Solar energy system economic evaluation for Solaron Akron, Akron, Ohio

NASA Technical Reports Server (NTRS)

1980-01-01

The economic analysis of the solar energy system that was installed at Akron, Ohio is developed for this and four other sites typical of a wide range of environmental and economic conditions. The analysis is accomplished based on the technical and economic models in the f chart design procedure with inputs based on the characteristics of the installed parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated. Results show that only in Albuquerque, New Mexico, where insolation is 1828 Btu/sq ft/day and the conventional energy cost is high, is this solar energy system marginally profitable.

Economic evaluation of algae biodiesel based on meta-analyses

NASA Astrophysics Data System (ADS)

Zhang, Yongli; Liu, Xiaowei; White, Mark A.; Colosi, Lisa M.

2017-08-01

The objective of this study is to elucidate the economic viability of algae-to-energy systems at a large scale, by developing a meta-analysis of five previously published economic evaluations of systems producing algae biodiesel. Data from original studies were harmonised into a standardised framework using financial and technical assumptions. Results suggest that the selling price of algae biodiesel under the base case would be 5.00-10.31/gal, higher than the selected benchmarks: 3.77/gal for petroleum diesel, and 4.21/gal for commercial biodiesel (B100) from conventional vegetable oil or animal fat. However, the projected selling price of algal biodiesel (2.76-4.92/gal), following anticipated improvements, would be competitive. A scenario-based sensitivity analysis reveals that the price of algae biodiesel is most sensitive to algae biomass productivity, algae oil content, and algae cultivation cost. This indicates that the improvements in the yield, quality, and cost of algae feedstock could be the key factors to make algae-derived biodiesel economically viable.

Assessment of energy and economic performance of office building models: a case study

NASA Astrophysics Data System (ADS)

Song, X. Y.; Ye, C. T.; Li, H. S.; Wang, X. L.; Ma, W. B.

2016-08-01

Energy consumption of building accounts for more than 37.3% of total energy consumption while the proportion of energy-saving buildings is just 5% in China. In this paper, in order to save potential energy, an office building in Southern China was selected as a test example for energy consumption characteristics. The base building model was developed by TRNSYS software and validated against the recorded data from the field work in six days out of August-September in 2013. Sensitivity analysis was conducted for energy performance of building envelope retrofitting; five envelope parameters were analyzed for assessing the thermal responses. Results indicated that the key sensitivity factors were obtained for the heat-transfer coefficient of exterior walls (U-wall), infiltration rate and shading coefficient (SC), of which the sum sensitivity factor was about 89.32%. In addition, the results were evaluated in terms of energy and economic analysis. The analysis of sensitivity validated against some important results of previous studies. On the other hand, the cost-effective method improved the efficiency of investment management in building energy.

Methods of international health technology assessment agencies for economic evaluations--a comparative analysis.

PubMed

Mathes, Tim; Jacobs, Esther; Morfeld, Jana-Carina; Pieper, Dawid

2013-09-30

The number of Health Technology Assessment (HTA) agencies increases. One component of HTAs are economic aspects. To incorporate economic aspects commonly economic evaluations are performed. A convergence of recommendations for methods of health economic evaluations between international HTA agencies would facilitate the adaption of results to different settings and avoid unnecessary expense. A first step in this direction is a detailed analysis of existing similarities and differences in recommendations to identify potential for harmonization. The objective is to provide an overview and comparison of the methodological recommendations of international HTA agencies for economic evaluations. The webpages of 127 international HTA agencies were searched for guidelines containing recommendations on methods for the preparation of economic evaluations. Additionally, the HTA agencies were requested information on methods for economic evaluations. Recommendations of the included guidelines were extracted in standardized tables according to 13 methodological aspects. All process steps were performed independently by two reviewers. Finally 25 publications of 14 HTA agencies were included in the analysis. Methods for economic evaluations vary widely. The greatest accordance could be found for the type of analysis and comparator. Cost-utility-analyses or cost-effectiveness-analyses are recommended. The comparator should continuously be usual care. Again the greatest differences were shown in the recommendations on the measurement/sources of effects, discounting and in the analysis of sensitivity. The main difference regarding effects is the focus either on efficacy or effectiveness. Recommended discounting rates range from 1.5%-5% for effects and 3%-5% for costs whereby it is mostly recommended to use the same rate for costs and effects. With respect to the analysis of sensitivity the main difference is that oftentimes the probabilistic or deterministic approach is recommended exclusively. Methods for modeling are only described vaguely and mainly with the rational that the "appropriate model" depends on the decision problem. Considering all other aspects a comparison is challenging as recommendations vary regarding detailedness and addressed issues. There is a considerable unexplainable variance in recommendations. Further effort is needed to harmonize methods for preparing economic evaluations.

Solar energy system economic evaluation for Elcam-Tempe, Tempe, Arizona and Elcam-San Diego, San Diego, California

NASA Technical Reports Server (NTRS)

1980-01-01

The long term economic performance of the solar energy system at its installation site is analyzed and four additional locations selected to demonstrate the viability of the design over a broad range of environmental and economic conditions. The economic analysis of the solar energy systems that were installed at Tempe, Arizona and San Diego, California, is developed for these and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f Chart design procedure with inputs based on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over a projected twenty year life: life cycle savings; year of positive savings; and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainites in constituent system and economic variables is also investigated. The results demonstrate that the solar energy system is economically viable at all of the sites for which the analysis was conducted.

A techno-economic assessment of grid connected photovoltaic system for hospital building in Malaysia

NASA Astrophysics Data System (ADS)

Mat Isa, Normazlina; Tan, Chee Wei; Yatim, AHM

2017-07-01

Conventionally, electricity in hospital building are supplied by the utility grid which uses mix fuel including coal and gas. Due to enhancement in renewable technology, many building shall moving forward to install their own PV panel along with the grid to employ the advantages of the renewable energy. This paper present an analysis of grid connected photovoltaic (GCPV) system for hospital building in Malaysia. A discussion is emphasized on the economic analysis based on Levelized Cost of Energy (LCOE) and total Net Present Post (TNPC) in regards with the annual interest rate. The analysis is performed using Hybrid Optimization Model for Electric Renewables (HOMER) software which give optimization and sensitivity analysis result. An optimization result followed by the sensitivity analysis also being discuss in this article thus the impact of the grid connected PV system has be evaluated. In addition, the benefit from Net Metering (NeM) mechanism also discussed.

ECONOMICS AND APPRAISAL OF CONVENTIONAL OIL AND GAS IN THE WESTERN GULF OF MEXICO.

USGS Publications Warehouse

Attanasi, E.D.; Haynes, John L.

1984-01-01

The oil and gas industry frequently appraises undiscovered oil and gas resources on a regional basis to decide whether to start or continue exploration programs. The appraisals are of little value unless conditioned by estimates of the costs of finding and producing the resources. This paper presents an economic appraisal of undiscovered oil and gas resources in the western Gulf of Mexico. Also presented are a description of the model used to make the assessment, results of a sensitivity analysis, and a discussion of the implications of the results to the industry. The appraisal is shown to be relatively robust to changes in physical and engineering assumptions. Because the number of commercial discoveries was found to be quite sensitive to economic conditions, the analysis has important implications in terms of forecasting future industry drilling and other associated activities in the western Gulf of Mexico.

Economic assessments of small-scale drinking-water interventions in pursuit of MDG target 7C.

PubMed

Cameron, John; Jagals, Paul; Hunter, Paul R; Pedley, Steve; Pond, Katherine

2011-12-01

This paper uses an applied rural case study of a safer water intervention in South Africa to illustrate how three levels of economic assessment can be used to understand the impact of the intervention on people's well-being. It is set in the context of Millennium Development Goal 7 which sets a target (7C) for safe drinking-water provision and the challenges of reaching people in remote rural areas with relatively small-scale schemes. The assessment moves from cost efficiency to cost effectiveness to a full social cost-benefit analysis (SCBA) with an associated sensitivity test. In addition to demonstrating techniques of analysis, the paper brings out many of the challenges in understanding how safer drinking-water impacts on people's livelihoods. The SCBA shows the case study intervention is justified economically, though the sensitivity test suggests 'downside' vulnerability. Copyright © 2011 Elsevier B.V. All rights reserved.

Cost Sensitivity Analysis for Consolidated Interim Storage of Spent Fuel: Evaluating the Effect of Economic Environment Parameters

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

Cumberland, Riley M.; Williams, Kent Alan; Jarrell, Joshua J.

This report evaluates how the economic environment (i.e., discount rate, inflation rate, escalation rate) can impact previously estimated differences in lifecycle costs between an integrated waste management system with an interim storage facility (ISF) and a similar system without an ISF.

Adding insult to injury

NASA Astrophysics Data System (ADS)

Friebele, Elaine

New predictions and observations suggest that global warming will exact the highest costs on developing countries. A recent economic analysis of global climate change indicates that developed countries, the primary emitters of carbon dioxide, would benefit by $82 billion per year from a 2°C increase in global mean temperature, while underdeveloped countries would lose $40 billion per year.For the economic analysis, global climate predictions were combined with economic data (for agriculture, forestry, coastal resources, energy, and tourism), but natural climate variability, including frosts, droughts, or severe thunderstorms, was not included. Countries predicted to suffer the greatest economic losses from global warming are island nations, said Michael Schlesinger, a University of Illinois atmospheric scientist who performed the economic analysis with colleagues from Yale University and Middlebury College. “These countries have long coast lines, sensitive tourism industries, and small, undeveloped economies.”

The economics of protecting tiger populations: Linking household behavior to poaching and prey depletion

USGS Publications Warehouse

Damania, R.; Stringer, R.; Karanth, K.U.; Stith, B.

2003-01-01

The tiger (Panthera tigris) is classified as endangered and populations continue to decline. This paper presents a formal economic analysis of the two most imminent threats to the survival of wild tigers: poaching tigers and hunting their prey. A model is developed to examine interactions between tigers and farm households living in and around tiger habitats. The analysis extends the existing literature on tiger demography, incorporating predator-prey interactions and exploring the sensitivity of tiger populations to key economic parameters. The analysis aims to contribute to policy debates on how best to protect one of the world's most endangered wild cats.

Economic conditions, hypertension, and cardiovascular disease: analysis of the Icelandic economic collapse.

PubMed

Birgisdóttir, Kristín Helga; Jónsson, Stefán Hrafn; Ásgeirsdóttir, Tinna Laufey

2017-12-01

Previous research has found a positive short-term relationship between the 2008 collapse and hypertension in Icelandic males. With Iceland's economy experiencing a phase of economic recovery, an opportunity to pursue a longer-term analysis of the collapse has emerged. Using data from a nationally representative sample, fixed-effect estimations and mediation analyses were performed to explore the relationship between the Icelandic economic collapse in 2008 and the longer-term impact on hypertension and cardiovascular health. A sensitivity analysis was carried out with pooled logit models estimated as well as an alternative dependent variable. Our attrition analysis revealed that results for cardiovascular diseases were affected by attrition, but not results from estimations on the relationship between the economic crisis and hypertension. When compared to the boom year 2007, our results point to an increased probability of Icelandic women having hypertension in the year 2012, when the Icelandic economy had recovered substantially from the economic collapse in 2008. This represents a deviation from pre-crisis trends, thus suggesting a true economic-recovery impact on hypertension.

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

PubMed

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

2015-01-01

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

Economic analysis of alternative nutritional management of dual-purpose cow herds in central coastal Veracruz, Mexico.

PubMed

Absalón-Medina, Victor Antonio; Nicholson, Charles F; Blake, Robert W; Fox, Danny Gene; Juárez-Lagunes, Francisco I; Canudas-Lara, Eduardo G; Rueda-Maldonado, Bertha L

2012-08-01

Market information was combined with predicted input-output relationships in an economic analysis of alternative nutritional management for dual-purpose member herds of the Genesis farmer organization of central coastal Veracruz, Mexico. Cow productivity outcomes for typical management and alternative feeding scenarios were obtained from structured sets of simulations in a companion study of productivity limitations and potentials using the Cornell Net Carbohydrate and Protein System model (Version 6.0). Partial budgeting methods and sensitivity analysis were used to identify economically viable alternatives based on expected change in milk income over feed cost (change in revenues from milk sales less change in feed costs). Herd owners in coastal Veracruz have large economic incentives, from $584 to $1,131 in predicted net margin, to increase milk sales by up to 74% across a three-lactation cow lifetime by improving diets based on good quality grass and legume forages. This increment is equal to, or exceeds, in value the total yield from at least one additional lactation per cow lifetime. Furthermore, marginal rates of return (change in milk income over feed costs divided by change in variable costs when alternative practices are used) of 3.3 ± 0.8 indicate clear economic incentives to remove fundamental productivity vulnerabilities due to chronic energy deficits and impeded growth of immature cows under typical management. Sensitivity analyses indicate that the economic outcomes are robust for a variety of market conditions.

Approach of technical decision-making by element flow analysis and Monte-Carlo simulation of municipal solid waste stream.

PubMed

Tian, Bao-Guo; Si, Ji-Tao; Zhao, Yan; Wang, Hong-Tao; Hao, Ji-Ming

2007-01-01

This paper deals with the procedure and methodology which can be used to select the optimal treatment and disposal technology of municipal solid waste (MSW), and to provide practical and effective technical support to policy-making, on the basis of study on solid waste management status and development trend in China and abroad. Focusing on various treatment and disposal technologies and processes of MSW, this study established a Monte-Carlo mathematical model of cost minimization for MSW handling subjected to environmental constraints. A new method of element stream (such as C, H, O, N, S) analysis in combination with economic stream analysis of MSW was developed. By following the streams of different treatment processes consisting of various techniques from generation, separation, transfer, transport, treatment, recycling and disposal of the wastes, the element constitution as well as its economic distribution in terms of possibility functions was identified. Every technique step was evaluated economically. The Mont-Carlo method was then conducted for model calibration. Sensitivity analysis was also carried out to identify the most sensitive factors. Model calibration indicated that landfill with power generation of landfill gas was economically the optimal technology at the present stage under the condition of more than 58% of C, H, O, N, S going to landfill. Whether or not to generate electricity was the most sensitive factor. If landfilling cost increases, MSW separation treatment was recommended by screening first followed with incinerating partially and composting partially with residue landfilling. The possibility of incineration model selection as the optimal technology was affected by the city scale. For big cities and metropolitans with large MSW generation, possibility for constructing large-scale incineration facilities increases, whereas, for middle and small cities, the effectiveness of incinerating waste decreases.

Solar energy system economic evaluation. Final report for SEECO Lincoln, Lincoln, Nebraska

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

None

1980-09-01

The economic analysis of the solar energy system that was installed at Lincoln, Nebraska is developed for this and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f-chart design procedure with inputs based on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings and year of payback formore » the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated. Although budget constraints preclude an economic reevaluation of each of the sites, a similar site, Carlsbad, New Nexico, was done. When 1985 escalated values for fuel, costs, mass production, and improved design and installation techniques were applied, a significantly higher degree of savings was realized.« less

Issues in the economic evaluation of influenza vaccination by injection of healthy working adults in the US: a review and decision analysis of ten published studies.

PubMed

Hogan, Thomas J

2012-05-01

The objective was to review recent economic evaluations of influenza vaccination by injection in the US, assess their evidence, and conclude on their collective findings. The literature was searched for economic evaluations of influenza vaccination injection in healthy working adults in the US published since 1995. Ten evaluations described in nine papers were identified. These were synopsized and their results evaluated, the basic structure of all evaluations was ascertained, and sensitivity of outcomes to changes in parameter values were explored using a decision model. Areas to improve economic evaluations were noted. Eight of nine evaluations with credible economic outcomes were favourable to vaccination, representing a statistically significant result compared with a proportion of 50% that would be expected if vaccination and no vaccination were economically equivalent. Evaluations shared a basic structure, but differed considerably with respect to cost components, assumptions, methods, and parameter estimates. Sensitivity analysis indicated that changes in parameter values within the feasible range, individually or simultaneously, could reverse economic outcomes. Given stated misgivings, the methods of estimating influenza reduction ascribed to vaccination must be researched to confirm that they produce accurate and reliable estimates. Research is also needed to improve estimates of the costs per case of influenza illness and the costs of vaccination. Based on their assumptions, the reviewed papers collectively appear to support the economic benefits of influenza vaccination of healthy adults. Yet the underlying assumptions, methods and parameter estimates themselves warrant further research to confirm they are accurate, reliable and appropriate to economic evaluation purposes.

Genome-wide association analysis of diverse soybean genotypes reveals novel markers for nitrogen traits

USDA-ARS?s Scientific Manuscript database

Nitrogen is a primary plant nutrient that plays a major role in achieving maximum economic yield. Insufficient availability most often limits soybean crop growth. Symbiotic N2 fixation in soybean is highly sensitive to limited water availability, and breeding for reduced N2 fixation sensitivity to ...

A sensitivity analysis of process design parameters, commodity prices and robustness on the economics of odour abatement technologies.

PubMed

Estrada, José M; Kraakman, N J R Bart; Lebrero, Raquel; Muñoz, Raúl

2012-01-01

The sensitivity of the economics of the five most commonly applied odour abatement technologies (biofiltration, biotrickling filtration, activated carbon adsorption, chemical scrubbing and a hybrid technology consisting of a biotrickling filter coupled with carbon adsorption) towards design parameters and commodity prices was evaluated. Besides, the influence of the geographical location on the Net Present Value calculated for a 20 years lifespan (NPV20) of each technology and its robustness towards typical process fluctuations and operational upsets were also assessed. This comparative analysis showed that biological techniques present lower operating costs (up to 6 times) and lower sensitivity than their physical/chemical counterparts, with the packing material being the key parameter affecting their operating costs (40-50% of the total operating costs). The use of recycled or partially treated water (e.g. secondary effluent in wastewater treatment plants) offers an opportunity to significantly reduce costs in biological techniques. Physical/chemical technologies present a high sensitivity towards H2S concentration, which is an important drawback due to the fluctuating nature of malodorous emissions. The geographical analysis evidenced high NPV20 variations around the world for all the technologies evaluated, but despite the differences in wage and price levels, biofiltration and biotrickling filtration are always the most cost-efficient alternatives (NPV20). When, in an economical evaluation, the robustness is as relevant as the overall costs (NPV20), the hybrid technology would move up next to BTF as the most preferred technologies. Copyright © 2012 Elsevier Inc. All rights reserved.

Economic analysis in medical education: definition of essential terms.

PubMed

Walsh, Kieran

2014-10-01

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

Applying geologic sensitivity analysis to environmental risk management: The financial implications

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

Rogers, D.T.

The financial risks associated with environmental contamination can be staggering and are often difficult to identify and accurately assess. Geologic sensitivity analysis is gaining recognition as a significant and useful tool that can empower the user with crucial information concerning environmental risk management and brownfield redevelopment. It is particularly useful when (1) evaluating the potential risks associated with redevelopment of historical industrial facilities (brownfields) and (2) planning for future development, especially in areas of rapid development because the number of potential contaminating sources often increases with an increase in economic development. An examination of the financial implications relating to geologicmore » sensitivity analysis in southeastern Michigan from numerous case studies indicate that the environmental cost of contamination may be 100 to 1,000 times greater at a geologically sensitive location compared to the least sensitive location. Geologic sensitivity analysis has demonstrated that near-surface geology may influence the environmental impact of a contaminated site to a greater extent than the amount and type of industrial development.« less

MEDICAL DEVICE PRICES IN ECONOMIC EVALUATIONS.

PubMed

Akpinar, Ilke; Jacobs, Philip; Husereau, Don

2015-01-01

Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices. We conducted a review of the economic concepts and implications of methods used for economic evaluations of the eleven most implanted medical devices from the Canadian perspective. We found Canadian economic studies for five of the eleven medical devices and identified nineteen Canadian studies. Overall, the device costs were important components of total procedure cost, with an average ratio of 44.1 %. Observational estimates of the device costs were obtained from buyers or sellers in 13 of the 19 studies. Although most of the devices last more than 1 year, standard costing methods for capital equipment was never used. In addition, only eight studies included a sensitivity analysis for the device cost. None of the sensitivity analyses were based on actual price distributions. Economic evaluations are potentially important for policy making, but although they are being conducted, there is no standardized approach for incorporating medical device prices in economic analyses. Our review provides suggestions for improvements in how the prices are incorporated for economic evaluations of medical devices.

The future viability of algae-derived biodiesel under economic and technical uncertainties.

PubMed

Brownbridge, George; Azadi, Pooya; Smallbone, Andrew; Bhave, Amit; Taylor, Benjamin; Kraft, Markus

2014-01-01

This study presents a techno-economic assessment of algae-derived biodiesel under economic and technical uncertainties associated with the development of algal biorefineries. A global sensitivity analysis was performed using a High Dimensional Model Representation (HDMR) method. It was found that, considering reasonable ranges over which each parameter can vary, the sensitivity of the biodiesel production cost to the key input parameters decreases in the following order: algae oil content>algae annual productivity per unit area>plant production capacity>carbon price increase rate. It was also found that the Return on Investment (ROI) is highly sensitive to the algae oil content, and to a lesser extent to the algae annual productivity, crude oil price and price increase rate, plant production capacity, and carbon price increase rate. For a large scale plant (100,000 tonnes of biodiesel per year) the production cost of biodiesel is likely to be £0.8-1.6 per kg. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Agreement between guidelines for pharmaco-economic research and never-before-published health-economics evaluations].

PubMed

Postma, M J; Kwik, J J; Rutten, W J M J; de Jong-van den Berg, L T W; Brouwers, J R B J

2002-06-08

To investigate whether the health-economics research published in Dutch journals is in agreement with the guidelines for pharmaco-economic research as published in 1999 by the Dutch 'College voor zorgverzekeringen' [Healthcare Insurance Board]. Descriptive. A literature search was performed for health-economic evaluations published during 1990-1999 in Dutch journals such as Nederlands Tijdschrift voor Geneeskunde (NTvG), Pharmaceutisch Weekblad and Tijdschrift voor Gezondheidswetenschappen. The resulting 19 studies, primarily published in the NTvG, were compared with the pharmaco-economic guidelines, summarised in 9 criteria. The social perspective was taken in 5 studies (26%), non-related medical costs were excluded in 19 (100%), relevant subgroup analyses were performed in 16 (84%), effectiveness was explicitly differentiated from efficacy in 15 (79%), incremental analysis was performed in 18 (95%), an adequate period of analysis was chosen in 16 (84%), costs, benefits and health gains were discounted in 13 (68%), sensitivity analysis was included in the investigation in 10 (53%), and estimated cost prices were used in 9 (47%). The methodology in recently published Dutch health-economics research was partly in agreement with the later official guidelines for pharmaco-economic studies in the Netherlands.

Cross-National Estimates of the Effects of Family Background on Student Achievement: A Sensitivity Analysis

ERIC Educational Resources Information Center

Nonoyama-Tarumi, Yuko

2008-01-01

This article uses the data from the Programme for International Student Assessment (PISA) 2000 to examine whether the influence of family background on educational achievement is sensitive to different measures of the family's socio-economic status (SES). The study finds that, when a multidimensional measure of SES is used, the family background…

Sensitivity analysis of add-on price estimate for select silicon wafering technologies

NASA Technical Reports Server (NTRS)

Mokashi, A. R.

1982-01-01

The cost of producing wafers from silicon ingots is a major component of the add-on price of silicon sheet. Economic analyses of the add-on price estimates and their sensitivity internal-diameter (ID) sawing, multiblade slurry (MBS) sawing and fixed-abrasive slicing technique (FAST) are presented. Interim price estimation guidelines (IPEG) are used for estimating a process add-on price. Sensitivity analysis of price is performed with respect to cost parameters such as equipment, space, direct labor, materials (blade life) and utilities, and the production parameters such as slicing rate, slices per centimeter and process yield, using a computer program specifically developed to do sensitivity analysis with IPEG. The results aid in identifying the important cost parameters and assist in deciding the direction of technology development efforts.

Economic Evaluation of First-Line Treatments for Metastatic Renal Cell Carcinoma: A Cost-Effectiveness Analysis in A Health Resource–Limited Setting

PubMed Central

Wu, Bin; Dong, Baijun; Xu, Yuejuan; Zhang, Qiang; Shen, Jinfang; Chen, Huafeng; Xue, Wei

2012-01-01

Background To estimate, from the perspective of the Chinese healthcare system, the economic outcomes of five different first-line strategies among patients with metastatic renal cell carcinoma (mRCC). Methods and Findings A decision-analytic model was developed to simulate the lifetime disease course associated with renal cell carcinoma. The health and economic outcomes of five first-line strategies (interferon-alfa, interleukin-2, interleukin-2 plus interferon-alfa, sunitinib and bevacizumab plus interferon-alfa) were estimated and assessed by indirect comparison. The clinical and utility data were taken from published studies. The cost data were estimated from local charge data and current Chinese practices. Sensitivity analyses were used to explore the impact of uncertainty regarding the results. The impact of the sunitinib patient assistant program (SPAP) was evaluated via scenario analysis. The base-case analysis showed that the sunitinib strategy yielded the maximum health benefits: 2.71 life years and 1.40 quality-adjusted life-years (QALY). The marginal cost-effectiveness (cost per additional QALY) gained via the sunitinib strategy compared with the conventional strategy was $220,384 (without SPAP, interleukin-2 plus interferon-alfa and bevacizumab plus interferon-alfa were dominated) and $16,993 (with SPAP, interferon-alfa, interleukin-2 plus interferon-alfa and bevacizumab plus interferon-alfa were dominated). In general, the results were sensitive to the hazard ratio of progression-free survival. The probabilistic sensitivity analysis demonstrated that the sunitinib strategy with SPAP was the most cost-effective approach when the willingness-to-pay threshold was over $16,000. Conclusions Our analysis suggests that traditional cytokine therapy is the cost-effective option in the Chinese healthcare setting. In some relatively developed regions, sunitinib with SPAP may be a favorable cost-effective alternative for mRCC. PMID:22412884

Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting.

PubMed

Wu, Bin; Dong, Baijun; Xu, Yuejuan; Zhang, Qiang; Shen, Jinfang; Chen, Huafeng; Xue, Wei

2012-01-01

To estimate, from the perspective of the Chinese healthcare system, the economic outcomes of five different first-line strategies among patients with metastatic renal cell carcinoma (mRCC). A decision-analytic model was developed to simulate the lifetime disease course associated with renal cell carcinoma. The health and economic outcomes of five first-line strategies (interferon-alfa, interleukin-2, interleukin-2 plus interferon-alfa, sunitinib and bevacizumab plus interferon-alfa) were estimated and assessed by indirect comparison. The clinical and utility data were taken from published studies. The cost data were estimated from local charge data and current Chinese practices. Sensitivity analyses were used to explore the impact of uncertainty regarding the results. The impact of the sunitinib patient assistant program (SPAP) was evaluated via scenario analysis. The base-case analysis showed that the sunitinib strategy yielded the maximum health benefits: 2.71 life years and 1.40 quality-adjusted life-years (QALY). The marginal cost-effectiveness (cost per additional QALY) gained via the sunitinib strategy compared with the conventional strategy was $220,384 (without SPAP, interleukin-2 plus interferon-alfa and bevacizumab plus interferon-alfa were dominated) and $16,993 (with SPAP, interferon-alfa, interleukin-2 plus interferon-alfa and bevacizumab plus interferon-alfa were dominated). In general, the results were sensitive to the hazard ratio of progression-free survival. The probabilistic sensitivity analysis demonstrated that the sunitinib strategy with SPAP was the most cost-effective approach when the willingness-to-pay threshold was over $16,000. Our analysis suggests that traditional cytokine therapy is the cost-effective option in the Chinese healthcare setting. In some relatively developed regions, sunitinib with SPAP may be a favorable cost-effective alternative for mRCC.

Costs of trastuzumab in combination with chemotherapy for HER2-positive advanced gastric or gastroesophageal junction cancer: an economic evaluation in the Chinese context.

PubMed

Wu, Bin; Ye, Ming; Chen, Huafeng; Shen, Jinfang F

2012-02-01

Adding trastuzumab to a conventional regimen of chemotherapy can improve survival in patients with human epidermal growth factor receptor 2 (HER2)-positive advanced gastric or gastroesophageal junction (GEJ) cancer, but the economic impact of this practice is unknown. The purpose of this cost-effectiveness analysis was to estimate the effects of adding trastuzumab to standard chemotherapy in patients with HER2-positive advanced gastric or GEJ cancer on health and economic outcomes in China. A Markov model was developed to simulate the clinical course of typical patients with HER2-positive advanced gastric or GEJ cancer. Five-year quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs) were estimated. Model inputs were derived from the published literature and government sources. Direct costs were estimated from the perspective of Chinese society. One-way and probabilistic sensitivity analyses were conducted. On baseline analysis, the addition of trastuzumab increased cost and QALY by $56,004.30 (year-2010 US $) and 0.18, respectively, relative to conventional chemotherapy, resulting in an ICER of $251,667.10/QALY gained. Probabilistic sensitivity analyses supported that the addition of trastuzumab was not cost-effective. Budgetary impact analysis estimated that the annual increase in fiscal expenditures would be ~$1 billion. On univariate sensitivity analysis, the median overall survival time for conventional chemotherapy was the most influential factor with respect to the robustness of the model. The findings from the present analysis suggest that the addition of trastuzumab to conventional chemotherapy might not be cost-effective in patients with HER2-positive advanced gastric or GEJ cancer. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

Feasibilities of a Coal-Biomass to Liquids Plant in Southern West Virginia

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

Bhattacharyya, Debangsu; DVallance, David; Henthorn, Greg

This project has generated comprehensive and realistic results of feasibilities for a coal-biomass to liquids (CBTL) plant in southern West Virginia; and evaluated the sensitivity of the analyses to various anticipated scenarios and parametric uncertainties. Specifically the project has addressed economic feasibility, technical feasibility, market feasibility, and financial feasibility. In the economic feasibility study, a multi-objective siting model was developed and was then used to identify and rank the suitable facility sites. Spatial models were also developed to assess the biomass and coal feedstock availabilities and economics. Environmental impact analysis was conducted mainly to assess life cycle analysis and greenhousemore » gas emission. Uncertainty and sensitivity analysis were also investigated in this study. Sensitivity analyses on required selling price (RSP) and greenhouse gas (GHG) emissions of CBTL fuels were conducted according to feedstock availability and price, biomass to coal mix ratio, conversion rate, internal rate of return (IRR), capital cost, operational and maintenance cost. The study of siting and capacity showed that feedstock mixed ratio limited the CBTL production. The price of coal had a more dominant effect on RSP than that of biomass. Different mix ratios in the feedstock and conversion rates led to RSP ranging from $104.3 - $157.9/bbl. LCA results indicated that GHG emissions ranged from 80.62 kg CO 2 eq to 101.46 kg CO2 eq/1,000 MJ of liquid fuel at various biomass to coal mix ratios and conversion rates if carbon capture and storage (CCS) was applied. Most of water and fossil energy were consumed in conversion process. Compared to petroleum-derived-liquid fuels, the reduction in GHG emissions could be between -2.7% and 16.2% with CBTL substitution. As for the technical study, three approaches of coal and biomass to liquids, direct, indirect and hybrid, were considered in the analysis. The process models including conceptual design, process modeling and process validation were developed and validated for different cases. Equipment design and capital costs were investigated on capital coast estimation and economical model validation. Material and energy balances and techno-economic analysis on base case were conducted for evaluation of projects. Also, sensitives studies of direct and indirect approaches were both used to evaluate the CBTL plant economic performance. In this study, techno-economic analysis were conducted in Aspen Process Economic Analyzer (APEA) environment for indirect, direct, and hybrid CBTL plants with CCS based on high fidelity process models developed in Aspen Plus and Excel. The process thermal efficiency ranges from 45% to 67%. The break-even oil price ranges from $86.1 to $100.6 per barrel for small scale (10000 bbl/day) CBTL plants and from $65.3 to $80.5 per barrel for large scale (50000 bbl/day) CBTL plants. Increasing biomass/coal ratio from 8/92 to 20/80 would increase the break-even oil price of indirect CBTL plant by $3/bbl and decrease the break-even oil price of direct CBTL plant by about $1/bbl. The order of carbon capture penalty is direct > indirect > hybrid. The order of capital investment is hybrid (with or without shale gas utilization) > direct (without shale gas utilization) > indirect > direct (with shale gas utilization). The order of thermal efficiency is direct > hybrid > indirect. The order of break-even oil price is hybrid (without shale gas utilization) > direct (without shale gas utilization) > hybrid (with shale gas utilization) > indirect > direct (with shale gas utilization).« less

Economic evaluation of home-based telebehavioural health care compared to in-person treatment delivery for depression.

PubMed

Bounthavong, Mark; Pruitt, Larry D; Smolenski, Derek J; Gahm, Gregory A; Bansal, Aasthaa; Hansen, Ryan N

2018-02-01

Introduction Home-based telebehavioural healthcare improves access to mental health care for patients restricted by travel burden. However, there is limited evidence assessing the economic value of home-based telebehavioural health care compared to in-person care. We sought to compare the economic impact of home-based telebehavioural health care and in-person care for depression among current and former US service members. Methods We performed trial-based cost-minimisation and cost-utility analyses to assess the economic impact of home-based telebehavioural health care versus in-person behavioural care for depression. Our analyses focused on the payer perspective (Department of Defense and Department of Veterans Affairs) at three months. We also performed a scenario analysis where all patients possessed video-conferencing technology that was approved by these agencies. The cost-utility analysis evaluated the impact of different depression categories on the incremental cost-effectiveness ratio. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model assumptions. Results In the base case analysis the total direct cost of home-based telebehavioural health care was higher than in-person care (US$71,974 versus US$20,322). Assuming that patients possessed government-approved video-conferencing technology, home-based telebehavioural health care was less costly compared to in-person care (US$19,177 versus US$20,322). In one-way sensitivity analyses, the proportion of patients possessing personal computers was a major driver of direct costs. In the cost-utility analysis, home-based telebehavioural health care was dominant when patients possessed video-conferencing technology. Results from probabilistic sensitivity analyses did not differ substantially from base case results. Discussion Home-based telebehavioural health care is dependent on the cost of supplying video-conferencing technology to patients but offers the opportunity to increase access to care. Health-care policies centred on implementation of home-based telebehavioural health care should ensure that these technologies are able to be successfully deployed on patients' existing technology.

Expansion of environmental impact assessment for eco-efficiency evaluation of China's economic sectors: An economic input-output based frontier approach.

PubMed

Xing, Zhencheng; Wang, Jigan; Zhang, Jie

2018-09-01

Due to the increasing environmental burdens caused by dramatic economic expansion, eco-efficiency indicating how efficient the economic activity is with respect to its environmental impacts has become a topic of considerable interest in China. In this context, Economic Input-output Life Cycle Assessment (EIO-LCA) and Data Envelopment Analysis (DEA) are combined to assess the environmental impacts and eco-efficiency of China's 26 economic sectors. The EIO-LCA results indicate that Electricity Production and Supply sector is the largest net exporter in energy usage, CO 2 emission and exhaust emission categories, while Construction sector is the largest net importer for five impact categories except for water withdrawal. Moreover, Construction sector is found to be the destination of the largest sector-to-sector environmental impact flows for the five impact categories and make the most contributions to the total environmental impacts. Another key finding is that Agriculture sector is both the largest net exporter and the greatest contributor for water withdrawal category. DEA results indicate that seven sectors are eco-efficient while over 70% of China's economic sectors are inefficient and require significant improvements. The average target improvements range between 23.30% and 35.06% depending on the impact category. Further sensitivity analysis reveals that the average sensitivity ratios vary from 7.7% to 15.7% among the six impact categories, which are found to be negatively correlated with their improvement potentials. Finally, several policy recommendations are made to mitigate environmental impacts of China's economic sectors and improve their eco-efficiency levels. Copyright © 2018 Elsevier B.V. All rights reserved.

Relevance of gender-sensitive policies and general health indicators to compare the status of South Asian women's health.

PubMed

Gill, Roopan; Stewart, Donna E

2011-01-01

despite goals for gender equity in South Asia, the relationship between gender-sensitive policies and the empowerment of women is complex and requires an analysis of how policies align with a broad set of social, cultural, political, and economic indicators that relate to women's health. through a review of four documents under the umbrella of the World Health Organization and the United Nations, a list of 17 gender-sensitive policy and 17 general health indicators was generated with a focus on health, education, economic, and political empowerment and violence against women. A series of policy documents and international and national databases that are accessible in the public domain were the major tools used to find supporting documentation to address women's health outcomes in Bangladesh, India, Nepal, Pakistan, and Sri Lanka. all five South Asian countries had several gender-sensitive policies that were measurable by indicators that contribute to health. Examination of political and economic status, birth sex ratios, human trafficking, illiteracy rates, maternal mortality rates, contraception prevalence, fertility rates, knowledge of HIV/AIDS prevention, access to skilled birth attendants, and microfinance show that large gender inequities still prevail despite the presence of gender-sensitive policies. in many cases, the presence of gender-sensitive policies did not reflect the realization of gender equity over a wide range of indicators. Although the economic, political, social, and cultural climates of the five countries may differ, the integration of women's needs into the formulation, implementation, and monitoring of policies is a universal necessity to achieve positive outcomes. 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc.

Study of effects of fuel properties in turbine-powered business aircraft

NASA Technical Reports Server (NTRS)

Powell, F. D.; Biegen, R. J.; Weitz, P. G., Jr.; Duke, A. M.

1984-01-01

Increased interest in research and technology concerning aviation turbine fuels and their properties was prompted by recent changes in the supply and demand situation of these fuels. The most obvious change is the rapid increase in fuel price. For commercial airplanes, fuel costs now approach 50 percent of the direct operating costs. In addition, there were occasional local supply disruptions and gradual shifts in delivered values of certain fuel properties. Dwindling petroleum reserves and the politically sensitive nature of the major world suppliers make the continuation of these trends likely. A summary of the principal findings, and conclusions are presented. Much of the material, especially the tables and graphs, is considered in greater detail later. The economic analysis and examination of operational considerations are described. Because some of the assumptions on which the economic analysis is founded are not easily verified, the sensitivity of the analysis to alternates for these assumptions is examined. The data base on which the analyses are founded is defined in a set of appendices.

Process simulation and techno economic analysis of renewable diesel production via catalytic decarboxylation of rubber seed oil - A case study in Malaysia.

PubMed

Cheah, Kin Wai; Yusup, Suzana; Gurdeep Singh, Haswin Kaur; Uemura, Yoshimitsu; Lam, Hon Loong

2017-12-01

This work describes the economic feasibility of hydroprocessed diesel fuel production via catalytic decarboxylation of rubber seed oil in Malaysia. A comprehensive techno-economic assessment is developed using Aspen HYSYS V8.0 software for process modelling and economic cost estimates. The profitability profile and minimum fuels selling price of this synthetic fuels production using rubber seed oil as biomass feedstock are assessed under a set of assumptions for what can be plausibly be achieved in 10-years framework. In this study, renewable diesel processing facility is modelled to be capable of processing 65,000 L of inedible oil per day and producing a total of 20 million litre of renewable diesel product per annual with assumed annual operational days of 347. With the forecasted renewable diesel retail price of 3.64 RM per kg, the pioneering renewable diesel project investment offers an assuring return of investment of 12.1% and net return as high as 1.35 million RM. Sensitivity analysis conducted showed that renewable diesel production cost is most sensitive to rubber seed oil price and hydrogen gas price, reflecting on the relative importance of feedstock prices in the overall profitability profile. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parametric sensitivity analysis of an agro-economic model of management of irrigation water

NASA Astrophysics Data System (ADS)

El Ouadi, Ihssan; Ouazar, Driss; El Menyari, Younesse

2015-04-01

The current work aims to build an analysis and decision support tool for policy options concerning the optimal allocation of water resources, while allowing a better reflection on the issue of valuation of water by the agricultural sector in particular. Thus, a model disaggregated by farm type was developed for the rural town of Ait Ben Yacoub located in the east Morocco. This model integrates economic, agronomic and hydraulic data and simulates agricultural gross margin across in this area taking into consideration changes in public policy and climatic conditions, taking into account the competition for collective resources. To identify the model input parameters that influence over the results of the model, a parametric sensitivity analysis is performed by the "One-Factor-At-A-Time" approach within the "Screening Designs" method. Preliminary results of this analysis show that among the 10 parameters analyzed, 6 parameters affect significantly the objective function of the model, it is in order of influence: i) Coefficient of crop yield response to water, ii) Average daily gain in weight of livestock, iii) Exchange of livestock reproduction, iv) maximum yield of crops, v) Supply of irrigation water and vi) precipitation. These 6 parameters register sensitivity indexes ranging between 0.22 and 1.28. Those results show high uncertainties on these parameters that can dramatically skew the results of the model or the need to pay particular attention to their estimates. Keywords: water, agriculture, modeling, optimal allocation, parametric sensitivity analysis, Screening Designs, One-Factor-At-A-Time, agricultural policy, climate change.

Economic Value of Narrowing the Uncertainty in Climate Sensitivity: Decadal Change in Shortwave Cloud Radiative Forcing and Low Cloud Feedback

NASA Astrophysics Data System (ADS)

Wielicki, B. A.; Cooke, R. M.; Golub, A. A.; Mlynczak, M. G.; Young, D. F.; Baize, R. R.

2016-12-01

Several previous studies have been published on the economic value of narrowing the uncertainty in climate sensitivity (Cooke et al. 2015, Cooke et al. 2016, Hope, 2015). All three of these studies estimated roughly 10 Trillion U.S. dollars for the Net Present Value and Real Option Value at a discount rate of 3%. This discount rate is the nominal discount rate used in the U.S. Social Cost of Carbon Memo (2010). The Cooke et al studies approached this problem by examining advances in accuracy of global temperature measurements, while the Hope 2015 study did not address the type of observations required. While temperature change is related to climate sensitivity, large uncertainties of a factor of 3 in current anthropogenic radiative forcing (IPCC, 2013) would need to be solved for advanced decadal temperature change observations to assist the challenge of narrowing climate sensitivity. The present study takes a new approach by extending the Cooke et al. 2015,2016 papers to replace observations of temperature change to observations of decadal change in the effects of changing clouds on the Earths radiative energy balance, a measurement known as Cloud Radiative Forcing, or Cloud Radiative Effect. Decadal change in this observation is direclty related to the largest uncertainty in climate sensitivity which is cloud feedback from changing amount of low clouds, primarily low clouds over the world's oceans. As a result, decadal changes in shortwave cloud radiative forcing are more directly related to cloud feedback uncertainty which is the dominant uncertainty in climate sensitivity. This paper will show results for the new approach, and allow an examination of the sensitivity of economic value results to different observations used as a constraint on uncertainty in climate sensitivity. The analysis suggests roughly a doubling of economic value to 20 Trillion Net Present Value or Real Option Value at 3% discount rate. The higher economic value results from two changes: a larger increase in accuracy for SW cloud radiative forcing vs temperature, and from a lower confounding noise from natural variability in the cloud radiative forcing variable compared to temperature. In particular, global average temperature is much more sensitive to the climate noise of ENSO cycles.

Guide to analyzing investment options using TWIGS.

Treesearch

Charles R Blinn; Dietmar W. Rose; Monique L. Belli

1988-01-01

Describes methods for analyzing economic return of simulated stand management alternatives in TWIGS. Defines and discusses net present value, equivalent annual income, soil expectation value, and real vs. nominal analyses. Discusses risk and sensitivity analysis when comparing alternatives.

A practical model for economic evaluation of tissue-engineered therapies.

PubMed

Tan, Tien-En; Peh, Gary S L; Finkelstein, Eric A; Mehta, Jodhbir S

2015-01-01

Tissue-engineered therapies are being developed across virtually all fields of medicine. Some of these therapies are already in clinical use, while others are still in clinical trials or the experimental phase. Most initial studies in the evaluation of new therapies focus on demonstration of clinical efficacy. However, cost considerations or economic viability are just as important. Many tissue-engineered therapies have failed to be impactful because of shortcomings in economic competitiveness, rather than clinical efficacy. Furthermore, such economic viability studies should be performed early in the process of development, before significant investment has been made. Cost-minimization analysis combined with sensitivity analysis is a useful model for the economic evaluation of new tissue-engineered therapies. The analysis can be performed early in the development process, and can provide valuable information to guide further investment and research. The utility of the model is illustrated with the practical real-world example of tissue-engineered constructs for corneal endothelial transplantation. The authors have declared no conflicts of interest for this article. © 2015 Wiley Periodicals, Inc.

Assessing the Impact of Operational Constraints on the Near-Term Unmanned Aircraft System Traffic Management Supported Market

NASA Technical Reports Server (NTRS)

Vascik, Parker D.; Jung, Jaewoo

2016-01-01

An economic impact market analysis was conducted for 16 leading sectors of commercial Unmanned Aerial System (UAS) applications predicted to be enabled by 2020 through the NASA UAS Traffic Management (UTM) program. Subject matter experts from seven industries were interviewed to validate concept of operations (ConOps) and market adoption assumptions for each sector. The market analysis was used to estimate direct economic impacts for each sector including serviceable addressable market, capital investment, revenue recovery potential, and operations cost savings. The resultant economic picture distinguishes the agricultural, pipeline and railroad inspection, construction, and maritime sectors of the nascent commercial UAS industry as providing the highest potential economic value in the United States. Sensitivity studies characterized the variability of select UAS sectors economic value to key regulatory or UTM ConOps requirements such as weight, altitude, and flight over populated area constraints. Takeaways from the analysis inform the validation of UTM requirements, technologies and timetables from a commercial market need and value viewpoint. This work concluded in August 2015 and reflects the state of the UAS industry and market projections at that time.

Thermodynamic and economic analysis of a gas turbine combined cycle plant with oxy-combustion

NASA Astrophysics Data System (ADS)

Kotowicz, Janusz; Job, Marcin

2013-12-01

This paper presents a gas turbine combined cycle plant with oxy-combustion and carbon dioxide capture. A gas turbine part of the unit with the operating parameters is presented. The methodology and results of optimization by the means of a genetic algorithm for the steam parts in three variants of the plant are shown. The variants of the plant differ by the heat recovery steam generator (HRSG) construction: the singlepressure HRSG (1P), the double-pressure HRSG with reheating (2PR), and the triple-pressure HRSG with reheating (3PR). For obtained results in all variants an economic evaluation was performed. The break-even prices of electricity were determined and the sensitivity analysis to the most significant economic factors were performed.

Cost-effectiveness of a quality improvement programme to reduce central line-associated bloodstream infections in intensive care units in the USA

PubMed Central

Herzer, Kurt R; Niessen, Louis; Constenla, Dagna O; Ward, William J; Pronovost, Peter J

2014-01-01

Objective To assess the cost-effectiveness of a multifaceted quality improvement programme focused on reducing central line-associated bloodstream infections in intensive care units. Design Cost-effectiveness analysis using a decision tree model to compare programme to non-programme intensive care units. Setting USA. Population Adult patients in the intensive care unit. Costs Economic costs of the programme and of central line-associated bloodstream infections were estimated from the perspective of the hospital and presented in 2013 US dollars. Main outcome measures Central line-associated bloodstream infections prevented, deaths averted due to central line-associated bloodstream infections prevented, and incremental cost-effectiveness ratios. Probabilistic sensitivity analysis was performed. Results Compared with current practice, the programme is strongly dominant and reduces bloodstream infections and deaths at no additional cost. The probabilistic sensitivity analysis showed that there was an almost 80% probability that the programme reduces bloodstream infections and the infections’ economic costs to hospitals. The opportunity cost of a bloodstream infection to a hospital was the most important model parameter in these analyses. Conclusions This multifaceted quality improvement programme, as it is currently implemented by hospitals on an increasingly large scale in the USA, likely reduces the economic costs of central line-associated bloodstream infections for US hospitals. Awareness among hospitals about the programme's benefits should enhance implementation. The programme's implementation has the potential to substantially reduce morbidity, mortality and economic costs associated with central line-associated bloodstream infections. PMID:25256190

Economic analysis of biomass power generation schemes under renewable energy initiative with Renewable Portfolio Standards (RPS) in Korea.

PubMed

Moon, Ji-Hong; Lee, Jeung-Woo; Lee, Uen-Do

2011-10-01

An economic analysis of biomass power generation was conducted. Two key technologies--direct combustion with a steam turbine and gasification with a syngas engine--were mainly examined. In view of the present domestic biomass infrastructure of Korea, a small and distributed power generation system ranging from 0.5 to 5 MW(e) was considered. It was found that gasification with a syngas engine becomes more economically feasible as the plant size decreases. Changes in the economic feasibilities with and without RPS or heat sales were also investigated. A sensitivity analysis of each system was conducted for representative parameters. Regarding the cost of electricity generation, electrical efficiency and fuel cost significantly affect both direct combustion and gasification systems. Regarding the internal rate of return (IRR), the heat sales price becomes important for obtaining a higher IRR, followed by power generation capacity and electrical efficiency. Copyright © 2011 Elsevier Ltd. All rights reserved.

Modeling imbalanced economic recovery following a natural disaster using input-output analysis.

PubMed

Li, Jun; Crawford-Brown, Douglas; Syddall, Mark; Guan, Dabo

2013-10-01

Input-output analysis is frequently used in studies of large-scale weather-related (e.g., Hurricanes and flooding) disruption of a regional economy. The economy after a sudden catastrophe shows a multitude of imbalances with respect to demand and production and may take months or years to recover. However, there is no consensus about how the economy recovers. This article presents a theoretical route map for imbalanced economic recovery called dynamic inequalities. Subsequently, it is applied to a hypothetical postdisaster economic scenario of flooding in London around the year 2020 to assess the influence of future shocks to a regional economy and suggest adaptation measures. Economic projections are produced by a macro econometric model and used as baseline conditions. The results suggest that London's economy would recover over approximately 70 months by applying a proportional rationing scheme under the assumption of initial 50% labor loss (with full recovery in six months), 40% initial loss to service sectors, and 10-30% initial loss to other sectors. The results also suggest that imbalance will be the norm during the postdisaster period of economic recovery even though balance may occur temporarily. Model sensitivity analysis suggests that a proportional rationing scheme may be an effective strategy to apply during postdisaster economic reconstruction, and that policies in transportation recovery and in health care are essential for effective postdisaster economic recovery. © 2013 Society for Risk Analysis.

Economic and life cycle assessments of biomass utilization for bioenergy products

DOE PAGES

Liu, Weiguo; Wang, Jingxin; Richard, Tom L.; ...

2017-05-04

A modeling process was developed to examine the economic and environmental benefits of utilizing energy crops for biofuels and bioproducts. Three energy crops (hybrid willow, switchgrass and miscanthus) that can potentially grow on marginal agricultural land or abandoned mine land in the northeastern United States were considered in the analytical process for the production of biofuels, biopower and pellet fuel. The supply chain components for both the economic analysis and life cycle modeling processes included feedstock establishment, harvest, transportation, storage, preprocessing, conversion, distribution and final usage. Sensitivity analysis was also conducted to assess the effects of energy crop yield, transportationmore » distance, conversion rate, facility capacity and internal rate of return (IRR) on the production of bioenergy products. The required selling price (RSP) ranged from $ 7.7/GJ to $ 47.9/GJ for different bioproducts. The production of biopower had the highest RSP and pellet fuel had the lowest. The results also indicated that bioenergy production using hybrid willow demonstrated lower RSP than the two perennial grass feedstocks. Pellet production presented the lowest greenhouse gas (GHG) emissions (less than 10 kg CO 2 eq per 1,000 MJ) and fossil energy consumption (less than 150 MJ per 1,000 MJ). The production of biofuel resulted in the highest GHG emissions. Sensitivity analysis indicated that IRR was the most sensitive factor to RSP and followed by conversion rate for biofuel and biopower production. As a result, conversion rate and transportation distance of feedstock presented a significant effect on environmental impacts during the production of the bioproducts.« less

Economic and life cycle assessments of biomass utilization for bioenergy products

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

Liu, Weiguo; Wang, Jingxin; Richard, Tom L.

A modeling process was developed to examine the economic and environmental benefits of utilizing energy crops for biofuels and bioproducts. Three energy crops (hybrid willow, switchgrass and miscanthus) that can potentially grow on marginal agricultural land or abandoned mine land in the northeastern United States were considered in the analytical process for the production of biofuels, biopower and pellet fuel. The supply chain components for both the economic analysis and life cycle modeling processes included feedstock establishment, harvest, transportation, storage, preprocessing, conversion, distribution and final usage. Sensitivity analysis was also conducted to assess the effects of energy crop yield, transportationmore » distance, conversion rate, facility capacity and internal rate of return (IRR) on the production of bioenergy products. The required selling price (RSP) ranged from $ 7.7/GJ to $ 47.9/GJ for different bioproducts. The production of biopower had the highest RSP and pellet fuel had the lowest. The results also indicated that bioenergy production using hybrid willow demonstrated lower RSP than the two perennial grass feedstocks. Pellet production presented the lowest greenhouse gas (GHG) emissions (less than 10 kg CO 2 eq per 1,000 MJ) and fossil energy consumption (less than 150 MJ per 1,000 MJ). The production of biofuel resulted in the highest GHG emissions. Sensitivity analysis indicated that IRR was the most sensitive factor to RSP and followed by conversion rate for biofuel and biopower production. As a result, conversion rate and transportation distance of feedstock presented a significant effect on environmental impacts during the production of the bioproducts.« less

Behavioral economic analysis of withdrawal- and cue-elicited craving for tobacco: an initial investigation.

PubMed

MacKillop, James; Brown, Courtney L; Stojek, Monika K; Murphy, Cara M; Sweet, Lawrence; Niaura, Ray S

2012-12-01

The role of craving in nicotine dependence remains controversial and may be a function of measurement challenges. The current study used behavioral economic approach to test the hypotheses that subjective craving from acute withdrawal and exposure to tobacco cues dynamically increases the relative value of cigarettes. Using a 2 (1-hr/12-hr deprivation) × 2 (neutral/tobacco cues) within-subjects design, 33 nicotine dependent adults completed 2 laboratory sessions. Assessment included subjective craving and behavioral economic indices of cigarette demand, namely Intensity (i.e., cigarette consumption at zero cost), O(max) (i.e., maximum total expenditure), Breakpoint (i.e., highest acceptable price for cigarettes), P(max) (i.e., price at which consumption becomes sensitive to price), and elasticity (i.e., price sensitivity). Behavioral economic indices were generated using a Cigarette Purchase Task in which participants selected between cigarettes for a subsequent 2-hr self-administration period and money. Main effects of deprivation and tobacco cues were present for subjective craving and multiple behavioral economic indices of cigarette demand. Interestingly, deprivation significantly increased Breakpoint (p ≤ .01) and P(max) (p ≤ .05) and had trend-level effects on Intensity and O(max) (p ≤ .10); whereas cues significantly reduced elasticity (p ≤ .01), reflecting lower sensitivity to increasing prices. Heterogeneous associations were evident among the motivational variables but with aggregations suggesting variably overlapping motivational channels. These findings further support a behavioral economic approach to craving and a multidimensional conception of acute motivation for addictive drugs. Methodological considerations, including potential order effects, and the need for further refinement of these findings are discussed.

Energy and economic analysis of the carbon dioxide capture installation with the use of monoethanolamine and ammonia

NASA Astrophysics Data System (ADS)

Bochon, Krzysztof; Chmielniak, Tadeusz

2015-03-01

In the study an accurate energy and economic analysis of the carbon capture installation was carried out. Chemical absorption with the use of monoethanolamine (MEA) and ammonia was adopted as the technology of carbon dioxide (CO2) capture from flue gases. The energy analysis was performed using a commercial software package to analyze the chemical processes. In the case of MEA, the demand for regeneration heat was about 3.5 MJ/kg of CO2, whereas for ammonia it totalled 2 MJ/kg CO2. The economic analysis was based on the net present value (NPV) method. The limit price for CO2 emissions allowances at which the investment project becomes profitable (NPV = 0) was more than 160 PLN/Mg for MEA and less than 150 PLN/Mg for ammonia. A sensitivity analysis was also carried out to determine the limit price of CO2 emissions allowances depending on electricity generation costs at different values of investment expenditures.

Estimating costs in the economic evaluation of medical technologies.

PubMed

Luce, B R; Elixhauser, A

1990-01-01

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

[Screening for cancer - economic consideration and cost-effectiveness].

PubMed

Kjellberg, Jakob

2014-06-09

Cost-effectiveness analysis has become an accepted method to evaluate medical technology and allocate scarce health-care resources. Published decision analyses show that screening for cancer in general is cost-effective. However, cost-effectiveness analyses are only as good as the clinical data and the results are sensitive to the chosen methods and perspective of the analysis.

Accounting for parameter uncertainty in the definition of parametric distributions used to describe individual patient variation in health economic models.

PubMed

Degeling, Koen; IJzerman, Maarten J; Koopman, Miriam; Koffijberg, Hendrik

2017-12-15

Parametric distributions based on individual patient data can be used to represent both stochastic and parameter uncertainty. Although general guidance is available on how parameter uncertainty should be accounted for in probabilistic sensitivity analysis, there is no comprehensive guidance on reflecting parameter uncertainty in the (correlated) parameters of distributions used to represent stochastic uncertainty in patient-level models. This study aims to provide this guidance by proposing appropriate methods and illustrating the impact of this uncertainty on modeling outcomes. Two approaches, 1) using non-parametric bootstrapping and 2) using multivariate Normal distributions, were applied in a simulation and case study. The approaches were compared based on point-estimates and distributions of time-to-event and health economic outcomes. To assess sample size impact on the uncertainty in these outcomes, sample size was varied in the simulation study and subgroup analyses were performed for the case-study. Accounting for parameter uncertainty in distributions that reflect stochastic uncertainty substantially increased the uncertainty surrounding health economic outcomes, illustrated by larger confidence ellipses surrounding the cost-effectiveness point-estimates and different cost-effectiveness acceptability curves. Although both approaches performed similar for larger sample sizes (i.e. n = 500), the second approach was more sensitive to extreme values for small sample sizes (i.e. n = 25), yielding infeasible modeling outcomes. Modelers should be aware that parameter uncertainty in distributions used to describe stochastic uncertainty needs to be reflected in probabilistic sensitivity analysis, as it could substantially impact the total amount of uncertainty surrounding health economic outcomes. If feasible, the bootstrap approach is recommended to account for this uncertainty.

Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?

PubMed

Oliveira, Maria Regina Fernandes; Leandro, Roseli; Decimoni, Tassia Cristina; Rozman, Luciana Martins; Novaes, Hillegonda Maria Dutilh; De Soárez, Patrícia Coelho

2017-08-01

The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.

Techno-economic evaluation of simultaneous production of extra-cellular polymeric substance (EPS) and lipids by Cloacibacterium normanense NK6 using crude glycerol and sludge as substrate.

PubMed

Ram, S K; Kumar, L R; Tyagi, R D; Drogui, P

2018-05-01

This study used the technical, economic analysis tool, SuperPro designer in evaluating a novel technology for simultaneous production of extracellular polymeric substance (EPS) and biodiesel using crude glycerol and secondary sludge. As renewable energy sources are depleting, the process utilizes municipal sewage sludge for production of EPS and biodiesel along with crude glycerol, which is a waste byproduct of biodiesel industry providing an alternate way for disposal of municipal sludge and crude glycerol. Newly isolated Cloacibacterium normanense NK6 is used as micro-organism in the study as it is capable of producing high EPS concentration, using activated sludge and crude glycerol as the sole carbon source. The technology has many environmental and economic advantages like the simultaneous production of two major products: EPS and lipids. Sensitivity analysis of the process revealed that biomass lipid content is a most significant factor where unit cost production of biodiesel was highly sensitive to lipid content during bioreaction. B7 biodiesel unit production cost can be lowered from $1 to $0.6 if the lipid content of the biomass is improved by various process parameter modifications.

THE ECONOMICS OF REPROCESSING vs DIRECT DISPOSAL OF SPENT NUCLEAR FUEL

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

Matthew Bunn; Steve Fetter; John P. Holdren

This report assesses the economics of reprocessing versus direct disposal of spent nuclear fuel. The breakeven uranium price at which reprocessing spent nuclear fuel from existing light-water reactors (LWRs) and recycling the resulting plutonium and uranium in LWRs would become economic is assessed, using central estimates of the costs of different elements of the nuclear fuel cycle (and other fuel cycle input parameters), for a wide range of range of potential reprocessing prices. Sensitivity analysis is performed, showing that the conclusions reached are robust across a wide range of input parameters. The contribution of direct disposal or reprocessing and recyclingmore » to electricity cost is also assessed. The choice of particular central estimates and ranges for the input parameters of the fuel cycle model is justified through a review of the relevant literature. The impact of different fuel cycle approaches on the volume needed for geologic repositories is briefly discussed, as are the issues surrounding the possibility of performing separations and transmutation on spent nuclear fuel to reduce the need for additional repositories. A similar analysis is then performed of the breakeven uranium price at which deploying fast neutron breeder reactors would become competitive compared with a once-through fuel cycle in LWRs, for a range of possible differences in capital cost between LWRs and fast neutron reactors. Sensitivity analysis is again provided, as are an analysis of the contribution to electricity cost, and a justification of the choices of central estimates and ranges for the input parameters. The equations used in the economic model are derived and explained in an appendix. Another appendix assesses the quantities of uranium likely to be recoverable worldwide in the future at a range of different possible future prices.« less

Health economics analysis of insulin aspart vs. regular human insulin in type 2 diabetes patients, based on observational real life evidence from general practices in Germany.

PubMed

Liebl, A; Seitz, L; Palmer, A J

2014-10-01

A retrospective analysis of German general practice data demonstrated that insulin aspart (IA) was associated with a significantly reduced incidence of macrovascular events (MVE: stroke, myocardial infarction, peripheral vascular disease or coronary heart disease) vs. regular human insulin (RHI) in type 2 diabetes patients. Economic implications, balanced against potential improvements in quality-adjusted life years (QALYs) resulting from lower risks of complications with IA in this setting have not yet been explored. A decision analysis model was developed utilizing 3-year initial MVE rates for each comparator, combined with published German-specific insulin and MVE costs and health utilities to calculate number needed to treat (NNT) to avoid any MVE, incremental costs and QALYs gained/ person for IA vs. RHI. A 3-year time horizon and German 3(rd)-party payer perspective were used. Probabilistic sensitivity analysis was performed, sampling from distributions of key parameters. Additional sensitivity analyses were performed. NNT over a 3 year period to avoid any MVE was 8 patients for IA vs. RHI. Due to lower MVE rates, IA dominated RHI with 0.020 QALYs gained (95% confidence interval: 0.014-0.025) and cost savings of EUR 1 556 (1 062-2 076)/person for IA vs. RHI over the 3-year time horizon. Sensitivity analysis revealed that IA would still be overall cost saving even if the cost of IA was double the cost/unit of RHI. From a health economics perspective, IA was the superior alternative for the insulin treatment of type 2 diabetes, with lower incidence of MVE events translating to improved QALYs and lower costs vs. RHI within a 3-year time horizon. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

Process modeling and supply chain design for advanced biofuel production based on bio-oil gasification

NASA Astrophysics Data System (ADS)

Li, Qi

As a potential substitute for petroleum-based fuel, second generation biofuels are playing an increasingly important role due to their economic, environmental, and social benefits. With the rapid development of biofuel industry, there has been an increasing literature on the techno-economic analysis and supply chain design for biofuel production based on a variety of production pathways. A recently proposed production pathway of advanced biofuel is to convert biomass to bio-oil at widely distributed small-scale fast pyrolysis plants, then gasify the bio-oil to syngas and upgrade the syngas to transportation fuels in centralized biorefinery. This thesis aims to investigate two types of assessments on this bio-oil gasification pathway: techno-economic analysis based on process modeling and literature data; supply chain design with a focus on optimal decisions for number of facilities to build, facility capacities and logistic decisions considering uncertainties. A detailed process modeling with corn stover as feedstock and liquid fuels as the final products is presented. Techno-economic analysis of the bio-oil gasification pathway is also discussed to assess the economic feasibility. Some preliminary results show a capital investment of 438 million dollar and minimum fuel selling price (MSP) of $5.6 per gallon of gasoline equivalent. The sensitivity analysis finds that MSP is most sensitive to internal rate of return (IRR), biomass feedstock cost, and fixed capital cost. A two-stage stochastic programming is formulated to solve the supply chain design problem considering uncertainties in biomass availability, technology advancement, and biofuel price. The first-stage makes the capital investment decisions including the locations and capacities of the decentralized fast pyrolysis plants and the centralized biorefinery while the second-stage determines the biomass and biofuel flows. The numerical results and case study illustrate that considering uncertainties can be pivotal in this supply chain design and optimization problem. Also, farmers' participation has a significant effect on the decision making process.

Integrated economic and environmental analysis of agricultural straw reuse in edible fungi industry

PubMed Central

Lu, Wencong; Yu, Shuao; Huang, Hairong

2018-01-01

Background China currently faces severe environmental pollution caused by burning agricultural straw; thus, resource utilization of these straws has become an urgent policy and practical objective for the Chinese government. Methods This study develops a bio-economic model, namely, “straw resource utilization for fungi in China (SRUFIC),” on the basis of a field survey of an edible fungi plant in Zhejiang, China, to investigate an integrated economic and environmental performance of straw reuse in fungi production. Five scenarios, which cover changes in the production scale, wage level, and price fluctuations of the main product and inputs, are simulated. Results Results reveal that (1) the pilot plant potentially provides enhanced economic benefits and disposes added agricultural residues by adjusting its production strategy; (2) the economic performance is most sensitive to fungi price fluctuations, whereas the environmental performance is more sensitive to production scale and price of fungi than other factors; (3) expanding the production scale can be the most efficient means of improving the performance of a plant economically and environmentally. Discussion Overall, agricultural straw reuse in the edible fungi industry can not only reduce the environmental risk derived from burning abandoned straws but also introduce economic benefits. Thus, the straw reuse in the fungi industry should be practiced in China, and specific economic incentive policies, such as price support or subsidies, must be implemented to promote the utilization of agricultural straws in the fungi industry. PMID:29682417

Sensitivity analysis of key components in large-scale hydroeconomic models

NASA Astrophysics Data System (ADS)

Medellin-Azuara, J.; Connell, C. R.; Lund, J. R.; Howitt, R. E.

2008-12-01

This paper explores the likely impact of different estimation methods in key components of hydro-economic models such as hydrology and economic costs or benefits, using the CALVIN hydro-economic optimization for water supply in California. In perform our analysis using two climate scenarios: historical and warm-dry. The components compared were perturbed hydrology using six versus eighteen basins, highly-elastic urban water demands, and different valuation of agricultural water scarcity. Results indicate that large scale hydroeconomic hydro-economic models are often rather robust to a variety of estimation methods of ancillary models and components. Increasing the level of detail in the hydrologic representation of this system might not greatly affect overall estimates of climate and its effects and adaptations for California's water supply. More price responsive urban water demands will have a limited role in allocating water optimally among competing uses. Different estimation methods for the economic value of water and scarcity in agriculture may influence economically optimal water allocation; however land conversion patterns may have a stronger influence in this allocation. Overall optimization results of large-scale hydro-economic models remain useful for a wide range of assumptions in eliciting promising water management alternatives.

High-resolution Behavioral Economic Analysis of Cigarette Demand to Inform Tax Policy

PubMed Central

MacKillop, James; Few, Lauren R.; Murphy, James G.; Wier, Lauren M.; Acker, John; Murphy, Cara; Stojek, Monika; Carrigan, Maureen; Chaloupka, Frank

2012-01-01

Aims Novel methods in behavioral economics permit the systematic assessment of the relationship between cigarette consumption and price. Toward informing tax policy, the goals of this study were to conduct a high-resolution analysis of cigarette demand in a large sample of adult smokers and to use the data to estimate the effects of tax increases in ten U.S. States. Design In-person descriptive survey assessment. Setting Academic departments at three universities. Participants Adult daily smokers (i.e., 5+ cigarettes/day; 18+ years old; ≥8th grade education); N = 1056. Measurements Estimated cigarette demand, demographics, expired carbon monoxide. Findings The cigarette demand curve exhibited highly variable levels of price sensitivity, especially in the form of ‘left-digit effects’ (i.e., very high price sensitivity as pack prices transitioned from one whole number to the next; e.g., $5.80-$6/pack). A $1 tax increase in the ten states was projected to reduce the economic burden of smoking by an average of $531M (range: $93.6M-$976.5M) and increase gross tax revenue by an average of 162% (range: 114%- 247%). Conclusions Tobacco price sensitivity is nonlinear across the demand curve and in particular for pack-level left-digit price transitions. Tax increases in U.S. states with similar price and tax rates to the sample are projected to result in substantial decreases in smoking-related costs and substantial increases in tax revenues. PMID:22845784

High-resolution behavioral economic analysis of cigarette demand to inform tax policy.

PubMed

MacKillop, James; Few, Lauren R; Murphy, James G; Wier, Lauren M; Acker, John; Murphy, Cara; Stojek, Monika; Carrigan, Maureen; Chaloupka, Frank

2012-12-01

Novel methods in behavioral economics permit the systematic assessment of the relationship between cigarette consumption and price. Towards informing tax policy, the goals of this study were to conduct a high-resolution analysis of cigarette demand in a large sample of adult smokers and to use the data to estimate the effects of tax increases in 10 US States. In-person descriptive survey assessment. Academic departments at three universities. Adult daily smokers (i.e. more than five cigarettes/day; 18+ years old; ≥8th grade education); n = 1056. Estimated cigarette demand, demographics, expired carbon monoxide. The cigarette demand curve exhibited highly variable levels of price sensitivity, especially in the form of 'left-digit effects' (i.e. very high price sensitivity as pack prices transitioned from one whole number to the next; e.g. $5.80-6/pack). A $1 tax increase in the 10 states was projected to reduce the economic burden of smoking by an average of $530.6 million (range: $93.6-976.5 million) and increase gross tax revenue by an average of 162% (range: 114-247%). Tobacco price sensitivity is non-linear across the demand curve and in particular for pack-level left-digit price transitions. Tax increases in US states with similar price and tax rates to the sample are projected to result in substantial decreases in smoking-related costs and substantial increases in tax revenues. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Cost-effectiveness of a quality improvement programme to reduce central line-associated bloodstream infections in intensive care units in the USA.

PubMed

Herzer, Kurt R; Niessen, Louis; Constenla, Dagna O; Ward, William J; Pronovost, Peter J

2014-09-25

To assess the cost-effectiveness of a multifaceted quality improvement programme focused on reducing central line-associated bloodstream infections in intensive care units. Cost-effectiveness analysis using a decision tree model to compare programme to non-programme intensive care units. USA. Adult patients in the intensive care unit. Economic costs of the programme and of central line-associated bloodstream infections were estimated from the perspective of the hospital and presented in 2013 US dollars. Central line-associated bloodstream infections prevented, deaths averted due to central line-associated bloodstream infections prevented, and incremental cost-effectiveness ratios. Probabilistic sensitivity analysis was performed. Compared with current practice, the programme is strongly dominant and reduces bloodstream infections and deaths at no additional cost. The probabilistic sensitivity analysis showed that there was an almost 80% probability that the programme reduces bloodstream infections and the infections' economic costs to hospitals. The opportunity cost of a bloodstream infection to a hospital was the most important model parameter in these analyses. This multifaceted quality improvement programme, as it is currently implemented by hospitals on an increasingly large scale in the USA, likely reduces the economic costs of central line-associated bloodstream infections for US hospitals. Awareness among hospitals about the programme's benefits should enhance implementation. The programme's implementation has the potential to substantially reduce morbidity, mortality and economic costs associated with central line-associated bloodstream infections. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Estimating the Economic Potential of Offshore Wind in the United States

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

Beiter, P.; Musial, W.; Smith, A.

The potential for cost reduction and market deployment for offshore wind varies considerably within the United States. This analysis estimates the future economic viability of offshore wind at more than 7,000 sites under a variety of electric sector and cost reduction scenarios. Identifying the economic potential of offshore wind at a high geospatial resolution can capture the significant variation in local offshore resource quality, costs, and revenue potential. In estimating economic potential, this article applies a method initially developed in Brown et al. (2015) to offshore wind and estimates the sensitivity of results under a variety of most likely electricmore » sector scenarios. For the purposes of this analysis, a theoretical framework is developed introducing a novel offshore resource classification system that is analogous to established resource classifications from the oil and gas sector. Analyzing economic potential within this framework can help establish a refined understanding across industries of the technology and site-specific risks and opportunities associated with future offshore wind development. The results of this analysis are intended to inform the development of the U.S. Department of Energy's offshore wind strategy.« less

Analysis of the economic impact of the national unified carbon trading market mechanism Hebei province, for example

NASA Astrophysics Data System (ADS)

Sun, Yuxing

2018-05-01

In this paper, a grey prediction model is used to predict the carbon emission in Hebei province, and the impact analysis model based on TermCo2 is established. At the same time, we read a lot about CGE and study on how to build the scene, the selection of key parameters, and sensitivity analysis of application scenarios do industry for reference.

Costs and cost-effectiveness of training traditional birth attendants to reduce neonatal mortality in the Lufwanyama Neonatal Survival study (LUNESP).

PubMed

Sabin, Lora L; Knapp, Anna B; MacLeod, William B; Phiri-Mazala, Grace; Kasimba, Joshua; Hamer, Davidson H; Gill, Christopher J

2012-01-01

The Lufwanyama Neonatal Survival Project ("LUNESP") was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness. We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011-2020). In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs) averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as 'conservative' and 'optimistic' scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation. Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was 'highly cost effective'. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care.

Costs and Cost-Effectiveness of Training Traditional Birth Attendants to Reduce Neonatal Mortality in the Lufwanyama Neonatal Survival Study (LUNESP)

PubMed Central

Sabin, Lora L.; Knapp, Anna B.; MacLeod, William B.; Phiri-Mazala, Grace; Kasimba, Joshua; Hamer, Davidson H.; Gill, Christopher J.

2012-01-01

Background The Lufwanyama Neonatal Survival Project (“LUNESP”) was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness. Methods and Findings We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011–2020). In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs) averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as ‘conservative’ and ‘optimistic’ scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation. Conclusions Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was ‘highly cost effective’. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care. PMID:22545117

A Cost-Effectiveness Analysis of Reverse Total Shoulder Arthroplasty versus Hemiarthroplasty for the Management of Complex Proximal Humeral Fractures in the Elderly.

PubMed

Osterhoff, Georg; O'Hara, Nathan N; D'Cruz, Jennifer; Sprague, Sheila A; Bansback, Nick; Evaniew, Nathan; Slobogean, Gerard P

2017-03-01

There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling. A single-payer perspective, with a willingness-to-pay (WTP) threshold of Can$50,000 (Canadian dollars), and a lifetime time horizon were used. The incremental cost-effectiveness ratio (ICER) was used as the study's primary outcome measure. In comparison with HA, the incremental cost per quality-adjusted life-year gained for RTSA was Can$13,679. One-way sensitivity analysis revealed the model to be sensitive to the RTSA implant cost and the RTSA procedural cost. The ICER of Can$13,679 is well below the WTP threshold of Can$50,000, and probabilistic sensitivity analysis demonstrated that 92.6% of model simulations favored RTSA. Our economic analysis found that RTSA for the treatment of complex proximal humeral fractures in the elderly is the preferred economic strategy when compared with HA. The ICER of RTSA is well below standard WTP thresholds, and its estimate of cost-effectiveness is similar to other highly successful orthopedic strategies such as total hip arthroplasty for the treatment of hip arthritis. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Surgical management of bilateral vocal fold paralysis: A cost-effectiveness comparison of two treatments.

PubMed

Naunheim, Matthew R; Song, Phillip C; Franco, Ramon A; Alkire, Blake C; Shrime, Mark G

2017-03-01

Endoscopic management of bilateral vocal fold paralysis (BVFP) includes cordotomy and arytenoidectomy, and has become a well-accepted alternative to tracheostomy. However, the costs and quality-of-life benefits of endoscopic management have not been examined with formal economic analysis. This study undertakes a cost-effectiveness analysis of tracheostomy versus endoscopic management of BVFP. Cost-effectiveness analysis. A literature review identified a range of costs and outcomes associated with surgical options for BVFP. Additional costs were derived from Medicare reimbursement data; all were adjusted to 2014 dollars. Cost-effectiveness analysis evaluated both therapeutic strategies in short-term and long-term scenarios. Probabilistic sensitivity analysis was used to assess confidence levels regarding the economic evaluation. The incremental cost effectiveness ratio for endoscopic management versus tracheostomy is $31,600.06 per quality-adjusted life year (QALY), indicating that endoscopic management is the cost-effective short-term strategy at a willingness-to-pay (WTP) threshold of $50,000/QALY. The probability that endoscopic management is more cost-effective than tracheostomy at this WTP is 65.1%. Threshold analysis demonstrated that the model is sensitive to both utilities and cost in the short-term scenario. When costs of long-term care are included, tracheostomy is dominated by endoscopic management, indicating the cost-effectiveness of endoscopic management at any WTP. Endoscopic management of BVFP appears to be more cost-effective than tracheostomy. Though endoscopic cordotomy and arytenoidectomy require expertise and specialized equipment, this model demonstrates utility gains and long-term cost advantages to an endoscopic strategy. These findings are limited by the relative paucity of robust utility data and emphasize the need for further economic analysis in otolaryngology. NA Laryngoscope, 127:691-697, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Economic Impact of Large-Scale Deployment of Offshore Marine and Hydrokinetic Technology in Oregon Coastal Counties

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

Jimenez, T.; Tegen, S.; Beiter, P.

To begin understanding the potential economic impacts of large-scale WEC technology, the Bureau of Ocean Energy Management (BOEM) commissioned the National Renewable Energy Laboratory (NREL) to conduct an economic impact analysis of largescale WEC deployment for Oregon coastal counties. This report follows a previously published report by BOEM and NREL on the jobs and economic impacts of WEC technology for the entire state (Jimenez and Tegen 2015). As in Jimenez and Tegen (2015), this analysis examined two deployment scenarios in the 2026-2045 timeframe: the first scenario assumed 13,000 megawatts (MW) of WEC technology deployed during the analysis period, and themore » second assumed 18,000 MW of WEC technology deployed by 2045. Both scenarios require major technology and cost improvements in the WEC devices. The study is on very large-scale deployment so readers can examine and discuss the potential of a successful and very large WEC industry. The 13,000-MW is used as the basis for the county analysis as it is the smaller of the two scenarios. Sensitivity studies examined the effects of a robust in-state WEC supply chain. The region of analysis is comprised of the seven coastal counties in Oregon—Clatsop, Coos, Curry, Douglas, Lane, Lincoln, and Tillamook—so estimates of jobs and other economic impacts are specific to this coastal county area.« less

Guidelines for economic analysis of pharmaceutical products: a draft document for Ontario and Canada.

PubMed

Detsky, A S

1993-05-01

In Canada, provincial formulary review committees consider the effectiveness, safety, and cost of products when they derive advice for each Minister of Health. This article offers a draft set of guidelines for pharmaceutical manufacturers making submissions which include economic information, moving beyond a simple presentation of the unit price of the pharmaceutical product (e.g. price per day or course of therapy) and comparison to similar prices for alternative products. A full economic analysis compares all relevant costs and clinical outcomes of the new product with alternate therapeutic strategies for treating patients with a particular condition. The perspective of the decision maker must be clearly identified. The quality of the evidence supporting estimates of the variables incorporated in the analysis should be evaluated. Sensitivity analyses are used to assess the robustness of the qualitative conclusions. Reviewers will examine the answers to a set of 19 questions. Manufacturers can use these questions as a worksheet for preparation of an economic analysis to be incorporated in a submission. These guidelines are intended to be a starting point for further refinement, and discussion with health economists in industry and academia. Considerable flexibility will be used in reviewing documentation supporting economic analysis. Those preparing submissions should be encouraged to experiment with various approaches as part of the general development of this field and to engage provincial review committees in ongoing discussions.

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

NASA Astrophysics Data System (ADS)

Korytárová, J.; Vaňková, L.

2017-10-01

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

Measuring precarious employment in times of crisis: the revised Employment Precariousness Scale (EPRES) in Spain.

PubMed

Vives, Alejandra; González, Francisca; Moncada, Salvador; Llorens, Clara; Benach, Joan

2015-01-01

This study examines the psychometric properties of the revised Employment Precariousness Scale (EPRES-2010) in a context of economic crisis and growing unemployment. Data correspond to salaried workers with a contract (n=4,750) from the second Psychosocial Work Environment Survey (Spain, 2010). Analyses included acceptability, scale score distributions, Cronbach's alpha coefficient and exploratory factor analysis. Response rates were 80% or above, scores were widely distributed with reductions in floor effects for temporariness among permanent workers and for vulnerability. Cronbach's alpha coefficients were 0.70 or above; exploratory factor analysis confirmed the theoretical allocation of 21 out of 22 items. The revised version of the EPRES demonstrated good metric properties and improved sensitivity to worker vulnerability and employment instability among permanent workers. Furthermore, it was sensitive to increased levels of precariousness in some dimensions despite decreases in others, demonstrating responsiveness to the context of the economic crisis affecting the Spanish labour market. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Economics of polysilicon processes

NASA Technical Reports Server (NTRS)

Yaws, C. L.; Li, K. Y.; Chou, S. M.

1986-01-01

Techniques are being developed to provide lower cost polysilicon material for solar cells. Existing technology which normally provides semiconductor industry polysilicon material is undergoing changes and also being used to provide polysilicon material for solar cells. Economics of new and existing technologies are presented for producing polysilicon. The economics are primarily based on the preliminary process design of a plant producing 1,000 metric tons/year of silicon. The polysilicon processes include: Siemen's process (hydrogen reduction of trichlorosilane); Union Carbide process (silane decomposition); and Hemlock Semiconductor process (hydrogen reduction of dichlorosilane). The economics include cost estimates of capital investment and product cost to produce polysilicon via the technology. Sensitivity analysis results are also presented to disclose the effect of major paramentes such as utilities, labor, raw materials and capital investment.

Economic analysis of waste-to-energy industry in China.

PubMed

Zhao, Xin-Gang; Jiang, Gui-Wu; Li, Ang; Wang, Ling

2016-02-01

The generation of municipal solid waste is further increasing in China with urbanization and improvement of living standards. The "12th five-year plan" period (2011-2015) promotes waste-to-energy technologies for the harmless disposal and recycling of municipal solid waste. Waste-to-energy plant plays an important role for reaching China's energy conservation and emission reduction targets. Industrial policies and market prospect of waste-to-energy industry are described. Technology, cost and benefit of waste-to-energy plant are also discussed. Based on an economic analysis of a waste-to-energy project in China (Return on Investment, Net Present Value, Internal Rate of Return, and Sensitivity Analysis) the paper makes the conclusions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Employment population age-share differences: an international comparison of the economic impact of population aging.

PubMed

Brucker, Eric

2009-01-01

International comparisons of the economic impact of population aging across nations can give valuable insights regarding which policies are most effective in addressing aging-related economic issues. Traditional old-age dependency ratios, by not accounting for differences in labor force participation rates, can be misleading. A new measure, the difference between an age group's share of total employment and its share of the total adult population, is developed and shown to be empirically sensitive to different policy actions. The analysis is built upon readily available and comparable International Labour Organization age-group data on population and labor force participation rates.

Medical tourists: who goes and what motivates them?

PubMed

Gan, Lydia L; Frederick, James R

2013-01-01

This study relates consumers' attitudes toward medical tourism to a number of consumer characteristics, such as age, education, income, and insurance status. Principal components analysis of the attitudes of 289 consumers from various communities of North Carolina resulted in three attitude-related factors: economic, treatment-related, and travel-related. Major findings include: (a) the uninsured and low-income consumers are more sensitive to economic factors than the insured and the middle-income consumers; (b) the 51- to 64-year-olds are less motivated by economic factors than young adults; (c) surprisingly, the better one's health, the more one is motivated by treatment-related factors.

Techno-economic analysis for the evaluation of three UCG synthesis gas end use approaches

NASA Astrophysics Data System (ADS)

Nakaten, Natalie; Kempka, Thomas; Burchart-Korol, Dorota; Krawczyk, Piotr; Kapusta, Krzysztof; Stańczyk, Krzysztof

2016-04-01

Underground coal gasification (UCG) enables the utilization of coal reserves that are economically not exploitable because of complex geological boundary conditions. In the present study we investigate UCG as a potential economic approach for conversion of deep-seated coals into a synthesis gas and its application within three different utilization options. Related to geological boundary conditions and the chosen gasification agent, UCG synthesis gas composes of varying methane, hydrogen, nitrogen, carbon monoxide and carbon dioxide amounts. In accordance to its calorific value, the processed UCG synthesis gas can be utilized in different manners, as for electricity generation in a combined cycle power plant or for feedstock production making use of its various chemical components. In the present study we analyze UCG synthesis gas utilization economics in the context of clean electricity generation with an integrated carbon capture and storage process (CCS) as well as synthetic fuel and fertilizer production (Kempka et al., 2010) based on a gas composition achieved during an in situ UCG trial in the Wieczorek Mine. Hereby, we also consider chemical feedstock production in order to mitigate CO2 emissions. Within a sensitivity analysis of UCG synthesis gas calorific value variations, we produce a range of capital and operational expenditure bandwidths that allow for an economic assessment of different synthesis gas end use approaches. To carry out the integrated techno-economic assessment of the coupled systems and the sensitivity analysis, we adapted the techno-economic UCG-CCS model developed by Nakaten et al. (2014). Our techno-economic modeling results demonstrate that the calorific value has a high impact on the economics of UCG synthesis gas utilization. In the underlying study, the synthesis gas is not suitable for an economic competitive electricity generation, due to the relatively low calorific value of 4.5 MJ/Nm³. To be a profitable option for electricity production, the UCG synthesis gas should have a calorific value of at least 7 MJ/Nm³. However, UCG feedstock production in view of the underlying geological and chemical boundary conditions can compete on the market. Kempka, T., Plötz, M.L., Hamann, J., Deowan, S.A., Azzam, R. (2010) Carbon dioxide utilisation for carbamide production by application of the coupled UCG-urea process. Energy Procedia 4: 2200-2205. Nakaten, N., Schlüter, R., Azzam, R., Kempka, T. (2014) Development of a techno-economic model for dynamic calculation of COE, energy demand and CO2 emissions of an integrated UCG-CCS process. Energy (in print). Doi 10.1016/j.energy.2014.01.014

Metrics for Evaluating the Accuracy of Solar Power Forecasting: Preprint

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

Zhang, J.; Hodge, B. M.; Florita, A.

2013-10-01

Forecasting solar energy generation is a challenging task due to the variety of solar power systems and weather regimes encountered. Forecast inaccuracies can result in substantial economic losses and power system reliability issues. This paper presents a suite of generally applicable and value-based metrics for solar forecasting for a comprehensive set of scenarios (i.e., different time horizons, geographic locations, applications, etc.). In addition, a comprehensive framework is developed to analyze the sensitivity of the proposed metrics to three types of solar forecasting improvements using a design of experiments methodology, in conjunction with response surface and sensitivity analysis methods. The resultsmore » show that the developed metrics can efficiently evaluate the quality of solar forecasts, and assess the economic and reliability impact of improved solar forecasting.« less

Cost analysis of school-based intermittent screening and treatment of malaria in Kenya

PubMed Central

2011-01-01

Background The control of malaria in schools is receiving increasing attention, but there remains currently no consensus as to the optimal intervention strategy. This paper analyses the costs of intermittent screening and treatment (IST) of malaria in schools, implemented as part of a cluster-randomized controlled trial on the Kenyan coast. Methods Financial and economic costs were estimated using an ingredients approach whereby all resources required in the delivery of IST are quantified and valued. Sensitivity analysis was conducted to investigate how programme variation affects costs and to identify potential cost savings in the future implementation of IST. Results The estimated financial cost of IST per child screened is US$ 6.61 (economic cost US$ 6.24). Key contributors to cost were salary costs (36%) and malaria rapid diagnostic tests (RDT) (22%). Almost half (47%) of the intervention cost comprises redeployment of existing resources including health worker time and use of hospital vehicles. Sensitivity analysis identified changes to intervention delivery that can reduce programme costs by 40%, including use of alternative RDTs and removal of supervised treatment. Cost-effectiveness is also likely to be highly sensitive to the proportion of children found to be RDT-positive. Conclusion In the current context, school-based IST is a relatively expensive malaria intervention, but reducing the complexity of delivery can result in considerable savings in the cost of intervention. (Costs are reported in US$ 2010). PMID:21933376

Presentation of economic evaluation results.

PubMed

Chaikledkaew, Usa

2014-05-01

The first HTA guidelines for Thailand included a chapter outlining a set of guidelines on how best to report the findings of health economic evaluations, based on a review of best practice and existing guidelines on the presentation of economic evaluation results from around the world. In this second edition of HTA guidelines for Thailand, the recommendations build on the first edition by using a case study to illustrate how the guidelines can be applied in a real research context. The guidelines propose that all reporting include ten key elements: defining the scope of the study, selection of comparator(s), defining the type of economic evaluation, measurement of costs, measurement of clinical effects, handling time in economic evaluation studies, handling uncertainty and sensitivity analysis, presentation of the results, discussion of the results, and disclosure of funding and authors conflict of interest.

Clinical laboratory as an economic model for business performance analysis

PubMed Central

Buljanović, Vikica; Patajac, Hrvoje; Petrovečki, Mladen

2011-01-01

Aim To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Methods Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. Conclusion The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by implementing changes in the next fiscal period. PMID:21853546

Clinical laboratory as an economic model for business performance analysis.

PubMed

Buljanović, Vikica; Patajac, Hrvoje; Petrovecki, Mladen

2011-08-15

To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by implementing changes in the next fiscal period.

Behavioral economics and regulatory analysis.

PubMed

Robinson, Lisa A; Hammitt, James K

2011-09-01

Behavioral economics has captured the interest of scholars and the general public by demonstrating ways in which individuals make decisions that appear irrational. While increasing attention is being focused on the implications of this research for the design of risk-reducing policies, less attention has been paid to how it affects the economic valuation of policy consequences. This article considers the latter issue, reviewing the behavioral economics literature and discussing its implications for the conduct of benefit-cost analysis, particularly in the context of environmental, health, and safety regulations. We explore three concerns: using estimates of willingness to pay or willingness to accept compensation for valuation, considering the psychological aspects of risk when valuing mortality-risk reductions, and discounting future consequences. In each case, we take the perspective that analysts should avoid making judgments about whether values are "rational" or "irrational." Instead, they should make every effort to rely on well-designed studies, using ranges, sensitivity analysis, or probabilistic modeling to reflect uncertainty. More generally, behavioral research has led some to argue for a more paternalistic approach to policy analysis. We argue instead for continued focus on describing the preferences of those affected, while working to ensure that these preferences are based on knowledge and careful reflection. © 2011 Society for Risk Analysis.

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

PubMed

Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam; Jensen, Martin Bach; Pedersen, Kjeld Møller

2017-05-01

In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.

Economic Evaluation in Global Perspective: A Bibliometric Analysis of the Recent Literature.

PubMed

Pitt, Catherine; Goodman, Catherine; Hanson, Kara

2016-02-01

We present a bibliometric analysis of recently published full economic evaluations of health interventions and reflect critically on the implications of our findings for this growing field. We created a database drawing on 14 health, economic, and/or general literature databases for articles published between 1 January 2012 and 3 May 2014 and identified 2844 economic evaluations meeting our criteria. We present findings regarding the sensitivity, specificity, and added value of searches in the different databases. We examine the distribution of publications between countries, regions, and health areas studied and compare the relative volume of research with disease burden. We analyse authors' country and institutional affiliations, journals and journal type, language, and type of economic evaluation conducted. More than 1200 economic evaluations were published annually, of which 4% addressed low-income countries, 4% lower-middle-income countries, 14% upper-middle-income countries, and 83% high-income countries. Across country income levels, 53, 54, 86, and 100% of articles, respectively, included an author based in a country within the income level studied. Biomedical journals published 74% of economic evaluations. The volume of research across health areas correlates more closely with disease burden in high-income than in low-income and middle-income countries. Our findings provide an empirical basis for further study on methods, research prioritization, and capacity development in health economic evaluation. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Health economics and outcomes methods in risk-based decision-making for blood safety.

PubMed

Custer, Brian; Janssen, Mart P

2015-08-01

Analytical methods appropriate for health economic assessments of transfusion safety interventions have not previously been described in ways that facilitate their use. Within the context of risk-based decision-making (RBDM), health economics can be important for optimizing decisions among competing interventions. The objective of this review is to address key considerations and limitations of current methods as they apply to blood safety. Because a voluntary blood supply is an example of a public good, analyses should be conducted from the societal perspective when possible. Two primary study designs are recommended for most blood safety intervention assessments: budget impact analysis (BIA), which measures the cost to implement an intervention both to the blood operator but also in a broader context, and cost-utility analysis (CUA), which measures the ratio between costs and health gain achieved, in terms of reduced morbidity and mortality, by use of an intervention. These analyses often have important limitations because data that reflect specific aspects, for example, blood recipient population characteristics or complication rates, are not available. Sensitivity analyses play an important role. The impact of various uncertain factors can be studied conjointly in probabilistic sensitivity analyses. The use of BIA and CUA together provides a comprehensive assessment of the costs and benefits from implementing (or not) specific interventions. RBDM is multifaceted and impacts a broad spectrum of stakeholders. Gathering and analyzing health economic evidence as part of the RBDM process enhances the quality, completeness, and transparency of decision-making. © 2015 AABB.

Health Economic Analysis of Antiplatelet Therapy for Acute Coronary Syndromes in the Context of Five Eastern Asian Countries.

PubMed

Wu, Bin; Tobe, Ruoyan Gai; Liu, Yuchen; He, Ben

2018-04-30

The economic outcomes of dual antiplatelet therapy in East Asian patients are still unclear. We aimed to evaluate the economic outcomes of ticagrelor versus clopidogrel for patients with acute coronary syndrome (ACS) in China, Japan, Korea, Taiwan and Hong Kong. A two-phase model consisting of a 1-year decision tree and a lifetime Markov model was used to estimate the economic outcomes. The data from the East Asian subgroup of Platelet Inhibition and Patient Outcomes (PLATO) and PHILO studies were used for the calculation of the events rate for ticagrelor and clopidogrel in the first 12 months, whereas the costs were obtained from East Asian sources and utility from the published literature. Sensitivity analyses were conducted to test model robustness. Ticagrelor showed the marginal lifetime quality-adjusted life-year (QALY) of 0.0050, 0.0091, 0.0107, 0.0050, and 0.0050 in China, Japan, Korea, Taiwan, and Hong Kong compared with clopidogrel, with marginal healthcare costs of (all values in US dollars) $562, $595, $975, $611, and $672, respectively. The marginal cost per QALY gained with ticagrelor was $112,051, $65,692, $91,207, $121,838, and $133,953 from a public healthcare system perspective of China, Japan, Korea, Taiwan, and Hong Kong, respectively. The sensitivity analysis showed consistent results. Treatment of ACS for 12 months with ticagrelor is not a cost-effective option for the prevention of thrombotic events in East Asia.

Climate impacts on agricultural land use in the USA: the role of socio-economic scenarios

USGS Publications Warehouse

Mu, Jianhong E.; Sleeter, Benjamin M.; Abatzoglou, John T.; Antle, John M.

2017-01-01

We examine the impacts of climate on net returns from crop and livestock production and the resulting impact on land-use change across the contiguous USA. We first estimate an econometric model to project effects of weather fluctuations on crop and livestock net returns and then use a semi-reduced form land-use share model to study agricultural land-use changes under future climate and socio-economic scenarios. Estimation results show that crop net returns are more sensitive to thermal and less sensitive to moisture variability than livestock net returns; other agricultural land uses substitute cropland use when 30-year averaged degree-days or precipitation are not beneficial for crop production. Under future climate and socio-economic scenarios, we project that crop and livestock net returns are both increasing, but with crop net returns increasing at a higher rate; cropland increases with declines of marginal and pastureland by the end of the twenty-first century. Projections also show that impacts of future climate on agricultural land uses are substantially different and a larger variation of land-use change is evident when socio-economic scenarios are incorporated into the climate impact analysis.

Pharmacoeconomic evaluations of pharmacogenetic and genomic screening programmes: a systematic review on content and adherence to guidelines.

PubMed

Vegter, Stefan; Boersma, Cornelis; Rozenbaum, Mark; Wilffert, Bob; Navis, Gerjan; Postma, Maarten J

2008-01-01

The fields of pharmacogenetics and pharmacogenomics have become important practical tools to progress goals in medical and pharmaceutical research and development. As more screening tests are being developed, with some already used in clinical practice, consideration of cost-effectiveness implications is important. A systematic review was performed on the content of and adherence to pharmacoeconomic guidelines of recent pharmacoeconomic analyses performed in the field of pharmacogenetics and pharmacogenomics. Economic analyses of screening strategies for genetic variations, which were evidence-based and assumed to be associated with drug efficacy or safety, were included in the review. The 20 papers included cover a variety of healthcare issues, including screening tests on several cytochrome P450 (CYP) enzyme genes, thiopurine S-methyltransferase (TMPT) and angiotensin-converting enzyme (ACE) insertion deletion (ACE I/D) polymorphisms. Most economic analyses reported that genetic screening was cost effective and often even clearly dominated existing non-screening strategies. However, we found a lack of standardization regarding aspects such as the perspective of the analysis, factors included in the sensitivity analysis and the applied discount rates. In particular, an important limitation of several studies related to the failure to provide a sufficient evidence-based rationale for an association between genotype and phenotype. Future economic analyses should be conducted utilizing correct methods, with adherence to guidelines and including extensive sensitivity analyses. Most importantly, genetic screening strategies should be based on good evidence-based rationales. For these goals, we provide a list of recommendations for good pharmacoeconomic practice deemed useful in the fields of pharmacogenetics and pharmacogenomics, regardless of country and origin of the economic analysis.

Comparing the economic and health benefits of different approaches to diagnosing Clostridium difficile infection.

PubMed

Bartsch, Sarah M; Umscheid, Craig A; Nachamkin, Irving; Hamilton, Keith; Lee, Bruce Y

2015-01-01

Accurate diagnosis of Clostridium difficile infection (CDI) is essential to effectively managing patients and preventing transmission. Despite the availability of several diagnostic tests, the optimal strategy is debatable and their economic values are unknown. We modified our previously existing C. difficile simulation model to determine the economic value of different CDI diagnostic approaches from the hospital perspective. We evaluated four diagnostic methods for a patient suspected of having CDI: 1) toxin A/B enzyme immunoassay, 2) glutamate dehydrogenase (GDH) antigen/toxin AB combined in one test, 3) nucleic acid amplification test (NAAT), and 4) GDH antigen/toxin AB combination test with NAAT confirmation of indeterminate results. Sensitivity analysis varied the proportion of those tested with clinically significant diarrhoea, the probability of CDI, NAAT cost and CDI treatment delay resulting from a false-negative test, length of stay and diagnostic sensitivity and specificity. The GDH/toxin AB plus NAAT approach leads to the timeliest treatment with the fewest unnecessary treatments given, resulted in the best bed management and generated the lowest cost. The NAAT-alone approach also leads to timely treatment. The GDH/toxin AB diagnostic (without NAAT confirmation) approach resulted in a large number of delayed treatments, but results in the fewest secondary colonisations. Results were robust to the sensitivity analysis. Choosing the right diagnostic approach is a matter of cost and test accuracy. GDH/toxin AB plus NAAT diagnosis led to the timeliest treatment and was the least costly. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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

DOE PAGES

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

2015-08-01

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

Techno-economic analysis of ethanol production from sugarcane bagasse using a Liquefaction plus Simultaneous Saccharification and co-Fermentation process.

PubMed

Gubicza, Krisztina; Nieves, Ismael U; Sagues, William J; Barta, Zsolt; Shanmugam, K T; Ingram, Lonnie O

2016-05-01

A techno-economic analysis was conducted for a simplified lignocellulosic ethanol production process developed and proven by the University of Florida at laboratory, pilot, and demonstration scales. Data obtained from all three scales of development were used with Aspen Plus to create models for an experimentally-proven base-case and 5 hypothetical scenarios. The model input parameters that differed among the hypothetical scenarios were fermentation time, enzyme loading, enzymatic conversion, solids loading, and overall process yield. The minimum ethanol selling price (MESP) varied between 50.38 and 62.72 US cents/L. The feedstock and the capital cost were the main contributors to the production cost, comprising between 23-28% and 40-49% of the MESP, respectively. A sensitivity analysis showed that overall ethanol yield had the greatest effect on the MESP. These findings suggest that future efforts to increase the economic feasibility of a cellulosic ethanol process should focus on optimization for highest ethanol yield. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

PubMed

Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

2016-01-01

To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

A model for estimating the impact of changes in children's vaccines.

PubMed

Simpson, K N; Biddle, A K; Rabinovich, N R

1995-12-01

To assist in strategic planning for the improvement of vaccines and vaccine programs, an economic model was developed and tested that estimates the potential impact of vaccine innovations on health outcomes and costs associated with vaccination and illness. A multistep, iterative process of data extraction/integration was used to develop the model and the scenarios. Parameter replication, sensitivity analysis, and expert review were used to validate the model. The greatest impact on the improvement of health is expected to result from the production of less reactogenic vaccines that require fewer inoculations for immunity. The greatest economic impact is predicted from improvements that decrease the number of inoculations required. Scenario analysis may be useful for integrating health outcomes and economic data into decision making. For childhood infections, this analysis indicates that large cost savings can be achieved in the future if we can improve vaccine efficacy so that the number of required inoculations is reduced. Such an improvement represents a large potential "payback" for the United States and might benefit other countries.

Socioeconomic Stratification and Its Influences on Talent Development: Some Interdisciplinary Perspectives.

ERIC Educational Resources Information Center

Ambrose, Don

2002-01-01

In this analysis, socioeconomic barriers to talent development are explored from the vantage points of major thinkers and recent research findings in context-sensitive disciplines such as economics, sociology, and ethical philosophy. Insights drawn from these perspectives provide the basis for recommendations for educators of the gifted. (Contains…

Role of Sectoral Transformation in the Evolution of Water Management Norms in Agricultural Catchments: A Sociohydrologic Modeling Analysis

NASA Astrophysics Data System (ADS)

Roobavannan, M.; Kandasamy, J.; Pande, S.; Vigneswaran, S.; Sivapalan, M.

2017-10-01

This study is focused on the water-agriculture-environment nexus as it played out in the Murrumbidgee River Basin, eastern Australia, and how coevolution of society and water management actually transpired. Over 100 years of agricultural development the Murrumbidgee Basin experienced a "pendulum swing" in terms of water allocation, initially exclusively for agriculture production changing over to reallocation back to the environment. In this paper, we hypothesize that in the competition for water between economic livelihood and environmental wellbeing, economic diversification was the key to swinging community sentiment in favor of environmental protection, and triggering policy action that resulted in more water allocation to the environment. To test this hypothesis, we developed a sociohydrology model to link the dynamics of the whole economy (both agriculture and industry composed of manufacturing and services) to the community's sensitivity toward the environment. Changing community sensitivity influenced how water was allocated and governed and how the agricultural sector grew relative to the industrial sector (composed of manufacturing and services sectors). In this way, we show that economic diversification played a key role in influencing the community's values and preferences with respect to the environment and economic growth. Without diversification, model simulations show that the community would not have been sufficiently sensitive and willing enough to act to restore the environment, highlighting the key role of sectoral transformation in achieving the goal of sustainable agricultural development.

Stability analysis on an economic epidemiological model with vaccination Pages : - , and.

PubMed

Avusuglo, Wisdom S; Abdella, Kenzu; Feng, Wenying

2017-08-01

In this paper, an economic epidemiological model with vaccination is studied. The stability of the endemic steady-state is analyzed and some bifurcation properties of the system are investigated. It is established that the system exhibits saddle-point and period-doubling bifurcations when adult susceptible individuals are vaccinated. Furthermore, it is shown that susceptible individuals also have the tendency of opting for more number of contacts even if the vaccine is inefficacious and thus causes the disease endemic to increase in the long run. Results from sensitivity analysis with specific disease parameters are also presented. Finally, it is shown that the qualitative behaviour of the system is affected by contact levels.

Sensitivity Analysis of OECD Benchmark Tests in BISON

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

Swiler, Laura Painton; Gamble, Kyle; Schmidt, Rodney C.

2015-09-01

This report summarizes a NEAMS (Nuclear Energy Advanced Modeling and Simulation) project focused on sensitivity analysis of a fuels performance benchmark problem. The benchmark problem was defined by the Uncertainty Analysis in Modeling working group of the Nuclear Science Committee, part of the Nuclear Energy Agency of the Organization for Economic Cooperation and Development (OECD ). The benchmark problem involv ed steady - state behavior of a fuel pin in a Pressurized Water Reactor (PWR). The problem was created in the BISON Fuels Performance code. Dakota was used to generate and analyze 300 samples of 17 input parameters defining coremore » boundary conditions, manuf acturing tolerances , and fuel properties. There were 24 responses of interest, including fuel centerline temperatures at a variety of locations and burnup levels, fission gas released, axial elongation of the fuel pin, etc. Pearson and Spearman correlatio n coefficients and Sobol' variance - based indices were used to perform the sensitivity analysis. This report summarizes the process and presents results from this study.« less

The economic value added (EVA) resulting from medical care of functional amblyopia, strabismus, (pathologies of binocular vision) and asthma.

PubMed

Beauchamp, Cynthia L; Felius, Joost; Beauchamp, George R

2010-01-01

Value analysis in health care calculates the economic value added (EVA) that results from improvements in health and health care. Our purpose was to develop an EVA model and to apply the model to typical and hypothetical (instantaneous and perfect) cures for amblyopia, surgical strabismus and asthma, as another, but non-ophthalmological disease standard for comparison, in the United States. The model is based on changes in utility and longevity, the associated incremental costs, and an estimate of the value of life. Univariate sensitivity analyses were performed to arrive at a plausible range of outcomes. For the United States, the EVA for current practice amblyopia care is 12.9B dollars (billion) per year, corresponding to a return on investment (ROI) of 10.4% per yr. With substantial increases in investment aimed at maximal improvement ("perfect cure"), the EVA is 32.7B per yr, with ROI of 5.3% per yr. The EVA for typical surgical strabismus care is 10.3B per yr. A perfect cure may yield EVA of 9.6B per yr. The EVA for asthma is 1317B per yr (ROI 20.4% per yr.., while a perfect cure may yield EVA of 110 B per yr. Sensitivity analysis demonstrated the relatively large effects of incidence, utility, and longevity, while incremental costs have a relatively minor effect on the EVA. The economic value added by improvements in patient-centered outcomes is very large. Failing to make the necessary investments in research, prevention, detection, prompt treatment and rehabilitation of these diseases, at virtually any conceivable cost, appears economically, medically, morally and ethically deficient and consequently wasteful at very least economically for our society.

Saugus River and Tributaries Flood Damage Reduction Study: Lynn, Malden, Revere and Saugus, Massachusetts. Section 1. Feasibility Report.

DTIC Science & Technology

1989-12-01

57 Table 5 Sensitivity Analysis - Point of Pines LPP 61 Table 6 Plan Comparison 64 Table 7 NED Plan Project Costs 96 Table 8 Estimated Operation...Costs 99 Table 13 Selected Plan/Estimated Annual Benefits 101 Table 14 Comparative Impacts - NED Regional Floodgate Plan 102 Table 15 Economic Analysis ...Includes detailed descriptions, plans and profiles and design considerations of the selected plan; coastal analysis of the shorefront; detailed project

Economic analysis of the design and fabrication of a space qualified power system

NASA Technical Reports Server (NTRS)

Ruselowski, G.

1980-01-01

An economic analysis was performed to determine the cost of the design and fabrication of a low Earth orbit, 2 kW photovoltaic/battery, space qualified power system. A commercially available computer program called PRICE (programmed review of information for costing and evaluation) was used to conduct the analysis. The sensitivity of the various cost factors to the assumptions used is discussed. Total cost of the power system was found to be $2.46 million with the solar array accounting for 70.5%. Using the assumption that the prototype becomes the flight system, 77.3% of the total cost is associated with manufacturing. Results will be used to establish whether the cost of space qualified hardware can be reduced by the incorporation of commercial design, fabrication, and quality assurance methods.

Valuation of medical resource units collected in health economic studies.

PubMed

Copley-Merriman, C; Lair, T J

1994-01-01

This paper reviews the issues that are critical for the valuation of medical resources in the context of health economic studies. There are several points to consider when undertaking the valuation of medical resources. The perspective of the analysis should be established before determining the valuation process. Future costs should be discounted to present values, and time and effort spent in assigning a monetary value to a medical resource should be proportional to its importance in the analysis. Prices vary considerably based on location of the service and the severity of the illness episode. Because of the wide variability in pricing data, sensitivity analysis is an important component of validation of study results. A variety of data sources have been applied to the valuation of medical resources. Several types of data are reviewed in this paper, including claims data, national survey data, administrative data, and marketing research data. Valuation of medical resources collected in clinical trials is complex because of the lack of standardization of the data sources. A national pricing data source for health economic valuation would greatly facilitate study analysis and make comparisons between results more meaningful.

Valuing vaccines using value of statistical life measures.

PubMed

Laxminarayan, Ramanan; Jamison, Dean T; Krupnick, Alan J; Norheim, Ole F

2014-09-03

Vaccines are effective tools to improve human health, but resources to pursue all vaccine-related investments are lacking. Benefit-cost and cost-effectiveness analysis are the two major methodological approaches used to assess the impact, efficiency, and distributional consequences of disease interventions, including those related to vaccinations. Childhood vaccinations can have important non-health consequences for productivity and economic well-being through multiple channels, including school attendance, physical growth, and cognitive ability. Benefit-cost analysis would capture such non-health benefits; cost-effectiveness analysis does not. Standard cost-effectiveness analysis may grossly underestimate the benefits of vaccines. A specific willingness-to-pay measure is based on the notion of the value of a statistical life (VSL), derived from trade-offs people are willing to make between fatality risk and wealth. Such methods have been used widely in the environmental and health literature to capture the broader economic benefits of improving health, but reservations remain about their acceptability. These reservations remain mainly because the methods may reflect ability to pay, and hence be discriminatory against the poor. However, willingness-to-pay methods can be made sensitive to income distribution by using appropriate income-sensitive distributional weights. Here, we describe the pros and cons of these methods and how they compare against standard cost-effectiveness analysis using pure health metrics, such as quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs), in the context of vaccine priorities. We conclude that if appropriately used, willingness-to-pay methods will not discriminate against the poor, and they can capture important non-health benefits such as financial risk protection, productivity gains, and economic wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.

Economic Analysis of First-Line Treatment with Erlotinib in an EGFR-Mutated Population with Advanced NSCLC.

PubMed

Vergnenegre, Alain; Massuti, Bartomeu; de Marinis, Filippo; Carcereny, Enric; Felip, Enriqueta; Do, Pascal; Sanchez, Jose Miguel; Paz-Arez, Luis; Chouaid, Christos; Rosell, Rafael

2016-06-01

The cost-effectiveness of first-line tyrosine kinase inhibitor therapy in epidermal growth factor receptor gene (EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is poorly documented. We therefore conducted a cost-effectiveness analysis of first-line treatment with erlotinib versus standard chemotherapy in European patients with advanced-stage EGFR-mutated NSCLC who were enrolled in the European Erlotinib versus Chemotherapy trial. The European Erlotinib versus Chemotherapy study was a multicenter, open-label, randomized phase III trial performed mainly in Spain, France, and Italy. We based our economic analysis on clinical data and data on resource consumption (drugs, drug administration, adverse events, and second-line treatments) collected during this trial. Utility values were derived from the literature. Incremental cost-effectiveness ratios were calculated for the first-line treatment phase and for the overall strategy from the perspective of the three participating countries. Sensitivity analyses were performed by selecting the main cost drivers. Compared with standard first-line chemotherapy, the first-line treatment with erlotinib was cost saving (€7807, €17,311, and €19,364 for Spain, Italy and France, respectively) and yielded a gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity analysis indicated that, given a willingness to pay at least €90,000 for 1 quality-adjusted life-year, the probability that a strategy of first-line erlotinib would be cost-effective was 100% in France, 100% in Italy, and 99.8% in Spain. This economic analysis shows that first-line treatment with erlotinib, versus standard chemotherapy, is a dominant strategy for EGFR-mutated advanced-stage NSCLC in three European countries. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

The Future of the Space Age or how to Evaluate Innovative Ideas

NASA Astrophysics Data System (ADS)

Vollerthun, A.; Fricke, E.

2002-05-01

Based on an initiative of the German Aerospace Industry Association to foster a more transparent and structured funding of German commercial-oriented space projects a three-phased approach is suggested in this paper, to stepwise improve and evaluate proposed concepts for space-related innovations. The objective of this concept was to develop a transparent, structured, and reproducible process to select the right innovative project in terms of political, economical, and technical objectives for funding by e.g. a governmental agency. A stepwise process and related methods, that cover technical as well as economical aspects (and related sensitivities) are proposed. Based on the special needs and requirements of space industry the proposals are compared to a set of predefined top level objectives/requirements. Using an initial trades analysis with the criteria company, technology, product, and market, an initial business case is analyzed. The alternative innovative concepts are in the third process step subject to a very detailed analysis. The full economical and technical scale of the projects is evaluated and metrics for e.g. the 'Return on Investment' or 'Break Even Point' are determined, to compare the various innovations. Risks related to time, cost, and quality are considered, when performing sensitivity analysis by varying the most important factors of the project. Before discussing critical aspects of the proposed process, space-related examples will be presented to show how the process could be applied, and how different concepts should be evaluated.

Cost-effectiveness of silver dressings for paediatric partial thickness burns: An economic evaluation from a randomized controlled trial.

PubMed

Gee Kee, E; Stockton, K; Kimble, R M; Cuttle, L; McPhail, S M

2017-06-01

Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome. This study was a trial based economic evaluation (incremental cost effectiveness) conducted from a healthcare provider perspective. Ninety-six children participated in the trial investigating Acticoat™, Acticoat™ with Mepitel™ or Mepilex Ag™. Costs directly related to the management of partial thickness burns ≤10% TBSA were collected during the trial from March 2013 to July 2014 and for a one year after re-epithelialization time horizon. Incremental cost effectiveness ratios were estimated and dominance probabilities calculated from bootstrap resampling trial data. Sensitivity analyses were conducted to examine the potential effect of accounting for infrequent, but high cost, skin grafting surgical procedures. Costs (dressing, labour, analgesics, scar management) were considerably lower in the Mepilex Ag™ group (median AUD$94.45) compared to the Acticoat™ (median $244.90) and Acticoat™ with Mepitel™ (median $196.66) interventions. There was a 99% and 97% probability that Mepilex Ag™ dominated (cheaper and more effective than) Acticoat™ and Acticoat™ with Mepitel™, respectively. This pattern of dominance was consistent across raw cost and effects, after a priori adjustments, and sensitivity analyses. There was an 82% probability that Acticoat™ with Mepitel dominated Acticoat™ in the primary analysis, although this probability was sensitive to the effect of skin graft procedures. This economic evaluation has demonstrated that Mepilex Ag™ was the dominant dressing choice over both Acticoat™ and Acticoat™ with Mepitel™ in this trial-based economic evaluation and is recommended for treatment of paediatric partial thickness burns ≤10% TBSA. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

A Primer on Health Economic Evaluations in Thoracic Oncology.

PubMed

Whittington, Melanie D; Atherly, Adam J; Bocsi, Gregary T; Camidge, D Ross

2016-08-01

There is growing interest for economic evaluation in oncology to illustrate the value of multiple new diagnostic and therapeutic interventions. As these analyses have started to move from specialist publications into mainstream medical literature, the wider medical audience consuming this information may need additional education to evaluate it appropriately. Here we review standard practices in economic evaluation, illustrating the different methods with thoracic oncology examples where possible. When interpreting and conducting health economic studies, it is important to appraise the method, perspective, time horizon, modeling technique, discount rate, and sensitivity analysis. Guidance on how to do this is provided. To provide a method to evaluate this literature, a literature search was conducted in spring 2015 to identify economic evaluations published in the Journal of Thoracic Oncology. Articles were reviewed for their study design, and areas for improvement were noted. Suggested improvements include using more rigorous sensitivity analyses, adopting a standard approach to reporting results, and conducting complete economic evaluations. Researchers should design high-quality studies to ensure the validity of the results, and consumers of this research should interpret these studies critically on the basis of a full understanding of the methodologies used before considering any of the conclusions. As advancements occur on both the research and consumer sides, this literature can be further developed to promote the best use of resources for this field. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Multi-criteria decision analysis in conservation planning: Designing conservation area networks in San Diego County

NASA Astrophysics Data System (ADS)

MacDonald, Garrick Richard

To limit biodiversity loss caused by human activity, conservation planning must protect biodiversity while considering socio-economic cost criteria. This research aimed to determine the effects of socio-economic criteria and spatial configurations on the development of CANs for three species with different distribution patterns, while simultaneously attempting to address the uncertainty and sensitivity of CANs produced by ConsNet. The socio-economic factors and spatial criteria included the cost of land, population density, agricultural output value, area, average cluster area, number of clusters, shape, and perimeter. Three sensitive mammal species with different distribution patterns were selected and included the Bobcat, Ringtail, and a custom created mammal distribution. Forty problems and the corresponding number of CANs were formulated and computed by running each predicted presence species model with and without the four different socioeconomic threshold groups at two different resolutions. Thirty-two percent less area was conserved after considering multiple socio-economic constraints and spatial configurations in comparison to CANs that did not consider multiple socio-economic constraints and spatial configurations. Without including socio-economic costs, ConsNet's ALL_CELLS heuristic solution was the highest ranking CAN. After considering multiple socio-economic costs, the number one ranking CAN was no longer the ALL_CELLS heuristic solution, but a spatially different meta-heuristic solution. The effects of multiple constraints and objectives on the design of CANs with different distribution patterns did not vary significantly across the criteria. The CANs produced by ConsNet appeared to demonstrate some uncertainty surrounding particular criteria, but did not demonstrate substantial uncertainty across all criteria used to rank the CANs. Similarly, the range of socio-economic criteria thresholds did not have a substantial impact. ConsNet was very applicable to the research project, however, it did exhibit a few limitations. Both the advantages and disadvantages of ConsNet should be considered before using ConsNet for future conservation planning projects. The research project is an example of a large data scenario undertaken with a multiple criteria decision analysis (MCDA) approach.

Sensitivity of projected long-term CO2 emissions across the Shared Socioeconomic Pathways

NASA Astrophysics Data System (ADS)

Marangoni, G.; Tavoni, M.; Bosetti, V.; Borgonovo, E.; Capros, P.; Fricko, O.; Gernaat, D. E. H. J.; Guivarch, C.; Havlik, P.; Huppmann, D.; Johnson, N.; Karkatsoulis, P.; Keppo, I.; Krey, V.; Ó Broin, E.; Price, J.; van Vuuren, D. P.

2017-01-01

Scenarios showing future greenhouse gas emissions are needed to estimate climate impacts and the mitigation efforts required for climate stabilization. Recently, the Shared Socioeconomic Pathways (SSPs) have been introduced to describe alternative social, economic and technical narratives, spanning a wide range of plausible futures in terms of challenges to mitigation and adaptation. Thus far the key drivers of the uncertainty in emissions projections have not been robustly disentangled. Here we assess the sensitivities of future CO2 emissions to key drivers characterizing the SSPs. We use six state-of-the-art integrated assessment models with different structural characteristics, and study the impact of five families of parameters, related to population, income, energy efficiency, fossil fuel availability, and low-carbon energy technology development. A recently developed sensitivity analysis algorithm allows us to parsimoniously compute both the direct and interaction effects of each of these drivers on cumulative emissions. The study reveals that the SSP assumptions about energy intensity and economic growth are the most important determinants of future CO2 emissions from energy combustion, both with and without a climate policy. Interaction terms between parameters are shown to be important determinants of the total sensitivities.

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

PubMed Central

Javanbakht, Mehdi; Mashayekhi, Atefeh; Baradaran, Hamid R.; Haghdoost, AliAkbar; Afshin, Ashkan

2015-01-01

Background The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030. Methods A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model. Results We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030. Conclusions The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority. PMID:26200913

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis.

PubMed

Javanbakht, Mehdi; Mashayekhi, Atefeh; Baradaran, Hamid R; Haghdoost, AliAkbar; Afshin, Ashkan

2015-01-01

The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030. A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model. We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030. The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority.

Task-shifting alcohol interventions for HIV+ persons in Kenya: a cost-benefit analysis.

PubMed

Galárraga, Omar; Gao, Burke; Gakinya, Benson N; Klein, Debra A; Wamai, Richard G; Sidle, John E; Papas, Rebecca K

2017-03-28

Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms. We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya. In our base-case, we estimated the costs and economic benefits from a societal perspective across a six-year time horizon, with a 3% annual discount rate. Costs included all costs associated with training and administering task-shifted CBT therapy. Benefits included the economic impact of lowered HIV incidence as well as the improvements in household and labor-force productivity. We conducted univariate and multivariate probabilistic sensitivity analyses to test the robustness of our results. Under the base case, total costs for CBT rollout was $554,000, the value of benefits were $628,000, and the benefit-to-cost ratio was 1.13. Sensitivity analyses showed that under most assumptions, the benefit-to-cost ratio remained above unity indicating that the intervention was cost-saving (i.e., had positive return on investment). The duration of the treatment effect most effected the results in sensitivity analyses. CBT can be effectively and economically task-shifted to paraprofessionals in Kenya. The intervention can generate not only reductions in morbidity and mortality, but also economic savings for the health system in the medium and long term. The findings have implications for other countries with generalized HIV epidemics, high prevalence of alcohol consumption, and shortages of mental health professionals. This paper uses data derived from "Cognitive Behavioral Treatment to Reduce Alcohol Use Among HIV-Infected Kenyans (KHBS)" with ClinicalTrials.gov registration NCT00792519 on 11/17/2008; and preliminary data from "A Stage 2 Cognitive-behavioral Trial: Reduce Alcohol First in Kenya Intervention" ( NCT01503255 , registered on 12/16/2011).

Production of biosolid fuels from municipal sewage sludge: Technical and economic optimisation.

PubMed

Wzorek, Małgorzata; Tańczuk, Mariusz

2015-08-01

The article presents the technical and economic analysis of the production of fuels from municipal sewage sludge. The analysis involved the production of two types of fuel compositions: sewage sludge with sawdust (PBT fuel) and sewage sludge with meat and bone meal (PBM fuel). The technology of the production line of these sewage fuels was proposed and analysed. The main objective of the study is to find the optimal production capacity. The optimisation analysis was performed for the adopted technical and economic parameters under Polish conditions. The objective function was set as a maximum of the net present value index and the optimisation procedure was carried out for the fuel production line input capacity from 0.5 to 3 t h(-1), using the search step 0.5 t h(-1). On the basis of technical and economic assumptions, economic efficiency indexes of the investment were determined for the case of optimal line productivity. The results of the optimisation analysis show that under appropriate conditions, such as prices of components and prices of produced fuels, the production of fuels from sewage sludge can be profitable. In the case of PBT fuel, calculated economic indexes show the best profitability for the capacity of a plant over 1.5 t h(-1) output, while production of PBM fuel is beneficial for a plant with the maximum of searched capacities: 3.0 t h(-1). Sensitivity analyses carried out during the investigation show that influence of both technical and economic assessments on the location of maximum of objective function (net present value) is significant. © The Author(s) 2015.

Economic analysis and assessment of syngas production using a modeling approach

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

Kim, Hakkwan; Parajuli, Prem B.; Yu, Fei

Economic analysis and modeling are essential and important issues for the development of current feedstock and process technology for bio-gasification. The objective of this study was to develop an economic model and apply to predict the unit cost of syngas production from a micro-scale bio-gasification facility. An economic model was programmed in C++ computer programming language and developed using a parametric cost approach, which included processes to calculate the total capital costs and the total operating costs. The model used measured economic data from the bio-gasification facility at Mississippi State University. The modeling results showed that the unit cost ofmore » syngas production was $1.217 for a 60 Nm-3 h-1 capacity bio-gasifier. The operating cost was the major part of the total production cost. The equipment purchase cost and the labor cost were the largest part of the total capital cost and the total operating cost, respectively. Sensitivity analysis indicated that labor costs rank the top as followed by equipment cost, loan life, feedstock cost, interest rate, utility cost, and waste treatment cost. The unit cost of syngas production increased with the increase of all parameters with exception of loan life. The annual cost regarding equipment, labor, feedstock, waste treatment, and utility cost showed a linear relationship with percent changes, while loan life and annual interest rate showed a non-linear relationship. This study provides the useful information for economic analysis and assessment of the syngas production using a modeling approach.« less

Sensitivity Analysis as a Tool to assess Energy-Water Nexus in India

NASA Astrophysics Data System (ADS)

Priyanka, P.; Banerjee, R.

2017-12-01

Rapid urbanization, population growth and related structural changes with-in the economy of a developing country act as a stressor on energy and water demand, which forms a well-established energy-water nexus. Energy-water nexus is thoroughly studied at various spatial scales viz. city level, river basin level and national level- to guide different stakeholders for sustainable management of energy and water. However, temporal dimensions of energy-water nexus at national level have not been thoroughly investigated because of unavailability of relevant time-series data. In this study we investigated energy-water nexus at national level using environmentally-extended input-output tables for Indian economy (2004-2013) as provided by EORA database. Perturbation based sensitivity analysis is proposed to highlight the critical nodes of interactions among economic sectors which is further linked to detect the synergistic effects of energy and water consumption. Technology changes (interpreted as change in value of nodes) results in modification of interactions among economic sectors and synergy is affected through direct as well as indirect effects. Indirect effects are not easily understood through preliminary examination of data, hence sensitivity analysis within an input-output framework is important to understand the indirect effects. Furthermore, time series data helps in developing the understanding on dynamics of synergistic effects. We identified the key sectors and technology changes for Indian economy which will provide the better decision support for policy makers about sustainable use of energy-water resources in India.

Sensitivity analysis of the agricultural policy/environmental extender (APEX) for phosphorus loads in tile-drained landscapes

USDA-ARS?s Scientific Manuscript database

Numerical modeling is an economical and feasible approach for quantifying the effects of best management practices on phosphorus (P) loadings from agricultural fields. However, tools that simulate both surface and subsurface P pathways are limited and have not been robustly evaluated in tile-drained...

An economic analysis of the electricity generation potential from biogas resources in the state of Indiana

NASA Astrophysics Data System (ADS)

Giraldo, Juan S.

Anaerobic digestion is a process that is a common part of organic waste management systems and is used in concentrated animal feeding operations (CAFOs), wastewater treatment plants (WWTPs), and municipal solid waste (MSW) landfills. The process produces biogas, which contains methane, and it can be burned to generate electricity. Previous reports have indicated that based on the availability of feedstocks there is a large potential for biogas production and use for electricity generation in the state of Indiana. However, these reports varied in their consideration of important factors that affect the technical and economic feasibility of being able to develop the resources available. The goal of this thesis is to make a more targeted assessment of the electricity generation potential from biogas resources at CAFOs, WWTPs, and MSW landfills in Indiana. A capital budgeting model is used to estimate the net present value (NPV) of biogas electricity projects at facilities that are identified as technically suitable. A statewide estimate of the potential generation capacity is made by estimating the number of facilities that could profitably undertake a biogas electricity project. In addition this thesis explored the impact that different incentive policies would have on the economic viability of these projects. The results indicated that the electricity generation potential is much smaller when technical and economic factors are taken into account in addition to feedstock availability. In particular it was found that projects at hog farms are unlikely to be economically feasible in the present even when financial incentives are considered. In total, 47.94 MW of potential generating capacity is estimated from biogas production at CAFOs, WWTPs, and MSW landfills. Though results indicated that 37.10 MW of capacity are economically feasible under current operating conditions, sensitivity analysis reveals that these projects are very sensitive to capital cost assumptions and incentives are likely needed to encourage investment.

School-Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program.

PubMed

Basurto-Dávila, Ricardo; Meltzer, Martin I; Mills, Dora A; Beeler Asay, Garrett R; Cho, Bo-Hyun; Graitcer, Samuel B; Dube, Nancy L; Thompson, Mark G; Patel, Suchita A; Peasah, Samuel K; Ferdinands, Jill M; Gargiullo, Paul; Messonnier, Mark; Shay, David K

2017-12-01

To estimate the societal economic and health impacts of Maine's school-based influenza vaccination (SIV) program during the 2009 A(H1N1) influenza pandemic. Primary and secondary data covering the 2008-09 and 2009-10 influenza seasons. We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference-in-difference-in-differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis. We used national survey data to estimate the impact of the SIV program on vaccine coverage. We used primary data and published studies to develop the microsimulation model. The program was associated with higher immunization among children and lower immunization among adults aged 18-49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations. SIV may be a cost-beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups. © Health Research and Educational Trust.

Mid-term financial impact of animal welfare improvements in Dutch broiler production.

PubMed

Gocsik, E; Lansink, A G J M Oude; Saatkamp, H W

2013-12-01

This study used a stochastic bioeconomic simulation model to simulate the business and financial risk of different broiler production systems over a 5-yr period. Simulation analysis was conducted using the @Risk add-in in MS Excel. To compare the impact of different production systems on economic feasibility, 2 cases were considered. The first case focused on the economic feasibility of a completely new system, whereas the second examined economic feasibilities when a farm switches from a conventional to an animal welfare-improving production system. A sensitivity analysis was conducted to assess the key drivers of economic feasibility and to reveal systematic differences across production systems. The study shows that economic feasibility of systems with improved animal welfare predominantly depends on the price that farmers receive. Moreover, the study demonstrates the importance of the level and variation of the price premium for improved welfare, particularly in the first 5 yr after conversion. The economic feasibility of the production system increases with the level of welfare improvements for a sufficiently high price level for broiler meat and low volatility in producer prices. If this is not the case, however, risk attitudes of farmers become important as well as the use of potential risk management instruments.

An analysis of the characteristics of Indonesian industrial sectors: 2005-2010

NASA Astrophysics Data System (ADS)

Zuhdi, Ubaidillah

2017-10-01

The purpose of the current study is to analyze the characteristics of Indonesian industrial sectors from 2005 through 2010. The study employs the analysis instruments from the Input-Output (IO) analysis, namely the indices of the power of dispersion, and the sensitivity of dispersion. For 2005 and 2010, the study focuses on nine and seventeen industries, respectively. The results show that industry 3, manufacturing, placed the quadrant I on the analysis period. The fact shows that, from 2005 through 2010, the industry had a strong influence on the Indonesian economic activities, and received high impacts from the external aspects. In other words, the industry has great potency for the Indonesian economy. From the results one can also see that sector 4, electricity and gas, included in the quadrant I in 2010. This fact explains that the sector has also great potency for the economic activities of Indonesia. Thus, the Indonesian government should prioritize the industries development.

Economic Efficiency and Investment Timing for Dual Water Systems

NASA Astrophysics Data System (ADS)

Leconte, Robert; Hughes, Trevor C.; Narayanan, Rangesan

1987-10-01

A general methodology to evaluate the economic feasibility of dual water systems is presented. In a first step, a static analysis (evaluation at a single point in time) is developed. The analysis requires the evaluation of consumers' and producer's surpluses from water use and the capital cost of the dual (outdoor) system. The analysis is then extended to a dynamic approach where the water demand increases with time (as a result of a population increase) and where the dual system is allowed to expand. The model determines whether construction of a dual system represents a net benefit, and if so, what is the best time to initiate the system (corresponding to maximization of social welfare). Conditions under which an analytic solution is possible are discussed and results of an application are summarized (including sensitivity to different parameters). The analysis allows identification of key parameters influencing attractiveness of dual water systems.

A simple, objective analysis scheme for scatterometer data. [Seasat A satellite observation of wind over ocean

NASA Technical Reports Server (NTRS)

Levy, G.; Brown, R. A.

1986-01-01

A simple economical objective analysis scheme is devised and tested on real scatterometer data. It is designed to treat dense data such as those of the Seasat A Satellite Scatterometer (SASS) for individual or multiple passes, and preserves subsynoptic scale features. Errors are evaluated with the aid of sampling ('bootstrap') statistical methods. In addition, sensitivity tests have been performed which establish qualitative confidence in calculated fields of divergence and vorticity. The SASS wind algorithm could be improved; however, the data at this point are limited by instrument errors rather than analysis errors. The analysis error is typically negligible in comparison with the instrument error, but amounts to 30 percent of the instrument error in areas of strong wind shear. The scheme is very economical, and thus suitable for large volumes of dense data such as SASS data.

Routine magnetic resonance imaging for idiopathic olfactory loss: a modeling-based economic evaluation.

PubMed

Rudmik, Luke; Smith, Kristine A; Soler, Zachary M; Schlosser, Rodney J; Smith, Timothy L

2014-10-01

Idiopathic olfactory loss is a common clinical scenario encountered by otolaryngologists. While trying to allocate limited health care resources appropriately, the decision to obtain a magnetic resonance imaging (MRI) scan to investigate for a rare intracranial abnormality can be difficult. To evaluate the cost-effectiveness of ordering routine MRI in patients with idiopathic olfactory loss. We performed a modeling-based economic evaluation with a time horizon of less than 1 year. Patients included in the analysis had idiopathic olfactory loss defined by no preceding viral illness or head trauma and negative findings of a physical examination and nasal endoscopy. Routine MRI vs no-imaging strategies. We developed a decision tree economic model from the societal perspective. Effectiveness, probability, and cost data were obtained from the published literature. Litigation rates and costs related to a missed diagnosis were obtained from the Physicians Insurers Association of America. A univariate threshold analysis and multivariate probabilistic sensitivity analysis were performed to quantify the degree of certainty in the economic conclusion of the reference case. The comparative groups included those who underwent routine MRI of the brain with contrast alone and those who underwent no brain imaging. The primary outcome was the cost per correct diagnosis of idiopathic olfactory loss. The mean (SD) cost for the MRI strategy totaled $2400.00 ($1717.54) and was effective 100% of the time, whereas the mean (SD) cost for the no-imaging strategy totaled $86.61 ($107.40) and was effective 98% of the time. The incremental cost-effectiveness ratio for the MRI strategy compared with the no-imaging strategy was $115 669.50, which is higher than most acceptable willingness-to-pay thresholds. The threshold analysis demonstrated that when the probability of having a treatable intracranial disease process reached 7.9%, the incremental cost-effectiveness ratio for MRI vs no imaging was $24 654.38. The probabilistic sensitivity analysis demonstrated that the no-imaging strategy was the cost-effective decision with 81% certainty at a willingness-to-pay threshold of $50 000. This economic evaluation suggests that the most cost-effective decision is to not obtain a routine MRI scan of the brain in patients with idiopathic olfactory loss. Outcomes from this study may be used to counsel patients and aid in the decision-making process.

State of health economic evaluation research in Saudi Arabia: a review.

PubMed

Al-Aqeel, Sinaa A

2012-01-01

If evaluation of economic evidence is to be used increasingly in Saudi Arabia, a review of the published literature would be useful to inform policy decision-makers of the current state of research and plan future research agendas. The purpose of this paper is to provide a critical review of the state of health economic evaluation research within the Saudi context with regard to the number, characteristics, and quality of published articles. A literature search was conducted on May 8, 2011 to identify health economic articles pertaining to Saudi Arabia in the PubMed, Embase, and EconLit databases, using the following terms alone or in combination: "cost*", "economics", "health economics", "cost-effectiveness", "cost-benefit", "cost minimization", "cost utility analysis", and "Saudi". Reference lists of the articles identified were also searched for further articles. The tables of contents of the Saudi Pharmaceutical Journal and the Saudi Medical Journal were reviewed for the previous 5 years. The search identified 535 citations. Based on a reading of abstracts and titles, 477 papers were excluded. Upon reviewing the full text of the remaining 58 papers, 43 were excluded. Fifteen papers were included. Ten were categorized as full economic evaluations and five as partial economic evaluations. These articles were published between 1997 and 2010. The majority of the studies identified did not clearly state the perspective of their evaluation. There are many concerns about the methods used to collect outcome and costs data. Only one study used some sort of sensitivity analysis to assess the effects of uncertainty on the robustness of its conclusions. This review highlights major flaws in the design, analysis, and reporting of the identified economic analyses. Such deficiencies mean that the local economic evidence available to decision-makers is not very useful. Thus, building research capability in health economics is warranted.

A Transient Dopamine Signal Represents Avoidance Value and Causally Influences the Demand to Avoid

PubMed Central

Pultorak, Katherine J.; Schelp, Scott A.; Isaacs, Dominic P.; Krzystyniak, Gregory

2018-01-01

Abstract While an extensive literature supports the notion that mesocorticolimbic dopamine plays a role in negative reinforcement, recent evidence suggests that dopamine exclusively encodes the value of positive reinforcement. In the present study, we employed a behavioral economics approach to investigate whether dopamine plays a role in the valuation of negative reinforcement. Using rats as subjects, we first applied fast-scan cyclic voltammetry (FSCV) to determine that dopamine concentration decreases with the number of lever presses required to avoid electrical footshock (i.e., the economic price of avoidance). Analysis of the rate of decay of avoidance demand curves, which depict an inverse relationship between avoidance and increasing price, allows for inference of the worth an animal places on avoidance outcomes. Rapidly decaying demand curves indicate increased price sensitivity, or low worth placed on avoidance outcomes, while slow rates of decay indicate reduced price sensitivity, or greater worth placed on avoidance outcomes. We therefore used optogenetics to assess how inducing dopamine release causally modifies the demand to avoid electrical footshock in an economic setting. Increasing release at an avoidance predictive cue made animals more sensitive to price, consistent with a negative reward prediction error (i.e., the animal perceives they received a worse outcome than expected). Increasing release at avoidance made animals less sensitive to price, consistent with a positive reward prediction error (i.e., the animal perceives they received a better outcome than expected). These data demonstrate that transient dopamine release events represent the value of avoidance outcomes and can predictably modify the demand to avoid. PMID:29766047

A case study of packaging waste collection systems in Portugal - Part II: Environmental and economic analysis.

PubMed

Pires, Ana; Sargedas, João; Miguel, Mécia; Pina, Joaquim; Martinho, Graça

2017-03-01

An understanding of the environmental impacts and costs related to waste collection is needed to ensure that existing waste collection schemes are the most appropriate with regard to both environment and cost. This paper is Part II of a three-part study of a mixed packaging waste collection system (curbside plus bring collection). Here, the mixed collection system is compared to an exclusive curbside system and an exclusive bring system. The scenarios were assessed using life cycle assessment and an assessment of costs to the waste management company. The analysis focuses on the collection itself so as to be relevant to waste managers and decision-makers who are involved only in this step of the packaging life cycle. The results show that the bring system has lower environmental impacts and lower economic costs, and is capable of reducing the environmental impacts of the mixed system. However, a sensitivity analysis shows that these results could differ if the curbside collection were to be optimized. From economic and environmental perspectives, the mixed system has few advantages. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects off system factors on the economics of and demand for small solar thermal power systems

NASA Technical Reports Server (NTRS)

1981-01-01

Market penetration as a function time, SPS performance factors, and market/economic considerations was estimated, and commercialization strategies were formulated. A market analysis task included personal interviews and supplemental mail surveys to acquire statistical data and to identify and measure attitudes, reactions and intentions of prospective SPS users. Interviews encompassed three ownership classes of electric utilities and industrial firms in the SIC codes for energy consumption. A market demand model was developed which utilized the data base developed, and projected energy price and consumption data to perform sensitivity analyses and estimate potential market for SPS.

Effects off system factors on the economics of and demand for small solar thermal power systems

NASA Astrophysics Data System (ADS)

1981-09-01

Market penetration as a function time, SPS performance factors, and market/economic considerations was estimated, and commercialization strategies were formulated. A market analysis task included personal interviews and supplemental mail surveys to acquire statistical data and to identify and measure attitudes, reactions and intentions of prospective SPS users. Interviews encompassed three ownership classes of electric utilities and industrial firms in the SIC codes for energy consumption. A market demand model was developed which utilized the data base developed, and projected energy price and consumption data to perform sensitivity analyses and estimate potential market for SPS.

Orthopaedic trauma care in Haiti: a cost-effectiveness analysis of an innovative surgical residency program.

PubMed

Carlson, Lucas C; Slobogean, Gerard P; Pollak, Andrew N

2012-01-01

In an effort to sustainably strengthen orthopaedic trauma care in Haiti, a 2-year Orthopaedic Trauma Care Specialist (OTCS) program for Haitian physicians has been developed. The program will provide focused training in orthopaedic trauma surgery and fracture care utilizing a train-the-trainer approach. The purpose of this analysis was to calculate the cost-effectiveness of the program relative to its potential to decrease disability in the Haitian population. Using established methodology originally outlined in the World Health Organization's Global Burden of Disease project, a cost-effectiveness analysis was performed for the OTCS program in Haiti. Costs and disability-adjusted life-years (DALYs) averted were estimated per fellow trained in the OTCS program by using a 20-year career time horizon. Probabilistic sensitivity analysis was used to simultaneously test the joint uncertainty of the cost and averted DALY estimates. A willingness-to-pay threshold of $1200 per DALY averted, equal to the gross domestic product per capita in Haiti, was selected on the basis of World Health Organization's definition of highly cost-effective health interventions. The OTCS program results in an incremental cost of $1,542,544 ± $109,134 and 12,213 ± 2,983 DALYs averted per fellow trained. The cost-effectiveness ratio of $133.97 ± $34.71 per DALY averted is well below the threshold of $1200 per DALY averted. Furthermore, sensitivity analysis suggests that implementing the OTCS program is the economically preferred strategy with more than 95% probability at a willingness-to-pay threshold of $200 per DALY averted and across the entire range of potential variable inputs. The current economic analysis suggests the OTCS program to be a highly cost-effective intervention. Probabilistic sensitivity analysis demonstrates that the conclusions remain stable even when considering the joint uncertainty of the cost and DALY estimates. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Hydrogen from coal cost estimation guidebook

NASA Technical Reports Server (NTRS)

Billings, R. E.

1981-01-01

In an effort to establish baseline information whereby specific projects can be evaluated, a current set of parameters which are typical of coal gasification applications was developed. Using these parameters a computer model allows researchers to interrelate cost components in a sensitivity analysis. The results make possible an approximate estimation of hydrogen energy economics from coal, under a variety of circumstances.

An engineering and economic evaluation of quick germ-quick fiber process for dry-grind ethanol facilities: analysis.

PubMed

Rodríguez, Luis F; Li, Changying; Khanna, Madhu; Spaulding, Aslihan D; Lin, Tao; Eckhoff, Steven R

2010-07-01

An engineering economic model, which is mass balanced and compositionally driven, was developed to compare the conventional corn dry-grind process and the pre-fractionation process called quick germ-quick fiber (QQ). In this model, documented in a companion article, the distillers dried grains with solubles (DDGS) price was linked with its protein and fiber content as well as with the long-term average relationship with the corn price. The detailed economic analysis showed that the QQ plant retrofitted from conventional dry-grind ethanol plant reduces the manufacturing cost of ethanol by 13.5 cent/gallon and has net present value of nearly $4 million greater than the conventional dry-grind plant at an interest rate of 4% in 15years. Ethanol and feedstock price sensitivity analysis showed that the QQ plant gains more profits when ethanol price increases than conventional dry-grind ethanol plant. An optimistic analysis of the QQ process suggests that the greater value of the modified DDGS would provide greater resistance to fluctuations in corn price for QQ facilities. This model can be used to provide decision support for ethanol producers. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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

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

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

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

An assessment of the regional and national socio-economic impacts of the 2007 Rift Valley fever outbreak in Kenya.

PubMed

Rich, Karl M; Wanyoike, Francis

2010-08-01

Although Rift Valley fever (RVF) has significant impacts on human health and livestock production, it can also induce significant (and often overlooked) economic losses among various stakeholders in the marketing chain. This work assesses and quantifies the multi-dimensional socio-economic impacts of the 2007 RVF outbreak in Kenya based on a rapid assessment of livestock value chains in the northeast part of the country and a national macroeconomic analysis. Although study results show negative impacts among producers in terms of food insecurity and reductions in income, we also found significant losses among other downstream actors in the value chain, including livestock traders, slaughterhouses, casual laborers, and butchers, as well as other, non-agricultural sectors. The study highlights the need for greater sensitivity and analyses that address the multitude of economic losses resulting from an animal disease to better inform policy and decision making during animal health emergencies.

Economics show CO2 EOR potential in central Kansas

USGS Publications Warehouse

Dubois, M.K.; Byrnes, A.P.; Pancake, R.E.; Willhite, G.P.; Schoeling, L.G.

2000-01-01

Carbon dioxide (CO2) enhanced oil recovery (EOR) may be the key to recovering hundreds of millions of bbl of trapped oil from the mature fields in central Kansas. Preliminary economic analysis indicates that CO2 EOR should provide an internal rate of return (IRR) greater than 20%, before income tax, assuming oil sells for \\$20/bbl, CO2 costs \\$1/Mcf, and gross utilization is 10 Mcf of CO2/bbl of oil recovered. If the CO2 cost is reduced to \\$0.75/Mcf, an oil price of $17/bbl yields an IRR of 20%. Reservoir and economic modeling indicates that IRR is most sensitive to oil price and CO2 cost. A project requires a minimum recovery of 1,500 net bbl/acre (about 1 million net bbl/1-mile section) under a best-case scenario. Less important variables to the economics are capital costs and non-CO2 related lease operating expenses.

The short-term impact of economic uncertainty on motor vehicle collisions.

PubMed

Vandoros, Sotiris; Avendano, Mauricio; Kawachi, Ichiro

2018-06-01

Stress and anxiety lead to attention loss and sleep deprivation and may reduce driving performance, increasing the risk of motor vehicle collision. We used evidence from a natural experiment to examine whether daily changes in economic uncertainty, potentially leading to attention or sleep loss, are associated with collisions in Great Britain. Daily data from the economic policy uncertainty index, derived from analysis of daily UK newspapers, were linked to the daily number of motor vehicle collisions in Great Britain over the period 2005-2015, obtained from the Department for Transport. Exploiting daily variations in economic uncertainty, we used a GARCH approach to model daily rates of motor vehicle collisions as a function of economic uncertainty, controlling for month and day of the week, monthly unemployment rates and weekly unleaded petrol prices. A spike in the daily economic uncertainty index was associated with an immediate increase in the number of motor vehicle collisions. Results were robust to various sensitivity analyses. Overall, daily increases in economic uncertainty are associated with short-term spikes in motor vehicle collisions. Preventive and traffic control measures may need to increase during periods of economic uncertainty. Copyright © 2018 Elsevier Inc. All rights reserved.

Supply Chain Vulnerability Analysis Using Scenario-Based Input-Output Modeling: Application to Port Operations.

PubMed

Thekdi, Shital A; Santos, Joost R

2016-05-01

Disruptive events such as natural disasters, loss or reduction of resources, work stoppages, and emergent conditions have potential to propagate economic losses across trade networks. In particular, disruptions to the operation of container port activity can be detrimental for international trade and commerce. Risk assessment should anticipate the impact of port operation disruptions with consideration of how priorities change due to uncertain scenarios and guide investments that are effective and feasible for implementation. Priorities for protective measures and continuity of operations planning must consider the economic impact of such disruptions across a variety of scenarios. This article introduces new performance metrics to characterize resiliency in interdependency modeling and also integrates scenario-based methods to measure economic sensitivity to sudden-onset disruptions. The methods will be demonstrated on a U.S. port responsible for handling $36.1 billion of cargo annually. The methods will be useful to port management, private industry supply chain planning, and transportation infrastructure management. © 2015 Society for Risk Analysis.

Economic Analysis in the Pacific Northwest Land Resources Project: Theoretical Considerations and Preliminary Results

NASA Technical Reports Server (NTRS)

Morse, D. R. A.; Sahlberg, J. T.

1977-01-01

The Pacific Northwest Land Resources Inventory Demonstration Project i s an a ttempt to combine a whole spectrum of heterogeneous geographic, institutional and applications elements in a synergistic approach to the evaluation of remote sensing techniques. This diversity is the prime motivating factor behind a theoretical investigation of alternative economic analysis procedures. For a multitude of reasons--simplicity, ease of understanding, financial constraints and credibility, among others--cost-effectiveness emerges as the most practical tool for conducting such evaluation determinatIons in the Pacific Northwest. Preliminary findings in two water resource application areas suggest, in conformity with most published studies, that Lands at-aided data collection methods enjoy substantial cost advantages over alternative techniques. The pntential for sensitivity analysis based on cost/accuracy tradeoffs is considered on a theoretical plane in the absence of current accuracy figures concerning the Landsat-aided approach.

Hidden flows and waste processing--an analysis of illustrative futures.

PubMed

Schiller, F; Raffield, T; Angus, A; Herben, M; Young, P J; Longhurst, P J; Pollard, S J T

2010-12-14

An existing materials flow model is adapted (using Excel and AMBER model platforms) to account for waste and hidden material flows within a domestic environment. Supported by national waste data, the implications of legislative change, domestic resource depletion and waste technology advances are explored. The revised methodology offers additional functionality for economic parameters that influence waste generation and disposal. We explore this accounting system under hypothetical future waste and resource management scenarios, illustrating the utility of the model. A sensitivity analysis confirms that imports, domestic extraction and their associated hidden flows impact mostly on waste generation. The model offers enhanced utility for policy and decision makers with regard to economic mass balance and strategic waste flows, and may promote further discussion about waste technology choice in the context of reducing carbon budgets.

Systematic Review and Quality Appraisal of Economic Evaluation Publications in Dentistry.

PubMed

Tonmukayakul, U; Calache, H; Clark, R; Wasiak, J; Faggion, C M

2015-10-01

Economic evaluation (EE) studies have been undertaken in dentistry since the late 20th century because economic data provide additional information to policy makers to develop guidelines and set future direction for oral health services. The objectives of this study were to assess the methodological quality of EEs in oral health. Electronic searching of Ovid MEDLINE, the Cochrane Library, and the NHS Economic Evaluation Database from 1975 to 2013 were undertaken to identify publications that include costs and outcomes in dentistry. Relevant reference lists were also searched for additional studies. Studies were retrieved and reviewed independently for inclusion by 3 authors. Furthermore, to appraise the EE methods, 1 author applied the Drummond 10-item (13-criteria) checklist tool to each study. Of the 114 publications identified, 79 studies were considered full EE and 35 partial. Twenty-eight studies (30%) were published between the years 2011 and 2013. Sixty-four (53%) studies focused on dental caries prevention or treatment. Median appraisal scores calculated for full and partial EE studies were 11 and 9 out of 13, respectively. Quality assessment scores showed that the quality of partial EE studies published after 2000 significantly improved (P = 0.02) compared to those published before 2000. Significant quality improvement was not found in full EE studies. Common methodological limitations were identified: absence of sensitivity analysis, discounting, and insufficient information on how costs and outcomes were measured and valued. EE studies in dentistry increased over the last 40 y in both quantity and quality, but a number of publications failed to satisfy some components of standard EE research methods, such as sensitivity analysis and discounting. © International & American Associations for Dental Research 2015.

[Economic evaluation on different two-dose-vaccination-strategies related to Measles, Mumps and Rubella Combined Attenuated Live Vaccine].

PubMed

He, H Q; Zhang, B; Yan, R; Li, Q; Fu, J; Tang, X W; Zhou, Y; Deng, X; Xie, S Y

2016-08-10

To evaluate the economic effect of Measles, Mumps and Rubella Combined Attenuated Live Vaccine (MMR) under different two-dose vaccination programs. A hypothetical birth cohort of 750 000 infants over their lifetime, was followed up from birth through death in Zhejiang province. The current MMR vaccination strategie would include three different ones: 1) Childlern were vaccinated with Measles-Rubella Combined Attenuated Live Vaccine and MMR, respectively at the age of 8 months and 18 months. 2) Children receive MMR at 8 months and 18 months, 3) Strategy 1 plus an additional vaccination of MMR at 4 years of age. Incremental cost-effectiveness ratio (ICER), incremental cost-benefit ratio (ICBR) and incremental net benefit (INB) were applied to calculate the health economic difference for Strategy 2 and Strategy 3 as compared to Strategy 1. Univariate sensitivity analysis was used to assess the robustness of results with main parameters, including the rate of immunization coverage, effectiveness of the vaccines, incidence and burdens of the related diseases, cost of vaccines and the vaccination program itself. ICER, ICBR and INB for Strategy 2 and Strategy 3 appeared as 2 012.51∶1 RMB Yuan per case and 4 238.72∶1 RMB Yuan per case, 1∶3.14 and 1∶1.58, 21 277 800 RMB Yuan and 9 276 500 RMB Yuan, respectively. Only slight changes (<20%) were found under the univariate sensitivity analysis, with varied values on main parameters. Based on the current national immunization program, infants vaccinated with MMR at 8 months of age, generated more health economic effects than the Strategy 3.

A technical, economic, and environmental performance of grid-connected hybrid (photovoltaic-wind) power system in Algeria.

PubMed

Saheb-Koussa, Djohra; Koussa, Mustapha; Said, Nourredine

2013-01-01

This paper studies the technical, economic, and environmental analysis of wind and photovoltaic power systems connected to a conventional grid. The main interest in such systems is on-site consumption of the produced energy, system hybridization, pooling of resources, and contribution to the environment protection. To ensure a better management of system energy, models have been used for determining the power that the constituting subsystems can deliver under specific weather conditions. Simulation is performed using MATLAB-SIMULINK. While, the economic and environmental study is performed using HOMER software. From an economic point of view, this allows to compare the financial constraints on each part of the system for the case of Adrar site which is located to the northern part of the south of Algeria. It also permits to optimally size and select the system presenting the best features on the basis of two parameters, that is, cost and effectiveness. From an environmental point of view, this study allows highlighting the role of renewable energy in reducing gas emissions related to greenhouse effects. In addition, through a set of sensitivity analysis, it is found that the wind speed has more effects on the environmental and economic performances of grid-connected hybrid (photovoltaic-wind) power systems.

A Technical, Economic, and Environmental Performance of Grid-Connected Hybrid (Photovoltaic-Wind) Power System in Algeria

PubMed Central

Saheb-Koussa, Djohra; Koussa, Mustapha; Said, Nourredine

2013-01-01

This paper studies the technical, economic, and environmental analysis of wind and photovoltaic power systems connected to a conventional grid. The main interest in such systems is on-site consumption of the produced energy, system hybridization, pooling of resources, and contribution to the environment protection. To ensure a better management of system energy, models have been used for determining the power that the constituting subsystems can deliver under specific weather conditions. Simulation is performed using MATLAB-SIMULINK. While, the economic and environmental study is performed using HOMER software. From an economic point of view, this allows to compare the financial constraints on each part of the system for the case of Adrar site which is located to the northern part of the south of Algeria. It also permits to optimally size and select the system presenting the best features on the basis of two parameters, that is, cost and effectiveness. From an environmental point of view, this study allows highlighting the role of renewable energy in reducing gas emissions related to greenhouse effects. In addition, through a set of sensitivity analysis, it is found that the wind speed has more effects on the environmental and economic performances of grid-connected hybrid (photovoltaic-wind) power systems. PMID:24489488

Economic optimization of operations for hybrid energy systems under variable markets

DOE PAGES

Chen, Jen; Garcia, Humberto E.

2016-05-21

We prosed a hybrid energy systems (HES) which is an important element to enable increasing penetration of clean energy. Our paper investigates the operations flexibility of HES, and develops a methodology for operations optimization for maximizing economic value based on predicted renewable generation and market information. A multi-environment computational platform for performing such operations optimization is also developed. In order to compensate for prediction error, a control strategy is accordingly designed to operate a standby energy storage element (ESE) to avoid energy imbalance within HES. The proposed operations optimizer allows systematic control of energy conversion for maximal economic value. Simulationmore » results of two specific HES configurations are included to illustrate the proposed methodology and computational capability. These results demonstrate the economic viability of HES under proposed operations optimizer, suggesting the diversion of energy for alternative energy output while participating in the ancillary service market. Economic advantages of such operations optimizer and associated flexible operations are illustrated by comparing the economic performance of flexible operations against that of constant operations. Sensitivity analysis with respect to market variability and prediction error, are also performed.« less

Economic optimization of operations for hybrid energy systems under variable markets

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

Chen, Jen; Garcia, Humberto E.

We prosed a hybrid energy systems (HES) which is an important element to enable increasing penetration of clean energy. Our paper investigates the operations flexibility of HES, and develops a methodology for operations optimization for maximizing economic value based on predicted renewable generation and market information. A multi-environment computational platform for performing such operations optimization is also developed. In order to compensate for prediction error, a control strategy is accordingly designed to operate a standby energy storage element (ESE) to avoid energy imbalance within HES. The proposed operations optimizer allows systematic control of energy conversion for maximal economic value. Simulationmore » results of two specific HES configurations are included to illustrate the proposed methodology and computational capability. These results demonstrate the economic viability of HES under proposed operations optimizer, suggesting the diversion of energy for alternative energy output while participating in the ancillary service market. Economic advantages of such operations optimizer and associated flexible operations are illustrated by comparing the economic performance of flexible operations against that of constant operations. Sensitivity analysis with respect to market variability and prediction error, are also performed.« less

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.

Economic damages of ozone air pollution to crops using combined air quality and GIS modelling

NASA Astrophysics Data System (ADS)

Vlachokostas, Ch.; Nastis, S. A.; Achillas, Ch.; Kalogeropoulos, K.; Karmiris, I.; Moussiopoulos, N.; Chourdakis, E.; Banias, G.; Limperi, N.

2010-09-01

This study aims at presenting a combined air quality and GIS modelling methodological approach in order to estimate crop damages from photochemical air pollution, depict their spatial resolution and assess the order of magnitude regarding the corresponding economic damages. The analysis is conducted within the Greater Thessaloniki Area, Greece, a Mediterranean territory which is characterised by high levels of photochemical air pollution and considerable agricultural activity. Ozone concentration fields for 2002 and for specific emission reduction scenarios for the year 2010 were estimated with the Ozone Fine Structure model in the area under consideration. Total economic damage to crops turns out to be significant and estimated to be approximately 43 M€ for the reference year. Production of cotton presents the highest economic loss, which is over 16 M€, followed by table tomato (9 M€), rice (4.2 M€), wheat (4 M€) and oilseed rape (2.8 M€) cultivations. Losses are not spread uniformly among farmers and the major losses occur in areas with valuable ozone-sensitive crops. The results are very useful for highlighting the magnitude of the total economic impacts of photochemical air pollution to the area's agricultural sector and can potentially be used for comparison with studies worldwide. Furthermore, spatial analysis of the economic damage could be of importance for governmental authorities and decision makers since it provides an indicative insight, especially if the economic instruments such as financial incentives or state subsidies to farmers are considered.

Sustainable Mining Land Use for Lignite Based Energy Projects

NASA Astrophysics Data System (ADS)

Dudek, Michal; Krysa, Zbigniew

2017-12-01

This research aims to discuss complex lignite based energy projects economic viability and its impact on sustainable land use with respect to project risk and uncertainty, economics, optimisation (e.g. Lerchs and Grossmann) and importance of lignite as fuel that may be expressed in situ as deposit of energy. Sensitivity analysis and simulation consist of estimated variable land acquisition costs, geostatistics, 3D deposit block modelling, electricity price considered as project product price, power station efficiency and power station lignite processing unit cost, CO2 allowance costs, mining unit cost and also lignite availability treated as lignite reserves kriging estimation error. Investigated parameters have nonlinear influence on results so that economically viable amount of lignite in optimal pit varies having also nonlinear impact on land area required for mining operation.

A techno-economic comparison of fuel processors utilizing diesel for solid oxide fuel cell auxiliary power units

NASA Astrophysics Data System (ADS)

Nehter, Pedro; Hansen, John Bøgild; Larsen, Peter Koch

Ultra-low sulphur diesel (ULSD) is the preferred fuel for mobile auxiliary power units (APU). The commercial available technologies in the kW-range are combustion engine based gensets, achieving system efficiencies about 20%. Solid oxide fuel cells (SOFC) promise improvements with respect to efficiency and emission, particularly for the low power range. Fuel processing methods i.e., catalytic partial oxidation, autothermal reforming and steam reforming have been demonstrated to operate on diesel with various sulphur contents. The choice of fuel processing method strongly affects the SOFC's system efficiency and power density. This paper investigates the impact of fuel processing methods on the economical potential in SOFC APUs, taking variable and capital cost into account. Autonomous concepts without any external water supply are compared with anode recycle configurations. The cost of electricity is very sensitive on the choice of the O/C ratio and the temperature conditions of the fuel processor. A sensitivity analysis is applied to identify the most cost effective concept for different economic boundary conditions. The favourite concepts are discussed with respect to technical challenges and requirements operating in the presence of sulphur.

The different modes of hydro-economic analysis (Invited)

NASA Astrophysics Data System (ADS)

Harou, J. J.; Binions, O.; Erfani, T.

2013-12-01

In the face of growing water demands, climate change and spatial and temporal water access variability, accurately assessing the economic impacts of proposed water resource management changes is useful. The objective of this project funded by UK Water Industry Research was to present and demonstrate a framework for identifying and using the ';value of water' to enable water utilities and their regulators to make better decisions. A hydro-economic model can help evaluate water management options in terms of their hydrological and economic impact at different locations throughout a catchment over time. In this talk we discuss three modes in which hydro-economic models can be implemented: evaluative, behavioral and prescriptive. In evaluation mode economic water demand and benefit functions are used to post-process water resource management model results to assess the economic impacts (over space and time) of a policy under consideration. In behavioral hydro-economic models users are represented as agents and the economics is used to help predict their actions. In prescriptive mode optimization is used to find the most economically efficient management actions such as allocation patterns or source selection. These three types of hydro-economic analysis are demonstrated on a UK watershed (Great River Ouse) that includes 97 different water abstractors from amongst the public water supply, agriculture, industry and energy plant cooling sectors. The following issues under dry and normal historical conditions were investigated: Supply/demand investment planning, societal cost of environmental flows, water market prices, and scarcity-sensitive charges for water rights. The talk discusses which hydro-economic modeling mode is used to study each of these issues and why; example results are shown and discussed. The topic of how hydro-economic models can be built and deployed effectively is covered along with how existing water utility operational and planning tools can be converted into hydro-economic models.

Improving the Effect and Efficiency of FMD Control by Enlarging Protection or Surveillance Zones

PubMed Central

Halasa, Tariq; Toft, Nils; Boklund, Anette

2015-01-01

An epidemic of foot-and-mouth disease (FMD) in a FMD-free country with large exports of livestock and livestock products would result in profound economic damage. This could be reduced by rapid and efficient control of the disease spread. The objectives of this study were to estimate the economic impact of a hypothetical FMD outbreak in Denmark based on changes to the economic assumptions of the model, and to investigate whether the control of an FMD epidemic can be improved by combining the enlargement of protection or surveillance zones with pre-emptive depopulation or emergency vaccination. The stochastic spatial simulation model DTU-DADS was used to simulate the spread of FMD in Denmark. The control strategies were the basic EU and Danish strategy, pre-emptive depopulation, suppressive or protective vaccination, enlarging protection or surveillance zones, and a combination of pre-emptive depopulation or emergency vaccination with enlarged protection or surveillance zones. Herds are detected either based on basic detection through the appearance of clinical signs, or as a result of surveillance in the control zones. The economic analyses consisted of direct costs and export losses. Sensitivity analysis was performed on uncertain and potentially influential input parameters. Enlarging the surveillance zones from 10 to 15 km, combined with pre-emptive depopulation over a 1-km radius around detected herds resulted in the lowest total costs. This was still the case even when the different input parameters were changed in the sensitivity analysis. Changing the resources for clinical surveillance did not affect the epidemic consequences. In conclusion, an FMD epidemic in Denmark would have a larger economic impact on the agricultural sector than previously anticipated. Furthermore, the control of a potential FMD outbreak in Denmark may be improved by combining pre-emptive depopulation with an enlarged protection or surveillance zone. PMID:26664996

Improving the Effect and Efficiency of FMD Control by Enlarging Protection or Surveillance Zones.

PubMed

Halasa, Tariq; Toft, Nils; Boklund, Anette

2015-01-01

An epidemic of foot-and-mouth disease (FMD) in a FMD-free country with large exports of livestock and livestock products would result in profound economic damage. This could be reduced by rapid and efficient control of the disease spread. The objectives of this study were to estimate the economic impact of a hypothetical FMD outbreak in Denmark based on changes to the economic assumptions of the model, and to investigate whether the control of an FMD epidemic can be improved by combining the enlargement of protection or surveillance zones with pre-emptive depopulation or emergency vaccination. The stochastic spatial simulation model DTU-DADS was used to simulate the spread of FMD in Denmark. The control strategies were the basic EU and Danish strategy, pre-emptive depopulation, suppressive or protective vaccination, enlarging protection or surveillance zones, and a combination of pre-emptive depopulation or emergency vaccination with enlarged protection or surveillance zones. Herds are detected either based on basic detection through the appearance of clinical signs, or as a result of surveillance in the control zones. The economic analyses consisted of direct costs and export losses. Sensitivity analysis was performed on uncertain and potentially influential input parameters. Enlarging the surveillance zones from 10 to 15 km, combined with pre-emptive depopulation over a 1-km radius around detected herds resulted in the lowest total costs. This was still the case even when the different input parameters were changed in the sensitivity analysis. Changing the resources for clinical surveillance did not affect the epidemic consequences. In conclusion, an FMD epidemic in Denmark would have a larger economic impact on the agricultural sector than previously anticipated. Furthermore, the control of a potential FMD outbreak in Denmark may be improved by combining pre-emptive depopulation with an enlarged protection or surveillance zone.

Assessing the economic impacts of drought from the perspective of profit loss rate: a case study of the sugar industry in China

NASA Astrophysics Data System (ADS)

Wang, Y.; Lin, L.; Chen, H.

2015-07-01

Natural disasters have enormous impacts on human society, especially on the development of the economy. To support decision-making in mitigation and adaption to natural disasters, assessment of economic impacts is fundamental and of great significance. Based on a review of the literature on economic impact evaluation, this paper proposes a new assessment model of the economic impacts of droughts by using the sugar industry in China as a case study, which focuses on the generation and transfer of economic impacts along a simple value chain involving only sugarcane growers and a sugar-producing company. A perspective of profit loss rate is applied to scale economic impact. By using "with and without" analysis, profit loss is defined as the difference in profits between disaster-hit and disaster-free scenarios. To calculate profit, analysis of a time series of sugar price is applied. With the support of a linear regression model, an endogenous trend in sugar price is identified and the time series of sugar price "without" disaster is obtained, using an autoregressive error model to separate impact of disasters from the internal trend in sugar price. Unlike the settings in other assessment models, representative sugar prices, which represent value level in disaster-free conditions and disaster-hit conditions, are integrated from a long time series that covers the whole period of drought. As a result, it is found that in a rigid farming contract, sugarcane growers suffer far more than the sugar company when impacted by severe drought, which may promote reflections among various economic bodies on economic equality related to the occurrence of natural disasters. Further, sensitivity analysis of the model built reveals that sugarcane purchase price has a significant influence on profit loss rate, which implies that setting a proper sugarcane purchase price would be an effective way of realizing economic equality in future practice of contract farming.

Alternative Active Duty Military Retirement Plan

DTIC Science & Technology

2011-03-24

savings. v AFIT/GCA/ENS/11-02 This work is dedicated to all the hardworking men and women in...discovering innovative ways to save money without decreasing the quality of life for their customers. The federal government is no different, and is...living adjustment, and life expectancy. The results could be distorted in the wake of a significant economic event. Sensitivity analysis was

Mapping Socio-Economic Vulnerability During Extreme Events (flash floods) in The Himalayan Region: A Case Study Of Bhagirathi Basin, Uttarakhand

NASA Astrophysics Data System (ADS)

Nisha, N.; Punia, M.

2016-12-01

Mountain stratigraphic system cannot be claimed as the extraordinarily fragile but a greater range of vulnerability to disturbance than many landscape, in the physical space leading to disturbance in social space, makes it special eco-sensitive zone with greater degree of fragility. The present study furnishes socio-economic vulnerability mapping of the Bhagirathi basin through computation of the Socio vulnerability Index (SoVI). SoVI correlates vulnerability to natural or anthropogenic disasters to socio - economic development and illustrates how developmental parameters alter equation of potential effect and recovery in event of a natural catastrophe in the study region. Use of time-series datasets from different sources, including the optical remote sensing data and the use of social and/or economic data to quantify the vulnerabilities during extreme events is attempted. From the analysis it has been found that the areas with high social vulnerability index are might prone to disaster than low index area. However, the analysis of social vulnerability not only helps to identify flood risk area but also raises the question how the key drivers trigger flood and controlled by the governments and local authorities.

Economics of infection control surveillance technology: cost-effective or just cost?

PubMed

Furuno, Jon P; Schweizer, Marin L; McGregor, Jessina C; Perencevich, Eli N

2008-04-01

Previous studies have suggested that informatics tools, such as automated alert and decision support systems, may increase the efficiency and quality of infection control surveillance. However, little is known about the cost-effectiveness of these tools. We focus on 2 types of economic analyses that have utility in assessing infection control interventions (cost-effectiveness analysis and business-case analysis) and review the available literature on the economics of computerized infection control surveillance systems. Previous studies on the effectiveness of computerized infection control surveillance have been limited to assessments of whether these tools increase the sensitivity and specificity of surveillance over traditional methods. Furthermore, we identified only 2 studies that assessed the costs associated with computerized infection control surveillance. Thus, it remains unknown whether computerized infection control surveillance systems are cost-effective and whether use of these systems improves patient outcomes. The existing data are insufficient to allow for a summary conclusion on the cost-effectiveness of infection control surveillance technology. All future studies of computerized infection control surveillance systems should aim to collect outcomes and economic data to inform decision making and assist hospitals with completing business-cases analyses.

A preliminary benefit-cost study of a Sandia wind farm.

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

Ehlen, Mark Andrew; Griffin, Taylor; Loose, Verne W.

In response to federal mandates and incentives for renewable energy, Sandia National Laboratories conducted a feasibility study of installing an on-site wind farm on Sandia National Laboratories and Kirtland Air Force Base property. This report describes this preliminary analysis of the costs and benefits of installing and operating a 15-turbine, 30-MW-capacity wind farm that delivers an estimated 16 percent of 2010 onsite demand. The report first describes market and non-market economic costs and benefits associated with operating a wind farm, and then uses a standard life-cycle costing and benefit-cost framework to estimate the costs and benefits of a wind farm.more » Based on these 'best-estimates' of costs and benefits and on factor, uncertainty and sensitivity analysis, the analysis results suggest that the benefits of a Sandia wind farm are greater than its costs. The analysis techniques used herein are applicable to the economic assessment of most if not all forms of renewable energy.« less

Cardiac resynchronization therapy (CRT) in heart failure--a model to assess the economic value of this new medical technology.

PubMed

Banz, Kurt

2005-01-01

This article describes the framework of a comprehensive European model developed to assess clinical and economic outcomes of cardiac resynchronization therapy (CRT) versus optimal pharmacological therapy (OPT) alone in patients with heart failure. The model structure is based on information obtained from the literature, expert opinion, and a European CRT Steering Committee. The decision-analysis tool allows a consideration of direct medical and indirect costs, and computes outcomes for distinctive periods of time up to 5 years. Qualitative data can also be entered for cost-utility analysis. Model input data for a preliminary economic appraisal of the economic value of CRT in Germany were obtained from clinical trials, experts, health statistics, and medical tariff lists. The model offers comprehensive analysis capabilities and high flexibility so that it can easily be adapted to any European country or special setting. The illustrative analysis for Germany indicates that CRT is a cost-effective intervention. Although CRT is associated with average direct medical net costs of Euro 5880 per patient, this finding means that 22% of its upfront implantation cost is recouped already within 1 year because of significantly decreased hospitalizations. With 36,600 Euros the incremental cost per quality-adjusted life-year (QALY) gained is below the euro equivalent (41,300 Euros, 1 Euro = US1.21 dollars) of the commonly used threshold level of US50,000 dollars considered to represent cost-effectiveness. The sensitivity analysis showed these preliminary results to be fairly robust towards changes in key assumptions. The European CRT model is an important tool to assess the economic value of CRT in patients with moderate to severe heart failure. In the light of the planned introduction of Diagnosis Related Group (DRG) based reimbursement in various European countries, the economic data generated by the model can play an important role in the decision-making process.

The sensitivity of predicted financial and genetic gains in Holsteins to changes in the economic value of traits.

PubMed

Cottle, D J; Coffey, M P

2013-02-01

The objective of this study was to assess the impact of using different relative economic values (REVs) in selection indices on predicted financial and trait gains from selection of sires of cows and on the choice of leading Holstein bulls available in the UK dairy industry. Breeding objective traits were milk yield, fat yield, protein yield, lifespan, mastitis, non-return rate, calving interval and lameness. Relative importance of a trait, as estimated by a.h(2), was only moderately related to the rate of financial loss or total economic merit (ΔTEM) per percentage under- or overestimation of REV (r = 0.38 and 0.29, respectively) as a result of the variance-covariance structure of traits. The effects on TEM of under- or overestimating trait REVs were non-symmetrical. TEM was most sensitive to incorrect REVs for protein, fat, milk and lifespan and least sensitive to incorrect calving interval, lameness, non-return and mastitis REVs. A guide to deciding which dairy traits require the most rigorous analysis in the calculation of their REVs is given. Varying the REVs within a fairly wide range resulted in different bulls being selected by index and their differing predicted transmitting abilities would result in the herds moving in different directions in the long term (20 years). It is suggested that customized indices, where the farmer creates rankings of bulls tailored to their specific farm circumstances, can be worthwhile. © 2012 Blackwell Verlag GmbH.

A systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union.

PubMed

Shields, Gemma E; Elvidge, Jamie; Davies, Linda M

2017-06-10

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population. The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU. Electronic searches of the NHS Economic Evaluation, Health Technology Assessment, MEDLINE and Embase databases were run to identify full economic evaluations. Two levels of screening were used, with explicit inclusion criteria applied by two independent reviewers at each stage. Prespecified data extraction and critical appraisal were performed on identified studies. Results were summarised qualitatively. Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics. Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates. © 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.

Operations Optimization of Nuclear Hybrid Energy Systems

DOE PAGES

Chen, Jun; Garcia, Humberto E.; Kim, Jong Suk; ...

2016-08-01

We proposed a plan for nuclear hybrid energy systems (NHES) as an effective element to incorporate high penetration of clean energy. Our paper focuses on the operations optimization of two specific NHES configurations to address the variability raised from various markets and renewable generation. Both analytical and numerical approaches are used to obtain the optimization solutions. Furthermore, key economic figures of merit are evaluated under optimized and constant operations to demonstrate the benefit of the optimization, which also suggests the economic viability of considered NHES under proposed operations optimizer. Furthermore, sensitivity analysis on commodity price is conducted for better understandingmore » of considered NHES.« less

Operations Optimization of Nuclear Hybrid Energy Systems

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

Chen, Jun; Garcia, Humberto E.; Kim, Jong Suk

We proposed a plan for nuclear hybrid energy systems (NHES) as an effective element to incorporate high penetration of clean energy. Our paper focuses on the operations optimization of two specific NHES configurations to address the variability raised from various markets and renewable generation. Both analytical and numerical approaches are used to obtain the optimization solutions. Furthermore, key economic figures of merit are evaluated under optimized and constant operations to demonstrate the benefit of the optimization, which also suggests the economic viability of considered NHES under proposed operations optimizer. Furthermore, sensitivity analysis on commodity price is conducted for better understandingmore » of considered NHES.« less

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

PubMed

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

2016-10-19

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

A model-based analysis of decision making under risk in obsessive-compulsive and hoarding disorders.

PubMed

Aranovich, Gabriel J; Cavagnaro, Daniel R; Pitt, Mark A; Myung, Jay I; Mathews, Carol A

2017-07-01

Attitudes towards risk are highly consequential in clinical disorders thought to be prone to "risky behavior", such as substance dependence, as well as those commonly associated with excessive risk aversion, such as obsessive-compulsive disorder (OCD) and hoarding disorder (HD). Moreover, it has recently been suggested that attitudes towards risk may serve as a behavioral biomarker for OCD. We investigated the risk preferences of participants with OCD and HD using a novel adaptive task and a quantitative model from behavioral economics that decomposes risk preferences into outcome sensitivity and probability sensitivity. Contrary to expectation, compared to healthy controls, participants with OCD and HD exhibited less outcome sensitivity, implying less risk aversion in the standard economic framework. In addition, risk attitudes were strongly correlated with depression, hoarding, and compulsion scores, while compulsion (hoarding) scores were associated with more (less) "rational" risk preferences. These results demonstrate how fundamental attitudes towards risk relate to specific psychopathology and thereby contribute to our understanding of the cognitive manifestations of mental disorders. In addition, our findings indicate that the conclusion made in recent work that decision making under risk is unaltered in OCD is premature. Copyright © 2017 Elsevier Ltd. All rights reserved.

Economic analysis of continuous antibiotic prophylaxis for prevention of urinary tract infections in infants with high-grade hydronephrosis.

PubMed

Tu, H Y V; Pemberton, J; Lorenzo, A J; Braga, L H

2015-10-01

For infants with hydronephrosis, continuous antibiotic prophylaxis (CAP) may reduce urinary tract infections (UTIs); however, its value remains controversial. Recent studies have suggested that neonates with severe obstructive hydronephrosis are at an increased risk of UTIs, and support the use of CAP. Other studies have demonstrated the negligible risk for UTIs in the setting of suspected ureteropelvic junction obstruction and have highlighted the limited role of CAP in hydronephrosis. Furthermore, economic studies in this patient population have been sparse. This study aimed to evaluate whether the use of CAP is an efficient expenditure for preventing UTIs in children with high-grade hydronephrosis within the first 2 years of life. A decision model was used to estimate expected costs, clinical outcomes and quality-adjusted life years (QALYs) of CAP versus no CAP (Fig. 1). Cost data were collected from provincial databases and converted to 2013 Canadian dollars (CAD). Estimates of risks and health utility values were extracted from published literature. The analysis was performed over a time horizon of 2 years. One-way and probabilistic sensitivity analyses were carried out to assess uncertainty and robustness. Overall, CAP use was less costly and provided a minimal increase in health utility when compared to no CAP (Table). The mean cost over two years for CAP and no CAP was CAD$1571.19 and CAD$1956.44, respectively. The use of CAP reduced outpatient-managed UTIs by 0.21 infections and UTIs requiring hospitalization by 0.04 infections over 2 years. Cost-utility analysis revealed an increase of 0.0001 QALYs/year when using CAP. The CAP arm exhibited strong dominance over no CAP in all sensitivity analyses and across all willingness-to-pay thresholds. The use of CAP exhibited strong dominance in the economic evaluation, despite a small gain of 0.0001 QALYs/year. Whether this slight gain is clinically significant remains to be determined. However, small QALY gains have been reported in other pediatric economic evaluations. Strengths of this study included the use of data from a recent systematic review and meta-analysis, in addition to a comprehensive probabilistic sensitivity analysis. Limitations of this study included the use of estimates for UTI probabilities in the second year of life and health utility values, given that they were lacking in the literature. Spontaneous resolution of hydronephrosis and surgical management were also not implemented in this model. To prevent UTIs within the first 2 years of life in infants with high-grade hydronephrosis, this probabilistic model has shown that CAP use is a prudent expenditure of healthcare resources when compared to no CAP. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Assessing climate change and socio-economic uncertainties in long term management of water resources

NASA Astrophysics Data System (ADS)

Jahanshahi, Golnaz; Dawson, Richard; Walsh, Claire; Birkinshaw, Stephen; Glenis, Vassilis

2015-04-01

Long term management of water resources is challenging for decision makers given the range of uncertainties that exist. Such uncertainties are a function of long term drivers of change, such as climate, environmental loadings, demography, land use and other socio economic drivers. Impacts of climate change on frequency of extreme events such as drought make it a serious threat to water resources and water security. The release of probabilistic climate information, such as the UKCP09 scenarios, provides improved understanding of some uncertainties in climate models. This has motivated a more rigorous approach to dealing with other uncertainties in order to understand the sensitivity of investment decisions to future uncertainty and identify adaptation options that are as far as possible robust. We have developed and coupled a system of models that includes a weather generator, simulations of catchment hydrology, demand for water and the water resource system. This integrated model has been applied in the Thames catchment which supplies the city of London, UK. This region is one of the driest in the UK and hence sensitive to water availability. In addition, it is one of the fastest growing parts of the UK and plays an important economic role. Key uncertainties in long term water resources in the Thames catchment, many of which result from earth system processes, are identified and quantified. The implications of these uncertainties are explored using a combination of uncertainty analysis and sensitivity testing. The analysis shows considerable uncertainty in future rainfall, river flow and consequently water resource. For example, results indicate that by the 2050s, low flow (Q95) in the Thames catchment will range from -44 to +9% compared with the control scenario (1970s). Consequently, by the 2050s the average number of drought days are expected to increase 4-6 times relative to the 1970s. Uncertainties associated with urban growth increase these risks further. Adaptation measures, such as new reservoirs can manage these risks to a certain extent, but our sensitivity testing demonstrates that they are less robust to future uncertainties than measures taken to reduce water demand. Keywords: Climate change, Uncertainty, Decision making, Drought, Risk, Water resources management.

Analysis of hydrogen as a Transportation Fuel FY17 Report

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

Pratt, Richard M.; Luzi, Francesco; Wilcox Freeburg, Eric D.

This report summarizes the results of literature reviews, surveys and analyses performed to evaluate the potential of hydrogen-fueled vehicles to be an economically viable transportation alternative. Five existing and important drivers of expanding hydrogen-fueled transportation adoption are multi-billion dollar sales reservations of Nikola Class 8 trucks, CALSTART viability analysis of hybrid-hydrogen drayage trucks in the shipyard cargo application, analysis showing economic advantages of Fuel Cell Electric Vehicles (FCEV)s over Battery Electric Vehicles (BEV)s beginning at 150-mile ranges, the announcement of a commercial 5kg electrolyzer, and commercial plans or vehicle availability by nine vehicle manufacturers of FCEV passenger vehicles. But hydrogenmore » infrastructure availability needed to support broad adoption of hydrogen-fueled vehicles is limited to less than 50 publicly-available refueling stations, primarily in California. The demand side (consumer) economics associated with FCEV adoption showed strong economic sensitivity to the original vehicle’s fuel economy (mpg), distance traveled, and hydrogen (H2) generation costs. Seven use cases were used to evaluate the broad range of potential FCEV purchasers, including autonomous vehicle applications. Each consumer use case analysis resulted in a different hydrogen fuel cost that would be equivalent to the current fuel cost being paid by the consumer. The H2 generation costs (supply side) were sensitive to the volume of H2 supplied and H2 production costs needed to repay H2 supply facility capital costs and produce competitively-priced energy. H2FAST was used to more accurately incorporate capital, maintenance and production costs into a viable H2 supply cost to the consumer. When the H2 generation and consumer economics were combined, several applications with positive economics became clear. The availability of low-cost hydrogen pipeline connections, and therefore low-cost hydrogen, greatly benefits the California drayage truck application with hybrid-hydrogen retrofits being repaid within seven years. Class 8 trucks could also take advantage of these low-cost, but regional hydrogen supplies. In addition, the IVYS electrolyzer-based hydrogen generation product showed the potential to deliver hydrogen economically in an urban or freeway off-ramp setting to a limited number of passenger vehicles in areas with low-cost electricity. These positive, manually developed results show the need to develop more advanced tools to provide an expanded evaluation of the economics of hydrogen-based fuel applications. The use cases evaluated showed significant potential for hydrogen-fueled vehicles to have a sustainable impact as a transportation fuel. The positive impact is not limited to transportation fuels, but also grid resilience and flexibility through the use of controllable and variable electrolyzer output to rapidly adjust to changing grid conditions and enable greater integration of solar and wind generated power. This capability would directly enable alternative fuel vehicles to impact energy consumption, GHG emissions, and the economy at the regional and national levels.« less

Cognitive capital, equity and child-sensitive social protection in Asia and the Pacific.

PubMed

Samson, Michael; Fajth, Gaspar; François, Daphne

2016-01-01

Promoting child development and welfare delivers human rights and builds sustainable economies through investment in 'cognitive capital'. This analysis looks at conditions that support optimal brain development in childhood and highlights how social protection promotes these conditions and strengthens the achievement of the Sustainable Development Goals (SDGs) in Asia and the Pacific. Embracing child-sensitive social protection offers multiple benefits. The region has been a leader in global poverty reduction but the underlying pattern of economic growth exacerbates inequality and is increasingly unsustainable. The strategy of channelling low-skilled rural labour to industrial jobs left millions of children behind with limited opportunities for development. Building child-sensitive social protection and investing better in children's cognitive capacity could check these trends and trigger powerful long-term human capital development-enabling labour productivity to grow faster than populations age. While governments are investing more in social protection, the region's spending remains low by international comparison. Investment is particularly inadequate where it yields the highest returns: during the first 1000 days of life. Five steps are recommended for moving forward: (1) building cognitive capital by adjusting the region's development paradigms to reflect better the economic and social returns from investing in children; (2) understand and track better child poverty and vulnerability; (3) progressively build universal, child-sensitive systems that strengthen comprehensive interventions within life cycle frameworks; (4) mobilise national resources for early childhood investments and child-sensitive social protection; and (5) leverage the SDGs and other channels of national and international collaboration.

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees.

PubMed

Rivière, Julie; Le Strat, Yann; Hendrikx, Pascal; Dufour, Barbara

2017-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in terms of coordination, sample collection and laboratory analysis.

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees

PubMed Central

2017-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in terms of coordination, sample collection and laboratory analysis. PMID:28800642

The worth of data in predicting aquitard continuity in hydrogeological design

NASA Astrophysics Data System (ADS)

James, Bruce R.; Freeze, R. Allan

1993-07-01

A Bayesian decision framework is developed for addressing questions of hydrogeological data worth associated with engineering design at sites in heterogeneous geological environments. The specific case investigated is one of remedial contaminant containment in an aquifer underlain by an aquitard of uncertain continuity. The framework is used to evaluate the worth of hard and soft data in investigating the aquitard's continuity. The analysis consists of four modules: (1) an aquitard realization generator based on indicator kriging, (2) a procedure for the Bayesian updating of the uncertainty with respect to aquitard windows, (3) a Monte Carlo simulation model for advective contaminant transport, and (4) an economic decision model. A sensitivity analysis for a generic design example involving a design decision between a no-action alternative and a containment alternative indicates that the data worth of a single borehole providing a hard point datum was more sensitive to economic parameters than to hydrogeological or geostatistical parameters. For this case, data worth is very sensitive to the projected cost of containment, the discount rate, and the estimated cost of failure. When it comes to hydrogeological parameters, such as the representative hydraulic conductivity of the aquitard or underlying aquifer, the sensitivity analysis indicates that it is more important to know whether the field value is above or below some threshold value than it is to know its actual numerical value. A good conceptual understanding of the site geology is important in estimating prior uncertainties. The framework was applied in a retrospective fashion to the design of a remediation program for soil contaminated by radioactive waste disposal at the Savannah River site in South Carolina. The cost-effectiveness of different patterns of boreholes was studied. A contour map is presented for the net expected value of sample information (EVSI) for a single borehole. The net EVSI of patterns of precise point measurements is also compared to that of an imprecise seismic survey.

Cost of Behavioral Interventions Utilizing Electronic Drug Monitoring for Antiretroviral Therapy Adherence

PubMed Central

Rasu, Rafia S.; Malewski, David F.; Banderas, Julie W.; Thomson, Domonique Malomo; Goggin, Kathy

2013-01-01

Objective To provide data on the actual costs associated with behavioral ART adherence interventions and electronic drug monitoring used in a clinical trial to inform their implementation in future studies and real-world practice. Methods Direct and time costs were calculated from a multi-site three-arm randomized controlled ART adherence trial. HIV positive participants (n = 204) were randomized to standard care (SC), enhanced counseling (EC), or EC and modified directly observed therapy (mDOT) interventions. Electronic drug monitoring (EDM) was used. Costs were calculated for various components of the 24-week adherence intervention. This economic evaluation was conducted from the perspective of an agency that may wish to implement these strategies. Sensitivity analyses were conducted to examine costs and savings associated with different scenarios. Results Total direct costs were $126,068 ($618/patient). Initial time costs were $53,590 ($262/patient). Base cost of labor was $0.36/minute. EC costs for 134 patients were $18,427 ($137/patient) and mDOT for 64 patients cost $18,638 ($291/patient). Total per patient costs were: SC=$880, EC=$1,018, EC/mDOT=$1,309. Removing driving costs evidenced the most variable impact on savings between the three study arms. The tornado diagram (sensitivity analysis) showed a graphical representation of how each sensitivity assumption reduced costs compared to each other and the resulting comparative costs for each group. Conclusion This novel economic analysis provides valuable cost information to guide treatment implementation and research design decisions. PMID:23337364

Economic implications of three strategies for the control of taeniasis.

PubMed

Alexander, Anu; John, K R; Jayaraman, T; Oommen, Anna; Venkata Raghava, M; Dorny, Pierre; Rajshekhar, Vedantam

2011-11-01

To evaluate the cost-effectiveness of three strategies for the control of taeniasis in a community, in terms of cost per case treated. A study was conducted in South India to determine the prevalence of taeniasis by screening stool samples from 653 randomly chosen subjects, for coproantigens. The costs incurred in the project were used to estimate the cost per case screened and treated. A one-way sensitivity analysis was carried out for varying rates of taeniasis, different screening strategies and mass therapy. Further sensitivity analysis was carried out with different manpower and test costs. The rate of taeniasis as detected by ELISA for coproantigen was 3 per 1000 (2 of 653 samples). Our study showed that mass therapy without screening for taeniasis would be the most economical strategy in terms of cost per case treated if field workers are employed exclusively for either mass therapy or screening. For each strategy, costs per case treated are higher at low prevalence of taeniasis, with a sharp rise below 15%. In places that are endemic for taeniasis and neurocysticercosis, mass therapy or screening for taeniasis should be considered. Screening by stool microscopy is not cost-effective in terms of cost per case of taeniasis treated owing to its low sensitivity. Although the cost per case of taeniasis treated is high at low prevalence of taeniasis for all options, incorporating mass therapy into existing mass drug distribution programmes might prove to be the most cost-effective control strategy. © 2011 Blackwell Publishing Ltd.

Cost-effectiveness analysis of rotavirus vaccination among Libyan children using a simple economic model

PubMed Central

Alkoshi, Salem; Maimaiti, Namaitijiang; Dahlui, Maznah

2014-01-01

Background Rotavirus infection is a major cause of childhood diarrhea in Libya. The objective of this study is to evaluate the cost-effectiveness of rotavirus vaccination in that country. Methods We used a published decision tree model that has been adapted to the Libyan situation to analyze a birth cohort of 160,000 children. The evaluation of diarrhea events in three public hospitals helped to estimate the rotavirus burden. The economic analysis was done from two perspectives: health care provider and societal. Univariate sensitivity analyses were conducted to assess uncertainty in some values of the variables selected. Results The three hospitals received 545 diarrhea patients aged≤5 with 311 (57%) rotavirus positive test results during a 9-month period. The societal cost for treatment of a case of rotavirus diarrhea was estimated at US$ 661/event. The incremental cost-effectiveness ratio with a vaccine price of US$ 27 per course was US$ 8,972 per quality-adjusted life year gained from the health care perspective. From a societal perspective, the analysis shows cost savings of around US$ 16 per child. Conclusion The model shows that rotavirus vaccination could be economically a very attractive intervention in Libya. PMID:25499622

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation.

PubMed

Edwards, Steven J; Karner, Charlotta; Trevor, Nicola; Wakefield, Victoria; Salih, Fatima

2015-08-01

Bradycardia [resting heart rate below 60 beats per minute (b.p.m.)] can be caused by conditions affecting the natural pacemakers of the heart, such as sick sinus syndrome (SSS) and atrioventricular (AV) blocks. People suffering from bradycardia may present with palpitations, exercise intolerance and fainting. The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker. To appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block. All databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment database, NHS Economic Evaluations Database) were searched from inception to June 2014. A systematic review of the clinical and economic literature was carried out in accordance with the general principles published by the Centre for Reviews and Dissemination. Randomised controlled trials (RCTs) evaluating dual-chamber and single-chamber atrial pacemakers and economic evaluations were included. Pairwise meta-analysis was carried out. A de novo economic model was developed. Of 493 references, six RCTs were included in the review. The results were predominantly influenced by the largest trial DANPACE. Dual-chamber pacing was associated with a statistically significant reduction in reoperation [odds ratio (OR) 0.48, 95% confidence interval (CI) 0.36 to 0.63] compared with single-chamber atrial pacing. The difference is primarily because of the development of AV block requiring upgrade to a dual-chamber device. The risk of paroxysmal atrial fibrillation was also reduced with dual-chamber pacing compared with single-chamber atrial pacing (OR 0.75, 95% CI 0.59 to 0.96). No statistically significant difference was found between the pacing modes for mortality, heart failure, stroke, chronic atrial fibrillation or quality of life. However, the risk of developing heart failure may vary with age and device. The de novo economic model shows that dual-chamber pacemakers are more expensive and more effective than single-chamber atrial devices, resulting in a base-case incremental cost-effectiveness ratio (ICER) of £6506. The ICER remains below £20,000 in probabilistic sensitivity analysis, structural sensitivity analysis and most scenario analyses and one-way sensitivity analyses. The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers. Results from an analysis based on age (> 75 years or ≤ 75 years) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers (i.e. are less expensive and more effective) in older patients, whereas dual-chamber pacemakers are dominated by (i.e. more expensive and less effective) single-chamber atrial pacemakers in younger patients. However, these results are based on a subgroup analysis and should be treated with caution. In patients with SSS without evidence of impaired AV conduction, dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers. The risk of developing a complete AV block and the lack of tools to identify patients at high risk of developing the condition argue for the implantation of a dual-chamber pacemaker programmed to minimise unnecessary ventricular pacing. However, considerations have to be made around the risk of developing heart failure, which may depend on age and device. This study is registered as PROSPERO CRD42013006708. The National Institute for Health Research Health Technology Assessment programme.

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.

Placental growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis.

PubMed

Frampton, Geoff K; Jones, Jeremy; Rose, Micah; Payne, Liz

2016-11-01

Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing. To evaluate the diagnostic accuracy and cost-effectiveness of PlGF-based tests for patients referred to secondary care with suspected PE in weeks 20-37 of pregnancy. Systematic reviews and an economic analysis. Bibliographic databases including MEDLINE, EMBASE, Web of Science and The Cochrane Library and Database of Abstracts of Reviews of Effects were searched up to July 2015 for English-language references. Conferences, websites, systematic reviews and confidential company submissions were also accessed. Systematic reviews of test accuracy and economic studies were conducted to inform an economic analysis. Test accuracy studies were required to include women with suspected PE and report quantitatively the accuracy of PlGF-based tests; their risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria. The economic studies review had broad eligibility criteria to capture any types of economic analysis; critical appraisal employed standard checklists consistent with National Institute for Health and Care Excellence criteria. Study selection, critical appraisal and data extraction in both reviews were performed by two reviewers. An independent economic analysis was conducted based on a decision tree model, using the best evidence available. The model evaluates costs (2014, GBP) from a NHS and Personal Social Services perspective. Given the short analysis time horizon, no discounting was undertaken. Four studies were included in the systematic review of test accuracy: two on Alere's Triage ® PlGF test (Alere, Inc., San Diego, CA, USA) for predicting PE requiring delivery within a specified time and two on Roche Diagnostics' Elecsys ® sFlt-1 to PlGF ratio test (Roche Diagnostics GmbH, Mannheim, Germany) for predicting PE within a specified time. Three studies were included in the systematic review of economic studies, and two confidential company economic analyses were assessed separately. Study heterogeneity precluded meta-analyses of test accuracy or cost-analysis outcomes, so narrative syntheses were conducted to inform the independent economic model. The model predicts that, when supplementing routine clinical assessment for rule-out and rule-in of PE, the two tests would be cost-saving in weeks 20-35 of gestation, and marginally cost-saving in weeks 35-37, but with minuscule impact on quality of life. Length of neonatal intensive care unit stay was the most influential parameter in sensitivity analyses. All other sensitivity analyses had negligible effects on results. No head-to-head comparisons of the tests were identified. No studies investigated accuracy of PlGF-based tests when used as a replacement for proteinuria testing. Test accuracy studies were found to be at high risk of clinical review bias. The Triage and Elecsys tests would save money if added to routine clinical assessment for PE. The magnitude of savings is uncertain, but the tests remain cost-saving under worst-case assumptions. Further research is required to clarify how the test results would be interpreted and applied in clinical practice. This study is registered as PROSPERO CRD42015017670. The National Institute for Health Research Health Technology Assessment programme.

Analysis of the design and economics of molten carbonate fuel cell tri-generation systems providing heat and power for commercial buildings and H2 for FC vehicles

NASA Astrophysics Data System (ADS)

Li, Xuping; Ogden, Joan; Yang, Christopher

2013-11-01

This study models the operation of molten carbonate fuel cell (MCFC) tri-generation systems for “big box” store businesses that combine grocery and retail business, and sometimes gasoline retail. Efficiency accounting methods and parameters for MCFC tri-generation systems have been developed. Interdisciplinary analysis and an engineering/economic model were applied for evaluating the technical, economic, and environmental performance of distributed MCFC tri-generation systems, and for exploring the optimal system design. Model results show that tri-generation is economically competitive with the conventional system, in which the stores purchase grid electricity and NG for heat, and sell gasoline fuel. The results are robust based on sensitivity analysis considering the uncertainty in energy prices and capital cost. Varying system sizes with base case engineering inputs, energy prices, and cost assumptions, it is found that there is a clear tradeoff between the portion of electricity demand covered and the capital cost increase of bigger system size. MCFC Tri-generation technology provides lower emission electricity, heat, and H2 fuel. With NG as feedstock the CO2 emission can be reduced by 10%-43.6%, depending on how the grid electricity is generated. With renewable methane as feedstock CO2 emission can be further reduced to near zero.

Economic analysis of uricase production under uncertainty: Contrast of chromatographic purification and aqueous two-phase extraction (with and without PEG recycle).

PubMed

Torres-Acosta, Mario A; Aguilar-Yáñez, José M; Rito-Palomares, Marco; Titchener-Hooker, Nigel J

2016-01-01

Uricase is the enzyme responsible for the breakdown of uric acid, the key molecule leading to gout in humans, into allantoin, but it is absent in humans. It has been produced as a PEGylated pharmaceutical where the purification is performed through three sequential chromatographic columns. More recently an aqueous two-phase system (ATPS) was reported that could recover Uricase with high yield and purity. Although the use of ATPS can decrease cost and time, it also generates a large amount of waste. The ability, therefore, to recycle key components of ATPS is of interest. Economic modelling is a powerful tool that allows the bioprocess engineer to compare possible outcomes and find areas where further research or optimization might be required without recourse to extensive experiments and time. This research provides an economic analysis using the commercial software BioSolve of the strategies for Uricase production: chromatographic and ATPS, and includes a third bioprocess that uses material recycling. The key parameters that affect the process the most were located via a sensitivity analysis and evaluated with a Monte Carlo analysis. Results show that ATPS is far less expensive than chromatography, but that there is an area where the cost of production of both bioprocesses overlap. Furthermore, recycling does not impact the cost of production. This study serves to provide a framework for the economic analysis of Uricase production using alternative techniques. © 2015 The Authors Biotechnology Progress published by Wiley Periodicals, Inc. on behalf of American Institute of Chemical Engineers.

Economic analysis of uricase production under uncertainty: Contrast of chromatographic purification and aqueous two‐phase extraction (with and without PEG recycle)

PubMed Central

Torres‐Acosta, Mario A.; Aguilar‐Yáñez, José M.; Rito‐Palomares, Marco

2015-01-01

Uricase is the enzyme responsible for the breakdown of uric acid, the key molecule leading to gout in humans, into allantoin, but it is absent in humans. It has been produced as a PEGylated pharmaceutical where the purification is performed through three sequential chromatographic columns. More recently an aqueous two‐phase system (ATPS) was reported that could recover Uricase with high yield and purity. Although the use of ATPS can decrease cost and time, it also generates a large amount of waste. The ability, therefore, to recycle key components of ATPS is of interest. Economic modelling is a powerful tool that allows the bioprocess engineer to compare possible outcomes and find areas where further research or optimization might be required without recourse to extensive experiments and time. This research provides an economic analysis using the commercial software BioSolve of the strategies for Uricase production: chromatographic and ATPS, and includes a third bioprocess that uses material recycling. The key parameters that affect the process the most were located via a sensitivity analysis and evaluated with a Monte Carlo analysis. Results show that ATPS is far less expensive than chromatography, but that there is an area where the cost of production of both bioprocesses overlap. Furthermore, recycling does not impact the cost of production. This study serves to provide a framework for the economic analysis of Uricase production using alternative techniques. © 2015 American Institute of Chemical Engineers Biotechnol. Prog., 32:126–133, 2016 PMID:26561271

An analysis of the influence of framework aspects on the study design of health economic modeling evaluations.

PubMed

Gurtner, Sebastian

2013-04-01

Research and practical guidelines have many implications for how to structure a health economic study. A major focus in recent decades has been the quality of health economic research. In practice, the factors influencing a study design are not limited to the quest for quality. Moreover, the framework of the study is important. This research addresses three major questions related to these framework aspects. First, we want to know whether the design of health economic studies has changed over time. Second, we want to know how the subject of a study, whether it is a process or product innovation, influences the parameters of the study design. Third, one of the most important questions we will answer is whether and how the study's source of funding has an impact on the design of the research. To answer these questions, a total of 234 health economic studies were analyzed using a correspondence analysis and a logistic regression analysis. All three categories of framework factors have an influence on the aspects of the study design. Health economic studies have evolved over time, leading to the use of more advanced methods like complex sensitivity analyses. Additionally, the patient's point of view has increased in importance. The evaluation of product innovations has focused more on utility concepts. On the other hand, the source of funding may influence only a few aspects of the study design, such as the use of evaluation methods, the source of data, and the use of certain utility measures. The most important trends in health care, such as the emphasis on the patients' point of view, become increasingly established in health economic evaluations with the passage of time. Although methodological challenges remain, modern information and communication technologies provide a basis for increasing the complexity and quality of health economic studies if used frequently.

Can economic deprivation protect health? Paradoxical multilevel effects of poverty on Hispanic children's wheezing.

PubMed

Collins, Timothy W; Kim, Young-an; Grineski, Sara E; Clark-Reyna, Stephanie

2014-08-06

Prior research suggests that economic deprivation has a generally negative influence on residents' health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children's current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor's asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children's wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health.

Can Economic Deprivation Protect Health? Paradoxical Multilevel Effects of Poverty on Hispanic Children’s Wheezing

PubMed Central

Collins, Timothy W.; Kim, Young-an; Grineski, Sara E.; Clark-Reyna, Stephanie

2014-01-01

Prior research suggests that economic deprivation has a generally negative influence on residents’ health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children’s current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor’s asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children’s wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health. PMID:25101769

Economic Context and HIV Vulnerability in Adolescents and Young Adults Living in Urban Slums in Kenya: A Qualitative Analysis Based on Scarcity Theory.

PubMed

Jennings, Larissa; Mathai, Muthoni; Linnemayr, Sebastian; Trujillo, Antonio; Mak'anyengo, Margaret; Montgomery, Brooke E E; Kerrigan, Deanna L

2017-09-01

Urban slum adolescents and young adults have disproportionately high rates of HIV compared to rural and non-slum urban youth. Yet, few studies have examined youth's perceptions of the economic drivers of HIV. Informed by traditional and behavioral economics, we applied a scarcity theoretical framework to qualitatively examine how poverty influences sexual risk behaviors among adolescents and young adults. Focus group discussions with one hundred twenty youth in Kenyan's urban slums were transcribed, coded, and analyzed using interpretive phenomenology. Results indicated that slum youth made many sexual decisions considered rational from a traditional economics perspective, such as acquiring more sex when resources were available, maximizing wealth through sex, being price-sensitive to costs of condoms or testing services, and taking more risks when protected from adverse sexual consequences. Youth's engagement in sexual risk behaviors was also motivated by scarcity phenomena explained by behavioral economics, such as compensating for sex lost during scarce periods (risk-seeking), valuing economic gains over HIV risks (tunneling, bandwidth tax), and transacting sex as an investment strategy (internal referencing). When scarcity was alleviated, young women additionally described reducing the number of sex partners to account for non-economic preferences (slack). Prevention strategies should address the traditional and behavioral economics of the HIV epidemic.

Economic viability of access broadband multiservice networks

NASA Astrophysics Data System (ADS)

Castelli, Francesco; Dammicco, Giacinto; Mocci, Ugo

1995-02-01

In this paper the economic viability of alternative architectures for optical access networks providing broad band services to different subscriber classes in a metropolitan environment, is investigated by a specific tool, NEVE (Network Economic Viability Evaluator), developed for broad band multiservice network planning, service evolutionary scenarios assessment, evaluation of tariff strategies and other actions taken at stimulating the demand growth. As the viability target can be achieved in different ways, different studies can be carried out by NEVE. In the paper some of them are discussed, particularly the ones addressed: to evaluate the impact on viability of alternative service scenarios; to determine the critical mass of broad band subscribers and the critical joint service adoption cost; to evaluate cross subsidiary policies among different subscriber classes and services; to perform sensitivity analysis with respect to variations of demand parameters and tariffs.

Probabilistic economic frameworks for disaster risk management

NASA Astrophysics Data System (ADS)

Dulac, Guillaume; Forni, Marc

2013-04-01

Starting from the general concept of risk, we set up an economic analysis framework for Disaster Risk Management (DRM) investment. It builds on uncertainty management techniques - notably Monte Carlo simulations - and includes both a risk and performance metrics adapted to recurring issues in disaster risk management as entertained by governments and international organisations. This type of framework proves to be enlightening in several regards, and is thought to ease the promotion of DRM projects as "investments" rather than "costs to be born" and allow for meaningful comparison between DRM and other sectors. We then look at the specificities of disaster risk investments of medium to large scales through this framework, where some "invariants" can be identified, notably: (i) it makes more sense to perform analysis over long-term horizons -space and time scales are somewhat linked; (ii) profiling of the fluctuations of the gains and losses of DRM investments over long periods requires the ability to handle possibly highly volatile variables; (iii) complexity increases with the scale which results in a higher sensitivity of the analytic framework on the results; (iv) as the perimeter of analysis (time, theme and space-wise) is widened, intrinsic parameters of the project tend to weight lighter. This puts DRM in a very different perspective from traditional modelling, which usually builds on more intrinsic features of the disaster as it relates to the scientific knowledge about hazard(s). As models hardly accommodate for such complexity or "data entropy" (they require highly structured inputs), there is a need for a complementary approach to understand risk at global scale. The proposed framework suggests opting for flexible ad hoc modelling of specific issues consistent with one's objective, risk and performance metrics. Such tailored solutions are strongly context-dependant (time and budget, sensitivity of the studied variable in the economic framework) and can range from simple elicitation of data from a subject matter expert to calibrate a probability distribution to more advanced stochastic modelling. This approach can be referred to more as a proficiency in the language of uncertainty rather than modelling per se in the sense that it allows for greater flexibility to adapt a given context. In a real decision making context, one seldom has neither time nor budget resources to investigate all of these variables thoroughly, hence the importance of being able to prioritize the level of effort among them. Under the proposed framework, this can be done in an optimised fashion. The point here consists in applying probabilistic sensitivity analysis together with the fundamentals of the economic value of information; the framework as built is well suited to such considerations, and variables can be ranked according to their contribution to risk understanding. Efforts to deal with second order uncertainties on variables prove to be valuable when dealing with the economic value of sample information.

Is FDG PET/CT cost-effective for pre-operation staging of potentially operative non-small cell lung cancer? - From Chinese healthcare system perspective.

PubMed

Wang, Yu-ting; Huang, Gang

2012-08-01

The remarkable morbidity and mortality of lung cancer in the large population address major economic challenges to Chinese healthcare system. This study aims to assess the cost-effectiveness of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for staging patients with non-small cell lung cancer (NSCLC) in China. Management of potentially operative NSCLC was modeled on decision analysis employing data in China. The strategies compared were conventional CT staging (strategy A), additional PET/CT in all patients (strategy B) or only in patients with normal-sized lymph nodes on CT (strategy C). Published medical data for Chinese patients was extracted. The costs corresponded to reimbursement by Chinese public health provider in 2010. Uncertainly of employed parameters was calculated in sensitivity analysis. Taking strategy A as baseline, the incremental cost-effectiveness ratio (ICER) of strategy B was 23,800RMB ($3500) per life year saved, which was acceptable in views of a developing country as China; while strategy C exhibited some loss of life years. Sensitivity analysis suggested the ICER (B-A) was raised more remarkably by a deterioration of PET specificity than by that of its sensitivity. The ICER was turned negative by PET specificity lower than 0.79. Economically, PET cost was proportional to the ICER (B-A), and decrease of palliative therapy cost could reduce both the ICER and overall cost. The PET/CT strategy is potentially cost-effective for management of NSCLC in China. Patients with nodal-positive CT results are not suggested to be excluded from further PET/CT. Furthermore, maintaining high specificity of PET in clinical scenarios is crucial. Prospective trials are warranted to transfer these results into policy making. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Economic Impact of Closed-Incision Negative-Pressure Therapy in High-Risk Abdominal Incisions: A Cost-Utility Analysis.

PubMed

Chopra, Karan; Gowda, Arvind U; Morrow, Chris; Holton, Luther; Singh, Devinder P

2016-04-01

Complex abdominal wall reconstruction is beset by postoperative complications. A recent meta-analysis comparing the use of closed-incision negative-pressure therapy to standard dressings found a statistically significant reduction in surgical-site infection. The use of closed-incision negative-pressure therapy is gaining acceptance in this population; however, the economic impact of this innovative dressing remains unknown. In this study, a cost-utility analysis was performed assessing closed-incision negative-pressure therapy and standard dressings following closure of abdominal incisions in high-risk patients. Cost-utility methodology involved reviewing literature related to closed-incision negative-pressure therapy in abdominal wall surgery, obtaining utility estimates to calculate quality-adjusted life-year scores for successful surgery and surgery complicated by surgical-site infection, summing costs using Medicare Current Procedural Terminology codes, and creating a decision tree illuminating the most cost-effective dressing strategy. One-way sensitivity analysis was performed to assess the robustness of the results. The aforementioned meta-analysis comparing closed-incision negative-pressure therapy to standard dressings included a subset of five studies assessing abdominal wall surgery in 829 patients (260 closed-incision negative-pressure therapy and 569 standard dressings). Decision tree analysis revealed an estimated savings of $1546.52 and a gain of 0.0024 quality-adjusted life-year with closed-incision negative-pressure therapy compared with standard dressings; therefore, closed-incision negative-pressure therapy is a dominant treatment strategy. One-way sensitivity analysis revealed that closed-incision negative-pressure therapy is a cost-effective option when the surgical-site infection rate is greater than 16.39 percent. The use of closed-incision negative-pressure therapy is cost-saving following closure of abdominal incisions in high-risk patients.

Cost-effectiveness analysis of antimuscarinics in the treatment of patients with overactive bladder in Spain: A decision-tree model

PubMed Central

2011-01-01

Background Fesoterodine, a new once daily antimuscarinic, has proven to be an effective, safe, and well-tolerated treatment in patients with overactive bladder (OAB). To date, no analysis has evaluated the economic costs and benefits associated with fesoterodine, compared to antimuscarinics in Spain. The purpose of this analysis was to assess the economic value of OAB treatment with fesoterodine relative to extended release tolterodine and solifenacin, from the societal perspective. Methods The economic model was based on data from two 12-week, randomized, double-blind, and multicenter trials comparing fesoterodine and tolterodine extended released (ER). Treatment response rates for solifenacin were extracted from the published literature. Discontinuation and efficacy were based on the results of a 12-week multinational randomized clinical trial extrapolated to 52 weeks. Changes in health related quality of life were assessed with the King's Health Questionnaire, which was transformed into preference-based utility values. Medical costs included (expressed in € 2010) were antimuscarinics, physician visits, laboratory tests, incontinence pads and the costs of OAB-related comorbidities, fractures, skin infections, urinary tract infections, depression, and nursing home admissions associated with incontinence. Time lost from work was also considered. Univariate sensitivity analyses were also performed. Results At week 12, continents accounted for 50.6%, 40.6% and 47.2% of patients in the fesoterodine, tolterodine, and solifenacin groups, respectively. By week 52, the projected proportions of patients remaining on therapy were 33.1%, 26.5% and 30.8%, respectively. The projected quality- adjusted life years (QALY) gain (compared to baseline) over the 52-week simulation period were 0.01014, 0.00846 and 0.00957, respectively. The overall treatment cost was estimated at €1,937, €2,089 and €1,960 for fesoterodine, tolterodine and solifenacin, respectively. Therefore, treatment with fesoterodine resulted in similar overall costs and greater QALY gain than treatment with either tolterodine or solifenacin. Sensitivity analysis showed that these results were robust to all changes performed. Conclusions The results of this economic analysis suggest that fesoterodine is a cost-effective alternative to tolterodine and solifenacin for the treatment of patients with OAB in Spain. Fesoterodine provides additional health benefits while maintain a similar level of costs being a cost-effective treatment strategy from a societal perspective. PMID:21599928

Impact of economic crisis on the social representation of mental health: Analysis of a decade of newspaper coverage.

PubMed

Dias Neto, David; Figueiras, Maria João; Campos, Sónia; Tavares, Patrícia

2017-12-01

Mass media plays a fundamental role in how communities understand mental health and its treatment. However, the effect of major events such as economic crises on the depiction of mental health is still unclear. This study aimed at analyzing representations of mental health and its treatment and the impact of the 2008 economic crisis. In total, 1,000 articles were randomly selected from two newspapers from a period before and after the economic crisis. These articles were analyzed with a closed coding system that classified the news as good or bad news according to the presence of themes associated with positive or stigmatizing representations. The results show a positive representation of mental health and a negative representation of treatment. Furthermore, the economic crisis had a negative impact on the representation of mental health, but not on treatment. These findings suggest that the representation of mental health is multifaceted and may be affected differently in its dimensions. There is a need for stigma-reducing interventions that both account for this complexity and are sensitive to context and period.

Cost minimization analysis for combinations of sampling techniques in bronchoscopy of endobronchial lesions.

PubMed

Roth, Kjetil; Hardie, Jon Andrew; Andreassen, Alf Henrik; Leh, Friedemann; Eagan, Tomas Mikal Lind

2009-06-01

The choice of sampling techniques in bronchoscopy with sampling from a visible lesion will depend on the expected diagnostic yields and the costs of the sampling techniques. The aim of this study was to determine the most economical combination of sampling techniques when approaching endobronchial visible lesions. A cost minimization analysis was performed. All bronchoscopies from 2003 and 2004 at Haukeland university hospital, Bergen, Norway, were reviewed retrospectively for diagnostic yields. 162 patients with endobronchial disease were included. Potential sampling techniques used were biopsy, brushing, endobronchial needle aspiration (EBNA) and washings. Costs were estimated based on registration of equipment costs and personnel costs. Sensitivity analyses were performed to determine threshold values. The combination of biopsy, brushing and EBNA was the most economical strategy with an average cost of Euro 893 (95% CI: 657, 1336). The cost of brushing had to be below Euro 83 and it had to increase the diagnostic yield more than 2.2%, for biopsy and brushing to be more economical than biopsy alone. The combination of biopsy, brushing and EBNA was more economical than biopsy and brushing when the cost of EBNA was below Euro 205 and the increase in diagnostic yield was above 5.2%. In the current study setting, biopsy, brushing and EBNA was the most economical combination of sampling techniques for endobronchial visible lesions.

Techno-economic assessment of Levulinic Acid Plant from Sorghum Bicolor in Indonesia

NASA Astrophysics Data System (ADS)

Gozan, M.; Ryan, B.; Krisnandi, Y.

2018-04-01

The increasing need of energy is one of the main energy security issues in Indonesia. Hence, alternative energy is needed. Levulinic acid (LA) is among chemical platform used in the synthesis for avariety of high-value materials, such as fuels and commodity chemicals. It is predicted that global LA market demand to reach 3.1 tons in 2016. This study examines industrial processdesign and economic analysis for LA production in Indonesia.Sorghum bicolor was used as feed because of its high cellulose, low lignin contents and availability in Indonesia. The conventional economic problem from biomass based production was diminished sincethe valuable waste from pretreatment processwas sold to otherindustry.This plant was recommended to be built in an industrial estate area in Jawa Timur (East Java) province. Results from simulation using SuperPro Designer 9.0 was used for the techno-economic assessment.The plant assessment showed that the minimum production capacity was 7.7 ton per day to achieve an internal rate of return (IRR) and payback period (PBP) values of 19.61% and 3.93 years, respectively. Sensitivity analysis showed that product selling price was the most predominant factor for IRR, NPV, PBP and ROI. Raw material and water had low effects on those economic parameters. These values indicated that LA plant was feasible to be built in Indonesia.

An Assessment of the Regional and National Socio-Economic Impacts of the 2007 Rift Valley Fever Outbreak in Kenya

PubMed Central

Rich, Karl M.; Wanyoike, Francis

2010-01-01

Although Rift Valley fever (RVF) has significant impacts on human health and livestock production, it can also induce significant (and often overlooked) economic losses among various stakeholders in the marketing chain. This work assesses and quantifies the multi-dimensional socio-economic impacts of the 2007 RVF outbreak in Kenya based on a rapid assessment of livestock value chains in the northeast part of the country and a national macroeconomic analysis. Although study results show negative impacts among producers in terms of food insecurity and reductions in income, we also found significant losses among other downstream actors in the value chain, including livestock traders, slaughterhouses, casual laborers, and butchers, as well as other, non-agricultural sectors. The study highlights the need for greater sensitivity and analyses that address the multitude of economic losses resulting from an animal disease to better inform policy and decision making during animal health emergencies. PMID:20682906

Techno-economical study of biogas production improved by steam explosion pretreatment.

PubMed

Shafiei, Marzieh; Kabir, Maryam M; Zilouei, Hamid; Sárvári Horváth, Ilona; Karimi, Keikhosro

2013-11-01

Economic feasibility of steam explosion pretreatment for improvement of biogas production from wheat straw and paper tube residuals was investigated. The process was simulated by Aspen plus ®, and the economical feasibility of five different plant capacities was studied by Aspen Process Economic Analyzer. Total project investment of a plant using paper tube residuals or wheat straw was 63.9 or 61.8 million Euros, respectively. The manufacturing cost of raw biogas for these two feedstocks was calculated to 0.36 or 0.48 €/m(3) of methane, respectively. Applying steam explosion pretreatment resulted in 13% higher total capital investment while significantly improved the economy of the biogas plant and decreased the manufacturing cost of methane by 36%. The sensitivity analysis showed that 5% improvement in the methane yield and 20% decrease in the raw material price resulted in 5.5% and 8% decrease in the manufacturing cost of methane, respectively. Copyright © 2013 Elsevier Ltd. All rights reserved.

Development of a decision model for the techno-economic assessment of municipal solid waste utilization pathways.

PubMed

Khan, Md Mohib-Ul-Haque; Jain, Siddharth; Vaezi, Mahdi; Kumar, Amit

2016-02-01

Economic competitiveness is one of the key factors in making decisions towards the development of waste conversion facilities and devising a sustainable waste management strategy. The goal of this study is to develop a framework, as well as to develop and demonstrate a comprehensive techno-economic model to help county and municipal decision makers in establishing waste conversion facilities. The user-friendly data-intensive model, called the FUNdamental ENgineering PrinciplEs-based ModeL for Estimation of Cost of Energy and Fuels from MSW (FUNNEL-Cost-MSW), compares nine different waste management scenarios, including landfilling and composting, in terms of economic parameters such as gate fees and return on investment. In addition, a geographic information system (GIS) model was developed to determine suitable locations for waste conversion facilities and landfill sites based on integration of environmental, social, and economic factors. Finally, a case study on Parkland County and its surrounding counties in the province of Alberta, Canada, was conducted and a sensitivity analysis was performed to assess the influence of the key technical and economic parameters on the calculated results. Copyright © 2015 Elsevier Ltd. All rights reserved.

Systems Analysis Of Advanced Coal-Based Power Plants

NASA Technical Reports Server (NTRS)

Ferrall, Joseph F.; Jennings, Charles N.; Pappano, Alfred W.

1988-01-01

Report presents appraisal of integrated coal-gasification/fuel-cell power plants. Based on study comparing fuel-cell technologies with each other and with coal-based alternatives and recommends most promising ones for research and development. Evaluates capital cost, cost of electricity, fuel consumption, and conformance with environmental standards. Analyzes sensitivity of cost of electricity to changes in fuel cost, to economic assumptions, and to level of technology. Recommends further evaluation of integrated coal-gasification/fuel-cell integrated coal-gasification/combined-cycle, and pulverized-coal-fired plants. Concludes with appendixes detailing plant-performance models, subsystem-performance parameters, performance goals, cost bases, plant-cost data sheets, and plant sensitivity to fuel-cell performance.

The family model stress and maternal psychological symptoms: mediated pathways from economic hardship to parenting.

PubMed

Newland, Rebecca P; Crnic, Keith A; Cox, Martha J; Mills-Koonce, W Roger

2013-02-01

Although much of the extant research on low-income families has targeted parental depression as the predominant psychological response to economic hardship, the current study examined a range of maternal psychological symptoms that may mediate the relations between early economic pressure and later parenting behaviors. A family stress model was examined using data from 1,142 mothers living in 2 areas of high rural poverty, focusing on the infancy through toddlerhood period. Maternal questionnaires and observations of mother-child interactions were collected across 4 time points (6, 15, 24, and 36 months). Results from structural equation analyses indicated that early economic pressure was significantly related to a variety of symptoms (depression, hostility, anxiety, and somatization), but only depression and somatization were significantly related to decreased levels of sensitive, supportive parenting behaviors. In contrast, anxiety was positively associated with sensitive parenting. Depression and anxiety were both found to mediate the relations between economic pressure and sensitive parenting behaviors. Results further suggest that mothers did not experience change in objective economic hardship over time but did experience a small decrease in economic pressure. Discussion centers on the apparent indirect influence of early economic hardship on later psychological symptoms and parenting behaviors, as well as detailing the need for broader and more complex perspectives on maternal psychological responses that arise as a result of economic disadvantage. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The economics of motion perception and invariants of visual sensitivity.

PubMed

Gepshtein, Sergei; Tyukin, Ivan; Kubovy, Michael

2007-06-21

Neural systems face the challenge of optimizing their performance with limited resources, just as economic systems do. Here, we use tools of neoclassical economic theory to explore how a frugal visual system should use a limited number of neurons to optimize perception of motion. The theory prescribes that vision should allocate its resources to different conditions of stimulation according to the degree of balance between measurement uncertainties and stimulus uncertainties. We find that human vision approximately follows the optimal prescription. The equilibrium theory explains why human visual sensitivity is distributed the way it is and why qualitatively different regimes of apparent motion are observed at different speeds. The theory offers a new normative framework for understanding the mechanisms of visual sensitivity at the threshold of visibility and above the threshold and predicts large-scale changes in visual sensitivity in response to changes in the statistics of stimulation and system goals.

Cost-utility analysis of antiviral use under pandemic influenza using a novel approach - linking pharmacology, epidemiology and heath economics.

PubMed

Wu, D B C; Chaiyakunapruk, N; Pratoomsoot, C; Lee, K K C; Chong, H Y; Nelson, R E; Smith, P F; Kirkpatrick, C M; Kamal, M A; Nieforth, K; Dall, G; Toovey, S; Kong, D C M; Kamauu, A; Rayner, C R

2018-03-01

Simulation models are used widely in pharmacology, epidemiology and health economics (HEs). However, there have been no attempts to incorporate models from these disciplines into a single integrated model. Accordingly, we explored this linkage to evaluate the epidemiological and economic impact of oseltamivir dose optimisation in supporting pandemic influenza planning in the USA. An HE decision analytic model was linked to a pharmacokinetic/pharmacodynamics (PK/PD) - dynamic transmission model simulating the impact of pandemic influenza with low virulence and low transmissibility and, high virulence and high transmissibility. The cost-utility analysis was from the payer and societal perspectives, comparing oseltamivir 75 and 150 mg twice daily (BID) to no treatment over a 1-year time horizon. Model parameters were derived from published studies. Outcomes were measured as cost per quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to examine the integrated model's robustness. Under both pandemic scenarios, compared to no treatment, the use of oseltamivir 75 or 150 mg BID led to a significant reduction of influenza episodes and influenza-related deaths, translating to substantial savings of QALYs. Overall drug costs were offset by the reduction of both direct and indirect costs, making these two interventions cost-saving from both perspectives. The results were sensitive to the proportion of inpatient presentation at the emergency visit and patients' quality of life. Integrating PK/PD-EPI/HE models is achievable. Whilst further refinement of this novel linkage model to more closely mimic the reality is needed, the current study has generated useful insights to support influenza pandemic planning.

An Economic Evaluation of Food Safety Education Interventions: Estimates and Critical Data Gaps.

PubMed

Zan, Hua; Lambea, Maria; McDowell, Joyce; Scharff, Robert L

2017-08-01

The economic evaluation of food safety interventions is an important tool that practitioners and policy makers use to assess the efficacy of their efforts. These evaluations are built on models that are dependent on accurate estimation of numerous input variables. In many cases, however, there is no data available to determine input values and expert opinion is used to generate estimates. This study uses a benefit-cost analysis of the food safety component of the adult Expanded Food and Nutrition Education Program (EFNEP) in Ohio as a vehicle for demonstrating how results based on variable values that are not objectively determined may be sensitive to alternative assumptions. In particular, the focus here is on how reported behavioral change is translated into economic benefits. Current gaps in the literature make it impossible to know with certainty how many people are protected by the education (what are the spillover effects?), the length of time education remains effective, and the level of risk reduction from change in behavior. Based on EFNEP survey data, food safety education led 37.4% of participants to improve their food safety behaviors. Under reasonable default assumptions, benefits from this improvement significantly outweigh costs, yielding a benefit-cost ratio of between 6.2 and 10.0. Incorporation of a sensitivity analysis using alternative estimates yields a greater range of estimates (0.2 to 56.3), which highlights the importance of future research aimed at filling these research gaps. Nevertheless, most reasonable assumptions lead to estimates of benefits that justify their costs.

Economic Evaluation of Endoscopic Sinus Surgery versus Continued Medical Therapy for Refractory Chronic Rhinosinusitis

PubMed Central

Rudmik, Luke; Soler, Zachary M.; Mace, Jess C.; Schlosser, Rodney J.; Smith, Timothy L.

2014-01-01

Objective To evaluate the long-term cost-effectiveness of endoscopic sinus surgery (ESS) compared to continued medical therapy for patients with refractory chronic rhinosinusitis (CRS). Study Design Cohort-style Markov decision tree economic evaluation Methods The economic perspective was the US third party payer with a 30 year time horizon. The two comparative treatment strategies were: 1) ESS followed by appropriate postoperative medical therapy and 2) continued medical therapy alone. Primary outcome was the incremental cost per quality adjusted life year (QALY). Costs were discounted at a rate of 3.5% in the reference case. Multiple sensitivity analyses were performed including differing time-horizons, discounting scenarios, and a probabilistic sensitivity analysis (PSA). Results The reference case demonstrated that the ESS strategy cost a total of $48,838.38 and produced a total of 20.50 QALYs. The medical therapy alone strategy cost a total of $28,948.98 and produced a total of 17.13 QALYs. The incremental cost effectiveness ratio (ICER) for ESS versus medical therapy alone is $5,901.90 per QALY. The cost-effectiveness acceptability curve from the PSA demonstrated that there is 74% certainty that the ESS strategy is the most cost-effective decision for any willingness to pay threshold greater then $25,000. The time horizon analysis suggests that ESS becomes the cost-effective intervention within the 3rd year after surgery. Conclusion Results from this study suggest that employing an ESS treatment strategy is the most cost-effective intervention compared to continued medical therapy alone for the long-term management of patients with refractory CRS. PMID:25186499

Cost-effectiveness analysis of pneumococcal polysaccharide vaccination from age 60 in São Paulo State, Brazil.

PubMed

Neto, Joao Tonolio; de Araujo, Gabriela Tannus Branco; Gagliardi, Anna; Pinho, Amanda; Durand, Laure; Fonseca, Marcelo

2011-10-01

Vaccination of adults aged 60 years and older against Streptococcus pneumonia is not recommended in Brazil. The 23-valent polysaccharide pneumococcal vaccine (PPV23) is only available for institutionalized persons or with underlying diseases despite the substantial medical and economic burden related to pneumococcal infections in adults over than 59 years. The study aimed at evaluating the cost effectiveness of implementing a large PPV program in this population. This analysis was performed using a static decision tree model. Demographic and epidemiological data were obtained from Brazilian official sources and international literature. Economic data were obtained from a study performed in 2007 in a public and a private hospital located in Sao Paulo. Vaccination was assumed to protect for 5 years with 60% effectiveness against bacteremic pneumococcal pneumonia (BPP) and 21% effectiveness against non bacteremic pneumococcal pneumonia (NBPP). Deterministic and sensitivity analyses were performed. The pneumococcal polysaccharide vaccination saved 5,218 life year gained (LYG). The vaccination program was found to be cost effective in the social security and public health care perspectives with a mean incremental cost-effectiveness ratio of R$10,887 and R$8,281 per LYG respectively. Results were sensitive to the vaccine effectiveness against NBPP, the incidence and case-fatality rate of NBPP. From a societal perspective, PPV23 program for adults 60 and older was found to be cost-saving. Pneumococcal polysaccharide vaccination is clinically and economically favored over the present vaccination strategy, in which persons aged over 59 years in Sao Paulo, have not been vaccinated.

Introducing a conditional 'Willingness to Pay' index as a quantifier for environmental impact assessment

NASA Astrophysics Data System (ADS)

Batzias, Fragiskos; Kopsidas, Odysseas

2012-12-01

The optimal concentration Copt of a pollutant in the environment can be determined as an equilibrium point in the trade off between (i) environmental cost, due to impact on man/ecosystem/economy, and (ii) economic cost for environmental protection, as it can be expressed by Pigouvian tax. These two conflict variables are internalized within the same techno-economic objective function of total cost, which is minimized. In this work, the first conflict variable is represented by a Willingness To Pay (WTP) index. A methodology is developed for the estimation of this index by using fuzzy sets to count for uncertainty. Implementation of this methodology is presented, concerning odor pollution of air round an olive pomace oil mill. The ASTM E544-99 (2004) 'Standard Practice for Referencing Suprathreshold Odor Intensity' has been modified to serve as a basis for testing, while a network of the quality standards, required for the realization/application of this 'Practice', is also presented. Last, sensitivity analysis of Copt as regards the impact of (i) the increase of environmental information/sensitization and (ii) the decrease of interest rate reveals a shifting of Copt to lower and higher values, respectively; certain positive and negative implications (i.e., shifting of Copt to lower and higher values, respectively) caused by socio-economic parameters are also discussed.

Integral modeling and financial impact of the geothermal situation and power plant at Soultz-sous-Forêts

NASA Astrophysics Data System (ADS)

Heidinger, Philipp

2010-07-01

The science about deep Enhanced Geothermal Systems (EGS) is still an emerging process and for further spreading economics is the key of the technology. To understand the financial situation, a program for economic evaluation was developed. This software (Euronaut) is completely modularized and considers all cash flows. Projects like an EGS are wrapped into tree-like structures. Based on the results which were gained at Soultz-sous-Forêts, two configurations were designed. The first EGS configuration consists of a simplified two well (doublet) system where the dependencies of all components (mainly the reservoir, wells, pumps and the heat-to-power conversion unit) are physically and economically linked together. The realization of these dependencies and their complex interactions enable a sensitivity analysis of the borehole depth and reservoir depth, respectively. As a result, depth dependent effective costs and revenues of an EGS plant with the geohydrological characteristics of Soultz-sous-Forêts are determined. As a future development, the second configuration will adapt the actual situation at Soultz-sous-Forêts with the individual features of all four wells (GPK1 - GPK4). Then, this model can be used for all kinds of sensitivity analyses to clarify the impact of certain components or to optimize the operation scheme; e.g. the flow rates.

Use of the partial farm budget technique to predict the economic impact of the flock management decision to use B-mode ultrasonographic pregnancy diagnosis.

PubMed

Sprecher, D J; Ley, W B; Whittier, W D; Bowen, J M; Thatcher, C D; Pelzer, K D; Moore, J M

1989-07-15

A computer spreadsheet was developed to predict the economic impact of a management decision to use B-mode ultrasonographic ovine pregnancy diagnosis. The spreadsheet design and spreadsheet cell formulas are provided. The program used the partial farm budget technique to calculate net return (NR) or cash flow changes that resulted from the decision to use ultrasonography. Using the program, either simple pregnancy diagnosis or pregnancy diagnosis with the ability to determine singleton or multiple pregnancies may be compared with no flock ultrasonographic pregnancy diagnosis. A wide range of user-selected regional variables are used to calculate the cash flow changes associated with the ultrasonography decisions. A variable may be altered through a range of values to conduct a sensitivity analysis of predicted NR. Example sensitivity analyses are included for flock conception rate, veterinary ultrasound fee, and the price of corn. Variables that influence the number of cull animals and the cost of ultrasonography have the greatest impact on predicted NR. Because the determination of singleton or multiple pregnancies is more time consuming, its economic practicality in comparison with simple pregnancy diagnosis is questionable. The value of feed saved by identifying and separately feeding ewes with singleton pregnancies is not offset by the increased ultrasonography cost.

The National Map: Benefits at what cost?

USGS Publications Warehouse

Halsing, D.L.; Theissen, K.M.; Bernknopf, R.L.

2004-01-01

The U.S. Geological Survey has conducted a cost-benefit analysis of The National Map, and determined that, during its 30-year projected lifespan, the project will likely bring a net present value of benefits to society of $2.05 billion. Such a survey enhances the United States' ability to access, integrate, and apply geospatial data at global, national, and local scales. This paper gives an overview on the underlying economic model for evaluating program benefits and presents the primary findings as well as a sensitivity analysis assessing the robustness of the results.

Google matrix of the world network of economic activities

NASA Astrophysics Data System (ADS)

Kandiah, Vivek; Escaith, Hubert; Shepelyansky, Dima L.

2015-07-01

Using the new data from the OECD-WTO world network of economic activities we construct the Google matrix G of this directed network and perform its detailed analysis. The network contains 58 countries and 37 activity sectors for years 1995 and 2008. The construction of G, based on Markov chain transitions, treats all countries on equal democratic grounds while the contribution of activity sectors is proportional to their exchange monetary volume. The Google matrix analysis allows to obtain reliable ranking of countries and activity sectors and to determine the sensitivity of CheiRank-PageRank commercial balance of countries in respect to price variations and labor cost in various countries. We demonstrate that the developed approach takes into account multiplicity of network links with economy interactions between countries and activity sectors thus being more efficient compared to the usual export-import analysis. The spectrum and eigenstates of G are also analyzed being related to specific activity communities of countries.

A Decadal Regional and Global Trend Analysis of the Aerosol Optical Depth using a Data-Assimilation Grade Over-Water MODIS and Level 2 MISR Aerosol Products

DTIC Science & Technology

2010-01-01

and seasonal sensitivities to clear sky fraction and emissions (e.g., see annual state of the climate summaries in the BAMS, http://www.ncdc.noaa...gov/bams- state - of - the - climate /). Long term changes are as- sumed to be attributable to more background changes of en- ergy use and economic development

Risk aversion affects economic values of blue fox breeding scheme.

PubMed

Peura, J; Kempe, R; Strandén, I; Rydhmer, L

2016-12-01

The profit and production of an average Finnish blue fox farm was simulated using a deterministic bio-economic farm model. Risk was included using Arrow-Prat absolute risk aversion coefficient and profit variance. Risk-rated economic values were calculated for pregnancy rate, litter loss, litter size, pelt size, pelt quality, pelt colour clarity, feed efficiency and eye infection. With high absolute risk aversion, economic values were lower than with low absolute risk aversion. Economic values were highest for litter loss (18.16 and 26.42 EUR), litter size (13.27 and 19.40 EUR), pregnancy (11.99 and 18.39 EUR) and eye infection (12.39 and 13.81 EUR). Sensitivity analysis showed that selection pressure for improved eye health depended strongly on proportion of culled animals among infected animals and much less on the proportion of infected animals. The economic value of feed efficiency was lower than expected (6.06 and 8.03 EUR). However, it was almost the same magnitude as pelt quality (7.30 and 7.30 EUR) and higher than the economic value of pelt size (3.37 and 5.26 EUR). Risk factors should be considered in blue fox breeding scheme because they change the relative importance of traits. © 2016 Blackwell Verlag GmbH.

Economic Evidence on the Health Impacts of Climate Change in Europe

PubMed Central

Hutton, Guy; Menne, Bettina

2014-01-01

BACKGROUND In responding to the health impacts of climate change, economic evidence and tools inform decision makers of the efficiency of alternative health policies and interventions. In a time when sweeping budget cuts are affecting all tiers of government, economic evidence on health protection from climate change spending enables comparison with other public spending. METHODS The review included 53 countries of the World Health Organization (WHO) European Region. Literature was obtained using a Medline and Internet search of key terms in published reports and peer-reviewed literature, and from institutions working on health and climate change. Articles were included if they provided economic estimation of the health impacts of climate change or adaptation measures to protect health from climate change in the WHO European Region. Economic studies are classified under health impact cost, health adaptation cost, and health economic evaluation (comparing both costs and impacts). RESULTS A total of 40 relevant studies from Europe were identified, covering the health damage or adaptation costs related to the health effects of climate change and response measures to climate-sensitive diseases. No economic evaluation studies were identified of response measures specific to the impacts of climate change. Existing studies vary in terms of the economic outcomes measured and the methods for evaluation of health benefits. The lack of robust health impact data underlying economic studies significantly affects the availability and precision of economic studies. CONCLUSIONS Economic evidence in European countries on the costs of and response to climate-sensitive diseases is extremely limited and fragmented. Further studies are urgently needed that examine health impacts and the costs and efficiency of alternative responses to climate-sensitive health conditions, in particular extreme weather events (other than heat) and potential emerging diseases and other conditions threatening Europe. PMID:25452694

Economic evidence on the health impacts of climate change in europe.

PubMed

Hutton, Guy; Menne, Bettina

2014-01-01

In responding to the health impacts of climate change, economic evidence and tools inform decision makers of the efficiency of alternative health policies and interventions. In a time when sweeping budget cuts are affecting all tiers of government, economic evidence on health protection from climate change spending enables comparison with other public spending. The review included 53 countries of the World Health Organization (WHO) European Region. Literature was obtained using a Medline and Internet search of key terms in published reports and peer-reviewed literature, and from institutions working on health and climate change. Articles were included if they provided economic estimation of the health impacts of climate change or adaptation measures to protect health from climate change in the WHO European Region. Economic studies are classified under health impact cost, health adaptation cost, and health economic evaluation (comparing both costs and impacts). A total of 40 relevant studies from Europe were identified, covering the health damage or adaptation costs related to the health effects of climate change and response measures to climate-sensitive diseases. No economic evaluation studies were identified of response measures specific to the impacts of climate change. Existing studies vary in terms of the economic outcomes measured and the methods for evaluation of health benefits. The lack of robust health impact data underlying economic studies significantly affects the availability and precision of economic studies. Economic evidence in European countries on the costs of and response to climate-sensitive diseases is extremely limited and fragmented. Further studies are urgently needed that examine health impacts and the costs and efficiency of alternative responses to climate-sensitive health conditions, in particular extreme weather events (other than heat) and potential emerging diseases and other conditions threatening Europe.

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

Wang, Lijuan; Gonder, Jeff; Burton, Evan

This study evaluates the costs and benefits associated with the use of a plug-in hybrid electric bus and determines the cost effectiveness relative to a conventional bus and a hybrid electric bus. A sensitivity sweep analysis was performed over a number of a different battery sizes, charging powers, and charging stations. The net present value was calculated for each vehicle design and provided the basis for the design evaluation. In all cases, given present day economic assumptions, the conventional bus achieved the lowest net present value while the optimal plug-in hybrid electric bus scenario reached lower lifetime costs than themore » hybrid electric bus. The study also performed parameter sensitivity analysis under low market potential assumptions and high market potential assumptions. The net present value of plug-in hybrid electric bus is close to that of conventional bus.« less

Culture and context of HIV prevention in rural Zimbabwe: the influence of gender inequality.

PubMed

Duffy, Lynne

2005-01-01

After many years of HIV prevention in Zimbabwe, AIDS morbidity and mortality rates continue to rise. This study explores factors facilitating or hindering rural Ndau women's participation in HIV prevention that might influence health promotion programming. Ethnographic methods were used with a sample of 38 females and 10 males. Women's existence is revealed as difficult and oppressive. Their socialization to become workers and mothers occurs within a context of limited voice, subservience, violence, and economic powerlessness, all barriers to HIV prevention. Through analysis of sociocultural and economic factors, it is suggested that cultural beliefs and practices, along with national and international forces, support and sustain gender inequality. For a change in the AIDS crisis, prevention strategies need to be multifaceted, consider people's culture and context, and include gender analysis. It is imperative that nurses working with diverse populations be sensitive to culture while challenging unjust and oppressive systems.

Pilot-based assessment of the economics of recycling construction demolition waste.

PubMed

Srour, Issam M; Chehab, Ghassan R; El-Fadel, Mutasem; Tamraz, Sandy

2013-11-01

The significant amount of waste generated from construction demolition has become a chronic problem in many developing countries. Using data obtained from demolition contractors and various other sources, this paper proposes a framework for proper handling of construction demolition waste (CDW) to serve as a decision support tool in countries suffering from the lack of national CDW management guidelines. The framework is then demonstrated through a case study in the city of Beirut, Lebanon, and a sensitivity analysis is carried out to examine the economic feasibility of developing a recycling facility. The analysis showed that in order for a facility to be feasible, a gate fee should be charged in the presence of a market for recycled aggregates. The results confirm the significance of instigating and implementing legislation to control illegal dumping, constructing, and managing engineered landfills, and establishing markets for recycled CDW.

Economic analysis of cloud-based desktop virtualization implementation at a hospital

PubMed Central

2012-01-01

Background Cloud-based desktop virtualization infrastructure (VDI) is known as providing simplified management of application and desktop, efficient management of physical resources, and rapid service deployment, as well as connection to the computer environment at anytime, anywhere with anydevice. However, the economic validity of investing in the adoption of the system at a hospital has not been established. Methods This study computed the actual investment cost of the hospital-wide VDI implementation at the 910-bed Seoul National University Bundang Hospital in Korea and the resulting effects (i.e., reductions in PC errors and difficulties, application and operating system update time, and account management time). Return on investment (ROI), net present value (NPV), and internal rate of return (IRR) indexes used for corporate investment decision-making were used for the economic analysis of VDI implementation. Results The results of five-year cost-benefit analysis given for 400 Virtual Machines (VMs; i.e., 1,100 users in the case of SNUBH) showed that the break-even point was reached in the fourth year of the investment. At that point, the ROI was 122.6%, the NPV was approximately US$192,000, and the IRR showed an investment validity of 10.8%. From our sensitivity analysis to changing the number of VMs (in terms of number of users), the greater the number of adopted VMs was the more investable the system was. Conclusions This study confirms that the emerging VDI can have an economic impact on hospital information system (HIS) operation and utilization in a tertiary hospital setting. PMID:23110661

Economic analysis of cloud-based desktop virtualization implementation at a hospital.

PubMed

Yoo, Sooyoung; Kim, Seok; Kim, Taeki; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb; Hwang, Hee

2012-10-30

Cloud-based desktop virtualization infrastructure (VDI) is known as providing simplified management of application and desktop, efficient management of physical resources, and rapid service deployment, as well as connection to the computer environment at anytime, anywhere with any device. However, the economic validity of investing in the adoption of the system at a hospital has not been established. This study computed the actual investment cost of the hospital-wide VDI implementation at the 910-bed Seoul National University Bundang Hospital in Korea and the resulting effects (i.e., reductions in PC errors and difficulties, application and operating system update time, and account management time). Return on investment (ROI), net present value (NPV), and internal rate of return (IRR) indexes used for corporate investment decision-making were used for the economic analysis of VDI implementation. The results of five-year cost-benefit analysis given for 400 Virtual Machines (VMs; i.e., 1,100 users in the case of SNUBH) showed that the break-even point was reached in the fourth year of the investment. At that point, the ROI was 122.6%, the NPV was approximately US$192,000, and the IRR showed an investment validity of 10.8%. From our sensitivity analysis to changing the number of VMs (in terms of number of users), the greater the number of adopted VMs was the more investable the system was. This study confirms that the emerging VDI can have an economic impact on hospital information system (HIS) operation and utilization in a tertiary hospital setting.

Economic evaluation of the Annual Cycle Energy System (ACES). Volume 1: Executive summary

NASA Astrophysics Data System (ADS)

1980-05-01

Three different classes of building are investigated, namely: single family residence; multifamily residence; and commercial office building. For each building type in each geographic location, the economic evaluation of the annual cycle energy system (ACES) is based on a comparison of the present worth of the ACES to the present worth of a number of conventional systems. The results of this analysis indicate that the economic viability of the ACES is very sensitive to the assumed value of the property tax, maintenance cost, and fuel escalation rates, while it is relatively insensitive to the assumed values of other parameters. Fortunately, any conceivable change in the fuel escalation rates would tend to increase the viability of the ACES concept. An increase in the assumed value of the maintenance cost or property tax would tend to make the ACES concept less viable; a decrease in either would tend to make the ACES concept more viable.

Cognitive capital, equity and child-sensitive social protection in Asia and the Pacific

PubMed Central

Samson, Michael; Fajth, Gaspar; François, Daphne

2016-01-01

Promoting child development and welfare delivers human rights and builds sustainable economies through investment in ‘cognitive capital’. This analysis looks at conditions that support optimal brain development in childhood and highlights how social protection promotes these conditions and strengthens the achievement of the Sustainable Development Goals (SDGs) in Asia and the Pacific. Embracing child-sensitive social protection offers multiple benefits. The region has been a leader in global poverty reduction but the underlying pattern of economic growth exacerbates inequality and is increasingly unsustainable. The strategy of channelling low-skilled rural labour to industrial jobs left millions of children behind with limited opportunities for development. Building child-sensitive social protection and investing better in children's cognitive capacity could check these trends and trigger powerful long-term human capital development—enabling labour productivity to grow faster than populations age. While governments are investing more in social protection, the region's spending remains low by international comparison. Investment is particularly inadequate where it yields the highest returns: during the first 1000 days of life. Five steps are recommended for moving forward: (1) building cognitive capital by adjusting the region's development paradigms to reflect better the economic and social returns from investing in children; (2) understand and track better child poverty and vulnerability; (3) progressively build universal, child-sensitive systems that strengthen comprehensive interventions within life cycle frameworks; (4) mobilise national resources for early childhood investments and child-sensitive social protection; and (5) leverage the SDGs and other channels of national and international collaboration. PMID:28588990

A Method For Assessing Economic Thresholds of Hardwood Competition

Treesearch

Steven A. Knowe

2002-01-01

A procedure was developed for computing economic thresholds for hardwood competition in pine plantations. The economic threshold represents the break-even level of competition above which hardwood control is a financially attractive treatment. Sensitivity analyses were conducted to examine the relative importance of biological and economic factors in determining...

Developing Vulnerability Analysis Method for Climate Change Adaptation on Agropolitan Region in Malang District

NASA Astrophysics Data System (ADS)

Sugiarto, Y.; Perdinan; Atmaja, T.; Wibowo, A.

2017-03-01

Agriculture plays a strategic role in strengthening sustainable development. Based on agropolitan concept, the village becomes the center of economic activities by combining agriculture, agro-industry, agribusiness and tourism that able to create high value-added economy. The impact of climate change on agriculture and water resources may increase the pressure on agropolitan development. The assessment method is required to measure the vulnerability of area-based communities in the agropolitan to climate change impact. An analysis of agropolitan vulnerability was conducted in Malang district based on four aspects and considering the availability and distribution of water as the problem. The indicators used to measure was vulnerability component which consisted of sensitivity and adaptive capacity and exposure component. The studies earned 21 indicators derived from the 115 village-based data. The results of vulnerability assessments showed that most of the villages were categorised at a moderate level. Around 20% of 388 villages were categorized at high to very high level of vulnerability due to low level of agricultural economic. In agropolitan region within the sub-district of Poncokusumo, the vulnerability of the villages varies between very low to very high. The most villages were vulnerable due to lower adaptive capacity, eventhough the level of sensitivity and exposure of all villages were relatively similar. The existence of water resources was the biggest contributor to the high exposure of the villages in Malang district, while the reception of credit facilities and source of family income were among the indicators that lead to high sensitivity component.

RAPD cluster analysis and chlorate sensitivity of some Indian isolates of Macrophomina phaseolina from sorghum and their relationships with pathogenicity.

PubMed

Das, I K; Fakrudin, B; Arora, D K

2008-01-01

Charcoal rot caused by Macrophomina phaseolina is an economically important disease in sorghum grown during the post rainy season in India. Variations in random amplified polymorphic DNA (RAPD) polymorphisms, chlorate sensitivity and pathogenicity were studied among sorghum isolates of M. phaseolina collected from different parts of India. RAPD data based on 14 random primers of Kit A and C (OPA and OPC) on 20 isolates showed a high degree of polymorphism (98.1%) in different isolates. UPGMA dendrogram on RAPD data produced 7 clusters at the level of 37% similarity. Isolates from the same locations showed a tendency to group closer, substantiating closer genetic relatedness. Sorghum infecting Macrophomina isolates showed a mixed response for sensitivity to potassium chlorate (120 mM). Chlorate-resistant isolates were predominant (>65% of the isolates) over sensitive isolates. Chlorate-sensitive isolates were found to be genetically closer among them than the resistant ones. For the first time it was shown that chlorate sensitivity in Macrophomina had some relations with charcoal rot severity in sorghum.

Dynamic Transmission Economic Evaluation of Infectious Disease Interventions in Low- and Middle-Income Countries: A Systematic Literature Review.

PubMed

Drake, Tom L; Devine, Angela; Yeung, Shunmay; Day, Nicholas P J; White, Lisa J; Lubell, Yoel

2016-02-01

Economic evaluation using dynamic transmission models is important for capturing the indirect effects of infectious disease interventions. We examine the use of these methods in low- and middle-income countries, where infectious diseases constitute a major burden. This review is comprised of two parts: (1) a summary of dynamic transmission economic evaluations across all disease areas published between 2011 and mid-2014 and (2) an in-depth review of mosquito-borne disease studies focusing on health economic methods and reporting. Studies were identified through a systematic search of the MEDLINE database and supplemented by reference list screening. Fifty-seven studies were eligible for inclusion in the all-disease review. The most common subject disease was HIV/AIDS, followed by malaria. A diverse range of modelling methods, outcome metrics and sensitivity analyses were used, indicating little standardisation. Seventeen studies were included in the mosquito-borne disease review. With notable exceptions, most studies did not employ economic evaluation methods beyond calculating a cost-effectiveness ratio or net benefit. Many did not adhere to health care economic evaluations reporting guidelines, particularly with respect to full model reporting and uncertainty analysis. We present a summary of the state-of-the-art and offer recommendations for improved implementation and reporting of health economic methods in this crossover discipline. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

The health and economic benefits of the global programme to eliminate lymphatic filariasis (2000-2014).

PubMed

Turner, Hugo C; Bettis, Alison A; Chu, Brian K; McFarland, Deborah A; Hooper, Pamela J; Ottesen, Eric A; Bradley, Mark H

2016-05-24

Lymphatic filariasis (LF), also known as elephantiasis, is a neglected tropical disease (NTD) targeted for elimination through a Global Programme to Eliminate LF (GPELF). Between 2000 and 2014, the GPELF has delivered 5.6 billion treatments to over 763 million people. Updating the estimated health and economic benefits of this significant achievement is important in justifying the resources and investment needed for eliminating LF. We combined previously established models to estimate the number of clinical manifestations and disability-adjusted life years (DALYs) averted from three benefit cohorts (those protected from acquiring infection, those with subclinical morbidity prevented from progressing and those with clinical disease alleviated). The economic savings associated with this disease prevention was then analysed in the context of prevented medical expenses incurred by LF clinical patients, potential income loss through lost-labour, and prevented costs to the health system to care for affected individuals. The indirect cost estimates were calculated using the human capital approach. A combination of four wage sources was used to estimate the fair market value of time for an agricultural worker with LF infection (to ensure a conservative estimate, the lowest wage value was used). We projected that due to the first 15 years of the GPELF 36 million clinical cases and 175 (116-250) million DALYs will potentially be averted. It was estimated that due to this notable health impact, US$100.5 billion will potentially be saved over the lifetimes of the benefit cohorts. This total amount results from summing the medical expenses incurred by LF patients (US$3 billion), potential income loss (US$94 billion), and costs to the health system (US$3.5 billion) that were projected to be prevented. The results were subjected to sensitivity analysis and were most sensitive to the assumed percentage of work hours lost for those suffering from chronic disease (changing the total economic benefit between US$69.30-150.7 billion). Despite the limitations of any such analysis, this study identifies substantial health and economic benefits that have resulted from the first 15 years of the GPELF, and it highlights the value and importance of continued investment in the GPELF.

Stochastic techno-economic analysis of alcohol-to-jet fuel production.

PubMed

Yao, Guolin; Staples, Mark D; Malina, Robert; Tyner, Wallace E

2017-01-01

Alcohol-to-jet (ATJ) is one of the technical feasible biofuel technologies. It produces jet fuel from sugary, starchy, and lignocellulosic biomass, such as sugarcane, corn grain, and switchgrass, via fermentation of sugars to ethanol or other alcohols. This study assesses the ATJ biofuel production pathway for these three biomass feedstocks, and advances existing techno-economic analyses of biofuels in three ways. First, we incorporate technical uncertainty for all by-products and co-products though statistical linkages between conversion efficiencies and input and output levels. Second, future price uncertainty is based on case-by-case time-series estimation, and a local sensitivity analysis is conducted with respect to each uncertain variable. Third, breakeven price distributions are developed to communicate the inherent uncertainty in breakeven price. This research also considers uncertainties in utility input requirements, fuel and by-product outputs, as well as price uncertainties for all major inputs, products, and co-products. All analyses are done from the perspective of a private firm. The stochastic dominance results of net present values (NPV) and breakeven price distributions show that sugarcane is the lowest cost feedstock over the entire range of uncertainty with the least risks, followed by corn grain and switchgrass, with the mean breakeven jet fuel prices being $0.96/L ($3.65/gal), $1.01/L ($3.84/gal), and $1.38/L ($5.21/gal), respectively. The variation of revenues from by-products in corn grain pathway can significantly impact its profitability. Sensitivity analyses show that technical uncertainty significantly impacts breakeven price and NPV distributions. Technical uncertainty is critical in determining the economic performance of the ATJ fuel pathway. Technical uncertainty needs to be considered in future economic analyses. The variation of revenues from by-products plays a significant role in profitability. With the distribution of breakeven prices, potential investors can apply whatever risk preferences they like to determine an appropriate bid or breakeven price that matches their risk profile.

Economic costs of childhood lead exposure in low- and middle-income countries.

PubMed

Attina, Teresa M; Trasande, Leonardo

2013-09-01

Children's blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries. Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries. We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure. We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6-1162.5 billion. We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries.

A sustainability analysis of an incineration project in Serbia.

PubMed

Mikic, Miljan; Naunovic, Zorana

2013-11-01

The only option for municipal solid waste (MSW) treatment adopted so far in Serbia is landfilling. Similarly to other south-eastern European countries, Serbia is not recovering any energy from MSW. Fifty percent of electricity in Serbia is produced in coal-fired power plants with emission control systems dating from the 1980s. In this article, the option of MSW incineration with energy recovery is proposed and examined for the city of Novi Sad. A sustainability analysis consisting of financial, economic and sensitivity analyses was done in the form of a cost-benefit analysis following recommendations from the European Commission. Positive and negative social and environmental effects of electricity generation through incineration were valuated partly using conversion factors and shadow prices, and partly using the results of previous studies. Public aversion to MSW incineration was considered. The results showed that the incineration project would require external financial assistance, and that an increase of the electricity and/or a waste treatment fee is needed to make the project financially positive. It is also more expensive than the landfilling option. However, the economic analysis showed that society would have net benefits from an incineration project. The feed-in tariff addition of only €0.03 (KWh)(-1) to the existing electricity price, which would enable the project to make a positive contribution to economic welfare, is lower than the actual external costs of electricity generation from coal in Serbia.

Neurobehavioral deficits, diseases, and associated costs of exposure to endocrine-disrupting chemicals in the European Union.

PubMed

Bellanger, Martine; Demeneix, Barbara; Grandjean, Philippe; Zoeller, R Thomas; Trasande, Leonardo

2015-04-01

Epidemiological studies and animal models demonstrate that endocrine-disrupting chemicals (EDCs) contribute to cognitive deficits and neurodevelopmental disabilities. The objective was to estimate neurodevelopmental disability and associated costs that can be reasonably attributed to EDC exposure in the European Union. An expert panel applied a weight-of-evidence characterization adapted from the Intergovernmental Panel on Climate Change. Exposure-response relationships and reference levels were evaluated for relevant EDCs, and biomarker data were organized from peer-reviewed studies to represent European exposure and approximate burden of disease. Cost estimation as of 2010 utilized lifetime economic productivity estimates, lifetime cost estimates for autism spectrum disorder, and annual costs for attention-deficit hyperactivity disorder. Setting, Patients and Participants, and Intervention: Cost estimation was carried out from a societal perspective, ie, including direct costs (eg, treatment costs) and indirect costs such as productivity loss. The panel identified a 70-100% probability that polybrominated diphenyl ether and organophosphate exposures contribute to IQ loss in the European population. Polybrominated diphenyl ether exposures were associated with 873,000 (sensitivity analysis, 148,000 to 2.02 million) lost IQ points and 3290 (sensitivity analysis, 3290 to 8080) cases of intellectual disability, at costs of €9.59 billion (sensitivity analysis, €1.58 billion to €22.4 billion). Organophosphate exposures were associated with 13.0 million (sensitivity analysis, 4.24 million to 17.1 million) lost IQ points and 59 300 (sensitivity analysis, 16,500 to 84,400) cases of intellectual disability, at costs of €146 billion (sensitivity analysis, €46.8 billion to €194 billion). Autism spectrum disorder causation by multiple EDCs was assigned a 20-39% probability, with 316 (sensitivity analysis, 126-631) attributable cases at a cost of €199 million (sensitivity analysis, €79.7 million to €399 million). Attention-deficit hyperactivity disorder causation by multiple EDCs was assigned a 20-69% probability, with 19 300 to 31 200 attributable cases at a cost of €1.21 billion to €2.86 billion. EDC exposures in Europe contribute substantially to neurobehavioral deficits and disease, with a high probability of >€150 billion costs/year. These results emphasize the advantages of controlling EDC exposure.

Economic Evaluation of Teledentistry in Cleft Lip and Palate Patients.

PubMed

Teoh, Jonathan; Hsueh, Arthur; Mariño, Rodrigo; Manton, David; Hallett, Kerrod

2018-06-01

To assess the use of Teledentistry (TD) in delivering specialist dental services at the Royal Children's Hospital (RCH) for rural and regional patients and to conduct an economic evaluation by building a decision model to estimate the costs and effectiveness of Teledental consultations compared with standard consultations at the RCH. A model-based analysis was conducted to determine the potential costs of implementing TD at the RCH. The outcome measure was timely consultations (whether the patient presented within an appropriate time according to the recommended schedule). Dental records at the RCH of those who presented for orthodontic or pediatric dental consultations were assessed. A cost-effectiveness analysis (CEA), comparing TD with the traditional method of consultation, was conducted. One-way sensitivity analysis was performed to test the robustness of the results. Results and Materials: A total of 367 TD appropriate consultations were identified, of which 241 were timely (65.7%). The mean cost of a RCH consultation was A$431.29, with the mean TD consult costing A$294.35. This represents a cost saving of A$136.95 per appointment. The CEA found TD to be a dominant option, with cost savings of A$3,160.81 for every additional timely consult. The model indicated that 36.7 days of clinic time may be freed up at the RCH to treat other patients and expand capacity. These results were robust when performing one-way sensitivity analysis. When taking a societal perspective, the implementation of TD is likely to be a cost-effective alternative compared with the standard practice of face-to-face consultation at the RCH.

Analysis of health economics assessment reports for pharmaceuticals in France – understanding the underlying philosophy of CEESP assessment

PubMed Central

Toumi, Mondher; Motrunich, Anastasiia; Millier, Aurélie; Rémuzat, Cécile; Chouaid, Christos; Falissard, Bruno; Aballéa, Samuel

2017-01-01

ABSTRACT Background: Despite the guidelines for Economic and Public Health Assessment Committee (CEESP) submission having been available for nearly six years, the dossiers submitted continue to deviate from them, potentially impacting product prices. Objective: to review the reports published by CEESP, analyse deviations from the guidelines, and discuss their implications for the pricing and reimbursement process. Study design: CEESP reports published until January 2017 were reviewed, and deviations from the guidelines were extracted. The frequency of deviations was described by type of methodological concern (minor, important or major). Results: In 19 reports, we identified 243 methodological concerns, most often concerning modelling, measurement and valuation of health states and results presentation and sensitivity analyses; nearly 63% were minor, 33% were important and 4.5% were major. All reports included minor methodological concerns, and 17 (89%) included at least one important and/or major methodological concern. Global major methodological concerns completely invalidated the analysis in seven dossiers (37%). Conclusion: The CEESP submission dossiers fail to adhere to the guidelines, potentially invalidating the health economics analysis and resulting in pricing negotiations. As these negotiations tend to be unfavourable for the manufacturer, the industry should strive to improve the quality of the analyses submitted to CEESP. PMID:28804600

Improvement of General Electric’s Chilled Ammonia Process with the use of Membrane Technology

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

Muraskin, Dave; Dube, Sanjay; Baburao, Barath

General Electric Environmental Control Solutions (formerly Alstom Power Environmental Control Systems) set out to complete the Phase 1 award requirements for a Phase II renewal application for their project selected under DOE-FOA-0001190 “Small and Large Scale Pilots for Reducing the Cost of CO 2 Capture and Compression”. The project focus was to implement several improvement concepts utilizing membrane technology at the recipient’s Chilled Ammonia Process (CAP) CO 2 capture large-scale pilot plant. The goal was to lower the overall cost of technology. During the development of costs for the preliminary techno-economic assessment (TEA), it became clear that the capital andmore » operating costs of this concept were not economically attractive. All work related to a Phase II renewal application at that point was halted as GE made the decision not to submit a Phase II renewal application. Discussions with DOE resulted in a path towards useful information produced from the design and cost work already completed on the project. With the reverse osmosis (RO) unit providing most of the cost issues, GE would provide a sensitivity analysis of the RO unit with respect to project cost. This information would be included with the Techno-Economic Analysis along with the Technology Gap Analysis.« less

The health economics of ankle and foot sprains and fractures: A systematic review of English-language published papers. Part 1: Overview and critical appraisal.

PubMed

Bielska, Iwona A; Wang, Xiang; Lee, Raymond; Johnson, Ana P

2017-07-01

Ankle and foot sprains and fractures are common injuries affecting many individuals, often requiring considerable and costly medical interventions. The objectives of this systematic review are to collect, assess, and critically appraise the published literature on the health economics of ankle and foot injury (sprain and fracture) treatment. A systematic literature review of Ovid MEDLINE, EMBASE, Cochrane DSR, ACP Journal Club, AMED, Ovid Healthstar, and CINAHL was conducted for English-language studies on the costs of treating ankle and foot sprains and fractures published from January 1980 to December 2014. Two reviewers assessed the articles for study quality and abstracted data. The literature search identified 2047 studies of which 32 were analyzed. A majority of the studies were published in the last decade. A number of the studies did not report full economic information, including the sources of the direct and indirect costs, as suggested in the guidelines. The perspective used in the analysis was missing in numerous studies, as was the follow-up time period of participants. Only five of the studies undertook a sensitivity analysis which is required whenever there are uncertainties regarding cost data. This systematic review found that publications do not consistently report on the components of health economics methodology, which in turn limits the quality of information. Future studies undertaking economic evaluations should ensure that their methods are transparent and understandable so as to yield accurate interpretation for assistance in forthcoming economic evaluations and policy decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dedicated Perioperative Hip Fracture Comanagement Programs are Cost-effective in High-volume Centers: An Economic Analysis.

PubMed

Swart, Eric; Vasudeva, Eshan; Makhni, Eric C; Macaulay, William; Bozic, Kevin J

2016-01-01

Osteoporotic hip fractures are common injuries typically occurring in patients who are older and medically frail. Studies have suggested that creation of a multidisciplinary team including orthopaedic surgeons, internal medicine physicians, social workers, and specialized physical therapists, to comanage these patients can decrease complication rates, improve time to surgery, and reduce hospital length of stay; however, they have yet to achieve widespread implementation, partly owing to concerns regarding resource requirements necessary for a comanagement program. We performed an economic analysis to determine whether implementation of a comanagement model of care for geriatric patients with osteoporotic hip fractures would be a cost-effective intervention at hospitals with moderate volume. We also calculated what annual volume of cases would be needed for a comanagement program to "break even", and finally we evaluated whether universal or risk-stratified comanagement was more cost effective. Decision analysis techniques were used to model the effect of implementing a systems-based strategy to improve inpatient perioperative care. Costs were obtained from best-available literature and included salary to support personnel and resources to expedite time to the operating room. The major economic benefit was decreased initial hospital length of stay, which was determined via literature review and meta-analysis, and a health benefit was improvement in perioperative mortality owing to expedited preoperative evaluation based on previously conducted meta-analyses. A break-even analysis was conducted to determine the annual case volume necessary for comanagement to be either (1) cost effective (improve health-related quality of life enough to be worth additional expenses) or (2) result in cost savings (actually result in decreased total expenses). This calculation assumed the scenario in which a hospital could hire only one hospitalist (and therapist and social worker) on a full-time basis. Additionally, we evaluated the scenario where the necessary staff was already employed at the hospital and could be dedicated to a comanagement service on a part-time basis, and explored the effect of triaging only patients considered high risk to a comanagement service versus comanaging all geriatric patients. Finally, probabilistic sensitivity analysis was conducted on all critical variables, with broad ranges used for values around which there was higher uncertainty. For the base case, universal comanagement was more cost effective than traditional care and risk-stratified comanagement (incremental cost effectiveness ratios of USD 41,100 per quality-adjusted life-year and USD 81,900 per quality-adjusted life-year, respectively). Comanagement was more cost effective than traditional management as long as the case volume was more than 54 patients annually (range, 41-68 patients based on sensitivity analysis) and resulted in cost savings when there were more than 318 patients annually (range, 238-397 patients). In a scenario where staff could be partially dedicated to a comanagement service, universal comanagement was more cost effective than risk-stratified comanagement (incremental cost effectiveness of USD 2300 per quality-adjusted life-year), and both comanagement programs had lower costs and better outcomes compared with traditional management. Sensitivity analysis was conducted and showed that the level of uncertainty in key variables was not high enough to change the core conclusions of the model. Implementation of a systems-based comanagement strategy using a dedicated team to improve perioperative medical care and expedite preoperative evaluation is cost effective in hospitals with moderate volume and can result in cost savings at higher-volume centers. The optimum patient population for a comanagement strategy is still being defined. Level 1, Economic and Decision Analysis.

Effects of Arthroscopy for Femoroacetabular Impingement Syndrome on Quality of Life and Economic Outcomes.

PubMed

Mather, Richard C; Nho, Shane J; Federer, Andrew; Demiralp, Berna; Nguyen, Jennifer; Saavoss, Asha; Salata, Michael J; Philippon, Marc J; Bedi, Asheesh; Larson, Christopher M; Byrd, J W Thomas; Koenig, Lane

2018-04-01

The diagnosis and treatment of femoroacetabular impingement (FAI) have increased steadily within the past decade, and research indicates clinically significant improvements after treatment of FAI with hip arthroscopy. This study examined the societal and economic impact of hip arthroscopy by high-volume surgeons for patients with FAI syndrome aged <50 years with noncontroversial diagnosis and indications for surgery. Economic and decision analysis; Level of evidence, 2. The cost-effectiveness of hip arthroscopy versus nonoperative treatment was evaluated by calculating direct and indirect treatment costs. Direct cost was calculated with Current Procedural Terminology medical codes associated with FAI treatment. Indirect cost was measured with the patient-reported data of 102 patients who underwent arthroscopy and from the reimbursement records of 32,143 individuals between the ages of 16 and 79 years who had information in a private insurance claims data set contained within the PearlDiver Patient Records Database. The indirect economic benefits of hip arthroscopy were inferred through regression analysis to estimate the statistical relationship between functional status and productivity. A simulation-based approach was then used to estimate the change in productivity associated with the change in functional status observed in the treatment cohort between baseline and follow-up. To analyze cost-effectiveness, 1-, 2-, and 3-way sensitivity analyses were performed on all variables in the model, and Monte Carlo analysis evaluated the impact of uncertainty in the model assumptions. Analysis of indirect costs identified a statistically significant increase of mean aggregate productivity of $8968 after surgery. Cost-effectiveness analysis showed a mean cumulative total 10-year societal savings of $67,418 per patient from hip arthroscopy versus nonoperative treatment. Hip arthroscopy also conferred a gain of 2.03 quality-adjusted life years over this period. The mean cost for hip arthroscopy was estimated at $23,120 ± $10,279, and the mean cost of nonoperative treatment was estimated at $91,602 ± $14,675. In 99% of trials, hip arthroscopy was recognized as the preferred cost-effective strategy. FAI syndrome produces a substantial economic burden on society that may be reduced through the indirect cost savings and economic benefits from hip arthroscopy.

Bayesian Estimation of Fish Disease Prevalence from Pooled Samples Incorporating Sensitivity and Specificity

NASA Astrophysics Data System (ADS)

Williams, Christopher J.; Moffitt, Christine M.

2003-03-01

An important emerging issue in fisheries biology is the health of free-ranging populations of fish, particularly with respect to the prevalence of certain pathogens. For many years, pathologists focused on captive populations and interest was in the presence or absence of certain pathogens, so it was economically attractive to test pooled samples of fish. Recently, investigators have begun to study individual fish prevalence from pooled samples. Estimation of disease prevalence from pooled samples is straightforward when assay sensitivity and specificity are perfect, but this assumption is unrealistic. Here we illustrate the use of a Bayesian approach for estimating disease prevalence from pooled samples when sensitivity and specificity are not perfect. We also focus on diagnostic plots to monitor the convergence of the Gibbs-sampling-based Bayesian analysis. The methods are illustrated with a sample data set.

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.

Surveys for sensitivity to fibers and potential impacts from fiber induced failures

NASA Technical Reports Server (NTRS)

Butterfield, A. J.

1979-01-01

The surveys for sensitivities to fibers and potential impacts from fiber induced failures begins with a review of the survey work completed to date and then describes an impact study involving four industrial installations located in Virginia. The observations and results from both the surveys and the study provide guidelines for future efforts. The survey work was done with three broad objectives: (1) identify the pieces of potentially vulnerable equipment as candidates for test; (2) support the transfer function work by gaining an understanding of how fibers could get into a building; and (3) support the economic analysis by understanding what would happen if fibers precipitated a failure in an item of equipment.

[Health economics analysis of specific immunotherapy in allergic rhinitis accompanied with asthma].

PubMed

Chen, Jianjun; Xiang, Jisheng; Wang, Yanjun; Shi, Qiumei; Tan, Huifang; Kong, Weijia

2013-09-01

To investigate the cost-effectiveness of standardized specific immunotherapy (SIT) for allergic rhinitis patients accompanied with asthma (ARAS) in China. Forty ARAS patients sensitized with house dust mite (HDM) were administered with SIT (SIT group) or merely medicine treatment (control group). Alutard dermatophagoides pteronyssinus vaccine from ALK company was used for immunotherapy. The usage of symptom control medicine was according to the ARIA and GINA guideline. Cost-effectiveness ratio (CER) and Incremental cost-effectiveness ratio(ICER) analysis was conducted. The effectiveness was measured in terms of symptom scores, quality of life, objective improvement of rhinitis and asthma. Sensitive analysis was conducted to verify the stability of the results. The cost of SIT group for 1 year (6578 yuan) was higher than that of control group (1733.3 yuan), while the cost-effectiveness ratio and incremental cost-effectiveness ratio of SIT group were significant better than that of control group in all items. CER was 1686.7 yuan in SIT group compared with 3466.6 yuan in control group for nasal symptom scores, 4698.6 yuan in SIT group compared with 5777.8 yuan in control group for asthma symptom scores, 3462.1 yuan in SIT group compared with 8666.7 yuan in control group. The sensitive analysis of the price 10 percent higher or lower showed the same results. The cost-effectiveness of specific immunotherapy (SIT) for mite sensitized ARAS patients was better than that of merely medicine treatment.

Economic evaluation of strategies for restarting anticoagulation therapy after a first event of unprovoked venous thromboembolism.

PubMed

Monahan, M; Ensor, J; Moore, D; Fitzmaurice, D; Jowett, S

2017-08-01

Essentials Correct duration of treatment after a first unprovoked venous thromboembolism (VTE) is unknown. We assessed when restarting anticoagulation was worthwhile based on patient risk of recurrent VTE. When the risk over a one-year period is 17.5%, restarting is cost-effective. However, sensitivity analyses indicate large uncertainty in the estimates. Background Following at least 3 months of anticoagulation therapy after a first unprovoked venous thromboembolism (VTE), there is uncertainty about the duration of therapy. Further anticoagulation therapy reduces the risk of having a potentially fatal recurrent VTE but at the expense of a higher risk of bleeding, which can also be fatal. Objective An economic evaluation sought to estimate the long-term cost-effectiveness of using a decision rule for restarting anticoagulation therapy vs. no extension of therapy in patients based on their risk of a further unprovoked VTE. Methods A Markov patient-level simulation model was developed, which adopted a lifetime time horizon with monthly time cycles and was from a UK National Health Service (NHS)/Personal Social Services (PSS) perspective. Results Base-case model results suggest that treating patients with a predicted 1 year VTE risk of 17.5% or higher may be cost-effective if decision makers are willing to pay up to £20 000 per quality adjusted life year (QALY) gained. However, probabilistic sensitivity analysis shows that the model was highly sensitive to overall parameter uncertainty and caution is warranted in selecting the optimal decision rule on cost-effectiveness grounds. Univariate sensitivity analyses indicate variables such as anticoagulation therapy disutility and mortality risks were very influential in driving model results. Conclusion This represents the first economic model to consider the use of a decision rule for restarting therapy for unprovoked VTE patients. Better data are required to predict long-term bleeding risks during therapy in this patient group. © 2017 International Society on Thrombosis and Haemostasis.

A methodology to estimate uncertainty for emission projections through sensitivity analysis.

PubMed

Lumbreras, Julio; de Andrés, Juan Manuel; Pérez, Javier; Borge, Rafael; de la Paz, David; Rodríguez, María Encarnación

2015-04-01

Air pollution abatement policies must be based on quantitative information on current and future emissions of pollutants. As emission projections uncertainties are inevitable and traditional statistical treatments of uncertainty are highly time/resources consuming, a simplified methodology for nonstatistical uncertainty estimation based on sensitivity analysis is presented in this work. The methodology was applied to the "with measures" scenario for Spain, concretely over the 12 highest emitting sectors regarding greenhouse gas and air pollutants emissions. Examples of methodology application for two important sectors (power plants, and agriculture and livestock) are shown and explained in depth. Uncertainty bands were obtained up to 2020 by modifying the driving factors of the 12 selected sectors and the methodology was tested against a recomputed emission trend in a low economic-growth perspective and official figures for 2010, showing a very good performance. A solid understanding and quantification of uncertainties related to atmospheric emission inventories and projections provide useful information for policy negotiations. However, as many of those uncertainties are irreducible, there is an interest on how they could be managed in order to derive robust policy conclusions. Taking this into account, a method developed to use sensitivity analysis as a source of information to derive nonstatistical uncertainty bands for emission projections is presented and applied to Spain. This method simplifies uncertainty assessment and allows other countries to take advantage of their sensitivity analyses.

Economic Analysis of a Multi-Site Prevention Program: Assessment of Program Costs and Characterizing Site-level Variability

PubMed Central

Corso, Phaedra S.; Ingels, Justin B.; Kogan, Steven M.; Foster, E. Michael; Chen, Yi-Fu; Brody, Gene H.

2013-01-01

Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95% confidence interval) incremental difference was $2149 ($397, $3901). With the probabilistic sensitivity analysis approach, the incremental difference was $2583 ($778, $4346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention. PMID:23299559

Economic analysis of a multi-site prevention program: assessment of program costs and characterizing site-level variability.

PubMed

Corso, Phaedra S; Ingels, Justin B; Kogan, Steven M; Foster, E Michael; Chen, Yi-Fu; Brody, Gene H

2013-10-01

Programmatic cost analyses of preventive interventions commonly have a number of methodological difficulties. To determine the mean total costs and properly characterize variability, one often has to deal with small sample sizes, skewed distributions, and especially missing data. Standard approaches for dealing with missing data such as multiple imputation may suffer from a small sample size, a lack of appropriate covariates, or too few details around the method used to handle the missing data. In this study, we estimate total programmatic costs for a prevention trial evaluating the Strong African American Families-Teen program. This intervention focuses on the prevention of substance abuse and risky sexual behavior. To account for missing data in the assessment of programmatic costs we compare multiple imputation to probabilistic sensitivity analysis. The latter approach uses collected cost data to create a distribution around each input parameter. We found that with the multiple imputation approach, the mean (95 % confidence interval) incremental difference was $2,149 ($397, $3,901). With the probabilistic sensitivity analysis approach, the incremental difference was $2,583 ($778, $4,346). Although the true cost of the program is unknown, probabilistic sensitivity analysis may be a more viable alternative for capturing variability in estimates of programmatic costs when dealing with missing data, particularly with small sample sizes and the lack of strong predictor variables. Further, the larger standard errors produced by the probabilistic sensitivity analysis method may signal its ability to capture more of the variability in the data, thus better informing policymakers on the potentially true cost of the intervention.

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

Wang, Lijuan; Gonder, Jeff; Burton, Evan

This study evaluates the costs and benefits associated with the use of a stationary-wireless- power-transfer-enabled plug-in hybrid electric bus and determines the cost effectiveness relative to a conventional bus and a hybrid electric bus. A sensitivity sweep was performed over many different battery sizes, charging power levels, and number/location of bus stop charging stations. The net present cost was calculated for each vehicle design and provided the basis for design evaluation. In all cases, given the assumed economic conditions, the conventional bus achieved the lowest net present cost while the optimal plug-in hybrid electric bus scenario beat out the hybridmore » electric comparison scenario. The study also performed parameter sensitivity analysis under favorable and high unfavorable market penetration assumptions. The analysis identifies fuel saving opportunities with plug-in hybrid electric bus scenarios at cumulative net present costs not too dissimilar from those for conventional buses.« less

Rapid detection of infectious hypodermal and hematopoietic necrosis virus (IHHNV) by real-time, isothermal recombinase polymerase amplification assay.

PubMed

Xia, Xiaoming; Yu, Yongxin; Hu, Linghao; Weidmann, Manfred; Pan, Yingjie; Yan, Shuling; Wang, Yongjie

2015-04-01

Infectious hypodermal and hematopoietic necrosis virus (IHHNV) causes mortality or runt deformity syndrome in penaeid shrimps and is responsible for significant economic losses in the shrimp aquaculture industry. Here, we describe a novel real-time isothermal recombinase polymerase amplification (RPA) assay developed for IHHNV detection. Using IHHNV plasmid standards and DNA samples from a variety of organisms, we evaluated the ability of the IHHNV-RPA assay to detect IHHNV based on analysis of its sensitivity, specificity, rapidity, and reproducibility. Probit analysis of eight independent experimental replicates indicated satisfactory performance of the RPA assay, which is sufficiently sensitive to detect as few as 4 copies of the IHHNV genome within 7 min at 39 °C with 95 % reliability. Therefore, this rapid RPA method has great potential for applications, either in field use or as a point of care diagnostic technique.

Evaluation of the cost-effectiveness of electrical stimulation therapy for pressure ulcers in spinal cord injury.

PubMed

Mittmann, Nicole; Chan, Brian C; Craven, B Cathy; Isogai, Pierre K; Houghton, Pamela

2011-06-01

To evaluate the incremental cost-effectiveness of electrical stimulation (ES) plus standard wound care (SWC) as compared with SWC only in a spinal cord injury (SCI) population with grade III/IV pressure ulcers (PUs) from the public payer perspective. A decision analytic model was constructed for a 1-year time horizon to determine the incremental cost-effectiveness of ES plus SWC to SWC in a cohort of participants with SCI and grade III/IV PUs. Model inputs for clinical probabilities were based on published literature. Model inputs, namely clinical probabilities and direct health system and medical resources were based on a randomized controlled trial of ES plus SWC versus SWC. Costs (Can $) included outpatient (clinic, home care, health professional) and inpatient management (surgery, complications). One way and probabilistic sensitivity (1000 Monte Carlo iterations) analyses were conducted. The perspective of this analysis is from a Canadian public health system payer. Model target population was an SCI cohort with grade III/IV PUs. Not applicable. Incremental cost per PU healed. ES plus SWC were associated with better outcomes and lower costs. There was a 16.4% increase in the PUs healed and a cost savings of $224 at 1 year. ES plus SWC were thus considered a dominant economic comparator. Probabilistic sensitivity analysis resulted in economic dominance for ES plus SWC in 62%, with another 35% having incremental cost-effectiveness ratios of $50,000 or less per PU healed. The largest driver of the economic model was the percentage of PU healed with ES plus SWC. The addition of ES to SWC improved healing in grade III/IV PU and reduced costs in an SCI population. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Cost-utility of laparoscopic Nissen fundoplication versus proton pump inhibitors for chronic and controlled gastroesophageal reflux disease: a 3-year prospective randomized controlled trial and economic evaluation.

PubMed

Goeree, Ron; Hopkins, Rob; Marshall, John K; Armstrong, David; Ungar, Wendy J; Goldsmith, Charles; Allen, Christopher; Anvari, Mehran

2011-01-01

Very few randomized controlled trials (RCTs) have compared laparoscopic Nissen fundoplication (LNF) to proton pump inhibitors (PPI) medical management for patients with chronic gastroesophageal reflux disease (GERD). Larger RCTs have been relatively short in duration, and have reported mixed results regarding symptom control and effect on quality of life (QOL). Economic evaluations have reported conflicting results. To determine the incremental cost-utility of LNF versus PPI for treating patients with chronic and controlled GERD over 3 years from the societal perspective. Economic evaluation was conducted alongside a RCT that enrolled 104 patients from October 2000 to September 2004. Primary study outcome was GERD symptoms (secondary outcomes included QOL and cost-utility). Resource utilization and QOL data collected at regular follow-up intervals determined incremental cost/QALY gained. Stochastic uncertainty was assessed using bootstrapping and methodologic assumptions were assessed using sensitivity analysis. No statistically significant differences in GERD symptom scores, but LNF did result in fewer heartburn days and improved QOL. Costs were higher for LNF patients by $3205/patient over 3 years but QOL was also higher as measured by either QOL instrument. Based on total costs, incremental cost-utility of LNF was $29,404/QALY gained using the Health Utility Index 3. Cost-utility results were sensitive to the utility instrument used ($29,404/QALY for Health Utility Index 3, $31,117/QALY for the Short Form 6D, and $76,310/QALY for EuroQol 5D) and if current lower prices for PPIs were used in the analysis. Results varied depending on resource use/costs included in the analysis, the QOL instrument used, and the cost of PPIs; however, LNF was generally found to be a cost-effective treatment for patients with symptomatic controlled GERD requiring long-term management. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Hospital admissions for severe mental illness in England: changes in equity of utilisation at the small area level between 2006 and 2010.

PubMed

White, Jonathan; Gutacker, Nils; Jacobs, Rowena; Mason, Anne

2014-11-01

Severe Mental Illness (SMI) encompasses a range of chronic conditions including schizophrenia, bipolar disorder and psychoses. Patients with SMI often require inpatient psychiatric care. Despite equity being a key objective in the English National Health Service (NHS) and in many other health care systems worldwide, little is known about the socio-economic equity of hospital care utilisation for patients with SMI and how it has changed over time. This analysis seeks to address that gap in the evidence base. We exploit a five-year (2006-2010) panel dataset of admission rates at small area level (n=162,410). The choice of control variables was informed by a systematic literature search. To assess changes in socio-economic equity of utilisation, OLS-based standardisation was first used to conduct analysis of discrete deprivation groups. Geographical inequity was then illustrated by plotting standardised and crude admission rates at local purchaser level. Lastly, formal statistical tests for changes in socio-economic equity of utilisation were applied to a continuous measure of deprivation using pooled negative binomial regression analysis, adjusting for a range of risk factors. Our results suggest that one additional percentage point of area income deprivation is associated with a 1.5% (p<0.001) increase in admissions for SMI after controlling for population size, age, sex, prevalence of SMI in the local population, as well as other need and supply factors. This finding is robust to sensitivity analyses, suggesting that a pro-poor inequality in utilisation exists for SMI-related inpatient services. One possible explanation is that the supply or quality of primary, community or social care for people with mental health problems is suboptimal in deprived areas. Although there is some evidence that inequity has reduced over time, the changes are small and not always robust to sensitivity analyses. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effect of Increased Intensity of Physiotherapy on Patient Outcomes After Stroke: An Economic Literature Review and Cost-Effectiveness Analysis

PubMed Central

Chan, B

2015-01-01

Background Functional improvements have been seen in stroke patients who have received an increased intensity of physiotherapy. This requires additional costs in the form of increased physiotherapist time. Objectives The objective of this economic analysis is to determine the cost-effectiveness of increasing the intensity of physiotherapy (duration and/or frequency) during inpatient rehabilitation after stroke, from the perspective of the Ontario Ministry of Health and Long-term Care. Data Sources The inputs for our economic evaluation were extracted from articles published in peer-reviewed journals and from reports from government sources or the Canadian Stroke Network. Where published data were not available, we sought expert opinion and used inputs based on the experts' estimates. Review Methods The primary outcome we considered was cost per quality-adjusted life-year (QALY). We also evaluated functional strength training because of its similarities to physiotherapy. We used a 2-state Markov model to evaluate the cost-effectiveness of functional strength training and increased physiotherapy intensity for stroke inpatient rehabilitation. The model had a lifetime timeframe with a 5% annual discount rate. We then used sensitivity analyses to evaluate uncertainty in the model inputs. Results We found that functional strength training and higher-intensity physiotherapy resulted in lower costs and improved outcomes over a lifetime. However, our sensitivity analyses revealed high levels of uncertainty in the model inputs, and therefore in the results. Limitations There is a high level of uncertainty in this analysis due to the uncertainty in model inputs, with some of the major inputs based on expert panel consensus or expert opinion. In addition, the utility outcomes were based on a clinical study conducted in the United Kingdom (i.e., 1 study only, and not in an Ontario or Canadian setting). Conclusions Functional strength training and higher-intensity physiotherapy may result in lower costs and improved health outcomes. However, these results should be interpreted with caution. PMID:26366241

Economic Impact Analyses of Interdisciplinary Multi-hazard Scenarios: ShakeOut and ARkStorm

NASA Astrophysics Data System (ADS)

Wein, A. M.; Rose, A.; Sue Wing, I.; Wei, D.

2011-12-01

U. S. Geological Survey (USGS) scientists are using an interdisciplinary strategy to develop and analyze multi-hazard scenarios to help communities enhance resilience to natural hazard disasters. Two such scenarios are the southern California ShakeOut earthquake and the California ARkStorm winter storm. Both scenarios are multi-hazard: Shakeout ground motions trigger landslides and liquefaction and ARkStorm involves wind, flood, landslide, and coastal hazards. A collaborative scenario-process engages partners and stakeholders throughout the development and use of the scenarios, In doing so, community resilience is enhanced by educating communities about hazards and hazard interdependencies, building networks from scientists to decision makers, exercising emergency management strategies, identifying emergency management issues, and motivating solutions prior to an event. In addition, interdisciplinary scenarios stimulate research on the various steps of analysis (e.g., natural hazard processes, physical damages, societal consequences, and policy connections). In particular, USGS scientists have collaborated with economists to advance methods to estimate the economic impacts (business interruption losses) of disasters. Our economic impact analyses evolved from the economic module in the Federal Emergency Management Agency's loss-estimation tool, HAZUS-MH, to a more encompassing input-output analysis for ShakeOut, to a more sophisticated Computable General Equilibrium model for ARkStorm. The analyses depend on physical damage and restoration time estimates from engineers and geographic analyses of economic assets in hazard zones. Economic resilience strategies are incorporated to represent resourcefulness and ingenuity that avoids potential losses during and after an event. Such strategies operate at three levels of the economy: micro (e.g., ability to catch up on lost production time), meso (e.g., coordination within a sector to share resources), and macro (e.g., price adjustments to redistribute scarce resources). A sensitivity analysis of the ARkStorm economic impact model explores the effects of 1) the magnitude of the shocks (e.g., flood damages to buildings and infrastructure, agricultural productivity, and lifeline service disruptions), 2) the sustainability of the economic resilience strategies, and 3) the amount, timing, and source of reconstruction funds. The inclusion of an economic analysis in ShakeOut and ARkStorm broadens the range of interest in the scenario results. For example, the relative contribution of ShakeOut economic shocks to business interruption losses emphasized the need to reduce the impacts of fire following earthquake and water service disruption. Based on the magnitude and duration of the economic impacts for the ARkStorm scenario, policy experts surmised that business interruption policy time elements would be exceeded and business interruptions would be largely unfunded calling attention to the need for innovative funding solutions. Finally, economic impact analyses inform the question of paying now to mitigate or paying more later to recover.

Sector Identification in a Set of Stock Return Time Series Traded at the London Stock Exchange

NASA Astrophysics Data System (ADS)

Coronnello, C.; Tumminello, M.; Lillo, F.; Micciche, S.; Mantegna, R. N.

2005-09-01

We compare some methods recently used in the literature to detect the existence of a certain degree of common behavior of stock returns belonging to the same economic sector. Specifically, we discuss methods based on random matrix theory and hierarchical clustering techniques. We apply these methods to a portfolio of stocks traded at the London Stock Exchange. The investigated time series are recorded both at a daily time horizon and at a 5-minute time horizon. The correlation coefficient matrix is very different at different time horizons confirming that more structured correlation coefficient matrices are observed for long time horizons. All the considered methods are able to detect economic information and the presence of clusters characterized by the economic sector of stocks. However, different methods present a different degree of sensitivity with respect to different sectors. Our comparative analysis suggests that the application of just a single method could not be able to extract all the economic information present in the correlation coefficient matrix of a stock portfolio.

The Role of Grade Sensitivity in Explaining the Gender Imbalance in Undergraduate Economics

ERIC Educational Resources Information Center

Rask, Kevin; Tiefenthaler, Jill

2008-01-01

There is a gender imbalance in undergraduate economics departments with most departments educating a strong majority of young men. This imbalance has led many economists to ponder the question of why relatively few women choose to take courses and major in economics. Our hypothesis is that the gender imbalance in undergraduate economics,…

[Gastos hospitalarios por neumonía neumocóccica invasora en adultos en un hospital general en Chile].

PubMed

Alarcón, Álvaro; Lagos, Isabel; Fica, Alberto

2016-08-01

Pneumococcal infections are important for their morbidity and economic burden, but there is no economical data from adults patients in Chile. Estimate direct medical costs of bacteremic pneumococcal pneumonia among adult patients hospitalized in a general hospital and to evaluate the sensitivity of ICD 10 discharge codes to capture infections from this pathogen. Analysis of hospital charges by components in a group of patients admitted for bacteremic pneumococcal pneumonia, correction of values by inflation and conversion from CLP to US$. Data were collected from 59 patients admitted during 2005-2010, mean age 71.9 years. Average hospital charges for those managed in general wards reached 2,756 US$, 8,978 US$ for those managed in critical care units (CCU) and 6,025 for the whole group. Charges were higher in CCU (p < 0.001), and patients managed in these units generated 78.3% of the whole cost (n = 31; 52.5% from total). The median cost in general wards was 1,558 US$, and 3,993 in CCU. Main components were bed occupancy (37.8% of charges), and medications (27.4%). There were no differences associated to age, comorbidities, severity scores or mortality. No single ICD discharge code involved a S. pneumoniae bacteremic case (0% sensitivity) and only 2 cases were coded as pneumococcal pneumonia (3.4%). Mean hospital charges (~6,000 US dollars) or median values (~2,400 US dollars) were high, underlying the economic impact of this condition. Costs were higher among patients managed in CCU. Recognition of bacteremic pneumococcal infections by ICD 10 discharge codes has a very low sensitivity.

[Medico-economic evaluation of therapeutic strategies at hospital: A systematic review of French studies].

PubMed

Baudouin, A; Armoiry, X; Dussart, C

2017-05-01

Therapeutic innovation contributes to the increase of health care expenditures in France. Medico-economic evaluation has still a minor role in the decision-making for the registration of drugs and medical devices in hospitals. This study aimed to systematically review published works on medico-economic studies conducted within French hospitals. A literature review was carried out to search for medico-economic studies conducted by hospital teams on therapeutic or diagnostic strategies employed within French hospitals and published from 2010 to 2014. Quality assessment of selected studies was performed according to Drummond et al.'s checklist, which is also used within French guidelines. Of the 44 analyzed articles, methods for identification and measure of costs and results complied with guidelines in 95 % of cases. For results interpretation, compliance was 91 %. Costs discounting (29 %) and the use of sensitivity analysis to account for results uncertainty (70 %) were the parameters with the lowest compliance to guidelines. A good training of health professionals in using economic and statistic tools, and the transferability of results of medico-economic studies are essential and should be optimized to enable a broader use of medico-economic evaluation within the scope of decision-making in French hospitals. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Coupling between ecological vulnerability and economic poverty in contiguous destitute areas, China: Empirical analysis of 714 poverty-stricken counties.

PubMed

Cao, Shi Song; Wang, Yan Hui; Duan, Fu Zhou; Zhao, Wen Ji; Wang, Zhi Heng; Fang, Na

2016-08-01

Maintaining the coordinated correlation between ecological environment and economic development is one of the important strategies in the new stage of poverty alleviation and development. Taking 714 poverty-stricken counties in contiguous destitute areas as study areas, this paper designed the ecological vulnerability evaluation indicator system based on the ecological sensitivity-resilience-pressure (SRP) conceptual model, as well as the comprehensive poverty evaluation indicators from the perspective of socioeconomic development, so as to build the coupling model to reveal the coupling between ecological vulnerability and economic poverty. The results showed that Hu-Line could act as a feasible partition label to depict the spatial distribution patterns of ecological vulnerability, economic poverty, as well as their coupling degree in contiguous destitute areas, which should be fully taken into consideration the influence of Hu-Line on the east-west pattern classification of national poverty reduction. In addition, there existed a symbiotic positive correlation between ecological vulnerability and economic poverty, therefore, the strategic significance of ecological and environment protection in poverty-stricken areas should be specifically emphasized to reduce economic poverty by synchronously protecting the ecological environment. Approximately half of the counties involved in the study area were in the coordinated type of recession disorders, where the ecological environment quality and the economic development could not be synchronized.

A strain-, cow-, and herd-specific bio-economic simulation model of intramammary infections in dairy cattle herds.

PubMed

Gussmann, Maya; Kirkeby, Carsten; Græsbøll, Kaare; Farre, Michael; Halasa, Tariq

2018-07-14

Intramammary infections (IMI) in dairy cattle lead to economic losses for farmers, both through reduced milk production and disease control measures. We present the first strain-, cow- and herd-specific bio-economic simulation model of intramammary infections in a dairy cattle herd. The model can be used to investigate the cost-effectiveness of different prevention and control strategies against IMI. The objective of this study was to describe a transmission framework, which simulates spread of IMI causing pathogens through different transmission modes. These include the traditional contagious and environmental spread and a new opportunistic transmission mode. In addition, the within-herd transmission dynamics of IMI causing pathogens were studied. Sensitivity analysis was conducted to investigate the influence of input parameters on model predictions. The results show that the model is able to represent various within-herd levels of IMI prevalence, depending on the simulated pathogens and their parameter settings. The parameters can be adjusted to include different combinations of IMI causing pathogens at different prevalence levels, representing herd-specific situations. The model is most sensitive to varying the transmission rate parameters and the strain-specific recovery rates from IMI. It can be used for investigating both short term operational and long term strategic decisions for the prevention and control of IMI in dairy cattle herds. Copyright © 2018 Elsevier Ltd. All rights reserved.

A systematic review of economic evaluations of health and health-related interventions in Bangladesh

PubMed Central

2011-01-01

Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The most frequently applied economic evaluation is cost-effectiveness analysis. The majority of the studies did not follow the scientific method of economic evaluation process, which consequently resulted into lack of robustness of the analyses. Capacity building on economic evaluation of health and health-related programs should be enhanced. PMID:21771343

A cost-benefit analysis of landfill mining and material recycling in China

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

Zhou, Chuanbin, E-mail: cbzhou@rcees.ac.cn; Gong, Zhe; Hu, Junsong

Highlights: • Assessing the economic feasibility of landfill mining. • We applied a cost-benefit analysis model for landfill mining. • Four material cycling and energy recovery scenarios were designed. • We used net present value to evaluate the cost-benefit efficiency. - Abstract: Landfill mining is an environmentally-friendly technology that combines the concepts of material recycling and sustainable waste management, and it has received a great deal of worldwide attention because of its significant environmental and economic potential in material recycling, energy recovery, land reclamation and pollution prevention. This work applied a cost-benefit analysis model for assessing the economic feasibility, whichmore » is important for promoting landfill mining. The model includes eight indicators of costs and nine indicators of benefits. Four landfill mining scenarios were designed and analyzed based on field data. The economic feasibility of landfill mining was then evaluated by the indicator of net present value (NPV). According to our case study of a typical old landfill mining project in China (Yingchun landfill), rental of excavation and hauling equipment, waste processing and material transportation were the top three costs of landfill mining, accounting for 88.2% of the total cost, and the average cost per unit of stored waste was 12.7 USD ton{sup −1}. The top three benefits of landfill mining were electricity generation by incineration, land reclamation and recycling soil-like materials. The NPV analysis of the four different scenarios indicated that the Yingchun landfill mining project could obtain a net positive benefit varying from 1.92 million USD to 16.63 million USD. However, the NPV was sensitive to the mode of land reuse, the availability of energy recovery facilities and the possibility of obtaining financial support by avoiding post-closure care.« less

Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients.

PubMed

Malet-Larrea, Amaia; Goyenechea, Estíbaliz; Gastelurrutia, Miguel A; Calvo, Begoña; García-Cárdenas, Victoria; Cabases, Juan M; Noain, Aránzazu; Martínez-Martínez, Fernando; Sabater-Hernández, Daniel; Benrimoj, Shalom I

2017-12-01

Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis. The economic evaluation was based on a cluster randomized controlled trial. Patients in the intervention group (IG) received the MRF service and the comparison group (CG) received usual care. The analysis was conducted from the national health system (NHS) perspective over 6 months. Direct medical costs were included and expressed in euros at 2014 prices. Health benefits were estimated by assigning a monetary value to the quality-adjusted life years. One-way deterministic sensitivity analysis was undertaken in order to analyse the uncertainty. The analysis included 1403 patients (IG: n = 688 vs CG: n = 715). The cost analysis showed that the MRF saved 97 € per patient in 6 months. Extrapolating data to 1 year and assuming a fee for service of 22 € per patient-month, the estimated savings were 273 € per patient-year. The cost-benefit ratio revealed that for every 1 € invested in MRF, a benefit of 3.3 € to 6.2 € was obtained. The MRF provided health benefits to patients and substantial cost savings to the NHS. Investment in this service would represent an efficient use of healthcare resources.

Comparative economics of space resource utilization

NASA Technical Reports Server (NTRS)

Cutler, Andrew Hall

1991-01-01

Physical economic factors such as mass payback ratio, total payback ratio, and capital payback time are discussed and used to compare the economics of using resources from the Moon, Mars and its moons, and near Earth asteroids to serve certain near term markets such as propellant in low Earth orbit or launched mass reduction for lunar and Martian exploration. Methods for accounting for the time cost of money in simple figures of merit such as MPRs are explored and applied to comparisons such as those between lunar, Martian, and asteroidal resources. Methods for trading off capital and operating costs to compare schemes with substantially different capital to operating cost ratio are presented and discussed. Areas where further research or engineering would be extremely useful in reducing economic uncertainty are identified, as are areas where economic merit is highly sensitive to engineering performance - as well as areas where such sensitivity is surprisingly low.

Pricing strategy for aesthetic surgery: economic analysis of a resident clinic's change in fees.

PubMed

Krieger, L M; Shaw, W W

1999-02-01

The laws of microeconomics explain how prices affect consumer purchasing decisions and thus overall revenues and profits. These principles can easily be applied to the behavior aesthetic plastic surgery patients. The UCLA Division of Plastic Surgery resident aesthetics clinic recently offered a radical price change for its services. The effects of this change on demand for services and revenue were tracked. Economic analysis was applied to see if this price change resulted in the maximization of total revenues, or if additional price changes could further optimize them. Economic analysis of pricing involves several steps. The first step is to assess demand. The number of procedures performed by a given practice at different price levels can be plotted to create a demand curve. From this curve, price sensitivities of consumers can be calculated (price elasticity of demand). This information can then be used to determine the pricing level that creates demand for the exact number of procedures that yield optimal revenues. In economic parlance, revenues are maximized by pricing services such that elasticity is equal to 1 (the point of unit elasticity). At the UCLA resident clinic, average total fees per procedure were reduced by 40 percent. This resulted in a 250-percent increase in procedures performed for representative 4-month periods before and after the price change. Net revenues increased by 52 percent. Economic analysis showed that the price elasticity of demand before the price change was 6.2. After the price change it was 1. We conclude that the magnitude of the price change resulted in a fee schedule that yielded the highest possible revenues from the resident clinic. These results show that changes in price do affect total revenue and that the nature of these effects can be understood, predicted, and maximized using the tools of microeconomics.

Assessment of UASB-DHS technology for sewage treatment: a comparative study from a sustainability perspective.

PubMed

Maharjan, Namita; Nomoto, Naoki; Tagawa, Tadashi; Okubo, Tsutomu; Uemura, Shigeki; Khalil, Nadeem; Hatamoto, Masashi; Yamaguchi, Takashi; Harada, Hideki

2018-04-06

This paper assesses the technical and economic sustainability of a combined system of an up-flow anaerobic sludge blanket (UASB)-down-flow hanging sponge (DHS) for sewage treatment. Additionally, this study compares UASB-DHS with current technologies in India like trickling filters (TF), sequencing batch reactor (SBR), moving bed biofilm reactor (MBBR), and other combinations of UASB with post-treatment systems such as final polishing ponds (FPU) and extended aeration sludge process (EASP). The sustainability of the sewage treatment plants (STPs) was evaluated using a composite indicator, which incorporated environmental, societal, and economic dimensions. In case of the individual sustainability indicator study, the results showed that UASB-FPU was the most economically sustainable system with a score of 0.512 and aeration systems such as MBBR, EASP, and SBR were environmentally sustainable, whereas UASB-DHS system was socially sustainable. However, the overall comparative analysis indicated that the UASB-DHS system scored the highest value of 2.619 on the global sustainability indicator followed by EASP and MBBR with scores of 2.322 and 2.279, respectively. The highlight of this study was that the most environmentally sustainable treatment plants were not economically and socially sustainable. Moreover, sensitivity analysis showed that five out of the seven scenarios tested, the UASB-DHS system showed good results amongst the treatment system.

Economic Costs of Childhood Lead Exposure in Low- and Middle-Income Countries

PubMed Central

Trasande, Leonardo

2013-01-01

Background: Children’s blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries. Objective: Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries. Methods: We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure. Results: We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6–1162.5 billion. Conclusions: We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries. Citation: Attina TM, Trasande L. 2013. Economic costs of childhood lead exposure in low- and middle-income countries. Environ Health Perspect 121:1097–1102; http://dx.doi.org/10.1289/ehp.1206424 PMID:23797342

Economic evaluation of the one-hour rule-out and rule-in algorithm for acute myocardial infarction using the high-sensitivity cardiac troponin T assay in the emergency department.

PubMed

Ambavane, Apoorva; Lindahl, Bertil; Giannitsis, Evangelos; Roiz, Julie; Mendivil, Joan; Frankenstein, Lutz; Body, Richard; Christ, Michael; Bingisser, Roland; Alquezar, Aitor; Mueller, Christian

2017-01-01

The 1-hour (h) algorithm triages patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED) towards "rule-out," "rule-in," or "observation," depending on baseline and 1-h levels of high-sensitivity cardiac troponin (hs-cTn). The economic consequences of applying the accelerated 1-h algorithm are unknown. We performed a post-hoc economic analysis in a large, diagnostic, multicenter study of hs-cTnT using central adjudication of the final diagnosis by two independent cardiologists. Length of stay (LoS), resource utilization (RU), and predicted diagnostic accuracy of the 1-h algorithm compared to standard of care (SoC) in the ED were estimated. The ED LoS, RU, and accuracy of the 1-h algorithm was compared to that achieved by the SoC at ED discharge. Expert opinion was sought to characterize clinical implementation of the 1-h algorithm, which required blood draws at ED presentation and 1h, after which "rule-in" patients were transferred for coronary angiography, "rule-out" patients underwent outpatient stress testing, and "observation" patients received SoC. Unit costs were for the United Kingdom, Switzerland, and Germany. The sensitivity and specificity for the 1-h algorithm were 87% and 96%, respectively, compared to 69% and 98% for SoC. The mean ED LoS for the 1-h algorithm was 4.3h-it was 6.5h for SoC, which is a reduction of 33%. The 1-h algorithm was associated with reductions in RU, driven largely by the shorter LoS in the ED for patients with a diagnosis other than AMI. The estimated total costs per patient were £2,480 for the 1-h algorithm compared to £4,561 for SoC, a reduction of up to 46%. The analysis shows that the use of 1-h algorithm is associated with reduction in overall AMI diagnostic costs, provided it is carefully implemented in clinical practice. These results need to be prospectively validated in the future.

A Review of Methods for Analysis of the Expected Value of Information.

PubMed

Heath, Anna; Manolopoulou, Ioanna; Baio, Gianluca

2017-10-01

In recent years, value-of-information analysis has become more widespread in health economic evaluations, specifically as a tool to guide further research and perform probabilistic sensitivity analysis. This is partly due to methodological advancements allowing for the fast computation of a typical summary known as the expected value of partial perfect information (EVPPI). A recent review discussed some approximation methods for calculating the EVPPI, but as the research has been active over the intervening years, that review does not discuss some key estimation methods. Therefore, this paper presents a comprehensive review of these new methods. We begin by providing the technical details of these computation methods. We then present two case studies in order to compare the estimation performance of these new methods. We conclude that a method based on nonparametric regression offers the best method for calculating the EVPPI in terms of accuracy, computational time, and ease of implementation. This means that the EVPPI can now be used practically in health economic evaluations, especially as all the methods are developed in parallel with R functions and a web app to aid practitioners.

Can economic evaluation in telemedicine be trusted? A systematic review of the literature

PubMed Central

Bergmo, Trine S

2009-01-01

Background Telemedicine has been advocated as an effective means to provide health care services over a distance. Systematic information on costs and consequences has been called for to support decision-making in this field. This paper provides a review of the quality, validity and generalisability of economic evaluations in telemedicine. Methods A systematic literature search in all relevant databases was conducted and forms the basis for addressing these issues. Only articles published in peer-reviewed journals and written in English in the period from 1990 to 2007 were analysed. The literature search identified 33 economic evaluations where both costs (resource use) and outcomes (non-resource consequences) were measured. Results This review shows that economic evaluations in telemedicine are highly diverse in terms of both the study context and the methods applied. The articles covered several medical specialities ranging from cardiology and dermatology to psychiatry. The studies analysed telemedicine in home care, and in primary and secondary care settings using a variety of different technologies including videoconferencing, still-images and monitoring (store-and-forward telemedicine). Most studies used multiple outcome measures and analysed the effects using disaggregated cost-consequence frameworks. Objectives, study design, and choice of comparators were mostly well reported. The majority of the studies lacked information on perspective and costing method, few used general statistics and sensitivity analysis to assess validity, and even fewer used marginal analysis. Conclusion As this paper demonstrates, the majority of the economic evaluations reviewed were not in accordance with standard evaluation techniques. Further research is needed to explore the reasons for this and to address how economic evaluation in telemedicine best can take advantage of local constraints and at the same time produce valid and generalisable results. PMID:19852828

Techno-economic analysis of sorption-enhanced steam methane reforming in a fixed bed reactor network integrated with fuel cell

NASA Astrophysics Data System (ADS)

Diglio, Giuseppe; Hanak, Dawid P.; Bareschino, Piero; Mancusi, Erasmo; Pepe, Francesco; Montagnaro, Fabio; Manovic, Vasilije

2017-10-01

Sorption-enhanced steam methane reforming (SE-SMR) is a promising alternative for H2 production with inherent CO2 capture. This study evaluates the techno-economic performance of SE-SMR in a network of fixed beds and its integration with a solid oxide fuel cell (SE-SMR-SOFC) for power generation. The analysis revealed that both proposed systems are characterised by better economic performance than the reference systems. In particular, for SE-SMR the levelised cost of hydrogen is 1.6 €ṡkg-1 and the cost of CO2 avoided is 29.9 €ṡtCO2-1 (2.4 €ṡkg-1 and 50 €ṡtCO2-1, respectively, for SMR with CO2 capture) while for SE-SMR-SOFC the levelised cost of electricity is 0.078 €ṡkWh-1 and the cost of CO2 avoided is 36.9 €ṡtCO2-1 (0.080 €ṡkWh-1 and 80 €ṡtCO2-1, respectively, for natural gas-fired power plant with carbon capture). The sensitivity analysis showed that the specific cost of fuel and the capital cost of fuel cell mainly affect the economic performance of SE-SMR and SE-SMR-SOFC, respectively. The daily revenue of the SE-SMR-SOFC system is higher than that of the natural gas-fired power plant if the difference between the carbon tax and the CO2 transport and storage cost is > 6 €ṡtCO2-1.

Genetic testing in combination with preventive donepezil treatment for patients with amnestic mild cognitive impairment: an exploratory economic evaluation of personalized medicine.

PubMed

Djalalov, Sandjar; Yong, Jean; Beca, Jaclyn; Black, Sandra; Saposnik, Gustavo; Musa, Zahra; Siminovitch, Katherine; Moretti, Myla; Hoch, Jeffrey S

2012-12-01

To evaluate the cost effectiveness of genetic screening for the apolipoprotein (APOE) ε4 allele in combination with preventive donepezil treatment in comparison with the standard of care for amnestic mild cognitive impairment (AMCI) patients in Canada. We performed a cost-effectiveness analysis using a Markov model with a societal perspective and a time horizon of 30 years. For each strategy, we calculated quality-adjusted life-years (QALYs), using utilities from the literature. Costs were also based on the literature and, when appropriate, Ontario sources. One-way and probabilistic sensitivity analyses were performed. Expected value of perfect information (EVPI) analysis was conducted to explore the value of future research. The base case results in our exploratory study suggest that the combination of genetic testing and preventive donepezil treatment resulted in a gain of 0.027 QALYs and an incremental cost of $1,015 (in 2009 Canadian dollars [Can$]), compared with the standard of care. The incremental cost-effectiveness ratio (ICER) for the base case was Can$38,016 per QALY. The ICER was sensitive to the effectiveness of donepezil in slowing the rate of progression to Alzheimer's disease (AD), utility in AMCI patients, and AD and donepezil treatment costs. EVPI analysis showed that additional information on these parameters would be of value. Using presently available clinical evidence, this exploratory study illustrates that genetic testing combined with preventive donepezil treatment for AMCI patients may be economically attractive. Since our results were based on a secondary post hoc analysis, our study alone is insufficient to warrant recommending APOE genotyping in AMCI patients. Future research on the effectiveness of preventive donepezil as a targeted therapy is recommended.

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

PubMed Central

2009-01-01

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

Latin American Clinical Epidemiology Network Series - Paper 4: Economic evaluation of Kangaroo Mother Care: cost utility analysis of results from a randomized controlled trial conducted in Bogotá.

PubMed

Ruiz, Juan Gabriel; Charpak, Nathalie; Castillo, Mario; Bernal, Astrid; Ríos, John; Trujillo, Tammy; Córdoba, María Adelaida

2017-06-01

Although kangaroo mother care (KMC) has been shown to be safe and effective in randomized controlled trials (RCTs), there are no published complete economic evaluations including the three components of the full intervention. A cost utility analysis performed on the results of an RCT conducted in Bogotá, Colombia between 1993 and 1996. Hospital and ambulatory costs were estimated by microcosting in a sample of preterm infants from a University Hospital in Bogotá in 2011 and at a KMC clinic in the same period. Utility scores were assigned by experts by means of (1) direct ordering and scoring discrete health states and (2) constructing a multi-attribute utility function. Ninety-five percent confidence intervals (CIs) for the incremental cost-utility ratios (ICURs) were computed by the Fiellers theorem method. One-way sensitivity analysis on price estimates for valuing costs was performed. ICUR at 1 year of corrected age was $ -1,546 per extra quality-adjusted life year gained using the KMC method (95% CI $ -7,963 to $ 4,910). In Bogotá, the use of KMC is dominant: more effective and cost-saving. Although results from an economic analysis should not be extrapolated to different systems and communities, this dominant result suggests that KMC could be cost-effective in similar low and middle income countries settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Application and evaluation of forecasting methods for municipal solid waste generation in an Eastern-European city.

PubMed

Rimaityte, Ingrida; Ruzgas, Tomas; Denafas, Gintaras; Racys, Viktoras; Martuzevicius, Dainius

2012-01-01

Forecasting of generation of municipal solid waste (MSW) in developing countries is often a challenging task due to the lack of data and selection of suitable forecasting method. This article aimed to select and evaluate several methods for MSW forecasting in a medium-scaled Eastern European city (Kaunas, Lithuania) with rapidly developing economics, with respect to affluence-related and seasonal impacts. The MSW generation was forecast with respect to the economic activity of the city (regression modelling) and using time series analysis. The modelling based on social-economic indicators (regression implemented in LCA-IWM model) showed particular sensitivity (deviation from actual data in the range from 2.2 to 20.6%) to external factors, such as the synergetic effects of affluence parameters or changes in MSW collection system. For the time series analysis, the combination of autoregressive integrated moving average (ARIMA) and seasonal exponential smoothing (SES) techniques were found to be the most accurate (mean absolute percentage error equalled to 6.5). Time series analysis method was very valuable for forecasting the weekly variation of waste generation data (r (2) > 0.87), but the forecast yearly increase should be verified against the data obtained by regression modelling. The methods and findings of this study may assist the experts, decision-makers and scientists performing forecasts of MSW generation, especially in developing countries.

Single-Step Syngas-to-Distillates (S2D) Process Based on Biomass-Derived Syngas – A Techno-Economic Analysis

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

Zhu, Yunhua; Jones, Susanne B.; Biddy, Mary J.

2012-08-01

This study reports the comparison of biomass gasification based syngas-to-distillate (S2D) systems using techno-economic analysis (TEA). Three cases, state of technology (SOT) case, goal case, and conventional case, were compared in terms of performance and cost. The SOT case and goal case represent technology being developed at Pacific Northwest National Laboratory for a process starting with syngas using a single-step dual-catalyst reactor for distillate generation (S2D process). The conventional case mirrors the two-step S2D process previously utilized and reported by Mobil using natural gas feedstock and consisting of separate syngas-to-methanol and methanol-to-gasoline (MTG) processes. Analysis of the three cases revealedmore » that the goal case could indeed reduce fuel production cost over the conventional case, but that the SOT was still more expensive than the conventional. The SOT case suffers from low one-pass yield and high selectivity to light hydrocarbons, both of which drive up production cost. Sensitivity analysis indicated that light hydrocarbon yield, single pass conversion efficiency, and reactor space velocity are the key factors driving the high cost for the SOT case.« less

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

PubMed

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

2009-05-01

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

Quality of clinical and economic evidence in dossier formulary submissions.

PubMed

Colmenero, Fernando; Sullivan, Sean D; Palmer, Jennifer A; Brauer, Carmen A; Bungay, Kathleen; Watkins, John; Neumann, Peter J

2007-07-01

To investigate the quality and completeness of clinical and economic data in dossiers submitted by drug companies to a health plan using Academy of Managed Care Pharmacy guidelines (the Format) for formulary submissions. We reviewed the quality of economic analyses in dossiers submitted to Premera Blue Cross Health Plan (Mountlake Terrace, Washington; enrollment 1.6 million) between January 2002 and September 2005. For dossiers submitted in 2003, we examined the clinical studies included. Dossiers were audited with a data collection form to judge the types of clinical studies used to support labeled and off-label indications, and the quality and transparency of economic analyses. We compared economic analyses for high-cost (30-day treatment cost > $1000) versus low-cost products, and for "innovative" versus "me-too" drugs. Evidence to support off-label indications often was included in 2003 dossiers, but the information was less extensive and of poorer quality than data for labeled indications. Of 115 dossiers submitted between 2002 and 2005, 53 (46%) included economic analyses. The economic analyses had low levels of compliance with standards: only 43% performed sensitivity analysis; 38% stated the study perspective; 37% discussed relevant treatment alternatives; 20% stated assumptions clearly; and 18% mentioned caveats to conclusions. Economic analyses of high-cost products and innovative products had higher compliance with recommended practices. Drug companies are submitting dossiers of evidence to formulary committees. Dossiers often included clinical data to support off-label indications, but concerns persist about their quality. About half of dossiers included economic analyses, but these analyses had relatively low levels of compliance with recommended practices.

Placental alpha-microglobulin-1 and combined traditional diagnostic test: a cost-benefit analysis.

PubMed

Echebiri, Nelson C; McDoom, M Maya; Pullen, Jessica A; Aalto, Meaghan M; Patel, Natasha N; Doyle, Nora M

2015-01-01

We sought to evaluate if the placental alpha-microglobulin (PAMG)-1 test vs the combined traditional diagnostic test (CTDT) of pooling, nitrazine, and ferning would be a cost-beneficial screening strategy in the setting of potential preterm premature rupture of membranes. A decision analysis model was used to estimate the economic impact of PAMG-1 test vs the CTDT on preterm delivery costs from a societal perspective. Our primary outcome was the annual net cost-benefit per person tested. Baseline probabilities and costs assumptions were derived from published literature. We conducted sensitivity analyses using both deterministic and probabilistic models. Cost estimates reflect 2013 US dollars. Annual net benefit from PAMG-1 was $20,014 per person tested, while CTDT had a net benefit of $15,757 per person tested. If the probability of rupture is <38%, PAMG-1 will be cost-beneficial with an annual net benefit of $16,000-37,000 per person tested, while CTDT will have an annual net benefit of $16,000-19,500 per person tested. If the probability of rupture is >38%, CTDT is more cost-beneficial. Monte Carlo simulations of 1 million trials selected PAMG-1 as the optimal strategy with a frequency of 89%, while CTDT was only selected as the optimal strategy with a frequency of 11%. Sensitivity analyses were robust. Our cost-benefit analysis provides the economic evidence for the adoption of PAMG-1 in diagnosing preterm premature rupture of membranes in uncertain presentations and when CTDT is equivocal at 34 to <37 weeks' gestation. Copyright © 2015 Elsevier Inc. All rights reserved.

The formation of continuous opinion dynamics based on a gambling mechanism and its sensitivity analysis

NASA Astrophysics Data System (ADS)

Zhu, Yueying; Alexandre Wang, Qiuping; Li, Wei; Cai, Xu

2017-09-01

The formation of continuous opinion dynamics is investigated based on a virtual gambling mechanism where agents fight for a limited resource. We propose a model with agents holding opinions between -1 and 1. Agents are segregated into two cliques according to the sign of their opinions. Local communication happens only when the opinion distance between corresponding agents is no larger than a pre-defined confidence threshold. Theoretical analysis regarding special cases provides a deep understanding of the roles of both the resource allocation parameter and confidence threshold in the formation of opinion dynamics. For a sparse network, the evolution of opinion dynamics is negligible in the region of low confidence threshold when the mindless agents are absent. Numerical results also imply that, in the presence of economic agents, high confidence threshold is required for apparent clustering of agents in opinion. Moreover, a consensus state is generated only when the following three conditions are satisfied simultaneously: mindless agents are absent, the resource is concentrated in one clique, and confidence threshold tends to a critical value(=1.25+2/ka ; k_a>8/3 , the average number of friends of individual agents). For fixed a confidence threshold and resource allocation parameter, the most chaotic steady state of the dynamics happens when the fraction of mindless agents is about 0.7. It is also demonstrated that economic agents are more likely to win at gambling, compared to mindless ones. Finally, the importance of three involved parameters in establishing the uncertainty of model response is quantified in terms of Latin hypercube sampling-based sensitivity analysis.

Cost-effectiveness analysis of treatment alternatives for beef bulls with preputial prolapse.

PubMed

Kasari, T R; McGrann, J M; Hooper, R N

1997-10-01

To develop an economic model for comparing cost-effectiveness of medical and surgical treatment versus replacement of beef bulls with preputial prolapse. Economic analysis. Estimates determined from medical records of bulls treated for preputial prolapse at our hospital and from information about treatment of bulls published elsewhere. Annual depreciation cost for treatment (ADC(T)) and replacement (ADC(R)) were calculated. Total investment for an injured bull equaled the sum of salvage value, maintenance cost, and expected cost of the treatment option under consideration. Total investment for a replacement bull was purchase price. Net present value of cost was calculated for each year of bull use. Sensitivity analyses were constructed to determine the value that would warrant treatment of an injured bull. The decision to treat was indicated when ADC(T) was less than ADC(R). In our example, it was more cost-effective for owners to cull an injured bull. The ADC(R) was $97 less than ADC(T) for medical treatment ($365 vs $462) and $280 less than ADC(T) for surgical treatment ($365 vs $645). Likewise, net present value of cost values indicated that it was more cost-effective for owners to cull an injured bull. Sensitivity analysis indicated treatment decisions were justified on the basis of replacement value or planned number of breeding seasons remaining for the bull. The model described here can be used by practitioners to provide an objective basis to guide decision making of owners who seek advice on whether to treat or replace bulls with preputial prolapse.

Integrated techno-economic and environmental analysis of butadiene production from biomass.

PubMed

Farzad, Somayeh; Mandegari, Mohsen Ali; Görgens, Johann F

2017-09-01

In this study, lignocellulose biorefineries annexed to a typical sugar mill were investigated to produce either ethanol (EtOH) or 1,3-butadiene (BD), utilizing bagasse and trash as feedstock. Aspen simulation of the scenarios were developed and evaluated in terms of economic and environmental performance. The minimum selling prices (MSPs) for bio-based BD and EtOH production were 2.9-3.3 and 1.26-1.38-fold higher than market prices, respectively. Based on the sensitivity analysis results, capital investment, Internal Rate of Return and extension of annual operating time had the greatest impact on the MSP. Monte Carlo simulation demonstrated that EtOH and BD productions could be profitable if the average of ten-year historical price increases by 1.05 and 1.9-fold, respectively. The fossil-based route was found inferior to bio-based pathway across all investigated environmental impact categories, due to burdens associated with oil extraction. Copyright © 2017 Elsevier Ltd. All rights reserved.

Process model and economic analysis of ethanol production from sugar beet raw juice as part of the cleaner production concept.

PubMed

Vučurović, Damjan G; Dodić, Siniša N; Popov, Stevan D; Dodić, Jelena M; Grahovac, Jovana A

2012-01-01

The batch fermentation process of sugar beet processing intermediates by free yeast cells is the most widely used method in the Autonomous Province of Vojvodina for producing ethanol as fuel. In this study a process and cost model was developed for producing ethanol from raw juice. The model can be used to calculate capital investment costs, unit production costs and operating costs for a plant producing 44 million l of 99.6% pure ethanol annually. In the sensitivity analysis the influence of sugar beet and yeast price, as well as the influence of recycled biomass on process economics, ethanol production costs and project feasibility was examined. The results of this study clearly demonstrate that the raw material costs have a significant influence on the expenses for producing ethanol. Also, the optimal percentage of recycled biomass turned out to be in the range from 50% to 70%. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Utility of Behavioral Economics in Expanding the Free-Feed Model of Obesity

PubMed Central

Rasmussen, Erin B.; Robertson, Stephen H.; Rodriguez, Luis R.

2016-01-01

Animal models of obesity are numerous and diverse in terms of identifying specific neural and peripheral mechanisms related to obesity; however, they are limited when it comes to behavior. The standard behavioral measure of food intake in most animal models occurs in a free-feeding environment. While easy and cost-effective for the researcher, the free-feeding environment omits some of the most important features of obesity-related food consumption—namely, properties of food availability, such as effort and delay to obtaining food. Behavior economics expands behavioral measures of obesity animal models by identifying such behavioral mechanisms. First, economic demand analysis allows researchers to understand the role of effort in food procurement, and how physiological and neural mechanisms are related. Second, studies on delay discounting contribute to a growing literature that shows that sensitivity to delayed food- and food-related outcomes is likely a fundamental process of obesity. Together, these data expand the animal model in a manner that better characterizes how environmental factors influence food consumption. PMID:26923097

Climate, weather, socio-economic and electricity usage data for the residential and commercial sectors in FL, U.S.

PubMed

Mukhopadhyay, Sayanti; Nateghi, Roshanak

2017-08-01

This paper presents the data that is used in the article entitled "Climate sensitivity of end-use electricity consumption in the built environment: An application to the state of Florida, United States" (Mukhopadhyay and Nateghi, 2017) [1]. The data described in this paper pertains to the state of Florida (during the period of January 1990 to November 2015). It can be classified into four categories of (i) state-level electricity consumption data; (ii) climate data; (iii) weather data; and (iv) socio-economic data. While, electricity consumption data and climate data are obtained at monthly scale directly from the source, the weather data was initially obtained at daily-level, and then aggregated to monthly level for the purpose of analysis. The time scale of socio-economic data varies from monthly-level to yearly-level. This dataset can be used to analyze the influence of climate and weather on the electricity demand as described in Mukhopadhyay and Nateghi (2017) [1].

Process simulation and economic assessment of hydrothermal pretreatment and enzymatic hydrolysis of multi-feedstock lignocellulose - Separate vs combined processing.

PubMed

Ashraf, Muhammad Tahir; Schmidt, Jens Ejbye

2018-02-01

Biorefinery based on multi-feedstock lignocellulose can be viable where a sustainable supply of a single substrate is limited, for example in arid regions. Processing of mixed feedstocks has been studied in lab scale, however, its economics are less studied. In this study, an economic comparison was made between separate and combined (mixed) processing approaches for multi-feedstock lignocellulose for the production of monomeric sugars. This modular approach of focusing on sugar platform makes the results applicable for many applications using the sugars as feedstock. Feedstock considered in this study were the green and woody lignocellulose residues: Bermuda grass, Jasmine hedges, and date palm fronds. Results showed that, at an identical total feed rate, combined processing was more advantageous as compared to separate processing. A further sensitivity analysis on mixed combined processing showed that the cellulase enzyme price and feed price are the two major factors affecting the production cost. Copyright © 2017 Elsevier Ltd. All rights reserved.

Techno-economic feasibility and life cycle assessment of dairy effluent to renewable diesel via hydrothermal liquefaction.

PubMed

Summers, Hailey M; Ledbetter, Rhesa N; McCurdy, Alex T; Morgan, Michael R; Seefeldt, Lance C; Jena, Umakanta; Hoekman, S Kent; Quinn, Jason C

2015-11-01

The economic feasibility and environmental impact is investigated for the conversion of agricultural waste, delactosed whey permeate, through yeast fermentation to a renewable diesel via hydrothermal liquefaction. Process feasibility was demonstrated at laboratory-scale with data leveraged to validate systems models used to perform industrial-scale economic and environmental impact analyses. Results show a minimum fuel selling price of $4.78 per gallon of renewable diesel, a net energy ratio of 0.81, and greenhouse gas emissions of 30.0g-CO2-eqMJ(-1). High production costs and greenhouse gas emissions can be attributed to operational temperatures and durations of both fermentation and hydrothermal liquefaction. However, high lipid yields of the yeast counter these operational demands, resulting in a favorable net energy ratio. Results are presented on the optimization of the process based on economy of scale and a sensitivity analysis highlights improvements in conversion efficiency, yeast biomass productivity and hydrotreating efficiency can dramatically improve commercial feasibility. Copyright © 2015 Elsevier Ltd. All rights reserved.

Techno-economic assessment of biofuel development by anaerobic digestion of European marine cold-water seaweeds.

PubMed

Dave, Ashok; Huang, Ye; Rezvani, Sina; McIlveen-Wright, David; Novaes, Marcio; Hewitt, Neil

2013-05-01

The techno-economic characteristics of macro-algae utilisation from European temperate zones was evaluated in a selected Anaerobic Digester (AD) using the chemical process modelling software ECLIPSE. The assessment covered the mass and energy balance of the entire process followed by the economic feasibility study, which included the total cost estimation, net present value calculation, and sensitivity analysis. The selected plant size corresponded to a community based AD of 1.6 MWth with a macro-algae feed rate of 8.64 tonnes per day (dry basis). The produced biogas was utilised in a combined heat and power plant generating 237 kWenet electricity and 367 kWth heat. The breakeven electricity-selling price in this study was estimated at around €120/MWh. On the ground of different national and regional policies, this study did not account for any government incentives. However, different support mechanisms such as Feed-in-Tariffs or Renewable Obligation Certificates can significantly improve the project viability. Copyright © 2013 Elsevier Ltd. All rights reserved.

Reducing Brain Signal Noise in the Prediction of Economic Choices: A Case Study in Neuroeconomics

PubMed Central

Sundararajan, Raanju R.; Palma, Marco A.; Pourahmadi, Mohsen

2017-01-01

In order to reduce the noise of brain signals, neuroeconomic experiments typically aggregate data from hundreds of trials collected from a few individuals. This contrasts with the principle of simple and controlled designs in experimental and behavioral economics. We use a frequency domain variant of the stationary subspace analysis (SSA) technique, denoted as DSSA, to filter out the noise (nonstationary sources) in EEG brain signals. The nonstationary sources in the brain signal are associated with variations in the mental state that are unrelated to the experimental task. DSSA is a powerful tool for reducing the number of trials needed from each participant in neuroeconomic experiments and also for improving the prediction performance of an economic choice task. For a single trial, when DSSA is used as a noise reduction technique, the prediction model in a food snack choice experiment has an increase in overall accuracy by around 10% and in sensitivity and specificity by around 20% and in AUC by around 30%, respectively. PMID:29311784

Reducing Brain Signal Noise in the Prediction of Economic Choices: A Case Study in Neuroeconomics.

PubMed

Sundararajan, Raanju R; Palma, Marco A; Pourahmadi, Mohsen

2017-01-01

In order to reduce the noise of brain signals, neuroeconomic experiments typically aggregate data from hundreds of trials collected from a few individuals. This contrasts with the principle of simple and controlled designs in experimental and behavioral economics. We use a frequency domain variant of the stationary subspace analysis (SSA) technique, denoted as DSSA, to filter out the noise (nonstationary sources) in EEG brain signals. The nonstationary sources in the brain signal are associated with variations in the mental state that are unrelated to the experimental task. DSSA is a powerful tool for reducing the number of trials needed from each participant in neuroeconomic experiments and also for improving the prediction performance of an economic choice task. For a single trial, when DSSA is used as a noise reduction technique, the prediction model in a food snack choice experiment has an increase in overall accuracy by around 10% and in sensitivity and specificity by around 20% and in AUC by around 30%, respectively.

Experimental sensitivity analysis of subsoil-slab behaviour regarding degree of fibre-concrete slab reinforcement

NASA Astrophysics Data System (ADS)

Hrubesova, E.; Lahuta, H.; Mohyla, M.; Quang, T. B.; Phi, N. D.

2018-04-01

The paper is focused on the sensitivity analysis of behaviour of the subsoil – foundation system as regards the variant properties of fibre-concrete slab resulting into different relative stiffness of the whole cooperating system. The character of slab and its properties are very important for the character of external load transfer, but the character of subsoil cannot be neglected either because it determines the stress-strain behaviour of the all system and consequently the bearing capacity of structure. The sensitivity analysis was carried out based on experimental results, which include both the stress values in soil below the foundation structure and settlements of structure, characterized by different quantity of fibres in it. Flat dynamometers GEOKON were used for the stress measurements below the observed slab, the strains inside slab were registered by tensometers, the settlements were monitored geodetically. The paper is focused on the comparison of soil stresses below the slab for different quantity of fibres in structure. The results obtained from the experimental stand can contribute to more objective knowledge of soil – slab interaction, to the evaluation of real carrying capacity of the slab, to the calibration of corresponding numerical models, to the optimization of quantity of fibres in the slab, and finally, to higher safety and more economical design of slab.

Digression and Value Concatenation to Enable Privacy-Preserving Regression.

PubMed

Li, Xiao-Bai; Sarkar, Sumit

2014-09-01

Regression techniques can be used not only for legitimate data analysis, but also to infer private information about individuals. In this paper, we demonstrate that regression trees, a popular data-analysis and data-mining technique, can be used to effectively reveal individuals' sensitive data. This problem, which we call a "regression attack," has not been addressed in the data privacy literature, and existing privacy-preserving techniques are not appropriate in coping with this problem. We propose a new approach to counter regression attacks. To protect against privacy disclosure, our approach introduces a novel measure, called digression , which assesses the sensitive value disclosure risk in the process of building a regression tree model. Specifically, we develop an algorithm that uses the measure for pruning the tree to limit disclosure of sensitive data. We also propose a dynamic value-concatenation method for anonymizing data, which better preserves data utility than a user-defined generalization scheme commonly used in existing approaches. Our approach can be used for anonymizing both numeric and categorical data. An experimental study is conducted using real-world financial, economic and healthcare data. The results of the experiments demonstrate that the proposed approach is very effective in protecting data privacy while preserving data quality for research and analysis.

Energy Conservation in the Acquisition Process

DTIC Science & Technology

1980-10-01

National Energy Strategies Project," S. H. Schurr, J. Darmstradter, W. Ramsey , H. Perry, M. Russell, The John Hopkins University Press, Baltimore, MD...1.8% 1990-1995 0 to 4.8% 2.1% 3.1% - 1995-2000 0 to 1.5% 1.2% 3.0% Source: Federal Register, 23 June 1980, p. 42193. should be tested for the effect...34Economic Analysis and Program Evaluation for Program Management" 18 Oct., 1972 calls for "a test of the sensitivity of the results of any factor

An empirical investigation on the forecasting ability of mallows model averaging in a macro economic environment

NASA Astrophysics Data System (ADS)

Yin, Yip Chee; Hock-Eam, Lim

2012-09-01

This paper investigates the forecasting ability of Mallows Model Averaging (MMA) by conducting an empirical analysis of five Asia countries, Malaysia, Thailand, Philippines, Indonesia and China's GDP growth rate. Results reveal that MMA has no noticeable differences in predictive ability compared to the general autoregressive fractional integrated moving average model (ARFIMA) and its predictive ability is sensitive to the effect of financial crisis. MMA could be an alternative forecasting method for samples without recent outliers such as financial crisis.

Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes.

PubMed

O'Sullivan, Ronan; Murphy, Aileen; O'Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D William

2016-04-26

Although advance care planning (ACP) and the use of advanced care directives (ACD) and end-of-life care plans are associated with a reduction in inappropriate hospitalisation, there is little evidence supporting the economic benefits of such programmes. We assessed the economic impact (gross savings) of the Let Me Decide (LMD) ACP programme in Ireland, specifically the impact on hospitalisations, bed days and location of resident deaths, before and after systematic implementation of the LMD-ACP combined with a palliative care education programme. The LMD-ACP was introduced into three long-term care (LTC) facilities in Southern Ireland and outcomes were compared pre and post implementation. In addition, 90 staff were trained in a palliative care educational programme. Economic analysis including probabilistic sensitivity analysis was performed. The uptake of an ACD or end-of-life care post-implementation rose from 25 to 76%. Post implementation, there were statistically significant decreases in hospitalisation rates from baseline (hospitalisation incidents declined from 27.8 to 14.6%, z = 3.96, p < 0.001; inpatient hospital days reduced from 0.54 to 0.36%, z = 8.85, p < 0.001). The percentage of hospital deaths also decreased from 22.9 to 8.4%, z = 3.22, p = 0.001. However, length of stay (LOS) increased marginally (7-9 days). Economic analysis suggested a cost-reduction related to reduced hospitalisations ranging between €10 and €17.8 million/annum and reduction in ambulance transfers, estimated at €0.4 million/annum if these results were extrapolated nationally. When unit costs and LOS estimates were varied in scenario analyses, the expected cost reduction owing to reduced hospitalisations, ranged from €17.7 to €42.4 million nationally. Implementation of the LMD-ACP (ACD/end-of-life care plans combined with palliative care education) programme resulted in reduced rates of hospitalisation. Despite an increase in LOS, likely reflecting more complex care needs of admitted residents, gross costs were reduced and scenario analysis projected large annual savings if these results were extrapolated to the wider LTC population in Ireland.

Economic evaluation on CO₂-EOR of onshore oil fields in China

DOE PAGES

Wei, Ning; Li, Xiaochun; Dahowski, Robert T.; ...

2015-06-01

Carbon dioxide enhanced oil recovery (CO₂-EOR) and sequestration in depleted oil reservoirs is a plausible option for utilizing anthropogenic CO₂ to increase oil production while storing CO₂ underground. Evaluation of the storage resources and cost of potential CO₂-EOR projects is an essential step before the commencement of large-scale deployment of such activities. In this paper, a hybrid techno-economic evaluation method, including a performance model and cost model for onshore CO₂-EOR projects, has been developed based on previous studies. Total 296 onshore oil fields, accounting for about 70% of total mature onshore oil fields in China, were evaluated by the techno-economicmore » method. The key findings of this study are summarized as follows: (1) deterministic analysis shows there are approximately 1.1 billion tons (7.7 billion barrels) of incremental crude oil and 2.2 billion tons CO₂ storage resource for onshore CO₂-EOR at net positive revenue within the Chinese oil fields reviewed under the given operating strategy and economic assumptions. (2) Sensitivity study highlights that the cumulative oil production and cumulative CO₂ storage resource are very sensitive to crude oil price, CO₂ cost, project lifetime, discount rate and tax policy. High oil price, short project lifetime, low discount rate, low CO₂ cost, and low tax policy can greatly increase the net income of the oil enterprise, incremental oil recovery and CO₂ storage resource. (3) From this techno-economic evaluation, the major barriers to large-scale deployment of CO₂-EOR include complex geological conditions, low API of crude oil, high tax policy, and lack of incentives for the CO₂-EOR project.« less

Economic evaluation on CO₂-EOR of onshore oil fields in China

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

Wei, Ning; Li, Xiaochun; Dahowski, Robert T.

Carbon dioxide enhanced oil recovery (CO₂-EOR) and sequestration in depleted oil reservoirs is a plausible option for utilizing anthropogenic CO₂ to increase oil production while storing CO₂ underground. Evaluation of the storage resources and cost of potential CO₂-EOR projects is an essential step before the commencement of large-scale deployment of such activities. In this paper, a hybrid techno-economic evaluation method, including a performance model and cost model for onshore CO₂-EOR projects, has been developed based on previous studies. Total 296 onshore oil fields, accounting for about 70% of total mature onshore oil fields in China, were evaluated by the techno-economicmore » method. The key findings of this study are summarized as follows: (1) deterministic analysis shows there are approximately 1.1 billion tons (7.7 billion barrels) of incremental crude oil and 2.2 billion tons CO₂ storage resource for onshore CO₂-EOR at net positive revenue within the Chinese oil fields reviewed under the given operating strategy and economic assumptions. (2) Sensitivity study highlights that the cumulative oil production and cumulative CO₂ storage resource are very sensitive to crude oil price, CO₂ cost, project lifetime, discount rate and tax policy. High oil price, short project lifetime, low discount rate, low CO₂ cost, and low tax policy can greatly increase the net income of the oil enterprise, incremental oil recovery and CO₂ storage resource. (3) From this techno-economic evaluation, the major barriers to large-scale deployment of CO₂-EOR include complex geological conditions, low API of crude oil, high tax policy, and lack of incentives for the CO₂-EOR project.« less

The association between living through a prolonged economic depression and the male:female birth ratio--a longitudinal study from Cuba, 1960-2008.

PubMed

Venero Fernández, Silvia Josefina; Medina, Ramon Suárez; Britton, John; Fogarty, Andrew W

2011-12-15

The Trivers-Willard hypothesis suggests that populations respond to scarcity by decreasing the ratio of males to females at livebirth. Cuba experienced an extreme economic depression in the 1990s called the "special period." Using time-series analysis, the authors studied the impact of this event on the male:female sex ratio at birth in Cuba from 1960 to 2008. From 1990 to 1993, the per capita gross domestic product in Cuba decreased by 36%. By use of a definition of the special period from 1991 to 1998, there was a prolonged increase in the male:female ratio of livebirths during this period of economic depression (P < 0.001), from 1.06 at baseline to a peak of 1.18. This association persisted when using alternative definitions of the duration of economic depression in sensitivity analyses. Once the period of economic depression was over, the male:female ratio returned to the baseline value. These data suggest that, in Cuba, contrary to the Trivers-Willard hypothesis, the human population responded to conditions of scarcity by increasing the ratio of males to females at livebirth. These data may be relevant in the modeling of demographic projections in countries that experience prolonged economic depression and in understanding adaptive human reproductive responses to environmental change.

Cost-effectiveness of the Carbon-13 Urea Breath Test for the Detection of Helicobacter Pylori

PubMed Central

Masucci, L; Blackhouse, G; Goeree, R

2013-01-01

Objectives This analysis aimed to evaluate the cost-effectiveness of various testing strategies for Helicobacter pylori in patients with uninvestigated dyspepsia and to calculate the budgetary impact of these tests for the province of Ontario. Data Sources Data on the sensitivity and specificity were obtained from the clinical evidence-based analysis. Resource items were obtained from expert opinion, and costs were applied on the basis of published sources as well as expert opinion. Review Methods A decision analytic model was constructed to compare the costs and outcomes (false-positive results, false-negative results, and misdiagnoses avoided) of the carbon-13 (13C) urea breath test (UBT), enzyme-linked immunosorbent assay (ELISA) serology test, and a 2-step strategy of an ELISA serology test and a confirmatory 13C UBT based on the sensitivity and specificity of the tests and prevalence estimates. Results The 2-step strategy is more costly and more effective than the ELISA serology test and results in $210 per misdiagnosis case avoided. The 13C UBT is dominated by the 2-step strategy, i.e., it is more costly and less effective. The budget impact analysis indicates that it will cost $7.9 million more to test a volume of 129,307 patients with the 13C UBT than with ELISA serology, and $4.7 million more to test these patients with the 2-step strategy. Limitations The clinical studies that were pooled varied in the technique used to perform the breath test and in reference standards used to make comparisons with the breath test. However, these parameters were varied in a sensitivity analysis. The economic model was designed to consider intermediate outcomes only (i.e., misdiagnosed cases) and was not a complete model with final patient outcomes (e.g., quality-adjusted life years). Conclusions Results indicate that the 2-step strategy could be economically attractive for the testing of H. pylori. However, testing with the 2-step strategy will cost the Ministry of Health and Long-Term Care $4.7 million more than with the ELISA serology test. PMID:24228083

The economic impact of Clostridium difficile infection: a systematic review.

PubMed

Nanwa, Natasha; Kendzerska, Tetyana; Krahn, Murray; Kwong, Jeffrey C; Daneman, Nick; Witteman, William; Mittmann, Nicole; Cadarette, Suzanne M; Rosella, Laura; Sander, Beate

2015-04-01

With Clostridium difficile infection (CDI) on the rise, knowledge of the current economic burden of CDI can inform decisions on interventions related to CDI. We systematically reviewed CDI cost-of-illness (COI) studies. We performed literature searches in six databases: MEDLINE, Embase, the Health Technology Assessment Database, the National Health Service Economic Evaluation Database, the Cost-Effectiveness Analysis Registry, and EconLit. We also searched gray literature and conducted reference list searches. Two reviewers screened articles independently. One reviewer abstracted data and assessed quality using a modified guideline for economic evaluations. The second reviewer validated the abstraction and assessment. We identified 45 COI studies between 1988 and June 2014. Most (84%) of the studies were from the United States, calculating costs of hospital stays (87%), and focusing on direct costs (100%). Attributable mean CDI costs ranged from $8,911 to $30,049 for hospitalized patients. Few studies stated resource quantification methods (0%), an epidemiological approach (0%), or a justified study perspective (16%) in their cost analyses. In addition, few studies conducted sensitivity analyses (7%). Forty-five COI studies quantified and confirmed the economic impact of CDI. Costing methods across studies were heterogeneous. Future studies should follow standard COI methodology, expand study perspectives (e.g., patient), and explore populations least studied (e.g., community-acquired CDI).

Study of quiet turbofan STOL aircraft for short-haul transportation. Volume 6: Systems analysis

NASA Technical Reports Server (NTRS)

1973-01-01

A systems analysis of the quiet turbofan aircraft for short-haul transportation was conducted. The purpose of the study was to integrate the representative data generated by aircraft, market, and economic analyses. Activities of the study were to develop the approach and to refine the methodologies for analytic tradeoff, and sensitivity studies of propulsive lift conceptual aircraft and their performance in simulated regional airlines. The operations of appropriate airlines in each of six geographic regions of the United States were simulated. The offshore domestic regions were evaluated to provide a complete domestic evaluation of the STOL concept applicability.

The Economics of Solar Heating

NASA Technical Reports Server (NTRS)

Forney, J. A.

1982-01-01

SHCOST program assesses economic feasibility of solar energy for single-family residences and light commercial applications. Program analyzes life-cycle costs as well as sensitivity studies to aid designer in selecting most economically attractive solar system for single-family residence or light commercial application. SHCOST includes fairly comprehensive list of cost elements from which user may select.

The Economic Impact of Eradicating Peste des Petits Ruminants: A Benefit-Cost Analysis

PubMed Central

Jones, Bryony A.; Rich, Karl M.; Mariner, Jeffrey C.; Anderson, John; Jeggo, Martyn; Thevasagayam, Sam; Cai, Yi; Peters, Andrew R.; Roeder, Peter

2016-01-01

Peste des petits ruminants (PPR) is an important cause of mortality and production loss among sheep and goats in the developing world. Despite control efforts in a number of countries, it has continued to spread across Africa and Asia, placing an increasing burden on the livelihoods of livestock keepers and on veterinary resources in affected countries. Given the similarities between PPR and rinderpest, and the lessons learned from the successful global eradication of rinderpest, the eradication of PPR seems appealing, both eliminating an important disease and improving the livelihoods of the poor in developing countries. We conducted a benefit-cost analysis to examine the economic returns from a proposed programme for the global eradication of PPR. Based on our knowledge and experience, we developed the eradication strategy and estimated its costs. The benefits of the programme were determined from (i) the averted mortality costs, based on an analysis of the literature, (ii) the downstream impact of reduced mortality using a social accounting matrix, and (iii) the avoided control costs based on current levels of vaccination. The results of the benefit-cost analysis suggest strong economic returns from PPR eradication. Based on a 15-year programme with total discounted costs of US$2.26 billion, we estimate discounted benefits of US$76.5 billion, yielding a net benefit of US$74.2 billion. This suggests a benefit cost ratio of 33.8, and an internal rate of return (IRR) of 199%. As PPR mortality rates are highly variable in different populations, we conducted a sensitivity analysis based on lower and higher mortality scenarios. All the scenarios examined indicate that investment in PPR eradication would be highly beneficial economically. Furthermore, removing one of the major constraints to small ruminant production would be of considerable benefit to many of the most vulnerable communities in Africa and Asia. PMID:26900944

Are iso-osmolar, as compared to low-osmolar, contrast media cost-effective in patients undergoing cardiac catheterization? An economic analysis.

PubMed

Hiremath, Swapnil; Akbari, Ayub; Wells, George A; Chow, Benjamin J W

2018-04-23

Contrast-induced acute kidney injury is a prominent complication following cardiac catheterization, though the risk has progressively decreased in recent times with appropriate risk stratification and use of safer contrast agents. Despite data supporting further lowering of risk with the iso-osmolar agent, iodixanol, uptake has lagged, perhaps due to increased upfront cost of this agent. We undertook an economic analysis to estimate the cost-effectiveness of a strategy utilizing iodixanol compared to using a low-osmolar contrast agent. We created a Markov model to evaluate the two strategies, and included a differential relative risk of contrast-induced acute kidney injury, based on a systematic review of the literature. Downstream clinical events, including need for dialysis and mortality, were modeled using data from existing published literature. A third-party payer perspective was utilized for the analysis and presentation of the primary economic analysis. The strategy of using iodixanol dominated in both the low-risk and high-risk base case analyses. However, the difference was quite small in the low-risk scenario (lifetime cost: C$678,034 vs. C$678,059 and life expectancy: 19.80 vs. 19.72 years). The difference was more marked (life expectancy 15.65 vs. 14.15 years and cost C$680,989 vs. C$682,023) in the high-risk case analysis. This was robust across most of the variables tested in sensitivity analyses. The use of iodixanol, compared with low-osmolar contrast agents, for cardiac catheterization, results in a small benefit clinical outcomes, and in a savings in direct healthcare costs. Overall, our analysis supports the use of iodixanol for cardiac catheterization, especially in patients at high risk of acute kidney injury.

Mixed crop-livestock systems: an economic and environmental-friendly way of farming?

PubMed

Ryschawy, J; Choisis, N; Choisis, J P; Joannon, A; Gibon, A

2012-10-01

Intensification and specialisation of agriculture in developed countries enabled productivity to be improved but had detrimental impacts on the environment and threatened the economic viability of a huge number of farms. The combination of livestock and crops, which was very common in the past, is assumed to be a viable alternative to specialised livestock or cropping systems. Mixed crop-livestock systems can improve nutrient cycling while reducing chemical inputs and generate economies of scope at farm level. Most assumptions underlying these views are based on theoretical and experimental evidence. Very few assessments of their environmental and economic advantages have nevertheless been undertaken in real-world farming conditions. In this paper, we present a comparative assessment of the environmental and economic performances of mixed crop-livestock farms v. specialised farms among the farm population of the French 'Coteaux de Gascogne'. In this hilly region, half of the farms currently use a mixed crop-livestock system including beef cattle and cash crops, the remaining farms being specialised in either crops or cattle. Data were collected through an exhaustive survey of farms located in our study area. The economic performances of farming systems were assessed on 48 farms on the basis of (i) overall gross margin, (ii) production costs and (iii) analysis of the sensitivity of gross margins to fluctuations in the price of inputs and outputs. The environmental dimension was analysed through (i) characterisation of farmers' crop management practices, (ii) analysis of farm land use diversity and (iii) nitrogen farm-gate balance. Local mixed crop-livestock farms did not have significantly higher overall gross margins than specialised farms but were less sensitive than dairy and crop farms to fluctuations in the price of inputs and outputs considered. Mixed crop-livestock farms had lower costs than crop farms, while beef farms had the lowest costs as they are grass-based systems. Concerning crop management practices, our results revealed an intensification gradient from low to high input farming systems. Beyond some general trends, a wide range of management practices and levels of intensification were observed among farms with a similar production system. Mixed crop-livestock farms were very heterogeneous with respect to the use of inputs. Nevertheless, our study revealed a lower potential for nitrogen pollution in mixed crop-livestock and beef production systems than in dairy and crop farming systems. Even if a wide variability exists within system, mixed crop-livestock systems appear to be a way for an environmental and economical sustainable agriculture.

The Effects of Climate Sensitivity and Carbon Cycle Interactions on Mitigation Policy Stringency

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

Calvin, Katherine V.; Bond-Lamberty, Benjamin; Edmonds, James A.

2015-07-01

Climate sensitivity and climate-carbon cycle feedbacks interact to determine how global carbon and energy cycles will change in the future. While the science of these connections is well documented, their economic implications are not well understood. Here we examine the effect of climate change on the carbon cycle, the uncertainty in climate outcomes inherent in any given policy target, and the economic implications. We examine three policy scenarios—a no policy “Reference” (REF) scenario, and two policies that limit total radiative forcing—with four climate sensitivities using a coupled integrated assessment model. Like previous work, we find that, within a given scenario,more » there is a wide range of temperature change and sea level rise depending on the realized climate sensitivity. We expand on this previous work to show that temperature-related feedbacks on the carbon cycle result in more mitigation required as climate sensitivity increases. Thus, achieving a particular radiative forcing target becomes increasingly expensive as climate sensitivity increases.« less

Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for advanced recurrent or refractory ovarian cancer: a systematic review and economic evaluation.

PubMed

Edwards, Steven J; Barton, Samantha; Thurgar, Elizabeth; Trevor, Nicola

2015-01-01

Ovarian cancer is the fifth most common cancer in the UK, and the fourth most common cause of cancer death. Of those people successfully treated with first-line chemotherapy, 55-75% will relapse within 2 years. At this time, it is uncertain which chemotherapy regimen is more clinically effective and cost-effective for the treatment of recurrent, advanced ovarian cancer. To determine the comparative clinical effectiveness and cost-effectiveness of topotecan (Hycamtin(®), GlaxoSmithKline), pegylated liposomal doxorubicin hydrochloride (PLDH; Caelyx(®), Schering-Plough), paclitaxel (Taxol(®), Bristol-Myers Squibb), trabectedin (Yondelis(®), PharmaMar) and gemcitabine (Gemzar(®), Eli Lilly and Company) for the treatment of advanced, recurrent ovarian cancer. Electronic databases (MEDLINE(®), EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment database, NHS Economic Evaluations Database) and trial registries were searched, and company submissions were reviewed. Databases were searched from inception to May 2013. A systematic review of the clinical and economic literature was carried out following standard methodological principles. Double-blind, randomised, placebo-controlled trials, evaluating topotecan, PLDH, paclitaxel, trabectedin and gemcitabine, and economic evaluations were included. A network meta-analysis (NMA) was carried out. A de novo economic model was developed. For most outcomes measuring clinical response, two networks were constructed: one evaluating platinum-based regimens and one evaluating non-platinum-based regimens. In people with platinum-sensitive disease, NMA found statistically significant benefits for PLDH plus platinum, and paclitaxel plus platinum for overall survival (OS) compared with platinum monotherapy. PLDH plus platinum significantly prolonged progression-free survival (PFS) compared with paclitaxel plus platinum. Of the non-platinum-based treatments, PLDH monotherapy and trabectedin plus PLDH were found to significantly increase OS, but not PFS, compared with topotecan monotherapy. In people with platinum-resistant/-refractory (PRR) disease, NMA found no statistically significant differences for any treatment compared with alternative regimens in OS and PFS. Economic modelling indicated that, for people with platinum-sensitive disease and receiving platinum-based therapy, the estimated probabilistic incremental cost-effectiveness ratio [ICER; incremental cost per additional quality-adjusted life-year (QALY)] for paclitaxel plus platinum compared with platinum was £24,539. Gemcitabine plus carboplatin was extendedly dominated, and PLDH plus platinum was strictly dominated. For people with platinum-sensitive disease and receiving non-platinum-based therapy, the probabilistic ICERs associated with PLDH compared with paclitaxel, and trabectedin plus PLDH compared with PLDH, were estimated to be £25,931 and £81,353, respectively. Topotecan was strictly dominated. For people with PRR disease, the probabilistic ICER associated with topotecan compared with PLDH was estimated to be £324,188. Paclitaxel was strictly dominated. As platinum- and non-platinum-based treatments were evaluated separately, the comparative clinical effectiveness and cost-effectiveness of these regimens is uncertain in patients with platinum-sensitive disease. For platinum-sensitive disease, it was not possible to compare the clinical effectiveness and cost-effectiveness of platinum-based therapies with non-platinum-based therapies. For people with platinum-sensitive disease and treated with platinum-based therapies, paclitaxel plus platinum could be considered cost-effective compared with platinum at a threshold of £30,000 per additional QALY. For people with platinum-sensitive disease and treated with non-platinum-based therapies, it is unclear whether PLDH would be considered cost-effective compared with paclitaxel at a threshold of £30,000 per additional QALY; trabectedin plus PLDH is unlikely to be considered cost-effective compared with PLDH. For patients with PRR disease, it is unlikely that topotecan would be considered cost-effective compared with PLDH. Randomised controlled trials comparing platinum with non-platinum-based treatments might help to verify the comparative effectiveness of these regimens. This study is registered as PROSPERO CRD42013003555. The National Institute for Health Research Health Technology Assessment programme.

Rural energy survey and cost-effectiveness analysis of renewable-energy technologies for a Philippine Island community

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

Manibog, F.R.

1982-01-01

This study presents the methodology and results of: (1) a rural energy survey that was conducted in a Philippine island community; and (2) a cost-effectiveness analysis of selected conventional and renewable-energy technologies. The rural energy survey section compares different survey techniques and analyzes energy utilization by providing: (1) a breakdown of energy flows and use patterns; (2) information on energy prices, ownership patterns, social relations, and their effects in terms of differential access to energy sources; (3) per household and per capita consumption figures; and (4) a village energy-consumption table. Correlation analysis is used to determine if the stratified, independentmore » socio-economic variables are indicators for dependent energy variables. Results of the economic analysis indicate that renewable-energy technologies are already least-cost alternatives to diesel generation in the village case study. The sensitivity analysis also shows that these technologies remain the least-cost options even if their capital costs were underestimated. The findings of the study are useful to the current Philippine renewable-energy program in terms of providing: (1) information essential for determining end-users' priority energy needs and for improving technology choice and project design; and (2) justification for promoting auto-generation based on renewable energy sources as alternatives to diesel fuel.« less

An economic evaluation of second-trimester genetic ultrasonography for prenatal detection of down syndrome.

PubMed

Vintzileos, A M; Ananth, C V; Fisher, A J; Smulian, J C; Day-Salvatore, D; Beazoglou, T; Knuppel, R A

1998-11-01

The objective of this study was to perform an economic evaluation of second-trimester genetic ultrasonography for prenatal detection of Down syndrome. More specifically, we sought to determine the following: (1) the diagnostic accuracy requirements (from the cost-benefit point of view) of genetic ultrasonography versus genetic amniocentesis for women at increased risk for fetal Down syndrome and (2) the possible economic impact of second-trimester genetic ultrasonography for the US population on the basis of the ultrasonographic accuracies reported in previously published studies. A cost-benefit equation was developed from the hypothesis that the cost of universal genetic amniocentesis of patients at increased risk for carrying a fetus with Down syndrome should be at least equal to the cost of universal genetic ultrasonography with amniocentesis used only for those with abnormal ultrasonographic results. The main components of the equation included the diagnostic accuracy of genetic ultrasonography (sensitivity and specificity for detecting Down syndrome), the costs of the amniocentesis package and genetic ultrasonography, and the lifetime cost of Down syndrome cases not detected by the genetic ultrasonography. After appropriate manipulation of the equation a graph was constructed, representing the balance between sensitivity and false-positive rate of genetic ultrasonography; this was used to examine the accuracy of previously published studies from the cost-benefit point of view. Sensitivity analyses included individual risks for Down syndrome ranging from 1:261 (risk of a 35-year-old at 18 weeks' gestation) to 1:44 (risk of a 44-year-old at 18 weeks' gestation). This economic evaluation was conducted from the societal perspective. Genetic ultrasonography was found to be economically beneficial only if the overall sensitivity for detecting Down syndrome was >74%. Even then, the cost-benefit ratio depended on the corresponding false-positive rate. Of the 7 published studies that used multiple ultrasonographic markers for genetic ultrasonography, 6 had accuracies compatible with benefits. The required ultrasonographic accuracy (sensitivity and false-positive rate) varied according to the prevalence of Down syndrome in the population tested. The cost-benefit ratio of second-trimester genetic ultrasonography depends on its diagnostic accuracy, and it is beneficial only when its overall sensitivity for Down syndrome is >74%.

Measuring and explaining eco-efficiencies of wastewater treatment plants in China: An uncertainty analysis perspective.

PubMed

Dong, Xin; Zhang, Xinyi; Zeng, Siyu

2017-04-01

In the context of sustainable development, there has been an increasing requirement for an eco-efficiency assessment of wastewater treatment plants (WWTPs). Data envelopment analysis (DEA), a technique that is widely applied for relative efficiency assessment, is used in combination with the tolerances approach to handle WWTPs' multiple inputs and outputs as well as their uncertainty. The economic cost, energy consumption, contaminant removal, and global warming effect during the treatment processes are integrated to interpret the eco-efficiency of WWTPs. A total of 736 sample plants from across China are assessed, and large sensitivities to variations in inputs and outputs are observed for most samples, with only three WWTPs identified as being stably efficient. Size of plant, overcapacity, climate type, and influent characteristics are proven to have a significant influence on both the mean efficiency and performance sensitivity of WWTPs, while no clear relationships were found between eco-efficiency and technology under the framework of uncertainty analysis. The incorporation of uncertainty quantification and environmental impact consideration has improved the liability and applicability of the assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Economic evaluation of the 70-gene prognosis-signature (MammaPrint®) in hormone receptor-positive, lymph node-negative, human epidermal growth factor receptor type 2-negative early stage breast cancer in Japan.

PubMed

Kondo, Masahide; Hoshi, Shu-Ling; Ishiguro, Hiroshi; Toi, Masakazu

2012-06-01

The 70-gene prognosis-signature is validated as a good predictor of recurrence for hormone receptor-positive (ER+), lymph node-negative (LN-), human epidermal growth factor receptor type 2-negative (HER2-) early stage breast cancer (ESBC) in Japanese patient population. Its high cost and potential in avoiding unnecessary adjuvant chemotherapy arouse interest in its economic impact. This study evaluates the cost-effectiveness of including the assay into Japan's social health insurance benefit package. An economic decision tree and Markov model under Japan's health system from the societal perspective is constructed with clinical evidence from the pool analysis of validation studies. One-way sensitivity analyses are also performed. Incremental cost-effectiveness ratio is estimated as ¥3,873,922/quality adjusted life year (QALY) (US$43,044/QALY), which is not more than the suggested social willingness-to-pay for one QALY gain from an innovative medical intervention in Japan, ¥5,000,000/QALY (US$55,556/QALY). However, sensitivity analyses show the instability of this estimation. The introduction of the assay into Japanese practice of ER+, LN-, HER2- ESBC treatment by including it to Japan's social health insurance benefit package has a reasonable chance to be judged as cost-effective and may be justified as an efficient deployment of finite health care resources.

A total internal reflection-fluorescence correlation spectroscopy setup with pulsed diode laser excitation

NASA Astrophysics Data System (ADS)

Weger, Lukas; Hoffmann-Jacobsen, Kerstin

2017-09-01

Fluorescence correlation spectroscopy (FCS) measures fluctuations in a (sub-)femtoliter volume to analyze the diffusive behavior of fluorescent particles. This highly sensitive method has proven to be useful for the analysis of dynamic biological systems as well as in chemistry, physics, and material sciences. It is routinely performed with commercial fluorescence microscopes, which provide a confined observation volume by the confocal technique. The evanescent wave of total internal reflectance (TIR) is used in home-built systems to permit a surface sensitive FCS analysis. We present a combined confocal and TIR-FCS setup which uses economic low-power pulsed diode lasers for excitation. Excitation and detection are coupled to time-correlated photon counting hardware. This allows simultaneous fluorescence lifetime and FCS measurements in a surface-sensitive mode. Moreover, the setup supports fluorescence lifetime correlation spectroscopy at surfaces. The excitation can be easily switched between TIR and epi-illumination to compare the surface properties with those in liquid bulk. The capabilities of the presented setup are demonstrated by measuring the diffusion coefficients of a free dye molecule, a labeled polyethylene glycol, and a fluorescent nanoparticle in confocal as well as in TIR-FCS.

Use of economic evaluation guidelines: 2 years' experience in Canada.

PubMed

Baladi, J F; Menon, D; Otten, N

1998-05-01

Considerable effort has been expended in recent years in the development of methodology guidelines for economic evaluation of pharmaceutical products, driven in part by the desire to improve the rigour and quality of economic evaluations and to help decision making. Canada was one of the first countries to develop such guidelines and to encourage their use. This paper examines the extent to which the economic evaluations that were submitted to the Canadian Coordinating Office for Health Technology Assessment in the last two years adhered to Canadian guidelines. The analytic technique employed by twelve studies as well as the comparator used, the perspective taken, the outcome measure selected, the cost items that were taken into consideration and the extent of sensitivity analyses that were performed are reviewed in this paper. It can be concluded that although studies have been of variable quality, the majority of them were well presented, complete and transparent, due in part to the guidelines. Except for the perspective of the analysis, guidelines were, in many respects, adhered to and did not restrict investigators to specific methodologies or specific techniques. They were also instrumental in ensuring a minimum set of standards.

Current technologies, economics, and perspectives for 2,5-dimethylfuran production from biomass-derived intermediates.

PubMed

Saha, Basudeb; Abu-Omar, Mahdi M

2015-04-13

Since the U.S. Department of Energy (DOE) published a perspective article that described the potential of the top ten biomass-derived platform chemicals as petroleum replacements for high-value commodity and specialty chemicals, researchers around the world have been motivated to develop technologies for the conversion of biomass and biomass-derived intermediates into chemicals and fuels. Among several biorefinery processes, the conversion of biomass carbohydrates into 2,5-dimethylfuran (DMF) has received significant attention because of its low oxygen content, high energy content, and high octane value. DMF can further serve as a petroleum-replacement, biorenewable feedstock for the production of p-xylene (pX). In this review, we aim specifically to present a concise and up-to-date analysis of DMF production technologies with a critical discussion on catalytic systems, mechanistic insight, and process economics, which includes sensitivity analysis, so that more effective catalysts can be designed. Special emphasis has been given to bifunctional catalysts that improve DMF yields and selectivity and the synergistic effect of the bifunctional sites. Process economics for the current processes and the scope for further improvement are discussed. It is anticipated that the chemistry detailed in this review will guide researchers to develop more practical catalytic processes to enable the economic production of bio-based DMF. Processes for the upgrade of DMF to pX are also described. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Detecting early signs of the 2007–2008 crisis in the world trade

PubMed Central

Saracco, Fabio; Di Clemente, Riccardo; Gabrielli, Andrea; Squartini, Tiziano

2016-01-01

Since 2007, several contributions have tried to identify early-warning signals of the financial crisis. However, the vast majority of analyses has focused on financial systems and little theoretical work has been done on the economic counterpart. In the present paper we fill this gap and employ the theoretical tools of network theory to shed light on the response of world trade to the financial crisis of 2007 and the economic recession of 2008–2009. We have explored the evolution of the bipartite World Trade Web (WTW) across the years 1995–2010, monitoring the behavior of the system both before and after 2007. Our analysis shows early structural changes in the WTW topology: since 2003, the WTW becomes increasingly compatible with the picture of a network where correlations between countries and products are progressively lost. Moreover, the WTW structural modification can be considered as concluded in 2010, after a seemingly stationary phase of three years. We have also refined our analysis by considering specific subsets of countries and products: the most statistically significant early-warning signals are provided by the most volatile macrosectors, especially when measured on developing countries, suggesting the emerging economies as being the most sensitive ones to the global economic cycles. PMID:27461469

Towards low carbon based economic development: Shanghai as a C40 city.

PubMed

Li, Zhijie; Galeano Galván, María José; Ravesteijn, Wim; Qi, Zhongying

2017-01-15

As a result of its rapid industrialization process, China has become the greatest emitter of carbon dioxide world-wide. Consequently, Shanghai - the most industrialized city in China - is facing serious challenges arising from carbon emissions and climate change in general. The main question of this paper is: How can Shanghai continue its economic growth, while controlling the negative consequences of its energy use and production in a responsible way? For the approach, it explores the use of the C40 framework, as an application and specification of new synergy seeking approaches, such as Value Sensitive Design. The C40 Cities Climate Leadership Group is a global city-level network to address climate change and promote world-class projects to reduce greenhouse gas emissions. In this paper, a quantitative analysis of Shanghai's energy trends is made as well as a SWOT analysis to map and evaluate its current environmental, social, economic and political characteristics. Three main challenges are presented, related to institutional inclusiveness, global relations, and long-term innovation. In view of the initiatives, targets, and the whole network of the C40 movement, this paper concludes that Shanghai is strongly recommended to fully use the C40 framework in creating a sustainable and responsible future. Copyright © 2016 Elsevier B.V. All rights reserved.

Detecting early signs of the 2007-2008 crisis in the world trade.

PubMed

Saracco, Fabio; Di Clemente, Riccardo; Gabrielli, Andrea; Squartini, Tiziano

2016-07-27

Since 2007, several contributions have tried to identify early-warning signals of the financial crisis. However, the vast majority of analyses has focused on financial systems and little theoretical work has been done on the economic counterpart. In the present paper we fill this gap and employ the theoretical tools of network theory to shed light on the response of world trade to the financial crisis of 2007 and the economic recession of 2008-2009. We have explored the evolution of the bipartite World Trade Web (WTW) across the years 1995-2010, monitoring the behavior of the system both before and after 2007. Our analysis shows early structural changes in the WTW topology: since 2003, the WTW becomes increasingly compatible with the picture of a network where correlations between countries and products are progressively lost. Moreover, the WTW structural modification can be considered as concluded in 2010, after a seemingly stationary phase of three years. We have also refined our analysis by considering specific subsets of countries and products: the most statistically significant early-warning signals are provided by the most volatile macrosectors, especially when measured on developing countries, suggesting the emerging economies as being the most sensitive ones to the global economic cycles.

Detecting early signs of the 2007-2008 crisis in the world trade

NASA Astrophysics Data System (ADS)

Saracco, Fabio; di Clemente, Riccardo; Gabrielli, Andrea; Squartini, Tiziano

2016-07-01

Since 2007, several contributions have tried to identify early-warning signals of the financial crisis. However, the vast majority of analyses has focused on financial systems and little theoretical work has been done on the economic counterpart. In the present paper we fill this gap and employ the theoretical tools of network theory to shed light on the response of world trade to the financial crisis of 2007 and the economic recession of 2008-2009. We have explored the evolution of the bipartite World Trade Web (WTW) across the years 1995-2010, monitoring the behavior of the system both before and after 2007. Our analysis shows early structural changes in the WTW topology: since 2003, the WTW becomes increasingly compatible with the picture of a network where correlations between countries and products are progressively lost. Moreover, the WTW structural modification can be considered as concluded in 2010, after a seemingly stationary phase of three years. We have also refined our analysis by considering specific subsets of countries and products: the most statistically significant early-warning signals are provided by the most volatile macrosectors, especially when measured on developing countries, suggesting the emerging economies as being the most sensitive ones to the global economic cycles.

The budget impact of oral nutritional supplements for disease related malnutrition in elderly in the community setting.

PubMed

Freijer, Karen; Nuijten, Mark J C; Schols, Jos M G A

2012-01-01

A health economic analysis was performed to assess the economic impact on the national health care budget of using oral nutritional supplements (ONS), being a food for special medical purposes also known as medical nutrition, for the treatment of disease related malnutrition (DRM) in the community in the Netherlands. An economic model was developed to calculate the budget impact of using ONS in community dwelling elderly (>5 years) with DRM in the Netherlands. The model reflects the costs of DRM and the cost reductions resulting from improvement in DRM due to treatment with ONS. Using ONS for the treatment of DRM in community dwelling elderly, leads to a total annual cost savings of € 13 million (18.9% savings), when all eligible patients are treated. The additional costs of ONS (€ 57 million) are more than balanced by a reduction of other health care costs, e.g., re-/hospitalization (€ 70 million). Sensitivity analyses were performed on all parameters, including duration of treatment with ONS and the prevalence of DRM. This budget impact analysis shows that the use of ONS for treatment of DRM in elderly patients in the community may lead to cost savings in the Netherlands.

The possible macroeconomic impact on the UK of an influenza pandemic.

PubMed

Keogh-Brown, Marcus R; Wren-Lewis, Simon; Edmunds, W John; Beutels, Philippe; Smith, Richard D

2010-11-01

Little is known about the possible impact of an influenza pandemic on a nation's economy. We applied the UK macroeconomic model 'COMPACT' to epidemiological data on previous UK influenza pandemics, and extrapolated a sensitivity analysis to cover more extreme disease scenarios. Analysis suggests that the economic impact of a repeat of the 1957 or 1968 pandemics, allowing for school closures, would be short-lived, constituting a loss of 3.35 and 0.58% of GDP in the first pandemic quarter and year, respectively. A more severe scenario (with more than 1% of the population dying) could yield impacts of 21 and 4.5%, respectively. The economic shockwave would be gravest when absenteeism (through school closures) increases beyond a few weeks, creating policy repercussions for influenza pandemic planning as the most severe economic impact is due to policies to contain the pandemic rather than the pandemic itself.Accounting for changes in consumption patterns made in an attempt to avoid infection worsens the potential impact. Our mild disease scenario then shows first quarter/first year reductions in GDP of 9.5/2.5%, compared with our severe scenario reductions of 29.5/6%. These results clearly indicate the significance of behavioural change over disease parameters. Copyright © 2009 John Wiley & Sons, Ltd.

Influence of watershed topographic and socio-economic attributes on the climate sensitivity of global river water quality

NASA Astrophysics Data System (ADS)

Khan, Afed U.; Jiang, Jiping; Wang, Peng; Zheng, Yi

2017-10-01

Surface waters exhibit regionalization due to various climatic conditions and anthropogenic activities. Here we assess the impact of topographic and socio-economic factors on the climate sensitivity of surface water quality, estimated using an elasticity approach (climate elasticity of water quality (CEWQ)), and identify potential risks of instability in different regions and climatic conditions. Large global datasets were used for 12 main water quality parameters from 43 water quality monitoring stations located at large major rivers. The results demonstrated that precipitation elasticity shows higher sensitivity to topographic and socio-economic determinants as compared to temperature elasticity. In tropical climate class (A), gross domestic product (GDP) played an important role in stabilizing the CEWQ. In temperate climate class (C), GDP played the same role in stability, while the runoff coefficient, slope, and population density fuelled the risk of instability. The results implied that watersheds with lower runoff coefficient, thick population density, over fertilization and manure application face a higher risk of instability. We discuss the socio-economic and topographic factors that cause instability of CEWQ parameters and conclude with some suggestions for watershed managers to bring sustainability in freshwater bodies.

[Evaluation of land resources carrying capacity of development zone based on planning environment impact assessment].

PubMed

Fu, Shi-Feng; Zhang, Ping; Jiang, Jin-Long

2012-02-01

Assessment of land resources carrying capacity is the key point of planning environment impact assessment and the main foundation to determine whether the planning could be implemented or not. With the help of the space analysis function of Geographic Information System, and selecting altitude, slope, land use type, distance from resident land, distance from main traffic roads, and distance from environmentally sensitive area as the sensitive factors, a comprehensive assessment on the ecological sensitivity and its spatial distribution in Zhangzhou Merchants Economic and Technological Development Zone, Fujian Province of East China was conducted, and the assessment results were combined with the planning land layout diagram for the ecological suitability analysis. In the Development Zone, 84.0% of resident land, 93.1% of industrial land, 86.0% of traffic land, and 76. 0% of other constructive lands in planning were located in insensitive and gently sensitive areas, and thus, the implement of the land use planning generally had little impact on the ecological environment, and the land resources in the planning area was able to meet the land use demand. The assessment of the population carrying capacity with ecological land as the limiting factor indicated that in considering the highly sensitive area and 60% of the moderately sensitive area as ecological land, the population within the Zone in the planning could reach 240000, and the available land area per capita could be 134.0 m2. Such a planned population scale is appropriate, according to the related standards of constructive land.

The development of a public optometry system in Mozambique: a Cost Benefit Analysis.

PubMed

Thompson, Stephen; Naidoo, Kovin; Harris, Geoff; Bilotto, Luigi; Ferrão, Jorge; Loughman, James

2014-09-23

The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa. A CBA methodology was applied across the period 2009-2049. Costs associated with establishing and operating a school of optometry, and a programme to address uncorrected refractive error, were included. Benefits were calculated using a human capital approach to valuing sight. Disability weightings from the Global Burden of Disease study were applied. Costs were subtracted from benefits to provide the net societal benefit, which was discounted to provide the net present value using a 3% discount rate. Using the most recently published disability weightings, the potential exists, through the correction of URE in 24.3 million potentially economically productive persons, to achieve a net present value societal benefit of up to $1.1 billion by 2049, at a Benefit-Cost ratio of 14:1. When CBA assumptions are varied as part of the sensitivity analysis, the results suggest the societal benefit could lie in the range of $649 million to $9.6 billion by 2049. This study demonstrates that a programme designed to address the burden of refractive error in Mozambique is economically justifiable in terms of the increased productivity that would result due to its implementation.

The clinical effectiveness and cost-effectiveness of testing for cytochrome P450 polymorphisms in patients with schizophrenia treated with antipsychotics: a systematic review and economic evaluation.

PubMed

Fleeman, N; McLeod, C; Bagust, A; Beale, S; Boland, A; Dundar, Y; Jorgensen, A; Payne, K; Pirmohamed, M; Pushpakom, S; Walley, T; de Warren-Penny, P; Dickson, R

2010-01-01

To determine whether testing for cytochrome P450 (CYP) polymorphisms in adults entering antipsychotic treatment for schizophrenia leads to improvement in outcomes, is useful in medical, personal or public health decision-making, and is a cost-effective use of health-care resources. The following electronic databases were searched for relevant published literature: Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, EMBASE, Health Technology Assessment database, ISI Web of Knowledge, MEDLINE, PsycINFO, NHS Economic Evaluation Database, Health Economic Evaluation Database, Cost-effectiveness Analysis (CEA) Registry and the Centre for Health Economics website. In addition, publicly available information on various genotyping tests was sought from the internet and advisory panel members. A systematic review of analytical validity, clinical validity and clinical utility of CYP testing was undertaken. Data were extracted into structured tables and narratively discussed, and meta-analysis was undertaken when possible. A review of economic evaluations of CYP testing in psychiatry and a review of economic models related to schizophrenia were also carried out. For analytical validity, 46 studies of a range of different genotyping tests for 11 different CYP polymorphisms (most commonly CYP2D6) were included. Sensitivity and specificity were high (99-100%). For clinical validity, 51 studies were found. In patients tested for CYP2D6, an association between genotype and tardive dyskinesia (including Abnormal Involuntary Movement Scale scores) was found. The only other significant finding linked the CYP2D6 genotype to parkinsonism. One small unpublished study met the inclusion criteria for clinical utility. One economic evaluation assessing the costs and benefits of CYP testing for prescribing antidepressants and 28 economic models of schizophrenia were identified; none was suitable for developing a model to examine the cost-effectiveness of CYP testing. Tests for determining genotypes appear to be accurate although not all aspects of analytical validity were reported. Given the absence of convincing evidence from clinical validity studies, the lack of clinical utility and economic studies, and the unsuitability of published schizophrenia models, no model was developed; instead key features and data requirements for economic modelling are presented. Recommendations for future research cover both aspects of research quality and data that will be required to inform the development of future economic models.

HOMER Economic Models - US Navy

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

Bush, Jason William; Myers, Kurt Steven

This LETTER REPORT has been prepared by Idaho National Laboratory for US Navy NAVFAC EXWC to support in testing pre-commercial SIREN (Simulated Integration of Renewable Energy Networks) computer software models. In the logistics mode SIREN software simulates the combination of renewable power sources (solar arrays, wind turbines, and energy storage systems) in supplying an electrical demand. NAVFAC EXWC will create SIREN software logistics models of existing or planned renewable energy projects at five Navy locations (San Nicolas Island, AUTEC, New London, & China Lake), and INL will deliver additional HOMER computer models for comparative analysis. In the transient mode SIRENmore » simulates the short time-scale variation of electrical parameters when a power outage or other destabilizing event occurs. In the HOMER model, a variety of inputs are entered such as location coordinates, Generators, PV arrays, Wind Turbines, Batteries, Converters, Grid costs/usage, Solar resources, Wind resources, Temperatures, Fuels, and Electric Loads. HOMER's optimization and sensitivity analysis algorithms then evaluate the economic and technical feasibility of these technology options and account for variations in technology costs, electric load, and energy resource availability. The Navy can then use HOMER’s optimization and sensitivity results to compare to those of the SIREN model. The U.S. Department of Energy (DOE) Idaho National Laboratory (INL) possesses unique expertise and experience in the software, hardware, and systems design for the integration of renewable energy into the electrical grid. NAVFAC EXWC will draw upon this expertise to complete mission requirements.« less

Study of aircraft in intraurban transportation systems, volume 1

NASA Technical Reports Server (NTRS)

Stout, E. G.; Kesling, P. H.; Matteson, H. C.; Sherwood, D. E.; Tuck, W. R., Jr.; Vaughn, L. A.

1971-01-01

An analysis of an effective short range, high density computer transportation system for intraurban systems is presented. The seven county Detroit, Michigan, metropolitan area, was chosen as the scenario for the analysis. The study consisted of an analysis and forecast of the Detroit market through 1985, a parametric analysis of appropriate short haul aircraft concepts and associated ground systems, and a preliminary overall economic analysis of a simplified total system designed to evaluate the candidate vehicles and select the most promising VTOL and STOL aircraft. Data are also included on the impact of advanced technology on the system, the sensitivity of mission performance to changes in aircraft characteristics and system operations, and identification of key problem areas that may be improved by additional research. The approach, logic, and computer models used are adaptable to other intraurban or interurban areas.

Economic comparison between conventional and disposables-based technology for the production of biopharmaceuticals.

PubMed

Novais, J L; Titchener-Hooker, N J; Hoare, M

2001-10-20

Time to market, cost effectiveness, and flexibility are key issues in today's biopharmaceutical market. Bioprocessing plants based on fully disposable, presterilized, and prevalidated components appear as an attractive alternative to conventional stainless steel plants, potentially allowing for shorter implementation times, smaller initial investments, and increased flexibility. To evaluate the economic case of such an alternative it was necessary to develop an appropriate costing model which allows an economic comparison between conventional and disposables-based engineering to be made. The production of an antibody fragment from an E. coli fermentation was used to provide a case study for both routes. The conventional bioprocessing option was costed through available models, which were then modified to account for the intrinsic differences observed in a disposables-based option. The outcome of the analysis indicates that the capital investment required for a disposables-based option is substantially reduced at less than 60% of that for a conventional option. The disposables-based running costs were evaluated as being 70% higher than those of the conventional equivalent. Despite this higher value, the net present value (NPV) of the disposables-based plant is positive and within 25% of that for the conventional plant. Sensitivity analysis performed on key variables indicated the robustness of the economic analysis presented. In particular a 9-month reduction in time to market arising from the adoption of a disposables-based approach, results in a NPV which is identical to that of the conventional option. Finally, the effect of any possible loss in yield resulting from the use of disposables was also examined. This had only a limited impact on the NPV: for example, a 50% lower yield in the disposable chromatography step results in a 10% reduction of the disposable NPV. The results provide the necessary framework for the economic comparison of disposables and conventional bioprocessing technologies. Copyright 2001 John Wiley & Sons, Inc.

Methods Used in Economic Evaluations of Chronic Kidney Disease Testing — A Systematic Review

PubMed Central

Sutton, Andrew J.; Breheny, Katie; Deeks, Jon; Khunti, Kamlesh; Sharpe, Claire; Ottridge, Ryan S.; Stevens, Paul E.; Cockwell, Paul; Kalra, Philp A.; Lamb, Edmund J.

2015-01-01

Background The prevalence of chronic kidney disease (CKD) is high in general populations around the world. Targeted testing and screening for CKD are often conducted to help identify individuals that may benefit from treatment to ameliorate or prevent their disease progression. Aims This systematic review examines the methods used in economic evaluations of testing and screening in CKD, with a particular focus on whether test accuracy has been considered, and how analysis has incorporated issues that may be important to the patient, such as the impact of testing on quality of life and the costs they incur. Methods Articles that described model-based economic evaluations of patient testing interventions focused on CKD were identified through the searching of electronic databases and the hand searching of the bibliographies of the included studies. Results The initial electronic searches identified 2,671 papers of which 21 were included in the final review. Eighteen studies focused on proteinuria, three evaluated glomerular filtration rate testing and one included both tests. The full impact of inaccurate test results was frequently not considered in economic evaluations in this setting as a societal perspective was rarely adopted. The impact of false positive tests on patients in terms of the costs incurred in re-attending for repeat testing, and the anxiety associated with a positive test was almost always overlooked. In one study where the impact of a false positive test on patient quality of life was examined in sensitivity analysis, it had a significant impact on the conclusions drawn from the model. Conclusion Future economic evaluations of kidney function testing should examine testing and monitoring pathways from the perspective of patients, to ensure that issues that are important to patients, such as the possibility of inaccurate test results, are properly considered in the analysis. PMID:26465773

Bio-physical vs. Economic Uncertainty in the Analysis of Climate Change Impacts on World Agriculture

NASA Astrophysics Data System (ADS)

Hertel, T. W.; Lobell, D. B.

2010-12-01

Accumulating evidence suggests that agricultural production could be greatly affected by climate change, but there remains little quantitative understanding of how these agricultural impacts would affect economic livelihoods in poor countries. The recent paper by Hertel, Burke and Lobell (GEC, 2010) considers three scenarios of agricultural impacts of climate change, corresponding to the fifth, fiftieth, and ninety fifth percentiles of projected yield distributions for the world’s crops in 2030. They evaluate the resulting changes in global commodity prices, national economic welfare, and the incidence of poverty in a set of 15 developing countries. Although the small price changes under the medium scenario are consistent with previous findings, their low productivity scenario reveals the potential for much larger food price changes than reported in recent studies which have hitherto focused on the most likely outcomes. The poverty impacts of price changes under the extremely adverse scenario are quite heterogeneous and very significant in some population strata. They conclude that it is critical to look beyond central case climate shocks and beyond a simple focus on yields and highly aggregated poverty impacts. In this paper, we conduct a more formal, systematic sensitivity analysis (SSA) with respect to uncertainty in the biophysical impacts of climate change on agriculture, by explicitly specifying joint distributions for global yield changes - this time focusing on 2050. This permits us to place confidence intervals on the resulting price impacts and poverty results which reflect the uncertainty inherited from the biophysical side of the analysis. We contrast this with the economic uncertainty inherited from the global general equilibrium model (GTAP), by undertaking SSA with respect to the behavioral parameters in that model. This permits us to assess which type of uncertainty is more important for regional price and poverty outcomes. Finally, we undertake a combined SSA, wherein climate change-induced productivity shocks are permitted to interact with the uncertain economic parameters. This permits us to examine potential interactions between the two sources of uncertainty.

Using Real-time Event Tracking Sensitivity Analysis to Overcome Sensor Measurement Uncertainties of Geo-Information Management in Drilling Disasters

NASA Astrophysics Data System (ADS)

Tavakoli, S.; Poslad, S.; Fruhwirth, R.; Winter, M.

2012-04-01

This paper introduces an application of a novel EventTracker platform for instantaneous Sensitivity Analysis (SA) of large scale real-time geo-information. Earth disaster management systems demand high quality information to aid a quick and timely response to their evolving environments. The idea behind the proposed EventTracker platform is the assumption that modern information management systems are able to capture data in real-time and have the technological flexibility to adjust their services to work with specific sources of data/information. However, to assure this adaptation in real time, the online data should be collected, interpreted, and translated into corrective actions in a concise and timely manner. This can hardly be handled by existing sensitivity analysis methods because they rely on historical data and lazy processing algorithms. In event-driven systems, the effect of system inputs on its state is of value, as events could cause this state to change. This 'event triggering' situation underpins the logic of the proposed approach. Event tracking sensitivity analysis method describes the system variables and states as a collection of events. The higher the occurrence of an input variable during the trigger of event, the greater its potential impact will be on the final analysis of the system state. Experiments were designed to compare the proposed event tracking sensitivity analysis with existing Entropy-based sensitivity analysis methods. The results have shown a 10% improvement in a computational efficiency with no compromise for accuracy. It has also shown that the computational time to perform the sensitivity analysis is 0.5% of the time required compared to using the Entropy-based method. The proposed method has been applied to real world data in the context of preventing emerging crises at drilling rigs. One of the major purposes of such rigs is to drill boreholes to explore oil or gas reservoirs with the final scope of recovering the content of such reservoirs; both in onshore regions as well as in offshore regions. Drilling a well is always guided by technical, economic and security constraints to prevent crew, equipment and environment from injury, damage and pollution. Although risk assessment and local practice provides a high degree of security, uncertainty is given by the behaviour of the formation which may cause crucial situations at the rig. To overcome such uncertainties real-time sensor measurements form a base to predict and thus prevent such crises, the proposed method supports the identification of the data necessary for that.

Cross-National Estimates of the Effects of Family Background on Student Achievement: A Sensitivity Analysis

NASA Astrophysics Data System (ADS)

Nonoyama-Tarumi, Yuko

2008-01-01

This article uses the data from the Programme for International Student Assessment (PISA) 2000 to examine whether the influence of family background on educational achievement is sensitive to different measures of the family's socio-economic status (SES). The study finds that, when a multidimensional measure of SES is used, the family background has a stronger influence on achievement across countries than if the simpler measure of SES is used. The new measure, which incorporated aspects of parental occupation, education and cultural resources, was not biased towards more wealthy nations, Western nations, or urban population. However, when a proxy of wealth was included in the measure of SES, this reduced the other measured effects of family background on achievement in many countries.

Potential Effects of a Scenario Earthquake on the Economy of Southern California: Labor Market Exposure and Sensitivity Analysis to a Magnitude 7.8 Earthquake

USGS Publications Warehouse

Sherrouse, Benson C.; Hester, David J.; Wein, Anne M.

2008-01-01

The Multi-Hazards Demonstration Project (MHDP) is a collaboration between the U.S. Geological Survey (USGS) and various partners from the public and private sectors and academia, meant to improve Southern California's resiliency to natural hazards (Jones and others, 2007). In support of the MHDP objectives, the ShakeOut Scenario was developed. It describes a magnitude 7.8 (M7.8) earthquake along the southernmost 300 kilometers (200 miles) of the San Andreas Fault, identified by geoscientists as a plausible event that will cause moderate to strong shaking over much of the eight-county (Imperial, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, and Ventura) Southern California region. This report contains an exposure and sensitivity analysis of economic Super Sectors in terms of labor and employment statistics. Exposure is measured as the absolute counts of labor market variables anticipated to experience each level of Instrumental Intensity (a proxy measure of damage). Sensitivity is the percentage of the exposure of each Super Sector to each Instrumental Intensity level. The analysis concerns the direct effect of the scenario earthquake on economic sectors and provides a baseline for the indirect and interactive analysis of an input-output model of the regional economy. The analysis is inspired by the Bureau of Labor Statistics (BLS) report that analyzed the labor market losses (exposure) of a M6.9 earthquake on the Hayward fault by overlaying geocoded labor market data on Instrumental Intensity values. The method used here is influenced by the ZIP-code-level data provided by the California Employment Development Department (CA EDD), which requires the assignment of Instrumental Intensities to ZIP codes. The ZIP-code-level labor market data includes the number of business establishments, employees, and quarterly payroll categorized by the North American Industry Classification System. According to the analysis results, nearly 225,000 business establishments, or 44 percent of all establishments, would experience Instrumental Intensities between VII (7) and X (10). This represents more than 4 million employees earning over $45 billion in quarterly payroll. Over 57,000 of these establishments, employing over 1 million employees earning over $10 billion in quarterly payroll, would experience Instrumental Intensities of IX (9) or X (10). Based upon absolute counts and percentages, the Trade, Transportation, and Utilities Super Sector and the Manufacturing Super Sector are estimated to have the greatest exposure and sensitivity respectively. The Information and the Natural Resources and Mining Super Sectors are estimated to be the least impacted. Areas estimated to experience an Instrumental Intensity of X (10) account for approximately 3 percent of the region's labor market.

Social exclusion, deprivation and child health: a spatial analysis of ambulatory care sensitive conditions in children aged 0-4 years in Victoria, Australia.

PubMed

Butler, Danielle C; Thurecht, Linc; Brown, Laurie; Konings, Paul

2013-10-01

Recent Australian policy initiatives regarding primary health care focus on planning services around community needs and delivering these at the local area. As in many other countries, there has also been a growing concern over social inequities in health outcomes. The aims of the analysis presented here were firstly to describe small area variations in hospital admissions for ambulatory care sensitive conditions (ACSC) among children aged 0-4 years between 2003 and 2009 in the state of Victoria, Australia, and secondly to explore the relationship of ACSC hospitalisations with socio-economic disadvantage using a comparative analysis of the Child Social Exclusion (CSE) index and the Composite Score of Deprivation (CSD). This is a cross sectional secondary data analysis, with data sourced from 2003 to 2009 ACSC data from the Victorian State Government Department of Health; the Australian Standard Geographical Classification of remoteness; the Australian 2006 Census of Population and Housing; and AMPCo General Practitioner data from 2010. The relationship between the indexes and child health outcomes was examined through bivariate analysis and visually through a series of maps. The results show there is significant variation in the geographical distribution of the relationship between ACSCs and socio-economic disadvantage, with both indexes capturing important social gradients in child health conditions. However, measures of access, such as geographical accessibility and workforce supply, detect additional small area variation in child health outcomes. This research has important implications for future primary health care policy and planning of services, as these findings confirm that not all areas are the same in terms of health outcomes, and there may be benefit in tailoring mechanisms for identifying areas of need depending on the outcome intended to be affected. Copyright © 2013 Elsevier Ltd. All rights reserved.

Decision making for best cogeneration power integration into a grid

NASA Astrophysics Data System (ADS)

Al Asmar, Joseph; Zakhia, Nadim; Kouta, Raed; Wack, Maxime

2016-07-01

Cogeneration systems are known to be efficient power systems for their ability to reduce pollution. Their integration into a grid requires simultaneous consideration of the economic and environmental challenges. Thus, an optimal cogeneration power are adopted to face such challenges. This work presents a novelty in selectinga suitable solution using heuristic optimization method. Its aim is to optimize the cogeneration capacity to be installed according to the economic and environmental concerns. This novelty is based on the sensitivity and data analysis method, namely, Multiple Linear Regression (MLR). This later establishes a compromise between power, economy, and pollution, which leads to find asuitable cogeneration power, and further, to be integrated into a grid. The data exploited were the results of the Genetic Algorithm (GA) multi-objective optimization. Moreover, the impact of the utility's subsidy on the selected power is shown.

Applying a multi-criteria genetic algorithm framework for brownfield reuse optimization: improving redevelopment options based on stakeholder preferences.

PubMed

Morio, Maximilian; Schädler, Sebastian; Finkel, Michael

2013-11-30

The reuse of underused or abandoned contaminated land, so-called brownfields, is increasingly seen as an important means for reducing the consumption of land and natural resources. Many existing decision support systems are not appropriate because they focus mainly on economic aspects, while neglecting sustainability issues. To fill this gap, we present a framework for spatially explicit, integrated planning and assessment of brownfield redevelopment options. A multi-criteria genetic algorithm allows us to determine optimal land use configurations with respect to assessment criteria and given constraints on the composition of land use classes, according to, e.g., stakeholder preferences. Assessment criteria include sustainability indicators as well as economic aspects, including remediation costs and land value. The framework is applied to a case study of a former military site near Potsdam, Germany. Emphasis is placed on the trade-off between possibly conflicting objectives (e.g., economic goals versus the need for sustainable development in the regional context of the brownfield site), which may represent different perspectives of involved stakeholders. The economic analysis reveals the trade-off between the increase in land value due to reuse and the costs for remediation required to make reuse possible. We identify various reuse options, which perform similarly well although they exhibit different land use patterns. High-cost high-value options dominated by residential land use and low-cost low-value options with less sensitive land use types may perform equally well economically. The results of the integrated analysis show that the quantitative integration of sustainability may change optimal land use patterns considerably. Copyright © 2013 Elsevier Ltd. All rights reserved.

A multicriteria decision analysis model and risk assessment framework for carbon capture and storage.

PubMed

Humphries Choptiany, John Michael; Pelot, Ronald

2014-09-01

Multicriteria decision analysis (MCDA) has been applied to various energy problems to incorporate a variety of qualitative and quantitative criteria, usually spanning environmental, social, engineering, and economic fields. MCDA and associated methods such as life-cycle assessments and cost-benefit analysis can also include risk analysis to address uncertainties in criteria estimates. One technology now being assessed to help mitigate climate change is carbon capture and storage (CCS). CCS is a new process that captures CO2 emissions from fossil-fueled power plants and injects them into geological reservoirs for storage. It presents a unique challenge to decisionmakers (DMs) due to its technical complexity, range of environmental, social, and economic impacts, variety of stakeholders, and long time spans. The authors have developed a risk assessment model using a MCDA approach for CCS decisions such as selecting between CO2 storage locations and choosing among different mitigation actions for reducing risks. The model includes uncertainty measures for several factors, utility curve representations of all variables, Monte Carlo simulation, and sensitivity analysis. This article uses a CCS scenario example to demonstrate the development and application of the model based on data derived from published articles and publicly available sources. The model allows high-level DMs to better understand project risks and the tradeoffs inherent in modern, complex energy decisions. © 2014 Society for Risk Analysis.

Economic feasibility of solar thermal industrial applications and selected case studies

NASA Astrophysics Data System (ADS)

Montelione, A.; Boyd, D.; Branz, M.

1981-12-01

The economic feasibility is assessed of utilizing solar energy to augment an existing fossil fuel system to generate industrial process heat. Several case studies in the textile and food processing industries in the southern United States were analyzed. Sensitivity analyses were performed, and comparisons illustrating the effects of the Economic Recovery Tax Act of 1981 were made. The economic desirability of the proposed solar systems varied with the type of system selected, location of the facility, state tax credits, and type of fuel displaced. For those systems presently not economical, the projected time to economic feasibility was ascertained.

Rapid and sensitive detection of mink circovirus by recombinase polymerase amplification.

PubMed

Ge, Junwei; Shi, Yunjia; Cui, Xingyang; Gu, Shanshan; Zhao, Lili; Chen, Hongyan

2018-06-01

To date, the pathogenic role of mink circovirus (MiCV) remains unclear, and its prevalence and economic importance are unknown. Therefore, a rapid and sensitive molecular diagnosis is necessary for disease management and epidemiological surveillance. However, only PCR methods can identify MiCV infection at present. In this study, we developed a nested PCR and established a novel recombinase polymerase amplification (RPA) assay for MiCV detection. Sensitivity analysis showed that the detection limit of nested PCR and RPA assay was 10 1 copies/reaction, and these methods were more sensitive than conventional PCR, which has a detection limit of 10 5 copies/reaction. The RPA assay had no cross-reactivity with other related viral pathogens, and amplification was completed in less than 20 min with a simple device. Further assessment of clinical samples showed that the two assays were accurate in identifying positive and negative conventional PCR samples. The detection rate of MiCV by the RPA assay in clinical samples was 38.09%, which was 97% consistent with that by the nested PCR. The developed nested PCR is a highly sensitive tool for practical use, and the RPA assay is a simple, sensitive, and potential alternative method for rapid and accurate MiCV diagnosis. Copyright © 2018 Elsevier B.V. All rights reserved.

A techno-economic analysis of aquaculture business in Ogun State, Nigeria

NASA Astrophysics Data System (ADS)

Kareem, R. O.; Williams, S. B.

2009-05-01

Fish supplies 25% of the total protein source in developing countries. A techno-economic analysis was performed for developing a good business proposal for aquaculture loans to enhance aquaculture development in Nigeria. A case study of catfish Clarias gariepinus framing was conducted in Abeokuta North Local Government of Ogun State, Nigeria. The results show that the fixed cost is N18 338 per year, and the variable cost is N459 700 per year, accounting for the largest amount of the total; therefore, a profit of N43 289 per month can be made. Sensitivity analysis was performed to assess any risk(s) that associated with unfavorable changes in government policy with particular reference to monetary policy. Positive net present value shows that the investment in fish farm is economically feasible and the net investment ratio is 3.52. Also, the benefit-cost ratio is 2.17. The internal rate of return (IRR) is 21% showing that the enterprise is able to offset the interest being charged on the loan. It is therefore worthwhile to invest into fish farm business in the study area. The study suggests that to better sustain the local aquaculture business, the government should create a good conducive environment to foster development of the fish farming. Government intervention is urgently needed to solve problems such as in traditional land tenure, grant credit facilities and subsidies, to enhance the aquacultural development in the country.

Sizing and economic analysis of stand alone photovoltaic system with hydrogen storage

NASA Astrophysics Data System (ADS)

Nordin, N. D.; Rahman, H. A.

2017-11-01

This paper proposes a design steps in sizing of standalone photovoltaic system with hydrogen storage using intuitive method. The main advantage of this method is it uses a direct mathematical approach to find system’s size based on daily load consumption and average irradiation data. The keys of system design are to satisfy a pre-determined load requirement and maintain hydrogen storage’s state of charge during low solar irradiation period. To test the effectiveness of the proposed method, a case study is conducted using Kuala Lumpur’s generated meteorological data and rural area’s typical daily load profile of 2.215 kWh. In addition, an economic analysis is performed to appraise the proposed system feasibility. The finding shows that the levelized cost of energy for proposed system is RM 1.98 kWh. However, based on sizing results obtained using a published method with AGM battery as back-up supply, the system cost is lower and more economically viable. The feasibility of PV system with hydrogen storage can be improved if the efficiency of hydrogen storage technologies significantly increases in the future. Hence, a sensitivity analysis is performed to verify the effect of electrolyzer and fuel cell efficiencies towards levelized cost of energy. Efficiencies of electrolyzer and fuel cell available in current market are validated using laboratory’s experimental data. This finding is needed to envisage the applicability of photovoltaic system with hydrogen storage as a future power supply source in Malaysia.

The role of gas heat pumps in electric DSM

NASA Astrophysics Data System (ADS)

Fulmer, M.; Hughes, P. J.

1993-05-01

Natural gas-fired heat pumps (GHP's), an emerging technology, may offer environmental economic, and energy benefits relative to standard and advanced space conditioning equipment now on the market. This paper describes an analysis of GHP's for residential space heating, and cooling relative to major competing technologies under an Integrated Resource (IRP) framework. Our study models a hypothetical GHP rebate program using conditions typical of the Great Lakes region. The analysis is performed for a base scenario with sensitivity cases. In the base scenario, the GHP program is cost-effective according to the societal test, total resource cost test (TRC), and the participant test, but is not cost-effective according to the non-participant test. The sensitivity analyses indicate that the results for the TRC test are most sensitive to the season in which electric demand peaks and the technology against which the GHP's are competing, and are less sensitive to changes in the marginal administrative costs. The modeled GHP program would save 900 million kWh over the life of the program and reduce peak load by about 100 MW in winter and about 135 MW in summer. We estimate all of the GHP's in service (both GHP's of program participants and nonparticipants) in the case study region would save 1,900 million kWh and reduce summer peak load by over 350 MW.

The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy

PubMed Central

Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa

2016-01-01

Background: Clinical practice protocols should consider both the psychological criteria related to a patient’s satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. Methods: A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Results: Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. Conclusion: The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed. PMID:27303347

Cost-Effectiveness Analysis of Isavuconazole vs. Voriconazole as First-Line Treatment for Invasive Aspergillosis.

PubMed

Harrington, Rachel; Lee, Edward; Yang, Hongbo; Wei, Jin; Messali, Andrew; Azie, Nkechi; Wu, Eric Q; Spalding, James

2017-01-01

Invasive aspergillosis (IA) is associated with a significant clinical and economic burden. The phase III SECURE trial demonstrated non-inferiority in clinical efficacy between isavuconazole and voriconazole. No studies have evaluated the cost-effectiveness of isavuconazole compared to voriconazole. The objective of this study was to evaluate the costs and cost-effectiveness of isavuconazole vs. voriconazole for the first-line treatment of IA from the US hospital perspective. An economic model was developed to assess the costs and cost-effectiveness of isavuconazole vs. voriconazole in hospitalized patients with IA. The time horizon was the duration of hospitalization. Length of stay for the initial admission, incidence of readmission, clinical response, overall survival rates, and experience of adverse events (AEs) came from the SECURE trial. Unit costs were from the literature. Total costs per patient were estimated, composed of drug costs, costs of AEs, and costs of hospitalizations. Incremental costs per death avoided and per additional clinical responders were reported. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted. Base case analysis showed that isavuconazole was associated with a $7418 lower total cost per patient than voriconazole. In both incremental costs per death avoided and incremental costs per additional clinical responder, isavuconazole dominated voriconazole. Results were robust in sensitivity analysis. Isavuconazole was cost saving and dominant vs. voriconazole in most DSA. In PSA, isavuconazole was cost saving in 80.2% of the simulations and cost-effective in 82.0% of the simulations at the $50,000 willingness to pay threshold per additional outcome. Isavuconazole is a cost-effective option for the treatment of IA among hospitalized patients. Astellas Pharma Global Development, Inc.

The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy.

PubMed

Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa

2016-01-01

Clinical practice protocols should consider both the psychological criteria related to a patient's satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed.

Economic evaluation of a psychological intervention for high distress cancer patients and carers: costs and quality-adjusted life years.

PubMed

Chatterton, Mary Lou; Chambers, Suzanne; Occhipinti, Stefano; Girgis, Afaf; Dunn, Jeffrey; Carter, Rob; Shih, Sophy; Mihalopoulos, Cathrine

2016-07-01

This study compared the cost-effectiveness of a psychologist-led, individualised cognitive behavioural intervention (PI) to a nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. This was an economic evaluation conducted alongside a randomised trial of highly distressed adult cancer patients and carers calling cancer helplines. Services used by participants were measured using a resource use questionnaire, and quality-adjusted life years were measured using the assessment of quality of life - eight-dimension - instrument collected through a computer-assisted telephone interview. The base case analysis stratified participants based on the baseline score on the Brief Symptom Inventory. Incremental cost-effectiveness ratio confidence intervals were calculated with a nonparametric bootstrap to reflect sampling uncertainty. The results were subjected to sensitivity analysis by varying unit costs for resource use and the method for handling missing data. No significant differences were found in overall total costs or quality-adjusted life years (QALYs) between intervention groups. Bootstrapped data suggest the PI had a higher probability of lower cost and greater QALYs for both carers and patients with high distress at baseline. For patients with low levels of distress at baseline, the PI had a higher probability of greater QALYs but at additional cost. Sensitivity analysis showed the results were robust. The PI may be cost-effective compared with the nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. More intensive psychological intervention for patients with greater levels of distress appears warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Cost-benefit analysis of avian influenza control in Nepal.

PubMed

Karki, S; Lupiani, B; Budke, C M; Karki, N P S; Rushton, J; Ivanek, R

2015-12-01

Numerous outbreaks of highly pathogenic avian influenza A strain H5N1 have occurred in Nepal since 2009 despite implementation of a national programme to control the disease through surveillance and culling of infected poultry flocks. The objective of the study was to use cost-benefit analysis to compare the current control programme (CCP) with the possible alternatives of: i) no intervention (i.e., absence of control measures [ACM]) and ii) vaccinating 60% of the national poultry flock twice a year. In terms of the benefit-cost ratio, findings indicate a return of US $1.94 for every dollar spent in the CCP compared with ACM. The net present value of the CCP versus ACM, i.e., the amount of money saved by implementing the CCP rather than ACM, is US $861,507 (the benefits of CCP [prevented losses which would have occurred under ACM] minus the cost of CCP). The vaccination programme yields a return of US $2.32 for every dollar spent when compared with the CCR The net present value of vaccination versus the CCP is approximately US $12 million. Sensitivity analysis indicated thatthe findings were robust to different rates of discounting, whereas results were sensitive to the assumed market loss and the number of birds affected in the outbreaks under the ACM and vaccination options. Overall, the findings of the study indicate that the CCP is economically superior to ACM, but that vaccination could give greater economic returns and may be a better control strategy. Future research should be directed towards evaluating the financial feasibility and social acceptability of the CCP and of vaccination, with an emphasis on evaluating market reaction to the presence of H5N1 infection in the country.

An economic evaluation of conception strategies for heterosexual serodiscordant couples where the male partner is HIV-positive.

PubMed

Letchumanan, Michelle; Coyte, Peter C; Loutfy, Mona

2015-01-01

To conduct an economic evaluation of the three commonly used interventions that reduce sexual HIV transmission when an HIV-negative female aims to conceive with an HIV-positive male on combination antiretroviral therapy (condomless sex restricted to timed ovulation [CS], sperm washing with intrauterine insemination [SW] and condomless sex restricted to timed ovulation with pre-exposure prophylaxis [CS-PrEP]). As SW and CS-PrEP are only privately available for pregnancy planning for this population in Canada, this study was conducted to inform policy decisions concerning potential public health insurance coverage, as well as to inform fertility counselling in settings with adequate combination antiretroviral therapy access globally. We developed a cohort Markov model with a lifetime horizon and used the perspective of Ontario's Ministry of Health (MOH). Input parameters were drawn from literature, the MOH's Schedule of Benefits and a time trade-off questionnaire designed for this study. Outcome measures included quality-adjusted life-years and incremental cost-effectiveness. Costs and benefits were discounted at annual rates of 3%. Costs were reported in Canadian 2013 dollars and an exchange rate of 1 USD to 1.066 CND was applied where necessary. Sensitivity analysis assessed the uncertainty of model parameters. The base case analysis found that CS-PrEP and SW were each more costly and less effective at conception than CS. The results were robust in the sensitivity analysis and suggest that CS is the dominant conception strategy in this population. Neither CS-PrEP nor SW represent better value for money relative to CS as a conception option for HIV-discordant couples with positive male partners. Based on these findings, CS-PrEP and SW cannot be recommended for public-funding in developed countries.

Left ventricular assist device as destination therapy: application of the payment-by-results approach for the device reimbursement.

PubMed

Messori, Andrea; Trippoli, Sabrina; Bonacchi, Massimo; Sani, Guido

2009-08-01

Value-based methods are increasingly used to reimburse therapeutic innovation, and the payment-by-results approach has been proposed for handling interventions with limited therapeutic evidence. Because most left ventricular assist devices are supported by preliminary efficacy data, we examined the effectiveness data of the HeartMate (Thoratec Corp, Pleasanton, CA) device to explore the application of the payment-by-results approach to these devices and to develop a model for handling reimbursements. According to our model, after establishing the societal economic countervalue for each month of life saved, each patient treated with one such device is associated to the payment of this countervalue for every month of survival lived beyond the final date of estimated life expectancy without left ventricular assist devices. Our base-case analysis, which used the published data of 68 patients who received the HeartMate device, was run with a monthly countervalue of euro 5000, no adjustment for quality of life, and a baseline life expectancy of 150 days without left ventricular assist devices. Sensitivity analysis was aimed at testing the effect of quality of life adjustments and changes in life expectancy without device. In our base-case analysis, the mean total reimbursement per patient was euro 82,426 (range, euro 0 to euro 250,000; N = 68) generated as the sum of monthly payments. This average value was close to the current price of the HeartMate device (euro 75,000). Sensitivity testing showed that the base-case reimbursement of euro 82,426 was little influenced by variations in life expectancy, whereas variations in utility had a more pronounced impact. Our report delineates an innovative procedure for appropriately allocating economic resources in this area of invasive cardiology.

Is shared care with annual hospital review better value for money than predominantly hospital‐based care in patients with established stable rheumatoid arthritis?

PubMed Central

Davies, Linda Mary; Fargher, Emily Anne; Tricker, Karen; Dawes, Peter; Scott, David L; Symmons, Deborah

2007-01-01

Objective To assess the cost effectiveness and cost effectiveness acceptability of symptom control delivered by shared care (SCSC) and aggressive treatment delivered in hospital (ATH) for established rheumatoid arthritis (RA). Methods Economic data were collected within the British Rheumatoid Outcome Study Group randomised controlled trial of SCSC and ATH. A broad perspective was used (UK National Health Service, social support services and patients). Cost per quality adjusted life year (QALY) gained, net benefit statistics and cost effectiveness acceptability curves were estimated. Costs and outcomes were discounted at 3.5%. Sensitivity analysis tested the robustness of the results to analytical assumptions. Results The mean (SD) cost per person was £4540 (4700) in the SCSC group and £4440 (4900) in the ATH group. The mean (SD) QALYs per person for 3 years were 1.67 (0.56) in the SCSC group and 1.60 (0.60) in the ATH group. If decision makers are prepared to pay ⩾£2000 to gain 1 QALY, SCSC is likely to be cost effective in 60–90% of cases. Conclusions The primary economic analysis and sensitivity analyses indicate that SCSC is likely to be more cost effective than ATH in 60–90% of cases. This result seems to be robust to assumptions required by the analysis. This study is one of a limited number of randomised controlled trials to collect detailed resource use and health status data and estimate the costs and QALYs of treatment for established RA. This trial is one of the largest RA studies to use the EuroQol. PMID:17124249

Is a HIV vaccine a viable option and at what price? An economic evaluation of adding HIV vaccination into existing prevention programs in Thailand.

PubMed

Leelahavarong, Pattara; Teerawattananon, Yot; Werayingyong, Pitsaphun; Akaleephan, Chutima; Premsri, Nakorn; Namwat, Chawetsan; Peerapatanapokin, Wiwat; Tangcharoensathien, Viroj

2011-07-05

This study aims to determine the maximum price at which HIV vaccination is cost-effective in the Thai healthcare setting. It also aims to identify the relative importance of vaccine characteristics and risk behavior changes among vaccine recipients to determine how they affect this cost-effectiveness. A semi-Markov model was developed to estimate the costs and health outcomes of HIV prevention programs combined with HIV vaccination in comparison to the existing HIV prevention programs without vaccination. The estimation was based on a lifetime horizon period (99 years) and used the government perspective. The analysis focused on both the general population and specific high-risk population groups. The maximum price of cost-effective vaccination was defined by using threshold analysis; one-way and probabilistic sensitivity analyses were performed. The study employed an expected value of perfect information (EVPI) analysis to determine the relative importance of parameters and to prioritize future studies. The most expensive HIV vaccination which is cost-effective when given to the general population was 12,000 Thai baht (US$1 = 34 Thai baht in 2009). This vaccination came with 70% vaccine efficacy and lifetime protection as long as risk behavior was unchanged post-vaccination. The vaccine would be considered cost-ineffective at any price if it demonstrated low efficacy (30%) and if post-vaccination risk behavior increased by 10% or more, especially among the high-risk population groups. The incremental cost-effectiveness ratios were the most sensitive to change in post-vaccination risk behavior, followed by vaccine efficacy and duration of protection. The EVPI indicated the need to quantify vaccine efficacy, changed post-vaccination risk behavior, and the costs of vaccination programs. The approach used in this study differentiated it from other economic evaluations and can be applied for the economic evaluation of other health interventions not available in healthcare systems. This study is important not only for researchers conducting future HIV vaccine research but also for policy decision makers who, in the future, will consider vaccine adoption.

Peginterferon beta-1a versus other self-injectable disease-modifying therapies in the treatment of relapsing-remitting multiple sclerosis in Scotland: a cost-effectiveness analysis.

PubMed

Hernandez, Luis; Guo, Shien; Toro-Diaz, Hector; Carroll, Stuart; Syed Farooq, Syed Feisal

2017-03-01

Peginterferon beta-1a 125 mcg administered subcutaneously every 2 weeks, a new disease-modifying therapy (DMT) for relapsing-remitting multiple sclerosis (RRMS), was approved in January 2015 by the Scottish Medicines Consortium. This study assesses long-term clinical and economic outcomes of peginterferon beta-1a compared with other self-injectable DMTs (interferon beta-1a [22 mcg, 30 mcg, and 44 mcg], interferon beta-1b, and glatiramer acetate 20 mg) in the treatment of RRMS, from the National Health Service and Personal Social Services perspective in Scotland. A previously published, validated Markov cohort model was adapted for this analysis. The model estimates changes in patient disability, occurrence of relapses, and other adverse events, and translates them into quality-adjusted life years and costs. Natural history data came from the ADVANCE trial of peginterferon beta-1a, the London Ontario (Canada) database, and a large population-based MS survey in the UK. The comparative efficacy of each DMT vs placebo was obtained from a network meta-analysis. Costs (2015 British Pounds) were obtained from public databases and literature. Clinical and economic outcomes were projected over 30 years and discounted at 3.5% per year. Over 30 years, peginterferon beta-1a was dominant compared with interferon beta-1a (22, 30, and 44 mcg), and interferon beta-1b, and cost-effective compared with glatiramer acetate 20 mg. Results were most sensitive to variations in each DMT's efficacy and acquisition costs. Deterministic and probabilistic sensitivity analyses confirmed the robustness of the results. The impact of improved adherence with peginterferon beta-1a on clinical and economic outcomes and the impact of subsequent DMTs after treatment discontinuation were not considered. Oral and infused DMTs were not included as comparators. Conclusion Long-term treatment with peginterferon beta-1a improves clinical outcomes, while its cost profile makes it either dominant or cost-effective compared with other self-injectable DMTs for the treatment of RRMS in Scotland.

Economic Impact of Increased Utilization of Multivariate Assay Testing to Guide the Treatment of Ovarian Cancer: Implications for Payers.

PubMed

Brodsky, Burton S; Owens, Gary M; Scotti, Dennis J; Needham, Keith A; Cool, Christina L

2017-10-01

Ovarian cancer is the eighth most common cancer among women, but ranks fifth in cancer-related causes of death, the majority of which are detected in late stages, after the cancer has metastasized. The CA125 test is the standard of care for assessing suspicious pelvic masses. However, the primary use of CA125 is to monitor treatment progress rather than to screen for disease, and its sensitivity is exceedingly low, unlike the multivariate assay OVA1. A cost-effective treatment of ovarian cancer requires early and accurate diagnosis of pelvic masses and reduced referrals of patients with benign tumors to a gynecologic oncologist. To analyze the economic impact of increased utilization of a multivariate assay, such as OVA1, to guide the treatment of ovarian cancer. The study population was drawn from Medicare and commercial health plan claims data. A budget impact model was constructed to estimate the economic consequences of substituting the multivariate assay OVA1 to replace the single biomarker assay CA125 to assess the likelihood of pelvic mass malignancy in premenopausal and/or postmenopausal women. All patients selected for the analysis had CA125 testing before surgical intervention. A total of 92,843 health plan members were included for analysis, comprising 48,113 commercially insured members and 44,730 Medicare beneficiaries. Estimates of future health plan expenditures, which were calculated from base-case assumptions, projected overall savings of $0.05 per-member per-month (PMPM) for commercially insured members and $0.01 PMPM for Medicare beneficiaries as a result of increased utilization of OVA1. Sensitivity analysis revealed potential savings of up to $0.17 PMPM for commercially insured patients and up to $0.05 for Medicare beneficiaries. The results of the budget impact model support the use of OVA1 instead of CA125 by indicating that modest cost-savings can be achieved, while reaping the clinical benefits of improved diagnostic accuracy, early disease detection, and reductions in multiple, and possibly unnecessary, referrals to gynecologic oncologists.

Analysis and Application of Quality Economics Based on Input-Output

NASA Astrophysics Data System (ADS)

Lu, Qiang; Li, Xin

2018-01-01

Quality economics analysis is an important research area in the current economic frontier, which has a huge role in promoting the quality-benefit type road development in China. Through the study of quality economics analysis and application, economics of quality and quality economics management are summarized, and theoretical framework of quality economics analysis is constructed. Finally, the quality economics analysis of aerospace equipment is taken as an example to carry on the application research.

[Economic evaluation of a program of coordination between levels for complex chronic patients' management].

PubMed

Allepuz Palau, Alejandro; Piñeiro Méndez, Pilar; Molina Hinojosa, José Carlos; Jou Ferre, Victoria; Gabarró Julià, Lourdes

2015-03-01

The complex chronic patient program (CCP) of the Alt Penedès aims to improve the coordination of care. The objective was to evaluate the relationship between the costs associated with the program, and its results in the form of avoided admissions. Dost-effectiveness analysis from the perspective of the health System based on a before-after study. Alt Penedès. Health services utilisation (hospital [admissions, emergency visits, day-care hospital] and primary care visits). CCP Program results were compared with those prior to its implementation. The cost assigned to each resource corresponded to the hospital CatSalut's concert and ICS fees for primary care. A sensitivity analysis using boot strapping was performed. The intervention was considered cost-effective if the incremental cost-effectiveness ratio (ICER) did not exceed the cost of admission (€ 1,742.01). 149 patients were included. Admissions dropped from 212 to 145. The ICER was €1,416.3 (94,892.9€/67). Sensitivity analysis showed that in 95% of cases the cost might vary between €70,847.3 and €121,882.5 and avoided admissions between 30 and 102. In 72.4% of the simulations the program was cost-effective. Sensitivity analysis showed that in most situations the PCC Program would be cost-effective, although in a percentage of cases the program could raise overall cost of care, despite always reducing the number of admissions. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Economic analysis and budget impact of clostridial collagenase ointment compared with medicinal honey for treatment of pressure ulcers in the US.

PubMed

Mearns, Elizabeth S; Liang, Michael; Limone, Brendan L; Gilligan, Adrienne M; Miller, Jeffrey D; Schaum, Kathleen D; Waycaster, Curtis R

2017-01-01

Pressure ulcer (PU) treatment poses significant clinical and economic challenges to health-care systems. The aim of this study was to assess the cost-effectiveness and budget impact of enzymatic debridement with clostridial collagenase ointment (CCO) compared with autolytic debridement with medicinal honey (MH) for PU treatment from a US payer/Medicare perspective in the hospital outpatient department setting. A cost-effectiveness analysis using a Markov model was developed using a 1-week cycle length across a 1-year time horizon. The three health states were inflammation/senescence, granulation/proliferation (ie, patients achieving 100% granulation), and epithelialization. Data sources included the US Wound Registry, Medicare fee schedules, and other published clinical and cost studies about PU treatment. In the base case analysis over a 1-year time horizon, CCO was the economically dominant strategy (ie, simultaneously conferring greater benefit at less cost). Patients treated with CCO experienced 22.7 quality-adjusted life weeks (QALWs) at a cost of $6,161 over 1 year, whereas MH patients experienced 21.9 QALWs at a cost of $7,149. Patients treated with CCO achieved 11.5 granulation weeks and 6.0 epithelization weeks compared with 10.6 and 4.4 weeks for MH, respectively. The number of clinic visits was 40.1 for CCO vs 43.4 for MH, and the number of debridements was 12.3 for CCO compared with 17.6 for MH. Probabilistic sensitivity analyses determined CCO dominant in 72% of 10,000 iterations and cost-effective in 91%, assuming a benchmark willingness-to-pay threshold of $50,000/quality-adjusted life year ($962/QALW). The budget impact analysis showed that for every 1% of patients shifted from MH to CCO, a cost savings of $9,883 over 1 year for a cohort of 1,000 patients was observed by the payer. The results of these economic analyses suggest that CCO is a cost-effective, economically dominant alternative to MH in the treatment of patients with PUs in the hospital outpatient department setting.

The economics and ethics of aerosol geoengineering strategies

NASA Astrophysics Data System (ADS)

Goes, Marlos; Keller, Klaus; Tuana, Nancy

2010-05-01

Anthropogenic greenhouse gas emissions are changing the Earth's climate and impose substantial risks for current and future generations. What are scientifically sound, economically viable, and ethically defendable strategies to manage these climate risks? Ratified international agreements call for a reduction of greenhouse gas emissions to avoid dangerous anthropogenic interference with the climate system. Recent proposals, however, call for a different approach: geoengineering climate by injecting aerosol precursors into the stratosphere. Published economic studies typically neglect the risks of aerosol geoengineering due to (i) a potential failure to sustain the aerosol forcing and (ii) due to potential negative impacts associated with aerosol forcings. Here we use a simple integrated assessment model of climate change to analyze potential economic impacts of aerosol geoengineering strategies over a wide range of uncertain parameters such as climate sensitivity, the economic damages due to climate change, and the economic damages due to aerosol geoengineering forcings. The simplicity of the model provides the advantages of parsimony and transparency, but it also imposes considerable caveats. For example, the analysis is based on a globally aggregated model and is hence silent on intragenerational distribution of costs and benefits. In addition, the analysis neglects the effects of future learning and is based on a simple representation of climate change impacts. We use this integrated assessment model to show three main points. First, substituting aerosol geoengineering for the reduction of greenhouse gas emissions can fail the test of economic efficiency. One key to this finding is that a failure to sustain the aerosol forcing can lead to sizeable and abrupt climatic changes. The monetary damages due to such a discontinuous aerosol geoengineering can dominate the cost-benefit analysis because the monetary damages of climate change are expected to increase with the rate of change. Second, the relative contribution of aerosol geoengineering to an economically optimal portfolio hinges critically on deeply uncertain estimates of the damages due to aerosol forcing. Even if we assume that aerosol forcing could be deployed continuously, the aerosol geoengineering does not considerably displace the reduction of greenhouse gas emissions in the simple economic optimal growth model until the damages due to the aerosol forcing are rather low. Third, deploying aerosol geoengineering may also fail an ethical test regarding issues of intergenerational justice. Substituting aerosol geoengineering for reducing greenhouse gas emissions constitutes a conscious risk transfer to future generations, for example due to the increased risk of future abrupt climate change. This risk transfer is in tension with the requirement of intergenerational justice that present generations should not create benefits for themselves in exchange for burdens on future generations.

The economics (or lack thereof) of aerosol geoengineering

NASA Astrophysics Data System (ADS)

Goes, M.; Keller, K.; Tuana, N.

2009-04-01

Anthropogenic greenhouse gas emissions are changing the Earth's climate and impose substantial risks for current and future generations. What are scientifically sound, economically viable, and ethically defendable strategies to manage these climate risks? Ratified international agreements call for a reduction of greenhouse gas emissions to avoid dangerous anthropogenic interference with the climate system. Recent proposals, however, call for the deployment of a different approach: to geoengineer climate by injecting aerosol precursors into the stratosphere. Published economic studies typically suggest that substituting aerosol geoengineering for abatement of carbon dioxide emissions results in large net monetary benefits. However, these studies neglect the risks of aerosol geoengineering due to (i) the potential for future geoengineering failures and (ii) the negative impacts associated with the aerosol forcing. Here we use a simple integrated assessment model of climate change to analyze potential economic impacts of aerosol geoengineering strategies over a wide range of uncertain parameters such as climate sensitivity, the economic damages due to climate change, and the economic damages due to aerosol geoengineering forcing. The simplicity of the model provides the advantages of parsimony and transparency, but it also imposes severe caveats on the interpretation of the results. For example, the analysis is based on a globally aggregated model and is hence silent on the question of intragenerational distribution of costs and benefits. In addition, the analysis neglects the effects of endogenous learning about the climate system. We show that the risks associated with a future geoengineering failure and negative impacts of aerosol forcings can cause geoenginering strategies to fail an economic cost-benefit test. One key to this finding is that a geoengineering failure would lead to dramatic and abrupt climatic changes. The monetary damages due to this failure can dominate the cost-benefit analysis because the monetary damages of climate change are expected to increase with the rate of change. Substituting aerosol geoengineering for greenhouse gas emission abatement might fail not only an economic cost-benefit test but also an ethical test of distributional justice. Substituting aerosol geoengineering for greenhouse gas emissions abatements constitutes a conscious risk transfer to future generations. Intergenerational justice demands distributional justice, namely that present generations may not create benefits for themselves in exchange for burdens on future generations. We use the economic model to quantify this risk transfer to better inform the judgment of whether substituting aerosol geoengineering for carbon dioxide emission abatement fails this ethical test.

This Land Was Made for You and Me: Teaching for Economic Justice in Upper Elementary and Middle School Grades

ERIC Educational Resources Information Center

Lucey, Thomas A.; Laney, James D.

2009-01-01

Teaching for economic justice can be challenging for upper elementary and middle school teachers. Many teachers may feel uncomfortable with the subject matter and thus avoid addressing sensitive social issues related to economic/financial inequities. This article describes how selected songs and works of visual art, expressions of social protest…

Impacts of social indicators on assessing the recovery potential of impaired watersheds.

PubMed

Sinshaw, Tadesse A; Surbeck, Cristiane Q

2018-05-09

An analysis was carried out to understand how watersheds' potential for restoration was impacted by social indicators. This study employed the USEPA Recovery Potential Screening tool, a decision support system, to compare 51 watersheds in the state of Mississippi, USA, using ecological, stressor, and social indices, and the recovery potential integrated (RPI) index. An in-depth analysis was performed on four watersheds in the Delta region of Mississippi (Lake Washington, Harris Bayou, Steele Bayou, and Coldwater River), each impaired by sediments and nutrients. Sixteen social indicators were categorized into three subcategories: Socio-Economic, Organizational, and Informational. Watersheds with lower social indices had lower RPI scores. In the particular watersheds studied, the Socio-Economic subcategory was observed to be the most impactful to the overall recovery potential when compared to the other two social subcategories. As a sensitivity analysis, a "what if" simulation was performed to explore alternatives to upgrade a watershed's social index and, consequently, the relative recovery potential of the watershed to a target level. This analysis is useful for understanding how particular social indicators of a community impact the relative potential for recovering a watershed, beyond just the ecological and stressor conditions. It also sheds light on assessing which social indicators can be improved. Copyright © 2018 Elsevier Ltd. All rights reserved.

Analysis of differentially expressed genes between fluoride-sensitive and fluoride-endurable individuals in midgut of silkworm, Bombyx mori.

PubMed

Qian, Heying; Li, Gang; He, Qingling; Zhang, Huaguang; Xu, Anying

2016-08-15

Fluoride tolerance is an economically important trait of silkworm. Near-isogenic lines (NILs) of the dominant endurance to fluoride (Def) gene in Bombyx mori has been constructed before. Here, we analyzed the gene expression profiles of midgut of fluoride-sensitive and fluoride-endurable individuals of Def NILs by using high-throughput Illumina sequencing technology and bioinformatics tools, and identified differentially expressed genes between these individuals. A total of 3,612,399 and 3,567,631 clean tags for the libraries of fluoride-endurable and fluoride-sensitive individuals were obtained, which corresponded to 32,933 and 43,976 distinct clean tags, respectively. Analysis of differentially expressed genes indicates that 241 genes are differentially expressed between the two libraries. Among the 241 genes, 30 are up-regulated and 211 are down-regulated in fluoride-endurable individuals. Pathway enrichment analysis demonstrates that genes related to ribosomes, pancreatic secretion, steroid biosynthesis, glutathione metabolism, steroid biosynthesis, and glycerolipid metabolism are down-regulated in fluoride-endurable individuals. qRT-PCR was conducted to confirm the results of the DGE. The present study analyzed differential expression of related genes and tried to find out whether the crucial genes were related to fluoride detoxification which might elucidate fluoride effect and provide a new way in the fluorosis research. Copyright © 2016 Elsevier B.V. All rights reserved.

Economic evaluation of DNA ploidy analysis vs liquid-based cytology for cervical screening.

PubMed

Nghiem, V T; Davies, K R; Beck, J R; Follen, M; MacAulay, C; Guillaud, M; Cantor, S B

2015-06-09

DNA ploidy analysis involves automated quantification of chromosomal aneuploidy, a potential marker of progression toward cervical carcinoma. We evaluated the cost-effectiveness of this method for cervical screening, comparing five ploidy strategies (using different numbers of aneuploid cells as cut points) with liquid-based Papanicolaou smear and no screening. A state-transition Markov model simulated the natural history of HPV infection and possible progression into cervical neoplasia in a cohort of 12-year-old females. The analysis evaluated cost in 2012 US$ and effectiveness in quality-adjusted life-years (QALYs) from a health-system perspective throughout a lifetime horizon in the US setting. We calculated incremental cost-effectiveness ratios (ICERs) to determine the best strategy. The robustness of optimal choices was examined in deterministic and probabilistic sensitivity analyses. In the base-case analysis, the ploidy 4 cell strategy was cost-effective, yielding an increase of 0.032 QALY and an ICER of $18 264/QALY compared to no screening. For most scenarios in the deterministic sensitivity analysis, the ploidy 4 cell strategy was the only cost-effective strategy. Cost-effectiveness acceptability curves showed that this strategy was more likely to be cost-effective than the Papanicolaou smear. Compared to the liquid-based Papanicolaou smear, screening with a DNA ploidy strategy appeared less costly and comparably effective.

Uncertainty and Sensitivity of Direct Economic Flood Damages: the FloodRisk Free and Open-Source Software

NASA Astrophysics Data System (ADS)

Albano, R.; Sole, A.; Mancusi, L.; Cantisani, A.; Perrone, A.

2017-12-01

The considerable increase of flood damages in the the past decades has shifted in Europe the attention from protection against floods to managing flood risks. In this context, the expected damages assessment represents a crucial information within the overall flood risk management process. The present paper proposes an open source software, called FloodRisk, that is able to operatively support stakeholders in the decision making processes with a what-if approach by carrying out the rapid assessment of the flood consequences, in terms of direct economic damage and loss of human lives. The evaluation of the damage scenarios, trough the use of the GIS software proposed here, is essential for cost-benefit or multi-criteria analysis of risk mitigation alternatives. However, considering that quantitative assessment of flood damages scenarios is characterized by intrinsic uncertainty, a scheme has been developed to identify and quantify the role of the input parameters in the total uncertainty of flood loss model application in urban areas with mild terrain and complex topography. By the concept of parallel models, the contribution of different module and input parameters to the total uncertainty is quantified. The results of the present case study have exhibited a high epistemic uncertainty on the damage estimation module and, in particular, on the type and form of the utilized damage functions, which have been adapted and transferred from different geographic and socio-economic contexts because there aren't depth-damage functions that are specifically developed for Italy. Considering that uncertainty and sensitivity depend considerably on local characteristics, the epistemic uncertainty associated with the risk estimate is reduced by introducing additional information into the risk analysis. In the light of the obtained results, it is evident the need to produce and disseminate (open) data to develop micro-scale vulnerability curves. Moreover, the urgent need to push forward research into the implementation of methods and models for the assimilation of uncertainties in decision-making processes emerges.

Sensitivity analysis and economic optimization studies of inverted five-spot gas cycling in gas condensate reservoir

NASA Astrophysics Data System (ADS)

Shams, Bilal; Yao, Jun; Zhang, Kai; Zhang, Lei

2017-08-01

Gas condensate reservoirs usually exhibit complex flow behaviors because of propagation response of pressure drop from the wellbore into the reservoir. When reservoir pressure drops below the dew point in two phase flow of gas and condensate, the accumulation of large condensate amount occurs in the gas condensate reservoirs. Usually, the saturation of condensate accumulation in volumetric gas condensate reservoirs is lower than the critical condensate saturation that causes trapping of large amount of condensate in reservoir pores. Trapped condensate often is lost due to condensate accumulation-condensate blockage courtesy of high molecular weight, heavy condensate residue. Recovering lost condensate most economically and optimally has always been a challenging goal. Thus, gas cycling is applied to alleviate such a drastic loss in resources. In gas injection, the flooding pattern, injection timing and injection duration are key parameters to study an efficient EOR scenario in order to recover lost condensate. This work contains sensitivity analysis on different parameters to generate an accurate investigation about the effects on performance of different injection scenarios in homogeneous gas condensate system. In this paper, starting time of gas cycling and injection period are the parameters used to influence condensate recovery of a five-spot well pattern which has an injection pressure constraint of 3000 psi and production wells are constraint at 500 psi min. BHP. Starting injection times of 1 month, 4 months and 9 months after natural depletion areapplied in the first study. The second study is conducted by varying injection duration. Three durations are selected: 100 days, 400 days and 900 days. In miscible gas injection, miscibility and vaporization of condensate by injected gas is more efficient mechanism for condensate recovery. From this study, it is proven that the application of gas cycling on five-spot well pattern greatly enhances condensate recovery preventing financial, economic and resource loss that previously occurred.

Clinical and economic impact of mirabegron compared with antimuscarinics for the treatment of overactive bladder in Canada.

PubMed

Hakimi, Zalmai; Nazir, Jameel; McCrea, Charles; Berling, Malin; Fatoye, Francis; Ramos, Barbara; Wagg, Adrian

2017-06-01

The β 3 -adrenoceptor agonist, mirabegron, and antimuscarinic agents provide similar efficacy for the treatment of overactive bladder (OAB), but mirabegron appears to be associated with better persistence, perhaps due to an absence of anticholinergic side-effects. This study estimated the expected costs associated with the management of OAB in Canada from a societal perspective by utilizing real-world evidence. An economic model with monthly cycles and a 1-year time horizon was developed to depict a treatment pathway for a hypothetical cohort of 100 patients with OAB. At model entry, patients receive mirabegron or an antimuscarinic. Patients who do not persist may switch treatment, undergo a minimally invasive procedure, or remain symptomatic (uncontrolled). The model includes direct costs (e.g. physician visits) and indirect costs (e.g. lost productivity). A one-way univariate sensitivity analysis assessed a ±20% variation in each of the key model inputs. At 1 year, a greater proportion of patients persisted on treatment with mirabegron compared with antimuscarinics (33% vs 15-23%), and a smaller proportion switched treatment (17% vs 20-22%). The number of healthcare visits (292 vs 299-304), pads used (74,098 vs 77,878-81,669), and work hours lost (4,497 vs 5,372-6,249) were all lower for mirabegron vs antimuscarinics. The estimated total annual cost of treatment per patient with mirabegron was $2,127.46 Canadian dollars (CAD) ($5.82 CAD/day) compared with $2,150.20-$2,496.69 CAD ($5.89-$6.84 CAD/day) for antimuscarinics. The one-way sensitivity analysis indicated the results are robust. Improved persistence observed in routine clinical practice with mirabegron appears to translate into benefits of reduced healthcare resource use, and lower direct and indirect costs of treatment compared with antimuscarinics. Overall, these data suggest that mirabegron may offer clinical and economic benefits for the management of patients with OAB in Canada.

Optimal Cycle Time and Preservation Technology Investment for Deteriorating Items with Price-sensitive Stock-dependent Demand Under Inflation

NASA Astrophysics Data System (ADS)

Shah, Nita H.; Shah, Arpan D.

2014-04-01

The article analyzes economic order quantity for the retailer who has to handle imperfect quality of the product and the units are subject to deteriorate at a constant rate. To control deterioration of the units in inventory, the retailer has to deploy advanced preservation technology. Another challenge for the retailer is to have perfect quality product. This requires mandatory inspection during the production process. This model is developed with the condition of random fraction of defective items. It is assumed that after inspection, the screened defective items are sold at a discounted rate instantly. Demand is considered to be price-sensitive stock-dependent. The model is incorporating effect of inflation which is critical factor globally. The objective is to maximize profit of the retailer with respect to preservation technology investment, order quantity and cycle time. The numerical example is given to validate the proposed model. Sensitivity analysis is carried out to work out managerial issues.

Improved ethanol yield and reduced minimum ethanol selling price (MESP) by modifying low severity dilute acid pretreatment with deacetylation and mechanical refining: 2) Techno-economic analysis

PubMed Central

2012-01-01

Background Our companion paper discussed the yield benefits achieved by integrating deacetylation, mechanical refining, and washing with low acid and low temperature pretreatment. To evaluate the impact of the modified process on the economic feasibility, a techno-economic analysis (TEA) was performed based on the experimental data presented in the companion paper. Results The cost benefits of dilute acid pretreatment technology combined with the process alternatives of deacetylation, mechanical refining, and pretreated solids washing were evaluated using cost benefit analysis within a conceptual modeling framework. Control cases were pretreated at much lower acid loadings and temperatures than used those in the NREL 2011 design case, resulting in much lower annual ethanol production. Therefore, the minimum ethanol selling prices (MESP) of the control cases were $0.41-$0.77 higher than the $2.15/gallon MESP of the design case. This increment is highly dependent on the carbohydrate content in the corn stover. However, if pretreatment was employed with either deacetylation or mechanical refining, the MESPs were reduced by $0.23-$0.30/gallon. Combing both steps could lower the MESP further by $0.44 ~ $0.54. Washing of the pretreated solids could also greatly improve the final ethanol yields. However, the large capital cost of the solid–liquid separation unit negatively influences the process economics. Finally, sensitivity analysis was performed to study the effect of the cost of the pretreatment reactor and the energy input for mechanical refining. A 50% cost reduction in the pretreatment reactor cost reduced the MESP of the entire conversion process by $0.11-$0.14/gallon, while a 10-fold increase in energy input for mechanical refining will increase the MESP by $0.07/gallon. Conclusion Deacetylation and mechanical refining process options combined with low acid, low severity pretreatments show improvements in ethanol yields and calculated MESP for cellulosic ethanol production. PMID:22967479

Sensitivity Analysis of the Sheet Metal Stamping Processes Based on Inverse Finite Element Modeling and Monte Carlo Simulation

NASA Astrophysics Data System (ADS)

Yu, Maolin; Du, R.

2005-08-01

Sheet metal stamping is one of the most commonly used manufacturing processes, and hence, much research has been carried for economic gain. Searching through the literatures, however, it is found that there are still a lots of problems unsolved. For example, it is well known that for a same press, same workpiece material, and same set of die, the product quality may vary owing to a number of factors, such as the inhomogeneous of the workpice material, the loading error, the lubrication, and etc. Presently, few seem able to predict the quality variation, not to mention what contribute to the quality variation. As a result, trial-and-error is still needed in the shop floor, causing additional cost and time delay. This paper introduces a new approach to predict the product quality variation and identify the sensitive design / process parameters. The new approach is based on a combination of inverse Finite Element Modeling (FEM) and Monte Carlo Simulation (more specifically, the Latin Hypercube Sampling (LHS) approach). With an acceptable accuracy, the inverse FEM (also called one-step FEM) requires much less computation load than that of the usual incremental FEM and hence, can be used to predict the quality variations under various conditions. LHS is a statistical method, through which the sensitivity analysis can be carried out. The result of the sensitivity analysis has clear physical meaning and can be used to optimize the die design and / or the process design. Two simulation examples are presented including drawing a rectangular box and drawing a two-step rectangular box.

An EOQ model for weibull distribution deterioration with time-dependent cubic demand and backlogging

NASA Astrophysics Data System (ADS)

Santhi, G.; Karthikeyan, K.

2017-11-01

In this article we introduce an economic order quantity model with weibull deterioration and time dependent cubic demand rate where holding costs as a linear function of time. Shortages are allowed in the inventory system are partially and fully backlogging. The objective of this model is to minimize the total inventory cost by using the optimal order quantity and the cycle length. The proposed model is illustrated by numerical examples and the sensitivity analysis is performed to study the effect of changes in parameters on the optimum solutions.

Economic benefits of midseason reordering in apparel retailing

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

Lamont, A.; Elayat, H.

1995-09-27

This report presents a method for determining the value of reordering, explores factors that affect its value, and provides an estimate of the value under a range of conditions. The method is based on a stochastic process model of the demands the retailer faces. It uses a dynamic programming model to determine the optimal quantities to order and the expected profits. The analysis shows that the benefits of reordering are quite sensitive to the uncertainties in the demand and to the assumptions about the markdown of unsold merchandise at the end of the season.

Addiction Research Ethics and the Belmont Principles: Do Drug Users Have a Different Moral Voice?

PubMed Central

Fisher, Celia B.

2013-01-01

This study used semi-structured interviews and content analysis to examine moral principles that street drug users apply to three hypothetical addiction research ethical dilemmas. Participants (n = 90) were ethnically diverse, economically disadvantaged drug users recruited in New York City in 2009. Participants applied a wide range of contextually sensitive moral precepts, including respect, beneficence, justice, relationality, professional obligations, rules, and pragmatic self-interest. Limitations and implications for future research and the responsible conduct of addiction research are discussed. PMID:21073412

Take a stand on your decisions, or take a sit: posture does not affect risk preferences in an economic task.

PubMed

O'Brien, Megan K; Ahmed, Alaa A

2014-01-01

Physiological and emotional states can affect our decision-making processes, even when these states are seemingly insignificant to the decision at hand. We examined whether posture and postural threat affect decisions in a non-related economic domain. Healthy young adults made a series of choices between economic lotteries in various conditions, including changes in body posture (sitting vs. standing) and changes in elevation (ground level vs. atop a 0.8-meter-high platform). We compared three metrics between conditions to assess changes in risk-sensitivity: frequency of risky choices, and parameter fits of both utility and probability weighting parameters using cumulative prospect theory. We also measured skin conductance level to evaluate physiological response to the postural threat. Our results demonstrate that body posture does not significantly affect decision making. Secondly, despite increased skin conductance level, economic risk-sensitivity was unaffected by increased threat. Our findings indicate that economic choices are fairly robust to the physiological and emotional changes that result from posture or postural threat.

Take a stand on your decisions, or take a sit: posture does not affect risk preferences in an economic task

PubMed Central

O’Brien, Megan K.

2014-01-01

Physiological and emotional states can affect our decision-making processes, even when these states are seemingly insignificant to the decision at hand. We examined whether posture and postural threat affect decisions in a non-related economic domain. Healthy young adults made a series of choices between economic lotteries in various conditions, including changes in body posture (sitting vs. standing) and changes in elevation (ground level vs. atop a 0.8-meter-high platform). We compared three metrics between conditions to assess changes in risk-sensitivity: frequency of risky choices, and parameter fits of both utility and probability weighting parameters using cumulative prospect theory. We also measured skin conductance level to evaluate physiological response to the postural threat. Our results demonstrate that body posture does not significantly affect decision making. Secondly, despite increased skin conductance level, economic risk-sensitivity was unaffected by increased threat. Our findings indicate that economic choices are fairly robust to the physiological and emotional changes that result from posture or postural threat. PMID:25083345

17 CFR 200.23a - Office of Economic Analysis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Office of Economic Analysis... Organization § 200.23a Office of Economic Analysis. The Office of Economic Analysis is responsible for providing an objective economic perspective to understand and evaluate the economic dimension of the...

17 CFR 200.23a - Office of Economic Analysis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Office of Economic Analysis... Organization § 200.23a Office of Economic Analysis. The Office of Economic Analysis is responsible for providing an objective economic perspective to understand and evaluate the economic dimension of the...

17 CFR 200.23a - Office of Economic Analysis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Office of Economic Analysis... Organization § 200.23a Office of Economic Analysis. The Office of Economic Analysis is responsible for providing an objective economic perspective to understand and evaluate the economic dimension of the...

17 CFR 200.23a - Office of Economic Analysis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false Office of Economic Analysis... Organization § 200.23a Office of Economic Analysis. The Office of Economic Analysis is responsible for providing an objective economic perspective to understand and evaluate the economic dimension of the...

17 CFR 200.23a - Office of Economic Analysis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Office of Economic Analysis... Organization § 200.23a Office of Economic Analysis. The Office of Economic Analysis is responsible for providing an objective economic perspective to understand and evaluate the economic dimension of the...

The economic burden of schizophrenia in Malaysia.

PubMed

Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

2017-01-01

Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

The economic burden of schizophrenia in Malaysia

PubMed Central

Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

2017-01-01

Introduction Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. Methods A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient’s identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. Results The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. Conclusion This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden. PMID:28814869

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

PubMed

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

2015-07-31

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

The economic cost of road traffic crashes in an urban setting

PubMed Central

García‐Altés, A; Pérez, K

2007-01-01

The objective of this article is to assess the total economic costs of road traffic crashes in Barcelona, a metropolitan city located in Southern Europe. A cost‐of‐illness study was conducted using a prevalence approximation, a societal and healthcare system perspective, and a 1‐year time horizon. Results were measured in terms of Euros in 2003. Total costs of road traffic crashes in Barcelona in 2003 were €367 million. Direct costs equalled €329 million (89.8% of total costs), including property damage costs, insurance administration costs and hospital costs. Police, emergency costs and transportation costs had a minimum effect on total direct costs. Indirect costs were €37 million, including lost productivity due to hospitalization and mortality. The results of the sensitivity analysis showed the upper limit of total economic cost of road traffic crashes in Barcelona to be €782 million. This is the first study to estimate the costs of road traffic crashes for a city in a developed country. The importance of the problem calls for further interventions to reduce road traffic crashes. PMID:17296693

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

Techno-economic assessment of a wood-based biorefinery concept for the production of polymer-grade ethylene, organosolv lignin and fuel.

PubMed

Nitzsche, Roy; Budzinski, Maik; Gröngröft, Arne

2016-01-01

Lignocellulose biorefineries are distinguished by an explicitly integrative, multi-functional concept that transforms biomass into multiple products, using a variety of conversion and separation processes. This study focuses on the technical design and economic evaluation of a lignocellulose biorefinery, that converts 400,000tDM/a (≙250MW) of beech wood into chemicals and fuel. A model was simulated with Aspen Plus® including the process steps pre-treatment, enzymatic hydrolysis, alcoholic fermentation, dehydration and biogas generation and upgrading. Mass and energy balances showed that 61,600t/a polymer-grade ethylene, 58,520tDM/a organosolv lignin, 38,400t/a biomethane and 90,800tDM/a hydrolysis lignin can be produced with a total energy efficiency of 87.1%. A discounted cash flow analysis indicated that the heat integrated biorefinery concept is not yet profitable. However, the economic results are greatly sensitive regarding various assumptions, in particular in terms of the prices for beech wood, ethylene and organosolv lignin. Copyright © 2015 Elsevier Ltd. All rights reserved.

Raising taxes to reduce smoking prevalence in the US: a simulation of the anticipated health and economic impacts.

PubMed

Ahmad, Sajjad; Franz, Gregor A

2008-01-01

To estimate health and economic outcomes of raising the excise taxes on cigarettes. We use a dynamic computer simulation model to estimate health and economic impacts of raising taxes on cigarettes (up to 100% price increase) for the entire population of the USA over 20 years. We also perform sensitivity analysis on price elasticity. A 40% tax-induced cigarette price increase would reduce smoking prevalence from 21% in 2004 to 15.2% in 2025 with large gains in cumulative life years (7 million) and quality adjusted life years (13 million) over 20 years. Total tax revenue will increase by $365 billion in that span, and total smoking-related medical costs would drop by $317 billion, resulting in total savings of $682 billion. These benefits increase greatly with larger tax increases, and tax revenues continue to rise even as smoking prevalence falls. Increasing taxes on cigarettes is a unique policy intervention that reduces smoking prevalence, generates additional tax revenue, and results in significant savings in medical care costs.

Raising Taxes to Reduce Smoking Prevalence in the US: A Simulation of the Anticipated Health and Economic Impacts

PubMed Central

Ahmad, Sajjad; Franz, Gregor A.

2008-01-01

Objective To estimate health and economic outcomes of raising the excise taxes on cigarettes. Methods We use a dynamic computer simulation model to estimate health and economic impacts of raising taxes on cigarettes (up to 100% price increase) for the entire population of USA over 20 years. We also perform sensitivity analysis on price elasticity. Results A 40% tax-induced cigarette price increase would reduce smoking prevalence from 21% in 2004 to 15.2% in 2025 with large gains in cumulative life years (7 million) and quality adjusted life years (13 million) over 20 years. Total tax revenue will increase by $365 billion in that span, and total smoking-related medical costs would drop by $317 billion, resulting in total savings of $682 billion. These benefits increase greatly with larger tax increases, and tax revenues continue to rise even as smoking prevalence falls. Conclusions Increasing taxes on cigarettes is a unique policy intervention that reduces smoking prevalence, generates additional tax revenue, and results in significant savings in medical care costs. PMID:17610918

Techno-economic comparison of biojet fuel production from lignocellulose, vegetable oil and sugar cane juice.

PubMed

Diederichs, Gabriel Wilhelm; Ali Mandegari, Mohsen; Farzad, Somayeh; Görgens, Johann F

2016-09-01

In this study, a techno-economic comparison was performed considering three processes (thermochemical, biochemical and hybrid) for production of jet fuel from lignocellulosic biomass (2G) versus two processes from first generation (1G) feedstocks, including vegetable oil and sugar cane juice. Mass and energy balances were constructed for energy self-sufficient versions of these processes, not utilising any fossil energy sources, using ASPEN Plus® simulations. All of the investigated processes obtained base minimum jet selling prices (MJSP) that is substantially higher than the market jet fuel price (2-4 fold). The 1G process which converts vegetable oil, obtained the lowest MJSPs of $2.22/kg jet fuel while the two most promising 2G processes- the thermochemical (gasification and Fischer-Tropsch synthesis) and hybrid (gasification and biochemical upgrading) processes- reached MJSPs of $2.44/kg and $2.50/kg jet fuel, respectively. According to the economic sensitivity analysis, the feedstock cost and fixed capital investment have the most influence on the MJSP. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2015-01-01

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

16 CFR 1000.28 - Directorate for Economic Analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Directorate for Economic Analysis. 1000.28... AND FUNCTIONS § 1000.28 Directorate for Economic Analysis. The Directorate for Economic Analysis, which is managed by the Associate Executive Director for Economic Analysis, is responsible for providing...

Thermochemical Conversion Techno-Economic Analysis | Bioenergy | NREL

Science.gov Websites

Conversion Techno-Economic Analysis Thermochemical Conversion Techno-Economic Analysis NREL's Thermochemical Conversion Analysis team focuses on the conceptual process design and techno-economic analysis , detailed process models, and TEA developed under this project provide insights into the potential economic

16 CFR 1000.28 - Directorate for Economic Analysis.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Directorate for Economic Analysis. 1000.28... AND FUNCTIONS § 1000.28 Directorate for Economic Analysis. The Directorate for Economic Analysis, which is managed by the Associate Executive Director for Economic Analysis, is responsible for providing...

16 CFR 1000.28 - Directorate for Economic Analysis.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Directorate for Economic Analysis. 1000.28... AND FUNCTIONS § 1000.28 Directorate for Economic Analysis. The Directorate for Economic Analysis, which is managed by the Associate Executive Director for Economic Analysis, is responsible for providing...

16 CFR 1000.28 - Directorate for Economic Analysis.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Directorate for Economic Analysis. 1000.28... AND FUNCTIONS § 1000.28 Directorate for Economic Analysis. The Directorate for Economic Analysis, which is managed by the Associate Executive Director for Economic Analysis, is responsible for providing...

Economic Return From the Women’s Health Initiative Estrogen Plus Progestin Clinical Trial

PubMed Central

Roth, Joshua A.; Etzioni, Ruth; Waters, Teresa M.; Pettinger, Mary; Rossouw, Jacques E.; Anderson, Garnet L.; Chlebowski, Rowan T.; Manson, JoAnn E.; Hlatky, Mark; Johnson, Karen C.; Ramsey, Scott D.

2014-01-01

Background The findings of the Women’s Health Initiative (WHI) estrogen plus progestin (E+P) trial led to a substantial reduction in use of combined hormone therapy (cHT) among postmenopausal women in the United States. The economic effect of this shift has not been evaluated relative to the trial’s $260 million cost (2012 U.S. dollars). Objective To estimate the economic return from the WHI E+P trial. Design Decision model to simulate health outcomes for a “WHI scenario” with observed cHT use and a “no-WHI scenario” with cHT use extrapolated from the pretrial period. Data Sources Primary analyses of WHI outcomes, peer-reviewed literature, and government sources. Target Population Postmenopausal women in the United States, aged 50 to 79 years, who did not have a hysterectomy. Time Horizon 2003 to 2012. Perspective Payer. Intervention Combined hormone therapy. Outcome Measures Disease incidence, expenditure, quality-adjusted life-years, and net economic return. Results of Base-Case Analysis The WHI scenario resulted in 4.3 million fewer cHT users, 126 000 fewer breast cancer cases, 76 000 fewer cardiovascular disease cases, 263 000 more fractures, 145 000 more quality-adjusted life-years, and expenditure savings of $35.2 billion. The corresponding net economic return of the trial was $37.1 billion ($140 per dollar invested in the trial) at a willingness-to-pay level of $100 000 per quality-adjusted life-year. Results of Sensitivity Analysis The 95% CI for the net economic return of the trial was $23.1 to $51.2 billion. Limitation No evaluation of indirect costs or outcomes beyond 2012. Conclusion The WHI E+P trial made high-value use of public funds with a substantial return on investment. These results can contribute to discussions about the role of public funding for large, prospective trials with high potential for public health effects. Primary Funding Source National Heart, Lung, and Blood Institute. PMID:24798522

Hydro-economic modelling in mining catchments

NASA Astrophysics Data System (ADS)

Ossa Moreno, J. S.; McIntyre, N.; Rivera, D.; Smart, J. C. R.

2017-12-01

Hydro-economic models are gaining momentum because of their capacity to model both the physical processes related to water supply, and socio-economic factors determining water demand. This is particularly valuable in the midst of the large uncertainty upon future climate conditions and social trends. Agriculture, urban uses and environmental flows have received a lot of attention from researchers, as these tend to be the main consumers of water in most catchments. Mine water demand, although very important in several small and medium-sized catchments worldwide, has received less attention and only few models have attempted to reproduce its dynamics with other users. This paper describes an on-going project that addresses this gap, by developing a hydro-economic model in the upper Aconcagua River in Chile. This is a mountain catchment with large scale mining and hydro-power users at high altitudes, and irrigation areas in a downstream valley. Relevant obstacles to the model included the lack of input climate data, which is a common feature in several mining areas, the complex hydrological processes in the area and the difficulty of quantifying the value of water used by mines. A semi-distributed model developed within the Water Evaluation and Planning System (WEAP), was calibrated to reproduce water supply, and this was complemented with an analysis of the value of water for mining based on two methods; water markets and an analysis of its production processes. Agriculture and other users were included through methods commonly used in similar models. The outputs help understanding the value of water in the catchment, and its sensitivity to changes in climate variables, market prices, environmental regulations and changes in the production of minerals, crops and energy. The results of the project highlight the importance of merging hydrology and socio-economic calculations in mining regions, in order to better understand trade-offs and cost of opportunity of using water for an economic activity with high revenues, averse to water risks and with potentially large catchment impacts.

Economic evaluation of gastric ulcer prophylaxis in patients with arthritis receiving non-steroidal anti-inflammatory drugs.

PubMed Central

Knill-Jones, R.; Drummond, M.; Kohli, H.; Davies, L.

1990-01-01

This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with gastric ulcer recorded in the routine data was substantially less (4% Scotland, 10% West Midlands) than the 21% found at case review. These data were combined with cost and patient management data in a decision analysis model to explore whether prophylactic use of misoprostol altered substantially the average cost of managing gastric ulcer. Using conservative assumptions and a daily dose of 400 micrograms, cost savings per patient to the National Health Service of 5-8 pounds over a 3-month period are expected in the groups of patients studied, while at the 800 micrograms dose there would be a net cost of 23-25 pounds. Sensitivity analysis showed that under many assumptions misoprostol is expected to be cost saving or cost neutral. PMID:2120690

Small modular reactor: First-of-a-Kind (FOAK) and Nth-of-a-Kind (NOAK) Economic Analysis

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

Boldon, Lauren M.; Sabharwall, Piyush

2014-08-01

Small modular reactors (SMRs) refer to any reactor design in which the electricity generated is less than 300 MWe. Often medium sized reactors with power less than 700 MWe are also grouped into this category. Internationally, the development of a variety of designs for SMRs is booming with many designs approaching maturity and even in or nearing the licensing stage. It is for this reason that a generalized yet comprehensive economic model for first of a kind (FOAK) through nth of a kind (NOAK) SMRs based upon rated power, plant configuration, and the fiscal environment was developed. In the model,more » a particular project’s feasibility is assessed with regards to market conditions and by commonly utilized capital budgeting techniques, such as the net present value (NPV), internal rate of return (IRR), Payback, and more importantly, the levelized cost of energy (LCOE) for comparison to other energy production technologies. Finally, a sensitivity analysis was performed to determine the effects of changing debt, equity, interest rate, and conditions on the LCOE.« less

Algal Biofuels Techno-Economic Analysis | Bioenergy | NREL

Science.gov Websites

Biofuels Techno-Economic Analysis Algal Biofuels Techno-Economic Analysis To promote an understanding of the challenges and opportunities unique to microalgae, NREL's Algae Techno-Economic Analysis group focuses on techno-economic analysis (TEA) for the production and conversion of algal biomass into

16 CFR § 1000.28 - Directorate for Economic Analysis.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Directorate for Economic Analysis. § 1000... ORGANIZATION AND FUNCTIONS § 1000.28 Directorate for Economic Analysis. The Directorate for Economic Analysis, which is managed by the Associate Executive Director for Economic Analysis, is responsible for providing...

Economic and Financial Analysis Tools | Energy Analysis | NREL

Science.gov Websites

Economic and Financial Analysis Tools Economic and Financial Analysis Tools Use these economic and . Job and Economic Development Impact (JEDI) Model Use these easy-to-use, spreadsheet-based tools to analyze the economic impacts of constructing and operating power generation and biofuel plants at the

Designing Military Pay. Contributions and Implications of the Economics Literature

DTIC Science & Technology

1993-01-01

34Time, Salary, and Incentive Payoffs in Labor Contracts," Journal of Labor Economics , VoL 9, No. 1, 1991, pp. 25-44. Foulkes, Fred K., Personnel...Edward Lazear, "The Excess Sensitivity of Layoffs and Quits to Demand," Journal of Labor Economics , VoL 2, No. 2,1984, pp. 233-257. Hashimoto, Masanori...34 Research in Labor Economics , VoL 9, Ronald Ehrenberg, ed., Ithaca, New York: JAI Press, Cornell University, 1988, pp. 225-256. Mellow, Wesley, "Employer Size

Cost Effectiveness of Stapled Haemorrhoidopexy and Traditional Excisional Surgery for the Treatment of Haemorrhoidal Disease.

PubMed

Kilonzo, Mary M; Brown, Steven R; Bruhn, Hanne; Cook, Jonathan A; Hudson, Jemma; Norrie, John; Watson, Angus J M; Wood, Jessica

2017-08-25

Our objective was to compare the cost effectiveness of stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH) in the treatment of grade II-IV haemorrhoidal disease from the perspective of the UK national health service. An economic evaluation was conducted alongside an open, two-arm, parallel-group, pragmatic, multicentre, randomised controlled trial conducted in several hospitals in the UK. Patients were randomised into either SH or TH surgery between January 2011 and August 2014 and were followed up for 24 months. Intervention and subsequent resource use data were collected using case review forms and questionnaires. Benefits were collected using the EQ-5D-3L (EuroQoL-five dimensions-three levels) instrument. The primary economic outcome was incremental cost measured in pounds (£), year 2016 values, relative to the incremental benefit, which was estimated using quality-adjusted life-years (QALYs). Cost and benefits accrued in the second year were discounted at 3.5%. The base-case analysis was based on imputed data. Uncertainty was explored using univariate sensitivity analyses. Participants (n = 777) were randomised to SH (n = 389) or TH (n = 388). The mean cost of SH was £337 (95% confidence interval [CI] 251-423) higher than that of TH and the mean QALYs were -0.070 (95% CI -0.127 to -0.011) lower than for TH. The base-case cost-utility analysis indicated that SH has zero probability of being cost effective at both the £20,000 and the £30,000 threshold. Results from the sensitivity analyses were similar to those from the base-case analysis. The evidence suggests that, on average, the total mean costs over the 24-month follow-up period were significantly higher for the SH arm than for the TH arm. The QALYs were also, on average, significantly lower for the SH arm. These results were supported by the sensitivity analyses. Therefore, in terms of cost effectiveness, TH is a superior surgical treatment for the management of grade II-IV haemorrhoids when compared with SH.

Cost/benefit analysis of advanced materials technology candidates for the 1980's, part 2

NASA Technical Reports Server (NTRS)

Dennis, R. E.; Maertins, H. F.

1980-01-01

Cost/benefit analyses to evaluate advanced material technologies projects considered for general aviation and turboprop commuter aircraft through estimated life-cycle costs, direct operating costs, and development costs are discussed. Specifically addressed is the selection of technologies to be evaluated; development of property goals; assessment of candidate technologies on typical engines and aircraft; sensitivity analysis of the changes in property goals on performance and economics, cost, and risk analysis for each technology; and ranking of each technology by relative value. The cost/benefit analysis was applied to a domestic, nonrevenue producing, business-type jet aircraft configured with two TFE731-3 turbofan engines, and to a domestic, nonrevenue producing, business type turboprop aircraft configured with two TPE331-10 turboprop engines. In addition, a cost/benefit analysis was applied to a commercial turboprop aircraft configured with a growth version of the TPE331-10.

Are policy decisions on surgical procedures informed by robust economic evidence? A systematic review.

PubMed

Ara, Roberta; Basarir, Hasan; Keetharuth, Anju D; Barbieri, Marco; Weatherly, Helen L A; Sculpher, Mark J S; Ahmed, Hashim; Brown, Steven

2014-10-01

The aim of this study was to examine the empirical and methodological cost-effectiveness evidence of surgical interventions for breast, colorectal, or prostate cancer. A systematic search of seven databases including MEDLINE, EMBASE, and NHSEED, research registers, the NICE Web site and conference proceedings was conducted in April 2012. Study quality was assessed in terms of meeting essential, preferred and UK NICE specific requirements for economic evaluations. The seventeen (breast = 3, colorectal = 7, prostate = 7) included studies covered a broad range of settings (nine European; eight non-European) and six were published over 10 years ago. The populations, interventions and comparators were generally well defined. Very few studies were informed by literature reviews and few used synthesized clinical evidence. Although the interventions had potential differential effects on recurrence and mortality rates, some studies used relatively short time horizons. Univariate sensitivity analyses were reported in all studies but less than a third characterized all uncertainty with a probabilistic sensitivity analysis. Although a third of studies incorporated patients' health-related quality of life data, only four studies used social tariff values. There is a dearth of recent robust evidence describing the cost-effectiveness of surgical interventions in the management of breast, colorectal and prostate cancers. Many of the recent publications did not satisfy essential methodological requirements such as using clinical evidence informed by a systematic review and synthesis. Given the ratio of potential benefit and harms associated with cancer surgery and the volume of resources consumed by these, there is an urgent need to increase economic evaluations of these technologies.

Preoperative localization strategies for primary hyperparathyroidism: an economic analysis.

PubMed

Lubitz, Carrie C; Stephen, Antonia E; Hodin, Richard A; Pandharipande, Pari

2012-12-01

Strategies for localizing parathyroid pathology preoperatively vary in cost and accuracy. Our purpose was to compute and compare comprehensive costs associated with common localization strategies. A decision-analytic model was developed to evaluate comprehensive, short-term costs of parathyroid localization strategies for patients with primary hyperparathyroidism. Eight strategies were compared. Probabilities of accurate localization were extracted from the literature, and costs associated with each strategy were based on 2011 Medicare reimbursement schedules. Differential cost considerations included outpatient versus inpatient surgeries, operative time, and costs of imaging. Sensitivity analyses were performed to determine effects of variability in key model parameters upon model results. Ultrasound (US) followed by 4D-CT was the least expensive strategy ($5,901), followed by US alone ($6,028), and 4D-CT alone ($6,110). Strategies including sestamibi (SM) were more expensive, with associated expenditures of up to $6,329 for contemporaneous US and SM. Four-gland, bilateral neck exploration (BNE) was the most expensive strategy ($6,824). Differences in cost were dependent upon differences in the sensitivity of each strategy for detecting single-gland disease, which determined the proportion of patients able to undergo outpatient minimally invasive parathyroidectomy. In sensitivity analysis, US alone was preferred over US followed by 4D-CT only when both the sensitivity of US alone for detecting an adenoma was ≥ 94 %, and the sensitivity of 4D-CT following negative US was ≤ 39 %. 4D-CT alone was the least costly strategy when US sensitivity was ≤ 31 %. Among commonly used strategies for preoperative localization of parathyroid pathology, US followed by selective 4D-CT is the least expensive.

Economic evaluation of first-line adjuvant chemotherapies for resectable gastric cancer patients in China.

PubMed

Tan, Chongqing; Peng, Liubao; Zeng, Xiaohui; Li, Jianhe; Wan, Xiaomin; Chen, Gannong; Yi, Lidan; Luo, Xia; Zhao, Ziying

2013-01-01

First-line postoperative adjuvant chemotherapies with S-1 and capecitabine and oxaliplatin (XELOX) were first recommended for resectable gastric cancer patients in the 2010 and 2011 Chinese NCCN Clinical Practice Guidelines in Oncology: Gastric Cancer; however, their economic impact in China is unknown. The aim of this study was to compare the cost-effectiveness of adjuvant chemotherapy with XELOX, with S-1 and no treatment after a gastrectomy with extended (D2) lymph-node dissection among patients with stage II-IIIB gastric cancer. A Markov model, based on data from two clinical phase III trials, was developed to analyse the cost-effectiveness of patients in the XELOX group, S-1 group and surgery only (SO) group. The costs were estimated from the perspective of Chinese healthcare system. The utilities were assumed on the basis of previously published reports. Costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICER) were calculated with a lifetime horizon. One-way and probabilistic sensitivity analyses were performed. For the base case, XELOX had the lowest total cost ($44,568) and cost-effectiveness ratio ($7,360/QALY). The relative scenario analyses showed that SO was dominated by XELOX and the ICERs of S-1 was $58,843/QALY compared with XELOX. The one-way sensitivity analysis showed that the most influential parameter was the utility of disease-free survival. The probabilistic sensitivity analysis predicted a 75.8% likelihood that the ICER for XELOX would be less than $13,527 compared with S-1. When ICER was more than $38,000, the likelihood of cost-effectiveness achieved by S-1 group was greater than 50%. Our results suggest that for patients in China with resectable disease, first-line adjuvant chemotherapy with XELOX after a D2 gastrectomy is a best option comparing with S-1 and SO in view of our current study. In addition, S-1 might be a better choice, especially with a higher value of willingness-to-pay threshold.

Drivers of Variability in Public-Supply Water Use Across the Contiguous United States

NASA Astrophysics Data System (ADS)

Worland, Scott C.; Steinschneider, Scott; Hornberger, George M.

2018-03-01

This study explores the relationship between municipal water use and an array of climate, economic, behavioral, and policy variables across the contiguous U.S. The relationship is explored using Bayesian-hierarchical regression models for over 2,500 counties, 18 covariates, and three higher-level grouping variables. Additionally, a second analysis is included for 83 cities where water price and water conservation policy information is available. A hierarchical model using the nine climate regions (product of National Oceanic and Atmospheric Administration) as the higher-level groups results in the best out-of-sample performance, as estimated by the Widely Available Information Criterion, compared to counties grouped by urban continuum classification or primary economic activity. The regression coefficients indicate that the controls on water use are not uniform across the nation: e.g., counties in the Northeast and Northwest climate regions are more sensitive to social variables, whereas counties in the Southwest and East North Central climate regions are more sensitive to environmental variables. For the national city-level model, it appears that arid cities with a high cost of living and relatively low water bills sell more water per customer, but as with the county-level model, the effect of each variable depends heavily on where a city is located.

Temperature impacts on economic growth warrant stringent mitigation policy

NASA Astrophysics Data System (ADS)

Moore, Frances C.; Diaz, Delavane B.

2015-02-01

Integrated assessment models compare the costs of greenhouse gas mitigation with damages from climate change to evaluate the social welfare implications of climate policy proposals and inform optimal emissions reduction trajectories. However, these models have been criticized for lacking a strong empirical basis for their damage functions, which do little to alter assumptions of sustained gross domestic product (GDP) growth, even under extreme temperature scenarios. We implement empirical estimates of temperature effects on GDP growth rates in the DICE model through two pathways, total factor productivity growth and capital depreciation. This damage specification, even under optimistic adaptation assumptions, substantially slows GDP growth in poor regions but has more modest effects in rich countries. Optimal climate policy in this model stabilizes global temperature change below 2 °C by eliminating emissions in the near future and implies a social cost of carbon several times larger than previous estimates. A sensitivity analysis shows that the magnitude of climate change impacts on economic growth, the rate of adaptation, and the dynamic interaction between damages and GDP are three critical uncertainties requiring further research. In particular, optimal mitigation rates are much lower if countries become less sensitive to climate change impacts as they develop, making this a major source of uncertainty and an important subject for future research.

Reducing uncertainty in value-based pricing using evidence development agreements: the case of continuous intraduodenal infusion of levodopa/carbidopa (Duodopa®) in Sweden.

PubMed

Willis, Michael; Persson, Ulf; Zoellner, York; Gradl, Birgit

2010-01-01

Value-based pricing (VBP), whereby prices are set according to the perceived benefits offered to the consumer at a time when costs and benefits are characterized by considerable uncertainty and are then reviewed ex post, is a much discussed topic in pharmaceutical reimbursement. It is usually combined with coverage with evidence development (CED), a tool in which manufacturers are granted temporary reimbursement but are required to collect and submit additional health economic data at review. Many countries, including the UK, are signalling shifts in this direction. Several countries, including Sweden, have already adopted this approach and offer good insight into the benefits and pitfalls in actual practice. To describe VBP reimbursement decision making using CED in actual practice in Sweden. Decision making by The Dental and Pharmaceutical Benefits Agency (TLV) in Sweden was reviewed using a case study of continuous intraduodenal infusion of levodopa/carbidopa (Duodopa®) in the treatment of advanced Parkinson's disease (PD) with severe motor fluctuations. The manufacturer of Duodopa® applied for reimbursement in late 2003. While the proper economic data were not included in the submission, TLV granted reimbursement until early 2005 to provide time for the manufacturer to submit a formal economic evaluation. The re-submission with economic data was considered inadequate to judge cost effectiveness, so TLV granted an additional extension of reimbursement until August 2007, at which time conclusive data were expected. The manufacturer initiated a 3-year, prospective health economic study and a formal economic model. Data from a pre-planned interim analysis of the data were loaded into the model and the cost-effectiveness ratio was the basis of the next re-submission. TLV concluded that the data were suitable for making a definite decision and that the drug was not cost effective, deciding to discontinue reimbursement for any new patients (current patients were unaffected). The manufacturer continued to collect data and to improve the economic model and re-submitted in 2008. New data and the improved model resulted in reduced uncertainty and a lower cost-effectiveness ratio in the range of Swedish kronor (SEK)430,000 per QALY gained in the base-case analysis, ranging up to SEK900,000 in the most conservative sensitivity analysis, resulting in reimbursement being granted. The case of Duodopa® provides excellent insight into VBP reimbursement decision making in combination with CED and ex post review in actual practice. Publicly available decisions document the rigorous, time-consuming process (four iterations were required before a final decision could be reached). The data generated as part of the risk-sharing agreement proved correct the initial decision to grant limited coverage despite lack of economic data. Access was provided to 100 patients while evidence was generated. Economic appraisal differs from clinical assessment, and decision makers benefit from analysis of naturalistic, actual practice data. Despite reviewing the initial trial-based, 'piggy-back' economic analysis, TLV was uncertain of the cost effectiveness in actual practice and deferred a final decision until observational data from the DAPHNE study became available. Second, acceptance of economic modelling and use of temporary reimbursement conditional on additional evidence development provide a mechanism for risk sharing between TLV and manufacturers, which enabled patient access to a drug with proven clinical benefit while necessary evidence to support claims of cost effectiveness could be generated.

Fuzzy portfolio model with fuzzy-input return rates and fuzzy-output proportions

NASA Astrophysics Data System (ADS)

Tsaur, Ruey-Chyn

2015-02-01

In the finance market, a short-term investment strategy is usually applied in portfolio selection in order to reduce investment risk; however, the economy is uncertain and the investment period is short. Further, an investor has incomplete information for selecting a portfolio with crisp proportions for each chosen security. In this paper we present a new method of constructing fuzzy portfolio model for the parameters of fuzzy-input return rates and fuzzy-output proportions, based on possibilistic mean-standard deviation models. Furthermore, we consider both excess or shortage of investment in different economic periods by using fuzzy constraint for the sum of the fuzzy proportions, and we also refer to risks of securities investment and vagueness of incomplete information during the period of depression economics for the portfolio selection. Finally, we present a numerical example of a portfolio selection problem to illustrate the proposed model and a sensitivity analysis is realised based on the results.

Landfill Site Selection by AHP Based Multi-criteria Decision Making Tool: A Case Study in Kolkata, India

NASA Astrophysics Data System (ADS)

Majumdar, Ankush; Hazra, Tumpa; Dutta, Amit

2017-09-01

This work presents a Multi-criteria Decision Making (MCDM) tool to select a landfill site from three candidate sites proposed for Kolkata Municipal Corporation (KMC) area that complies with accessibility, receptor, environment, public acceptability, geological and economic criteria. Analytical Hierarchy Process has been used to solve the MCDM problem. Suitability of the three sites (viz. Natagachi, Gangajoara and Kharamba) as landfills as proposed by KMC has been checked by Landfill Site Sensitivity Index (LSSI) as well as Economic Viability Index (EVI). Land area availability for disposing huge quantity of Municipal Solid Waste for the design period has been checked. Analysis of the studied sites show that they are moderately suitable for landfill facility construction as both LSSI and EVI scores lay between 300 and 750. The proposed approach represents an effective MCDM tool for siting sanitary landfill in growing metropolitan cities of developing countries like India.

Economic Order Quantity (EOQ) Optimal Control Considering Selling Price and Salesman Initiative Cost

NASA Astrophysics Data System (ADS)

Hertini, Elis; Anggriani, Nursanti; Mianna, Winda; Supriatna, Asep K.

2018-03-01

Retailers usually offer several types of similar products. A larger number of available stock products in display space will lead consumer to buy more, as well as giving a negative impression on other types of less available products. However, the amount of display space is limited so capacity of carrying the products is limited. Competition among products to increase demand rate is influenced by stock levels available in display space, price and salesmen’s initiative in promoting the products. The Economic Order Quantity (EOQ) to replenish the stock of the product is dependent on the on-hand inventory. Salesman’s initiative also affects maximum profit obtained by the seller. In this paper, Potryagin’s Maximal Principle is used to determine the state of the inventory levels response to control prices of products. Sensitivity analysis of capacity allocation display space is also presented numerically.

Handling time in economic evaluation studies.

PubMed

Permsuwan, Unchalee; Guntawongwan, Kansinee; Buddhawongsa, Piyaluk

2014-05-01

The discount rates and time horizons used in a health technology assessment (HTA) can have a significant impact on the results, and thus the prioritization of technologies. Therefore, it is important that clear guidance be provided on the appropriate discount rates for cost and health effect and appropriate time horizons. In this paper we conduct a review of relevant case studies and guidelines and provide guidance for all researchers conducting economic evaluations of health technologies in the Thai context. A uniform discount rate of 3% is recommended for both costs and health effects in base case analyses. A sensitivity analysis should also be conducted, with a discount range of 0-6%. For technologies where the effects are likely to sustain for at least 30y ears, a rate of 4% for costs and 2% for health effects is recommended. The time horizon should be long enough to capture the full costs and effects of the programs.

Template-Directed Instrumentation Reduces Cost and Improves Efficiency for Total Knee Arthroplasty: An Economic Decision Analysis and Pilot Study.

PubMed

McLawhorn, Alexander S; Carroll, Kaitlin M; Blevins, Jason L; DeNegre, Scott T; Mayman, David J; Jerabek, Seth A

2015-10-01

Template-directed instrumentation (TDI) for total knee arthroplasty (TKA) may streamline operating room (OR) workflow and reduce costs by preselecting implants and minimizing instrument tray burden. A decision model simulated the economics of TDI. Sensitivity analyses determined thresholds for model variables to ensure TDI success. A clinical pilot was reviewed. The accuracy of preoperative templates was validated, and 20 consecutive primary TKAs were performed using TDI. The model determined that preoperative component size estimation should be accurate to ±1 implant size for 50% of TKAs to implement TDI. The pilot showed that preoperative template accuracy exceeded 97%. There were statistically significant improvements in OR turnover time and in-room time for TDI compared to an historical cohort of TKAs. TDI reduces costs and improves OR efficiency. Copyright © 2015 Elsevier Inc. All rights reserved.

Electric power from sugar cane in Costa Rica. A technical and economic analysis

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

Tugwell, F.; Gowen, M.; Kenda, W.

1988-07-01

A team of specialists visited Costa Rica in May 1988 to analyze the potential for production and sale of electricity by the sugar-cane industry. Focusing on three sugar mills, the team made technical projections at four levels of investment, ranging from the simplest sale of surplus power to the installation of new turbogenerator systems. For each level, capital costs, electricity production and sales, and fuel options were estimated. Associated risks were assessed through sensitivity analyses to demonstrate the possible impacts of varying interest rates, fuel costs, and electricity sales prices. The team concluded that production and sale of electricity formore » the national grid could be an excellent investment opportunity for the sugar industry and would provide important economic benefits, including creation of additional jobs in rural areas, diversification of the sugar industry, and (in the short term) displacement of the need for imported fuels.« less

Fetal, Infant, and Maternal Mortality During Periods of Economic Instability

ERIC Educational Resources Information Center

Brenner, M. H.

1973-01-01

One of the most sensitive indicators of the general socioeconomic level of a nation is the infant mortality rate. Evidence indicates that economic recessions and upswings have played a significant role in fetal, infant, and maternal mortality in the last 45 years. (RJ)

Economic analysis of conventional-dose chemotherapy compared with high-dose chemotherapy plus autologous hematopoietic stem-cell transplantation for metastatic breast cancer.

PubMed

Schulman, K A; Stadtmauer, E A; Reed, S D; Glick, H A; Goldstein, L J; Pines, J M; Jackman, J A; Suzuki, S; Styler, M J; Crilley, P A; Klumpp, T R; Mangan, K F; Glick, J H

2003-02-01

We performed an economic analysis of data from 180 women in a clinical trial of conventional-dose chemotherapy vs high-dose chemotherapy plus stem-cell transplantation for metastatic breast cancer responding to first-line chemotherapy. Data on resource use, including hospitalizations, medical procedures, medications, and diagnostic tests, were abstracted from subjects' clinical trial records. Resources were valued using the Medicare Fee Schedule for inpatient costs at one academic medical center and average wholesale prices for medications. Monthly costs were calculated and stratified by treatment group and clinical phase. Mean follow-up was 690 days in the transplantation group and 758 days in the conventional-dose chemotherapy group. Subjects in the transplantation group were hospitalized for more days (28.6 vs 17.8, P=0.0041) and incurred higher costs (US dollars 84055 vs US dollars 28169) than subjects receiving conventional-dose chemotherapy, with a mean difference of US dollars 55886 (95% CI, US dollars 47298-US dollars 63666). Sensitivity analyses resulted in cost differences between the treatment groups from US dollars 36528 to US dollars 75531. High-dose chemotherapy plus stem-cell transplantation resulted in substantial additional morbidity and costs at no improvement in survival. Neither the survival results nor the economic findings support the use of this procedure outside of the clinical trial setting.

Developing guidance for budget impact analysis.

PubMed

Trueman, P; Drummond, M; Hutton, J

2001-01-01

The role of economic evaluation in the efficient allocation of healthcare resources has been widely debated. Whilst economic evidence is undoubtedly useful to purchasers, it does not address the issue of affordability which is an increasing concern. Healthcare purchasers are concerned not just with maximising efficiency but also with the more simplistic goal of remaining within their annual budgets. These two objectives are not necessarily consistent. This paper examines the issue of affordability, the relationship between affordability and efficiency and builds the case for why there is a growing need for budget impact models to complement economic evaluation. Guidance currently available for such models is also examined and it is concluded that this guidance is currently insufficient. Some of these insufficiencies are addressed and some thoughts on what constitutes best practice in budget impact modelling are suggested. These suggestions include consideration of transparency, clarity of perspective, reliability of data sources, the relationship between intermediate and final end-points and rates of adoption of new therapies. They also include the impact of intervention by population subgroups or indications, reporting of results, probability of re-deploying resources, the time horizon, exploring uncertainty and sensitivity analysis, and decision-maker access to the model. Due to the nature of budget impact models, the paper does not deliver stringent methodological guidance on modelling. The intention was to provide some suggestions of best practice in addition to some foundations upon which future research can build.

An economic evaluation of highly purified HMG and recombinant FSH based on a large randomized trial.

PubMed

Wechowski, Jaroslaw; Connolly, Mark; McEwan, Philip; Kennedy, Richard

2007-11-01

Public funding for IVF is increasingly being challenged by health authorities in an attempt to minimize health service costs. In light of treatment rationing, the need to consider costs in relation to outcomes is paramount. To assess the cost implications of gonadotrophin treatment options, an economic evaluation comparing highly purified human menopausal gonadotrophin (HP-HMG) and recombinant FSH (rFSH) has been conducted. The analysis is based on individual patient data from a large randomized controlled trial (n = 731) in a long agonist IVF protocol. The economic evaluation uses a discrete event simulation model to assess treatment costs in relation to live births for both treatments based on published UK costs. After one cycle the mean costs per IVF treatment for HP-HMG and rFSH were pound2396 (95% CI pound2383-2414) and pound2633 ( pound2615-2652), respectively. The average cost-saving of pound237 per IVF cycle using HP-HMG allows one additional cycle to be delivered for every 10 cycles. With maternal and neonatal costs applied, the median cost per IVF baby delivered with HP-HMG was pound8893 compared with pound11,741 for rFSH (P < 0.001). The cost-saving potential of HP-HMG in IVF was still apparent after varying critical cost parameters in the probabilistic sensitivity analysis.

Navigating environmental, economic, and technological trade-offs in the design and operation of submerged anaerobic membrane bioreactors (AnMBRs).

PubMed

Pretel, R; Shoener, B D; Ferrer, J; Guest, J S

2015-12-15

Anaerobic membrane bioreactors (AnMBRs) enable energy recovery from wastewater while simultaneously achieving high levels of treatment. The objective of this study was to elucidate how detailed design and operational decisions of submerged AnMBRs influence the technological, environmental, and economic sustainability of the system across its life cycle. Specific design and operational decisions evaluated included: solids retention time (SRT), mixed liquor suspended solids (MLSS) concentration, sludge recycling ratio (r), flux (J), and specific gas demand per membrane area (SGD). The possibility of methane recovery (both as biogas and as soluble methane in reactor effluent) and bioenergy production, nutrient recovery, and final destination of the sludge (land application, landfill, or incineration) were also evaluated. The implications of these design and operational decisions were characterized by leveraging a quantitative sustainable design (QSD) framework which integrated steady-state performance modeling across seasonal temperatures (using pilot-scale experimental data and the simulating software DESASS), life cycle cost (LCC) analysis, and life cycle assessment (LCA). Sensitivity and uncertainty analyses were used to characterize the relative importance of individual design decisions, and to navigate trade-offs across environmental, economic, and technological criteria. Based on this analysis, there are design and operational conditions under which submerged AnMBRs could be net energy positive and contribute to the pursuit of carbon negative wastewater treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus.

PubMed

Ulfsdotter, Malin; Lindberg, Lene; Månsdotter, Anna

2015-01-01

There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. The cost was € 326.3 per parent, of which € 53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and € 272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of € 47 290 per gained QALY. The sensitivity analyses resulted in ratios from € 41 739 to € 55 072. With the common Swedish threshold value of € 55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation.

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus

PubMed Central

Ulfsdotter, Malin

2015-01-01

Objective There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. Methods A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. Results The cost was €326.3 per parent, of which €53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and €272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of €47 290 per gained QALY. The sensitivity analyses resulted in ratios from €41 739 to €55 072. With the common Swedish threshold value of €55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Conclusion Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation. PMID:26681349

Cost-Effectiveness of Haemorrhoidal Artery Ligation versus Rubber Band Ligation for the Treatment of Grade II-III Haemorrhoids: Analysis Using Evidence from the HubBLe Trial.

PubMed

Alshreef, Abualbishr; Wailoo, Allan J; Brown, Steven R; Tiernan, James P; Watson, Angus J M; Biggs, Katie; Bradburn, Mike; Hind, Daniel

2017-09-01

Haemorrhoids are a common condition, with nearly 30,000 procedures carried out in England in 2014/15, and result in a significant quality-of-life burden to patients and a financial burden to the healthcare system. This study examined the cost effectiveness of haemorrhoidal artery ligation (HAL) compared with rubber band ligation (RBL) in the treatment of grade II-III haemorrhoids. This analyses used data from the HubBLe study, a multicentre, open-label, parallel group, randomised controlled trial conducted in 17 acute UK hospitals between September 2012 and August 2015. A full economic evaluation, including long-term cost effectiveness, was conducted from the UK National Health Service (NHS) perspective. Main outcomes included healthcare costs, quality-adjusted life-years (QALYs) and recurrence. Cost-effectiveness results were presented in terms of incremental cost per QALY gained and cost per recurrence avoided. Extrapolation analysis for 3 years beyond the trial follow-up, two subgroup analyses (by grade of haemorrhoids and recurrence following RBL at baseline), and various sensitivity analyses were undertaken. In the primary base-case within-trial analysis, the incremental total mean cost per patient for HAL compared with RBL was £1027 (95% confidence interval [CI] £782-£1272, p < 0.001). The incremental QALYs were 0.01 QALYs (95% CI -0.02 to 0.04, p = 0.49). This generated an incremental cost-effectiveness ratio (ICER) of £104,427 per QALY. In the extrapolation analysis, the estimated probabilistic ICER was £21,798 per QALY. Results from all subgroup and sensitivity analyses did not materially change the base-case result. Under all assessed scenarios, the HAL procedure was not cost effective compared with RBL for the treatment of grade II-III haemorrhoids at a cost-effectiveness threshold of £20,000 per QALY; therefore, economically, its use in the NHS should be questioned.

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.

Economic viability and critical influencing factors assessment of black water and grey water source-separation sanitation system.

PubMed

Thibodeau, C; Monette, F; Glaus, M; Laflamme, C B

2011-01-01

The black water and grey water source-separation sanitation system aims at efficient use of energy (biogas), water and nutrients but currently lacks evidence of economic viability to be considered a credible alternative to the conventional system. This study intends to demonstrate economic viability, identify main cost contributors and assess critical influencing factors. A technico-economic model was built based on a new neighbourhood in a Canadian context. Three implementation scales of source-separation system are defined: 500, 5,000 and 50,000 inhabitants. The results show that the source-separation system is 33% to 118% more costly than the conventional system, with the larger cost differential obtained by lower source-separation system implementation scales. A sensitivity analysis demonstrates that vacuum toilet flow reduction from 1.0 to 0.25 L/flush decreases source-separation system cost between 23 and 27%. It also shows that high resource costs can be beneficial or unfavourable to the source-separation system depending on whether the vacuum toilet flow is low or normal. Therefore, the future of this configuration of the source-separation system lies mainly in vacuum toilet flow reduction or the introduction of new efficient effluent volume reduction processes (e.g. reverse osmosis).

Efficient Monte Carlo Estimation of the Expected Value of Sample Information Using Moment Matching.

PubMed

Heath, Anna; Manolopoulou, Ioanna; Baio, Gianluca

2018-02-01

The Expected Value of Sample Information (EVSI) is used to calculate the economic value of a new research strategy. Although this value would be important to both researchers and funders, there are very few practical applications of the EVSI. This is due to computational difficulties associated with calculating the EVSI in practical health economic models using nested simulations. We present an approximation method for the EVSI that is framed in a Bayesian setting and is based on estimating the distribution of the posterior mean of the incremental net benefit across all possible future samples, known as the distribution of the preposterior mean. Specifically, this distribution is estimated using moment matching coupled with simulations that are available for probabilistic sensitivity analysis, which is typically mandatory in health economic evaluations. This novel approximation method is applied to a health economic model that has previously been used to assess the performance of other EVSI estimators and accurately estimates the EVSI. The computational time for this method is competitive with other methods. We have developed a new calculation method for the EVSI which is computationally efficient and accurate. This novel method relies on some additional simulation so can be expensive in models with a large computational cost.

Large size biogas-fed Solid Oxide Fuel Cell power plants with carbon dioxide management: Technical and economic optimization

NASA Astrophysics Data System (ADS)

Curletti, F.; Gandiglio, M.; Lanzini, A.; Santarelli, M.; Maréchal, F.

2015-10-01

This article investigates the techno-economic performance of large integrated biogas Solid Oxide Fuel Cell (SOFC) power plants. Both atmospheric and pressurized operation is analysed with CO2 vented or captured. The SOFC module produces a constant electrical power of 1 MWe. Sensitivity analysis and multi-objective optimization are the mathematical tools used to investigate the effects of Fuel Utilization (FU), SOFC operating temperature and pressure on the plant energy and economic performances. FU is the design variable that most affects the plant performance. Pressurized SOFC with hybridization with a gas turbine provides a notable boost in electrical efficiency. For most of the proposed plant configurations, the electrical efficiency ranges in the interval 50-62% (LHV biogas) when a trade-off of between energy and economic performances is applied based on Pareto charts obtained from multi-objective plant optimization. The hybrid SOFC is potentially able to reach an efficiency above 70% when FU is 90%. Carbon capture entails a penalty of more 10 percentage points in pressurized configurations mainly due to the extra energy burdens of captured CO2 pressurization and oxygen production and for the separate and different handling of the anode and cathode exhausts and power recovery from them.

Estimating the Health and Economic Impacts of Changes in Local Air Quality

PubMed Central

Carvour, Martha L.; Hughes, Amy E.; Fann, Neal

2018-01-01

Objectives. To demonstrate the benefits-mapping software Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE), which integrates local air quality data with previously published concentration–response and health–economic valuation functions to estimate the health effects of changes in air pollution levels and their economic consequences. Methods. We illustrate a local health impact assessment of ozone changes in the 10-county nonattainment area of the Dallas–Fort Worth region of Texas, estimating the short-term effects on mortality predicted by 2 scenarios for 3 years (2008, 2011, and 2013): an incremental rollback of the daily 8-hour maximum ozone levels of all area monitors by 10 parts per billion and a rollback-to-a-standard ambient level of 65 parts per billion at only monitors above that level. Results. Estimates of preventable premature deaths attributable to ozone air pollution obtained by the incremental rollback method varied little by year, whereas those obtained by the rollback-to-a-standard method varied by year and were sensitive to the choice of ordinality and the use of preloaded or imported data. Conclusions. BenMAP-CE allows local and regional public health analysts to generate timely, evidence-based estimates of the health impacts and economic consequences of potential policy options in their communities. PMID:29698094

The average cost of pressure ulcer management in a community dwelling spinal cord injury population.

PubMed

Chan, Brian C; Nanwa, Natasha; Mittmann, Nicole; Bryant, Dianne; Coyte, Peter C; Houghton, Pamela E

2013-08-01

Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

76 FR 59111 - Bureau of Economic Analysis Advisory Committee

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2011-09-23

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2012-04-09

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2011-02-22

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Techno-Economic, Sustainability, and Market Analysis | Bioenergy | NREL

Science.gov Websites

Techno-Economic, Sustainability, and Market Analysis Techno-Economic, Sustainability, and Market Analysis NREL conducts techno-economic analyses (TEAs) for algal biofuels, thermochemical conversion, and agitating the liquid as it flows around. Algal Biofuels Techno-Economic Analysis NREL's Algae Techno

75 FR 8922 - Bureau of Economic Analysis Advisory Committee

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2010-02-26

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75 FR 49890 - Bureau of Economic Analysis Advisory Committee

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2010-08-16

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Analysis of digester design concepts

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

Ashare, E.; Wilson, E. H.

1979-01-29

Engineering economic analyses were performed on various digester design concepts to determine the relative performance for various biomass feedstocks. A comprehensive literature survey describing the state-of-the-art of the various digestion designs is included. The digester designs included in the analyses are CSTR, plug flow, batch, CSTR in series, multi-stage digestion and biomethanation. Other process options investigated included pretreatment processes such as shredding, degritting, and chemical pretreatment, and post-digestion processes, such as dewatering and gas purification. The biomass sources considered include feedlot manure, rice straw, and bagasse. The results of the analysis indicate that the most economical (on a unit gasmore » cost basis) digester design concept is the plug flow reactor. This conclusion results from this system providing a high gas production rate combined with a low capital hole-in-the-ground digester design concept. The costs determined in this analysis do not include any credits or penalties for feedstock or by-products, but present the costs only for conversion of biomass to methane. The batch land-fill type digester design was shown to have a unit gas cost comparable to that for a conventional stirred tank digester, with the potential of reducing the cost if a land-fill site were available for a lower cost per unit volume. The use of chemical pretreatment resulted in a higher unit gas cost, primarily due to the cost of pretreatment chemical. A sensitivity analysis indicated that the use of chemical pretreatment could improve the economics provided a process could be developed which utilized either less pretreatment chemical or a less costly chemical. The use of other process options resulted in higher unit gas costs. These options should only be used when necessary for proper process performance, or to result in production of a valuable by-product.« less

Cost benefit analysis of two policy options for cannabis: status quo and legalisation.

PubMed

Shanahan, Marian; Ritter, Alison

2014-01-01

To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised-regulated option was conducted. A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised-regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised-regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case.

Cost Benefit Analysis of Two Policy Options for Cannabis: Status Quo and Legalisation

PubMed Central

Shanahan, Marian; Ritter, Alison

2014-01-01

Aims To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised–regulated option was conducted. Method A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). Findings The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised–regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised–regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Conclusion Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case. PMID:24755942

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.

Economic analysis of the TAX 317 trial: docetaxel versus best supportive care as second-line therapy of advanced non-small-cell lung cancer.

PubMed

Leighl, Natasha B; Shepherd, Frances A; Kwong, Rita; Burkes, Ronald L; Feld, Ronald; Goodwin, Pamela J

2002-03-01

To determine the cost-effectiveness (CE) of second-line docetaxel compared with best supportive care (BSC) in the TAX 317 trial, a randomized clinical trial of second-line chemotherapy in non-small-cell lung cancer. A retrospective CE analysis of the TAX 317 trial was undertaken, evaluating direct medical costs of therapy from the viewpoint of Canada's public health care system. Costs were derived in 1999 Canadian dollars, and resource use was determined through prospective trial data. The incremental survival benefit in the docetaxel arm over BSC was 2 months (P =.047). The CE of docetaxel was $57,749 per year of life gained. For patients treated with docetaxel 75 mg/m(2), the CE was $31,776 per year of life gained. In univariate sensitivity analyses, CE estimates were most sensitive to changes in survival, ranging from $18,374 to $117,434 with 20% variation in survival at the recommended dose. The largest cost center in both arms was hospitalization, followed by the cost of drugs, investigations, radiotherapy, and community care. BSC patients had fewer hospitalizations than patients in the chemotherapy arm and were more often palliated at home. Although the decision to treat should not be based on economic considerations alone, our CE estimate of $31,776 per year of life gained (at the currently recommended dose of docetaxel) is within an acceptable range of health care expenditures, and the total costs of therapy are similar to those of second-line palliative chemotherapy for other solid tumors.

Latent factor structure of a behavioral economic marijuana demand curve.

PubMed

Aston, Elizabeth R; Farris, Samantha G; MacKillop, James; Metrik, Jane

2017-08-01

Drug demand, or relative value, can be assessed via analysis of behavioral economic purchase task performance. Five demand indices are typically obtained from drug purchase tasks. The goal of this research was to determine whether metrics of marijuana reinforcement from a marijuana purchase task (MPT) exhibit a latent factor structure that efficiently characterizes marijuana demand. Participants were regular marijuana users (n = 99; 37.4% female, 71.5% marijuana use days [5 days/week], 15.2% cannabis dependent) who completed study assessments, including the MPT, during a baseline session. Principal component analysis was used to examine the latent structure underlying MPT indices. Concurrent validity was assessed via examination of relationships between latent factors and marijuana use, past quit attempts, and marijuana expectancies. A two-factor solution was confirmed as the best fitting structure, accounting for 88.5% of the overall variance. Factor 1 (65.8% variance) reflected "Persistence," indicating sensitivity to escalating marijuana price, which comprised four MPT indices (elasticity, O max , P max , and breakpoint). Factor 2 (22.7% variance) reflected "Amplitude," indicating the amount consumed at unrestricted price (intensity). Persistence factor scores were associated with fewer past marijuana quit attempts and lower expectancies of negative use outcomes. Amplitude factor scores were associated with more frequent use, dependence symptoms, craving severity, and positive marijuana outcome expectancies. Consistent with research on alcohol and cigarette purchase tasks, the MPT can be characterized with a latent two-factor structure. Thus, demand for marijuana appears to encompass distinct dimensions of price sensitivity and volumetric consumption, with differential relations to other aspects of marijuana motivation.

Evaluation of comparative advantages in the profitability and competitiveness of the small-scale dairy system of Tulancingo Valley, Mexico.

PubMed

Posadas-Domínguez, Rodolfo Rogelio; Del Razo-Rodríguez, Oscar Enrique; Almaraz-Buendía, Isaac; Pelaez-Acero, Armando; Espinosa-Muñoz, Verónica; Rebollar-Rebollar, Samuel; Salinas-Martínez, Jesús Armando

2018-06-01

This article combines a Policy Analysis Matrix with a sensitivity and poverty line analysis with the objective of evaluating the economic contribution of comparative advantages to the private profitability and competitiveness of small-scale dairy systems. For 1 year, socioeconomic data were collected from 82 farms selected from four strata via statistical sampling. Two scenarios were established to determine the quantitative contribution of comparative advantages: (1) a simulated scenario, which accounted for the cost of purchasing the total food and the opportunity cost of the family labour force (FLF), and (2) an actual production scenario, which accounted for the cost of producing food and eliminating the payment of the FLF and included other income. The E3 and E4 producers were the most profitable and competitive in the simulated scenario and actual production scenario. Of the four scales evaluated, the E2 and E1 producers were the most efficient in taking advantage of the economic contribution provided by the comparative advantages in their own production of food and employment of the FLF, in addition to accounting for other income, a condition that increased their profitability by 171 and 144% and competitiveness by 346 and 273%, respectively. The poverty results indicated that only E3 and E4 producers were non-vulnerable in the simulated scenario and actual production scenario. The purchase of food was the comparative advantage with the greatest sensitivity to cost increases in the two scenarios analysed, which exacerbated the effect on the E1 and E2 producers.

The economics of a pharmacy-based central intravenous additive service for paediatric patients.

PubMed

Armour, D J; Cairns, C J; Costello, I; Riley, S J; Davies, E G

1996-10-01

This study was designed to compare the costs of a pharmacy-based Central Intravenous Additive Service (CIVAS) with those of traditional ward-based preparation of intravenous doses for a paediatric population. Labour costs were derived from timings of preparation of individual doses in both the pharmacy and ward by an independent observer. The use of disposables and diluents was recorded and their acquisition costs apportioned to the cost of each dose prepared. Data were collected from 20 CIVAS sessions (501 doses) and 26 ward-based sessions (30 doses). In addition, the costs avoided by the use of part vials in CIVAS was calculated. This was derived from a total of 50 CIVAS sessions. Labour, disposable and diluent costs were significantly lower for CIVAS compared with ward-based preparation (p < 0.001). The ratio of costs per dose [in 1994 pounds sterling] between ward and pharmacy was 2.35:1 (2.51 pounds:1.07 pounds). Sensitivity analysis of the best and worst staff mixes in both locations ranged from 2.3:1 to 4.0:1, always in favour of CIVAS. There were considerable costs avoided in CIVAS from the multiple use of vials; the estimated annual sum derived from the study was 44,000 pounds. In addition, CIVAS was less vulnerable to unanticipated interruptions in work flow than ward-based preparation. CIVAS for children was more economical than traditional ward-based preparation, because of a cost-minimisation effect. Sensitivity analysis showed that these advantages were maintained over a full range of skill mixes. Additionally, significant savings accrued from the multiple use of vials in CIVAS.

Antenatal corticosteroids: analytical decision model and economic analysis in a Brazilian cohort of preterm infants.

PubMed

Ogata, Joice Fabiola Meneguel; Fonseca, Marcelo Cunio Machado; de Almeida, Maria Fernanda Branco; Guinsburg, Ruth

2016-09-01

To analyze the hospital costs and the effectiveness of antenatal corticosteroid (ACS) therapy in a cohort of Brazilian preterm infants. Infants with gestational age (GA) 26 to 32 weeks, born between 2006 and 2009 in a tertiary university hospital and who survived hospitalization were included. A decision tree was built according to GA (26-27, 28-29, 30-31 and 32 weeks), assuming that each patient exposed or not to ACS may or not develop one of the clinical outcomes included in the model. The cost of each outcome was calculated by microcosting. Sensitivity analysis tested the model stability and calculated outcomes and costs per 1000 patients. The cost-effectiveness analysis indicated that ACS reduced USD 3413 in hospital costs per patient exposed to ACS. Its use decreased oxygen dependency at 36 weeks in 11%, advanced resuscitation in delivery room in 24%, severe peri-intraventricular hemorrhage in 12%, patent ductus arteriosus requiring surgery in 3.6% and retinopathy of prematurity in 0.3%, but increased the probability of late-onset sepsis in 2.5%. The sensitivity analysis indicated that ACS was dominant over no ACS therapy for most outcomes. The results indicate that ACS therapy decreases costs and severe neonatal outcomes of preterm infants.

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

The Agricultural Model Intercomparison and Improvement Project (AgMIP): Protocols and Pilot Studies

NASA Technical Reports Server (NTRS)

Rosenzweig, C.; Jones, J. W.; Hatfield, J. L.; Ruane, A. C.; Boote, K. J.; Thorburn, P.; Antle, J. M.; Nelson, G. C.; Porter, C.; Janssen, S.;

Measuring the economic value of wildlife: a caution

Treesearch

T. H. Stevens

1992-01-01

Wildlife values appear to be very sensitive to whether species are evaluated separately or together, and value estimates often seem inconsistent with neoclassical economic theory. Wildlife value estimates must therefore be used with caution. Additional research about the nature of individual value structures for wildlife is needed.

Gender Equity and Secondary School Home Economics Textbooks.

ERIC Educational Resources Information Center

Hayibor, Bernice; Peterat, Linda

1995-01-01

Three home economics textbooks on human relations were analyzed in terms of intentions, photographs, language, and content about gender relations. In terms of five approaches (visual balance, neutral/inclusive language, gender balance in information, gender sensitivity, and critical thinking), many parts were inadequate and contributed to myths…

Integrating economic parameters into genetic selection for Large White pigs.

PubMed

Dube, Bekezela; Mulugeta, Sendros D; Dzama, Kennedy

2013-08-01

The objective of the study was to integrate economic parameters into genetic selection for sow productivity, growth performance and carcass characteristics in South African Large White pigs. Simulation models for sow productivity and terminal production systems were performed based on a hypothetical 100-sow herd, to derive economic values for the economically relevant traits. The traits included in the study were number born alive (NBA), 21-day litter size (D21LS), 21-day litter weight (D21LWT), average daily gain (ADG), feed conversion ratio (FCR), age at slaughter (AGES), dressing percentage (DRESS), lean content (LEAN) and backfat thickness (BFAT). Growth of a pig was described by the Gompertz growth function, while feed intake was derived from the nutrient requirements of pigs at the respective ages. Partial budgeting and partial differentiation of the profit function were used to derive economic values, which were defined as the change in profit per unit genetic change in a given trait. The respective economic values (ZAR) were: 61.26, 38.02, 210.15, 33.34, -21.81, -68.18, 5.78, 4.69 and -1.48. These economic values indicated the direction and emphases of selection, and were sensitive to changes in feed prices and marketing prices for carcasses and maiden gilts. Economic values for NBA, D21LS, DRESS and LEAN decreased with increasing feed prices, suggesting a point where genetic improvement would be a loss, if feed prices continued to increase. The economic values for DRESS and LEAN increased as the marketing prices for carcasses increased, while the economic value for BFAT was not sensitive to changes in all prices. Reductions in economic values can be counterbalanced by simultaneous increases in marketing prices of carcasses and maiden gilts. Economic values facilitate genetic improvement by translating it to proportionate profitability. Breeders should, however, continually recalculate economic values to place the most appropriate emphases on the respective traits during genetic selection.

Economic Evaluations of Pathology Tests, 2010-2015: A Scoping Review.

PubMed

Watts, Rory D; Li, Ian W; Geelhoed, Elizabeth A; Sanfilippo, Frank M; St John, Andrew

2017-09-01

Concerns about pathology testing such as the value provided by new tests and the potential for inappropriate utilization have led to a greater need to assess costs and benefits. Economic evaluations are a formal method of analyzing costs and benefits, yet for pathology tests, questions remain about the scope and quality of the economic evidence. To describe the extent and quality of published evidence provided by economic evaluations of pathology tests from 2010 to 2015. Economic evaluations relating to pathology tests from 2010 to 2015 were reviewed. Eight databases were searched for published studies, and details recorded for the country, clinical focus, type of testing, and consideration of sensitivity, specificity, and false test results. The reporting quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist and cost-effectiveness ratios were analyzed for publication bias. We found 356 economic evaluations of pathology tests, most of which regarded developed countries. The most common economic evaluations were cost-utility analyses and the most common clinical focus was infectious diseases. More than half of the studies considered sensitivity and specificity, but few studies considered the impact of false test results. The average Consolidated Health Economic Evaluation Reporting Standards checklist score was 17 out of 24. Cost-utility ratios were commonly less than $10,000/quality-adjusted life-year or more than $200,000/quality-adjusted life-year. The number of economic evaluations of pathology tests has increased in recent years, but the rate of increase has plateaued. Furthermore, the quality of studies in the past 5 years was highly variable, and there is some question of publication bias in reporting cost-effectiveness ratios. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

PubMed

Liu, C Carrie; Rudmik, Luke

2016-10-01

The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

A cost-benefit analysis of landfill mining and material recycling in China.

PubMed

Zhou, Chuanbin; Gong, Zhe; Hu, Junsong; Cao, Aixin; Liang, Hanwen

2015-01-01

Landfill mining is an environmentally-friendly technology that combines the concepts of material recycling and sustainable waste management, and it has received a great deal of worldwide attention because of its significant environmental and economic potential in material recycling, energy recovery, land reclamation and pollution prevention. This work applied a cost-benefit analysis model for assessing the economic feasibility, which is important for promoting landfill mining. The model includes eight indicators of costs and nine indicators of benefits. Four landfill mining scenarios were designed and analyzed based on field data. The economic feasibility of landfill mining was then evaluated by the indicator of net present value (NPV). According to our case study of a typical old landfill mining project in China (Yingchun landfill), rental of excavation and hauling equipment, waste processing and material transportation were the top three costs of landfill mining, accounting for 88.2% of the total cost, and the average cost per unit of stored waste was 12.7USDton(-1). The top three benefits of landfill mining were electricity generation by incineration, land reclamation and recycling soil-like materials. The NPV analysis of the four different scenarios indicated that the Yingchun landfill mining project could obtain a net positive benefit varying from 1.92 million USD to 16.63 million USD. However, the NPV was sensitive to the mode of land reuse, the availability of energy recovery facilities and the possibility of obtaining financial support by avoiding post-closure care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Autoantibody recognition mechanisms of p53 epitopes

NASA Astrophysics Data System (ADS)

Phillips, J. C.

2016-06-01

There is an urgent need for economical blood based, noninvasive molecular biomarkers to assist in the detection and diagnosis of cancers in a cost-effective manner at an early stage, when curative interventions are still possible. Serum autoantibodies are attractive biomarkers for early cancer detection, but their development has been hindered by the punctuated genetic nature of the ten million known cancer mutations. A landmark study of 50,000 patients (Pedersen et al., 2013) showed that a few p53 15-mer epitopes are much more sensitive colon cancer biomarkers than p53, which in turn is a more sensitive cancer biomarker than any other protein. The function of p53 as a nearly universal ;tumor suppressor; is well established, because of its strong immunogenicity in terms of not only antibody recruitment, but also stimulation of autoantibodies. Here we examine dimensionally compressed bioinformatic fractal scaling analysis for identifying the few sensitive epitopes from the p53 amino acid sequence, and show how it could be used for early cancer detection (ECD). We trim 15-mers to 7-mers, and identify specific 7-mers from other species that could be more sensitive to aggressive human cancers, such as liver cancer. Our results could provide a roadmap for ECD.

[A cost-effectiveness analysis on universal infant rotavirus vaccination strategy in China].

PubMed

Sun, S L; Gao, Y Q; Yin, J; Zhuang, G H

2016-02-01

To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy, in China. Through constructing decision tree-Markov model, we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as: group with no vaccination, Rotavirus vaccination group and Rotateq vaccination group, respectively. We determined the optimal program, based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP). Compared with non-vaccination group, the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss, respectively. RESULTS from sensitivity analysis indicated that both results were robust. Compared with Rotavirus vaccination program, the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss. Data from the sensitivity analysis indicated that the result was not robust. From the perspective of health economics, both two-dose Rotarix vaccine and three-dose' s Rotateq vaccine programs were highly cost-effective, when compared to the non-vaccination program. It was appropriate to integrate rotavirus vaccine into the routine immunization program. Considering the large amount of extra cost that had to spend on Rotateq vaccination program, results from the sensitivity analysis showed that it was not robust. Rotateq vaccine required one more dose than the Rotarix vaccine, to be effective. However, it appeared more difficult to practice, suggesting that it was better to choose the Rotarix vaccine, at current stage.

Revenue Potential for Inpatient IR Consultation Services: A Financial Model.

PubMed

Misono, Alexander S; Mueller, Peter R; Hirsch, Joshua A; Sheridan, Robert M; Siddiqi, Assad U; Liu, Raymond W

2016-05-01

Interventional radiology (IR) has historically failed to fully capture the value of evaluation and management services in the inpatient setting. Understanding financial benefits of a formally incorporated billing discipline may yield meaningful insights for interventional practices. A revenue modeling tool was created deploying standard financial modeling techniques, including sensitivity and scenario analyses. Sensitivity analysis calculates revenue fluctuation related to dynamic adjustment of discrete variables. In scenario analysis, possible future scenarios as well as revenue potential of different-size clinical practices are modeled. Assuming a hypothetical inpatient IR consultation service with a daily patient census of 35 patients and two new consults per day, the model estimates annual charges of $2.3 million and collected revenue of $390,000. Revenues are most sensitive to provider billing documentation rates and patient volume. A range of realistic scenarios-from cautious to optimistic-results in a range of annual charges of $1.8 million to $2.7 million and a collected revenue range of $241,000 to $601,000. Even a small practice with a daily patient census of 5 and 0.20 new consults per day may expect annual charges of $320,000 and collected revenue of $55,000. A financial revenue modeling tool is a powerful adjunct in understanding economics of an inpatient IR consultation service. Sensitivity and scenario analyses demonstrate a wide range of revenue potential and uncover levers for financial optimization. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Defining the breeding goal for a sheep breed including production and functional traits using market data.

PubMed

Theodoridis, A; Ragkos, A; Rose, G; Roustemis, D; Arsenos, G

2017-11-16

In this study, the economic values for production and functional traits of dairy sheep are estimated through the application of a profit function model using farm-level technical and economic data. The traits incorporated in the model were milk production, prolificacy, fertility, milking speed, longevity and mastitis occurrence. The economic values for these traits were derived as the approximate partial derivative of the specified profit function. A sensitivity analysis was also conducted in order to examine how potential changes in input and output prices would affect the breeding goal. The estimated economic values of the traits revealed their economic impact on the definition of the breeding goal for the specified production system. Milk production and fertility had the highest economic values (€40.30 and €20.28 per standard genetic deviation (SDa)), while, mastitis only had a low negative value of -0.57 €/SDa. Therefore, breeding for clinical mastitis will have a minor impact on farm profitability because it affects a small proportion of the flock and has low additive variance. The production traits, which include milk production, prolificacy and milking speed, contributed most to the breeding goal (70.0%), but functional traits still had a considerable share (30.0%). The results of this study highlight the importance of the knowledge of economic values of traits in the design of a breeding program. It is also suggested that the production and functional traits under consideration can be categorized as those which can be efficiently treated through genetic improvement (e.g. milk production and fertility) while others would be better dealt with through managerial interventions (e.g. mastitis occurrence). Also, sub-clinical mastitis that affects a higher proportion of flocks could have a higher contribution to breeding goals.

"We Don't Want to Talk about That": Overcoming Barriers to Rural Aging Research and Interventions on Sensitive Topics

ERIC Educational Resources Information Center

Zanjani, Faika; Rowles, Graham D.

2012-01-01

Geographical, economic, social and cultural barriers to accessing services in rural areas are widely reported. Less widely discussed are dilemmas posed by individual and community reluctance to address sensitive health issues. This article, focusing on the highly sensitive area of mental health, and employing a participatory action approach,…

Cost-effectiveness of percutaneous coronary intervention with cobalt-chromium everolimus eluting stents versus bare metal stents: Results from a patient level meta-analysis of randomized trials.

PubMed

Ferko, Nicole; Ferrante, Giuseppe; Hasegawa, James T; Schikorr, Tanya; Soleas, Ireena M; Hernandez, John B; Sabaté, Manel; Kaiser, Christoph; Brugaletta, Salvatore; de la Torre Hernandez, Jose Maria; Galatius, Soeren; Cequier, Angel; Eberli, Franz; de Belder, Adam; Serruys, Patrick W; Valgimigli, Marco

2017-05-01

Second-generation drug eluting stents (DES) may reduce costs and improve clinical outcomes compared to first-generation DES with improved cost-effectiveness when compared to bare metal stents (BMS). We aimed to conduct an economic evaluation of a cobalt-chromium everolimus eluting stent (Co-Cr EES) compared with BMS in percutaneous coronary intervention (PCI). To conduct a cost-effectiveness analysis (CEA) of a cobalt-chromium everolimus eluting stent (Co-Cr EES) versus BMS in PCI. A Markov state transition model with a 2-year time horizon was applied from a US Medicare setting with patients undergoing PCI with Co-Cr EES or BMS. Baseline characteristics, treatment effects, and safety measures were taken from a patient level meta-analysis of 5 RCTs (n = 4,896). The base-case analysis evaluated stent-related outcomes; a secondary analysis considered the broader set of outcomes reported in the meta-analysis. The base-case and secondary analyses reported an additional 0.018 and 0.013 quality-adjusted life years (QALYs) and cost savings of $236 and $288, respectively with Co-Cr EES versus BMS. Results were robust to sensitivity analyses and were most sensitive to the price of clopidogrel. In the probabilistic sensitivity analysis, Co-Cr EES was associated with a greater than 99% chance of being cost saving or cost effective (at a cost per QALY threshold of $50,000) versus BMS. Using data from a recent patient level meta-analysis and contemporary cost data, this analysis found that PCI with Co-Cr EES is more effective and less costly than PCI with BMS. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

Quantifying the daily economic impact of extreme space weather due to failure in electricity transmission infrastructure

NASA Astrophysics Data System (ADS)

Oughton, Edward J.; Skelton, Andrew; Horne, Richard B.; Thomson, Alan W. P.; Gaunt, Charles T.

2017-01-01

Extreme space weather due to coronal mass ejections has the potential to cause considerable disruption to the global economy by damaging the transformers required to operate electricity transmission infrastructure. However, expert opinion is split between the potential outcome being one of a temporary regional blackout and of a more prolonged event. The temporary blackout scenario proposed by some is expected to last the length of the disturbance, with normal operations resuming after a couple of days. On the other hand, others have predicted widespread equipment damage with blackout scenarios lasting months. In this paper we explore the potential costs associated with failure in the electricity transmission infrastructure in the U.S. due to extreme space weather, focusing on daily economic loss. This provides insight into the direct and indirect economic consequences of how an extreme space weather event may affect domestic production, as well as other nations, via supply chain linkages. By exploring the sensitivity of the blackout zone, we show that on average the direct economic cost incurred from disruption to electricity represents only 49% of the total potential macroeconomic cost. Therefore, if indirect supply chain costs are not considered when undertaking cost-benefit analysis of space weather forecasting and mitigation investment, the total potential macroeconomic cost is not correctly represented. The paper contributes to our understanding of the economic impact of space weather, as well as making a number of key methodological contributions relevant for future work. Further economic impact assessment of this threat must consider multiday, multiregional events.

The Determinants of Postsecondary Enrollment Rates in Ontario.

ERIC Educational Resources Information Center

Foot, David K.; Pervin, Barry

1983-01-01

Application of economic theories of educational supply and demand to Ontario postsecondary enrollments show that community college enrollments are more income-sensitive than university enrollments, and graduate enrollments are more price sensitive than undergraduate enrollments. No competition effects between community colleges and universities…

[Impact of Socioeconomic Risk Exposure on Maternal Sensitivity, Stress and Family Functionality].

PubMed

Sidor, Anna; Köhler, Hubert; Cierpka, Manfred

2018-03-01

Impact of Socioeconomic Risk Exposure on Maternal Sensitivity, Stress and Family Functionality Parental stress exposure can influence the parent-child relationship, child development and child wellbeing in negative ways. The aim of this study was to investigate the impact of socio-economic risk exposure on the quality of the mother-child-interaction and family functionality. A sample of 294 mother-infant dyads at psychosocial risk was compared with a lower-risk, middle-class sample of 125 mother-infant-dyads in regard to maternal sensitivity/child's cooperation (CARE-Index), maternal stress (PSI-SF) and family functionality (FB-K). Lower levels of maternal sensitivity/child's cooperation and by trend also of the family functionality were found among the mothers from the at-risk sample in comparison to the low-risk sample. The level of maternal stress was similar in both samples. The results underpin the negative effects of a socio-economic risk exposure on the mother-child relationship. An early, sensitivity-focused family support could be encouraged to counteract the negative effects of early socioeconomic stress.

Solar energy system economic evaluation: Fern Tunkhannock, Tunkhannock, Pennsylvania

NASA Astrophysics Data System (ADS)

1980-09-01

The economic performance of an Operational Test Site (OTS) is described. The long term economic performance of the system at its installation site and extrapolation to four additional selected locations to demonstrate the viability of the design over a broad range of environmental and economic conditions is reported. Topics discussed are: system description, study approach, economic analysis and system optimization, and technical and economical results of analysis. Data for the economic analysis are generated through evaluation of the OTS. The simulation is based on the technical results of the seasonal report simulation. In addition localized and standard economic parameters are used for economic analysis.

Solar energy system economic evaluation: Fern Tunkhannock, Tunkhannock, Pennsylvania

NASA Technical Reports Server (NTRS)

1980-01-01

The economic performance of an Operational Test Site (OTS) is described. The long term economic performance of the system at its installation site and extrapolation to four additional selected locations to demonstrate the viability of the design over a broad range of environmental and economic conditions is reported. Topics discussed are: system description, study approach, economic analysis and system optimization, and technical and economical results of analysis. Data for the economic analysis are generated through evaluation of the OTS. The simulation is based on the technical results of the seasonal report simulation. In addition localized and standard economic parameters are used for economic analysis.

Foundations to the unified psycho-cognitive engine.

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

Bernard, Michael Lewis; Bier, Asmeret Brooke; Backus, George A.

This document outlines the key features of the SNL psychological engine. The engine is designed to be a generic presentation of cognitive entities interacting among themselves and with the external world. The engine combines the most accepted theories of behavioral psychology with those of behavioral economics to produce a unified simulation of human response from stimuli through executed behavior. The engine explicitly recognizes emotive and reasoned contributions to behavior and simulates the dynamics associated with cue processing, learning, and choice selection. Most importantly, the model parameterization can come from available media or survey information, as well subject-matter-expert information. The frameworkmore » design allows the use of uncertainty quantification and sensitivity analysis to manage confidence in using the analysis results for intervention decisions.« less

Plasma for electrification of chemical industry: a case study on CO2 reduction

NASA Astrophysics Data System (ADS)

van Rooij, G. J.; Akse, H. N.; Bongers, W. A.; van de Sanden, M. C. M.

2018-01-01

Significant growth of the share of (intermittent) renewable power in the chemical industry is imperative to meet increasingly stricter limits on CO2 exhaust that are being implemented within Europe. This paper aims to evaluate the potential of a plasma process that converts input CO2 into a pure stream of CO to aid in renewable energy penetration in this sector. A realistic process design is constructed to serve as a basis for an economical analysis. The manufacturing cost price of CO is estimated at 1.2 kUS ton-1 CO. A sensitivity analysis shows that separation is the dominant cost factor, so that improving conversion is currently more effective to lower the price than e.g. energy efficiency.

A method based on coffee-ring deposition confocal Raman spectroscopy of analysis of melamine in milk

NASA Astrophysics Data System (ADS)

Tan, Zong; Chen, Da

2016-10-01

In this work, an economical and high-efficiency method for detection of melamine in milk was developed. The enrichment effect of coffee-ring was combined with the micro-region analysis of confocal Raman spectroscopy, in addition, assisted with chemometric algorithmthe. Consequently, a desired result was obtained that the LOD of melamine in this method was 1 ppm, which was excellent because the sensitivity of conventional Raman detection was generally low. Furthermore, the whole process were processed in an easily available condition with almost no chemical reagents consumption, and the chosen substrates for the formation of coffee-ring were reusable. Thus, the method is environmental friendly and has a great potential application in food safety inspection.

Modeling and stability analysis for the upper atmosphere research satellite auxiliary array switch component

NASA Technical Reports Server (NTRS)

Wolfgang, R.; Natarajan, T.; Day, J.

1987-01-01

A feedback control system, called an auxiliary array switch, was designed to connect or disconnect auxiliary solar panel segments from a spacecraft electrical bus to meet fluctuating demand for power. A simulation of the control system was used to carry out a number of design and analysis tasks that could not economically be performed with a breadboard of the hardware. These tasks included: (1) the diagnosis of a stability problem, (2) identification of parameters to which the performance of the control system was particularly sensitive, (3) verification that the response of the control system to anticipated fluctuations in the electrical load of the spacecraft was satisfactory, and (4) specification of limitations on the frequency and amplitude of the load fluctuations.

Section 2: Corrosion and failure analysis studies in support of the pulp and paper industry

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

Keiser, J.R.; Pawel, S.J.; Swindeman, R.W.

1997-04-01

Technical support is being provided to various pulp and paper companies and related industries to help determine the cause of material degradation problems and to identify alternate materials to prevent such degradation. During the past year, examinations have included parts from several sootblowers, two failed economizer tubes, and inspection of a continuous digester. The results of the analyses and inspections were communicated to the plant operators, and, in some cases, recommendations were made. This article discusses examination of sootblower nozzles, which evidenced intergranular cracking. Analysis indicated the presence of chromium carbide precipitates along the grain boundaries, which can cause themore » sample to be sensitized to grain boundary attack.« less

Supraorbital Versus Endoscopic Endonasal Approaches for Olfactory Groove Meningiomas: A Cost-Minimization Study.

PubMed

Gandhoke, Gurpreet S; Pease, Matthew; Smith, Kenneth J; Sekula, Raymond F

2017-09-01

To perform a cost-minimization study comparing the supraorbital and endoscopic endonasal (EEA) approach with or without craniotomy for the resection of olfactory groove meningiomas (OGMs). We built a decision tree using probabilities of gross total resection (GTR) and cerebrospinal fluid (CSF) leak rates with the supraorbital approach versus EEA with and without additional craniotomy. The cost (not charge or reimbursement) at each "stem" of this decision tree for both surgical options was obtained from our hospital's finance department. After a base case calculation, we applied plausible ranges to all parameters and carried out multiple 1-way sensitivity analyses. Probabilistic sensitivity analyses confirmed our results. The probabilities of GTR (0.8) and CSF leak (0.2) for the supraorbital craniotomy were obtained from our series of 5 patients who underwent a supraorbital approach for the resection of an OGM. The mean tumor volume was 54.6 cm 3 (range, 17-94.2 cm 3 ). Literature-reported rates of GTR (0.6) and CSF leak (0.3) with EEA were applied to our economic analysis. Supraorbital craniotomy was the preferred strategy, with an expected value of $29,423, compared with an EEA cost of $83,838. On multiple 1-way sensitivity analyses, supraorbital craniotomy remained the preferred strategy, with a minimum cost savings of $46,000 and a maximum savings of $64,000. Probabilistic sensitivity analysis found the lowest cost difference between the 2 surgical options to be $37,431. Compared with EEA, supraorbital craniotomy provides substantial cost savings in the treatment of OGMs. Given the potential differences in effectiveness between approaches, a cost-effectiveness analysis should be undertaken. Copyright © 2017 Elsevier Inc. All rights reserved.

Sensitivity Analysis of the Agricultural Policy/Environmental eXtender (APEX) for Phosphorus Loads in Tile-Drained Landscapes.

PubMed

Ford, W; King, K; Williams, M; Williams, J; Fausey, N

2015-07-01

Numerical modeling is an economical and feasible approach for quantifying the effects of best management practices on dissolved reactive phosphorus (DRP) loadings from agricultural fields. However, tools that simulate both surface and subsurface DRP pathways are limited and have not been robustly evaluated in tile-drained landscapes. The objectives of this study were to test the ability of the Agricultural Policy/Environmental eXtender (APEX), a widely used field-scale model, to simulate surface and tile P loadings over management, hydrologic, biologic, tile, and soil gradients and to better understand the behavior of P delivery at the edge-of-field in tile-drained midwestern landscapes. To do this, a global, variance-based sensitivity analysis was performed, and model outputs were compared with measured P loads obtained from 14 surface and subsurface edge-of-field sites across central and northwestern Ohio. Results of the sensitivity analysis showed that response variables for DRP were highly sensitive to coupled interactions between presumed important parameters, suggesting nonlinearity of DRP delivery at the edge-of-field. Comparison of model results to edge-of-field data showcased the ability of APEX to simulate surface and subsurface runoff and the associated DRP loading at monthly to annual timescales; however, some high DRP concentrations and fluxes were not reflected in the model, suggesting the presence of preferential flow. Results from this study provide new insights into baseline tile DRP loadings that exceed thresholds for algal proliferation. Further, negative feedbacks between surface and subsurface DRP delivery suggest caution is needed when implementing DRP-based best management practices designed for a specific flow pathway. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Technoeconomic analysis of biojet fuel production from camelina at commercial scale: Case of Canadian Prairies.

PubMed

Li, Xue; Mupondwa, Edmund; Tabil, Lope

2018-02-01

This study undertakes technoeconomic analysis of commercial production of hydro-processed renewable jet (HRJ) fuel from camelina oil in the Canadian Prairies. An engineering economic model designed in SuperPro Designer® investigated capital investment, scale, and profitability of producing HRJ and co-products (biodiesel, naphtha, LPG, and propane) based on biorefinery plant sizes of 112.5-675 million L annum -1 . Under base case scenario, the minimum selling price (MSP) of HRJ was $1.06 L -1 for a biorefinery plant with size of 225 million L. However, it could range from $0.40 to $1.71 L -1 given variations in plant capacity, feedstock cost, and co-product credits. MSP is highly sensitive to camelina feedstock cost and co-product credits, with little sensitivity to capital cost, discount rate, plant capacity, and hydrogen cost. Marginal and average cost curves suggest the region could support an HRJ plant capacity of up to 675 million L annum -1 (capital investment of $167 million). Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Funding a smoking cessation program for Crohn's disease: an economic evaluation.

PubMed

Coward, Stephanie; Heitman, Steven J; Clement, Fiona; Negron, Maria; Panaccione, Remo; Ghosh, Subrata; Barkema, Herman W; Seow, Cynthia; Leung, Yvette P Y; Kaplan, Gilaad G

2015-03-01

Patients with Crohn's disease (CD) who smoke are at a higher risk of flaring and requiring surgery. Cost-effectiveness studies of funding smoking cessation programs are lacking. Thus, we performed a cost-utility analysis of funding smoking cessation programs for CD. A cost-utility analysis was performed comparing five smoking cessation strategies: No Program, Counseling, Nicotine Replacement Therapy (NRT), NRT+Counseling, and Varenicline. The time horizon for the Markov model was 5 years. The health states included medical remission (azathioprine or antitumor necrosis factor (anti-TNF), dose escalation of an anti-TNF, second anti-TNF, surgery, and death. Probabilities were taken from peer-reviewed literature, and costs (CAN$) for surgery, medications, and smoking cessation programs were estimated locally. The primary outcome was the cost per quality-adjusted life year (QALY) gained associated with each smoking cessation strategy. Threshold, three-way sensitivity, probabilistic sensitivity analysis (PSA), and budget impact analysis (BIA) were carried out. All strategies dominated No Program. Strategies from most to least cost effective were as follows: Varenicline (cost: $55,614, QALY: 3.70), NRT+Counseling (cost: $58,878, QALY: 3.69), NRT (cost: $59,540, QALY: 3.69), Counseling (cost: $61,029, QALY: 3.68), and No Program (cost: $63,601, QALY: 3.67). Three-way sensitivity analysis demonstrated that No Program was only more cost effective when every strategy's cost exceeded approximately 10 times their estimated costs. The PSA showed that No Program was the most cost-effective <1% of the time. The BIA showed that any strategy saved the health-care system money over No Program. Health-care systems should consider funding smoking cessation programs for CD, as they improve health outcomes and reduce costs.

An Economic Evaluation of Tofacitinib Treatment in Rheumatoid Arthritis: Modeling the Cost of Treatment Strategies in the United States.

PubMed

Claxton, Lindsay; Jenks, Michelle; Taylor, Matthew; Wallenstein, Gene; Mendelsohn, Alan M; Bourret, Jeffrey A; Singh, Amitabh; Moynagh, Dermot; Gerber, Robert A

2016-09-01

Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Tofacitinib is approved in the United States for use in adults with moderately to severely active RA and an inadequate response or intolerance to methotrexate. To (a) evaluate, using an economic model, the treatment costs of an RA strategy including tofacitinib, compared with adalimumab, etanercept, certolizumab and tocilizumab biologic RA treatment strategies, which are commonly prescribed in the United States, and (b) assess the economic impact of monotherapy and combination therapy in patients who had an inadequate response to methotrexate therapy (MTX-IR analysis) and to combination therapy in patients who had an inadequate response to a tumor necrosis factor inhibitor (TNF-IR analysis). A transparent, Excel-based economic model with a decision-tree approach was developed to evaluate costs over a 1- and 2-year time horizon. The model compared tofacitinib 5 mg twice a day (BID) either as monotherapy or in combination with MTX with similarly labeled biologic therapies. Response to treatment was modeled as American College of Rheumatology (ACR) 20/50/70 response. ACR20 represented clinical response and determined whether patients continued therapy. ACR response rates at 6-month intervals were sourced from prescribing information and safety event rates from a published meta-analysis. Following an adverse event or a lack of response to treatment, it was assumed that 75% of patients switched to the next line of treatment (first to abatacept and then to rituximab). The perspective was that of a U.S. payer. Costs were reported in 2015 U.S. dollars and included drug wholesale acquisition costs, monitoring, drug administration, and treatment for minor and serious adverse events. The patient population eligible for treatment was based on the total number of members (i.e., RA and non-RA) in a payer organization; members with RA treated with biologic therapies were estimated using epidemiological data. Sensitivity analyses were conducted to explore the impact of varying key parameters, including treatment-switching probability, product rebate, major rates of adverse drug reaction, and ACR20 rates, on the model outcomes. Tofacitinib combination therapy after MTX failure was associated with the lowest cost per member per month (PMPM) over a 2-year time frame at $5.53, compared with $6.49 for adalimumab, $6.43 for etanercept, $5.95 for certolizumab, and $5.89 for tocilizumab. Similar savings were observed when all biologics were administered as monotherapy. Tofacitinib combination therapy was also associated with the lower PMPM cost compared with adalimumab combination therapy in the TNF-IR analysis. Tofacitinib was also among the lowest cost per ACR20 responder in each analysis. Sensitivity analyses demonstrated that tofacitinib would potentially be cost saving even in the least optimistic scenarios. This analysis suggests that tofacitinib 5 mg BID following MTX failure is a lower cost per patient treatment option when used either as monotherapy or combination therapy, compared with adalimumab, etanercept, certolizumab and tocilizumab biologic regimens. Tofacitinib + MTX in TNF-IR patients was also predicted to be a lower-cost treatment option compared with adalimumab+MTX and was associated with the lowest cost per ACR 20/50/70 responder. This study was funded by Pfizer, which determined the research topic and paid York Health Economics Consortium to develop the analysis and conduct the research. York Health Economics Consortium has received consultancy fees from Pfizer. Gerber, Wallenstein, Mendelsohn, Bourret, Singh, and Moynagh are employees and shareholders of Pfizer. Editorial support was funded by Pfizer and was provided by Claxton, Jenks, and Taylor, who are employees of York Health Economics Consortium. Study concept and design were contributed primarily by Taylor, Jenks, Gerber, and Singh, along with the other authors. Gerber, Moynagh, and Singh collected the data, assisted by Bouret and Mendelsohn; data interpretation was performed by Claxton, Gerber, Bouret, and Mendelsohn. The manuscript was written primarily by Claxton, with assistance from the other authors, and revised by Claxton, Gerber, Bouret, and Mendelsohn, with assistance from the other authors.

Uncertainty and sensitivity analysis of control strategies using the benchmark simulation model No1 (BSM1).

PubMed

Flores-Alsina, Xavier; Rodriguez-Roda, Ignasi; Sin, Gürkan; Gernaey, Krist V

2009-01-01

The objective of this paper is to perform an uncertainty and sensitivity analysis of the predictions of the Benchmark Simulation Model (BSM) No. 1, when comparing four activated sludge control strategies. The Monte Carlo simulation technique is used to evaluate the uncertainty in the BSM1 predictions, considering the ASM1 bio-kinetic parameters and influent fractions as input uncertainties while the Effluent Quality Index (EQI) and the Operating Cost Index (OCI) are focused on as model outputs. The resulting Monte Carlo simulations are presented using descriptive statistics indicating the degree of uncertainty in the predicted EQI and OCI. Next, the Standard Regression Coefficients (SRC) method is used for sensitivity analysis to identify which input parameters influence the uncertainty in the EQI predictions the most. The results show that control strategies including an ammonium (S(NH)) controller reduce uncertainty in both overall pollution removal and effluent total Kjeldahl nitrogen. Also, control strategies with an external carbon source reduce the effluent nitrate (S(NO)) uncertainty increasing both their economical cost and variability as a trade-off. Finally, the maximum specific autotrophic growth rate (micro(A)) causes most of the variance in the effluent for all the evaluated control strategies. The influence of denitrification related parameters, e.g. eta(g) (anoxic growth rate correction factor) and eta(h) (anoxic hydrolysis rate correction factor), becomes less important when a S(NO) controller manipulating an external carbon source addition is implemented.

An Economic Evaluation of Onshore and Floating Liquefied Natural Gas Receiving Terminals: the Case Study of Indonesia

NASA Astrophysics Data System (ADS)

Giranza, M. J.; Bergmann, A.

2018-05-01

Indonesia has abundant natural gas resources, however the primary fuel used for electricity generation is coal and oil. Insufficient natural gas infrastructure with-in the country acts as a barrier to increased natural gas usage. In Indonesia LNG is the most efficient and effective method for distributing natural gas given the difficult geographical conditions, the world’s largest archipelago and located in a deep sea area. The Government is planning to initiate natural gas imports by 2019 to meet the country’s energy demands. In order to allocate adequate amounts of natural gas across the geographic regions Indonesia must build more LNG regasification terminals. The Indonesia government has not yet determined if the additional regasification terminals will be floating or land-based facilities. This paper assesses the two options and identifies which facility attains greater profitability. The financial analysis of investing in the Sorong LNG regasification terminal project is conducted using NPV, IRR, and sensitivity analysis. This analysis demonstrates that FSRU facilities have greater economic viability than onshore LNG regasification facilities. The FSRU project earns greater than a 12% IRR as compared to a negative IRR earned by an onshore project. The government can make the onshore projects viable by increasing the sales fee from US10.00/MMBTU to US10.60/MMBTU.

Freedom space for rivers: An economically viable river management concept in a changing climate

NASA Astrophysics Data System (ADS)

Buffin-Bélanger, Thomas; Biron, Pascale M.; Larocque, Marie; Demers, Sylvio; Olsen, Taylor; Choné, Guénolé; Ouellet, Marie-Audray; Cloutier, Claude-André; Desjarlais, Claude; Eyquem, Joanna

2015-12-01

The freedom space concept applies hydrogeomorphic principles to delineate zones that are either frequently flooded or actively eroding, or that include riparian wetlands. Freedom space limits mapped for three rivers in southern Quebec (Canada) were assessed to determine whether they would still be valid under a future climate using a sensitivity analysis approach with numerical models predicting mobility of meanders (RVRMeander) and flood stage (HEC-RAS). The freedom space limits were also used in a cost-benefit analysis over a 50-year period where costs consist of loss or limitations to the right of farming and construction in this zone, whereas benefits are avoided costs for existing or future bank stabilization structures and avoided costs of flooding in agricultural areas. The economic value of ecosystem services provided by riparian wetlands and increased buffer zones within the freedom space were also included in the analysis. Results show that freedom space limits would be robust in future climate, and show net present values ranging from CDN0.7 to 3.7 million for the three rivers, with ratios of benefits over costs ranging between 1.5:1 and 4.8:1. River management based on freedom space is thus beneficial for society over a 50-year period.

Gender-related dimensions of childhood adversities in the general population.

PubMed

Coêlho, Bruno M; Santana, Geilson L; Viana, Maria C; Andrade, Laura H; Wang, Yuan-Pang

2018-06-11

Childhood adversities (CAs) comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women. Parental mental illness, substance misuse, criminality, death, divorce, other parental loss, family violence, physical abuse, sexual abuse, neglect, physical illness, and economic adversity were assessed in a general-population sample (n=5,037). Exploratory and confirmatory factor analysis determined gender-related dimensions of CA. The contribution of each individual adversity was explored through Rasch analysis. Adversities were reported by 53.6% of the sample. A three-factor model of CA dimensions fit the data better for men, and a two-factor model for women. For both genders, the dimension of family maladjustment - encompassing physical abuse, neglect, parental mental disorders, and family violence - was the core cluster of CAs. Women endorsed more CAs than men. Rasch analysis found that sexual abuse, physical illness, parental criminal behavior, parental divorce, and economic adversity were difficult to report in face-to-face interviews. CAs embrace sensitive personal information, clustering of which differed by gender. Acknowledging CAs may have an impact on medical and psychiatric outcomes in adulthood.

In vitro steroid profiling system for the evaluation of endocrine disruptors.

PubMed

Nakano, Yosuke; Yamashita, Toshiyuki; Okuno, Masashi; Fukusaki, Eiichiro; Bamba, Takeshi

2016-09-01

Endocrine disruptors (ED) are chemicals that affect various aspects of the endocrine system, often leading to the inhibition of steroidogenesis. Current chemical safety policies that restrict human exposure to such chemicals describe often time-consuming and costly methods for the evaluation of ED effects. We aimed to develop an effective tool for accurate phenotypic chemical toxicology studies. We developed an in vitro ED evaluation system using gas chromatography/mass spectrometry (GC/MS/MS) methods for metabolomic analysis of multi-marker profiles. Accounting for sample preparation and GC/MS/MS conditions, we established a screening method that allowed the simultaneous analysis of 17 steroids with good reproducibility and a linear calibration curve. Moreover, we applied the developed system to H295R human adrenocortical cells exposed to forskolin and prochloraz in accordance with the Organization for Economic Cooperation and Development (OECD) guidelines and observed dose-dependent variations in steroid profiles. While the OECD guidelines include only testosterone and 17β-estradiol, our system enabled a comprehensive and highly sensitive analysis of steroid profile alteration due to ED exposure. The application of our ED evaluation screen could be economical and provide novel insights into the hazards of ED exposure to the endocrine system. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

An economic analysis of the EHAS telemedicine system in Alto Amazonas.

PubMed

Martínez, Andrés; Villarroel, Valentín; Puig-Junoy, Jaume; Seoane, Joaquín; del Pozo, Francisco

2007-01-01

Telemedicine systems providing voice communication and email by radio were installed at seven health centres (HCs) and 32 health posts (HPs) in the Alto Amazonas province of Peru during 2001. A cost analysis was performed to estimate the net effect on direct resource consumption from the perspective of society. Prior to the availability of the EHAS telemedicine system, there was a mean of 11.1 urgent patient referrals per year from the HPs and 14.0 referrals per year from the HCs. After the implementation of telemedicine, patient referrals fell to 2.5 per year from the HPs (P = 0.03) and to 8.4 per year from the HCs (P = 0.17). The net economic effect of the telemedicine programme over a four-year period was clearly positive, amounting to annual net savings of US$320,126 (using a 5% discounting rate). A one-way sensitivity analysis using a range of values for the discounting rate, and the number of urgent referrals, confirms that the programme was efficient (i.e. it made net financial savings) in all cases. From the restricted budgetary perspective of the health network, the results also demonstrate that the additional operational costs (telephone and maintenance) introduced by the telemedicine system were lower than the direct cost-savings produced for the health-care network.

The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design.

PubMed

Sun, Xiao; Guo, Liping; Shang, Hongcai; Ren, Ming; Wang, Yue; Huo, Da; Lei, Xiang; Wang, Hui; Zhai, Jingbo

2015-11-03

At present, diabetes is a chronic disease of great cost and heavy burdens. The International Diabetes Federation has repeatedly warned that by 2025, the global number of diabetics would rise to 333 million from 194 million in 2003. Although the occurrence of diabetes in developing countries is lower, China has a large population, so that the number of cases is increased. At the same time, more people have prediabetes, a growing health concern where a large percentage of the patients develop full type 2 diabetes. In addition, the patients of diabetes easily incur complications such as blindness, kidney failure, and cardiovascular diseases that can seriously affect the patients' quality of life and cause great economic burdens to family and society. Therefore, effective interventions for prediabetes are needed to prevent or delay the occurrence and development of diabetes. A randomized controlled trial that was assessed with pharmacoeconomic methods was undertaken in this study. The study term was 24 months (12 months for the intervention and 12 months for follow up). Four hundred participants, recruited from four cities in China: Beijing, Tianjin, Xian, and Naning, were randomized to the treatment group (JQJT tablets) and the control group (placebo). Participants included in this study had been diagnosed with prediabetes according to the criteria for western medicine and Traditional Chinese Medicine (TCM). The end-point effectiveness indexes included the incidence of diabetes and the reversion rate. The drug costs and lifestyle intervention costs were included in the total costs. The study used the cost-effectiveness analysis to discuss the economic advantage of the JQJT tablets. The outcomes of the study contained 2 sections,namely clinical outcomes and cost-effectiveness analysis outcomes. The clinical outcomes: the treatment group and control group had no significant statistical difference P> 0.05) on the baseline of situation; Jinqi Jiangtang tablet effectively reduced the incidence of diabetes mellitus and enhanced reversion rate. compared with the control group (p< 0.05); the scores of SF-36 of two groups had no significant difference P> 0.05); finally the compliance of participants between the two groups had no significant difference. The cost-effectiveness analysis outcomes:in the intervention period of 12 months,on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio;on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio; in the follow-up period of 24 months, on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio, on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectivenes ratio and the incremental cost-effectiveness ratio.At the same time, these outcomes remained the same by sensitivity analysis. Assuming that prices and resident incomes rose 5%, the sensitiveness analysis shows that the two group affected by the paremeters changed little. The importance and effectiveness of lifestyle education and JinQi Jiangtang tablets was proven. In both the intervention period and follow-up, JinQi Jiangtang tablets combined with lifestyle education had a greater cost advantage effect than the lifestyle education alone on the reversion rate; the lifestyle education had a greater cost advantage effect than the JinQi Jiangtang tablets combined with lifestyle education on the incidence of diabetes. Chinese Clinical Trials ChiCTR-TRC-09000401 ) , registered on 25 May 2009.

Behavioral economic analysis of cue-elicited craving for tobacco: a virtual reality study.

PubMed

Acker, John; MacKillop, James

2013-08-01

Subjective craving is a prominent construct in the study of tobacco motivation; yet, the precise measurement of tobacco craving poses several difficulties. A behavioral economic approach to understanding drug motivation imports concepts and methods from economics to improve the assessment of craving. Using an immersive virtual reality (VR) cue reactivity paradigm, this study tested the hypothesis that, compared with neutral cues, tobacco cues would result in significant increases in subjective craving and diverse aspects of demand for tobacco in a community sample of 47 regular smokers. In addition, the study examined these motivational indices in relation to a dual-component delay and cigarette consumption self-administration paradigm. In response to the VR tobacco cues, significant increases were observed for tobacco craving and the demand indices of Omax (i.e., maximum total expenditure toward cigarettes) and Breakpoint (i.e., price at which consumption is completely suppressed), whereas a significant decrease was observed for Elasticity (i.e., lower cigarette price sensitivity). Continuous analyses revealed trend-level inverse associations between Omax and Intensity in relation to delay duration and significant positive associations between subjective craving, Omax, and Elasticity in relation to the number of cigarettes purchased. The results from this study provide further evidence for the utility of behavioral economic concepts and methods in understanding smoking motivation. These data also reveal the incremental contribution of behavioral economic indices beyond subjective craving in predicting in vivo cigarette consumption. Relationships to previous studies and methodological considerations are discussed.

Behavioral Economic Analysis of Cue-Elicited Craving for Tobacco: A Virtual Reality Study

PubMed Central

2013-01-01

Introduction: Subjective craving is a prominent construct in the study of tobacco motivation; yet, the precise measurement of tobacco craving poses several difficulties. A behavioral economic approach to understanding drug motivation imports concepts and methods from economics to improve the assessment of craving. Methods: Using an immersive virtual reality (VR) cue reactivity paradigm, this study tested the hypothesis that, compared with neutral cues, tobacco cues would result in significant increases in subjective craving and diverse aspects of demand for tobacco in a community sample of 47 regular smokers. In addition, the study examined these motivational indices in relation to a dual-component delay and cigarette consumption self-administration paradigm. Results: In response to the VR tobacco cues, significant increases were observed for tobacco craving and the demand indices of Omax (i.e., maximum total expenditure toward cigarettes) and Breakpoint (i.e., price at which consumption is completely suppressed), whereas a significant decrease was observed for Elasticity (i.e., lower cigarette price sensitivity). Continuous analyses revealed trend-level inverse associations between Omax and Intensity in relation to delay duration and significant positive associations between subjective craving, Omax, and Elasticity in relation to the number of cigarettes purchased. Conclusions: The results from this study provide further evidence for the utility of behavioral economic concepts and methods in understanding smoking motivation. These data also reveal the incremental contribution of behavioral economic indices beyond subjective craving in predicting in vivo cigarette consumption. Relationships to previous studies and methodological considerations are discussed. PMID:23322768

Economic and health risk trade-offs of swim closures at a Lake Michigan beach

USGS Publications Warehouse

Rabinovici, Sharyl M.; Bernknopf, Richard L.; Wein, Anne M.; Coursey, Don L.; Whitman, Richard L.

2004-01-01

This paper presents a framework for analyzing the economic, health, and recreation implications of swim closures related to high fecal indicator bacteria (FIB) levels. The framework utilizes benefit transfer policy analysis to provide a practical procedure for estimating the effectiveness of recreational water quality policies. Evaluation criteria include the rates of intended and unintended management outcomes, whether the chosen protocols generate closures with positive net economic benefits to swimmers, and the number of predicted illnesses the policy is able to prevent. We demonstrate the framework through a case study of a Lake Michigan freshwater beach using existing water quality and visitor data from 1998 to 2001. We find that a typical closure causes a net economic loss among would-be swimmers totaling $1274-37 030/ day, depending on the value assumptions used. Unnecessary closures, caused by high indicator variability and a 24-h time delay between when samples are taken and the management decision can be made, occurred on 14 (12%) out of 118 monitored summer days. Days with high FIB levels when the swim area is open are also common but do relatively little economic harm in comparison. Also, even if the closure policy could be implemented daily and perfectly without error, only about 42% of predicted illnesses would be avoided. These conclusions were sensitive to the relative values and risk preferences that swimmers have for recreation access and avoiding health effects, suggesting a need for further study of the impacts of recreational water quality policies on individuals.

The impact of the 2008 economic crisis on the increasing number of young psychiatric inpatients.

PubMed

Medel-Herrero, Alvaro; Gomez-Beneyto, Manuel

2017-11-21

Little is published about the impact of the 2008 economic crisis on mental health services in Spain. An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic crisis and the number of psychiatric hospital admissions. The timing of the intervention (April 2008) was based on observed changes in Gross Domestic Product (GDP). Data on 1,152,880 psychiatric inpatients from the national Hospital Morbidity Survey, 69 months before and after the onset of the economic crisis (April 2008), were analyzed. Age-adjusted psychiatric (ICD9 290-319) hospital discharge rates significantly increased from April 2008, matching the onset of the crisis, especially for inpatients aged 15-24 years old and to a less extend for inpatients aged 25-34 years old. Other age groups were not affected. There was a significant increase in diagnoses for disturbance of conduct and emotions, depression, neurotic and personality disorders and alcohol and drug disorders; however, diagnoses for mental retardation and organic psychosis for 15-34 years old inpatients were unaffected. Psychiatric hospital admissions abruptly increased in April 2008, coinciding with the onset of the economic crisis. We identified age groups and diagnoses affected. Increased hospitalizations were found only at the age-ranges most affected by the rise in unemployment. The diagnoses affected were those most sensitive to environmental changes. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Frequency of under- and overweight among children and adolescents during the economic transition in Poland.

PubMed

Ządzińska, E; Rosset, I; Kozieł, S; Nawarycz, T; Borowska-Strugińska, B; Lorkiewicz, W; Ostrowska-Nawarycz, L; Sitek, A

2012-06-01

The aim of this study is to examine the prevalence of underweight, overweight and obesity, using International Obesity Task Force (IOTF) criteria, in four cohorts of children and adolescents living in Poland in different economic eras: communist economy (1977/1978), crisis of the 1980s (1987/1988), political and economic transformation (1992/1994) and the free market economy (2002/2004). Analysis was conducted on a database including 10,934 records for children of the age 7-18 years. In Poland, in the last 26 years of economic and political transformations, the epidemic of obesity was not noticed but the growing incidence of children and adolescents with body mass deficit was observed (p<0.0001) (20.2% of girls in 2002/2004 vs. 11.0% in 1977/1978 and 12.1% of boys in 2002/2004 vs. 7.2% in 1977/1978). Lower parental education and a higher number of children in a family resulted in a higher prevalence of underweight (odds ratio [OR] fluctuated from 1.26 to 1.63). The social effects of the political transformation in Poland significantly affected families with low socio-economic status (SES), and especially more eco-sensitive boys. This result is opposite to the trends observed in Western countries and makes an important contribution to the current knowledge of the course of further changes in weight-to-height ratio at a global scale. Copyright © 2012 Elsevier GmbH. All rights reserved.

Effect of corn stover compositional variability on minimum ethanol selling price (MESP).

PubMed

Tao, Ling; Templeton, David W; Humbird, David; Aden, Andy

2013-07-01

A techno-economic sensitivity analysis was performed using a National Renewable Energy Laboratory (NREL) 2011 biochemical conversion design model varying feedstock compositions. A total of 496 feedstock near infrared (NIR) compositions from 47 locations in eight US Corn Belt states were used as the inputs to calculate minimum ethanol selling price (MESP), ethanol yield (gallons per dry ton biomass feedstock), ethanol annual production, as well as total installed project cost for each composition. From this study, the calculated MESP is $2.20 ± 0.21 (average ± 3 SD) per gallon ethanol. Copyright © 2013. Published by Elsevier Ltd.