessons for inferring generalizability are not straightforward, although the implications of variation for decision making depend critically on the cost-effectiveness thresholds applying in Western Europe.

A tutorial on activity-based costing of electronic health records.

PubMed

Federowicz, Marie H; Grossman, Mila N; Hayes, Bryant J; Riggs, Joseph

2010-01-01

As the American Recovery and Restoration Act of 2009 allocates $19 billion to health information technology, it will be useful for health care managers to project the true cost of implementing an electronic health record (EHR). This study presents a step-by-step guide for using activity-based costing (ABC) to estimate the cost of an EHR. ABC is a cost accounting method with a "top-down" approach for estimating the cost of a project or service within an organization. The total cost to implement an EHR includes obvious costs, such as licensing fees, and hidden costs, such as impact on productivity. Unlike other methods, ABC includes all of the organization's expenditures and is less likely to miss hidden costs. Although ABC is used considerably in manufacturing and other industries, it is a relatively new phenomenon in health care. ABC is a comprehensive approach that the health care field can use to analyze the cost-effectiveness of implementing EHRs. In this article, ABC is applied to a health clinic that recently implemented an EHR, and the clinic is found to be more productive after EHR implementation. This methodology can help health care administrators assess the impact of a stimulus investment on organizational performance.

Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

PubMed

Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

2017-04-01

It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country

PubMed Central

Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

2017-01-01

Background It is believed that laboratory tariffs in Iran don’t reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. Objective This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. Methods This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. Results In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector’s tariffs in 2015. Conclusion This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories. PMID:28607638

Use of operating room information system data to predict the impact of reducing turnover times on staffing costs.

PubMed

Dexter, Franklin; Abouleish, Amr E; Epstein, Richard H; Whitten, Charles W; Lubarsky, David A

2003-10-01

Potential benefits to reducing turnover times are both quantitative (e.g., complete more cases and reduce staffing costs) and qualitative (e.g., improve professional satisfaction). Analyses have shown the quantitative arguments to be unsound except for reducing staffing costs. We describe a methodology by which each surgical suite can use its own numbers to calculate its individual potential reduction in staffing costs from reducing its turnover times. Calculations estimate optimal allocated operating room (OR) time (based on maximizing OR efficiency) before and after reducing the maximum and average turnover times. At four academic tertiary hospitals, reductions in average turnover times of 3 to 9 min would result in 0.8% to 1.8% reductions in staffing cost. Reductions in average turnover times of 10 to 19 min would result in 2.5% to 4.0% reductions in staffing costs. These reductions in staffing cost are achieved predominantly by reducing allocated OR time, not by reducing the hours that staff work late. Heads of anesthesiology groups often serve on OR committees that are fixated on turnover times. Rather than having to argue based on scientific studies, this methodology provides the ability to show the specific quantitative effects (small decreases in staffing costs and allocated OR time) of reducing turnover time using a surgical suite's own data. Many anesthesiologists work at hospitals where surgeons and/or operating room (OR) committees focus repeatedly on turnover time reduction. We developed a methodology by which the reductions in staffing cost as a result of turnover time reduction can be calculated for each facility using its own data. Staffing cost reductions are generally very small and would be achieved predominantly by reducing allocated OR time to the surgeons.

Assessing the Economics of Dengue: Results from a Systematic Review of the Literature and Expert Survey.

PubMed

Constenla, Dagna; Garcia, Cristina; Lefcourt, Noah

2015-11-01

The economics of dengue is complex and multifaceted. We performed a systematic review of the literature to provide a critical overview of the issues related to dengue economics research and to form a background with which to address the question of cost. Three literature databases were searched [PubMed, Embase and Latin American and Caribbean Health Sciences Literature (LILACS)], covering a period from 1980 to 2013, to identify papers meeting preset inclusion criteria. Studies were reviewed for methodological quality on the basis of a quality checklist developed for this purpose. An expert survey was designed to identify priority areas in dengue economics research and to identify gaps between the methodology and actual practice. Survey responses were combined with the literature review findings to determine stakeholder priorities in dengue economics research. The review identified over 700 papers. Forty-two of these papers met the selection criteria. The studies that were reviewed presented results from 32 dengue-endemic countries, underscoring the importance of dengue as a global public health problem. Cost analyses were the most common, with 21 papers, followed by nine cost-effectiveness analyses and seven cost-of-illness studies, indicating a relatively strong mix of methodologies. Dengue annual overall costs (in 2010 values) ranged from US$13.5 million (in Nicaragua) to $56 million (in Malaysia), showing cost variations across countries. Little consistency exists in the way costs were estimated and dengue interventions evaluated, making generalizations around costs difficult. The current evidence suggests that dengue costs are substantial because of the cost of hospital care and lost earnings. Further research in this area will broaden our understanding of the true economic impact of dengue.

A methodology to identify stranded generation facilities and estimate stranded costs for Louisiana's electric utility industry

NASA Astrophysics Data System (ADS)

Cope, Robert Frank, III

1998-12-01

The electric utility industry in the United States is currently experiencing a new and different type of growing pain. It is the pain of having to restructure itself into a competitive business. Many industry experts are trying to explain how the nation as a whole, as well as individual states, will implement restructuring and handle its numerous "transition problems." One significant transition problem for federal and state regulators rests with determining a utility's stranded costs. Stranded generation facilities are assets which would be uneconomic in a competitive environment or costs for assets whose regulated book value is greater than market value. At issue is the methodology which will be used to estimate stranded costs. The two primary methods are known as "Top-Down" and "Bottom-Up." The "Top-Down" approach simply determines the present value of the losses in revenue as the market price for electricity changes over a period of time into the future. The problem with this approach is that it does not take into account technical issues associated with the generation and wheeling of electricity. The "Bottom-Up" approach computes the present value of specific strandable generation facilities and compares the resulting valuations with their historical costs. It is regarded as a detailed and difficult, but more precise, approach to identifying stranded assets and their associated costs. This dissertation develops a "Bottom-Up" quantitative, optimization-based approach to electric power wheeling within the state of Louisiana. It optimally evaluates all production capabilities and coordinates the movement of bulk power through transmission interconnections of competing companies in and around the state. Sensitivity analysis to this approach is performed by varying seasonal consumer demand, electric power imports, and transmission inter-connection cost parameters. Generation facility economic dispatch and transmission interconnection bulk power transfers, specific to each set of parameters, lead to the identification of stranded generation facilities. Stranded costs of non-dispatched and uneconomically dispatched generation facilities can then be estimated to indicate, arguably, the largest portion of restructuring transition costs as the industry is transformed from its present monopolistic structure to a competitive one.

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.

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

10 CFR 436.12 - Life cycle cost methodology.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Life cycle cost methodology. 436.12 Section 436.12 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.12 Life cycle cost methodology. The life cycle cost methodology...

Cost Performance Estimating Relationships for Hybrid Electric Vehicle Components

DTIC Science & Technology

2003-07-31

Permanent magnet motors are more likely to be used as generators, while AC induction motors are more efficiently used as motors. Inverters/controllers can...than permanent magnet motors . Switched Reluctance motors are also used on hybrid electric vehicles, but are not used as widely as either AC...induction or permanent magnet motors , and are not analyzed here. Methodology The motor estimates are based on power, with kilowatts being the unit of

Cost analysis of new and retrofit hot-air type solar assisted heating systems

NASA Technical Reports Server (NTRS)

Stewart, R. D.; Hawkins, B. J.

1978-01-01

A detailed cost analysis/cost improvement study was performed on two Department of Energy/National Aeronautics and Space Administration operational test sites to determine actual costs and potential cost improvements of new and retrofit hot air type, solar assisted heating and hot water systems for single family sized structures. This analysis concentrated on the first cost of a system which included procurement, installation, and integration of a solar assisted heating and hot water system on a new or retrofit basis; it also provided several cost projections which can be used as inputs to payback analyses, depending upon the degree of optimism or future improvements assumed. Cost definitions were developed for five categories of cost, and preliminary estimates were developed for each. The costing methodology, approach, and results together with several candidate low cost designs are described.

Methodology for Prioritization of Investments to Support the Army Energy Strategy for Installations

DTIC Science & Technology

2012-07-01

kind of energy source onto its own footprint. Whether this is a solar, wind, biomass, geothermal , or any other kind of renewable energy source, it...more common. Right now extortion and disgruntled employers are the attacked and not sophisticated enemies such as China . Our current nation power...users to: • Estimate the NPV cost of energy (COE) and levelized cost of energy (LCOE) from a range of solar, wind and geothermal electricity generation

Testing the DMAA's recommendations for disease management program evaluation.

PubMed

Serxner, Seth; Mattke, Soeren; Zakowski, Sarah; Gold, Daniel

2008-10-01

The objective of this study was to compare and contrast findings regarding the financial savings projections of the disease management (DM) programs of 2 large employers based on different evaluation methods. In particular, this research tests the impact of differences in assumptions on the underlying growth rate of group health costs, exclusions of high-cost conditions and claims, and the length of the baseline period for determined health care costs. A pre-post study design was used. The data for this research came from 2 large employers in the consumer goods industry with comprehensive Health and Productivity Management programs. It contained medical and prescription drug claims and health plan enrollment data as well as program activity data from 2001 to 2005, covering an average yearly sample size of 201,037 members with 12 consecutive months of enrollment. Analyses were done on group-level averages using nominal cost data and were run to reflect the impact of a DM-only intervention. While the trend estimate and length of baseline had the largest effects on estimated program impact, the use of exclusions had an important effect as well. These findings demonstrate the importance of developing and instituting a standardized evaluation methodology. Without increasing consistency in the way evaluators develop their methodologies, it will remain difficult to be able to compare one evaluation to another, or to have faith in the results at hand.

Mechanical System Reliability and Cost Integration Using a Sequential Linear Approximation Method

NASA Technical Reports Server (NTRS)

Kowal, Michael T.

1997-01-01

The development of new products is dependent on product designs that incorporate high levels of reliability along with a design that meets predetermined levels of system cost. Additional constraints on the product include explicit and implicit performance requirements. Existing reliability and cost prediction methods result in no direct linkage between variables affecting these two dominant product attributes. A methodology to integrate reliability and cost estimates using a sequential linear approximation method is proposed. The sequential linear approximation method utilizes probability of failure sensitivities determined from probabilistic reliability methods as well a manufacturing cost sensitivities. The application of the sequential linear approximation method to a mechanical system is demonstrated.

Sedimentation and the Economics of Selecting an Optimum Reservoir Size

NASA Astrophysics Data System (ADS)

Miltz, David; White, David C.

1987-08-01

This paper attempts to develop an easily reproducible methodology for the economic selection of an optimal reservoir size given an annual sedimentation rate. The optimal capacity is that at which the marginal cost of constructing additional storage capacity is equal to the dredging costs avoided by having that additional capacity available to store sediment. The cost implications of misestimating dredging costs, construction costs, and sediment delivery rates are investigated. In general, it is shown that oversizing is a rational response to uncertainty in the estimation of parameters. The sensitivity of the results to alternative discount rates is also discussed. The theoretical discussion is illustrated with a case study drawn from Highland Silver Lake in southwestern Illinois.

Satellite servicing mission preliminary cost estimation model

NASA Technical Reports Server (NTRS)

1987-01-01

The cost model presented is a preliminary methodology for determining a rough order-of-magnitude cost for implementing a satellite servicing mission. Mission implementation, in this context, encompassess all activities associated with mission design and planning, including both flight and ground crew training and systems integration (payload processing) of servicing hardward with the Shuttle. A basic assumption made in developing this cost model is that a generic set of servicing hardware was developed and flight tested, is inventoried, and is maintained by NASA. This implies that all hardware physical and functional interfaces are well known and therefore recurring CITE testing is not required. The development of the cost model algorithms and examples of their use are discussed.

The cost of prevention and treatment of pressure ulcers: A systematic review.

PubMed

Demarré, Liesbet; Van Lancker, Aurélie; Van Hecke, Ann; Verhaeghe, Sofie; Grypdonck, Maria; Lemey, Juul; Annemans, Lieven; Beeckman, Dimitri

2015-11-01

Pressure ulcers impose a substantial financial burden. The need for high-quality health care while expenditures are constrained entails the interest to calculate the cost of preventing and treating pressure ulcers and their impact on patients, healthcare, and society. The aim of this paper is to provide insight into the cost of pressure ulcer prevention and treatment in an adult population. A systematic literature review was performed to conform the Cochrane Collaboration guidelines for systematic reviews. The search strategy contained index terms and key words related to pressure ulcers and cost. The search was performed in Medline, CINAHL, Web of Science, The Cochrane Library, Embase, and EconLit covering articles up to September 2013. Reference lists and conference abstracts were screened. Articles were eligible if they reported on direct medical cost of pressure ulcer prevention or treatment, and provided national cost estimates, cost per patient, or cost per patient per day. The Consensus on Health Economic Criteria checklist was used to assess methodological quality of the included studies. In total, 2542 records were retrieved. After assessing eligibility, 17 articles were included. Five articles reported on both the cost of prevention and treatment, three articles reported on cost of prevention, and nine articles reported on the cost of pressure ulcer treatment. All articles were published between 2001 and 2013. Cost of pressure ulcer prevention per patient per day varied between 2.65 € to 87.57 € across all settings. Cost of pressure ulcer treatment per patient per day ranged from 1.71 € to 470.49 € across different settings. The methodological heterogeneity among studies was considerable, and encompassed differences regarding type of health economic design, perspective, cost components, and health outcomes. Cost of pressure ulcer prevention and treatment differed considerable between studies. Although the cost to provide pressure ulcer prevention to patients at risk can importantly impact health care services' budgets, the costs to treat a severe pressure ulcer were found to be substantially higher. Methodological heterogeneity among studies identified the need to use available, and study design-specific methodological guidelines to conduct health economic studies, and the need for additional pressure ulcer specific recommendations. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Socio-Technical Exploration for Reducing & Mitigating the Risk of Retained Foreign Objects

PubMed Central

Corrigan, Siobhán; Kay, Alison; O’Byrne, Katie; Slattery, Dubhfeasa; Sheehan, Sharon; McDonald, Nick; Smyth, David; Mealy, Ken; Cromie, Sam

2018-01-01

A Retained Foreign Object (RFO) is a fairly infrequent but serious adverse event. An accurate rate of RFOs is difficult to establish due to underreporting but it has been estimated that incidences range between 1/1000 and 1/19,000 procedures. The cost of a RFO incident may be substantial and three-fold: (i) the cost to the patient of physical and/or psychological harm; (ii) the reputational cost to an institution and/or healthcare provider; and (iii) the financial cost to the taxpayer in the event of a legal claim. This Health Research Board-funded project aims to analyse and understand the problem of RFOs in surgical and maternity settings in Ireland and develop hospital-specific foreign object management processes and implementation roadmaps. This project will deploy an integrated evidence-based assessment methodology for social-technical modelling (Supply, Context, Organising, Process & Effects/ SCOPE Analysis Cube) and bow tie methodologies that focuses on managing the risks in effectively implementing and sustaining change. It comprises a multi-phase research approach that involves active and ongoing collaboration with clinical and other healthcare staff through each phase of the research. The specific objective of this paper is to present the methodological approach and outline the potential to produce generalisable results which could be applied to other health-related issues. PMID:29642646

Does technology acceleration equate to mask cost acceleration?

NASA Astrophysics Data System (ADS)

Trybula, Walter J.; Grenon, Brian J.

2003-06-01

The technology acceleration of the ITRS Roadmap has many implications on both the semiconductor sup-plier community and the manufacturers. INTERNATIONAL SEMATECH has revaluated the projected cost of advanced technology masks. Building on the methodology developed in 1996 for mask costs, this work provided a critical review of mask yields and factors relating to the manufacture of photolithography masks. The impact of the yields provided insight into the learning curve for leading edge mask manufac-turing. The projected mask set cost was surprising, and the ability to provide first and second year cost estimates provided additional information on technology introduction. From this information, the impact of technology acceleration can be added to the projected yields to evaluate the impact on mask costs.

The Estimation and Inclusion of Presenteeism Costs in Applied Economic Evaluation: A Systematic Review.

PubMed

Kigozi, Jesse; Jowett, Sue; Lewis, Martyn; Barton, Pelham; Coast, Joanna

2017-03-01

Given the significant costs of reduced productivity (presenteeism) in comparison to absenteeism, and overall societal costs, presenteeism has a potentially important role to play in economic evaluations. However, these costs are often excluded. The objective of this study is to review applied cost of illness studies and economic evaluations to identify valuation methods used for, and impact of including presenteeism costs in practice. A structured systematic review was carried out to explore (i) the extent to which presenteeism has been applied in cost of illness studies and economic evaluations and (ii) the overall impact of including presenteeism on overall costs and outcomes. Potential articles were identified by searching Medline, PsycINFO and NHS EED databases. A standard template was developed and used to extract information from economic evaluations and cost of illness studies incorporating presenteeism costs. A total of 28 studies were included in the systematic review which also demonstrated that presenteeism costs are rarely included in full economic evaluations. Estimation and monetisation methods differed between the instruments. The impact of disease on presenteeism whilst in paid work is high. The potential impact of presenteeism costs needs to be highlighted and greater consideration should be given to including these in economic evaluations and cost of illness studies. The importance of including presenteeism costs when conducting economic evaluation from a societal perspective should be emphasised in national economic guidelines and more methodological work is required to improve the practical application of presenteeism instruments to generate productivity cost estimates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland.

PubMed

Ginindza, Themba G; Sartorius, Benn; Dlamini, Xolisile; Östensson, Ellinor

2017-01-01

Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden. A prevalence-based cost of illness (COI) methodology was used to investigate the economic burden of HPV-related diseases. We used a top-down approach for the cost associated with hospital care and a bottom-up approach to estimate the cost associated with outpatient and primary care. The current study was conducted from a provider perspective since the state bears the majority of the costs of screening and treatment in Swaziland. All identifiable direct medical costs were considered for cervical lesions, cervical cancer and genital warts, which were primary diagnoses during 2015. A mix of bottom up micro-costing ingredients approach and top-down approaches was used to collect data on costs. All costs were computed at the price level of 2015 and converted to dollars ($). The total annual estimated direct medical cost associated with screening, managing and treating cervical lesions, CC and genital warts in Swaziland was $16 million. The largest cost in the analysis was estimated for treatment of high-grade cervical lesions and cervical cancer representing 80% of the total cost ($12.6 million). Costs for screening only represented 5% of the total cost ($0.9 million). Treatment of genital warts represented 6% of the total cost ($1million). According to the cost estimations in this study, the economic burden of HPV-related cervical diseases and genital warts represents a major public health issue in Swaziland. Prevention of HPV infection with a national HPV immunization programme for pre-adolescent girls would prevent the majority of CC related deaths and associated costs.

Estimating stream discharge from a Himalayan Glacier using coupled satellite sensor data

NASA Astrophysics Data System (ADS)

Child, S. F.; Stearns, L. A.; van der Veen, C. J.; Haritashya, U. K.; Tarpanelli, A.

2015-12-01

The 4th IPCC report highlighted our limited understanding of Himalayan glacier behavior and contribution to the region's hydrology. Seasonal snow and glacier melt in the Himalayas are important sources of water, but estimates greatly differ about the actual contribution of melted glacier ice to stream discharge. A more comprehensive understanding of the contribution of glaciers to stream discharge is needed because streams being fed by glaciers affect the livelihoods of a large part of the world's population. Most of the streams in the Himalayas are unmonitored because in situ measurements are logistically difficult and costly. This necessitates the use of remote sensing platforms to obtain estimates of river discharge for validating hydrological models. In this study, we estimate stream discharge using cost-effective methods via repeat satellite imagery from Landsat-8 and SENTINEL-1A sensors. The methodology is based on previous studies, which show that ratio values from optical satellite bands correlate well with measured stream discharge. While similar, our methodology relies on significantly higher resolution imagery (30 m) and utilizes bands that are in the blue and near-infrared spectrum as opposed to previous studies using 250 m resolution imagery and spectral bands only in the near-infrared. Higher resolution imagery is necessary for streams where the source is a glacier's terminus because the width of the stream is often only 10s of meters. We validate our methodology using two rivers in the state of Kansas, where stream gauges are plentiful. We then apply our method to the Bhagirathi River, in the North-Central Himalayas, which is fed by the Gangotri Glacier and has a well monitored stream gauge. The analysis will later be used to couple river discharge and glacier flow and mass balance through an integrated hydrologic model in the Bhagirathi Basin.

A high-resolution, empirical approach to climate impact assessment for regulatory analysis

NASA Astrophysics Data System (ADS)

Delgado, M.; Simcock, J. G.; Greenstone, M.; Hsiang, S. M.; Kopp, R. E.; Carleton, T.; Hultgren, A.; Jina, A.; Rising, J. A.; Nath, I.; Yuan, J.; Rode, A.; Chong, T.; Dobbels, G.; Hussain, A.; Wang, J.; Song, Y.; Mohan, S.; Larsen, K.; Houser, T.

2017-12-01

Recent breakthroughs in computing, data availability, and methodology have precipitated significant advances in the understanding of the relationship between climate and socioeconomic outcomes [1]. And while the use of estimates of the global marginal costs of greenhouse gas emissions (e.g. the SCC) are a mandatory component of regulatory policy in many jurisdictions, existing SCC-IAMs have lagged advances in impact assessment and valuation [2]. Recent work shows that incorporating high spatial and temporal resolution can significantly affect the observed relationships of economic outcomes to climate and socioeconomic factors [3] and that maintaining this granularity is critical to understanding the sensitivity of aggregate measures of valuation to inequality and risk adjustment methodologies [4]. We propose a novel framework that decomposes uncertainty in the SCC along multiple sources, including aggregate climate response parameters, the translation of global climate into local weather, the effect of weather on physical and economic systems, human and macro-economic responses, and impact valuation methodologies. This work extends Hsiang et al. (2017) [4] to directly estimate local response functions for multiple sectors in each of 24,378 global regions and to estimate impacts at this resolution daily, incorporating endogenous, empirically-estimated adaptation and costs. The goal of this work is to provide insight into the heterogeneity of climate impacts and to work with other modeling teams to enhance the empirical grounding of integrated climate impact assessment in more complex energy-environment-economics models. [1] T. Carleton and S. Hsiang (2016), DOI: 10.1126/science.aad9837. [2] National Academies of Sciences, Engineering, and Medicine (2017), DOI: 10.17226/24651. [3] Burke, M., S. Hsiang, and E. Miguel (2015), DOI: 10.1038/nature15725. [4] S. Hsiang et al. (2017), DOI: 10.1126/science.aal4369.

The cost of post-abortion care in developing countries: a comparative analysis of four studies.

PubMed

Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi

2016-10-01

Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology-the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30-60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52-68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3-12% of the average cost of treating a PAC patient. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

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

Ramuhalli, Pradeep; Hirt, Evelyn H.; Veeramany, Arun

This research report summaries the development and evaluation of a prototypic enhanced risk monitor (ERM) methodology (framework) that includes alternative risk metrics and uncertainty analysis. This updated ERM methodology accounts for uncertainty in the equipment condition assessment (ECA), the prognostic result, and the probabilistic risk assessment (PRA) model. It is anticipated that the ability to characterize uncertainty in the estimated risk and update the risk estimates in real time based on equipment condition assessment (ECA) will provide a mechanism for optimizing plant performance while staying within specified safety margins. These results (based on impacting active component O&M using real-time equipmentmore » condition information) are a step towards ERMs that, if integrated with AR supervisory plant control systems, can help control O&M costs and improve affordability of advanced reactors.« less

Telemonitoring for chronic obstructive pulmonary disease: a cost and cost-utility analysis of a randomised controlled trial.

PubMed

Stoddart, Andrew; van der Pol, Marjon; Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Todd, Allison; Krishan, Ashma; McKinstry, Brian

2015-03-01

We compared the costs and cost-effectiveness of telemonitoring vs usual care for patients with chronic obstructive pulmonary disease (COPD). A total of 256 patients were randomised to either telemonitoring or usual care. In the telemonitoring arm, the touch-screen telemonitoring equipment transmitted data to clinical teams monitoring the patients. Total healthcare costs were estimated over a 12-month period from a National Health Service perspective and quality adjusted life year (QALYs) were estimated by the EQ-5D tool. Telemonitoring was not significantly more costly than usual care (mean difference per patient £2065.90 (P < 0.18). The increased costs were predominantly due to telemonitoring service costs and non-significantly higher secondary care costs. Telemonitoring for COPD was not cost-effective at a base case of £137,277 per QALY with only 15% probability of being cost-effective at the usual threshold of £30,000 per QALY. Although there was some statistical and methodological uncertainty in the measures used, telemonitoring was not cost-effective in the sensitivity analyses performed. It seems unlikely that a telemonitoring service of the kind that was trialled would be cost-effective in providing care for people with COPD. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

[Costing nuclear medicine diagnostic procedures].

PubMed

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

Experiences of Structured Elicitation for Model-Based Cost-Effectiveness Analyses.

PubMed

Soares, Marta O; Sharples, Linda; Morton, Alec; Claxton, Karl; Bojke, Laura

2018-06-01

Empirical evidence supporting the cost-effectiveness estimates of particular health care technologies may be limited, or it may even be missing entirely. In these situations, additional information, often in the form of expert judgments, is needed to reach a decision. There are formal methods to quantify experts' beliefs, termed as structured expert elicitation (SEE), but only limited research is available in support of methodological choices. Perhaps as a consequence, the use of SEE in the context of cost-effectiveness modelling is limited. This article reviews applications of SEE in cost-effectiveness modelling with the aim of summarizing the basis for methodological choices made in each application and recording the difficulties and challenges reported by the authors in the design, conduct, and analyses. The methods used in each application were extracted along with the criteria used to support methodological and practical choices and any issues or challenges discussed in the text. Issues and challenges were extracted using an open field, and then categorised and grouped for reporting. The review demonstrates considerable heterogeneity in methods used, and authors acknowledge great methodological uncertainty in justifying their choices. Specificities of the context area emerging as potentially important in determining further methodological research in elicitation are between- expert variation and its interpretation, the fact that substantive experts in the area may not be trained in quantitative subjects, that judgments are often needed on various parameter types, the need for some form of assessment of validity, and the need for more integration with behavioural research to devise relevant debiasing strategies. This review of experiences of SEE highlights a number of specificities/constraints that can shape the development of guidance and target future research efforts in this area. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Expanding Early Childhood Care and Education: How Much Does It Cost? A Proposal for a Methodology to Estimate the Costs of Early Childhood Care and Education at Macro-Level, Applied to Arab States. Working Papers in Early Childhood Development, No. 46

ERIC Educational Resources Information Center

van Ravens, Jan; Aggio, Carlos

2008-01-01

While the critical importance of early childhood care and education (ECCE) is undisputed, few developing countries are presently pursuing strong national policies to expand it. Thus, Goal One of the Education for All (EFA) agenda--"Expanding and improving comprehensive early childhood care and education, especially for the most vulnerable and…

Analytical Study on Thermal and Mechanical Design of Printed Circuit Heat Exchanger

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

Yoon, Su-Jong; Sabharwall, Piyush; Kim, Eung-Soo

2013-09-01

The analytical methodologies for the thermal design, mechanical design and cost estimation of printed circuit heat exchanger are presented in this study. In this study, three flow arrangements of parallel flow, countercurrent flow and crossflow are taken into account. For each flow arrangement, the analytical solution of temperature profile of heat exchanger is introduced. The size and cost of printed circuit heat exchangers for advanced small modular reactors, which employ various coolants such as sodium, molten salts, helium, and water, are also presented.

New model framework and structure and the commonality evaluation model. [concerning unmanned spacecraft projects

NASA Technical Reports Server (NTRS)

1977-01-01

The development of a framework and structure for shuttle era unmanned spacecraft projects and the development of a commonality evaluation model is documented. The methodology developed for model utilization in performing cost trades and comparative evaluations for commonality studies is discussed. The model framework consists of categories of activities associated with the spacecraft system's development process. The model structure describes the physical elements to be treated as separate identifiable entities. Cost estimating relationships for subsystem and program-level components were calculated.

Estimating Soil Hydraulic Parameters using Gradient Based Approach

NASA Astrophysics Data System (ADS)

Rai, P. K.; Tripathi, S.

2017-12-01

The conventional way of estimating parameters of a differential equation is to minimize the error between the observations and their estimates. The estimates are produced from forward solution (numerical or analytical) of differential equation assuming a set of parameters. Parameter estimation using the conventional approach requires high computational cost, setting-up of initial and boundary conditions, and formation of difference equations in case the forward solution is obtained numerically. Gaussian process based approaches like Gaussian Process Ordinary Differential Equation (GPODE) and Adaptive Gradient Matching (AGM) have been developed to estimate the parameters of Ordinary Differential Equations without explicitly solving them. Claims have been made that these approaches can straightforwardly be extended to Partial Differential Equations; however, it has been never demonstrated. This study extends AGM approach to PDEs and applies it for estimating parameters of Richards equation. Unlike the conventional approach, the AGM approach does not require setting-up of initial and boundary conditions explicitly, which is often difficult in real world application of Richards equation. The developed methodology was applied to synthetic soil moisture data. It was seen that the proposed methodology can estimate the soil hydraulic parameters correctly and can be a potential alternative to the conventional method.

Drug utilisation review (DUR) of the third generation cephalosporins. Focus on ceftriaxone, ceftazidime and cefotaxime.

PubMed

Adu, A; Armour, C L

1995-09-01

Six parenteral third generation cephalosporins have been introduced into clinical use in the past 10 years. The 3 most frequently available agents are cefotaxime, ceftriaxone and ceftazidime. These 3 third generation cephalosporins are characterised by a broad spectrum of activity and increased stability to beta-lactamases compared with the first and second generation cephalosporins. However, there are growing numbers of reports of resistance to these agents with increasing use. The major differences in the properties of the 3 agents are the long half-life of ceftriaxone and its dual route of elimination. Ceftazidime is best restricted to Pseudomonas aeruginosa infections where other agents are contraindicated or ineffective. Cefotaxime and ceftriaxone can be used in nosocomial Gram-negative infections where P. aeruginosa can be ruled out. The types and incidences of adverse drug reactions are not different for the 3 agents. A number of drug utilisation review (DUR) studies of these agents in the hospital setting have reported a considerable incidence of inappropriate use and substantial avoidable costs. There are methodological problems with most of the DUR studies, especially the criteria and the methods of cost estimation. The use of pharmacoeconomic methodology could ensure more realistic cost estimation; however, outcome data are, in most cases, not available.

Pediatric Price Transparency: Still Opaque With Opportunities for Improvement.

PubMed

Faherty, Laura J; Wong, Charlene A; Feingold, Jordyn; Li, Joan; Town, Robert; Fieldston, Evan; Werner, Rachel M

2017-10-01

Price transparency is gaining importance as families' portion of health care costs rise. We describe (1) online price transparency data for pediatric care on children's hospital Web sites and state-based price transparency Web sites, and (2) the consumer experience of obtaining an out-of-pocket estimate from children's hospitals for a common procedure. From 2015 to 2016, we audited 45 children's hospital Web sites and 38 state-based price transparency Web sites, describing availability and characteristics of health care prices and personalized cost estimate tools. Using secret shopper methodology, we called children's hospitals and submitted online estimate requests posing as a self-paying family requesting an out-of-pocket estimate for a tonsillectomy-adenoidectomy. Eight children's hospital Web sites (18%) listed prices. Twelve (27%) provided personalized cost estimate tool (online form n = 5 and/or phone number n = 9). All 9 hospitals with a phone number for estimates provided the estimated patient liability for a tonsillectomy-adenoidectomy (mean $6008, range $2622-$9840). Of the remaining 36 hospitals without a dedicated price estimate phone number, 21 (58%) provided estimates (mean $7144, range $1200-$15 360). Two of 4 hospitals with online forms provided estimates. Fifteen (39%) state-based Web sites distinguished between prices for pediatric and adult care. One had a personalized cost estimate tool. Meaningful prices for pediatric care were not widely available online through children's hospital or state-based price transparency Web sites. A phone line or online form for price estimates were effective strategies for hospitals to provide out-of-pocket price information. Opportunities exist to improve pediatric price transparency. Copyright © 2017 by the American Academy of Pediatrics.

Cost-Effectiveness of Buprenorphine and Naltrexone Treatments for Heroin Dependence in Malaysia

PubMed Central

Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Ng, Nora; Schottenfeld, Richard

2012-01-01

Aims To aid public health policymaking, we studied the cost-effectiveness of buprenorphine, naltrexone, and placebo interventions for heroin dependence in Malaysia. Design We estimated the cost-effectiveness ratios of three treatments for heroin dependence. We used a microcosting methodology to determine fixed, variable, and societal costs of each intervention. Cost data were collected from investigators, staff, and project records on the number and type of resources used and unit costs; societal costs for participants’ time were estimated using Malaysia’s minimum wage. Costs were estimated from a provider and societal perspective and reported in 2004 US dollars. Setting Muar, Malaysia. Participants 126 patients enrolled in a randomized, double-blind, placebo-controlled clinical trial in Malaysia (2003–2005) receiving counseling and buprenorphine, naltrexone, or placebo for treatment of heroin dependence. Measurements Primary outcome measures included days in treatment, maximum consecutive days of heroin abstinence, days to first heroin use, and days to heroin relapse. Secondary outcome measures included treatment retention, injection drug use, illicit opiate use, AIDS Risk Inventory total score, and drug risk and sex risk subscores. Findings Buprenorphine was more effective and more costly than naltrexone for all primary and most secondary outcomes. Incremental cost-effectiveness ratios were below $50 for primary outcomes, mostly below $350 for secondary outcomes. Naltrexone was dominated by placebo for all secondary outcomes at almost all endpoints. Incremental treatment costs were driven mainly by medication costs, especially the price of buprenorphine. Conclusions Buprenorphine appears to be a cost-effective alternative to naltrexone that might enhance economic productivity and reduce drug use over a longer term. PMID:23226534

Cost-effectiveness of buprenorphine and naltrexone treatments for heroin dependence in Malaysia.

PubMed

Ruger, Jennifer Prah; Chawarski, Marek; Mazlan, Mahmud; Ng, Nora; Schottenfeld, Richard

2012-01-01

To aid public health policymaking, we studied the cost-effectiveness of buprenorphine, naltrexone, and placebo interventions for heroin dependence in Malaysia. We estimated the cost-effectiveness ratios of three treatments for heroin dependence. We used a microcosting methodology to determine fixed, variable, and societal costs of each intervention. Cost data were collected from investigators, staff, and project records on the number and type of resources used and unit costs; societal costs for participants' time were estimated using Malaysia's minimum wage. Costs were estimated from a provider and societal perspective and reported in 2004 US dollars. Muar, Malaysia. 126 patients enrolled in a randomized, double-blind, placebo-controlled clinical trial in Malaysia (2003-2005) receiving counseling and buprenorphine, naltrexone, or placebo for treatment of heroin dependence. Primary outcome measures included days in treatment, maximum consecutive days of heroin abstinence, days to first heroin use, and days to heroin relapse. Secondary outcome measures included treatment retention, injection drug use, illicit opiate use, AIDS Risk Inventory total score, and drug risk and sex risk subscores. Buprenorphine was more effective and more costly than naltrexone for all primary and most secondary outcomes. Incremental cost-effectiveness ratios were below $50 for primary outcomes, mostly below $350 for secondary outcomes. Naltrexone was dominated by placebo for all secondary outcomes at almost all endpoints. Incremental treatment costs were driven mainly by medication costs, especially the price of buprenorphine. Buprenorphine appears to be a cost-effective alternative to naltrexone that might enhance economic productivity and reduce drug use over a longer term.

Concept design theory and model for multi-use space facilities: Analysis of key system design parameters through variance of mission requirements

NASA Astrophysics Data System (ADS)

Reynerson, Charles Martin

This research has been performed to create concept design and economic feasibility data for space business parks. A space business park is a commercially run multi-use space station facility designed for use by a wide variety of customers. Both space hardware and crew are considered as revenue producing payloads. Examples of commercial markets may include biological and materials research, processing, and production, space tourism habitats, and satellite maintenance and resupply depots. This research develops a design methodology and an analytical tool to create feasible preliminary design information for space business parks. The design tool is validated against a number of real facility designs. Appropriate model variables are adjusted to ensure that statistical approximations are valid for subsequent analyses. The tool is used to analyze the effect of various payload requirements on the size, weight and power of the facility. The approach for the analytical tool was to input potential payloads as simple requirements, such as volume, weight, power, crew size, and endurance. In creating the theory, basic principles are used and combined with parametric estimation of data when necessary. Key system parameters are identified for overall system design. Typical ranges for these key parameters are identified based on real human spaceflight systems. To connect the economics to design, a life-cycle cost model is created based upon facility mass. This rough cost model estimates potential return on investments, initial investment requirements and number of years to return on the initial investment. Example cases are analyzed for both performance and cost driven requirements for space hotels, microgravity processing facilities, and multi-use facilities. In combining both engineering and economic models, a design-to-cost methodology is created for more accurately estimating the commercial viability for multiple space business park markets.

Labor costs incurred by anesthesiology groups because of operating rooms not being allocated and cases not being scheduled to maximize operating room efficiency.

PubMed

Abouleish, Amr E; Dexter, Franklin; Epstein, Richard H; Lubarsky, David A; Whitten, Charles W; Prough, Donald S

2003-04-01

Determination of operating room (OR) block allocation and case scheduling is often not based on maximizing OR efficiency, but rather on tradition and surgeon convenience. As a result, anesthesiology groups often incur additional labor costs. When negotiating financial support, heads of anesthesiology departments are often challenged to justify the subsidy necessary to offset these additional labor costs. In this study, we describe a method for calculating a statistically sound estimate of the excess labor costs incurred by an anesthesiology group because of inefficient OR allocation and case scheduling. OR information system and anesthesia staffing data for 1 yr were obtained from two university hospitals. Optimal OR allocation for each surgical service was determined by maximizing the efficiency of use of the OR staff. Hourly costs were converted to dollar amounts by using the nationwide median compensation for academic and private-practice anesthesia providers. Differences between actual costs and the optimal OR allocation were determined. For Hospital A, estimated annual excess labor costs were $1.6 million (95% confidence interval, $1.5-$1.7 million) and $2.0 million ($1.89-$2.05 million) when academic and private-practice compensation, respectively, was calculated. For Hospital B, excess labor costs were $1.0 million ($1.08-$1.17 million) and $1.4 million ($1.32-1.43 million) for academic and private-practice compensation, respectively. This study demonstrates a methodology for an anesthesiology group to estimate its excess labor costs. The group can then use these estimates when negotiating for subsidies with its hospital, medical school, or multispecialty medical group. We describe a new application for a previously reported statistical method to calculate operating room (OR) allocations to maximize OR efficiency. When optimal OR allocations and case scheduling are not implemented, the resulting increase in labor costs can be used in negotiations as a statistically sound estimate for the increased labor cost to the anesthesiology department.

Healthcare tariffs for specialist inpatient neurorehabilitation services: rationale and development of a UK casemix and costing methodology.

PubMed

Turner-Stokes, Lynne; Sutch, Stephen; Dredge, Robert

2012-03-01

To describe the rationale and development of a casemix model and costing methodology for tariff development for specialist neurorehabilitation services in the UK. Patients with complex needs incur higher treatment costs. Fair payment should be weighted in proportion to costs of providing treatment, and should allow for variation over time CASEMIX MODEL AND BAND-WEIGHTING: Case complexity is measured by the Rehabilitation Complexity Scale (RCS). Cases are divided into five bands of complexity, based on the total RCS score. The principal determinant of costs in rehabilitation is staff time. Total staff hours/week (estimated from the Northwick Park Nursing and Therapy Dependency Scales) are analysed within each complexity band, through cross-sectional analysis of parallel ratings. A 'band-weighting' factor is derived from the relative proportions of staff time within each of the five bands. Total unit treatment costs are obtained from retrospective analysis of provider hospitals' budget and accounting statements. Mean bed-day costs (total unit cost/occupied bed days) are divided broadly into 'variable' and 'non-variable' components. In the weighted costing model, the band-weighting factor is applied to the variable portion of the bed-day cost to derive a banded cost, and thence a set of cost-multipliers. Preliminary data from one unit are presented to illustrate how this weighted costing model will be applied to derive a multilevel banded payment model, based on serial complexity ratings, to allow for change over time.

Assessment of Integrated Pedestrian Protection Systems with Autonomous Emergency Braking (AEB) and Passive Safety Components.

PubMed

Edwards, Mervyn; Nathanson, Andrew; Carroll, Jolyon; Wisch, Marcus; Zander, Oliver; Lubbe, Nils

2015-01-01

Autonomous emergency braking (AEB) systems fitted to cars for pedestrians have been predicted to offer substantial benefit. On this basis, consumer rating programs-for example, the European New Car Assessment Programme (Euro NCAP)-are developing rating schemes to encourage fitment of these systems. One of the questions that needs to be answered to do this fully is how the assessment of the speed reduction offered by the AEB is integrated with the current assessment of the passive safety for mitigation of pedestrian injury. Ideally, this should be done on a benefit-related basis. The objective of this research was to develop a benefit-based methodology for assessment of integrated pedestrian protection systems with AEB and passive safety components. The method should include weighting procedures to ensure that it represents injury patterns from accident data and replicates an independently estimated benefit of AEB. A methodology has been developed to calculate the expected societal cost of pedestrian injuries, assuming that all pedestrians in the target population (i.e., pedestrians impacted by the front of a passenger car) are impacted by the car being assessed, taking into account the impact speed reduction offered by the car's AEB (if fitted) and the passive safety protection offered by the car's frontal structure. For rating purposes, the cost for the assessed car is normalized by comparing it to the cost calculated for a reference car. The speed reductions measured in AEB tests are used to determine the speed at which each pedestrian in the target population will be impacted. Injury probabilities for each impact are then calculated using the results from Euro NCAP pedestrian impactor tests and injury risk curves. These injury probabilities are converted into cost using "harm"-type costs for the body regions tested. These costs are weighted and summed. Weighting factors were determined using accident data from Germany and Great Britain and an independently estimated AEB benefit. German and Great Britain versions of the methodology are available. The methodology was used to assess cars with good, average, and poor Euro NCAP pedestrian ratings, in combination with a current AEB system. The fitment of a hypothetical A-pillar airbag was also investigated. It was found that the decrease in casualty injury cost achieved by fitting an AEB system was approximately equivalent to that achieved by increasing the passive safety rating from poor to average. Because the assessment was influenced strongly by the level of head protection offered in the scuttle and windscreen area, a hypothetical A-pillar airbag showed high potential to reduce overall casualty cost. A benefit-based methodology for assessment of integrated pedestrian protection systems with AEB has been developed and tested. It uses input from AEB tests and Euro NCAP passive safety tests to give an integrated assessment of the system performance, which includes consideration of effects such as the change in head impact location caused by the impact speed reduction given by the AEB.

78 FR 60885 - Proposed Collection; 60-Day Notice Request: Application Process for Clinical Research Training...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... the Office of Management and Budget (OMB) for review and approval. Written comments and/or suggestions... methodology and assumptions used; (3) The quality, utility, and clarity of the information to be collected.... There are capital, operating, and/or maintenance costs of $98,022. The total estimated annualized burden...

Benefit/cost comparison for utility SMES applications

NASA Astrophysics Data System (ADS)

Desteese, J. G.; Dagle, J. E.

1991-08-01

This paper summarizes eight case studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES applications in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios than those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in many utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems.

Costs and Effects of Abdominal versus Laparoscopic Hysterectomy: Systematic Review of Controlled Trials

PubMed Central

Bijen, Claudia B. M.; Vermeulen, Karin M.; Mourits, Marian J. E.; de Bock, Geertruida H.

2009-01-01

Objective Comparative evaluation of costs and effects of laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH). Data sources Controlled trials from Cochrane Central register of controlled trials, Medline, Embase and prospective trial registers. Selection of studies Twelve (randomized) controlled studies including the search terms costs, laparoscopy, laparotomy and hysterectomy were identified. Methods The type of cost analysis, perspective of cost analyses and separate cost components were assessed. The direct and indirect costs were extracted from the original studies. For the cost estimation, hospital stay and procedure costs were selected as most important cost drivers. As main outcome the major complication rate was taken. Findings Analysis was performed on 2226 patients, of which 1013 (45.5%) in the LH group and 1213 (54.5%) in the AH group. Five studies scored ≥10 points (out of 19) for methodological quality. The reported total direct costs in the LH group ($63,997) were 6.1% higher than the AH group ($60,114). The reported total indirect costs of the LH group ($1,609) were half of the total indirect in the AH group ($3,139). The estimated mean major complication rate in the LH group (14.3%) was lower than in the AH group (15.9%). The estimated total costs in the LH group were $3,884 versus $3,312 in the AH group. The incremental costs for reducing one patient with major complication(s) in the LH group compared to the AH group was $35,750. Conclusions The shorter hospital stay in the LH group compensates for the increased procedure costs, with less morbidity. LH points in the direction of cost effectiveness, however further research is warranted with a broader costs perspective including long term effects as societal benefit, quality of life and survival. PMID:19806210

Describing the epidemiology of rheumatic diseases: methodological aspects.

PubMed

Guillemin, Francis

2012-03-01

Producing descriptive epidemiology data is essential to understand the burden of rheumatic diseases (prevalence) and their dynamic in the population (incidence). No matter how simple such indicators may look, the correct collection of data and the appropriate interpretation of the results face several challenges: distinguishing indicators, facing the costs of obtaining data, using appropriate definition, identifying optimal sources of data, choosing among many survey methods, dealing with estimates precision, and standardizing results. This study describes the underlying methodological difficulties to be overcome so as to make descriptive indicators reliable and interpretable.

Estimation of spatial-temporal gait parameters using a low-cost ultrasonic motion analysis system.

PubMed

Qi, Yongbin; Soh, Cheong Boon; Gunawan, Erry; Low, Kay-Soon; Thomas, Rijil

2014-08-20

In this paper, a low-cost motion analysis system using a wireless ultrasonic sensor network is proposed and investigated. A methodology has been developed to extract spatial-temporal gait parameters including stride length, stride duration, stride velocity, stride cadence, and stride symmetry from 3D foot displacements estimated by the combination of spherical positioning technique and unscented Kalman filter. The performance of this system is validated against a camera-based system in the laboratory with 10 healthy volunteers. Numerical results show the feasibility of the proposed system with average error of 2.7% for all the estimated gait parameters. The influence of walking speed on the measurement accuracy of proposed system is also evaluated. Statistical analysis demonstrates its capability of being used as a gait assessment tool for some medical applications.

Overview of methods in economic analyses of behavioral interventions to promote oral health

PubMed Central

O’Connell, Joan M.; Griffin, Susan

2016-01-01

Background Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. Objective To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. Methods We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Discussion Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly. PMID:21656966

Overview of methods in economic analyses of behavioral interventions to promote oral health.

PubMed

O'Connell, Joan M; Griffin, Susan

2011-01-01

Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.

A model for the sustainable selection of building envelope assemblies

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

Huedo, Patricia, E-mail: huedo@uji.es; Mulet, Elena, E-mail: emulet@uji.es; López-Mesa, Belinda, E-mail: belinda@unizar.es

2016-02-15

The aim of this article is to define an evaluation model for the environmental impacts of building envelopes to support planners in the early phases of materials selection. The model is intended to estimate environmental impacts for different combinations of building envelope assemblies based on scientifically recognised sustainability indicators. These indicators will increase the amount of information that existing catalogues show to support planners in the selection of building assemblies. To define the model, first the environmental indicators were selected based on the specific aims of the intended sustainability assessment. Then, a simplified LCA methodology was developed to estimate themore » impacts applicable to three types of dwellings considering different envelope assemblies, building orientations and climate zones. This methodology takes into account the manufacturing, installation, maintenance and use phases of the building. Finally, the model was validated and a matrix in Excel was created as implementation of the model. - Highlights: • Method to assess the envelope impacts based on a simplified LCA • To be used at an earlier phase than the existing methods in a simple way. • It assigns a score by means of known sustainability indicators. • It estimates data about the embodied and operating environmental impacts. • It compares the investment costs with the costs of the consumed energy.« less

Macro-economic assessment of flood risk in Italy under current and future climate

NASA Astrophysics Data System (ADS)

Carrera, Lorenzo; Koks, Elco; Mysiak, Jaroslav; Aerts, Jeroen; Standardi, Gabriele

2014-05-01

This paper explores an integrated methodology for assessing direct and indirect costs of fluvial flooding to estimate current and future fluvial flood risk in Italy. Our methodology combines a Geographic Information System spatial approach, with a general economic equilibrium approach using a downscaled modified version of a Computable General Equilibrium model at NUTS2 scale. Given the level of uncertainty in the behavior of disaster-affected economies, the simulation considers a wide range of business recovery periods. We calculate expected annual losses for each NUTS2 region, and exceedence probability curves to determine probable maximum losses. Given a certain acceptable level of risk, we describe the conditions of flood protection and business recovery periods under which losses are contained within this limit. Because of the difference between direct costs, which are an overestimation of stock losses, and indirect costs, which represent the macro-economic effects, our results have different policy meanings. While the former is relevant for post-disaster recovery, the latter is more relevant for public policy issues, particularly for cost-benefit analysis and resilience assessment.

CubeSat mission design software tool for risk estimating relationships

NASA Astrophysics Data System (ADS)

Gamble, Katharine Brumbaugh; Lightsey, E. Glenn

2014-09-01

In an effort to make the CubeSat risk estimation and management process more scientific, a software tool has been created that enables mission designers to estimate mission risks. CubeSat mission designers are able to input mission characteristics, such as form factor, mass, development cycle, and launch information, in order to determine the mission risk root causes which historically present the highest risk for their mission. Historical data was collected from the CubeSat community and analyzed to provide a statistical background to characterize these Risk Estimating Relationships (RERs). This paper develops and validates the mathematical model based on the same cost estimating relationship methodology used by the Unmanned Spacecraft Cost Model (USCM) and the Small Satellite Cost Model (SSCM). The RER development uses general error regression models to determine the best fit relationship between root cause consequence and likelihood values and the input factors of interest. These root causes are combined into seven overall CubeSat mission risks which are then graphed on the industry-standard 5×5 Likelihood-Consequence (L-C) chart to help mission designers quickly identify areas of concern within their mission. This paper is the first to document not only the creation of a historical database of CubeSat mission risks, but, more importantly, the scientific representation of Risk Estimating Relationships.

[Economic assessment in health and environment from control of persistent organic pollutants in Colombia].

PubMed

García-Ubaque, César A; García-Ubaque, Juan C; Vaca-Bohórquez, Martha L

2015-12-01

Objective To estimate the economic benefits related to environment and health in the context of the implementation of the Stockholm Convention for the control of Persistent Organic Pollutants in the country. The estimation was conducted based on two scenarios: non-compliance with the agreement and compliance with the Convention. Gross profit was derived from the difference in present value between the health and environmental costs that are assumed in each scenario. Results Gross profit by decreasing health costs arising from the implementation of the Convention was estimated at USD $ 511 and USD $ 501 million. By introducing variables such as management costs and agreement on potential benefits for access to international markets, the benefits to the country were estimated at between USD $1 631 and USD $ 3 118 million. Discussion Despite the economic benefits generated by lower expenditure on health for the Convention implementation, the costs associated with reducing pollutant emissions generated a negative balance, compensated only by the expectation of higher revenues for international market access. We consider this initial economic assessment an important contribution, but it should be reviewed to include valuation methodologies involving other social profitability variables and different scenarios for emerging technologies, new scientific knowledge about these pollutants, changes in legislation and / or changes in trade agreement conditions, among others.

Mitigation potential and cost in tropical forestry - relative role for agroforestry

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

Makundi, Willy R.; Sathaye, Jayant A.

2004-01-01

This paper summarizes studies of carbon mitigation potential (MP) and costs of forestry options in seven developing countries with a focus on the role of agroforestry. A common methodological approach known as comprehensive mitigation assessment process (COMAP) was used in each study to estimate the potential and costs between 2000 and 2030. The approach requires the projection of baseline and mitigation land-use scenarios derived from the demand for forest products and forestland for other uses such as agriculture and pasture. By using data on estimated carbon sequestration, emission avoidance, costs and benefits, the model enables one to estimate cost effectivenessmore » indicators based on monetary benefit per t C, as well as estimates of total mitigation costs and potential when the activities are implemented at equilibrium level. The results show that about half the MP of 6.9 Gt C (an average of 223 Mt C per year) between 2000 and 2030 in the seven countries could be achieved at a negative cost, and the other half at costs not exceeding $100 per t C. Negative cost indicates that non-carbon revenue is sufficient to offset direct costs of about half of the options. The agroforestry options analyzed bear a significant proportion of the potential at medium to low cost per t C when compared to other options. The role of agroforestry in these countries varied between 6% and 21% of the MP, though the options are much more cost effective than most due to the low wage or opportunity cost of rural labor. Agroforestry options are attractive due to the large number of people and potential area currently engaged in agriculture, but they pose unique challenges for carbon and cost accounting due to the dispersed nature of agricultural activities in the tropics, as well as specific difficulties arising from requirements for monitoring, verification, leakage assessment and the establishment of credible baselines.« less

Societal costs of multiple sclerosis in Ireland.

PubMed

Carney, Peter; O'Boyle, Derek; Larkin, Aidan; McGuigan, Christopher; O'Rourke, Killian

2018-05-01

This paper evaluates the impact of multiple sclerosis (MS) in Ireland, and estimates the associated direct, indirect, and intangible costs to society based on a large nationally representative sample. A questionnaire was developed to capture the demographics, disease characteristics, healthcare use, informal care, employment, and wellbeing. Referencing international studies, standardized survey instruments were included (e.g. CSRI, MFIS-5, EQ-5D) or adapted (EDSS) for inclusion in an online survey platform. Recruitment was directed at people with MS via the MS Society mailing list and social media platforms, as well as in traditional media. The economic costing was primarily conducted using a 'bottom-up' methodology, and national estimates were achieved using 'prevalence-based' extrapolation. A total of 594 people completed the survey in full. The sample had geographic, disease, and demographic characteristics indicating good representativeness. At an individual level, average societal cost was estimated at €47,683; the average annual costs for those with mild, moderate, and severe MS were calculated as €34,942, €57,857, and €100,554, respectively. For a total Irish MS population of 9,000, the total societal costs of MS amounted to €429m. Direct costs accounted for just 30% of the total societal costs, indirect costs amounted to 50% of the total, and intangible or QoL costs represented 20%. The societal cost associated with a relapse in the sample is estimated as €2,438. The findings highlight that up to 70% of the total costs associated with MS are not routinely counted. These "hidden" costs are higher in Ireland than the rest of Europe, due in part to significantly lower levels of workforce participation, a higher likelihood of permanent workforce withdrawal, and higher levels of informal care needs. The relationship between disease progression and costs emphasize the societal importance of managing and slowing the progression of the illness.

Estimating Renewable Energy Economic Potential in the United States: Methodology and Initial Results

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

Brown, Austin; Beiter, Philipp; Heimiller, Donna

The report describes a geospatial analysis method to estimate the economic potential of several renewable resources available for electricity generation in the United States. Economic potential, one measure of renewable generation potential, is defined in this report as the subset of the available resource technical potential where the cost required to generate the electricity (which determines the minimum revenue requirements for development of the resource) is below the revenue available in terms of displaced energy and displaced capacity.

Evaluating the Treatment Costs for Uncomplicated Malaria at a Public Healthcare Facility in Nigeria and the Implications.

PubMed

Ezenduka, Charles C; Falleiros, Daniel Resende; Godman, Brian B

2017-09-01

Accurate information on the facility costs of treatment is essential to enhance decision making and funding for malaria control. The objective of this study was to estimate the costs of providing treatment for uncomplicated malaria through a public health facility in Nigeria. Hospital costs were estimated from a provider perspective, applying a standard costing procedure. Capital and recurrent expenditures were estimated using an ingredient approach combined with step-down methodology. Costs attributable to malaria treatment were calculated based on the proportion of malaria cases to total outpatient visits. The costs were calculated in local currency [Naira (N)] and converted to US dollars at the 2013 exchange rate. Total annual costs of N28.723 million (US$182,953.65) were spent by the facility on the treatment of uncomplicated malaria, at a rate of US$31.49 per case, representing approximately 25% of the hospital's total expenditure in the study year. Personnel accounted for over 82.5% of total expenditure, followed by antimalarial medicines at 6.6%. More than 45% of outpatients visits were for uncomplicated malaria. Changes in personnel costs, drug prices and malaria prevalence significantly impacted on the study results, indicating the need for improved efficiency in the use of hospital resources. Malaria treatment currently consumes a considerable amount of resources in the facility, driven mainly by personnel cost and a high proportion of malaria cases. There is scope for enhanced efficiency to prevent waste and reduce costs to the provider and ultimately the consumer.

Costs of occupational injury and illness across industries.

PubMed

Leigh, J Paul; Waehrer, Geetha; Miller, Ted R; Keenan, Craig

2004-06-01

This study has ranked industries using estimated total costs and costs per worker. This incidence study of nationwide data was carried out in 1993. The main outcome measure was total cost for medical care, lost productivity, and pain and suffering for the entire United States (US). The analysis was conducted using fatal and nonfatal injury and illness data recorded in large data sets from the US Bureau of Labor Statistics. Cost data were derived from workers' compensation records, estimates of lost wages, and jury awards. Current-value calculations were used to express all costs in 1993 in US dollars. The following industries were at the top of the list for average cost (cost per worker): taxicabs, bituminous coal and lignite mining, logging, crushed stone, oil field services, water transportation services, sand and gravel, and trucking. Industries high on the total-cost list were trucking, eating and drinking places, hospitals, grocery stores, nursing homes, motor vehicles, and department stores. Industries at the bottom of the cost-per-worker list included legal services, security brokers, mortgage bankers, security exchanges, and labor union offices. Detailed methodology was developed for ranking industries by total cost and cost per worker. Ranking by total costs provided information on total burden of hazards, and ranking by cost per worker provided information on risk. Industries that ranked high on both lists deserve increased research and regulatory attention.

Evaluating performance of stormwater sampling approaches using a dynamic watershed model.

PubMed

Ackerman, Drew; Stein, Eric D; Ritter, Kerry J

2011-09-01

Accurate quantification of stormwater pollutant levels is essential for estimating overall contaminant discharge to receiving waters. Numerous sampling approaches exist that attempt to balance accuracy against the costs associated with the sampling method. This study employs a novel and practical approach of evaluating the accuracy of different stormwater monitoring methodologies using stormflows and constituent concentrations produced by a fully validated continuous simulation watershed model. A major advantage of using a watershed model to simulate pollutant concentrations is that a large number of storms representing a broad range of conditions can be applied in testing the various sampling approaches. Seventy-eight distinct methodologies were evaluated by "virtual samplings" of 166 simulated storms of varying size, intensity and duration, representing 14 years of storms in Ballona Creek near Los Angeles, California. The 78 methods can be grouped into four general strategies: volume-paced compositing, time-paced compositing, pollutograph sampling, and microsampling. The performances of each sampling strategy was evaluated by comparing the (1) median relative error between the virtually sampled and the true modeled event mean concentration (EMC) of each storm (accuracy), (2) median absolute deviation about the median or "MAD" of the relative error or (precision), and (3) the percentage of storms where sampling methods were within 10% of the true EMC (combined measures of accuracy and precision). Finally, costs associated with site setup, sampling, and laboratory analysis were estimated for each method. Pollutograph sampling consistently outperformed the other three methods both in terms of accuracy and precision, but was the most costly method evaluated. Time-paced sampling consistently underestimated while volume-paced sampling over estimated the storm EMCs. Microsampling performance approached that of pollutograph sampling at a substantial cost savings. The most efficient method for routine stormwater monitoring in terms of a balance between performance and cost was volume-paced microsampling, with variable sample pacing to ensure that the entirety of the storm was captured. Pollutograph sampling is recommended if the data are to be used for detailed analysis of runoff dynamics.

Making historic loss data comparable over time and place

NASA Astrophysics Data System (ADS)

Eichner, Jan; Steuer, Markus; Löw, Petra

2017-04-01

When utilizing historic loss data for present day risk assessment, it is necessary to make the data comparable over time and place. To achieve this, the assessment of costs from natural hazard events requires consistent and homogeneous methodologies for loss estimation as well as a robust treatment of loss data to estimate and/or reduce distorting effects due to a temporal bias in the reporting of small-scale loss events. Here we introduce Munich Re's NatCatSERVICE loss database and present a novel methodology of peril-specific normalization of the historic losses (to account for socio-economic growth of assets over time), and we introduce a metric of severity classification (called CatClass) that allows for a global comparison of impact severity across countries of different stages of economic development.

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review.

PubMed

Mogasale, Vittal; Ramani, Enusa; Wee, Hyeseung; Kim, Jerome H

2016-12-01

Use of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers. To review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries. Peer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination. The publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014. No participants are involved, only costs are collected. Oral cholera vaccination and cost estimation. A systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$). Ten studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014). The reported cost categories are not standardized at collection point and may lead to misclassification. Costs for some OCV campaigns are not available and analysis does not include direct and indirect costs to vaccine recipients. Vaccine delivery cost estimation is needed for budgeting and economic analysis of vaccination programs. The cost categorization methodology presented in this study is helpful in collecting OCV delivery costs in a standardized manner, comparing delivery costs, planning vaccination campaigns and informing decision-making.

The economic impact of alcohol consumption: a systematic review.

PubMed

Thavorncharoensap, Montarat; Teerawattananon, Yot; Yothasamut, Jomkwan; Lertpitakpong, Chanida; Chaikledkaew, Usa

2009-11-25

Information on the economic impact of alcohol consumption can provide important evidence in supporting policies to reduce its associated harm. To date, several studies on the economic costs of alcohol consumption have been conducted worldwide. This study aims to review the economic impact of alcohol worldwide, summarizing the state of knowledge with regard to two elements: (1) cost components included in the estimation; (2) the methodologies employed in works conducted to date. Relevant publications concerning the societal cost of alcohol consumption published during the years 1990-2007 were identified through MEDLINE. The World Health Organization's global status report on alcohol, bibliographies and expert communications were also used to identify additional relevant studies. Twenty studies met the inclusion criteria for full review while an additional two studies were considered for partial review. Most studies employed the human capital approach and estimated the gross cost of alcohol consumption. Both direct and indirect costs were taken into account in all studies while intangible costs were incorporated in only a few studies. The economic burden of alcohol in the 12 selected countries was estimated to equate to 0.45 - 5.44% of Gross Domestic Product (GDP). Discrepancies in the estimation method and cost components included in the analyses limit a direct comparison across studies. The findings, however, consistently confirmed that the economic burden of alcohol on society is substantial. Given the importance of this issue and the limitation in generalizing the findings across different settings, further well-designed research studies are warranted in specific countries to support the formulation of alcohol-related policies.

Integrated Surveys of Neglected Tropical Diseases in Southern Sudan: How Much Do They Cost and Can They Be Refined?

PubMed Central

Kolaczinski, Jan H.; Hanson, Kara; Robinson, Emily; Picon, Diana; Sabasio, Anthony; Mpakateni, Martin; Lado, Mounir; Moore, Stephen; Petty, Nora; Brooker, Simon

2010-01-01

Background Increasing emphasis on integrated control of neglected tropical diseases (NTDs) requires identification of co-endemic areas. Integrated surveys for lymphatic filariasis (LF), schistosomiasis and soil-transmitted helminth (STH) infection have been recommended for this purpose. Integrated survey designs inevitably involve balancing the costs of surveys against accuracy of classifying areas for treatment, so-called implementation units (IUs). This requires an understanding of the main cost drivers and of how operating procedures may affect both cost and accuracy of surveys. Here we report a detailed cost analysis of the first round of integrated NTD surveys in Southern Sudan. Methods and Findings Financial and economic costs were estimated from financial expenditure records and interviews with survey staff using an ingredients approach. The main outcome was cost per IU surveyed. Uncertain variables were subjected to univariate sensitivity analysis and the effects of modifying standard operating procedures were explored. The average economic cost per IU surveyed was USD 40,206 or USD 9,573, depending on the size of the IU. The major cost drivers were two key categories of recurrent costs: i) survey consumables, and ii) personnel. Conclusion The cost of integrated surveys in Southern Sudan could be reduced by surveying larger administrative areas for LF. If this approach was taken, the estimated economic cost of completing LF, schistosomiasis and STH mapping in Southern Sudan would amount to USD 1.6 million. The methodological detail and costing template provided here could be used to generate cost estimates in other settings and readily compare these to the present study, and may help budget for integrated and single NTDs surveys elsewhere. PMID:20644619

Anticipating the Chaotic Behaviour of Industrial Systems Based on Stochastic, Event-Driven Simulations

NASA Astrophysics Data System (ADS)

Bruzzone, Agostino G.; Revetria, Roberto; Simeoni, Simone; Viazzo, Simone; Orsoni, Alessandra

2004-08-01

In logistics and industrial production managers must deal with the impact of stochastic events to improve performances and reduce costs. In fact, production and logistics systems are generally designed considering some parameters as deterministically distributed. While this assumption is mostly used for preliminary prototyping, it is sometimes also retained during the final design stage, and especially for estimated parameters (i.e. Market Request). The proposed methodology can determine the impact of stochastic events in the system by evaluating the chaotic threshold level. Such an approach, based on the application of a new and innovative methodology, can be implemented to find the condition under which chaos makes the system become uncontrollable. Starting from problem identification and risk assessment, several classification techniques are used to carry out an effect analysis and contingency plan estimation. In this paper the authors illustrate the methodology with respect to a real industrial case: a production problem related to the logistics of distributed chemical processing.

Economic Studies in Motor Neurone Disease: A Systematic Methodological Review.

PubMed

Moore, Alan; Young, Carolyn A; Hughes, Dyfrig A

2017-04-01

Motor neurone disease (MND) is a devastating condition which greatly diminishes patients' quality of life and limits life expectancy. Health technology appraisals of future interventions in MND need robust data on costs and utilities. Existing economic evaluations have been noted to be limited and fraught with challenges. The aim of this study was to identify and critique methodological aspects of all published economic evaluations, cost studies, and utility studies in MND. We systematically reviewed all relevant published studies in English from 1946 until January 2016, searching the databases of Medline, EMBASE, Econlit, NHS Economic Evaluation Database (NHS EED) and the Health Economics Evaluation Database (HEED). Key data were extracted and synthesised narratively. A total of 1830 articles were identified, of which 15 economic evaluations, 23 cost and 3 utility studies were included. Most economic studies focused on riluzole (n = 9). Six studies modelled the progressive decline in motor function using a Markov design but did not include mutually exclusive health states. Cost estimates for a number of evaluations were based on expert opinion and were hampered by high variability and location-specific characteristics. Few cost studies reported disease-stage-specific costs (n = 3) or fully captured indirect costs. Utilities in three studies of MND patients used the EuroQol EQ-5D questionnaire or standard gamble, but included potentially unrepresentative cohorts and did not consider any health impacts on caregivers. Economic evaluations in MND suffer from significant methodological issues such as a lack of data, uncertainty with the disease course and use of inappropriate modelling framework. Limitations may be addressed through the collection of detailed and representative data from large cohorts of patients.

The Launch Systems Operations Cost Model

NASA Technical Reports Server (NTRS)

Prince, Frank A.; Hamaker, Joseph W. (Technical Monitor)

2001-01-01

One of NASA's primary missions is to reduce the cost of access to space while simultaneously increasing safety. A key component, and one of the least understood, is the recurring operations and support cost for reusable launch systems. In order to predict these costs, NASA, under the leadership of the Independent Program Assessment Office (IPAO), has commissioned the development of a Launch Systems Operations Cost Model (LSOCM). LSOCM is a tool to predict the operations & support (O&S) cost of new and modified reusable (and partially reusable) launch systems. The requirements are to predict the non-recurring cost for the ground infrastructure and the recurring cost of maintaining that infrastructure, performing vehicle logistics, and performing the O&S actions to return the vehicle to flight. In addition, the model must estimate the time required to cycle the vehicle through all of the ground processing activities. The current version of LSOCM is an amalgamation of existing tools, leveraging our understanding of shuttle operations cost with a means of predicting how the maintenance burden will change as the vehicle becomes more aircraft like. The use of the Conceptual Operations Manpower Estimating Tool/Operations Cost Model (COMET/OCM) provides a solid point of departure based on shuttle and expendable launch vehicle (ELV) experience. The incorporation of the Reliability and Maintainability Analysis Tool (RMAT) as expressed by a set of response surface model equations gives a method for estimating how changing launch system characteristics affects cost and cycle time as compared to today's shuttle system. Plans are being made to improve the model. The development team will be spending the next few months devising a structured methodology that will enable verified and validated algorithms to give accurate cost estimates. To assist in this endeavor the LSOCM team is part of an Agency wide effort to combine resources with other cost and operations professionals to support models, databases, and operations assessments.

Methodology for Calculating Cost-per-Mile for Current and Future Vehicle Powertrain Technologies, with Projections to 2024: Preprint

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

Ruth, M.; Timbario, T. A.; Timbario, T. J.

2011-01-01

Currently, several cost-per-mile calculators exist that can provide estimates of acquisition and operating costs for consumers and fleets. However, these calculators are limited in their ability to determine the difference in cost per mile for consumer versus fleet ownership, to calculate the costs beyond one ownership period, to show the sensitivity of the cost per mile to the annual vehicle miles traveled (VMT), and to estimate future increases in operating and ownership costs. Oftentimes, these tools apply a constant percentage increase over the time period of vehicle operation, or in some cases, no increase in direct costs at all overmore » time. A more accurate cost-per-mile calculator has been developed that allows the user to analyze these costs for both consumers and fleets. The calculator was developed to allow simultaneous comparisons of conventional light-duty internal combustion engine (ICE) vehicles, mild and full hybrid electric vehicles (HEVs), and fuel cell vehicles (FCVs). This paper is a summary of the development by the authors of a more accurate cost-per-mile calculator that allows the user to analyze vehicle acquisition and operating costs for both consumer and fleets. Cost-per-mile results are reported for consumer-operated vehicles travelling 15,000 miles per year and for fleets travelling 25,000 miles per year.« less

Cost of diabetic eye, renal and foot complications: a methodological review.

PubMed

Schirr-Bonnans, Solène; Costa, Nadège; Derumeaux-Burel, Hélène; Bos, Jérémy; Lepage, Benoît; Garnault, Valérie; Martini, Jacques; Hanaire, Hélène; Turnin, Marie-Christine; Molinier, Laurent

2017-04-01

Diabetic retinopathy (DR), diabetic kidney disease (DKD) and diabetic foot ulcer (DFU) represent a public health and economic concern that may be assessed with cost-of-illness (COI) studies. (1) To review COI studies published between 2000 and 2015, about DR, DKD and DFU; (2) to analyse methods used. Disease definition, epidemiological approach, perspective, type of costs, activity data sources, cost valuation, sensitivity analysis, cost discounting and presentation of costs may be described in COI studies. Each reviewed study was assessed with a methodological grid including these nine items. The five following items have been detailed in the reviewed studies: epidemiological approach (59 % of studies described it), perspective (75 %), type of costs (98 %), activity data sources (91 %) and cost valuation (59 %). The disease definition and the presentation of results were detailed in fewer studies (respectively 50 and 46 %). In contrast, sensitivity analysis was only performed in 14 % of studies and cost discounting in 7 %. Considering the studies showing an average cost per patient and per year with a societal perspective, DR cost estimates were US $2297 (range 5-67,486), DKD cost ranged from US $1095 to US $16,384, and DFU cost was US $10,604 (range 1444-85,718). This review reinforces the need to adequately describe the method to facilitate literature comparisons and projections. It also recalls that COI studies represent complementary tools to cost-effectiveness studies to help decision makers in the allocation of economic resources for the management of DR, DKD and DFU.

Life cycle cost modeling of conceptual space vehicles

NASA Technical Reports Server (NTRS)

Ebeling, Charles

1993-01-01

This paper documents progress to date by the University of Dayton on the development of a life cycle cost model for use during the conceptual design of new launch vehicles and spacecraft. This research is being conducted under NASA Research Grant NAG-1-1327. This research effort changes the focus from that of the first two years in which a reliability and maintainability model was developed to the initial development of a life cycle cost model. Cost categories are initially patterned after NASA's three axis work breakdown structure consisting of a configuration axis (vehicle), a function axis, and a cost axis. The focus will be on operations and maintenance costs and other recurring costs. Secondary tasks performed concurrent with the development of the life cycle costing model include continual support and upgrade of the R&M model. The primary result of the completed research will be a methodology and a computer implementation of the methodology to provide for timely cost analysis in support of the conceptual design activities. The major objectives of this research are: to obtain and to develop improved methods for estimating manpower, spares, software and hardware costs, facilities costs, and other cost categories as identified by NASA personnel; to construct a life cycle cost model of a space transportation system for budget exercises and performance-cost trade-off analysis during the conceptual and development stages; to continue to support modifications and enhancements to the R&M model; and to continue to assist in the development of a simulation model to provide an integrated view of the operations and support of the proposed system.

Toward quantifying the effectiveness of water trading under uncertainty.

PubMed

Luo, B; Huang, G H; Zou, Y; Yin, Y Y

2007-04-01

This paper presents a methodology for quantifying the effectiveness of water-trading under uncertainty, by developing an optimization model based on the interval-parameter two-stage stochastic program (TSP) technique. In the study, the effectiveness of a water-trading program is measured by the water volume that can be released through trading from a statistical point of view. The methodology can also deal with recourse water allocation problems generated by randomness in water availability and, at the same time, tackle uncertainties expressed as intervals in the trading system. The developed methodology was tested with a hypothetical water-trading program in an agricultural system in the Swift Current Creek watershed, Canada. Study results indicate that the methodology can effectively measure the effectiveness of a trading program through estimating the water volume being released through trading in a long-term view. A sensitivity analysis was also conducted to analyze the effects of different trading costs on the trading program. It shows that the trading efforts would become ineffective when the trading costs are too high. The case study also demonstrates that the trading program is more effective in a dry season when total water availability is in shortage.

Are camera surveys useful for assessing recruitment in white-tailed deer?

Treesearch

M. Colter Chitwood; Marcus A. Lashley; John C. Kilgo; Michael J. Cherry; L. Mike Conner; Mark Vukovich; H. Scott Ray; Charles Ruth; Robert J. Warren; Christopher S. DePerno; Christopher E. Moorman

2017-01-01

Camera surveys commonly are used by managers and hunters to estimate white-tailed deer Odocoileus virginianus density and demographic rates. Though studies have documented biases and inaccuracies in the camera survey methodology, camera traps remain popular due to ease of use, cost-effectiveness, and ability to survey large areas. Because recruitment is a key parameter...

Audit of Trichomonas vaginalis test requesting by community referrers after a change from culture to molecular testing, including a cost analysis.

PubMed

Bissessor, Liselle; Wilson, Janet; McAuliffe, Gary; Upton, Arlo

2017-06-16

Trichomonas vaginalis (TV) prevalence varies among different communities and peoples. The availability of robust molecular platforms for the detection of TV has advanced diagnosis; however, molecular tests are more costly than phenotypic methodologies, and testing all urogenital samples is costly. We recently replaced culture methods with the Aptima Trichomonas vaginalis nucleic acid amplification test on specific request and as reflex testing by the laboratory, and have audited this change. Data were collected from August 2015 (microbroth culture and microscopy) and August 2016 (Aptima TV assay) including referrer, testing volumes, results and test cost estimates. In August 2015, 10,299 vaginal swabs, and in August 2016, 2,189 specimens (urogenital swabs and urines), were tested. The positivity rate went from 0.9% to 5.3%, and overall more TV infections were detected in 2016. The number needed to test and cost for one positive TV result respectively was 111 and $902.55 in 2015, and 19 and $368.92 in 2016. Request volumes and positivity rates differed among referrers. The methodology change was associated with higher overall detection of TV, and reductions in the numbers needed to test/cost for one TV diagnosis. Our audit suggests that there is room for improvement with TV test requesting in our community.

Carbon mitigation potential and costs of forestry options in Brazil, China, India, Indonesia, Mexico, the Philippines and Tanzania

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

Sathaye, J.; Makundi, W.; Andrasko, K.

2001-01-01

This paper summarizes studies of carbon (C) mitigation potential and costs of about 40 forestry options in seven developing countries. Each study uses the same methodological approach - Comprehensive Mitigation Assessment Process (COMAP) - to estimate the above parameters between 2000 and 2030. The approach requires the projection of baseline and mitigation land-use scenarios. Coupled with data on a per ha basis on C sequestration or avoidance, and costs and benefits, it allows the estimation of monetary benefit per Mg C, and the total costs and carbon potential. The results show that about half (3.0 Pg C) the cumulative mitigationmore » potential of 6.2 Petagram (Pg) C between 2000 and 2030 in the seven countries (about 200 x 106 Mg C yr-1) could be achieved at a negative cost and the remainder at costs ranging up to $100 Mg C-1. About 5 Pg C could be achieved, at a cost less than $20 per Mg C. Negative cost potential indicates that non-carbon revenue is sufficient to offset direct costs of these options. The achievable potential is likely to be smaller, however, due to market, institutional, and sociocultural barriers that can delay or prevent the implementation of the analyzed options.« less

The economic burden of treating neonates in Intensive Care Units (ICUs) in Greece

PubMed Central

Geitona, Mary; Hatzikou, Magdalini; Hatzistamatiou, Zoi; Anastasiadou, Aggeliki; Theodoratou, Theodora D

2007-01-01

Background In a period when a public-private mix in Greece is under consideration and hospital budgets become restrained, economic assessment is important for rational decision making. The study aimed to estimate the hospitalization cost of neonates admitted to the ICUs and demonstrate discrepancies with reimbursement. Methods Chosen methodology was based on the selection of medical records of all NICUs and intermediate care admissions within February to April 2004. Neonates (n = 99) were classified according to birthweight and gestational age. Results Mean cost per infant was estimated at €5.485 while reimbursement from social funds arises to €3.952. Costs per birthweight or gestational age show an inverse relationship. Personnel costs accounted for 59.9%, followed by enteral/parenteral feeding (16.14%) and pharmaceuticals expenses (11.10%) of all resources consumed. Sensitivity analysis increases the robustness of the results Conclusion Neonatal intensive care in Greece is associated with significant costs that exceed reimbursement from social funds. Reimbursement should be adjusted to make neonatal intensive care economically viable to private hospitals and thus, increase capacity of the services provided. PMID:17634126

Peristomal Skin Complications Are Common, Expensive, and Difficult to Manage: A Population Based Cost Modeling Study

PubMed Central

Meisner, Søren; Lehur, Paul-Antoine; Moran, Brendan; Martins, Lina; Jemec, Gregor Borut Ernst

2012-01-01

Background Peristomal skin complications (PSCs) are the most common post-operative complications following creation of a stoma. Living with a stoma is a challenge, not only for the patient and their carers, but also for society as a whole. Due to methodological problems of PSC assessment, the associated health-economic burden of medium to longterm complications has been poorly described. Aim The aim of the present study was to create a model to estimate treatment costs of PSCs using the standardized assessment Ostomy Skin Tool as a reference. The resultant model was applied to a real-life global data set of stoma patients (n = 3017) to determine the prevalence and financial burden of PSCs. Methods Eleven experienced stoma care nurses were interviewed to get a global understanding of a treatment algorithm that formed the basis of the cost analysis. The estimated costs were based on a seven week treatment period. PSC costs were estimated for five underlying diagnostic categories and three levels of severity. The estimated treatment costs of severe cases of PSCs were increased 2–5 fold for the different diagnostic categories of PSCs compared with mild cases. French unit costs were applied to the global data set. Results The estimated total average cost for a seven week treatment period (including appliances and accessories) was 263€ for those with PSCs (n = 1742) compared to 215€ for those without PSCs (n = 1172). A co-variance analysis showed that leakage level had a significant impact on PSC cost from ‘rarely/never’ to ‘always/often’ p<0.00001 and from ‘rarely/never’ to ‘sometimes’ p = 0.0115. Conclusion PSCs are common and troublesome and the consequences are substantial, both for the patient and from a health economic viewpoint. PSCs should be diagnosed and treated at an early stage to prevent long term, debilitating and expensive complications. PMID:22679479

Estimating the return on investment in disease management programs using a pre-post analysis.

PubMed

Fetterolf, Donald; Wennberg, David; Devries, Andrea

2004-01-01

Disease management programs have become increasingly popular over the past 5-10 years. Recent increases in overall medical costs have precipitated new concerns about the cost-effectiveness of medical management programs that have extended to the program directors for these programs. Initial success of the disease management movement is being challenged on the grounds that reported results have been the result of the application of faulty, if intuitive, methodologies. This paper discusses the use of "pre-post" methodology approaches in the analysis of disease management programs, and areas where application of this approach can result in spurious results and incorrect financial outcome assessments. The paper includes a checklist of these items for use by operational staff working with the programs, and a comprehensive bibliography that addresses many of the issues discussed.

Comparison of cost-benefit analysis of nitrogen dioxide control in Tokyo, Japan with those in other countries and cities

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

Voorhees, A.S.; Araki, S.; Sakai, R.

1999-07-01

To evaluate the economic effectiveness of past NO{sub 2} controls in Tokyo, the authors compared the results of their cost-benefit analysis (CBA) of these controls with other investigations. The authors carried out a CBA of NO{sub 2} controls in Tokyo using Freeman's benefit methodology and EPA and Dixon et al. cost methodologies and they compared their assumptions and results to work done by other researchers for other countries and cities, which were collected from the literature. The authors assumed 2 to 3 days duration per incidence of respiratory illness. Kenkel suggested 4.1 days and Dixon et al. assumed 2 weeks. They estimated avoided incidence per person in adults as 2.6 (upper limit UL 2.7; lower limit LL 2.4) and in children as 0.33 (UL 0.35; LL 0.30). Ostro estimated 0.20 for respiratory symptoms in adults from NO{sub 2} exposure, 5.2 for respiratory symptoms and 0.078 for asthma attacks in adults from particulates. The authors estimated work loss days (WLDs) per person for workers as 4.7 (UL 5.0; LL 4.4) and for working mothers as 0.61 (UL 0.66; LL 0.56). Shin et al.'s per-person estimates included 4.5 WLDs in Bangkok, 3.7 in Beijing, 2.3 in Shanghai, and 1.1 in Kuala Lumpur. They estimated the cost effectiveness of NO{sub 2} control in Tokyo to bemore » $1,400/ton (UL $1,500; LL $1,300) for motor vehicles, $21,000/ton (UL $23,000; LL $$19,000) for all NO{sub x} sources, and $$91,000/ton (UL $98,000; LL $84,000) for stationary point sources. This compares to $240 to $$1,500/ton in West Virginia for all NO{sub x} sources, $$2,700/ton in northern Virginia from motor vehicles, $5,600/ton from motor vehicles in Virginia, and $17,000 to $26,000/ton from all NO{sub x} sources in the Chesapeake River Watershed. Herein, the benefits in Tokyo exceeded the costs by a ratio of approximately 6 to 1 (UL 7:1; LL 5:1).« less

Component costs of foodborne illness: a scoping review

PubMed Central

2014-01-01

Background Governments require high-quality scientific evidence to prioritize resource allocation and the cost-of-illness (COI) methodology is one technique used to estimate the economic burden of a disease. However, variable cost inventories make it difficult to interpret and compare costs across multiple studies. Methods A scoping review was conducted to identify the component costs and the respective data sources used for estimating the cost of foodborne illnesses in a population. This review was accomplished by: (1) identifying the research question and relevant literature, (2) selecting the literature, (3) charting, collating, and summarizing the results. All pertinent data were extracted at the level of detail reported in a study, and the component cost and source data were subsequently grouped into themes. Results Eighty-four studies were identified that described the cost of foodborne illness in humans. Most studies (80%) were published in the last two decades (1992–2012) in North America and Europe. The 10 most frequently estimated costs were due to illnesses caused by bacterial foodborne pathogens, with non-typhoidal Salmonella spp. being the most commonly studied. Forty studies described both individual (direct and indirect) and societal level costs. The direct individual level component costs most often included were hospital services, physician personnel, and drug costs. The most commonly reported indirect individual level component cost was productivity losses due to sick leave from work. Prior estimates published in the literature were the most commonly used source of component cost data. Data sources were not provided or specifically linked to component costs in several studies. Conclusions The results illustrated a highly variable depth and breadth of individual and societal level component costs, and a wide range of data sources being used. This scoping review can be used as evidence that there is a lack of standardization in cost inventories in the cost of foodborne illness literature, and to promote greater transparency and detail of data source reporting. By conforming to a more standardized cost inventory, and by reporting data sources in more detail, there will be an increase in cost of foodborne illness research that can be interpreted and compared in a meaningful way. PMID:24885154

Cost-Effectiveness Analysis: a proposal of new reporting standards in statistical analysis

PubMed Central

Bang, Heejung; Zhao, Hongwei

2014-01-01

Cost-effectiveness analysis (CEA) is a method for evaluating the outcomes and costs of competing strategies designed to improve health, and has been applied to a variety of different scientific fields. Yet, there are inherent complexities in cost estimation and CEA from statistical perspectives (e.g., skewness, bi-dimensionality, and censoring). The incremental cost-effectiveness ratio that represents the additional cost per one unit of outcome gained by a new strategy has served as the most widely accepted methodology in the CEA. In this article, we call for expanded perspectives and reporting standards reflecting a more comprehensive analysis that can elucidate different aspects of available data. Specifically, we propose that mean and median-based incremental cost-effectiveness ratios and average cost-effectiveness ratios be reported together, along with relevant summary and inferential statistics as complementary measures for informed decision making. PMID:24605979

A probabilistic analysis of silicon cost

NASA Technical Reports Server (NTRS)

Reiter, L. J.

1983-01-01

Silicon materials costs represent both a cost driver and an area where improvement can be made in the manufacture of photovoltaic modules. The cost from three processes for the production of low-cost silicon being developed under the U.S. Department of Energy's (DOE) National Photovoltaic Program is analyzed. The approach is based on probabilistic inputs and makes use of two models developed at the Jet Propulsion Laboratory: SIMRAND (SIMulation of Research ANd Development) and IPEG (Improved Price Estimating Guidelines). The approach, assumptions, and limitations are detailed along with a verification of the cost analyses methodology. Results, presented in the form of cumulative probability distributions for silicon cost, indicate that there is a 55% chance of reaching the DOE target of $16/kg for silicon material. This is a technically achievable cost based on expert forecasts of the results of ongoing research and development and do not imply any market prices for a given year.

Cost analysis of water recovery systems

NASA Technical Reports Server (NTRS)

Yakut, M. M.

1973-01-01

A methodology was developed to predict the relevant contributions of the more intangible cost elements encountered in the development of flight-qualified hardware based on an extrapolation of past hardware development experience. Major items of costs within water recovery systems were identified and related to physical and/or performance criteria. Cost and performance data from Gemini, Skylab, and other aerospace and biotechnology programs were analyzed to identify major cost elements required to establish cost estimating relationships for advanced water recovery systems. The results of the study are expected to assist NASA in long-range planning and allocation of resources in a cost effective manner in support of earth orbital programs. This report deals with the cost analysis of the five leading water reclamation systems, namely: (1) RITE waste management-water system, (2) reverse osmosis system, (3) multifiltration system, (4) vapor compression system, and (5) closed air evaporation system with electrolytic pretreatment.

Costs of Illness Due to Endemic Cholera

PubMed Central

Poulos, C.; Riewpaiboon, A.; Stewart, J.F.; Clemens, J.; Guh, S.; Agtini, M.; Sur, D.; Islam, Z.; Lucas, M.; Whittington, D.

2013-01-01

Summary Economic analyses of cholera immunization programmes require estimates of the costs of cholera. The Diseases of the Most Impoverished programme measured the public, provider, and patient costs of culture-confirmed cholera in four study sites with endemic cholera using a combination of hospital- and community-based studies. Families with culture-proven cases were surveyed at home 7 and 14 days after confirmation of illness. Public costs were measured at local health facilities using a micro-costing methodology. Hospital-based studies found that the costs of severe cholera were USD 32 and 47 in Matlab and Beira. Community-based studies in North Jakarta and Kolkata found that cholera cases cost between USD 28 and USD 206, depending on hospitalization. Patient costs of illness as a percentage of average monthly income were 21% and 65% for hospitalized cases in Kolkata and North Jakarta, respectively. This burden on families is not captured by studies that adopt a provider perspective. PMID:21554781

Understanding cost growth during operations of planetary missions: An explanation of changes

NASA Astrophysics Data System (ADS)

McNeill, J. F.; Chapman, E. L.; Sklar, M. E.

In the development of project cost estimates for interplanetary missions, considerable focus is generally given to the development of cost estimates for the development of ground, flight, and launch systems, i.e., Phases B, C, and D. Depending on the project team, efforts expended to develop cost estimates for operations (Phase E) may be relatively less rigorous than that devoted to estimates for ground and flight systems development. Furthermore, the project team may be challenged to develop a solid estimate of operations cost in the early stages of mission development, e.g., Concept Study Report or Systems Requirement Review (CSR/SRR), Preliminary Design Review (PDR), as mission specific peculiarities that impact cost may not be well understood. In addition, a methodology generally used to develop Phase E cost is engineering build-up, also known as “ grass roots” . Phase E can include cost and schedule risks that are not anticipated at the time of the major milestone reviews prior to launch. If not incorporated into the engineering build-up cost method for Phase E, this may translate into an estimation of the complexity of operations and overall cost estimates that are not mature and at worse, insufficient. As a result, projects may find themselves with thin reserves during cruise and on-orbit operations or project overruns prior to the end of mission. This paper examines a set of interplanetary missions in an effort to better understand the reasons for cost and staffing growth in Phase E. The method used in the study is discussed as well as the major findings summarized as the Phase E Explanation of Change (EoC). Research for the study entailed the review of project materials, including Estimates at Completion (EAC) for Phase E and staffing profiles, major project milestone reviews, e.g., CSR, PDR, Critical Design Review (CDR), the interviewing of select project and mission management, and review of Phase E replan materials. From this work, a detai- ed picture is constructed of why cost grew during the operations phase, even to the level of specific events in the life of the missions. As a next step, the Phase E EoC results were gleaned and synthesized to produce leading indicators, i.e., what may be identifiable signs of cost and staffing growth that may be present as early as PDR or CDR. Both a qualitative and quantitative approach was used to determine leading indicators. These leading indicators will be reviewed and a practical method for their use will be discussed.

The cost of pressure ulcers in the UK.

PubMed

Bennett, Gerry; Dealey, Carol; Posnett, John

2004-05-01

To estimate the annual cost of treating pressure ulcers in the UK. Costs were derived from a bottom-up methodology, based on the daily resources required to deliver protocols of care reflecting good clinical practice. Health and social care system in the UK. Patients developing a pressure ulcer. A bottom-up costing approach is used to estimate treatment cost per episode of care and per patient for ulcers of different grades and level of complications. Also, total treatment cost to the health and social care system in the UK. The cost of treating a pressure ulcer varies from pound 1,064 (Grade 1) to pound 10,551 (Grade 4). Costs increase with ulcer grade because the time to heal is longer and because the incidence of complications is higher in more severe cases. The total cost in the UK is pound 1.4- pound 2.1 billion annually (4% of total NHS expenditure). Most of this cost is nurse time. Pressure ulcers represent a very significant cost burden in the UK. Without concerted effort this cost is likely to increase in the future as the population ages. To the extent that pressure ulcers are avoidable, pressure damage may be indicative of clinical negligence and there is evidence that litigation could soon become a significant threat to healthcare providers in the UK, as it is in the USA.

Economic burden of underweight and overweight among adults in the Asia-Pacific region: a systematic review.

PubMed

Hoque, Mohammad Enamul; Mannan, Munim; Long, Kurt Z; Al Mamun, Abdullah

2016-04-01

To assess the economic burden of underweight and overweight among adults in the Asia-Pacific region. Systematic review of articles published until March 2015. Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5-9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5-3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7-9.8% and more, and extra healthcare costs for obese individuals of 17-22.3% and higher. Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia-Pacific region. © 2016 John Wiley & Sons Ltd.

Wavelet Analyses of Oil Prices, USD Variations and Impact on Logistics

NASA Astrophysics Data System (ADS)

Melek, M.; Tokgozlu, A.; Aslan, Z.

2009-07-01

This paper is related with temporal variations of historical oil prices and Dollar and Euro in Turkey. Daily data based on OECD and Central Bank of Turkey records beginning from 1946 has been considered. 1D-continuous wavelets and wavelet packets analysis techniques have been applied on data. Wavelet techniques help to detect abrupt changing's, increasing and decreasing trends of data. Estimation of variables has been presented by using linear regression estimation techniques. The results of this study have been compared with the small and large scale effects. Transportation costs of track show a similar variation with fuel prices. The second part of the paper is related with estimation of imports, exports, costs, total number of vehicles and annual variations by considering temporal variation of oil prices and Dollar currency in Turkey. Wavelet techniques offer a user friendly methodology to interpret some local effects on increasing trend of imports and exports data.

Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital

PubMed Central

Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

2014-01-01

Context: Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. Aim: The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. Materials and Methods: A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. Results: The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. Conclusion: ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments. PMID:25400363

Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland

PubMed Central

Sartorius, Benn; Dlamini, Xolisile; Östensson, Ellinor

2017-01-01

Background Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden. Materials and methods A prevalence-based cost of illness (COI) methodology was used to investigate the economic burden of HPV-related diseases. We used a top-down approach for the cost associated with hospital care and a bottom-up approach to estimate the cost associated with outpatient and primary care. The current study was conducted from a provider perspective since the state bears the majority of the costs of screening and treatment in Swaziland. All identifiable direct medical costs were considered for cervical lesions, cervical cancer and genital warts, which were primary diagnoses during 2015. A mix of bottom up micro-costing ingredients approach and top-down approaches was used to collect data on costs. All costs were computed at the price level of 2015 and converted to dollars ($). Results The total annual estimated direct medical cost associated with screening, managing and treating cervical lesions, CC and genital warts in Swaziland was $16 million. The largest cost in the analysis was estimated for treatment of high-grade cervical lesions and cervical cancer representing 80% of the total cost ($12.6 million). Costs for screening only represented 5% of the total cost ($0.9 million). Treatment of genital warts represented 6% of the total cost ($1million). Conclusion According to the cost estimations in this study, the economic burden of HPV-related cervical diseases and genital warts represents a major public health issue in Swaziland. Prevention of HPV infection with a national HPV immunization programme for pre-adolescent girls would prevent the majority of CC related deaths and associated costs. PMID:28531205

Energy Cost Impact of Non-Residential Energy Code Requirements

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

Zhang, Jian; Hart, Philip R.; Rosenberg, Michael I.

2016-08-22

The 2012 International Energy Conservation Code contains 396 separate requirements applicable to non-residential buildings; however, there is no systematic analysis of the energy cost impact of each requirement. Consequently, limited code department budgets for plan review, inspection, and training cannot be focused on the most impactful items. An inventory and ranking of code requirements based on their potential energy cost impact is under development. The initial phase focuses on office buildings with simple HVAC systems in climate zone 4C. Prototype building simulations were used to estimate the energy cost impact of varying levels of non-compliance. A preliminary estimate of themore » probability of occurrence of each level of non-compliance was combined with the estimated lost savings for each level to rank the requirements according to expected savings impact. The methodology to develop and refine further energy cost impacts, specific to building type, system type, and climate location is demonstrated. As results are developed, an innovative alternative method for compliance verification can focus efforts so only the most impactful requirements from an energy cost perspective are verified for every building and a subset of the less impactful requirements are verified on a random basis across a building population. The results can be further applied in prioritizing training material development and specific areas of building official training.« less

Cost analysis in a clinical microbiology laboratory.

PubMed

Brezmes, M F; Ochoa, C; Eiros, J M

2002-08-01

The use of models for business management and cost control in public hospitals has led to a need for microbiology laboratories to know the real cost of the different products they offer. For this reason, a catalogue of microbiological products was prepared, and the costs (direct and indirect) for each product were analysed, along with estimated profitability. All tests performed in the microbiology laboratory of the "Virgen de la Concha" Hospital in Zamora over a 2-year period (73192 tests) were studied. The microbiological product catalogue was designed using homogeneity criteria with respect to procedures used, workloads and costs. For each product, the direct personnel costs (estimated from workloads following the method of the College of American Pathologists, 1992 version), the indirect personnel costs, the direct and indirect material costs and the portion of costs corresponding to the remaining laboratory costs (capital and structural costs) were calculated. The average product cost was 16.05 euros. The average cost of a urine culture (considered, for purposes of this study, as a relative value unit) reached 13.59 euros, with a significant difference observed between positive and negative cultures (negative urine culture, 10.72 euros; positive culture, 29.65 euros). Significant heterogeneity exists, both in the costs of different products and especially in the cost per positive test. The application of a detailed methodology of cost analysis facilitates the calculation of the real cost of microbiological products. This information provides a basic tool for establishing clinical management strategies.

Building Loss Estimation for Earthquake Insurance Pricing

NASA Astrophysics Data System (ADS)

Durukal, E.; Erdik, M.; Sesetyan, K.; Demircioglu, M. B.; Fahjan, Y.; Siyahi, B.

2005-12-01

After the 1999 earthquakes in Turkey several changes in the insurance sector took place. A compulsory earthquake insurance scheme was introduced by the government. The reinsurance companies increased their rates. Some even supended operations in the market. And, most important, the insurance companies realized the importance of portfolio analysis in shaping their future market strategies. The paper describes an earthquake loss assessment methodology that can be used for insurance pricing and portfolio loss estimation that is based on our work esperience in the insurance market. The basic ingredients are probabilistic and deterministic regional site dependent earthquake hazard, regional building inventory (and/or portfolio), building vulnerabilities associated with typical construction systems in Turkey and estimations of building replacement costs for different damage levels. Probable maximum and average annualized losses are estimated as the result of analysis. There is a two-level earthquake insurance system in Turkey, the effect of which is incorporated in the algorithm: the national compulsory earthquake insurance scheme and the private earthquake insurance system. To buy private insurance one has to be covered by the national system, that has limited coverage. As a demonstration of the methodology we look at the case of Istanbul and use its building inventory data instead of a portfolio. A state-of-the-art time depent earthquake hazard model that portrays the increased earthquake expectancies in Istanbul is used. Intensity and spectral displacement based vulnerability relationships are incorporated in the analysis. In particular we look at the uncertainty in the loss estimations that arise from the vulnerability relationships, and at the effect of the implemented repair cost ratios.

Cost Effectiveness of HPV Vaccination: A Systematic Review of Modelling Approaches.

PubMed

Pink, Joshua; Parker, Ben; Petrou, Stavros

2016-09-01

A large number of economic evaluations have been published that assess alternative possible human papillomavirus (HPV) vaccination strategies. Understanding differences in the modelling methodologies used in these studies is important to assess the accuracy, comparability and generalisability of their results. The aim of this review was to identify published economic models of HPV vaccination programmes and understand how characteristics of these studies vary by geographical area, date of publication and the policy question being addressed. We performed literature searches in MEDLINE, Embase, Econlit, The Health Economic Evaluations Database (HEED) and The National Health Service Economic Evaluation Database (NHS EED). From the 1189 unique studies retrieved, 65 studies were included for data extraction based on a priori eligibility criteria. Two authors independently reviewed these articles to determine eligibility for the final review. Data were extracted from the selected studies, focussing on six key structural or methodological themes covering different aspects of the model(s) used that may influence cost-effectiveness results. More recently published studies tend to model a larger number of HPV strains, and include a larger number of HPV-associated diseases. Studies published in Europe and North America also tend to include a larger number of diseases and are more likely to incorporate the impact of herd immunity and to use more realistic assumptions around vaccine efficacy and coverage. Studies based on previous models often do not include sufficiently robust justifications as to the applicability of the adapted model to the new context. The considerable between-study heterogeneity in economic evaluations of HPV vaccination programmes makes comparisons between studies difficult, as observed differences in cost effectiveness may be driven by differences in methodology as well as by variations in funding and delivery models and estimates of model parameters. Studies should consistently report not only all simplifying assumptions made but also the estimated impact of these assumptions on the cost-effectiveness results.

77 FR 59348 - Revisions to Page 700 of FERC Form No. 6

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

.... The components of an oil pipeline's rate base are governed by the Trended Original Cost Methodology... ratemaking methodology to the Trended Original Cost methodology as adopted in Opinion 154-B. The SRB was to... trended original cost methodology divides the nominal return on equity component of the cost of service...

Advanced Composite Air Frame Life Cycle Cost Estimating

DTIC Science & Technology

2014-06-19

Kilic, H., et al x Klumpp, Joseph J. x Koury, Jennifer x Kutner, M.,et al Lambert , Daniel x x x x x x x x x x x x x x x Methodology Areas...Joseph J. x x x x x x x Koury, Jennifer x Kutner, M.,et al x x x x x x x x Lambert , Daniel x x x x x x...Company, Houston, TX., 1996. 5. Beer , F., and E. Jr. Johnston. Mechanics of Materials. McGraw-Hill. New York, 1981. 6. Bock, D. Cost Effectiveness

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

PubMed

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

1992-01-01

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

Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement.

PubMed

Egede, Leonard E; Gebregziabher, Mulugeta; Dismuke, Clara E; Lynch, Cheryl P; Axon, R Neal; Zhao, Yumin; Mauldin, Patrick D

2012-12-01

To examine the longitudinal effects of medication nonadherence (MNA) on key costs and estimate potential savings from increased adherence using a novel methodology that accounts for shared correlation among cost categories. Veterans with type 2 diabetes (740,195) were followed from January 2002 until death, loss to follow-up, or December 2006. A novel multivariate, generalized, linear, mixed modeling approach was used to assess the differential effect of MNA, defined as medication possession ratio (MPR) ≥0.8 on healthcare costs. A sensitivity analysis was performed to assess potential cost savings at different MNA levels using the Consumer Price Index to adjust estimates to 2012 dollar value. Mean MPR for the full sample over 5 years was 0.78, with a mean of 0.93 for the adherent group and 0.58 for the MNA group. In fully adjusted models, all annual cost categories increased ∼3% per year (P = 0.001) during the 5-year study time period. MNA was associated with a 37% lower pharmacy cost, 7% lower outpatient cost, and 41% higher inpatient cost. Based on sensitivity analyses, improving adherence in the MNA group would result in annual estimated cost savings ranging from ∼$661 million (MPR <0.6 vs. ≥0.6) to ∼$1.16 billion (MPR <1 vs. 1). Maximal incremental annual savings would occur by raising MPR from <0.8 to ≥0.8 ($204,530,778) among MNA subjects. Aggressive strategies and policies are needed to achieve optimal medication adherence in diabetes. Such approaches may further the so-called "triple aim" of achieving better health, better quality care, and lower cost.

A methodology to evaluate differential costs of full field digital as compared to conventional screen film mammography in a clinical setting.

PubMed

Ciatto, S; Brancato, B; Baglioni, R; Turci, M

2006-01-01

The use of full field digital mammography (FFDM) in alternative to conventional screen film mammography (SFM) in the current practice is delayed by the high costs of FFDM. The present study, performed at the Centro per lo Studio e la Prevenzione Oncologica of Florence, using both FFDM and SFM, was aimed at estimating the impact of introducing the new FFDM technique on overall mammography costs. We estimated the differential costs of both methods, based on real expenditures, as provided by the administrative department, and on radiologists, radiographers and other staff's working time. Two different workload scenarios (5000 and 10,000 tests/year per mammography equipment) were considered. Common costs of both techniques were censored for study purpose. Beside a higher cost due to purchase and hire/leasing costs of equipment, FFDM implies a greater workload for radiologists (reading time almost doubled). SFM implies a greater workload for the administrative staff to run the archive and for loading/unloading films of the roller viewer, whereas no different workload has been observed for radiographers. Overall FFDM costs 24.22-26.46 for examination more than SFM for the 5000 tests scenario and 9.91-12.15 more for the 10,000 tests scenario. Although present study estimates cannot easily be generalised to any local setting, the model for cost calculation is easy to be exported to another scenario by applying different local parameters. The advantages made available by FFDM (computerised data recording, tele-transmission, tele-reporting, tele-consulting, automatic display on monitor of previous exams and use of CAD) may justify the higher cost, but a limited reduction in purchase and assistance costs could easily allow a turnover, with FFDM being more convenient than SFM even on the cost side.

The cost of headache disorders in Europe: the Eurolight project.

PubMed

Linde, M; Gustavsson, A; Stovner, L J; Steiner, T J; Barré, J; Katsarava, Z; Lainez, J M; Lampl, C; Lantéri-Minet, M; Rastenyte, D; Ruiz de la Torre, E; Tassorelli, C; Andrée, C

2012-05-01

Headache disorders are very common, but their monetary costs in Europe are unknown. We performed the first comprehensive estimation of how economic resources are lost to headache in Europe.   From November 2008 to August 2009, a cross-sectional survey was conducted in eight countries representing 55% of the adult EU population. Participation rates varied between 11% and 59%. In total, 8412 questionnaires contributed to this analysis. Using bottom-up methodology, we estimated direct (medications, outpatient health care, hospitalization and investigations) and indirect (work absenteeism and reduced productivity at work) annual per-person costs. Prevalence data, simultaneously collected and, for migraine, also derived from a systematic review, were used to impute national costs.   Mean per-person annual costs were €1222 for migraine (95% CI 1055-1389; indirect costs 93%), €303 for tension-type headache (TTH, 95% CI 230-376; indirect costs 92%), €3561 for medication-overuse headache (MOH, 95% CI 2487-4635; indirect costs 92%), and €253 for other headaches (95% CI 99-407; indirect costs 82%). In the EU, the total annual cost of headache amongst adults aged 18-65 years was calculated, according to our prevalence estimates, at €173 billion, apportioned to migraine (€111 billion; 64%), TTH (€21 billion; 12%), MOH (€37 billion; 21%) and other headaches (€3 billion; 2%). Using the 15% systematic review prevalence of migraine, calculated costs were somewhat lower (migraine €50 billion, all headache €112 billion annually).   Headache disorders are prominent health-related drivers of immense economic losses for the EU. This has immediate implications for healthcare policy. Health care for headache can be both improved and cost saving. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

Costs of examinations performed in a hospital laboratory in Chile.

PubMed

Andrade, Germán Lobos; Palma, Carolina Salas

2018-01-01

To determine the total average costs related to laboratory examinations performed in a hospital laboratory in Chile. Retrospective study with data from July 2014 to June 2015. 92 examinations classified in ten groups were selected according to the analysis methodology. The costs were estimated as the sum of direct and indirect laboratory costs and indirect institutional factors. The average values obtained for the costs according to examination group (in USD) were: 1.79 (clinical chemistry), 10.21 (immunoassay techniques), 13.27 (coagulation), 26.06 (high-performance liquid chromatography), 21.2 (immunological), 3.85 (gases and electrolytes), 156.48 (cytogenetic), 1.38 (urine), 4.02 (automated hematological), 4.93 (manual hematological). The value, or service fee, returned to public institutions who perform laboratory services does not adequately reflect the true total average production costs of examinations.

The social cost of illicit drugs use in Spain.

PubMed

Rivera, Berta; Casal, Bruno; Currais, Luis

2017-06-01

Illegal drugs consumption not only has a notable impact on the population's health, but also leads to major socio-economic costs. A significant characteristic of drug consumers is that the majority are of working age. The main aim of this study is to estimate the economic impact of drug consumption in Spain from a social perspective. A cost-of-illness methodology is carried out and a distinction is made between health-related and non-health related direct costs, as well as indirect costs. Among the direct health care costs included are hospitalisations, primary and emergency care, support programmes and HIV outpatient care. Expenditure on prevention, law enforcement and research was included as direct costs falling outside of health care. Productivity losses due to premature deaths attributed to substance abuse and patient hospitalisation formed part of indirect costs. For 2012, the total social cost related to drug consumption in Spain was somewhere between 1,436 and 1,651 million euros. The minimum cost of this consumption represented 0.14% of Spain's GDP for that year. The present cost estimations provide a measure of the social burden that illegal drug consumption represents for the community. When it comes to allocating resources, the obtained results quantify the potential economic returns that could be achieved from effective policies and programmes aimed at reducing the consumption of illegal drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

Modeling of GE Appliances: Cost Benefit Study of Smart Appliances in Wholesale Energy, Frequency Regulation, and Spinning Reserve Markets

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

Fuller, Jason C.; Parker, Graham B.

This report is the second in a series of three reports describing the potential of GE’s DR-enabled appliances to provide benefits to the utility grid. The first report described the modeling methodology used to represent the GE appliances in the GridLAB-D simulation environment and the estimated potential for peak demand reduction at various deployment levels. The third report will explore the technical capability of aggregated group actions to positively impact grid stability, including frequency and voltage regulation and spinning reserves, and the impacts on distribution feeder voltage regulation, including mitigation of fluctuations caused by high penetration of photovoltaic distributed generation.more » In this report, a series of analytical methods were presented to estimate the potential cost benefit of smart appliances while utilizing demand response. Previous work estimated the potential technical benefit (i.e., peak reduction) of smart appliances, while this report focuses on the monetary value of that participation. The effects on wholesale energy cost and possible additional revenue available by participating in frequency regulation and spinning reserve markets were explored.« less

Air-kerma evaluation at the maze entrance of HDR brachytherapy facilities.

PubMed

Pujades, M C; Granero, D; Vijande, J; Ballester, F; Perez-Calatayud, J; Papagiannis, P; Siebert, F A

2014-12-01

In the absence of procedures for evaluating the design of brachytherapy (BT) facilities for radiation protection purposes, the methodology used for external beam radiotherapy facilities is often adapted. The purpose of this study is to adapt the NCRP 151 methodology for estimating the air-kerma rate at the door in BT facilities. Such methodology was checked against Monte Carlo (MC) techniques using the code Geant4. Five different facility designs were studied for (192)Ir and (60)Co HDR applications to account for several different bunker layouts.For the estimation of the lead thickness needed at the door, the use of transmission data for the real spectra at the door instead of the ones emitted by (192)Ir and (60)Co will reduce the lead thickness by a factor of five for (192)Ir and ten for (60)Co. This will significantly lighten the door and hence simplify construction and operating requirements for all bunkers.The adaptation proposed in this study to estimate the air-kerma rate at the door depends on the complexity of the maze: it provides good results for bunkers with a maze (i.e. similar to those used for linacs for which the NCRP 151 methodology was developed) but fails for less conventional designs. For those facilities, a specific Monte Carlo study is in order for reasons of safety and cost-effectiveness.

Remote-sensing application for facilitating land resource assessment and monitoring for utility-scale solar energy development

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

Hamada, Yuki; Grippo, Mark A.

2015-01-01

A monitoring plan that incorporates regional datasets and integrates cost-effective data collection methods is necessary to sustain the long-term environmental monitoring of utility-scale solar energy development in expansive, environmentally sensitive desert environments. Using very high spatial resolution (VHSR; 15 cm) multispectral imagery collected in November 2012 and January 2014, an image processing routine was developed to characterize ephemeral streams, vegetation, and land surface in the southwestern United States where increased utility-scale solar development is anticipated. In addition to knowledge about desert landscapes, the methodology integrates existing spectral indices and transformation (e.g., visible atmospherically resistant index and principal components); a newlymore » developed index, erosion resistance index (ERI); and digital terrain and surface models, all of which were derived from a common VHSR image. The methodology identified fine-scale ephemeral streams with greater detail than the National Hydrography Dataset and accurately estimated vegetation distribution and fractional cover of various surface types. The ERI classified surface types that have a range of erosive potentials. The remote-sensing methodology could ultimately reduce uncertainty and monitoring costs for all stakeholders by providing a cost-effective monitoring approach that accurately characterizes the land resources at potential development sites.« less

10 CFR 455.64 - Life-cycle cost methodology.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Life-cycle cost methodology. 455.64 Section 455.64 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.64 Life-cycle cost methodology. (a) The life-cycle cost methodology under § 455.63(b) of this part is a systematic comparison of the...

10 CFR 455.64 - Life-cycle cost methodology.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Life-cycle cost methodology. 455.64 Section 455.64 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.64 Life-cycle cost methodology. (a) The life-cycle cost methodology under § 455.63(b) of this part is a systematic comparison of the...

On estimation of linear transformation models with nested case–control sampling

PubMed Central

Liu, Mengling

2011-01-01

Nested case–control (NCC) sampling is widely used in large epidemiological cohort studies for its cost effectiveness, but its data analysis primarily relies on the Cox proportional hazards model. In this paper, we consider a family of linear transformation models for analyzing NCC data and propose an inverse selection probability weighted estimating equation method for inference. Consistency and asymptotic normality of our estimators for regression coefficients are established. We show that the asymptotic variance has a closed analytic form and can be easily estimated. Numerical studies are conducted to support the theory and an application to the Wilms’ Tumor Study is also given to illustrate the methodology. PMID:21912975

Screening, prevention and treatment of cervical cancer -- a global and regional generalized cost-effectiveness analysis.

PubMed

Ginsberg, Gary Michael; Edejer, Tessa Tan-Torres; Lauer, Jeremy A; Sepulveda, Cecilia

2009-10-09

The paper calculates regional generalized cost-effectiveness estimates of screening, prevention, treatment and combined interventions for cervical cancer. Using standardised WHO-CHOICE methodology, a cervical cancer model was employed to provide estimates of screening, vaccination and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. In regions characterized by high income, low mortality and high existing treatment coverage, the addition of any screening programme to the current high treatment levels is very cost-effective. However, based on projections of the future price per dose (representing the economic costs of the vaccination excluding monopolistic rents and vaccine development cost) vaccination is the most cost-effective intervention. In regions characterized by low income, low mortality and existing treatment coverage around 50%, expanding treatment with or without combining it with screening appears to be cost-effective or very cost-effective. Abandoning treatment in favour of screening in a no-treatment scenario would not be cost-effective. Vaccination is usually the most cost-effective intervention. Penta or tri-annual PAP smears appear to be cost-effective, though when combined with HPV-DNA testing they are not cost-effective. In regions characterized by low income, high mortality and low treatment levels, expanding treatment with or without adding screening would be very cost-effective. A one off vaccination plus expanding treatment was usually very cost-effective. One-off PAP or VIA screening at age 40 are more cost-effective than other interventions though less effective overall. From a cost-effectiveness perspective, consideration should be given to implementing vaccination (depending on cost per dose and longevity of efficacy) and screening programmes on a worldwide basis to reduce the burden of disease from cervical cancer. Treatment should also be increased where coverage is low.

Impact of voice- and knowledge-enabled clinical reporting--US example.

PubMed

Bushko, Renata G; Havlicek, Penny L; Deppert, Edward; Epner, Stephen

2002-01-01

This study shows qualitative and quantitative estimates of the national and the clinic level impact of utilizing voice and knowledge enabled clinical reporting systems. Using common sense estimation methodology, we show that the delivery of health care can experience a dramatic improvement in four areas as a result of the broad use of voice and knowledge enabled clinical reporting: (1) Process Quality as measured by cost savings, (2) Organizational Quality as measured by compliance, (3) Clinical Quality as measured by clinical outcomes and (4) Service Quality as measured by patient satisfaction. If only 15 percent of US physicians replaced transcription with modem clinical reporting voice-based methodology, about one half billion dollars could be saved. $6.7 Billion could be saved annually if all medical reporting currently transcribed was handled with voice-and knowledge-enabled dictation and reporting systems.

Methodologies Used by Midwest Region States for Studying Teacher Supply and Demand. Issues & Answers. REL 2009-080

ERIC Educational Resources Information Center

Lindsay, James J.; Wan, Yinmei; Gossin-Wilson, Will

2009-01-01

This report describes how state education agencies in the Midwest Region monitor teacher supply, demand, and shortage; details why they monitor these data; and offers estimates of the monetary costs incurred in performing such studies. This study responds to a request from state education agencies in the Midwest Region (Illinois, Indiana, Iowa,…

Systematic review of the cost effectiveness of prophylactic treatments in the prevention of gastropathy in patients with rheumatoid arthritis or osteoarthritis taking non-steroidal anti-inflammatory drugs

PubMed Central

van Dieten, H. E M; Bos, I.; van Tulder, M. W; Lems, W.; Dijkmans, B.; Boers, M.

2000-01-01

A systematic review on the cost effectiveness of prophylactic treatments of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy in patients with osteoarthritis or rheumatoid arthritis was conducted. Two reviewers conducted the literature search and the review. Both full and partial economic evaluations published in English, Dutch, or German were included. The criteria list published in the textbook of Drummond was used to determine the quality of the economic evaluations. The methodological quality of three randomised controlled trials (RCTs) in which the economic evaluations obtained probability estimates of NSAID induced gastropathy and adverse events was assessed by a list of internal validity criteria. The conclusions were based on a rating system consisting of four levels of evidence.
  Ten economic evaluations were included; three were based on RCTs. All evaluations studied misoprostol as prophylactic treatment: in one evaluation misoprostol was studied as a fixed component in a combination with diclofenac (Arthrotec). All economic evaluations comprised analytical studies containing a decision tree. The three trials were of high methodological quality. Nine economic evaluations were considered high quality and one economic evaluation was considered of low methodological quality. There is strong evidence (level "A") that the use of misoprostol for the prevention of NSAID induced gastropathy is cost effective, and limited evidence (level "C") that the use of Arthrotec is cost effective. Although the levels of evidence used in this review are arbitrary, it is believed that a qualitative analysis is useful: quantitative analyses in this field are hampered by the heterogeneity of economic evaluations. Existing criteria to evaluate the methodological quality of economic evaluations may need refinement for use in systematic reviews.

 PMID:11005773

Systematic review of the cost effectiveness of prophylactic treatments in the prevention of gastropathy in patients with rheumatoid arthritis or osteoarthritis taking non-steroidal anti-inflammatory drugs.

PubMed

van Dieten, H E; Korthals-de Bos, I B; van Tulder, M W; Lems, W F; Dijkmans, B A; Boers, M

2000-10-01

A systematic review on the cost effectiveness of prophylactic treatments of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy in patients with osteoarthritis or rheumatoid arthritis was conducted. Two reviewers conducted the literature search and the review. Both full and partial economic evaluations published in English, Dutch, or German were included. The criteria list published in the textbook of Drummond was used to determine the quality of the economic evaluations. The methodological quality of three randomised controlled trials (RCTs) in which the economic evaluations obtained probability estimates of NSAID induced gastropathy and adverse events was assessed by a list of internal validity criteria. The conclusions were based on a rating system consisting of four levels of evidence. Ten economic evaluations were included; three were based on RCTs. All evaluations studied misoprostol as prophylactic treatment: in one evaluation misoprostol was studied as a fixed component in a combination with diclofenac (Arthrotec). All economic evaluations comprised analytical studies containing a decision tree. The three trials were of high methodological quality. Nine economic evaluations were considered high quality and one economic evaluation was considered of low methodological quality. There is strong evidence (level "A") that the use of misoprostol for the prevention of NSAID induced gastropathy is cost effective, and limited evidence (level "C") that the use of Arthrotec is cost effective. Although the levels of evidence used in this review are arbitrary, it is believed that a qualitative analysis is useful: quantitative analyses in this field are hampered by the heterogeneity of economic evaluations. Existing criteria to evaluate the methodological quality of economic evaluations may need refinement for use in systematic reviews.

A Fuzzy analytical hierarchy process approach in irrigation networks maintenance

NASA Astrophysics Data System (ADS)

Riza Permana, Angga; Rintis Hadiani, Rr.; Syafi'i

2017-11-01

Ponorogo Regency has 440 Irrigation Area with a total area of 17,950 Ha. Due to the limited budget and lack of maintenance cause decreased function on the irrigation. The aim of this study is to make an appropriate system to determine the indices weighted of the rank prioritization criteria for irrigation network maintenance using a fuzzy-based methodology. The criteria that are used such as the physical condition of irrigation networks, area of service, estimated maintenance cost, and efficiency of irrigation water distribution. 26 experts in the field of water resources in the Dinas Pekerjaan Umum were asked to fill out the questionnaire, and the result will be used as a benchmark to determine the rank of irrigation network maintenance priority. The results demonstrate that the physical condition of irrigation networks criterion (W1) = 0,279 has the greatest impact on the assessment process. The area of service (W2) = 0,270, efficiency of irrigation water distribution (W4) = 0,249, and estimated maintenance cost (W3) = 0,202 criteria rank next in effectiveness, respectively. The proposed methodology deals with uncertainty and vague data using triangular fuzzy numbers, and, moreover, it provides a comprehensive decision-making technique to assess maintenance priority on irrigation network.

Ground water contamination and costs of pesticide restrictions in the southeastern coastal plain

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

Danielson, L.E.; Carlson, G.A.; Liu, S.

The project developed new methodology for estimating: (1) groundwater contamination potential (GWCP) in the Southeast Coastal Plain, and (2) the potential economic impacts of selected policies that restrict pesticide use. The potential for ground water contamination was estimated by use of a simple matrix for combining ratings for both soil leaching potential and pesticide leaching potential. Key soil variables included soil texture, soil acidity and organic matter content. Key pesticide characteristics included Koc, pesticide half-life, the rate of application and the fraction of the pesticide hitting the soil. Comparisons of pesticide use from various farmer and expert opinion surveys weremore » made for pesticide groups and for individual pesticide products. Methodology for merging the GWCP changes and lost benefits from selected herbicide cancellations was developed using corn production in the North Carolina Coastal Plain. Economic evaluations of pesticide cancellations for corn included national and Coastal Plain estimates for atrazine; metolachlor; dicamba; dicamba and atrazine; and dicamba, atrazine and metolachlor.« less

Development Of Regional Climate Mitigation Baseline For A DominantAgro-Ecological Zone Of Karnataka, India

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

Sudha, P.; Shubhashree, D.; Khan, H.

2007-06-01

Setting a baseline for carbon stock changes in forest andland use sector mitigation projects is an essential step for assessingadditionality of the project. There are two approaches for settingbaselines namely, project-specific and regional baseline. This paperpresents the methodology adopted for estimating the land available formitigation, for developing a regional baseline, transaction cost involvedand a comparison of project-specific and regional baseline. The studyshowed that it is possible to estimate the potential land and itssuitability for afforestation and reforestation mitigation projects,using existing maps and data, in the dry zone of Karnataka, southernIndia. The study adopted a three-step approach for developing a regionalbaseline,more » namely: i) identification of likely baseline options for landuse, ii) estimation of baseline rates of land-use change, and iii)quantification of baseline carbon profile over time. The analysis showedthat carbon stock estimates made for wastelands and fallow lands forproject-specific as well as the regional baseline are comparable. Theratio of wasteland Carbon stocks of a project to regional baseline is1.02, and that of fallow lands in the project to regional baseline is0.97. The cost of conducting field studies for determination of regionalbaseline is about a quarter of the cost of developing a project-specificbaseline on a per hectare basis. The study has shown the reliability,feasibility and cost-effectiveness of adopting regional baseline forforestry sectormitigation projects.« less

Bayesian WLS/GLS regression for regional skewness analysis for regions with large crest stage gage networks

USGS Publications Warehouse

Veilleux, Andrea G.; Stedinger, Jery R.; Eash, David A.

2012-01-01

This paper summarizes methodological advances in regional log-space skewness analyses that support flood-frequency analysis with the log Pearson Type III (LP3) distribution. A Bayesian Weighted Least Squares/Generalized Least Squares (B-WLS/B-GLS) methodology that relates observed skewness coefficient estimators to basin characteristics in conjunction with diagnostic statistics represents an extension of the previously developed B-GLS methodology. B-WLS/B-GLS has been shown to be effective in two California studies. B-WLS/B-GLS uses B-WLS to generate stable estimators of model parameters and B-GLS to estimate the precision of those B-WLS regression parameters, as well as the precision of the model. The study described here employs this methodology to develop a regional skewness model for the State of Iowa. To provide cost effective peak-flow data for smaller drainage basins in Iowa, the U.S. Geological Survey operates a large network of crest stage gages (CSGs) that only record flow values above an identified recording threshold (thus producing a censored data record). CSGs are different from continuous-record gages, which record almost all flow values and have been used in previous B-GLS and B-WLS/B-GLS regional skewness studies. The complexity of analyzing a large CSG network is addressed by using the B-WLS/B-GLS framework along with the Expected Moments Algorithm (EMA). Because EMA allows for the censoring of low outliers, as well as the use of estimated interval discharges for missing, censored, and historic data, it complicates the calculations of effective record length (and effective concurrent record length) used to describe the precision of sample estimators because the peak discharges are no longer solely represented by single values. Thus new record length calculations were developed. The regional skewness analysis for the State of Iowa illustrates the value of the new B-WLS/BGLS methodology with these new extensions.

Precipitable water vapour content from ESR/SKYNET sun-sky radiometers: validation against GNSS/GPS and AERONET over three different sites in Europe

NASA Astrophysics Data System (ADS)

Campanelli, Monica; Mascitelli, Alessandra; Sanò, Paolo; Diémoz, Henri; Estellés, Victor; Federico, Stefano; Iannarelli, Anna Maria; Fratarcangeli, Francesca; Mazzoni, Augusto; Realini, Eugenio; Crespi, Mattia; Bock, Olivier; Martínez-Lozano, Jose A.; Dietrich, Stefano

2018-01-01

The estimation of the precipitable water vapour content (W) with high temporal and spatial resolution is of great interest to both meteorological and climatological studies. Several methodologies based on remote sensing techniques have been recently developed in order to obtain accurate and frequent measurements of this atmospheric parameter. Among them, the relative low cost and easy deployment of sun-sky radiometers, or sun photometers, operating in several international networks, allowed the development of automatic estimations of W from these instruments with high temporal resolution. However, the great problem of this methodology is the estimation of the sun-photometric calibration parameters. The objective of this paper is to validate a new methodology based on the hypothesis that the calibration parameters characterizing the atmospheric transmittance at 940 nm are dependent on vertical profiles of temperature, air pressure and moisture typical of each measurement site. To obtain the calibration parameters some simultaneously seasonal measurements of W, from independent sources, taken over a large range of solar zenith angle and covering a wide range of W, are needed. In this work yearly GNSS/GPS datasets were used for obtaining a table of photometric calibration constants and the methodology was applied and validated in three European ESR-SKYNET network sites, characterized by different atmospheric and climatic conditions: Rome, Valencia and Aosta. Results were validated against the GNSS/GPS and AErosol RObotic NETwork (AERONET) W estimations. In both the validations the agreement was very high, with a percentage RMSD of about 6, 13 and 8 % in the case of GPS intercomparison at Rome, Aosta and Valencia, respectively, and of 8 % in the case of AERONET comparison in Valencia. Analysing the results by W classes, the present methodology was found to clearly improve W estimation at low W content when compared against AERONET in terms of % bias, bringing the agreement with the GPS (considered the reference one) from a % bias of 5.76 to 0.52.

Assessing the costs of photovoltaic and wind power in six developing countries

NASA Astrophysics Data System (ADS)

Schmidt, Tobias S.; Born, Robin; Schneider, Malte

2012-07-01

To support developing countries in greenhouse-gas emission abatement the 2010 Cancún Agreement established various institutions, among others a financial mechanism administered by the Green Climate Fund. However, the instruments for delivering the support and the magnitude of different countries' financial needs are strongly debated. Both debates are predominantly underpinned by rather aggregate and strongly varying top-down cost estimates. To complement these numbers, we provide a more fine-grained bottom-up approach, comparing the cost of the renewable-energy technologies photovoltaics and wind in six developing countries with those of conventional technologies. Our results unveil large cost variations across specific technology-country combinations and show to what extent fossil-fuel subsidies can negatively affect the competitiveness of renewable-energy technologies. Regarding the instrument debate, our results indicate that to foster transformative changes, nationally appropriate mitigation actions are often more suited than a reformed clean development mechanism. Regarding the debate on financial needs, our results highlight the need for a decision on a fair baseline calculation methodology. To this end, we propose a new methodology that incentivizes changes in the baseline through subsidy phase-out. Finally, we contribute to the debate on domestic versus international support for these measures.

The cost of post-abortion care in developing countries: a comparative analysis of four studies

PubMed Central

Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi

2016-01-01

Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology—the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30–60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52–68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3–12% of the average cost of treating a PAC patient. PMID:27045001

Assessment of Methodological Quality of Economic Evaluations in Belgian Drug Reimbursement Applications

PubMed Central

Simoens, Steven

2013-01-01

Objectives This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. Materials and Methods For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Results Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Conclusions Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation. PMID:24386474

Assessment of methodological quality of economic evaluations in belgian drug reimbursement applications.

PubMed

Simoens, Steven

2013-01-01

This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation.

Methodical approaches to value assessment and determination of the capitalization level of high-rise construction

NASA Astrophysics Data System (ADS)

Smirnov, Vitaly; Dashkov, Leonid; Gorshkov, Roman; Burova, Olga; Romanova, Alina

2018-03-01

The article presents the analysis of the methodological approaches to cost estimation and determination of the capitalization level of high-rise construction objects. Factors determining the value of real estate were considered, three main approaches for estimating the value of real estate objects are given. The main methods of capitalization estimation were analyzed, the most reasonable method for determining the level of capitalization of high-rise buildings was proposed. In order to increase the value of real estate objects, the author proposes measures that enable to increase significantly the capitalization of the enterprise through more efficient use of intangible assets and goodwill.

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

Petruccelli, Umberto, E-mail: umberto.petruccelli@unibas.it

Many studies about the external costs generated by the transport system have been developed in the last twenty years. To standardize methodologies and assessment procedures to be used in the evaluation of the projects, some European countries recently have adopted specific guidelines that differ from each other in some aspects even sensibly. This paper presents a critical analysis of the British, Italian and German guidelines and is aimed at cataloguing the external cost types regarded and the assessment methods indicated as well as to highlight the differences of the results, in terms of applicability and reliability. The goal is tomore » contribute to a European standardization process that would lead to the drafting of guidelines suited for all EU countries. - Highlights: • The analyzed guidelines agree on the methods to evaluate costs from air pollution, greenhouse gases and accidents. • They recommend respectively: dose-resp. approach; costs to reduce/permit emissions; whole direct, indirect and social costs. • For noise, DE guide indicates defensive expenditure or SP methods; IT guide, SP method; UK guide, the hedonic prices one. • For on territory impact, DE guide regards only the barrier effect; the IT one, also the soil consumption and system effects. • British guide proposes a qualitative methodology to estimate the impact on various landscapes and environments.« less

Cost-effectiveness in the contemporary management of critical limb ischemia with tissue loss.

PubMed

Barshes, Neal R; Chambers, James D; Cohen, Joshua; Belkin, Michael

2012-10-01

The care of patients with critical limb ischemia (CLI) and tissue loss is notoriously challenging and expensive. We evaluated the cost-effectiveness of various management strategies to identify those that would optimize value to patients. A probabilistic Markov model was used to create a detailed simulation of patient-oriented outcomes, including clinical events, wound healing, functional outcomes, and quality-adjusted life-years (QALYs) after various management strategies in a CLI patient cohort during a 10-year period. Direct and indirect cost estimates for these strategies were obtained using transition cost-accounting methodology. Incremental cost-effectiveness ratios (ICERs), in 2009 U.S. dollars per QALYs, were calculated compared with the most conservative management strategy of local wound care with amputation as needed. With an ICER of $47,735/QALY, an initial surgical bypass with subsequent endovascular revision(s) as needed was the most cost-effective alternative to local wound care alone. Endovascular-first management strategies achieved comparable clinical outcomes but at higher cost (ICERs ≥$101,702/QALY); however, endovascular management did become cost-effective when the initial foot wound closure rate was >37% or when procedural costs were decreased by >42%. Primary amputation was dominated (less effectiveness and more costly than wound care alone). Contemporary clinical effectiveness and cost estimates show an initial surgical bypass is the most cost-effective alternative to local wound care alone for CLI with tissue loss and can be supported even in a cost-averse health care environment. Copyright © 2012. Published by Mosby, Inc.

The cost of postabortion care and legal abortion in Colombia.

PubMed

Prada, Elena; Maddow-Zimet, Isaac; Juarez, Fatima

2013-09-01

Although Colombia partially liberalized its abortion law in 2006, many abortions continue to occur outside the law and result in complications. Assessing the costs to the health care system of safe, legal abortions and of treating complications of unsafe, illegal abortions has important policy implications. The Post-Abortion Care Costing Methodology was used to produce estimates of direct and indirect costs of postabortion care and direct costs of legal abortions in Colombia. Data on estimated costs were obtained through structured interviews with key informants at a randomly selected sample of facilities that provide abortion-related care, including 25 public and private secondary and tertiary facilities and five primary-level private facilities that provide specialized reproductive health services. The median direct cost of treating a woman with abortion complications ranged from $44 to $141 (in U.S. dollars), representing an annual direct cost to the health system of about $14 million per year. A legal abortion at a secondary or tertiary facility was costly (medians, $213 and $189, respectively), in part because of the use of dilation and curettage, as well as because of administrative barriers. At specialized facilities, where manual vacuum aspiration and medication abortion are used, the median cost of provision was much lower ($45). Provision of postabortion care and legal abortion services at higher-level facilities results in unnecessarily high health care costs. These costs can be reduced significantly by providing services in a timely fashion at primary-level facilities and by using safe, noninvasive and less costly abortion methods.

Enhanced methods for determining operational capabilities and support costs of proposed space systems

NASA Technical Reports Server (NTRS)

Ebeling, Charles

1993-01-01

This report documents the work accomplished during the first two years of research to provide support to NASA in predicting operational and support parameters and costs of proposed space systems. The first year's research developed a methodology for deriving reliability and maintainability (R & M) parameters based upon the use of regression analysis to establish empirical relationships between performance and design specifications and corresponding mean times of failure and repair. The second year focused on enhancements to the methodology, increased scope of the model, and software improvements. This follow-on effort expands the prediction of R & M parameters and their effect on the operations and support of space transportation vehicles to include other system components such as booster rockets and external fuel tanks. It also increases the scope of the methodology and the capabilities of the model as implemented by the software. The focus is on the failure and repair of major subsystems and their impact on vehicle reliability, turn times, maintenance manpower, and repairable spares requirements. The report documents the data utilized in this study, outlines the general methodology for estimating and relating R&M parameters, presents the analyses and results of application to the initial data base, and describes the implementation of the methodology through the use of a computer model. The report concludes with a discussion on validation and a summary of the research findings and results.

Incidence and lifetime costs of injuries in the United States

PubMed Central

Corso, P; Finkelstein, E; Miller, T; Fiebelkorn, I; Zaloshnja, E

2006-01-01

Background Standardized methodologies for assessing economic burden of injury at the national or international level do not exist. Objective To measure national incidence, medical costs, and productivity losses of medically treated injuries using the most recent data available in the United States, as a case study for similarly developed countries undertaking economic burden analyses. Method The authors combined several data sets to estimate the incidence of fatal and non‐fatal injuries in 2000. They computed unit medical and productivity costs and multiplied these costs by corresponding incidence estimates to yield total lifetime costs of injuries occurring in 2000. Main outcome measures Incidence, medical costs, productivity losses, and total costs for injuries stratified by age group, sex, and mechanism. Results More than 50 million Americans experienced a medically treated injury in 2000, resulting in lifetime costs of $406 billion; $80 billion for medical treatment and $326 billion for lost productivity. Males had a 20% higher rate of injury than females. Injuries resulting from falls or being struck by/against an object accounted for more than 44% of injuries. The rate of medically treated injuries declined by 15% from 1985 to 2000 in the US. For those aged 0–44, the incidence rate of injuries declined by more than 20%; while persons aged 75 and older experienced a 20% increase. Conclusions These national burden estimates provide unequivocal evidence of the large health and financial burden of injuries. This study can serve as a template for other countries or be used in intercountry comparisons. PMID:16887941

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

PubMed Central

Ramani, Enusa; Wee, Hyeseung; Kim, Jerome H.

2016-01-01

Background Use of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers. Objectives To review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries. Data sources Peer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination. Study eligibility criteria The publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014. Participants No participants are involved, only costs are collected. Intervention Oral cholera vaccination and cost estimation. Study appraisal and synthesis method A systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$). Results Ten studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014). Limitations The reported cost categories are not standardized at collection point and may lead to misclassification. Costs for some OCV campaigns are not available and analysis does not include direct and indirect costs to vaccine recipients. Conclusions and implications of key findings Vaccine delivery cost estimation is needed for budgeting and economic analysis of vaccination programs. The cost categorization methodology presented in this study is helpful in collecting OCV delivery costs in a standardized manner, comparing delivery costs, planning vaccination campaigns and informing decision-making. PMID:27930668

Resource Consumption of a Diffusion Model for Prevention Programs: The PROSPER Delivery System

PubMed Central

Crowley, Daniel M.; Jones, Damon E.; Greenberg, Mark T.; Feinberg, Mark E.; Spoth, Richard L.

2012-01-01

Purpose To prepare public systems to implement evidence-based prevention programs for adolescents, it is necessary to have accurate estimates of programs’ resource consumption. When evidence-based programs are implemented through a specialized prevention delivery system, additional costs may be incurred during cultivation of the delivery infrastructure. Currently, there is limited research on the resource consumption of such delivery systems and programs. In this article, we describe the resource consumption of implementing the PROSPER (PROmoting School–Community–University Partnerships to Enhance Resilience) delivery system for a period of 5 years in one state, and how the financial and economic costs of its implementation affect local communities as well as the Cooperative Extension and University systems. Methods We used a six-step framework for conducting cost analysis, using a Cost–Procedure–Process–Outcome Analysis model (Yates, Analyzing costs, procedures, processes, and outcomes in human services: An introduction, 1996; Yates, 2009). This method entails defining the delivery System; bounding cost parameters; identifying, quantifying, and valuing systemic resource Consumption, and conducting sensitivity analysis of the cost estimates. Results Our analyses estimated both the financial and economic costs of the PROSPER delivery system. Evaluation of PROSPER illustrated how costs vary over time depending on the primacy of certain activities (e.g., team development, facilitator training, program implementation). Additionally, this work describes how the PROSPER model cultivates a complex resource infrastructure and provides preliminary evidence of systemic efficiencies. Conclusions This work highlights the need to study the costs of diffusion across time and broadens definitions of what is essential for successful implementation. In particular, cost analyses offer innovative methodologies for analyzing the resource needs of prevention systems. PMID:22325131

Optimizing Clinical Trial Enrollment Methods Through "Goal Programming"

PubMed Central

Davis, J.M.; Sandgren, A.J.; Manley, A.R.; Daleo, M.A.; Smith, S.S.

2014-01-01

Introduction Clinical trials often fail to reach desired goals due to poor recruitment outcomes, including low participant turnout, high recruitment cost, or poor representation of minorities. At present, there is limited literature available to guide recruitment methodology. This study, conducted by researchers at the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI), provides an example of how iterative analysis of recruitment data may be used to optimize recruitment outcomes during ongoing recruitment. Study methodology UW-CTRI’s research team provided a description of methods used to recruit smokers in two randomized trials (n = 196 and n = 175). The trials targeted low socioeconomic status (SES) smokers and involved time-intensive smoking cessation interventions. Primary recruitment goals were to meet required sample size and provide representative diversity while working with limited funds and limited time. Recruitment data was analyzed repeatedly throughout each study to optimize recruitment outcomes. Results Estimates of recruitment outcomes based on prior studies on smoking cessation suggested that researchers would be able to recruit 240 low SES smokers within 30 months at a cost of $72,000. With employment of methods described herein, researchers were able to recruit 374 low SES smokers over 30 months at a cost of $36,260. Discussion Each human subjects study presents unique recruitment challenges with time and cost of recruitment dependent on the sample population and study methodology. Nonetheless, researchers may be able to improve recruitment outcomes though iterative analysis of recruitment data and optimization of recruitment methods throughout the recruitment period. PMID:25642125

Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology.

PubMed

Kolaczinski, Jan; Hanson, Kara

2006-05-08

Insecticide-treated nets (ITNs) are an effective and cost-effective means of malaria control. Scaling-up coverage of ITNs is challenging. It requires substantial resources and there are a number of strategies to choose from. Information on the cost of different strategies is still scarce. To guide the choice of a delivery strategy (or combination of strategies), reliable and standardized cost information for the different options is required. The electronic online database PubMed was used for a systematic search of the published English literature on costing and economic evaluations of ITN distribution programmes. The keywords used were: net, bednet, insecticide, treated, ITN, cost, effectiveness, economic and evaluation. Identified papers were analysed to determine and evaluate the costing methods used. Methods were judged against existing standards of cost analysis to arrive at proposed standards for undertaking and presenting cost analyses. Cost estimates were often not readily comparable or could not be adjusted to a different context. This resulted from the wide range of methods applied and measures of output chosen. Most common shortcomings were the omission of certain costs and failure to adjust financial costs to generate economic costs. Generalisability was hampered by authors not reporting quantities and prices of resources separately and not examining the sensitivity of their results to variations in underlying assumptions. The observed shortcomings have arisen despite the abundance of literature and guidelines on costing of health care interventions. This paper provides ITN specific recommendations in the hope that these will help to standardize future cost estimates.

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

PubMed

Waters, H; Abdallah, H; Santillán, D

2001-01-01

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

Estimating Renewable Energy Economic Potential in the United States. Methodology and Initial Results

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

Brown, Austin; Beiter, Philipp; Heimiller, Donna

This report describes a geospatial analysis method to estimate the economic potential of several renewable resources available for electricity generation in the United States. Economic potential, one measure of renewable generation potential, may be defined in several ways. For example, one definition might be expected revenues (based on local market prices) minus generation costs, considered over the expected lifetime of the generation asset. Another definition might be generation costs relative to a benchmark (e.g., a natural gas combined cycle plant) using assumptions of fuel prices, capital cost, and plant efficiency. Economic potential in this report is defined as the subsetmore » of the available resource technical potential where the cost required to generate the electricity (which determines the minimum revenue requirements for development of the resource) is below the revenue available in terms of displaced energy and displaced capacity. The assessment is conducted at a high geospatial resolution (more than 150,000 technology-specific sites in the continental United States) to capture the significant variation in local resource, costs, and revenue potential. This metric can be a useful screening factor for understanding the economic viability of renewable generation technologies at a specific location. In contrast to many common estimates of renewable energy potential, economic potential does not consider market dynamics, customer demand, or most policy drivers that may incent renewable energy generation.« less

Population-Level Cost-Effectiveness of Implementing Evidence-Based Practices into Routine Care

PubMed Central

Fortney, John C; Pyne, Jeffrey M; Burgess, James F

2014-01-01

Objective The objective of this research was to apply a new methodology (population-level cost-effectiveness analysis) to determine the value of implementing an evidence-based practice in routine care. Data Sources/Study Setting Data are from sequentially conducted studies: a randomized controlled trial and an implementation trial of collaborative care for depression. Both trials were conducted in the same practice setting and population (primary care patients prescribed antidepressants). Study Design The study combined results from a randomized controlled trial and a pre-post-quasi-experimental implementation trial. Data Collection/Extraction Methods The randomized controlled trial collected quality-adjusted life years (QALYs) from survey and medication possession ratios (MPRs) from administrative data. The implementation trial collected MPRs and intervention costs from administrative data and implementation costs from survey. Principal Findings In the randomized controlled trial, MPRs were significantly correlated with QALYs (p = .03). In the implementation trial, patients at implementation sites had significantly higher MPRs (p = .01) than patients at control sites, and by extrapolation higher QALYs (0.00188). Total costs (implementation, intervention) were nonsignificantly higher ($63.76) at implementation sites. The incremental population-level cost-effectiveness ratio was $33,905.92/QALY (bootstrap interquartile range −$45,343.10/QALY to $99,260.90/QALY). Conclusions The methodology was feasible to operationalize and gave reasonable estimates of implementation value. PMID:25328029

How can activity-based costing methodology be performed as a powerful tool to calculate costs and secure appropriate patient care?

PubMed

Lin, Blossom Yen-Ju; Chao, Te-Hsin; Yao, Yuh; Tu, Shu-Min; Wu, Chun-Ching; Chern, Jin-Yuan; Chao, Shiu-Hsiung; Shaw, Keh-Yuong

2007-04-01

Previous studies have shown the advantages of using activity-based costing (ABC) methodology in the health care industry. The potential values of ABC methodology in health care are derived from the more accurate cost calculation compared to the traditional step-down costing, and the potentials to evaluate quality or effectiveness of health care based on health care activities. This project used ABC methodology to profile the cost structure of inpatients with surgical procedures at the Department of Colorectal Surgery in a public teaching hospital, and to identify the missing or inappropriate clinical procedures. We found that ABC methodology was able to accurately calculate costs and to identify several missing pre- and post-surgical nursing education activities in the course of treatment.

Pseudo-spectral methodology for a quantitative assessment of the cover of in-stream vegetation in small streams

NASA Astrophysics Data System (ADS)

Hershkovitz, Yaron; Anker, Yaakov; Ben-Dor, Eyal; Schwartz, Guy; Gasith, Avital

2010-05-01

In-stream vegetation is a key ecosystem component in many fluvial ecosystems, having cascading effects on stream conditions and biotic structure. Traditionally, ground-level surveys (e.g. grid and transect analyses) are commonly used for estimating cover of aquatic macrophytes. Nonetheless, this methodological approach is highly time consuming and usually yields information which is practically limited to habitat and sub-reach scales. In contrast, remote-sensing techniques (e.g. satellite imagery and airborne photography), enable collection of large datasets over section, stream and basin scales, in relatively short time and reasonable cost. However, the commonly used spatial high resolution (1m) is often inadequate for examining aquatic vegetation on habitat or sub-reach scales. We examined the utility of a pseudo-spectral methodology, using RGB digital photography for estimating the cover of in-stream vegetation in a small Mediterranean-climate stream. We compared this methodology with that obtained by traditional ground-level grid methodology and with an airborne hyper-spectral remote sensing survey (AISA-ES). The study was conducted along a 2 km section of an intermittent stream (Taninim stream, Israel). When studied, the stream was dominated by patches of watercress (Nasturtium officinale) and mats of filamentous algae (Cladophora glomerata). The extent of vegetation cover at the habitat and section scales (100 and 104 m, respectively) were estimated by the pseudo-spectral methodology, using an airborne Roli camera with a Phase-One P 45 (39 MP) CCD image acquisition unit. The swaths were taken in elevation of about 460 m having a spatial resolution of about 4 cm (NADIR). For measuring vegetation cover at the section scale (104 m) we also used a 'push-broom' AISA-ES hyper-spectral swath having a sensor configuration of 182 bands (350-2500 nm) at elevation of ca. 1,200 m (i.e. spatial resolution of ca. 1 m). Simultaneously, with every swath we used an Analytical Spectral Device (ASD) to measure hyper-spectral signatures (2150 bands configuration; 350-2500 nm) of selected ground-level targets (located by GPS) of soil, water; vegetation (common reed, watercress, filamentous algae) and standard EVA foam colored sheets (red, green, blue, black and white). Processing and analysis of the data were performed over an ITT ENVI platform. The hyper-spectral image underwent radiometric calibration according to the flight and sensor calibration parameters on CALIGEO platform and the raw DN scale was converted into radiance scale. Ground level visual survey of vegetation cover and height was applied at the habitat scale (100 m) by placing a 1m2 netted grids (10x10cm cells) along 'bank-to-bank' transect (in triplicates). Estimates of plant cover obtained by the pseudo-spectral methodology at the habitat scale were 35-61% for the watercress, 0.4-25% for the filamentous algae and 27-51% for plant-free patches. The respective estimates by ground level visual survey were 26-50, 14-43% and 36-50%. The pseudo-spectral methodology also yielded estimates for the section scale (104 m) of ca. 39% for the watercress, ca. 32% for the filamentous algae and 6% for plant-free patches. The respective estimates obtained by hyper-spectral swath were 38, 26 and 8%. Validation against ground-level measurements proved that pseudo-spectral methodology gives reasonably good estimates of in-stream plant cover. Therefore, this methodology can serve as a substitute for ground level estimates at small stream scales and for the low resolution hyper-spectral methodology at larger scales.

Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services.

PubMed

Bertram, Melanie Y; Sweeny, Kim; Lauer, Jeremy A; Chisholm, Daniel; Sheehan, Peter; Rasmussen, Bruce; Upreti, Senendra Raj; Dixit, Lonim Prasai; George, Kenneth; Deane, Samuel

2018-05-19

The global burden of non-communicable diseases (NCDs) is growing, and there is an urgent need to estimate the costs and benefits of an investment strategy to prevent and control NCDs. Results from an investment-case analysis can provide important new evidence to inform decision making by governments and donors. We propose a methodology for calculating the economic benefits of investing in NCDs during the Sustainable Development Goals (SDGs) era, and we applied this methodology to cardiovascular disease prevention in 20 countries with the highest NCD burden. For a limited set of prevention interventions, we estimated that US$120 billion must be invested in these countries between 2015 and 2030. This investment represents an additional $1·50 per capita per year and would avert 15 million deaths, 8 million incidents of ischaemic heart disease, and 13 million incidents of stroke in the 20 countries. Benefit-cost ratios varied between interventions and country-income levels, with an average ratio of 5·6 for economic returns but a ratio of 10·9 if social returns are included. Investing in cardiovascular disease prevention is integral to achieving SDG target 3.4 (reducing premature mortality from NCDs by a third) and to progress towards SDG target 3.8 (the realisation of universal health coverage). Many countries have implemented cost-effective interventions at low levels, so the potential to achieve these targets and strengthen national income by scaling up these interventions is enormous. Copyright © 2018 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Alternative Fuels Data Center: Vehicle Cost Calculator Assumptions and

Science.gov Websites

Center: Vehicle Cost Calculator Assumptions and Methodology on Facebook Tweet about Alternative Fuels Data Center: Vehicle Cost Calculator Assumptions and Methodology on Twitter Bookmark Alternative Fuels Data Center: Vehicle Cost Calculator Assumptions and Methodology on Google Bookmark Alternative Fuels

Estimating the environmental and resource costs of leakage in water distribution systems: A shadow price approach.

PubMed

Molinos-Senante, María; Mocholí-Arce, Manuel; Sala-Garrido, Ramon

2016-10-15

Water scarcity is one of the main problems faced by many regions in the XXIst century. In this context, the need to reduce leakages from water distribution systems has gained almost universal acceptance. The concept of sustainable economic level of leakage (SELL) has been proposed to internalize the environmental and resource costs within economic level of leakage calculations. However, because these costs are not set by the market, they have not often been calculated. In this paper, the directional-distance function was used to estimate the shadow price of leakages as a proxy of their environmental and resource costs. This is a pioneering approach to the economic valuation of leakage externalities. An empirical application was carried out for the main Chilean water companies. The estimated results indicated that for 2014, the average shadow price of leakages was approximately 32% of the price of the water delivered. Moreover, as a sensitivity analysis, the shadow prices of the leakages were calculated from the perspective of the water companies' managers and the regulator. The methodology and findings of this study are essential for supporting the decision process of reducing leakage, contributing to the improvement of economic, social and environmental efficiency and sustainability of urban water supplies. Copyright © 2016 Elsevier B.V. All rights reserved.

Methodology for urban rail and construction technology research and development planning

NASA Technical Reports Server (NTRS)

Rubenstein, L. D.; Land, J. E.; Deshpande, G.; Dayman, B.; Warren, E. H.

1980-01-01

A series of transit system visits, organized by the American Public Transit Association (APTA), was conducted in which the system operators identified the most pressing development needs. These varied by property and were reformulated into a series of potential projects. To assist in the evaluation, a data base useful for estimating the present capital and operating costs of various transit system elements was generated from published data. An evaluation model was developed which considered the rate of deployment of the research and development project, potential benefits, development time and cost. An outline of an evaluation methodology that considered benefits other than capital and operating cost savings was also presented. During the course of the study, five candidate projects were selected for detailed investigation; (1) air comfort systems; (2) solid state auxiliary power conditioners; (3) door systems; (4) escalators; and (5) fare collection systems. Application of the evaluation model to these five examples showed the usefulness of modeling deployment rates and indicated a need to increase the scope of the model to quantitatively consider reliability impacts.

Cost effectiveness of pharmacological maintenance treatment for chronic obstructive pulmonary disease: a review of the evidence and methodological issues.

PubMed

Rutten-van Mölken, Maureen P M H; Goossens, Lucas M A

2012-04-01

Over 200 million people have chronic obstructive pulmonary disease (COPD) worldwide. The number of disease-year equivalents and deaths attributable to COPD are high. Guidelines for the pharmacological treatment of the disease recommend an individualized step-up approach in which treatment is intensified when results are unsatisfactory. Our objective was to present a systematic review of the cost effectiveness of pharmacological maintenance treatment for COPD and to discuss the methodological strengths and weaknesses of the studies. A systematic literature search for economic evaluations of drug therapy in COPD was performed in MEDLINE, EMBASE, the Economic Evaluation Database of the UK NHS (NHS-EED) and the European Network of Health Economic Evaluation Databases (EURONHEED). Full economic evaluations presenting both costs and health outcomes were included. A total of 40 studies were included in the review. Of these, 16 were linked to a clinical trial, 14 used Markov models, eight were based on observational data and two used a different approach. The few studies on combining short-acting bronchodilators were consistent in finding net cost savings compared with monotherapy. Studies comparing inhaled corticosteroids (ICS) with placebo or no maintenance treatment reported inconsistent results. Studies comparing fluticasone with salmeterol consistently found salmeterol to be more cost effective. The cost-effectiveness studies of tiotropium versus placebo, ipratropium or salmeterol pointed towards a reduction in total COPD-related healthcare costs for tiotropium in many but not all studies. All of these studies reported additional health benefits of tiotropium. The cost-effectiveness studies of the combination of inhaled long-acting β₂-agonists and ICS all report additional health benefits at an increase in total COPD-related costs in most studies. The cost-per-QALY estimates of this combination treatment vary widely and are very sensitive to the assumptions on mortality benefit and time horizon. The currently available economic evaluations indicate differences in cost effectiveness between COPD maintenance therapies, but for a more meaningful comparison of results it is important to improve the consistency with respect to study methodology and choice of comparator.

The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in Turkey.

PubMed

Malhan, Simten; Pay, Salih; Ataman, Sebnem; Dalkilic, Ediz; Dinc, Ayhan; Erken, Eren; Ertenli, Ihsan; Ertugrul, Esin; Gogus, Feride; Hamuryudan, Vedat; Inanc, Murat; Karaarslan, Yasar; Karadag, Omer; Karakoc, Yuksel; Keskin, Goksal; Kisacik, Bunyamin; Kiraz, Sedat; Oksel, Fahrettin; Oksuz, Ergun; Pirildar, Timur; Sari, Ismail; Soy, Mehmet; Senturk, Taskin; Taylan, Ali

2012-01-01

To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey. An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using 'cost-of-illness' methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the 'human capital approach', based on the minimum wage. The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey. From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively.

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

PubMed Central

Nunamaker, T R

1983-01-01

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

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

Van Geet, Otto

NREL has developed a methodology to prioritize which data center cooling systems could be upgraded for better efficiency based on estimated cost savings and economics. The best efficiency results are in cool or dry climates where 'free' economizer or evaporative cooling can provide most of the data center cooling. Locations with a high cost of energy and facilities with high power usage effectiveness (PUE) are also good candidates for data center cooling system upgrades. In one case study of a major cable provider's data centers, most of the sites studied had opportunities for cost-effective cooling system upgrades with payback periodmore » of 5 years or less. If the cable provider invested in all opportunities for upgrades with payback periods of less than 15 years, it could save 27% on annual energy costs.« less

The effectiveness and cost-effectiveness of diversion and aftercare programmes for offenders using class A drugs: a systematic review and economic evaluation.

PubMed

Hayhurst, Karen P; Leitner, Maria; Davies, Linda; Flentje, Rachel; Millar, Tim; Jones, Andrew; King, Carlene; Donmall, Michael; Farrell, Michael; Fazel, Seena; Harris, Rochelle; Hickman, Matthew; Lennox, Charlotte; Mayet, Soraya; Senior, Jane; Shaw, Jennifer

2015-01-01

The societal costs of problematic class A drug use in England and Wales exceed £15B; drug-related crime accounts for almost 90% of costs. Diversion plus treatment and/or aftercare programmes may reduce drug-related crime and costs. To assess the effectiveness and cost-effectiveness of diversion and aftercare for class A drug-using offenders, compared with no diversion. Adult class A drug-using offenders diverted to treatment or an aftercare programme for their drug use. Programmes to identify and divert problematic drug users to treatment (voluntary, court mandated or monitored services) at any point within the criminal justice system (CJS). Aftercare follows diversion and treatment, excluding care following prison or non-diversionary drug treatment. Thirty-three electronic databases and government online resources were searched for studies published between January 1985 and January 2012, including MEDLINE, PsycINFO and ISI Web of Science. Bibliographies of identified studies were screened. The UK Drug Data Warehouse, the UK Drug Treatment Outcomes Research Study and published statistics and reports provided data for the economic evaluation. Included studies evaluated diversion in adult class A drug-using offenders, in contact with the CJS. The main outcomes were drug use and offending behaviour, and these were pooled using meta-analysis. The economic review included full economic evaluations for adult opiate and/or crack, or powder, cocaine users. An economic decision analytic model, estimated incremental costs per unit of outcome gained by diversion and aftercare, over a 12-month time horizon. The perspectives included the CJS, NHS, social care providers and offenders. Probabilistic sensitivity analysis and one-way sensitivity analysis explored variance in parameter estimates, longer time horizons and structural uncertainty. Sixteen studies met the effectiveness review inclusion criteria, characterised by poor methodological quality, with modest sample sizes, high attrition rates, retrospective data collection, limited follow-up, no random allocation and publication bias. Most study samples comprised US methamphetamine users. Limited meta-analysis was possible, indicating a potential small impact of diversion interventions on reducing drug use [odds ratio (OR) 1.68, 95% confidence interval (CI) 1.12 to 2.53 for reduced primary drug use, and OR 2.60, 95% CI 1.70 to 3.98 for reduced use of other drugs]. The cost-effectiveness review did not identify any relevant studies. The economic evaluation indicated high uncertainty because of variance in data estimates and limitations in the model design. The primary analysis was unclear whether or not diversion was cost-effective. The sensitivity analyses indicated some scenarios where diversion may be cost-effective. Nearly all participants (99.6%) in the effectiveness review were American (Californian) methamphetamine users, limiting transfer of conclusions to the UK. Data and methodological limitations mean it is unclear whether or not diversion is effective or cost-effective. High-quality evidence for the effectiveness and cost-effectiveness of diversion schemes is sparse and does not relate to the UK. Importantly this research identified a range of methodological limitations in existing evidence. These highlight the need for research to conceptualise, define and develop models of diversion programmes and identify a core outcome set. A programme of feasibility, pilot and definitive trials, combined with process evaluation and qualitative research is recommended to assess the effectiveness and cost-effectiveness of diversionary interventions in class A drug-using offenders. The National Institute for Health Research Health Technology Assessment programme.

Estimating the Hospital Burden of Norovirus-Associated Gastroenteritis in England and its Opportunity Costs for Non-Admitted Patients.

PubMed

Sandmann, Frank G; Shallcross, Laura; Adams, Natalie; Allen, David J; Coen, Pietro G; Jeanes, Annette; Kozlakidis, Zisis; Larkin, Lesley; Wurie, Fatima; Robotham, Julie V; Jit, Mark; Deeny, Sarah R

2018-02-26

Norovirus places a substantial burden on healthcare systems, arising from infected patients, disease outbreaks, beds kept unoccupied for infection control, and staff absences due to infection. In settings with high rates of bed occupancy, opportunity costs arise from patients who cannot be admitted due to beds being unavailable. With several treatments and vaccines against norovirus in development, quantifying the expected economic burden is timely. The number of inpatients with norovirus-associated gastroenteritis in England were modelled using infectious and non-infectious gastrointestinal Hospital Episode Statistics codes and laboratory reports of gastrointestinal pathogens collected at Public Health England. The excess length of stay from norovirus was estimated with a multi-state model and local outbreak data. Unoccupied bed-days and staff absences were estimated from national outbreak surveillance. The burden was valued conventionally using accounting expenditures and wages, which we contrasted to the opportunity costs from forgone patients using a novel methodology. Between July 2013 and June 2016, 17.7% (95%-confidence interval: 15.6%‒21.6%) of primary and 23.8% (20.6%‒29.9%) of secondary gastrointestinal diagnoses were norovirus-attributable. Annually, the estimated median 290,000 (interquartile range: 282,000‒297,000) occupied and unoccupied bed-days used for norovirus displaced 57,800 patients. Conventional costs for the National Health Service reached £107.6 million; the economic burden approximated to £297.7 million and a loss of 6,300 quality-adjusted life years annually. In England, norovirus is now the second-largest contributor of the gastrointestinal hospital burden. With the projected impact being greater than previously estimated, improved capture of relevant opportunity costs seems imperative for diseases like norovirus.

Flexible versus common technology to estimate economies of scale and scope in the water and sewerage industry: an application to England and Wales.

PubMed

Molinos-Senante, María; Maziotis, Alexandros

2018-05-01

The water industry presents several structures in different countries and also within countries. Hence, several studies have been conducted to evaluate the presence of economies of scope and scale in the water industry leading to inconclusive results. The lack of a common methodology has been identified as an important factor contributing to divergent conclusions. This paper evaluates, for the first time, the presence of economies of scale and scope in the water industry using a flexible technology approach integrating operational and exogenous variables of the water companies in the cost functions. The empirical application carried out for the English and Welsh water industry evidenced that the inclusion of exogenous variables accounts for significant differences in economies of scale and scope. Moreover, completely different results were obtained when the economies of scale and scope were estimated using common and flexible technology methodological approaches. The findings of this study reveal the importance of using an appropriate methodology to support policy decision-making processes to promote sustainable urban water activities.

Alternative Fuels Data Center: Vehicle Cost Calculator Widget Assumptions

Science.gov Websites

Data Center: Vehicle Cost Calculator Widget Assumptions and Methodology on Facebook Tweet about Alternative Fuels Data Center: Vehicle Cost Calculator Widget Assumptions and Methodology on Twitter Bookmark Alternative Fuels Data Center: Vehicle Cost Calculator Widget Assumptions and Methodology on Google Bookmark

Estimating productivity costs in health economic evaluations: a review of instruments and psychometric evidence.

PubMed

Tang, Kenneth

2015-01-01

Health economic evaluations (i.e. cost-effectiveness appraisal of an intervention) are useful aids for decision makers responsible for the allocation of scarce healthcare resources. The relevance of including health-related productivity costs (or benefits) in these evaluations is increasingly recognized and, as such, reliable and valid instruments to quantify productivity costs are needed. Over the years, a number of work productivity instruments have emerged in the literature, along with a growing body of psychometric evidence. The overall aim of this paper is to provide a review of available instruments with potential for estimating health-related productivity costs. This included the Health and Labor Questionnaire, Health and Work Performance Questionnaire, Health-Related Productivity Questionnaire Diary, Productivity and Disease Questionnaire, Quantity and Quality method, Stanford Presenteeism Scale 13, Valuation of Lost Productivity, Work and Health Interview, Work Limitations Questionnaire, Work Productivity and Activity Impairment Questionnaire, and Work Productivity Short Inventory. Critical discussions on the instruments' overall strengths and limitations, applicability for health economic evaluations, as well as the methodological quality of existing psychometric evidence were provided. Lastly, a set of reflective questions were proposed for users to consider when selecting an instrument for health economic evaluations.

Risk-adjusted econometric model to estimate postoperative costs: an additional instrument for monitoring performance after major lung resection.

PubMed

Brunelli, Alessandro; Salati, Michele; Refai, Majed; Xiumé, Francesco; Rocco, Gaetano; Sabbatini, Armando

2007-09-01

The objectives of this study were to develop a risk-adjusted model to estimate individual postoperative costs after major lung resection and to use it for internal economic audit. Variable and fixed hospital costs were collected for 679 consecutive patients who underwent major lung resection from January 2000 through October 2006 at our unit. Several preoperative variables were used to develop a risk-adjusted econometric model from all patients operated on during the period 2000 through 2003 by a stepwise multiple regression analysis (validated by bootstrap). The model was then used to estimate the postoperative costs in the patients operated on during the 3 subsequent periods (years 2004, 2005, and 2006). Observed and predicted costs were then compared within each period by the Wilcoxon signed rank test. Multiple regression and bootstrap analysis yielded the following model predicting postoperative cost: 11,078 + 1340.3X (age > 70 years) + 1927.8X cardiac comorbidity - 95X ppoFEV1%. No differences between predicted and observed costs were noted in the first 2 periods analyzed (year 2004, $6188.40 vs $6241.40, P = .3; year 2005, $6308.60 vs $6483.60, P = .4), whereas in the most recent period (2006) observed costs were significantly lower than the predicted ones ($3457.30 vs $6162.70, P < .0001). Greater precision in predicting outcome and costs after therapy may assist clinicians in the optimization of clinical pathways and allocation of resources. Our economic model may be used as a methodologic template for economic audit in our specialty and complement more traditional outcome measures in the assessment of performance.

[Direct hospitalization costs associated with chronic Hepatitis C in the Valencian Community in 2013].

PubMed

Barrachina Martínez, Isabel; Giner Durán, Remedios; Vivas-Consuelo, David; López Rodado, Antonio; Maldonado Segura, José Alberto

2018-04-23

Hospital costs associated with Chronic Hepatitis C (HCC) arise in the final stages of the disease. Its quantification is very helpful in order to estimate and check the burden of the disease and to make financial decisions for new antivirals. The highest costs are due to the decompensation of cirrosis. Cross-sectional observational study of hospital costs of HCC diagnoses in the Valencian Community in 2013 (n= 4,486 hospital discharges). Information source: Minimum basic set of data/ Basic Minimum Data Set. The costs were considered according to the rates established for the DRG (Diagnosis related group) associated with the episodes with diagnosis of hepatitis C. The average survival of patients since the onset of the decom- pensation of their cirrhosis was estimated by a Markov model, according to the probabilities of evolution of the disease existing in Literatura. There were 4,486 hospital episodes, 1,108 due to complications of HCC, which generated 6,713 stays, readmission rate of 28.2% and mortality of 10.2%. The hospital cost amounted to 8,788,593EUR: 3,306,333EUR corresponded to Cirrhosis (5,273EUR/patient); 1,060,521EUR to Carcinoma (6,350EUR/ patient) and 2,962,873EUR to transplantation (70,544EUR/paciente. Comorbidity was 1,458,866EUR. These costs are maintai- ned for an average of 4 years once the cirrhosis decompensation begins. Cirrhosis due to HCC generates a very high hospitalization's costs. The methodology used in the estimation of these costs from the DRG can be very useful to evaluate the trend and economic impact of this disease.

Federal Research and Development Contract Trends and the Supporting Industrial Base, 2000-2014

DTIC Science & Technology

2016-04-30

Homeland Security, and government-wide services contracting trends; sourcing policy and cost estimation methodologies; and recent U.S. Army modernization ...been fears that the sharp downturn in federal contract obligations would disproportionately impact the R&D contracting portfolios within individual...329 - contracting portfolios , and the industrial base that supports those efforts, within each R&D contracting agency. The main finding of this

Estimation of the Cost-Effectiveness of Breast Cancer Screening Using Mammography in Mexico Through a Simulation.

PubMed

Ulloa-Pérez, Ernesto; Mohar-Betancourt, Alejandro; Reynoso-Noverón, Nancy

2016-01-01

Currently, breast cancer is the most prevalent tumor among Mexican women. Screening methods such as mammography could potentially reduce the health and economic burden of breast cancer; however, its risk-benefit balance is still unclear. To estimate the cost-effectiveness of different breast cancer screening programs using mammography in Mexico and to contribute to the decision-making process on this preventive measure. A simulation study was performed using population data and incidence rates. Several screening programs were assessed using the cost-effectiveness methodology recommended by the World Health Organization. The feasible recommended screening program has an examination schedule periodicity of every three years, with a population coverage of 0, 15, 18, 20, 25, 20, 18, and 0% for the age groups of 25-40, 40-45, 45-50, 50-55, 55-60, 60-65, 65-70, and 70-75 years, respectively. Given the present coverage in Mexico, it is necessary to optimize our resource allocation to improve the country's breast cancer prevention policy.

The cost of multiple sclerosis in Norway.

PubMed

Svendsen, B; Myhr, K-M; Nyland, H; Aarseth, J H

2012-02-01

Health economic aspects have been increasingly important during introduction of new treatments for multiple sclerosis. As a partial response for Norway, a cost-of-illness study was carried out to estimate the yearly cost of the illness to society and relate costs and patients' quality of life to illness severity. Estimated cost to society was Euro 439 million in 2002 exclusive of the cost of reduced quality of life. The cost per patient was close to Euro 65,000. Account taken of methodological differences, the results compare to results for Sweden, Norway's closest neighboring country. The illness reduced patients' quality of life with 0.26. More patients were early retired because of their MS in Norway than in any of nine other European countries comprised by a recent European study, illustrating a liberal practice in Norway. The Norwegian cost of unpaid assistance was almost identical to the Swedish cost that was the lowest found across the countries in the European study. When related to illness severity, the cost per patient increased, and the patients' experienced quality of life decreased with increasing EDSS levels in line with what has been found for other countries. Cost-of-MS studies have been carried out for a number of countries. Together they contribute to our understanding of the economic consequences of multiple sclerosis and, if their results are related to illness severity, also provide valuable information for further economic analyses of treatment and medication. Our study adds to this.

The Costs of Preventing and Treating Chagas Disease in Colombia

PubMed Central

Castillo-Riquelme, Marianela; Guhl, Felipe; Turriago, Brenda; Pinto, Nestor; Rosas, Fernando; Martínez, Mónica Flórez; Fox-Rushby, Julia; Davies, Clive; Campbell-Lendrum, Diarmid

2008-01-01

Background The objective of this study is to report the costs of Chagas disease in Colombia, in terms of vector disease control programmes and the costs of providing care to chronic Chagas disease patients with cardiomyopathy. Methods Data were collected from Colombia in 2004. A retrospective review of costs for vector control programmes carried out in rural areas included 3,084 houses surveyed for infestation with triatomine bugs and 3,305 houses sprayed with insecticide. A total of 63 patient records from 3 different hospitals were selected for a retrospective review of resource use. Consensus methodology with local experts was used to estimate care seeking behaviour and to complement observed data on utilisation. Findings The mean cost per house per entomological survey was $4.4 (in US$ of 2004), whereas the mean cost of spraying a house with insecticide was $27. The main cost driver of spraying was the price of the insecticide, which varied greatly. Treatment of a chronic Chagas disease patient costs between $46.4 and $7,981 per year in Colombia, depending on severity and the level of care used. Combining cost and utilisation estimates the expected cost of treatment per patient-year is $1,028, whereas lifetime costs averaged $11,619 per patient. Chronic Chagas disease patients have limited access to healthcare, with an estimated 22% of patients never seeking care. Conclusion Chagas disease is a preventable condition that affects mostly poor populations living in rural areas. The mean costs of surveying houses for infestation and spraying infested houses were low in comparison to other studies and in line with treatment costs. Care seeking behaviour and the type of insurance affiliation seem to play a role in the facilities and type of care that patients use, thus raising concerns about equitable access to care. Preventing Chagas disease in Colombia would be cost-effective and could contribute to prevent inequalities in health and healthcare. PMID:19015725

Fundamentals of carbon dioxide-enhanced oil recovery (CO2-EOR): a supporting document of the assessment methodology for hydrocarbon recovery using CO2-EOR associated with carbon sequestration

USGS Publications Warehouse

Verma, Mahendra K.

2015-01-01

The objective of this report is to provide basic technical information regarding the CO2-EOR process, which is at the core of the assessment methodology, to estimate the technically recoverable oil within the fields of the identified sedimentary basins of the United States. Emphasis is on CO2-EOR because this is currently one technology being considered as an ultimate long-term geologic storage solution for CO2 owing to its economic profitability from incremental oil production offsetting the cost of carbon sequestration.

Mapping financial flows for immunisation in Uganda 2009/10 and 2010/11: New insights for methodologies and policy.

PubMed

Guthrie, Teresa; Zikusooka, Charlotte; Kwesiga, Brendan; Abewe, Christabel; Lagony, Stephen; Schutte, Carl; Marinda, Edmore; Humphreys, Kerrin; Motlogelwa, Katlego; Nombewu, Zipozihle Chuma; Brenzel, Logan; Kinghorn, Anthony

2015-05-07

The Global Vaccine Action Plan highlights the need for immunisation programmes to have sustainable access to predictable funding. A good understanding of current and future funding needs, commitments, and gaps is required to enhance planning, improve resource allocation and mobilisation, and to avoid funding bottlenecks, as well as to ensure that co-funding arrangements are appropriate. This study aimed to map the resource envelope and flows for immunisation in Uganda in 2009/10 and 2010/11. To assess costs and financing of immunisation, the study applied a common methodology as part of the multi-country Expanded Program on Immunisation Costing (EPIC) study (Brenzel et al., 2015). The financial mapping developed a customised extension of the System of Health Accounts (SHA) codes to explore immunisation financing in detail. Data were collected from government and external sources. The mapping was able to assess financing more comprehensively than many studies, and the simultaneous costing of routine immunisation collected detailed data about human resources costs. The Ugandan government contributed 56% and 42% of routine immunisation funds in 2009/10 and 2010/11, respectively, higher than previously estimated, and managed up to 90% of funds. Direct delivery of services used 93% of the immunisation financial resources in 2010/11, while the above service delivery costs were small (7%). Vaccines and supplies (41%) and salaries (38%) absorbed most funding. There were differences in the key cost categories between actual resource flows and the estimates from the comprehensive multi-year plan (cMYP). Results highlight that governments and partners need to improve systems to routinely track immunisation financing flows for enhanced accountability, performance, and sustainability. The modified SHA coding allowed financing to be mapped to specific immunisation activities, and could be used for standardised, resource tracking compatible with National Health Accounts (NHA). Recommendations are made for refining routine resource mapping approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

Distributed Multisensor Data Fusion under Unknown Correlation and Data Inconsistency

PubMed Central

Abu Bakr, Muhammad; Lee, Sukhan

2017-01-01

The paradigm of multisensor data fusion has been evolved from a centralized architecture to a decentralized or distributed architecture along with the advancement in sensor and communication technologies. These days, distributed state estimation and data fusion has been widely explored in diverse fields of engineering and control due to its superior performance over the centralized one in terms of flexibility, robustness to failure and cost effectiveness in infrastructure and communication. However, distributed multisensor data fusion is not without technical challenges to overcome: namely, dealing with cross-correlation and inconsistency among state estimates and sensor data. In this paper, we review the key theories and methodologies of distributed multisensor data fusion available to date with a specific focus on handling unknown correlation and data inconsistency. We aim at providing readers with a unifying view out of individual theories and methodologies by presenting a formal analysis of their implications. Finally, several directions of future research are highlighted. PMID:29077035

Optimal allocation of testing resources for statistical simulations

NASA Astrophysics Data System (ADS)

Quintana, Carolina; Millwater, Harry R.; Singh, Gulshan; Golden, Patrick

2015-07-01

Statistical estimates from simulation involve uncertainty caused by the variability in the input random variables due to limited data. Allocating resources to obtain more experimental data of the input variables to better characterize their probability distributions can reduce the variance of statistical estimates. The methodology proposed determines the optimal number of additional experiments required to minimize the variance of the output moments given single or multiple constraints. The method uses multivariate t-distribution and Wishart distribution to generate realizations of the population mean and covariance of the input variables, respectively, given an amount of available data. This method handles independent and correlated random variables. A particle swarm method is used for the optimization. The optimal number of additional experiments per variable depends on the number and variance of the initial data, the influence of the variable in the output function and the cost of each additional experiment. The methodology is demonstrated using a fretting fatigue example.

Estimating Health-State Utility for Economic Models in Clinical Studies: An ISPOR Good Research Practices Task Force Report.

PubMed

Wolowacz, Sorrel E; Briggs, Andrew; Belozeroff, Vasily; Clarke, Philip; Doward, Lynda; Goeree, Ron; Lloyd, Andrew; Norman, Richard

Cost-utility models are increasingly used in many countries to establish whether the cost of a new intervention can be justified in terms of health benefits. Health-state utility (HSU) estimates (the preference for a given state of health on a cardinal scale where 0 represents dead and 1 represents full health) are typically among the most important and uncertain data inputs in cost-utility models. Clinical trials represent an important opportunity for the collection of health-utility data. However, trials designed primarily to evaluate efficacy and safety often present challenges to the optimal collection of HSU estimates for economic models. Careful planning is needed to determine which of the HSU estimates may be measured in planned trials; to establish the optimal methodology; and to plan any additional studies needed. This report aimed to provide a framework for researchers to plan the collection of health-utility data in clinical studies to provide high-quality HSU estimates for economic modeling. Recommendations are made for early planning of health-utility data collection within a research and development program; design of health-utility data collection during protocol development for a planned clinical trial; design of prospective and cross-sectional observational studies and alternative study types; and statistical analyses and reporting. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Estimating the Effects of Module Area on Thin-Film Photovoltaic System Costs: Preprint

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

Horowitz, Kelsey A; Fu, Ran; Silverman, Timothy J

We investigate the potential effects of module area on the cost and performance of photovoltaic systems. Applying a bottom-up methodology, we analyzed the costs associated with thin-film modules and systems as a function of module area. We calculate a potential for savings of up to 0.10 dollars/W and 0.13 dollars/W in module manufacturing costs for CdTe and CIGS respectively, with large area modules. We also find that an additional 0.04 dollars/W savings in balance-of-systems costs may be achieved. Sensitivity of the dollar/W cost savings to module efficiency, manufacturing yield, and other parameters is presented. Lifetime energy yield must also bemore » maintained to realize reductions in the levelized cost of energy; the effects of module size on energy yield for monolithic thin-film modules are not yet well understood. Finally, we discuss possible non-cost barriers to adoption of large area modules.« less

A methodology for spacecraft technology insertion analysis balancing benefit, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David Allen

Emerging technologies are changing the way space missions are developed and implemented. Technology development programs are proceeding with the goal of enhancing spacecraft performance and reducing mass and cost. However, it is often the case that technology insertion assessment activities, in the interest of maximizing performance and/or mass reduction, do not consider synergistic system-level effects. Furthermore, even though technical risks are often identified as a large cost and schedule driver, many design processes ignore effects of cost and schedule uncertainty. This research is based on the hypothesis that technology selection is a problem of balancing interrelated (and potentially competing) objectives. Current spacecraft technology selection approaches are summarized, and a Methodology for Evaluating and Ranking Insertion of Technology (MERIT) that expands on these practices to attack otherwise unsolved problems is demonstrated. MERIT combines the modern techniques of technology maturity measures, parametric models, genetic algorithms, and risk assessment (cost and schedule) in a unique manner to resolve very difficult issues including: user-generated uncertainty, relationships between cost/schedule and complexity, and technology "portfolio" management. While the methodology is sufficiently generic that it may in theory be applied to a number of technology insertion problems, this research focuses on application to the specific case of small (<500 kg) satellite design. Small satellite missions are of particular interest because they are often developed under rigid programmatic (cost and schedule) constraints and are motivated to introduce advanced technologies into the design. MERIT is demonstrated for programs procured under varying conditions and constraints such as stringent performance goals, not-to-exceed costs, or hard schedule requirements. MERIT'S contributions to the engineering community are its: unique coupling of the aspects of performance, cost, and schedule; assessment of system level impacts of technology insertion; procedures for estimating uncertainties (risks) associated with advanced technology; and application of heuristics to facilitate informed system-level technology utilization decisions earlier in the conceptual design phase. MERIT extends the state of the art in technology insertion assessment selection practice and, if adopted, may aid designers in determining the configuration of complex systems that meet essential requirements in a timely, cost-effective manner.

National-level infrastructure and economic effects of switchgrass cofiring with coal in existing power plants for carbon mitigation.

PubMed

Morrow, William R; Griffin, W Michael; Matthews, H Scott

2008-05-15

We update a previously presented Linear Programming (LP) methodology for estimating state level costs for reducing CO2 emissions from existing coal-fired power plants by cofiring switchgrass, a biomass energy crop, and coal. This paper presents national level results of applying the methodology to the entire portion of the United States in which switchgrass could be grown without irrigation. We present incremental switchgrass and coal cofiring carbon cost of mitigation curves along with a presentation of regionally specific cofiring economics and policy issues. The results show that cofiring 189 million dry short tons of switchgrass with coal in the existing U.S. coal-fired electricity generation fleet can mitigate approximately 256 million short tons of carbon-dioxide (CO2) per year, representing a 9% reduction of 2005 electricity sector CO2 emissions. Total marginal costs, including capital, labor, feedstock, and transportation, range from $20 to $86/ton CO2 mitigated,with average costs ranging from $20 to $45/ton. If some existing power plants upgrade to boilers designed for combusting switchgrass, an additional 54 million tons of switchgrass can be cofired. In this case, total marginal costs range from $26 to $100/ton CO2 mitigated, with average costs ranging from $20 to $60/ton. Costs for states east of the Mississippi River are largely unaffected by boiler replacement; Atlantic seaboard states represent the lowest cofiring cost of carbon mitigation. The central plains states west of the Mississippi River are most affected by the boiler replacement option and, in general, go from one of the lowest cofiring cost of carbon mitigation regions to the highest. We explain the variation in transportation expenses and highlight regional cost of mitigation variations as transportation overwhelms other cofiring costs.

Levelized cost of energy for a Backward Bent Duct Buoy

DOE PAGES

Bull, Diana; Jenne, D. Scott; Smith, Christopher S.; ...

2016-07-18

The Reference Model Project, supported by the U.S. Department of Energy, was developed to provide publicly available technical and economic benchmarks for a variety of marine energy converters. The methodology to achieve these benchmarks is to develop public domain designs that incorporate power performance estimates, structural models, anchor and mooring designs, power conversion chain designs, and estimates of the operations and maintenance, installation, and environmental permitting required. The reference model designs are intended to be conservative, robust, and experimentally verified. The Backward Bent Duct Buoy (BBDB) presented in this paper is one of three wave energy conversion devices studied withinmore » the Reference Model Project. Furthermore, comprehensive modeling of the BBDB in a Northern California climate has enabled a full levelized cost of energy (LCOE) analysis to be completed on this device.« less

Levelized cost of energy for a Backward Bent Duct Buoy

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

Bull, Diana; Jenne, D. Scott; Smith, Christopher S.

2016-12-01

The Reference Model Project, supported by the U.S. Department of Energy, was developed to provide publically available technical and economic benchmarks for a variety of marine energy converters. The methodology to achieve these benchmarks is to develop public domain designs that incorporate power performance estimates, structural models, anchor and mooring designs, power conversion chain designs, and estimates of the operations and maintenance, installation, and environmental permitting required. The reference model designs are intended to be conservative, robust, and experimentally verified. The Backward Bent Duct Buoy (BBDB) presented in this paper is one of three wave energy conversion devices studied withinmore » the Reference Model Project. Comprehensive modeling of the BBDB in a Northern California climate has enabled a full levelized cost of energy (LCOE) analysis to be completed on this device.« less

How Much Can Non-industry Standard Measurement Methodologies Benefit Methane Reduction Programs?

NASA Astrophysics Data System (ADS)

Risk, D. A.; O'Connell, L.; Atherton, E.

2017-12-01

In recent years, energy sector methane emissions have been recorded in large part by applying modern non-industry-standard techniques. Industry may lack the regulatory flexibility to use such techniques, or in some cases may not understand the possible associated economic advantage. As progressive jurisdictions move from estimation and towards routine measurement, the research community should provide guidance to help regulators and companies measure more effectively, and economically if possible. In this study, we outline a modelling experiment in which we explore the integration of non-industry-standard measurement techniques as part of a generalized compliance measurement program. The study was not intended to be exhaustive, or to recommend particular combinations, but instead to explore the inter-relationships between methodologies, development type, compliance practice. We first defined the role, applicable scale, detection limits, working distances, and approximate deployment cost of several measurement methodologies. We then considered a variety of development types differing mainly in footprint, density, and emissions "profile". Using a Monte Carlo approach, we evaluated the effect of these various factors on the cost and confidence of the compliance measurement program. We found that when added individually, some of the research techniques were indeed able to deliver an improvement in cost and/or confidence when used alongside industry-standard Optical Gas Imaging. When applied in combination, the ideal fraction of each measurement technique depended on development type, emission profile, and whether confidence or cost was more important. Results suggest that measurement cost and confidence could be improved if energy companies exploited a wider range of measurement techniques, and in a manner tailored to each development. In the short-term, combining clear scientific guidance with economic information could benefit immediate mitigation efforts over developing new super sensors.

Estimating the costs of psychiatric hospital services at a public health facility in Nigeria.

PubMed

Ezenduka, Charles; Ichoku, Hyacinth; Ochonma, Ogbonnia

2012-09-01

Information on the cost of mental health services in Africa is very limited even though mental health disorders represent a significant public health concern, in terms of health and economic impact. Cost analysis is important for planning and for efficiency in the provision of hospital services. The study estimated the total and unit costs of psychiatric hospital services to guide policy and psychiatric hospital management efficiency in Nigeria. The study was exploratory and analytical, examining 2008 data. A standard costing methodology based on ingredient approach was adopted combining top-down method with step-down approach to allocate resources (overhead and indirect costs) to the final cost centers. Total and unit cost items related to the treatment of psychiatric patients (including the costs of personnel, overhead and annualised costs of capital items) were identified and measured on the basis of outpatients' visits, inpatients' days and inpatients' admissions. The exercise reflected the input-output process of hospital services where inputs were measured in terms of resource utilisation and output measured by activities carried out at both the outpatient and inpatient departments. In the estimation process total costs were calculated at every cost center/department and divided by a measure of corresponding patient output to produce the average cost per output. This followed a stepwise process of first allocating the direct costs of overhead to the intermediate and final cost centers and from intermediate cost centers to final cost centers for the calculation of total and unit costs. Costs were calculated from the perspective of the healthcare facility, and converted to the US Dollars at the 2008 exchange rate. Personnel constituted the greatest resource input in all departments, averaging 80% of total hospital cost, reflecting the mix of capital and recurrent inputs. Cost per inpatient day, at $56 was equivalent to 1.4 times the cost per outpatient visit at $41, while cost per emergency visit was about two times the cost per outpatient visit. The cost of one psychiatric inpatient admission averaged $3,675, including the costs of drugs and laboratory services, which was equivalent to the cost of 90 outpatients' visits. Cost of drugs was about 4.4% of the total costs and each prescription averaged $7.48. The male ward was the most expensive cost center. Levels of subsidization for inpatient services were over 90% while ancillary services were not subsidized hence full cost recovery. The hospital costs were driven by personnel which reflected the mix of inputs that relied most on technical manpower. The unit cost estimates are significantly higher than the upper limit range for low income countries based on the WHO-CHOICE estimates. Findings suggest a scope for improving efficiency of resource use given the high proportion of fixed costs which indicates excess capacity. Adequate research is needed for effective comparisons and valid assessment of efficiency in psychiatric hospital services in Africa. The unit cost estimates will be useful in making projections for total psychiatric hospital package and a basis for determining the cost of specific neuropsychiatric cases.

Computational circular dichroism estimation for point-of-care diagnostics via vortex half-wave retarders

NASA Astrophysics Data System (ADS)

Haider, Shahid A.; Tran, Megan Y.; Wong, Alexander

2018-02-01

Observing the circular dichroism (CD) caused by organic molecules in biological fluids can provide powerful indicators of patient health and provide diagnostic clues for treatment. Methods for this kind of analysis involve tabletop devices that weigh tens of kilograms with costs on the order of tens of thousands of dollars, making them prohibitive in point-of-care diagnostic applications. In an e ort to reduce the size, cost, and complexity of CD estimation systems for point-of-care diagnostics, we propose a novel method for CD estimation that leverages a vortex half-wave retarder in between two linear polarizers and a two-dimensional photodetector array to provide an overall complexity reduction in the system. This enables the measurement of polarization variations across multiple polarizations after they interact with a biological sample, simultaneously, without the need for mechanical actuation. We further discuss design considerations of this methodology in the context of practical applications to point-of-care diagnostics.

Optimizing value utilizing Toyota Kata methodology in a multidisciplinary clinic.

PubMed

Merguerian, Paul A; Grady, Richard; Waldhausen, John; Libby, Arlene; Murphy, Whitney; Melzer, Lilah; Avansino, Jeffrey

2015-08-01

Value in healthcare is measured in terms of patient outcomes achieved per dollar expended. Outcomes and cost must be measured at the patient level to optimize value. Multidisciplinary clinics have been shown to be effective in providing coordinated and comprehensive care with improved outcomes, yet tend to have higher cost than typical clinics. We sought to lower individual patient cost and optimize value in a pediatric multidisciplinary reconstructive pelvic medicine (RPM) clinic. The RPM clinic is a multidisciplinary clinic that takes care of patients with anomalies of the pelvic organs. The specialties involved include Urology, General Surgery, Gynecology, and Gastroenterology/Motility. From May 2012 to November 2014 we performed time-driven activity-based costing (TDABC) analysis by measuring provider time for each step in the patient flow. Using observed time and the estimated hourly cost of each of the providers we calculated the final cost at the individual patient level, targeting clinic preparation. We utilized Toyota Kata methodology to enhance operational efficiency in an effort to optimize value. Variables measured included cost, time to perform a task, number of patients seen in clinic, percent value-added time (VAT) to patients (face to face time) and family experience scores (FES). At the beginning of the study period, clinic costs were $619 per patient. We reduced conference time from 6 min/patient to 1 min per patient, physician preparation time from 8 min to 6 min and increased Medical Assistant (MA) preparation time from 9.5 min to 20 min, achieving a cost reduction of 41% to $366 per patient. Continued improvements further reduced the MA preparation time to 14 min and the MD preparation time to 5 min with a further cost reduction to $194 (69%) (Figure). During this study period, we increased the number of appointments per clinic. We demonstrated sustained improvement in FES with regards to the families overall experience with their providers. Value added time was increased from 60% to 78% but this was not significant. Time-based cost analysis effectively measures individualized patient cost. We achieved a 69% reduction in clinic preparation costs. Despite this reduction in costs, we were able to maintain VAT and sustain improvements in family experience. In caring for complex patients, lean management methodology enables optimization of value in a multidisciplinary clinic. Copyright © 2015. Published by Elsevier Ltd.

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

PubMed

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

2016-02-01

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

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

Cornuelle, John C.

In March, 2001, the TESLA Collaboration published its Technical Design Report (TDR, see references and links in Appendix), the first sentence of which stated ''...TESLA (TeV-Energy Superconducting Linear Collider) (will be) a superconducting electron-positron collider of initially 500 GeV total energy, extendable to 800 GeV, and an integrated X-ray laser laboratory.'' The TDR included cost and manpower estimates for a 500 GeV e{sup +}e{sup -} collider (250 on 250 GeV) based on superconducting RF cavity technology. This was submitted as a proposal to the German government. The government asked the German Science Council to evaluate this proposal. The recommendation frommore » this body is anticipated to be available by November 2002. The government has indicated that it will react on this recommendation by mid-2003. In June 2001, Steve Holmes, Fermilab's Associate Director for Accelerators, commissioned Helen Edwards and Peter Garbincius to organize a study of the TESLA Technical Design Report and the associated cost and manpower estimates. Since the elements and methodology used in producing the TESLA cost estimate were somewhat different from those used in preparing similar estimates for projects within the U.S., it is important to understand the similarities, differences, and equivalences between the TESLA estimate and U.S. cost estimates. In particular, the project cost estimate includes only purchased equipment, materials, and services, but not manpower from DESY or other TESLA collaborating institutions, which is listed separately. It does not include the R&D on the TESLA Test Facility (TTF) nor the costs of preparing the TDR nor the costs of performing the conceptual studies so far. The manpower for the pre-operations commissioning program (up to beam) is included in the estimate, but not the electrical power or liquid Nitrogen (for initial cooldown of the cryogenics plant). There is no inclusion of any contingency or management reserve. If the U.S. were to become involved with the TESLA project, either as a collaborator for an LC in Germany, or as host country for TESLA in the U.S., it is important to begin to understand the scope and technical details of the project, what R&D still needs to be done, and how the U.S. can contribute. The charge for this study is included in the Appendix to this report.« less

Incorporating economies of scale in the cost estimation in economic evaluation of PCV and HPV vaccination programmes in the Philippines: a game changer?

PubMed

Suwanthawornkul, Thanthima; Praditsitthikorn, Naiyana; Kulpeng, Wantanee; Haasis, Manuel Alexander; Guerrero, Anna Melissa; Teerawattananon, Yot

2018-01-01

Many economic evaluations ignore economies of scale in their cost estimation, which means that cost parameters are assumed to have a linear relationship with the level of production. Economies of scale is the situation when the average total cost of producing a product decreases with increasing volume caused by reducing the variable costs due to more efficient operation. This study investigates the significance of applying the economies of scale concept: the saving in costs gained by an increased level of production in economic evaluation of pneumococcal conjugate vaccines (PCV) and human papillomavirus (HPV) vaccinations. The fixed and variable costs of providing partial (20% coverage) and universal (100% coverage) vaccination programs in the Philippines were estimated using various methods, including costs of conducting questionnaire survey, focus-group discussion, and analysis of secondary data. Costing parameters were utilised as inputs for the two economic evaluation models for PCV and HPV. Incremental cost-effectiveness ratios (ICERs) and 5-year budget impacts with and without applying economies of scale to the costing parameters for partial and universal coverage were compared in order to determine the effect of these different costing approaches. The program costs of the partial coverage for the two immunisation programs were not very different when applying and not applying the economies of scale concept. Nevertheless, the program costs for universal coverage were 0.26 and 0.32 times lower when applying economies of scale compared to not applying economies of scale for the pneumococcal and human papillomavirus vaccinations, respectively. ICERs varied by up to 98% for pneumococcal vaccinations, whereas the change in ICERs in the human papillomavirus vaccination depended on both the costs of cervical cancer screening and the vaccination program. This results in a significant difference in the 5-year budget impact, accounting for 30 and 40% of reduction in the 5-year budget impact for the pneumococcal and human papillomavirus vaccination programs. This study demonstrated the feasibility and importance of applying economies of scale in the cost estimation in economic evaluation, which would lead to different conclusions in terms of value for money regarding the interventions, particularly with population-wide interventions such as vaccination programs. The economies of scale approach to costing is recommended for the creation of methodological guidelines for conducting economic evaluations.

[Economic impact of nosocomial bacteraemia. A comparison of three calculation methods].

PubMed

Riu, Marta; Chiarello, Pietro; Terradas, Roser; Sala, Maria; Castells, Xavier; Knobel, Hernando; Cots, Francesc

2016-12-01

The excess cost associated with nosocomial bacteraemia (NB) is used as a measurement of the impact of these infections. However, some authors have suggested that traditional methods overestimate the incremental cost due to the presence of various types of bias. The aim of this study was to compare three assessment methods of NB incremental cost to correct biases in previous analyses. Patients who experienced an episode of NB between 2005 and 2007 were compared with patients grouped within the same All Patient Refined-Diagnosis-Related Group (APR-DRG) without NB. The causative organisms were grouped according to the Gram stain, and whether bacteraemia was caused by a single or multiple microorganisms, or by a fungus. Three assessment methods are compared: stratification by disease; econometric multivariate adjustment using a generalised linear model (GLM); and propensity score matching (PSM) was performed to control for biases in the econometric model. The analysis included 640 admissions with NB and 28,459 without NB. The observed mean cost was €24,515 for admissions with NB and €4,851.6 for controls (without NB). Mean incremental cost was estimated at €14,735 in stratified analysis. Gram positive microorganism had the lowest mean incremental cost, €10,051. In the GLM, mean incremental cost was estimated as €20,922, and adjusting with PSM, the mean incremental cost was €11,916. The three estimates showed important differences between groups of microorganisms. Using enhanced methodologies improves the adjustment in this type of study and increases the value of the results. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Antihypertensive drugs: a perspective on pharmaceutical price erosion and its impact on cost-effectiveness.

PubMed

Refoios Camejo, Rodrigo; McGrath, Clare; Herings, Ron; Meerding, Willem-Jan; Rutten, Frans

2012-01-01

When comparators' prices decrease due to market competition and loss of exclusivity, the incremental clinical effectiveness required for a new technology to be cost-effective is expected to increase; and/or the minimum price at which it will be funded will tend to decrease. This may be, however, either unattainable physiologically or financially unviable for drug development. The objective of this study is to provide an empirical basis for this discussion by estimating the potential for price decreases to impact on the cost-effectiveness of new therapies in hypertension. Cost-effectiveness at launch was estimated for all antihypertensive drugs launched between 1998 and 2008 in the United Kingdom using hypothetical degrees of incremental clinical effectiveness within the methodologic framework applied by the UK National Institute for Health and Clinical Excellence. Incremental cost-effectiveness ratios were computed and compared with funding thresholds. In addition, the levels of incremental clinical effectiveness required to achieve specific cost-effectiveness thresholds at given prices were estimated. Significant price decreases were observed for existing drugs. This was shown to markedly affect cost-effectiveness of technologies entering the market. The required incremental clinical effectiveness was in many cases greater than physiologically possible so, as a consequence, a number of products might not be available today if current methods of economic appraisal had been applied. We conclude that the definition of cost-effectiveness thresholds is fundamental in promoting efficient innovation. Our findings demonstrate that comparator price attrition has the potential to put pressure in the pharmaceutical research model and presents a challenge to new therapies being accepted for funding. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology

PubMed Central

Kolaczinski, Jan; Hanson, Kara

2006-01-01

Background Insecticide-treated nets (ITNs) are an effective and cost-effective means of malaria control. Scaling-up coverage of ITNs is challenging. It requires substantial resources and there are a number of strategies to choose from. Information on the cost of different strategies is still scarce. To guide the choice of a delivery strategy (or combination of strategies), reliable and standardized cost information for the different options is required. Methods The electronic online database PubMed was used for a systematic search of the published English literature on costing and economic evaluations of ITN distribution programmes. The keywords used were: net, bednet, insecticide, treated, ITN, cost, effectiveness, economic and evaluation. Identified papers were analysed to determine and evaluate the costing methods used. Methods were judged against existing standards of cost analysis to arrive at proposed standards for undertaking and presenting cost analyses. Results Cost estimates were often not readily comparable or could not be adjusted to a different context. This resulted from the wide range of methods applied and measures of output chosen. Most common shortcomings were the omission of certain costs and failure to adjust financial costs to generate economic costs. Generalisability was hampered by authors not reporting quantities and prices of resources separately and not examining the sensitivity of their results to variations in underlying assumptions. Conclusion The observed shortcomings have arisen despite the abundance of literature and guidelines on costing of health care interventions. This paper provides ITN specific recommendations in the hope that these will help to standardize future cost estimates. PMID:16681856

A cost-effectiveness analysis of a residential radon remediation programme in the United Kingdom.

PubMed

Kennedy, C A; Gray, A M; Denman, A R; Phillips, P S

1999-12-01

As residential radon programmes of identification and remediation have proceeded, so questions have been raised about their costs and benefits. This study presents a generalizable model for estimating the cost-effectiveness of a radon mitigation programme using the methodological framework now considered appropriate in the economic evaluation of health interventions. Its use will help to inform future discussion of radon remediation and lung cancer prevention programmes. Data from Northamptonshire were analysed, resulting in a societal cost-effectiveness ratio of Pounds Sterling 13250 per life-year gained in 1997. The percentage of houses found to be over the action level, and the percentage of householders who decide to remediate are shown to be important parameters for the cost-effectiveness analysis. Questions are raised about the particular importance of perspective in this type of analysis and suggestions are made for future research directions.

An estimation of the cost per visit of nursing home care services.

PubMed

Ryu, Ho-Sihn

2009-01-01

Procedures used for analyzing the cost of providing home care nursing services through hospital-based home care agencies (HCAs) was the focus of this study. A cross-sectional descriptive study design was used to analyze the workload and caseload of 36 home care nurses from ten HCAs. In addition, information obtained from a national health insurance database, including 54,639 home care claim cases from a total of 185 HCAs during a 6-month period, were analyzed. The findings provide a foundation for improving the alternative home care billing and reimbursement system by using the actual amount of time invested in providing home care when calculating the cost of providing home care nursing services. Further, this study provides a procedure for calculating nursing service costs by analyzing actual data. The results have great potential for use in nursing service cost analysis methodology, which is an essential step in developing a policy for providing home care.

The global economic burden of asthma and chronic obstructive pulmonary disease.

PubMed

Ehteshami-Afshar, S; FitzGerald, J M; Doyle-Waters, M M; Sadatsafavi, M

2016-01-01

Non-communicable diseases are now the number one cause of disabilities and loss of life expectancy. Among them, chronic respiratory conditions constitute a major class. The burden of chronic respiratory diseases is generally increasing across the globe, and asthma and chronic obstructive pulmonary disease (COPD) are among the main causes of mortality and morbidity. However, the direct and indirect costs of these conditions vary across jurisdictions. This article reports on recent estimates of the costs of asthma and COPD, with a focus on comparing disease burden across different regions. Overall, there is tremendous variation in per capita annual costs of asthma and COPD. However, the methodology of the cost-of-illness studies is also vastly different, making it difficult to associate differences in reported costs to differences in the true burden of asthma and COPD. Suggestions are provided towards improving the validity and comparability of future studies.

A comparative review of nurse turnover rates and costs across countries.

PubMed

Duffield, Christine M; Roche, Michael A; Homer, Caroline; Buchan, James; Dimitrelis, Sofia

2014-12-01

To compare nurse turnover rates and costs from four studies in four countries (US, Canada, Australia, New Zealand) that have used the same costing methodology; the original Nursing Turnover Cost Calculation Methodology. Measuring and comparing the costs and rates of turnover is difficult because of differences in definitions and methodologies. Comparative review. Searches were carried out within CINAHL, Business Source Complete and Medline for studies that used the original Nursing Turnover Cost Calculation Methodology and reported on both costs and rates of nurse turnover, published from 2014 and prior. A comparative review of turnover data was conducted using four studies that employed the original Nursing Turnover Cost Calculation Methodology. Costing data items were converted to percentages, while total turnover costs were converted to US 2014 dollars and adjusted according to inflation rates, to permit cross-country comparisons. Despite using the same methodology, Australia reported significantly higher turnover costs ($48,790) due to higher termination (~50% of indirect costs) and temporary replacement costs (~90% of direct costs). Costs were almost 50% lower in the US ($20,561), Canada ($26,652) and New Zealand ($23,711). Turnover rates also varied significantly across countries with the highest rate reported in New Zealand (44·3%) followed by the US (26·8%), Canada (19·9%) and Australia (15·1%). A significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention. The authors suggest a minimum dataset is also required to eliminate potential variability across countries, states, hospitals and departments. © 2014 John Wiley & Sons Ltd.

The methodological quality of health economic evaluations for the management of hip fractures: A systematic review of the literature.

PubMed

Sabharwal, Sanjeeve; Carter, Alexander; Darzi, Lord Ara; Reilly, Peter; Gupte, Chinmay M

2015-06-01

Approximately 76,000 people a year sustain a hip fracture in the UK and the estimated cost to the NHS is £1.4 billion a year. Health economic evaluations (HEEs) are one of the methods employed by decision makers to deliver healthcare policy supported by clinical and economic evidence. The objective of this study was to (1) identify and characterize HEEs for the management of patients with hip fractures, and (2) examine their methodological quality. A literature search was performed in MEDLINE, EMBASE and the NHS Economic Evaluation Database. Studies that met the specified definition for a HEE and evaluated hip fracture management were included. Methodological quality was assessed using the Consensus on Health Economic Criteria (CHEC). Twenty-seven publications met the inclusion criteria of this study and were included in our descriptive and methodological analysis. Domains of methodology that performed poorly included use of an appropriate time horizon (66.7% of studies), incremental analysis of costs and outcomes (63%), future discounting (44.4%), sensitivity analysis (40.7%), declaration of conflicts of interest (37%) and discussion of ethical considerations (29.6%). HEEs for patients with hip fractures are increasing in publication in recent years. Most of these studies fail to adopt a societal perspective and key aspects of their methodology are poor. The development of future HEEs in this field must adhere to established principles of methodology, so that better quality research can be used to inform health policy on the management of patients with a hip fracture. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

The cost of adherence mismeasurement in serious mental illness: a claims-based analysis.

PubMed

Shafrin, Jason; Forma, Felicia; Scherer, Ethan; Hatch, Ainslie; Vytlacil, Edward; Lakdawalla, Darius

2017-05-01

To quantify how adherence mismeasurement affects the estimated impact of adherence on inpatient costs among patients with serious mental illness (SMI). Proportion of days covered (PDC) is a common claims-based measure of medication adherence. Because PDC does not measure medication ingestion, however, it may inaccurately measure adherence. We derived a formula to correct the bias that occurs in adherence-utilization studies resulting from errors in claims-based measures of adherence. We conducted a literature review to identify the correlation between gold-standard and claims-based adherence measures. We derived a bias-correction methodology to address claims-based medication adherence measurement error. We then applied this methodology to a case study of patients with SMI who initiated atypical antipsychotics in 2 large claims databases. Our literature review identified 6 studies of interest. The 4 most relevant ones measured correlations between 0.38 and 0.91. Our preferred estimate implies that the effect of adherence on inpatient spending estimated from claims data would understate the true effect by a factor of 5.3, if there were no other sources of bias. Although our procedure corrects for measurement error, such error also may amplify or mitigate other potential biases. For instance, if adherent patients are healthier than nonadherent ones, measurement error makes the resulting bias worse. On the other hand, if adherent patients are sicker, measurement error mitigates the other bias. Measurement error due to claims-based adherence measures is worth addressing, alongside other more widely emphasized sources of bias in inference.

A comparison of medical records and patient questionnaires as sources for the estimation of costs within research studies and the implications for economic evaluation.

PubMed

Gillespie, Paddy; O'Shea, Eamon; Smith, Susan M; Cupples, Margaret E; Murphy, Andrew W

2016-12-01

Data on health care utilization may be collected using a variety of mechanisms within research studies, each of which may have implications for cost and cost effectiveness. The aim of this observational study is to compare data collected from medical records searches and self-report questionnaires for the cost analysis of a cardiac secondary prevention intervention. Secondary data analysis of the Secondary Prevention of Heart Disease in General Practice (SPHERE) randomized controlled trial (RCT). Resource use data for a range of health care services were collected by research nurse searches of medical records and self-report questionnaires and costs of care estimated for each data collection mechanism. A series of statistical analyses were conducted to compare the mean costs for medical records data versus questionnaire data and to conduct incremental analyses for the intervention and control arms in the trial. Data were available to estimate costs for 95% of patients in the intervention and 96% of patients in the control using the medical records data compared to 65% and 66%, respectively, using the questionnaire data. The incremental analysis revealed a statistically significant difference in mean cost of -€796 (95% CI: -1447, -144; P-value: 0.017) for the intervention relative to the control. This compared to no significant difference in mean cost (95% CI: -1446, 860; P-value: 0.619) for the questionnaire analysis. Our findings illustrate the importance of the choice of health care utilization data collection mechanism for the conduct of economic evaluation alongside randomized trials in primary care. This choice will have implications for the costing methodology employed and potentially, for the cost and cost effectiveness outcomes generated. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Economic costs of alcohol use in Sri Lanka.

PubMed

Ranaweera, Sajeeva; Amarasinghe, Hemantha; Chandraratne, Nadeeka; Thavorncharoensap, Montarat; Ranasinghe, Thushara; Karunaratna, Sumudu; Kumara, Dinesh; Santatiwongchai, Benjarin; Chaikledkaew, Usa; Abeykoon, Palitha; De Silva, Amala

2018-01-01

Alcohol related disease conditions are responsible for a significant proportion of morbidity and mortality in Sri Lanka. This study quantified the economic cost of selected alcohol related disease conditions in Sri Lanka in 2015. This study uses the prevalence-based cost of illness methodology specified by the World Health Organization, and uses the gross costing approach. The direct costs includes the costs of curative care (inpatient and outpatient care borne by the state and out of pocket expenditure borne by patients) for alcohol related diseases, weighted by the respective population attributable fractions. Indirect costs consist of lost earnings due to absenteeism of the patient and carers due to seeking care and recuperation, and the loss of income due to mortality. Data form the Ministry of Health, Registrar General's Department, Department of Census and Statistics and the National Cancer Registry was used. Systemic and house costs and population attributable fractions were obtained from research studies. Economists, Public Health Experts, Medical Administrators and Clinical Specialists were iteratively consulted during the estimation and validation of the costs and the results. The estimated present value of current and future economic cost of the alcohol-related conditions for Sri Lanka in 2015 was USD 885.86 million, 1.07% of the GDP of that year. The direct cost of alcohol related disease conditions was USD 388.35 million, which was 44% of the total cost, while the indirect cost was USD 497.50 million, which was 66% of the total cost. Road Injury cost was the highest cost category among the conditions studied. Addressing alcohol use and its harms through effective implementation of evidence-based polices and interventions is urgently required to address the economic costs of alcohol use in Sri Lanka as it imposes a significant burden to the country.

Cost analysis of the surgical treatment of fractures of the proximal humerus: an evaluation of the determinants of cost and comparison of the institutional cost of treatment with the national tariff.

PubMed

Sabharwal, S; Carter, A W; Rashid, A; Darzi, A; Reilly, P; Gupte, C M

2016-02-01

The aims of this study were to estimate the cost of surgical treatment of fractures of the proximal humerus using a micro-costing methodology, contrast this cost with the national reimbursement tariff and establish the major determinants of cost. A detailed inpatient treatment pathway was constructed using semi-structured interviews with 32 members of hospital staff. Its content validity was established through a Delphi panel evaluation. Costs were calculated using time-driven activity-based costing (TDABC) and sensitivity analysis was performed to evaluate the determinants of cost The mean cost of the different surgical treatments was estimated to be £3282. Although this represented a profit of £1138 against the national tariff, hemiarthroplasty as a treatment choice resulted in a net loss of £952. Choice of implant and theatre staffing were the largest cost drivers. Operating theatre delays of more than one hour resulted in a loss of income Our findings indicate that the national tariff does not accurately represent the cost of treatment for this condition. Effective use of the operating theatre and implant discounting are likely to be more effective cost containment approaches than control of bed-day costs. This cost analysis of fractures of the proximal humerus reinforces the limitations of the national tariff within the English National Health Service, and underlines the importance of effective use of the operating theatre, as well as appropriate implant procurement where controlling costs of treatment is concerned. ©2016 The British Editorial Society of Bone & Joint Surgery.

Economic costs of alcohol use in Sri Lanka

PubMed Central

Ranaweera, Sajeeva; Amarasinghe, Hemantha; Thavorncharoensap, Montarat; Ranasinghe, Thushara; Karunaratna, Sumudu; Santatiwongchai, Benjarin; Chaikledkaew, Usa; Abeykoon, Palitha; De Silva, Amala

2018-01-01

Aim Alcohol related disease conditions are responsible for a significant proportion of morbidity and mortality in Sri Lanka. This study quantified the economic cost of selected alcohol related disease conditions in Sri Lanka in 2015. Methods This study uses the prevalence-based cost of illness methodology specified by the World Health Organization, and uses the gross costing approach. The direct costs includes the costs of curative care (inpatient and outpatient care borne by the state and out of pocket expenditure borne by patients) for alcohol related diseases, weighted by the respective population attributable fractions. Indirect costs consist of lost earnings due to absenteeism of the patient and carers due to seeking care and recuperation, and the loss of income due to mortality. Data form the Ministry of Health, Registrar General’s Department, Department of Census and Statistics and the National Cancer Registry was used. Systemic and house costs and population attributable fractions were obtained from research studies. Economists, Public Health Experts, Medical Administrators and Clinical Specialists were iteratively consulted during the estimation and validation of the costs and the results. Results The estimated present value of current and future economic cost of the alcohol-related conditions for Sri Lanka in 2015 was USD 885.86 million, 1.07% of the GDP of that year. The direct cost of alcohol related disease conditions was USD 388.35 million, which was 44% of the total cost, while the indirect cost was USD 497.50 million, which was 66% of the total cost. Road Injury cost was the highest cost category among the conditions studied. Conclusion Addressing alcohol use and its harms through effective implementation of evidence-based polices and interventions is urgently required to address the economic costs of alcohol use in Sri Lanka as it imposes a significant burden to the country. PMID:29879178

Gyrokinetic modelling of the quasilinear particle flux for plasmas with neutral-beam fuelling

NASA Astrophysics Data System (ADS)

Narita, E.; Honda, M.; Nakata, M.; Yoshida, M.; Takenaga, H.; Hayashi, N.

2018-02-01

A quasilinear particle flux is modelled based on gyrokinetic calculations. The particle flux is estimated by determining factors, namely, coefficients of off-diagonal terms and a particle diffusivity. In this paper, the methodology to estimate the factors is presented using a subset of JT-60U plasmas. First, the coefficients of off-diagonal terms are estimated by linear gyrokinetic calculations. Next, to obtain the particle diffusivity, a semi-empirical approach is taken. Most experimental analyses for particle transport have assumed that turbulent particle fluxes are zero in the core region. On the other hand, even in the stationary state, the plasmas in question have a finite turbulent particle flux due to neutral-beam fuelling. By combining estimates of the experimental turbulent particle flux and the coefficients of off-diagonal terms calculated earlier, the particle diffusivity is obtained. The particle diffusivity should reflect a saturation amplitude of instabilities. The particle diffusivity is investigated in terms of the effects of the linear instability and linear zonal flow response, and it is found that a formula including these effects roughly reproduces the particle diffusivity. The developed framework for prediction of the particle flux is flexible to add terms neglected in the current model. The methodology to estimate the quasilinear particle flux requires so low computational cost that a database consisting of the resultant coefficients of off-diagonal terms and particle diffusivity can be constructed to train a neural network. The development of the methodology is the first step towards a neural-network-based particle transport model for fast prediction of the particle flux.

Analytical Model For Fluid Dynamics In A Microgravity Environment

NASA Technical Reports Server (NTRS)

Naumann, Robert J.

1995-01-01

Report presents analytical approximation methodology for providing coupled fluid-flow, heat, and mass-transfer equations in microgravity environment. Experimental engineering estimates accurate to within factor of 2 made quickly and easily, eliminating need for time-consuming and costly numerical modeling. Any proposed experiment reviewed to see how it would perform in microgravity environment. Model applied in commercial setting for preliminary design of low-Grashoff/Rayleigh-number experiments.

Military Jet Engine Acquisition: Technology Basics and Cost-Estimating Methodology

DTIC Science & Technology

2002-01-01

aircraft , rather than by these forms of jet engines . Like the turbofan or turbojet , these engines have a nozzle down- stream of the low-pressure...2.5 illustrates the process of turbine blade cooling. Figure 2.6 illustrates the steady and rapid increase in RIT for turbo - jets , turbofans , and...87 B. AN OVERVIEW OF MILITARY JET ENGINE HISTORY ... 97 C. AIRCRAFT TURBINE ENGINE DEVELOPMENT ...... 121 D.

Potential Energy Cost Savings from Increased Commercial Energy Code Compliance

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

Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.

2016-08-22

An important question for commercial energy code compliance is: “How much energy cost savings can better compliance achieve?” This question is in sharp contrast to prior efforts that used a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. A field investigation method is being developed that goes beyond the binary approach to determine how much energy cost savings is not realized. Prototype building simulations were used to estimate the energy cost impact of varying levels of non-compliance for newly constructed officemore » buildings in climate zone 4C. Field data collected from actual buildings on specific conditions relative to code requirements was then applied to the simulation results to find the potential lost energy savings for a single building or for a sample of buildings. This new methodology was tested on nine office buildings in climate zone 4C. The amount of additional energy cost savings they could have achieved had they complied fully with the 2012 International Energy Conservation Code is determined. This paper will present the results of the test, lessons learned, describe follow-on research that is needed to verify that the methodology is both accurate and practical, and discuss the benefits that might accrue if the method were widely adopted.« less

Uncertainty propagation by using spectral methods: A practical application to a two-dimensional turbulence fluid model

NASA Astrophysics Data System (ADS)

Riva, Fabio; Milanese, Lucio; Ricci, Paolo

2017-10-01

To reduce the computational cost of the uncertainty propagation analysis, which is used to study the impact of input parameter variations on the results of a simulation, a general and simple to apply methodology based on decomposing the solution to the model equations in terms of Chebyshev polynomials is discussed. This methodology, based on the work by Scheffel [Am. J. Comput. Math. 2, 173-193 (2012)], approximates the model equation solution with a semi-analytic expression that depends explicitly on time, spatial coordinates, and input parameters. By employing a weighted residual method, a set of nonlinear algebraic equations for the coefficients appearing in the Chebyshev decomposition is then obtained. The methodology is applied to a two-dimensional Braginskii model used to simulate plasma turbulence in basic plasma physics experiments and in the scrape-off layer of tokamaks, in order to study the impact on the simulation results of the input parameter that describes the parallel losses. The uncertainty that characterizes the time-averaged density gradient lengths, time-averaged densities, and fluctuation density level are evaluated. A reasonable estimate of the uncertainty of these distributions can be obtained with a single reduced-cost simulation.

National Launch System comparative economic analysis

NASA Technical Reports Server (NTRS)

Prince, A.

1992-01-01

Results are presented from an analysis of economic benefits (or losses), in the form of the life cycle cost savings, resulting from the development of the National Launch System (NLS) family of launch vehicles. The analysis was carried out by comparing various NLS-based architectures with the current Shuttle/Titan IV fleet. The basic methodology behind this NLS analysis was to develop a set of annual payload requirements for the Space Station Freedom and LEO, to design launch vehicle architectures around these requirements, and to perform life-cycle cost analyses on all of the architectures. A SEI requirement was included. Launch failure costs were estimated and combined with the relative reliability assumptions to measure the effects of losses. Based on the analysis, a Shuttle/NLS architecture evolving into a pressurized-logistics-carrier/NLS architecture appears to offer the best long-term cost benefit.

What is the cost of palliative care in the UK? A systematic review.

PubMed

Gardiner, Clare; Ryan, Tony; Gott, Merryn

2018-04-13

Little is known about the cost of a palliative care approach in the UK, and there is an absence of robust activity and unit cost data. The aim of this study was to review evidence on the costs of specialist and generalist palliative care in the UK, and to explore different approaches used for capturing activity and unit cost data. A systematic review with narrative synthesis. Four electronic databases were searched for empirical literature on the costs of a palliative care approach in the UK, and a narrative method was used to synthesise the data. Ten papers met our inclusion criteria. The studies displayed significant variation in their estimates of the cost of palliative care, therefore it was not possible to present an accurate aggregate cost of palliative care in the UK. The majority of studies explored costs from a National Health Service perspective and only two studies included informal care costs. Approaches to estimating activity and costs varied. Particular challenges were noted with capturing activity and cost data for hospice and informal care. The data are limited, and the heterogeneity is such that it is not possible to provide an aggregate cost of palliative care in the UK. It is notable that the costs of hospice care and informal care are often neglected in economic studies. Further work is needed to address methodological and practical challenges in order to gain a more complete understanding of the costs of palliative care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

PubMed

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.