Effect of facility on the operative costs of distal radius fractures.

PubMed

Mather, Richard C; Wysocki, Robert W; Mack Aldridge, J; Pietrobon, Ricardo; Nunley, James A

2011-07-01

The purpose of this study was to investigate whether ambulatory surgery centers can deliver lower-cost care and to identify sources of those cost savings. We performed a cost identification analysis of outpatient volar plating for closed distal radius fractures at a single academic medical center. Multiple costs and time measures were taken from an internal database of 130 consecutive patients and were compared by venue of treatment, either an inpatient facility or an ambulatory, stand-alone surgery facility. The relationships between total cost and operative time and multiple variables, including fracture severity, patient age, gender, comorbidities, use of bone graft, concurrent carpal tunnel release, and surgeon experience, were examined, using multivariate analysis and regression modeling to identify other cost drivers or explanatory variables. The mean operative cost was considerably greater at the inpatient facility ($7,640) than at the outpatient facility ($5,220). Cost drivers of this difference were anesthesia services, post-anesthesia care unit, and operating room costs. Total surgical time, nursing time, set-up, and operative times were 33%, 109%, 105%, and 35% longer, respectively, at the inpatient facility. There was no significant difference between facilities for the additional variables, and none of those variables independently affected cost or operative time. The only predictor of cost and time was facility type. This study supports the use of ambulatory stand-alone surgical facilities to achieve efficient resource utilization in the operative treatment of distal radius fractures. We also identified several specific costs and time measurements that differed between facilities, which can serve as potential targets for tertiary facilities to improve utilization. Economic and Decisional Analysis III. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Multi-country analysis of treatment costs for HIV/AIDS (MATCH): facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

PubMed

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment). This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

PubMed Central

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

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

PubMed

Baker, David G

2011-08-19

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

Cost containment and KSC Shuttle facilities or cost containment and aerospace construction

NASA Technical Reports Server (NTRS)

Brown, J. A.

1985-01-01

This presentation has the objective to show examples of Cost Containment of Aerospace Construction at Kennedy Space Center (KSC), taking into account four major levels of Project Development of the Space Shuttle Facilities. The levels are related to conceptual criteria and site selection, the design of construction and ground support equipment, the construction of facilities and ground support equipment (GSE), and operation and maintenance. Examples of cost containment are discussed. The continued reduction of processing time from landing to launching represents a demonstration of the success of the cost containment methods. Attention is given to the factors which led to the selection of KSC, the use of Cost Engineering, the employment of the Construction Management Concept, and the use of Computer Aided Design/Drafting.

Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe

PubMed Central

Mwenge, Lawrence; Sande, Linda; Mangenah, Collin; Ahmed, Nurilign; Kanema, Sarah; d’Elbée, Marc; Sibanda, Euphemia; Kalua, Thokozani; Ncube, Gertrude; Johnson, Cheryl C.; Hatzold, Karin; Cowan, Frances M.; Corbett, Elizabeth L.; Ayles, Helen; Maheswaran, Hendramoorthy

2017-01-01

Background Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three southern African countries with high HIV burden. Methods Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs. Results Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03.9 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. Conclusions Health facility based HIV testing remains an essential service to meet HIV universal access goals. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggests that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services. PMID:29036171

Potential cost-effectiveness of supervised injection facilities in Toronto and Ottawa, Canada.

PubMed

Enns, Eva A; Zaric, Gregory S; Strike, Carol J; Jairam, Jennifer A; Kolla, Gillian; Bayoumi, Ahmed M

2016-03-01

Supervised injection facilities (legally sanctioned spaces for supervised consumption of illicitly obtained drugs) are controversial public health interventions. We determined the optimal number of facilities in two Canadian cities using health economic methods. Dynamic compartmental model of HIV and hepatitis C transmission through sexual contact and sharing of drug use equipment. Toronto and Ottawa, Canada. Simulated population of each city. Zero to five supervised injection facilities. Direct health-care costs and quality-adjusted life-years (QALYs) over 20 years, discounted at 5% per year; incremental cost-effectiveness ratios. In Toronto, one facility cost $4.1 million and resulted in a gain of 385 QALYs over 20 years, for an incremental cost-effectiveness ratio (ICER) of $10,763 per QALY [95% credible interval (95CrI): cost-saving to $278,311]. Establishing one facility in Ottawa had an ICER of $6127 per QALY (95CrI: cost-saving to $179,272). At a $50,000 per QALY threshold, three facilities would be cost-effective in Toronto and two in Ottawa. The probability that establishing three, four, or five facilities in Toronto was cost-effective was 17, 21, and 41%, respectively. Establishing one, two, or three facilities in Ottawa was cost-effective with 13, 35, and 41% probability, respectively. Establishing no facility was unlikely to be the most cost-effective option (14% in Toronto and 10% in Ottawa). In both cities, results were robust if the reduction in needle-sharing among clients of the facilities was at least 50% and fixed operating costs were less than $2.0 million. Using a $50,000 per quality-adjusted life-years threshold for cost-effectiveness, it is likely to be cost-effective to establish at least three legally sanctioned spaces for supervised injection of illicitly obtained drugs in Toronto, Canada and two in Ottawa, Canada. © 2015 Society for the Study of Addiction.

RCRA Facility Information

EPA Pesticide Factsheets

This asset includes hazardous waste information, which is mostly contained in the Resource Conservation and Recovery Act Information (RCRAInfo) System, a national program management and inventory system addressing hazardous waste handlers. In general, all entities that generate, transport, treat, store, and dispose of hazardous waste are required to provide information about their activities to state environmental agencies. These agencies pass on that information to regional and national EPA offices. This regulation is governed by the Resource Conservation and Recovery Act (RCRA), as amended by the Hazardous and Solid Waste Amendments of 1984. RCRAInfo Search can be used to determine identification and location data for specific hazardous waste handlers and to find a wide range of information on treatment, storage, and disposal facilities regarding permit/closure status, compliance with Federal and State regulations, and cleanup activities. Categories of information in this asset include:-- Handlers-- Permit Information-- GIS information on facility location-- Financial Assurance-- Corrective Action-- Compliance Monitoring and Enforcement (CM&E)

Patient and Facility Variation in Costs of VHA Heart Failure Patients

PubMed Central

Yoon, Jean; Fonarow, Gregg C.; Groeneveld, Peter W.; Teerlink, John; Whooley, Mary A.; Sahay, Anju; Heidenreich, Paul

2017-01-01

Objectives To determine the variation in annual health care costs among heart failure patients in the VA system. Background Heart failure is associated with considerable use of health care resources, but little is known about patterns in patient characteristics related to higher costs. Methods We obtained VA utilization and cost records for all patients with a diagnosis of heart failure in fiscal year 2010. We compared total VA costs by patient demographic factors, comorbid conditions, and facility where they were treated in bivariate analyses. We regressed total costs on patient factors alone; VA facility alone; and all factors combined to determine the relative contribution of patient factors and facility to explaining cost differences. Results There were 117,870 patients with heart failure, and their mean annual VA costs were $30,719 (SD=49,180) with more than half of their costs due to inpatient care. Patients at younger ages, of Hispanic or black race/ethnicity, diagnosed with comorbid drug use disorders, or who died during the year had the highest costs (all P<0.01). There was variation in costs by facility as mean adjusted costs ranged from approximately $15,000 to $48,000. In adjusted analyses patient factors alone explained more of the variation in health care costs (R2=0.116) compared to the facility where the patient was treated (R2=0.018). Conclusion A large variation in costs of heart failure patients was observed across facilities although this was explained largely by patient factors. Improving the efficiency of VA resource utilization may require increased scrutiny of high-cost patients to determine if adequate value is being delivered to those patients. PMID:26970829

MIMI: multimodality, multiresource, information integration environment for biomedical core facilities.

PubMed

Szymanski, Jacek; Wilson, David L; Zhang, Guo-Qiang

2009-10-01

The rapid expansion of biomedical research has brought substantial scientific and administrative data management challenges to modern core facilities. Scientifically, a core facility must be able to manage experimental workflow and the corresponding set of large and complex scientific data. It must also disseminate experimental data to relevant researchers in a secure and expedient manner that facilitates collaboration and provides support for data interpretation and analysis. Administratively, a core facility must be able to manage the scheduling of its equipment and to maintain a flexible and effective billing system to track material, resource, and personnel costs and charge for services to sustain its operation. It must also have the ability to regularly monitor the usage and performance of its equipment and to provide summary statistics on resources spent on different categories of research. To address these informatics challenges, we introduce a comprehensive system called MIMI (multimodality, multiresource, information integration environment) that integrates the administrative and scientific support of a core facility into a single web-based environment. We report the design, development, and deployment experience of a baseline MIMI system at an imaging core facility and discuss the general applicability of such a system in other types of core facilities. These initial results suggest that MIMI will be a unique, cost-effective approach to addressing the informatics infrastructure needs of core facilities and similar research laboratories.

Construction Cost Growth for New Department of Energy Nuclear Facilities

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

Kubic, Jr., William L.

Cost growth and construction delays are problems that plague many large construction projects including the construction of new Department of Energy (DOE) nuclear facilities. A study was conducted to evaluate cost growth of large DOE construction projects. The purpose of the study was to compile relevant data, consider the possible causes of cost growth, and recommend measures that could be used to avoid extreme cost growth in the future. Both large DOE and non-DOE construction projects were considered in this study. With the exception of Chemical and Metallurgical Research Building Replacement Project (CMRR) and the Mixed Oxide Fuel Fabrication Facilitymore » (MFFF), cost growth for DOE Nuclear facilities is comparable to the growth experienced in other mega construction projects. The largest increase in estimated cost was found to occur between early cost estimates and establishing the project baseline during detailed design. Once the project baseline was established, cost growth for DOE nuclear facilities was modest compared to non-DOE mega projects.« less

Energy Cost Reduction for Automotive Service Facilities.

ERIC Educational Resources Information Center

Federal Energy Administration, Washington, DC.

This handbook on energy cost reduction for automotive service facilities consists of four sections. The importance and economic benefits of energy conservation are discussed in the first section. In the second section six energy cost reduction measures are discussed: relamping interior areas; relamping and reducing interior lighting; setting back…

Controlling Infrastructure Costs: Right-Sizing the Mission Control Facility

NASA Technical Reports Server (NTRS)

Martin, Keith; Sen-Roy, Michael; Heiman, Jennifer

2009-01-01

Johnson Space Center's Mission Control Center is a space vehicle, space program agnostic facility. The current operational design is essentially identical to the original facility architecture that was developed and deployed in the mid-90's. In an effort to streamline the support costs of the mission critical facility, the Mission Operations Division (MOD) of Johnson Space Center (JSC) has sponsored an exploratory project to evaluate and inject current state-of-the-practice Information Technology (IT) tools, processes and technology into legacy operations. The general push in the IT industry has been trending towards a data-centric computer infrastructure for the past several years. Organizations facing challenges with facility operations costs are turning to creative solutions combining hardware consolidation, virtualization and remote access to meet and exceed performance, security, and availability requirements. The Operations Technology Facility (OTF) organization at the Johnson Space Center has been chartered to build and evaluate a parallel Mission Control infrastructure, replacing the existing, thick-client distributed computing model and network architecture with a data center model utilizing virtualization to provide the MCC Infrastructure as a Service. The OTF will design a replacement architecture for the Mission Control Facility, leveraging hardware consolidation through the use of blade servers, increasing utilization rates for compute platforms through virtualization while expanding connectivity options through the deployment of secure remote access. The architecture demonstrates the maturity of the technologies generally available in industry today and the ability to successfully abstract the tightly coupled relationship between thick-client software and legacy hardware into a hardware agnostic "Infrastructure as a Service" capability that can scale to meet future requirements of new space programs and spacecraft. This paper discusses the benefits

An analysis of decommissioning costs for the AFRRI TRIGA reactor facility

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

Forsbacka, Matt

1990-07-01

A decommissioning cost analysis for the AFRRI TRIGA Reactor Facility was made. AFRRI is not at this time suggesting that the AFRRI TRIGA Reactor Facility be decommissioned. This report was prepared to be in compliance with paragraph 50.33 of Title 10, Code of Federal Regulations which requires the assurance of availability of future decommissioning funding. The planned method of decommissioning is the immediate decontamination of the AFRRI TRIGA Reactor site to allow for restoration of the site to full public access - this is called DECON. The cost of DECON for the AFRRI TRIGA Reactor Facility in 1990 dollars ismore » estimated to be $3,200,000. The anticipated ancillary costs of facility site demobilization and spent fuel shipment is an additional $600,000. Thus the total cost of terminating reactor operations at AFRRI will be about $3,800,000. The primary basis for this cost estimate is a study of the decommissioning costs of a similar reactor facility that was performed by Battelle Pacific Northwest Laboratory (PNL) as provided in USNRC publication NUREG/CR-1756. The data in this study were adapted to reflect the decommissioning requirements of the AFRRI TRIGA. (author)« less

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

PubMed

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

2017-09-01

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

Analysis of decommissioning costs for the AFRRI TRIGA reactor facility. Technical report

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

Forsbacka, M.; Moore, M.

1989-12-01

This report provides a cost analysis for decommissioning the Armed Forces Radiobiology Research Institute (AFRRI) TRIGA reactor facility. AFRRI is not suggesting that the AFRRI TRIGA reactor facility be decommissioned. This report was prepared in compliance with paragraph 50.33 of Title 10, Code of Federal Regulations, which requires that funding for the decommissioning of reactor facilities be available when licensed activities cease. The planned method of decommissioning is complete decontamination (DECON) of the AFRRI TRIGA reactor site to allow for restoration of the site to full public access. The cost of DECON in 1990 dollars is estimated to be $3,200,000.more » The anticipated ancillary costs of facility site demobilization and spent fuel shipment will be an additional $600,000. Thus, the total cost of terminating reactor operations at AFRRI will be about $3,800,000. The primary basis for developing this cost estimate was a study of the decommissioning costs of similar reactor facility performed by Battelle Pacific Northwest Laboratory, as provided in U.S. Nuclear Regulatory Commission publication NUREG/CR-1756. The data in this study were adapted to reflect the decommissioning requirements of the AFRRI TRIGA reactor facility.« less

Estimating the Cost and Payment for Sanitation in the Informal Settlements of Kisumu, Kenya: A Cross Sectional Study.

PubMed

Simiyu, Sheillah; Swilling, Mark; Rheingans, Richard; Cairncross, Sandy

2017-01-06

Lack of sanitation facilities is a common occurrence in informal settlements that are common in most developing countries. One challenge with sanitation provision in these settlements is the cost and financing of sanitation. This study aimed at estimating the cost of sanitation, and investigating the social and economic dynamics within Kisumu's informal settlements that hinder provision and uptake of sanitation facilities. Primary data was collected from residents of the settlements, and using logistic and hedonic regression analysis, we identify characteristics of residents with sanitation facilities, and estimate the cost of sanitation as revealed in rental prices. Our study finds that sanitation constitutes approximately 54% of the rent paid in the settlements; and dynamics such as landlords and tenants preferences, and sharing of sanitation facilities influence provision and payment for sanitation. This study contributes to general development by estimating the cost of sanitation, and further identifies barriers and opportunities for improvement including the interplay between landlords and tenants. Provision of sanitation in informal settlements is intertwined in social and economic dynamics, and development approaches should target both landlords and tenants, while also engaging various stakeholders to work together to identify affordable and appropriate sanitation technologies.

Estimating the Cost and Payment for Sanitation in the Informal Settlements of Kisumu, Kenya: A Cross Sectional Study

PubMed Central

Simiyu, Sheillah; Swilling, Mark; Rheingans, Richard; Cairncross, Sandy

2017-01-01

Lack of sanitation facilities is a common occurrence in informal settlements that are common in most developing countries. One challenge with sanitation provision in these settlements is the cost and financing of sanitation. This study aimed at estimating the cost of sanitation, and investigating the social and economic dynamics within Kisumu’s informal settlements that hinder provision and uptake of sanitation facilities. Primary data was collected from residents of the settlements, and using logistic and hedonic regression analysis, we identify characteristics of residents with sanitation facilities, and estimate the cost of sanitation as revealed in rental prices. Our study finds that sanitation constitutes approximately 54% of the rent paid in the settlements; and dynamics such as landlords and tenants preferences, and sharing of sanitation facilities influence provision and payment for sanitation. This study contributes to general development by estimating the cost of sanitation, and further identifies barriers and opportunities for improvement including the interplay between landlords and tenants. Provision of sanitation in informal settlements is intertwined in social and economic dynamics, and development approaches should target both landlords and tenants, while also engaging various stakeholders to work together to identify affordable and appropriate sanitation technologies. PMID:28067812

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 3. User's Manual and Program Documentation for the Facilities Maintenance Cost Model

DOT National Transportation Integrated Search

1978-05-01

The Facilities Maintenance Cost Model (FMCM) is an analytic model designed to calculate expected annual labor costs of maintenance within a given FAA maintenance sector. The model is programmed in FORTRAN IV and has been demonstrated on the CDC Krono...

Cost-of-illness of cholera to households and health facilities in rural Malawi

PubMed Central

Huang, Xiao Xian; Ngwira, Bagrey; Mwanyungwe, Abel; Mogasale, Vittal; Mengel, Martin A.; Cavailler, Philippe; Gessner, Bradford D.; Le Gargasson, Jean-Bernard

2017-01-01

Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients’ households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$) 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera. PMID:28934285

Cost-of-illness of cholera to households and health facilities in rural Malawi.

PubMed

Ilboudo, Patrick G; Huang, Xiao Xian; Ngwira, Bagrey; Mwanyungwe, Abel; Mogasale, Vittal; Mengel, Martin A; Cavailler, Philippe; Gessner, Bradford D; Le Gargasson, Jean-Bernard

2017-01-01

Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$) 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.

48 CFR 52.215-17 - Waiver of Facilities Capital Cost of Money.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Capital Cost of Money. 52.215-17 Section 52.215-17 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-17 Waiver of Facilities Capital Cost of Money. As prescribed in 15.408(i), insert the following clause: Waiver of Facilities Capital Cost of Money (OCT 1997) The Contractor did not...

48 CFR 52.215-17 - Waiver of Facilities Capital Cost of Money.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Capital Cost of Money. 52.215-17 Section 52.215-17 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-17 Waiver of Facilities Capital Cost of Money. As prescribed in 15.408(i), insert the following clause: Waiver of Facilities Capital Cost of Money (OCT 1997) The Contractor did not...

48 CFR 52.215-17 - Waiver of Facilities Capital Cost of Money.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Capital Cost of Money. 52.215-17 Section 52.215-17 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-17 Waiver of Facilities Capital Cost of Money. As prescribed in 15.408(i), insert the following clause: Waiver of Facilities Capital Cost of Money (OCT 1997) The Contractor did not...

48 CFR 52.215-17 - Waiver of Facilities Capital Cost of Money.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Capital Cost of Money. 52.215-17 Section 52.215-17 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-17 Waiver of Facilities Capital Cost of Money. As prescribed in 15.408(i), insert the following clause: Waiver of Facilities Capital Cost of Money (OCT 1997) The Contractor did not...

48 CFR 52.215-17 - Waiver of Facilities Capital Cost of Money.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Capital Cost of Money. 52.215-17 Section 52.215-17 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-17 Waiver of Facilities Capital Cost of Money. As prescribed in 15.408(i), insert the following clause: Waiver of Facilities Capital Cost of Money (OCT 1997) The Contractor did not...

Cost of delivering health care services at primary health facilities in Ghana.

PubMed

Dalaba, Maxwell Ayindenaba; Welaga, Paul; Matsubara, Chieko

2017-11-17

There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana. The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs) from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD) attendance were estimated. The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC). The cost per OPD attendance was higher at CHPS (US$8.79) than at HCs (US$5.16). The average Internally Generated Funds (IGF) recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS) reimbursement was the main source of revenue accounting for over 90% total IGF. The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar studies involving large numbers of primary health facilities in

Reducing Operating Costs by Optimizing Space in Facilities

DTIC Science & Technology

2012-03-01

Base level 5 engineering units will provide facility floor plans, furniture layouts, and staffing documentation as necessary. One obstacle...due to the quantity and diverse locations. Base level engineering units provided facility floor plans, furniture layouts, and staffing documentation... furniture purchases and placement 5. Follow a quality systematic process in all decisions The per person costs can be better understood with a real

Comparing the Costs of Military Treatment Facilities with Private Sector Care

DTIC Science & Technology

2016-02-01

Log: H 15-000527 Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie INSTITUTE FOR DEFENSE ANALYSES 4850 Mark...other national challenges. Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie I N S T I T U T E F O R D...members. The latter benefit, known as TRICARE, serves 9.5 million beneficiaries worldwide, and consists of care in Military Treatment Facilities (MTFs

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Montreal, Canada.

PubMed

Jozaghi, Ehsan; Reid, Andrew A; Andresen, Martin A

2013-07-09

This paper will determine whether expanding Insite (North America's first and only supervised injection facility) to more locations in Canada such as Montreal, cost less than the health care consequences of not having such expanded programs for injection drug users. By analyzing secondary data gathered in 2012, this paper relies on mathematical models to estimate the number of new HIV and Hepatitis C (HCV) infections prevented as a result of additional SIF locations in Montreal. With very conservative estimates, it is predicted that the addition of each supervised injection facility (up-to a maximum of three) in Montreal will on average prevent 11 cases of HIV and 65 cases of HCV each year. As a result, there is a net cost saving of CDN$0.686 million (HIV) and CDN$0.8 million (HCV) for each additional supervised injection site each year. This translates into a net average benefit-cost ratio of 1.21: 1 for both HIV and HCV. Funding supervised injection facilities in Montreal appears to be an efficient and effective use of financial resources in the public health domain.

Florida Educational Facilities, 1996.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Office of Educational Facilities.

This document contains information, photographs, and floor plans of many of Florida's new elementary through high school facilities occupied in 1996. Each entry lists the facility's type, building size, student capacity, and general structural information. Also provided is information on the facility's total construction cost; the architects and…

Florida Educational Facilities, 1997.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Office of Educational Facilities.

This document contains information, photographs, and floor plans of many of Florida's new elementary through high school facilities occupied in 1997. Each entry lists the facility's type, building size, student capacity, and general structural information. Also provided is information on the facility's total construction cost; the architects and…

Florida Educational Facilities, 1998.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Office of Educational Facilities.

This document contains information, photographs, and floor plans of many of Florida's new elementary through high school facilities occupied in 1998. Each entry lists the facility's type, building size, student capacity, and general structural information. Also provided is information on the facility's total construction cost; the architects and…

The drivers of facility-based immunization performance and costs. An application to Moldova.

PubMed

Maceira, Daniel; Goguadze, Ketevan; Gotsadze, George

2015-05-07

This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire. Ordinary least square (OLS) regression analysis was performed to determine factors affecting facility outputs (number of doses administered and fully immunized children) and explaining variation in total facility costs. The study found that the number of working hours, vaccine wastage rates, and whether or not a doctor worked at a facility (among other factors) were positively and significantly associated with output levels. In addition, the level of output, price of inputs and share of the population with university education were significantly associated with higher facility costs. A 1% increase in fully immunized child would increase total cost by 0.7%. Few costing studies of primary health care services in developing countries evaluate the drivers of performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care district and national level that could be addressed by improved program management aimed at improved performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cost analysis and facility reimbursement in the long-term health care industry.

PubMed Central

Ullmann, S G

1984-01-01

This article examines costs and develops a system of prospective reimbursement for the industry committed to long-term health care. Together with estimates of average cost functions--for purposes of determining those factors affecting the costs of long-term health care, the author examines in depth the cost effects of patient mix and facility quality. Policy implications are indicated. The article estimates cost savings and predicted improvements in facility performance resulting from adoption of a prospective reimbursement system. PMID:6427138

The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

PubMed

Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J

2015-07-01

Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.

Information Technology Budgets and Costs: Do You Know What Your Information Technology Costs Each Year?

ERIC Educational Resources Information Center

Dugan, Robert E.

2002-01-01

Discusses yearly information technology costs for academic libraries. Topics include transformation and modernization activities that affect prices and budgeting; a cost model for information technologies; life cycle costs, including initial costs and recurring costs; cost benchmarks; and examples of pressures concerning cost accountability. (LRW)

A reliable facility location design model with site-dependent disruption in the imperfect information context

PubMed Central

Yun, Lifen; Wang, Xifu; Fan, Hongqiang; Li, Xiaopeng

2017-01-01

This paper proposes a reliable facility location design model under imperfect information with site-dependent disruptions; i.e., each facility is subject to a unique disruption probability that varies across the space. In the imperfect information contexts, customers adopt a realistic “trial-and-error” strategy to visit facilities; i.e., they visit a number of pre-assigned facilities sequentially until they arrive at the first operational facility or give up looking for the service. This proposed model aims to balance initial facility investment and expected long-term operational cost by finding the optimal facility locations. A nonlinear integer programming model is proposed to describe this problem. We apply a linearization technique to reduce the difficulty of solving the proposed model. A number of problem instances are studied to illustrate the performance of the proposed model. The results indicate that our proposed model can reveal a number of interesting insights into the facility location design with site-dependent disruptions, including the benefit of backup facilities and system robustness against variation of the loss-of-service penalty. PMID:28486564

Comparative Costs and Staffing Report for College and University Facilities, 1993-94.

ERIC Educational Resources Information Center

Silberman, Gil, Ed.; Glazner, Steve, Ed.

This report presents comparative data on facility management costs and staffing based on responses from 516 U.S. postsecondary educational facilities during 1993-94. It lists statistics from both private and public institutions, beginning with statistical reductions presenting the survey response tally, institutional profiles, and mean costs per…

Cost and cost-effectiveness of community based and health facility based directly observed treatment of tuberculosis in Dar es Salaam, Tanzania

PubMed Central

Wandwalo, Eliud; Robberstad, Bjarne; Morkve, Odd

2005-01-01

Background Identifying new approaches to tuberculosis treatment that are effective and put less demand to meagre health resources is important. One such approach is community based direct observed treatment (DOT). The purpose of the study was to determine the cost and cost effectiveness of health facility and community based directly observed treatment of tuberculosis in an urban setting in Tanzania. Methods Two alternative strategies were compared: health facility based directly observed treatment by health personnel and community based directly observed treatment by treatment supervisors. Costs were analysed from the perspective of health services, patients and community in the year 2002 in US $ using standard methods. Treatment outcomes were obtained from a randomised-controlled trial which was conducted alongside the cost study. Smear positive, smear negative and extra-pulmonary TB patients were included. Cost-effectiveness was calculated as the cost per patient successfully treated. Results The total cost of treating a patient with conventional health facility based DOT and community based DOT were $ 145 and $ 94 respectively. Community based DOT reduced cost by 35%. Cost fell by 27% for health services and 72% for patients. When smear positive and smear negative patients were considered separately, community DOT was associated with 45% and 19% reduction of the costs respectively. Patients used about $ 43 to follow their medication to health facility which is equivalent to their monthly income. Indirect costs were as important as direct costs, contributing to about 49% of the total patient's cost. The main reason for reduced cost was fewer number of visits to the TB clinic. Community based DOT was more cost-effective at $ 128 per patient successfully treated compared to $ 203 for a patient successfully treated with health facility based DOT. Conclusion Community based DOT presents an economically attractive option to complement health facility based DOT. This

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada.

PubMed

Jozaghi, Ehsan; Reid, Andrew A; Andresen, Martin A; Juneau, Alexandre

2014-08-04

Supervised injection facilities (SIFs) are venues where people who inject drugs (PWID) have access to a clean and medically supervised environment in which they can safely inject their own illicit drugs. There is currently only one legal SIF in North America: Insite in Vancouver, British Columbia, Canada. The responses and feedback generated by the evaluations of Insite in Vancouver have been overwhelmingly positive. This study assesses whether the above mentioned facility in the Downtown Eastside of Vancouver needs to be expanded to other locations, more specifically that of Canada's capital city, Ottawa. The current study is aimed at contributing to the existing literature on health policy by conducting cost-benefit and cost-effective analyses for the opening of SIFs in Ottawa, Ontario. In particular, the costs of operating numerous SIFs in Ottawa was compared to the savings incurred; this was done after accounting for the prevention of new HIV and Hepatitis C (HCV) infections. To ensure accuracy, two distinct mathematical models and a sensitivity analysis were employed. The sensitivity analyses conducted with the models reveals the potential for SIFs in Ottawa to be a fiscally responsible harm reduction strategy for the prevention of HCV cases--when considered independently. With a baseline sharing rate of 19%, the cumulative annual cost model supported the establishment of two SIFs and the marginal annual cost model supported the establishment of a single SIF. More often, the prevention of HIV or HCV alone were not sufficient to justify the establishment cost-effectiveness; rather, only when both HIV and HCV are considered does sufficient economic support became apparent. Funded supervised injection facilities in Ottawa appear to be an efficient and effective use of financial resources in the public health domain.

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada

PubMed Central

2014-01-01

Background Supervised injection facilities (SIFs) are venues where people who inject drugs (PWID) have access to a clean and medically supervised environment in which they can safely inject their own illicit drugs. There is currently only one legal SIF in North America: Insite in Vancouver, British Columbia, Canada. The responses and feedback generated by the evaluations of Insite in Vancouver have been overwhelmingly positive. This study assesses whether the above mentioned facility in the Downtown Eastside of Vancouver needs to be expanded to other locations, more specifically that of Canada’s capital city, Ottawa. Methods The current study is aimed at contributing to the existing literature on health policy by conducting cost-benefit and cost-effective analyses for the opening of SIFs in Ottawa, Ontario. In particular, the costs of operating numerous SIFs in Ottawa was compared to the savings incurred; this was done after accounting for the prevention of new HIV and Hepatitis C (HCV) infections. To ensure accuracy, two distinct mathematical models and a sensitivity analysis were employed. Results The sensitivity analyses conducted with the models reveals the potential for SIFs in Ottawa to be a fiscally responsible harm reduction strategy for the prevention of HCV cases – when considered independently. With a baseline sharing rate of 19%, the cumulative annual cost model supported the establishment of two SIFs and the marginal annual cost model supported the establishment of a single SIF. More often, the prevention of HIV or HCV alone were not sufficient to justify the establishment cost-effectiveness; rather, only when both HIV and HCV are considered does sufficient economic support became apparent. Conclusions Funded supervised injection facilities in Ottawa appear to be an efficient and effective use of financial resources in the public health domain. PMID:25091704

Use of information systems in Air Force medical treatment facilities in strategic planning and decision-making.

PubMed

Yap, Glenn A; Platonova, Elena A; Musa, Philip F

2006-02-01

An exploratory study used Ansoff's strategic planning model as a framework to assess perceived effectiveness of information systems in supporting strategic business plan development at Air Force medical treatment facilities (MTFs). Results showed information systems were most effective in supporting historical trend analysis, strategic business plans appeared to be a balance of operational and strategic plans, and facilities perceived a greater need for new clinical, vice administrative, information systems to support strategic planning processes. Administrators believed information systems should not be developed at the local level and perceived information systems have the greatest impact on improving clinical quality outcomes, followed by ability to deliver cost effective care and finally, ability to increase market share.

Comparison of mass balance, energy consumption and cost of composting facilities for different types of organic waste

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

Zhang Huijun; Matsuto, Toshihiko, E-mail: matsuto@eng.hokudai.ac.jp

2011-03-15

Mass balance, energy consumption and cost are basic pieces of information necessary for selecting a waste management technology. In this study, composting facilities that treat different types of organic waste were studied by questionnaire survey and via a chemical analysis of material collected at the facilities. The mass balance was calculated on a dry weight basis because the moisture content of organic waste was very high. Even though the ratio of bulking material to total input varied in the range 0-65% on a dry basis, the carbon and ash content, carbon/nitrogen ratio, heavy metal content and inorganic nutrients in themore » compost were clearly influenced by the different characteristics of the input waste. The use of bulking material was not correlated with ash or elemental content in the compost. The operating costs were categorised into two groups. There was some economy of scale for wages and maintenance cost, but the costs for electricity and fuel were proportional to the amount of waste. Differences in operating costs can be explained by differences in the process characteristics.« less

Facility Management as a Way of Reducing Costs in Transport Companies

NASA Astrophysics Data System (ADS)

Matusova, Dominika; Gogolova, Martina

2017-10-01

For facility management exists a several interpretations. These interpretations emerged progressively. At the time of the notion of facility management was designed to manage an administrative building, in the United States (US). They can ensure their operation and maintenance. From the US, this trend is further moved to Europe and now it start becoming a current and actual topic also in Slovakia. Facility management is contractually agreed scheme of services, semantically recalls traditional building management. There by finally pushed for activities related to real estates. For facility management is fundamental - certification and certification systems. Therefore, is essential to know, the cost structure of certification. The most commonly occurring austerity measures include: heat pumps, use of renewable energy, solar panels and water savings. These measures can reduce the cost.

Out-of-pocket costs for facility-based maternity care in three African countries.

PubMed

Perkins, Margaret; Brazier, Ellen; Themmen, Ellen; Bassane, Brahima; Diallo, Djeneba; Mutunga, Angeline; Mwakajonga, Tuntufye; Ngobola, Olipa

2009-07-01

OBJECTIVE To estimate out-of-pocket medical expenses to women and families for maternity care at all levels of the health system in Burkina Faso, Kenya and Tanzania. METHODS In a population-based survey in 2003, 6345 women who had given birth in the previous 24 months were interviewed about the costs incurred during childbirth. Three years later, in 2006, an additional 8302 women with recent deliveries were interviewed in the same districts to explore their maternity care-seeking experiences and associated costs. The majority of women interviewed reported paying out-of-pocket costs for facility-based deliveries. Out-of-pocket costs were highest in Kenya (a mean of US$18.4 for normal and complicated deliveries), where 98% of women who delivered in a health facility had to pay some fees. In Burkina Faso, 92% of women reported paying some fees (mean of US$7.9). Costs were lowest in Tanzania, where 91% of women reported paying some fees (mean of US$5.1). In all three countries, women in the poorest wealth quintile did not pay significantly less for maternity costs than the wealthiest women. Costs for complicated delivery were double those for normal delivery in Burkina Faso and Kenya, and represented more than 16% of mean monthly household income in Burkina Faso, and 35% in Kenya. In Tanzania and Burkina Faso most institutional births were at mid-level government health facilities (health centres or dispensaries). In contrast, in Kenya, 42% of births were at government hospitals, and 28% were at private or mission facilities, contributing to the overall higher costs in this country compared with Burkina Faso and Tanzania. However, among women delivering in government health facilities in Kenya, reported out-of-pocket costs were significantly lower in 2006 than in 2003, indicating that a 2004 national policy eliminating user fees at mid- and lower-level government health facilities was having some impact.

The cost-effectiveness of three methods of disseminating information to improve medical male circumcision in Uganda

PubMed Central

Karamagi, Esther; Kigonya, Angella; Lawino, Anna; Marquez, Lani; Lunsford, Sarah Smith; Twinomugisha, Albert

2018-01-01

Background Uganda is working to increase voluntary medical male circumcision (VMMC) to prevent HIV infection. To support VMMC quality improvement, this study compared three methods of disseminating information to facilities on how to improve VMMC quality: M—providing a written manual; MH—providing the manual plus a handover meeting in which clinicians shared advice on implementing key changes and participated in group discussion; and MHC—manual, handover meeting, and three site visits to the facility in which a coach provided individualized guidance and mentoring on improvement. We determined the different effects these had on compliance with indicators of quality of care. Methods This controlled pre-post intervention study randomized health facility groups to receive M, MH, or MHC. Observations of VMMCs performance determined compliance with quality indicators. Intervention costs per patient receiving VMMC were used in a decision-tree cost-effectiveness model to calculate the incremental cost per additional patient treated to compliance with indicators of informed consent, history taking, anesthesia administration, and post-operative instructions. Results The most intensive method (MHC) cost $28.83 per patient and produced the biggest gains in history taking (35% improvement), anesthesia administration (20% improvement), and post-operative instructions (37% improvement). The least intensive method (M; $1.13 per patient) was most efficient because it produced small gains for a very low cost. The handover meeting (MH) was the most expensive among the three interventions but did not have a corresponding positive effect on quality. Conclusion Health workers in facilities that received the VMMC improvement manual and participated in the handover meeting and coaching visits showed more improvement in VMMC quality indicators than those in the other two intervention groups. Providing the manual alone cost the least but was also the least effective in achieving

Comparative Costs and Staffing Report for Educational Facilities, 1997-1998.

ERIC Educational Resources Information Center

Glazner, Steve, Ed.

This report presents comparative data on facility management costs and staffing based on responses from 193 U.S. postsecondary educational facilities and K-12 institutions during 1997-98. It also lists data from both private and public institutions. Section 1 contains general data on the survey response tally and institutional profiles listed by…

Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

PubMed

Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

2017-06-01

Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

FEDFacts: Information about the Federal Electronic Docket Facilities

EPA Pesticide Factsheets

Cleanup status information related to Federal Facilities contained in EPA's Federal Agency Hazardous Waste Compliance Docket. Information includes maps, lists of facilities, dashboard view with graphs, links to community resources, and news items.

Health Facility Cost of Buruli Ulcer Wound Treatment in Ghana: A Case Study.

PubMed

Asare, Kofi Hene; Aikins, Moses

2014-09-01

To estimate the wound treatment cost borne by the Buruli Ulcer Treatment Centre of the Amasaman Government Hospital, Ghana. Three different types of data collection approaches were used, namely, 1) observation checklist, 2) in-depth interviews, and 3) expenditure data review. Wound dressing processes were observed. Retrospective health facility cost data of Buruli ulcer (BU) wound treatment for the year 2011 were used. Cost data gathered covered medical and nonmedical items. Cost analyses were carried out to determine the health facility's financial and economic costs. The total annual financial cost was US $121,189.16, of which 99% was recurrent cost. This constitutes about 13% of the expenditure by the Amasaman Government Hospital for the year 2011. The total annual economic cost was US $143,609.22, of which 93% was recurrent cost. The main cost driver for both financial and economic costs was personnel. The annual BU wound treatment costs per capita were US $1615.86 for financial cost and US $1914.79 for economic cost, respectively. The study did not cover household patient costs. The cost of BU wound treatment takes a considerable amount of the hospital's expenditure. This shows the importance of health facility cost as one of the decision-making tools for both resource allocation and mobilization. Hospital management must therefore constantly examine its staffing norms and the associated cost to improve the hospital's resource allocation. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Unifying cost and information in information-theoretic competitive learning.

PubMed

Kamimura, Ryotaro

2005-01-01

In this paper, we introduce costs into the framework of information maximization and try to maximize the ratio of information to its associated cost. We have shown that competitive learning is realized by maximizing mutual information between input patterns and competitive units. One shortcoming of the method is that maximizing information does not necessarily produce representations faithful to input patterns. Information maximizing primarily focuses on some parts of input patterns that are used to distinguish between patterns. Therefore, we introduce the cost, which represents average distance between input patterns and connection weights. By minimizing the cost, final connection weights reflect input patterns well. We applied the method to a political data analysis, a voting attitude problem and a Wisconsin cancer problem. Experimental results confirmed that, when the cost was introduced, representations faithful to input patterns were obtained. In addition, improved generalization performance was obtained within a relatively short learning time.

Cost analysis of a disaster facility at an apex tertiary care trauma center of India

PubMed Central

Singh, Sheetal; Gupta, Shakti; Daga, Anoop; Siddharth, Vijaydeep; Wundavalli, LaxmiTej

2016-01-01

Introduction: For the Commonwealth Games 2010, Jai Prakash Narayan Apex Trauma Centre (JPNATC) of India had been directed by the Director General Health Services and Ministry of Health and Family Welfare, Government of India, to set up a specialized unit for the definitive management of the injured/unwell athletes, officials, and related personnel coming for the Commonwealth Games in October 2010. The facility included a 20-bedded fully equipped ward, six ICU beds with ventilator capacity, one very very important person observation area, one perioperative management cubicle, and one fully modular and integrated operating room. Objective: The objective of this study was to calculate the cost of disaster facility at JPNATC, All India Institute of Medical Sciences, New Delhi. Methodology: Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of these services by this facility. Results: The annual cost of providing services at disaster facility at JPNATC, New Delhi, was calculated to be INR 61,007,334.08 (US$ 983,989.258) while the per hour cost was calculated to be INR 7061.03 of the total cost toward the provisioning of services by disaster facility where 26% was the capital cost and 74% was the operating cost. Human resource caters to maximum chunk of the expenditures (47%). Conclusion: The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 62 in the year 2013). PMID:27904258

Cost analysis of a disaster facility at an apex tertiary care trauma center of India.

PubMed

Singh, Sheetal; Gupta, Shakti; Daga, Anoop; Siddharth, Vijaydeep; Wundavalli, LaxmiTej

2016-01-01

For the Commonwealth Games 2010, Jai Prakash Narayan Apex Trauma Centre (JPNATC) of India had been directed by the Director General Health Services and Ministry of Health and Family Welfare, Government of India, to set up a specialized unit for the definitive management of the injured/unwell athletes, officials, and related personnel coming for the Commonwealth Games in October 2010. The facility included a 20-bedded fully equipped ward, six ICU beds with ventilator capacity, one very very important person observation area, one perioperative management cubicle, and one fully modular and integrated operating room. The objective of this study was to calculate the cost of disaster facility at JPNATC, All India Institute of Medical Sciences, New Delhi. Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of these services by this facility. The annual cost of providing services at disaster facility at JPNATC, New Delhi, was calculated to be INR 61,007,334.08 (US$ 983,989.258) while the per hour cost was calculated to be INR 7061.03 of the total cost toward the provisioning of services by disaster facility where 26% was the capital cost and 74% was the operating cost. Human resource caters to maximum chunk of the expenditures (47%). The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 62 in the year 2013).

Information security management system planning for CBRN facilities

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

Lenaeu, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.

The focus of this document is to provide guidance for the development of information security management system planning documents at chemical, biological, radiological, or nuclear (CBRN) facilities. It describes a risk-based approach for planning information security programs based on the sensitivity of the data developed, processed, communicated, and stored on facility information systems.

Cost-effectiveness of essential newborn care training in urban first-level facilities.

PubMed

Manasyan, Albert; Chomba, Elwyn; McClure, Elizabeth M; Wright, Linda L; Krzywanski, Sara; Carlo, Waldemar A

2011-05-01

To determine the cost-effectiveness of the World Health Organization (WHO) Essential Newborn Care (ENC) training of health care providers in first-level facilities in the 2 largest cities in Zambia. Data were extracted from a study in which the effectiveness of the ENC training was evaluated (including universal precautions and cleanliness, routine neonatal care, resuscitation, thermoregulation, breastfeeding, skin-to-skin care, care of the small infant, danger signs, and common illnesses). The costs to train an ENC instructor for each first-level delivery facility and the costs of salary/benefits for 2 coordinators responsible for maintenance of the program were recorded in 2005 US dollars. The incremental costs per life gained and per disability-adjusted life-year averted were calculated. A 5-day ENC training-of-trainers was conducted in Lusaka, Zambia, to certify 18 college-trained midwives as ENC instructors. The instructors trained all clinic midwives working in their first-level facilities as part of a before-and-after study of the effect of ENC training on early neonatal mortality conducted from Oct 2004 to Nov 2006. All-cause 7-day (early) neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 live births after ENC training of the clinic midwives (relative risk: 0.59; 95% confidence interval: 0.48-0.77; P < .001; 40 615 births). The intervention costs were $208 per life saved and $5.24 per disability-adjusted life-year averted. ENC training of clinic midwives who provide care in low-risk facilities is a low-cost intervention that can reduce early neonatal mortality in these settings.

Lead Coolant Test Facility Systems Design, Thermal Hydraulic Analysis and Cost Estimate

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

Soli Khericha; Edwin Harvego; John Svoboda

2012-01-01

The Idaho National Laboratory prepared a preliminary technical and functional requirements (T&FR), thermal hydraulic design and cost estimate for a lead coolant test facility. The purpose of this small scale facility is to simulate lead coolant fast reactor (LFR) coolant flow in an open lattice geometry core using seven electrical rods and liquid lead or lead-bismuth eutectic coolant. Based on review of current world lead or lead-bismuth test facilities and research needs listed in the Generation IV Roadmap, five broad areas of requirements were identified as listed: (1) Develop and Demonstrate Feasibility of Submerged Heat Exchanger; (2) Develop and Demonstratemore » Open-lattice Flow in Electrically Heated Core; (3) Develop and Demonstrate Chemistry Control; (4) Demonstrate Safe Operation; and (5) Provision for Future Testing. This paper discusses the preliminary design of systems, thermal hydraulic analysis, and simplified cost estimate. The facility thermal hydraulic design is based on the maximum simulated core power using seven electrical heater rods of 420 kW; average linear heat generation rate of 300 W/cm. The core inlet temperature for liquid lead or Pb/Bi eutectic is 4200 C. The design includes approximately seventy-five data measurements such as pressure, temperature, and flow rates. The preliminary estimated cost of construction of the facility is $3.7M (in 2006 $). It is also estimated that the facility will require two years to be constructed and ready for operation.« less

10 CFR 60.47 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Facility information and verification. 60.47 Section 60.47 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES Licenses Us/iaea Safeguards Agreement § 60.47 Facility information and verification. (a) In...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Facility information and verification. 61.32 Section 61.32 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Facility information and verification. 61.32 Section 61.32 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Facility information and verification. 61.32 Section 61.32 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In...

COSTS OF URBAN STORMWATER CONTROL

EPA Science Inventory

This report presents information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these studies was collected,...

Cost (non)-recovery by platform technology facilities in the Bio21 Cluster.

PubMed

Gibbs, Gerard; Clark, Stella; Quinn, Julieanne; Gleeson, Mary Joy

2010-04-01

Platform technologies (PT) are techniques or tools that enable a range of scientific investigations and are critical to today's advanced technology research environment. Once installed, they require specialized staff for their operations, who in turn, provide expertise to researchers in designing appropriate experiments. Through this pipeline, research outputs are raised to the benefit of the researcher and the host institution. Platform facilities provide access to instrumentation and expertise for a wide range of users beyond the host institution, including other academic and industry users. To maximize the return on these substantial public investments, this wider access needs to be supported. The question of support and the mechanisms through which this occurs need to be established based on a greater understanding of how PT facilities operate. This investigation was aimed at understanding if and how platform facilities across the Bio21 Cluster meet operating costs. Our investigation found: 74% of platforms surveyed do not recover 100% of direct operating costs and are heavily subsidized by their home institution, which has a vested interest in maintaining the technology platform; platform managers play a major role in establishing the costs and pricing of the facility, normally in a collaborative process with a management committee or institutional accountant; and most facilities have a three-tier pricing structure recognizing internal academic, external academic, and commercial clients.

Cost (Non)-Recovery by Platform Technology Facilities in the Bio21 Cluster

PubMed Central

Gibbs, Gerard; Clark, Stella; Quinn, JulieAnne; Gleeson, Mary Joy

2010-01-01

Platform technologies (PT) are techniques or tools that enable a range of scientific investigations and are critical to today's advanced technology research environment. Once installed, they require specialized staff for their operations, who in turn, provide expertise to researchers in designing appropriate experiments. Through this pipeline, research outputs are raised to the benefit of the researcher and the host institution.1 Platform facilities provide access to instrumentation and expertise for a wide range of users beyond the host institution, including other academic and industry users. To maximize the return on these substantial public investments, this wider access needs to be supported. The question of support and the mechanisms through which this occurs need to be established based on a greater understanding of how PT facilities operate. This investigation was aimed at understanding if and how platform facilities across the Bio21 Cluster meet operating costs. Our investigation found: 74% of platforms surveyed do not recover 100% of direct operating costs and are heavily subsidized by their home institution, which has a vested interest in maintaining the technology platform; platform managers play a major role in establishing the costs and pricing of the facility, normally in a collaborative process with a management committee or institutional accountant; and most facilities have a three-tier pricing structure recognizing internal academic, external academic, and commercial clients. PMID:20357980

COSTS OF URBAN STORMWATER CONTROL

EPA Science Inventory

This paper presents information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these studies was collected, r...

Delivering information: a descriptive study of Australian women's information needs for decision-making about birth facility.

PubMed

Thompson, Rachel; Wojcieszek, Aleena M

2012-06-18

Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women's recommendations about the facility, freedom to choose one's preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities.

Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost

PubMed Central

Sheffer, Christine; Stitzer, Maxine; Wheeler, J. Gary

2009-01-01

Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113) were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10–50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change. PMID:19440281

Value Engineering. "A Working Tool for Cost Control in the Design of Educational Facilities."

ERIC Educational Resources Information Center

Lawrence, Jerry

Value Engineering (VE) is a cost optimizing technique used to analyze design quality and cost-effectiveness. The application of VE procedures to the design and construction of school facilities has been adopted by the state of Washington. By using VE, the optimum value for every life cycle dollar spent on a facility is obtained by identifying not…

Budgeting Facilities Operation Costs Using the Facilities Operation Model

DTIC Science & Technology

2011-06-01

practices that today’s modern buildings have built into them. Several factors can change from the time the requirement is generated to when actual...information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and...BOS required $4.2 billion.2 In FY2012, it is estimated it will reach $4.6 billion.3 Unlike sustainment and modernization , failure to fund facility

Clinicians' views on displaying cost information to increase clinician cost-consciousness.

PubMed

Kruger, Jenna F; Chen, Alice Hm; Rybkin, Alex; Leeds, Kiren; Frosch, Dominick L; Goldman, Elizabeth

2014-01-01

To evaluate 1) clinician attitudes towards incorporating cost information into decision making when ordering imaging studies; and 2) clinician reactions to the display of Medicare reimbursement information for imaging studies at clinician electronic order entry. Focus group study with inductive thematic analysis. We conducted focus groups of primary care clinicians and subspecialty physicians (nephrology, pulmonary, and neurology) (N = 50) who deliver outpatient care in 12 hospital-based clinics and community health centers in an urban safety net health system. We analyzed focus group transcripts using an inductive framework to identify emergent themes and illustrative quotations. Clinicians believed that their knowledge of healthcare costs was low and wanted access to relevant cost information for reference. However, many clinicians believed it was inappropriate and unethical to consider costs in individual patient care decisions. Among clinicians' negative reactions toward displaying costs at order entry, 4 underlying themes emerged: 1) belief that ordering is already limited to clinically necessary tests; 2) importance of prioritizing responsibility to patients above that to the healthcare system; 3) concern about worsening healthcare disparities; and 4) perceived lack of accountability for healthcare costs in the system. Although clinicians want relevant cost information, many voiced concerns about displaying cost information at clinician order entry in safety net health systems. Alternative approaches to increasing cost-consciousness may be more acceptable to clinicians.

Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

PubMed

Potančok, Martin; Voříšek, Jiří

2016-09-01

Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making. © The Author(s) 2015.

Cost analysis of routine immunisation in Zambia.

PubMed

Schütte, Carl; Chansa, Collins; Marinda, Edmore; Guthrie, Teresa A; Banda, Stanley; Nombewu, Zipozihle; Motlogelwa, Katlego; Lervik, Marita; Brenzel, Logan; Kinghorn, Anthony

2015-05-07

This study aimed to inform planning and funding by providing updated, detailed information on total and unit costs of routine immunisation (RI) in Zambia, a GAVI-eligible lower middle-income country with a population of 13 million. The exercise was part of a multi-country study on costs and financing of routine immunisation (EPIC) that utilized a common, ingredients-based approach to costing. Data on inputs, prices and outputs were collected in a stratified, random sample of 51 facilities in nine districts between December 2012 and March 2013 using a pre-tested questionnaire. Shared inputs were allocated to RI costs on the basis of tracing factors developed for the study. A comprehensive set of costs were analysed to obtain total and unit costs, at facility and above-facility levels. The total annual economic cost of RI was $38.16 million, equivalent to approximately 10% of government health spending. Government contributed 83% of finances. Labour accounted for the lion's share (49%) of total costs followed by vaccines (16%) and travel allowances (12%). Analysis of specific activity costs showed that outreach and facility-based services accounted for half of total economic costs. Costs for managing the program at district, provincial and national levels (above-facility costs) represented 24% of total costs. Average unit costs were $7.18 per dose, $59.32 per infant and $65.89 per DPT3 immunised child, with markedly higher unit costs in rural facilities. Analyses suggest that greater efficiency is associated with higher utilisation levels and urban facility type. Total and unit costs, and government's contribution, were considerably higher than previous Zambian estimates and international benchmarks. These findings have substantial implications for planners, efficiency improvement and sustainable financing, particularly as new vaccines are introduced. Variations in immunisation costs at facility level warrant further statistical analyses. Copyright © 2015 Elsevier

PIMS sequencing extension: a laboratory information management system for DNA sequencing facilities

PubMed Central

2011-01-01

Background Facilities that provide a service for DNA sequencing typically support large numbers of users and experiment types. The cost of services is often reduced by the use of liquid handling robots but the efficiency of such facilities is hampered because the software for such robots does not usually integrate well with the systems that run the sequencing machines. Accordingly, there is a need for software systems capable of integrating different robotic systems and managing sample information for DNA sequencing services. In this paper, we describe an extension to the Protein Information Management System (PIMS) that is designed for DNA sequencing facilities. The new version of PIMS has a user-friendly web interface and integrates all aspects of the sequencing process, including sample submission, handling and tracking, together with capture and management of the data. Results The PIMS sequencing extension has been in production since July 2009 at the University of Leeds DNA Sequencing Facility. It has completely replaced manual data handling and simplified the tasks of data management and user communication. Samples from 45 groups have been processed with an average throughput of 10000 samples per month. The current version of the PIMS sequencing extension works with Applied Biosystems 3130XL 96-well plate sequencer and MWG 4204 or Aviso Theonyx liquid handling robots, but is readily adaptable for use with other combinations of robots. Conclusions PIMS has been extended to provide a user-friendly and integrated data management solution for DNA sequencing facilities that is accessed through a normal web browser and allows simultaneous access by multiple users as well as facility managers. The system integrates sequencing and liquid handling robots, manages the data flow, and provides remote access to the sequencing results. The software is freely available, for academic users, from http://www.pims-lims.org/. PMID:21385349

PIMS sequencing extension: a laboratory information management system for DNA sequencing facilities.

PubMed

Troshin, Peter V; Postis, Vincent Lg; Ashworth, Denise; Baldwin, Stephen A; McPherson, Michael J; Barton, Geoffrey J

2011-03-07

Facilities that provide a service for DNA sequencing typically support large numbers of users and experiment types. The cost of services is often reduced by the use of liquid handling robots but the efficiency of such facilities is hampered because the software for such robots does not usually integrate well with the systems that run the sequencing machines. Accordingly, there is a need for software systems capable of integrating different robotic systems and managing sample information for DNA sequencing services. In this paper, we describe an extension to the Protein Information Management System (PIMS) that is designed for DNA sequencing facilities. The new version of PIMS has a user-friendly web interface and integrates all aspects of the sequencing process, including sample submission, handling and tracking, together with capture and management of the data. The PIMS sequencing extension has been in production since July 2009 at the University of Leeds DNA Sequencing Facility. It has completely replaced manual data handling and simplified the tasks of data management and user communication. Samples from 45 groups have been processed with an average throughput of 10000 samples per month. The current version of the PIMS sequencing extension works with Applied Biosystems 3130XL 96-well plate sequencer and MWG 4204 or Aviso Theonyx liquid handling robots, but is readily adaptable for use with other combinations of robots. PIMS has been extended to provide a user-friendly and integrated data management solution for DNA sequencing facilities that is accessed through a normal web browser and allows simultaneous access by multiple users as well as facility managers. The system integrates sequencing and liquid handling robots, manages the data flow, and provides remote access to the sequencing results. The software is freely available, for academic users, from http://www.pims-lims.org/.

The ICCB Computer Based Facilities Inventory & Utilization Management Information Subsystem.

ERIC Educational Resources Information Center

Lach, Ivan J.

The Illinois Community College Board (ICCB) Facilities Inventory and Utilization subsystem, a part of the ICCB management information system, was designed to provide decision makers with needed information to better manage the facility resources of Illinois community colleges. This subsystem, dependent upon facilities inventory data and course…

Delivering information: A descriptive study of Australian women’s information needs for decision-making about birth facility

PubMed Central

2012-01-01

Background Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Methods Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. Results On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women’s recommendations about the facility, freedom to choose one’s preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. Conclusions The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities. PMID:22708648

Space Station Furnace Facility. Volume 3: Program cost estimate

NASA Technical Reports Server (NTRS)

1992-01-01

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

Cost Implications of an Interim Storage Facility in the Waste Management System

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

Jarrell, Joshua J.; Joseph, III, Robert Anthony; Howard, Rob L

2016-09-01

This report provides an evaluation of the cost implications of incorporating a consolidated interim storage facility (ISF) into the waste management system (WMS). Specifically, the impacts of the timing of opening an ISF relative to opening a repository were analyzed to understand the potential effects on total system costs.

Optimal pricing policies for services with consideration of facility maintenance costs

NASA Astrophysics Data System (ADS)

Yeh, Ruey Huei; Lin, Yi-Fang

2012-06-01

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

12 CFR 1010.114 - Recreational facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association assessment, and the developer's maintenance assessment. If the cost information is lengthy, you may use an asterisk or other appropriate...

12 CFR 1010.114 - Recreational facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association assessment, and the developer's maintenance assessment. If the cost information is lengthy, you may use an asterisk or other appropriate...

12 CFR 1010.114 - Recreational facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association assessment, and the developer's maintenance assessment. If the cost information is lengthy, you may use an asterisk or other appropriate...

The Benefits of Guided Facility Self-Assessments

ERIC Educational Resources Information Center

O'Leary, Keith

2012-01-01

A growing number of educational institutions have discovered that a guided self-assessment solution helps them to consistently and cost-effectively obtain facility condition information and make better-informed capital planning decisions. Facility self-assessment employs a consistent, repeatable process for internal staff to quickly assess assets…

To Build or Not to Build: Addressing Facilities Needs While Controlling Costs

ERIC Educational Resources Information Center

Kadamus, James A.

2015-01-01

When trustees, presidents, and senior college administrators meet, one topic dominates the conversation: how to keep education quality high and costs down. To keep quality high, college leaders need to have strong faculties and state-of-the-art facilities for teaching and research. Quality counts but it also costs, and that is where the pressures…

9 CFR 93.309 - Horse quarantine facilities; payment information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Horse quarantine facilities; payment...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Horses § 93.309 Horse quarantine facilities; payment information. (a) Privately operated quarantine facilities. The importer, or his or her agent, of...

9 CFR 93.309 - Horse quarantine facilities; payment information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Horse quarantine facilities; payment...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Horses § 93.309 Horse quarantine facilities; payment information. (a) Privately operated quarantine facilities. The importer, or his or her agent, of...

9 CFR 93.309 - Horse quarantine facilities; payment information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Horse quarantine facilities; payment...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Horses § 93.309 Horse quarantine facilities; payment information. (a) Privately operated quarantine facilities. The importer, or his or her agent, of...

9 CFR 93.309 - Horse quarantine facilities; payment information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Horse quarantine facilities; payment...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Horses § 93.309 Horse quarantine facilities; payment information. (a) Privately operated quarantine facilities. The importer, or his or her agent, of...

9 CFR 93.309 - Horse quarantine facilities; payment information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Horse quarantine facilities; payment...; REQUIREMENTS FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Horses § 93.309 Horse quarantine facilities; payment information. (a) Privately operated quarantine facilities. The importer, or his or her agent, of...

76 FR 6516 - Insurance Cost Information Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

...-0009] Insurance Cost Information Regulation AGENCY: National Highway Traffic Safety Administration... 2011 text and data for the annual insurance cost information booklet that all car dealers must make available to prospective purchasers, pursuant to 49 CFR 582.4. This information is intended to assist...

Process cost and facility considerations in the selection of primary cell culture clarification technology.

PubMed

Felo, Michael; Christensen, Brandon; Higgins, John

2013-01-01

The bioreactor volume delineating the selection of primary clarification technology is not always easily defined. Development of a commercial scale process for the manufacture of therapeutic proteins requires scale-up from a few liters to thousands of liters. While the separation techniques used for protein purification are largely conserved across scales, the separation techniques for primary cell culture clarification vary with scale. Process models were developed to compare monoclonal antibody production costs using two cell culture clarification technologies. One process model was created for cell culture clarification by disc stack centrifugation with depth filtration. A second process model was created for clarification by multi-stage depth filtration. Analyses were performed to examine the influence of bioreactor volume, product titer, depth filter capacity, and facility utilization on overall operating costs. At bioreactor volumes <1,000 L, clarification using multi-stage depth filtration offers cost savings compared to clarification using centrifugation. For bioreactor volumes >5,000 L, clarification using centrifugation followed by depth filtration offers significant cost savings. For bioreactor volumes of ∼ 2,000 L, clarification costs are similar between depth filtration and centrifugation. At this scale, factors including facility utilization, available capital, ease of process development, implementation timelines, and process performance characterization play an important role in clarification technology selection. In the case study presented, a multi-product facility selected multi-stage depth filtration for cell culture clarification at the 500 and 2,000 L scales of operation. Facility implementation timelines, process development activities, equipment commissioning and validation, scale-up effects, and process robustness are examined. © 2013 American Institute of Chemical Engineers.

Facilities Management via Computer: Information at Your Fingertips.

ERIC Educational Resources Information Center

Hensey, Susan

1996-01-01

Computer-aided facilities management is a software program consisting of a relational database of facility information--such as occupancy, usage, student counts, etc.--attached to or merged with computerized floor plans. This program can integrate data with drawings, thereby allowing the development of "what if" scenarios. (MLF)

Information Technology and the Human Research Facility

NASA Technical Reports Server (NTRS)

Klee, Margaret

2002-01-01

This slide presentation reviews how information technology supports the Human Research Facility (HRF) and specifically the uses that contractor has for the information. There is information about the contractor, the HRF, some of the experiments that were performed using the HRF on board the Shuttle, overviews of the data architecture, and software both commercial and specially developed software for the specific experiments.

Experiments, conceptual design, preliminary cost estimates and schedules for an underground research facility

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

Korbin, G.; Wollenberg, H.; Wilson, C.

Plans for an underground research facility are presented, incorporating techniques to assess the hydrological and thermomechanical response of a rock mass to the introduction and long-term isolation of radioactive waste, and to assess the effects of excavation on the hydrologic integrity of a repository and its subsequent backfill, plugging, and sealing. The project is designed to utilize existing mine or civil works for access to experimental areas and is estimated to last 8 years at a total cost for contruction and operation of $39.0 million (1981 dollars). Performing the same experiments in an existing underground research facility would reduce themore » duration to 7-1/2 years and cost $27.7 million as a lower-bound estimate. These preliminary plans and estimates should be revised after specific sites are identified which would accommodate the facility.« less

An inventory of aeronautical ground research facilities. Volume 4: Engineering flight simulation facilities

NASA Technical Reports Server (NTRS)

Pirrello, C. J.; Hardin, R. D.; Capelluro, L. P.; Harrison, W. D.

1971-01-01

The general purpose capabilities of government and industry in the area of real time engineering flight simulation are discussed. The information covers computer equipment, visual systems, crew stations, and motion systems, along with brief statements of facility capabilities. Facility construction and typical operational costs are included where available. The facilities provide for economical and safe solutions to vehicle design, performance, control, and flying qualities problems of manned and unmanned flight systems.

10 CFR 50.78 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Facility information and verification. 50.78 Section 50.78 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Us/iaea... International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US/IAEA Safeguards...

10 CFR 50.78 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Facility information and verification. 50.78 Section 50.78 Energy NUCLEAR REGULATORY COMMISSION DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES Us/iaea... International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US/IAEA Safeguards...

Summary of Information and Resources Related to Energy Use in Healthcare Facilities - Version 1

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

Singer, Brett C.; Coughlin, Jennifer L.; Mathew, Paul A.

This document presents the results of a review of publicly available information on energy use in health care facilities. The information contained in this document and in the sources cited herein provides the background and context for efforts to reduce energy use and costs in health care. Recognizing the breadth and diversity of relevant information, the author acknowledges that the report is likely not comprehensive. It is intended only to present a broad picture of what is currently known about health care energy use. This review was conducted as part of a 'High Performance Health Care Buildings' research study fundedmore » by the California Energy Commission. The study was motivated by the recognition that health care facilities collectively account for a substantial fraction of total commercial building energy use, due in large part to the very high energy intensity of hospitals and other inpatient care facilities. The goal of the study was to develop a roadmap of research, development and deployment (RD&D) needs for the health care industry. In addition to this information review, the road map development process included interviews with industry experts and a full-day workshop at LBNL in March 2009. This report is described as 'Version 1' with the intent that it will be expanded and updated as part of an ongoing LBNL program in healthcare energy efficiency. The document is being released in this form with the hope that it can assist others in finding and accessing the resources described within.« less

Shared use of school facilities with community organizations and afterschool physical activity program participation: a cost-benefit assessment.

PubMed

Kanters, Michael A; Bocarro, Jason N; Filardo, Mary; Edwards, Michael B; McKenzie, Thomas L; Floyd, Myron F

2014-05-01

Partnerships between school districts and community-based organizations to share school facilities during afterschool hours can be an effective strategy for increasing physical activity. However, the perceived cost of shared use has been noted as an important reason for restricting community access to schools. This study examined shared use of middle school facilities, the amount and type of afterschool physical activity programs provided at middle schools together with the costs of operating the facilities. Afterschool programs were assessed for frequency, duration, and type of structured physical activity programs provided and the number of boys and girls in each program. School operating costs were used to calculate a cost per student and cost per building square foot measure. Data were collected at all 30 middle schools in a large school district over 12 months in 2010-2011. Policies that permitted more use of school facilities for community-sponsored programs increased participation in afterschool programs without a significant increase in operating expenses. These results suggest partnerships between schools and other community agencies to share facilities and create new opportunities for afterschool physical activity programs are a promising health promotion strategy. © 2014, American School Health Association.

Cost and quality of life analysis of HIV self-testing and facility-based HIV testing and counselling in Blantyre, Malawi.

PubMed

Maheswaran, Hendramoorthy; Petrou, Stavros; MacPherson, Peter; Choko, Augustine T; Kumwenda, Felistas; Lalloo, David G; Clarke, Aileen; Corbett, Elizabeth L

2016-02-19

HIV self-testing (HIVST) has been found to be highly effective, but no cost analysis has been undertaken to guide the design of affordable and scalable implementation strategies. Consecutive HIV self-testers and facility-based testers were recruited from participants in a community cluster-randomised trial ( ISRCTN02004005 ) investigating the impact of offering HIVST in addition to facility-based HIV testing and counselling (HTC). Primary costing studies were undertaken of the HIVST service and of health facilities providing HTC to the trial population. Costs were adjusted to 2014 US$ and INT$. Recruited participants were asked about direct non-medical and indirect costs associated with accessing either modality of HIV testing, and additionally their health-related quality of life was measured using the EuroQol EQ-5D. A total of 1,241 participants underwent either HIVST (n = 775) or facility-based HTC (n = 446). The mean societal cost per participant tested through HIVST (US$9.23; 95 % CI: US$9.14-US$9.32) was lower than through facility-based HTC (US$11.84; 95 % CI: US$10.81-12.86). Although the mean health provider cost per participant tested through HIVST (US$8.78) was comparable to facility-based HTC (range: US$7.53-US$10.57), the associated mean direct non-medical and indirect cost was lower (US$2.93; 95 % CI: US$1.90-US$3.96). The mean health provider cost per HIV positive participant identified through HIVST was higher (US$97.50) than for health facilities (range: US$25.18-US$76.14), as was the mean cost per HIV positive individual assessed for anti-retroviral treatment (ART) eligibility and the mean cost per HIV positive individual initiated onto ART. In comparison to the facility-testing group, the adjusted mean EQ-5D utility score was 0.046 (95 % CI: 0.022-0.070) higher in the HIVST group. HIVST reduces the economic burden on clients, but is a costlier strategy for the health provider aiming to identify HIV positive individuals for treatment. The

Safety Information, Transportation & Public Facilities, State of Alaska

Science.gov Websites

Department of Transportation & Public Facilities/ Safety Information Search DOT&PF State of Alaska DOT&PF> Safety Information DOT&PF Safety Information link to 511 511.alaska.gov - Traveler Information link to AHSO Alaska Highway Safety Office link to HSIP Highway Safety Improvement Program link to

Activity-based costing of health-care delivery, Haiti.

PubMed

McBain, Ryan K; Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient's medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated.

Counting the cost of not costing HIV health facilities accurately: pay now, or pay more later.

PubMed

Beck, Eduard J; Avila, Carlos; Gerbase, Sofia; Harling, Guy; De Lay, Paul

2012-10-01

The HIV pandemic continues to be one of our greatest contemporary public health threats. Policy makers in many middle- and low-income countries are in the process of scaling up HIV prevention, treatment and care services in the context of a reduction in international HIV funding due to the global economic downturn. In order to scale up services that are sustainable in the long term, policy makers and implementers need to have access to robust and contemporary strategic information, including financial information on expenditure and cost, in order to be able to plan, implement, monitor and evaluate HIV services. A major problem in middle- and low-income countries continues to be a lack of basic information on the use of services, their cost, outcome and impact, while those few costing studies that have been performed were often not done in a standardized fashion. Some researchers handle this by transposing information from one country to another, developing mathematical or statistical models that rest on assumptions or information that may not be applicable, or using top-down costing methods that only provide global financial costs rather than using bottom-up ingredients-based costing. While these methods provide answers in the short term, countries should develop systematic data collection systems to store, transfer and produce robust and contemporary strategic financial information for stakeholders at local, sub-national and national levels. National aggregated information should act as the main source of financial data for international donors, agencies or other organizations involved with the global HIV response. This paper describes the financial information required by policy makers and other stakeholders to enable them to make evidence-informed decisions and reviews the quantity and quality of the financial information available, as indicated by cost studies published between 1981 and 2008. Among the lessons learned from reviewing these studies, a need was

Nursing Information Flow in Long-Term Care Facilities.

PubMed

Wei, Quan; Courtney, Karen L

2018-04-01

 Long-term care (LTC), residential care requiring 24-hour nursing services, plays an important role in the health care service delivery system. The purpose of this study was to identify the needed clinical information and information flow to support LTC Registered Nurses (RNs) in care collaboration and clinical decision making.  This descriptive qualitative study combines direct observations and semistructured interviews, conducted at Alberta's LTC facilities between May 2014 and August 2015. The constant comparative method (CCM) of joint coding was used for data analysis.  Nine RNs from six LTC facilities participated in the study. The RN practice environment includes two essential RN information management aspects: information resources and information spaces. Ten commonly used information resources by RNs included: (1) RN-personal notes; (2) facility-specific templates/forms; (3) nursing processes/tasks; (4) paper-based resident profile; (5) daily care plans; (6) RN-notebooks; (7) medication administration records (MARs); (8) reporting software application (RAI-MDS); (9) people (care providers); and (10) references (i.e., books). Nurses used a combination of shared information spaces, such as the Nurses Station or RN-notebook, and personal information spaces, such as personal notebooks or "sticky" notes. Four essential RN information management functions were identified: collection, classification, storage, and distribution. Six sets of information were necessary to perform RN care tasks and communication, including: (1) admission, discharge, and transfer (ADT); (2) assessment; (3) care plan; (4) intervention (with two subsets: medication and care procedure); (5) report; and (6) reference. Based on the RN information management system requirements, a graphic information flow model was constructed.  This baseline study identified key components of a current LTC nursing information management system. The information flow model may assist health information

Costing Information Services

PubMed Central

Lutz, Raymond P.

1971-01-01

Information centers are being established for many disciplines. For the medical profession, users can benefit directly from these centers by having information searched by medical library professionals and readily available. If the users of an information system are to share in the operating expenses, some equitable system of charges must be established. The numerous systems of establishing user charges are listed and discussed, with the advantages or disadvantages of each system explained. After the systems have been reviewed, alternative methods of establishing prices are presented along with a typical example of what these prices might be, ranging from $7.50 to $2.50 per request. The implementation of the cost system is outlined and certain philosophical questions are posed. PMID:5582090

Estimating costs of programme services and products using information provided in standard financial statements.

PubMed

Ellwein, L B; Thulasiraj, R D; Boulter, A R; Dhittal, S P

1998-01-01

The financial viability of programme services and product offerings requires that revenue exceeds expenses. Revenue includes payments for services and products as well as donor cash and in-kind contributions. Expenses reflect consumption of purchased or contributed time and materials and utilization (depreciation) of physical plant facilities and equipment. Standard financial reports contain this revenue and expense information, complemented when necessary by valuation and accounting of in-kind contributions. Since financial statements are prepared using consistent and accepted accounting practices, year-to-year and organization-to-organization comparisons can be made. The use of such financial information is illustrated in this article by determining the unit cost of cataract surgery in two hospitals in Nepal. The proportion of unit cost attributed to personnel, medical supplies, administrative materials, and depreciation varied significantly by institution. These variations are accounted for by examining differences in operational structure and capacity utilization.

Estimating costs of programme services and products using information provided in standard financial statements.

PubMed Central

Ellwein, L. B.; Thulasiraj, R. D.; Boulter, A. R.; Dhittal, S. P.

1998-01-01

The financial viability of programme services and product offerings requires that revenue exceeds expenses. Revenue includes payments for services and products as well as donor cash and in-kind contributions. Expenses reflect consumption of purchased or contributed time and materials and utilization (depreciation) of physical plant facilities and equipment. Standard financial reports contain this revenue and expense information, complemented when necessary by valuation and accounting of in-kind contributions. Since financial statements are prepared using consistent and accepted accounting practices, year-to-year and organization-to-organization comparisons can be made. The use of such financial information is illustrated in this article by determining the unit cost of cataract surgery in two hospitals in Nepal. The proportion of unit cost attributed to personnel, medical supplies, administrative materials, and depreciation varied significantly by institution. These variations are accounted for by examining differences in operational structure and capacity utilization. PMID:9868836

Information technology systems in public sector health facilities in developing countries: the case of South Africa

PubMed Central

2013-01-01

Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation. PMID:23347433

Information technology systems in public sector health facilities in developing countries: the case of South Africa.

PubMed

Cline, Gregory B; Luiz, John M

2013-01-24

The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

6 CFR 27.200 - Information regarding security risk for a chemical facility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Information regarding security risk for a chemical facility. 27.200 Section 27.200 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.200 Information...

Feasibility Investigation for a Solar Power Generation Facility

NASA Technical Reports Server (NTRS)

Nathan, Lakshmi

2010-01-01

The Energy Policy Act of 2005 states that by fiscal year 2013, at least 7.5% of the energy consumed by the government must be renewable energy. In an effort to help meet this goal, Johnson Space Center (JSC) is considering installing a solar power generation facility. The purpose of this project is to conduct a feasibility investigation for such a facility. Because Kennedy Space Center (KSC) has a solar power generation facility, the first step in this investigation is to learn about KSC's facility and obtain information on how it was constructed. After collecting this information, the following must be determined: the amount of power desired, the size of the facility, potential locations for it, and estimated construction and maintenance costs. Contacts with JSC's energy provider must also be established to determine if a partnership would be agreeable to both parties. Lastly, all of this data must be analyzed to decide whether or not JSC should construct the facility. The results from analyzing the data collected indicate that a 200 kW facility would provide enough energy to meet 1% of JSC's energy demand. This facility would require less than 1 acre of land. In the map below, potential locations are shown in green. The solar power facility is projected to cost $2 M. So far, the information collected indicates that such a facility could be constructed. The next steps in this investigation include contacting JSC's energy provider, CenterPoint Energy, to discuss entering a partnership; developing a life cycle cost analysis to determine payback time; developing more detailed plans; and securing funding.

Cost-analysis of teledentistry in residential aged care facilities.

PubMed

Mariño, Rodrigo; Tonmukayakul, Utsana; Manton, David; Stranieri, Andrew; Clarke, Ken

2016-09-01

The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional. It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident. Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination. © The Author(s) 2015.

A facility monitoring system: The single most valuable and cost-effective tool available to an energy manager

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

Holmes, W.A.

Energy engineering and management combines engineering problem-solving and financial management techniques to reduce utility costs. At present, substantial amounts of time and money are being spent in order to attempt to quantify energy consumption and costs and define opportunities for savings. Unfortunately, accurate verification of results is often overlooked. Advances in technology during the last few years have made the installation of a permanent, PC-based monitoring system possible for any facility, often for no more than the cost of a detailed study. By investing initially in a monitoring system rather than audits or studies, the actual consumption and cost datamore » will be available on a continuing basis and can be used to produce immediate operational savings, more accurately analyze opportunities requiring capital investments, and to verify actual savings resulting from changes. A permanent monitoring system, installed as the first step in a utility cost reduction effort, to identify where and how energy is used in a facility on a dynamic and real-time basis, can provide the most valuable and cost-effective tool available to an energy manager. The resulting data allows energy consumption patterns and utility costs to be understood and managed in the same manner as all other costs within a facility.« less

Activity-based costing of health-care delivery, Haiti

PubMed Central

Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

Abstract Objective To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Methods Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient’s medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Findings Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Conclusion Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated. PMID:29403096

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

NASA Astrophysics Data System (ADS)

Cope, Robert Frank, III

1998-12-01

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

Telepsychiatry in correctional facilities: using technology to improve access and decrease costs of mental health care in underserved populations.

PubMed

Deslich, Stacie Anne; Thistlethwaite, Timothy; Coustasse, Alberto

2013-01-01

It is unclear if telepsychiatry, a subset of telemedicine, increases access to mental health care for inmates in correctional facilities or decreases costs for clinicians or facility administrators. The purpose of this investigation was to determine how utilization of telepsychiatry affected access to care and costs of providing mental health care in correctional facilities. A literature review complemented by a semistructured interview with a telepsychiatry practitioner. Five electronic databases, the National Bureau of Justice, and the American Psychiatric Association Web sites were searched for this research, and 49 sources were referenced. The literature review examined implementation of telepsychiatry in correctional facilities in Arizona, California, Georgia, Kansas, Ohio, Texas, and West Virginia to determine the effect of telepsychiatry on inmate access to mental health services and the costs of providing mental health care in correctional facilities. Telepsychiatry provided improved access to mental health services for inmates, and this increase in access is through the continuum of mental health care, which has been instrumental in increasing quality of care for inmates. Use of telepsychiatry saved correctional facilities from $12,000 to more than $1 million. The semistructured interview with the telepsychiatry practitioner supported utilization of telepsychiatry to increase access and lower costs of providing mental health care in correctional facilities. Increasing access to mental health care for this underserved group through telepsychiatry may improve living conditions and safety inside correctional facilities. Providers, facilities, and state and federal governments can expect increased savings with utilization of telepsychiatry.

In Search of Cost-Effective Schools.

ERIC Educational Resources Information Center

Raywid, Mary Anne; Shaheen, Thomas A.

1994-01-01

Examines major cost-effectiveness proposals, describing developments that highlight concerns over making schools cost effective. The article discusses ways to blend the concerns of educational quality, equity, and costs (district consolidations, shared service and facilities arrangements, new accountability strategies, new information systems,…

Obtaining Life-Cycle Cost-Effective Facilities in the Department of Defense

DTIC Science & Technology

2013-01-01

8 Step 3: Regional, Service- Level , and OSD Project Ranking...13 2.3. Actors and Barriers to Life-Cycle Cost-Effective Facilities in the Regional, Service- Level , and OSD Project Ranking...Congressional authorization and appropriation OMB evaluation Regional, service- level , and OSD project ranking Economic analysis and DD form 1391 completed

Efficiency and cost advantages of an advanced-technology nuclear electrolytic hydrogen-energy production facility

NASA Technical Reports Server (NTRS)

Donakowski, T. D.; Escher, W. J. D.; Gregory, D. P.

1977-01-01

The concept of an advanced-technology (viz., 1985 technology) nuclear-electrolytic water electrolysis facility was assessed for hydrogen production cost and efficiency expectations. The facility integrates (1) a high-temperature gas-cooled nuclear reactor (HTGR) operating a binary work cycle, (2) direct-current (d-c) electricity generation via acyclic generators, and (3) high-current-density, high-pressure electrolyzers using a solid polymer electrolyte (SPE). All subsystems are close-coupled and optimally interfaced for hydrogen production alone (i.e., without separate production of electrical power). Pipeline-pressure hydrogen and oxygen are produced at 6900 kPa (1000 psi). We found that this advanced facility would produce hydrogen at costs that were approximately half those associated with contemporary-technology nuclear electrolysis: $5.36 versus $10.86/million Btu, respectively. The nuclear-heat-to-hydrogen-energy conversion efficiency for the advanced system was estimated as 43%, versus 25% for the contemporary system.

Managerial Cost Accounting for a Technical Information Center.

ERIC Educational Resources Information Center

Helmkamp, John G.

A two-fold solution to the cost information deficiency problem is proposed. A formal managerial cost accounting system is designed expressly for the two information services of retrospective search and selective dissemination. The system was employed during a trial period to test its effectiveness in a technical information center. Once…

42 CFR 413.186 - Payment exception: Self-dialysis training costs in pediatric facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs § 413... completed, being retrained, or in the process of being trained). (7) The total treatments from the patient...

Cost-effectiveness and affordability of community mobilisation through women's groups and quality improvement in health facilities (MaiKhanda trial) in Malawi.

PubMed

Colbourn, Tim; Pulkki-Brännström, Anni-Maria; Nambiar, Bejoy; Kim, Sungwook; Bondo, Austin; Banda, Lumbani; Makwenda, Charles; Batura, Neha; Haghparast-Bidgoli, Hassan; Hunter, Rachael; Costello, Anthony; Baio, Gianluca; Skordis-Worrall, Jolene

2015-01-01

Understanding the cost-effectiveness and affordability of interventions to reduce maternal and newborn deaths is critical to persuading policymakers and donors to implement at scale. The effectiveness of community mobilisation through women's groups and health facility quality improvement, both aiming to reduce maternal and neonatal mortality, was assessed by a cluster randomised controlled trial conducted in rural Malawi in 2008-2010. In this paper, we calculate intervention cost-effectiveness and model the affordability of the interventions at scale. Bayesian methods are used to estimate the incremental cost-effectiveness of the community and facility interventions on their own (CI, FI), and together (FICI), compared to current practice in rural Malawi. Effects are estimated with Monte Carlo simulation using the combined full probability distributions of intervention effects on stillbirths, neonatal deaths and maternal deaths. Cost data was collected prospectively from a provider perspective using an ingredients approach and disaggregated at the intervention (not cluster or individual) level. Expected Incremental Benefit, Cost-effectiveness Acceptability Curves and Expected Value of Information (EVI) were calculated using a threshold of $780 per disability-adjusted life-year (DALY) averted, the per capita gross domestic product of Malawi in 2013 international $. The incremental cost-effectiveness of CI, FI, and combined FICI was $79, $281, and $146 per DALY averted respectively, compared to current practice. FI is dominated by CI and FICI. Taking into account uncertainty, both CI and combined FICI are highly likely to be cost effective (probability 98% and 93%, EVI $210,423 and $598,177 respectively). Combined FICI is incrementally cost effective compared to either intervention individually (probability 60%, ICER $292, EIB $9,334,580 compared to CI). Future scenarios also found FICI to be the optimal decision. Scaling-up to the whole of Malawi, CI is of greatest

Hanford facility dangerous waste permit application, general information portion

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

Hays, C.B.

1998-05-19

The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOE/RL-91-28) and a Unit-Specific Portion. Both the General Information and Unit-Specific portions of the Hanford Facility Dangerous Waste Permit Application address the content of the Part B permit application guidance prepared by the Washington State Department of Ecology (Ecology 1996) and the U.S. Environmental Protection Agency (40 Code of Federal Regulations 270), with additional information needed by the Hazardous and Solid Waste Amendments and revisions of Washington Administrative Code 173-303. Documentation contained in the General Information Portion ismore » broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in this report).« less

What is the cost of providing outpatient HIV counseling and testing and antiretroviral therapy services in selected public health facilities in Nigeria?

PubMed

Aliyu, Husaina Bello; Chuku, Nkata Nwani; Kola-Jebutu, Abimbola; Abubakar, Zubaida; Torpey, Kwasi; Chabikuli, Otto Nzapfurundi

2012-10-01

Limited data on actual cost of providing HIV/AIDS services in Nigeria makes planning difficult. A study was conducted in 9 public health facilities supported by the Global HIV/AIDS Initiative Nigeria. The objective was to determine the cost of outpatient HIV Testing and Counseling (HTC) and antiretroviral therapy (ART) services per patient. Two tertiary and 7 secondary facilities were purposively selected across the six geopolitical regions. Facilities were distributed in urban and rural settings. Utilization and cost data for a 12-month period (January to December 2010) were analyzed. Cost elements included consumables, human resources, infrastructure, trainings, facility management, and Global HIV/AIDS Initiative Nigeria technical support. Total costs were apportioned based on percentage utilization by services, and unit costs were derived by dividing resource inputs by service outputs. Data were analyzed using Microsoft Excel 2003. A sensitivity analysis was also conducted for key assumptions. Mean costs for HTC and ART were US $7.4 and US $209.0, respectively. Costs were higher in Northern facilities (US $6.9, US $250.8), compared with Southern ones (US $6.7, US $194.7); and in tertiary facilities ($18.5, $338.4), compared with secondary ones ($6.3, $204.9). Major cost drivers for HTC and ART were human resources--ranging from 62% to 50%, and ARV drugs--ranging from 54% to 31%, respectively. Governments' ability to negotiate lower priced antiretroviral drugs will be central to reducing the cost of ART. Additionally, use of lower cadre staff to provide HTC will reduce costs and improves efficiency.

30 CFR 251.13 - Reimbursement for the costs of reproducing data and information and certain processing costs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and information and certain processing costs. 251.13 Section 251.13 Mineral Resources MINERALS... third party for the reasonable costs of processing geophysical information (which does not include cost... OUTER CONTINENTAL SHELF § 251.13 Reimbursement for the costs of reproducing data and information and...

Costs of postabortion care in public sector health facilities in Malawi: a cross-sectional survey.

PubMed

Benson, Janie; Gebreselassie, Hailemichael; Mañibo, Maribel Amor; Raisanen, Keris; Johnston, Heidi Bart; Mhango, Chisale; Levandowski, Brooke A

2015-12-17

Health systems could obtain substantial cost savings by providing safe abortion care rather than providing expensive treatment for complications of unsafely performed abortions. This study estimates current health system costs of treating unsafe abortion complications and compares these findings with newly-projected costs for providing safe abortion in Malawi. We conducted in-depth surveys of medications, supplies, and time spent by clinical personnel dedicated to postabortion care (PAC) for three treatment categories (simple, severe non-surgical, and severe surgical complications) and three uterine evacuation (UE) procedure types (manual vacuum aspiration (MVA), dilation and curettage (D&C) and misoprostol-alone) at 15 purposively-selected public health facilities. Per-case treatment costs were calculated and applied to national, annual PAC caseload data. The median cost per D&C case ($63) was 29% higher than MVA treatment ($49). Costs to treat severe non-surgical complications ($63) were almost five times higher than those of a simple PAC case ($13). Severe surgical complications were especially costly to treat at $128. PAC treatment in public facilities cost an estimated $314,000 annually. Transition to safe, legal abortion would yield an estimated cost reduction of 20%-30%. The method of UE and severity of complications have a large impact on overall costs. With a liberalized abortion law and implementation of induced abortion services with WHO-recommended UE methods, current PAC costs to the health system could markedly decrease.

Solar project cost report for Ingham County, Medical Care Facility, Okemos, Michigan

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

Not Available

The solar energy system supplies service hot water for a 204 bed medical and geriatric care facility with laundry and kitchen. The system was designed at the time the building was designed. The 9,374 ft/sup 2/ of collectors were manufactured by Revere Copper and Brass, Inc., and are mounted at grade level behind the building. Solar heated water for use in heating service water is stored in a 5000 gallon hot water storage tank. The heaviest use of hot water occurs during the day so the requirement for thermal storage is modest. The construction costs of this solar project aremore » presented. Category costs are listed by materials, direct labor, ad subcontract costs. The subcontract costs include both materials, labor, overhead and profit for electrical, control and other minor subcontractors. The installed cost of the system was $312,825 not including prime contractor overhead and profit and general and administrative costs. (MHR)« less

A cost-benefit/cost-effectiveness analysis of an unsanctioned supervised smoking facility in the Downtown Eastside of Vancouver, Canada.

PubMed

Jozaghi, Ehsan

2014-11-13

Smoking crack involves the risk of transmitting diseases such as HIV and hepatitis C (HCV). The current study determines whether the formerly unsanctioned supervised smoking facility (SSF)-operated by the grassroot organization, Vancouver Area Network of Drug Users (VANDU) for the last few years-costs less than the costs incurred for health-care services as a direct consequence of not having such a program in Vancouver, Canada. The data pertaining to the attendance at the SSF was gathered in 2012-2013 by VANDU. By relying on this data, a mathematical model was employed to estimate the number of HCV infections prevented by the former facility in Vancouver's Downtown Eastside (DTES). The DTES SSF's benefit-cost ratio was conservatively estimated at 12.1:1 due to its low operating cost. The study used 70% and 90% initial pipe-sharing rates for sensitivity analysis. At 80% sharing rate, the marginal HCV cases prevented were determined to be 55 cases. Moreover, at 80% sharing rate, the marginal cost-effectiveness ratio ranges from $1,705 to $97,203. The results from both the baseline and sensitivity analysis demonstrated that the establishment of the SSF by VANDU on average had annually saved CAD$1.8 million dollars in taxpayer's money. Funding SSFs in Vancouver is an efficient and effective use of financial resources in the public health domain; therefore, Vancouver Coastal Health should actively participate in their establishment in order to reduce HCV and other blood-borne infections such as HIV within the non-injecting drug users.

A Patient-specific Approach to Hospital Cost Accounting

PubMed Central

Macdonald, Larry K.; Reuter, Louis F.

1973-01-01

The hospital facilities and manpower used for the various procedures of a delivery suite are identified and measured as the basis for determining individual patient costs. The method of measuring staff and facility requirements, including the “cost of readiness” and the cost of inherent inefficiencies, generates detailed information that can be used in determining utilization ranges for budgeting decisions, for planning space needs, for personnel scheduling, and for patient billing. PMID:4269322

40 CFR 270.300 - What container information must I keep at my facility?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false What container information must I keep at my facility? 270.300 Section 270.300 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Facility § 270.300 What container information must I keep at my facility? If you store or treat hazardous...

10 CFR 63.47 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REPOSITORY AT YUCCA MOUNTAIN, NEVADA Licenses Us/iaea Safeguards Agreement § 63.47 Facility information and... the International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US...

10 CFR 63.47 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REPOSITORY AT YUCCA MOUNTAIN, NEVADA Licenses Us/iaea Safeguards Agreement § 63.47 Facility information and... the International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US...

10 CFR 60.47 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REPOSITORIES Licenses Us/iaea Safeguards Agreement § 60.47 Facility information and verification. (a) In... International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US/IAEA Safeguards...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In... as necessary to implement the US/IAEA Safeguards Agreement, as described in Part 75 of this chapter...

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 1. Model Formulation and Demonstration

DOT National Transportation Integrated Search

1978-05-01

The User Delay Cost Model (UDCM) is a Monte Carlo computer simulation of essential aspects of Terminal Control Area (TCA) air traffic movements that would be affected by facility outages. The model can also evaluate delay effects due to other factors...

Instructional Facilities for the Information Age. An ERIC Information Analysis Product.

ERIC Educational Resources Information Center

Knirk, Frederick G.

Intended to assist educators and trainers who must make recommendations about facilities to architects and school authorities, this ERIC information analysis project summarizes research on the design of both classrooms and individualized learning spaces that will optimize learning. Six teaching/learning space topics are considered: (1) light and…

INVENTORY ANALYSIS AND COST ACCOUNTING OF FACILITY MAINTANANCE IN WASTE INCINERATION

NASA Astrophysics Data System (ADS)

Morioka, Tohru; Ozaki, Taira; Kitazume, Keiichi; Yamamoto, Tsukasa

A solid waste incineration plant consists of so many facilities and mechanical parts that it requires periodic careful maintenance of them for stable solid waste management. The current research investigates maintenance costs of the stoker type incinerator and continuous firing plants in detail and develops an accounting model for maintenance of them. This model is able to distinguish among the costs of inspection, repair and renewal by plant with seven process flaw s and three common factors. Parameters based on real data collected by questionnaire surveys give appropriate results in comparison with other plants and enable to apply the model to plants which incinerates 500 - 600 ton solid waste per day.

48 CFR 570.110 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 570.110 Section 570.110 Federal Acquisition Regulations System... PROPERTY General 570.110 Cost or pricing data and information other than cost or pricing data. (a) The...

76 FR 18222 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... proposed information collection for the proper performance of the agency's functions; (2) the accuracy of... currently approved collection; Title of Information Collection: Independent Renal Dialysis Facility Cost Report; Use: The Independent Renal Dialysis Facility Cost Report, is filed annually by providers...

A demonstration of a low cost approach to security at shipping facilities and ports

NASA Astrophysics Data System (ADS)

Huck, Robert C.; Al Akkoumi, Mouhammad K.; Herath, Ruchira W.; Sluss, James J., Jr.; Radhakrishnan, Sridhar; Landers, Thomas L.

2010-04-01

Government funding for the security at shipping facilities and ports is limited so there is a need for low cost scalable security systems. With over 20 million sea, truck, and rail containers entering the United States every year, these facilities pose a large risk to security. Securing these facilities and monitoring the variety of traffic that enter and leave is a major task. To accomplish this, the authors have developed and fielded a low cost fully distributed building block approach to port security at the inland Port of Catoosa in Oklahoma. Based on prior work accomplished in the design and fielding of an intelligent transportation system in the United States, functional building blocks, (e.g. Network, Camera, Sensor, Display, and Operator Console blocks) can be assembled, mixed and matched, and scaled to provide a comprehensive security system. The following functions are demonstrated and scaled through analysis and demonstration: Barge tracking, credential checking, container inventory, vehicle tracking, and situational awareness. The concept behind this research is "any operator on any console can control any device at any time."

A flight test facility design for examining digital information transfer

NASA Technical Reports Server (NTRS)

Knox, Charles E.

1990-01-01

Information is given in viewgraph form on a flight test facility design for examining digital information transfer. Information is given on aircraft/ground exchange, data link research activities, data link display format, a data link flight test, and the flight test setup.

Managing Costs and Medical Information

Cancer.gov

People with cancer may face major financial challenges and need help dealing with the high costs of care. Cancer treatment can be very expensive, even when you have insurance. Learn ways to manage medical information, paperwork, bills, and other records.

Transaction costs, externalities and information technology in health care.

PubMed

Ferguson, B; Keen, J

1996-01-01

This paper discusses some of the economic issues which underpin the rationale for investment in information and communications technologies (ICTs). Information imperfections lead to significant transaction costs (search, negotiating and monitoring) which in turn confer a negative externality on parties involved in exchange. This divergence in private and social costs leads to a degree of resource misallocation (efficiency loss) which, uncorrected, results in a sub-optimal outcome. Traditional solutions to this problem are to rely upon direct government action to reduce the costs of transacting between market agents, or to employ tax/subsidy measures and other legislative action to achieve the desired market outcome. Three key policy questions are raised in the context of the NHS purchaser/provider relationship. Firstly, what is the optimum level of transaction costs; secondly, can ICTs assist in lowering the level of transaction costs to the optimum level; thirdly, who should bear the investment cost in reducing the level of transaction costs? The issue of property rights in different information systems is discussed and raises interesting policy questions about how much investment should be undertaken centrally rather than devolved to a more local level. In some ways this economic framework offers a post hoc justification of why different ICT systems have been introduced at various levels of the NHS. Essentially this reduces to the problem of externalities: providing good information confers a positive externality: not providing relevant, timely and accurate information confers a negative externality, by increasing further the level of transaction costs. The crucial role which ICT systems can play lies in attempting to reduce the level of transaction costs and driving the market towards what Dahlman has described as the transaction-cost-constrained equilibrium.

78 FR 71558 - Insurance Cost Information Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

... [Docket No. NHTSA-2013-0078] Insurance Cost Information Regulation AGENCY: National Highway Traffic Safety... method for reporting simple and understandable motor vehicle damage susceptibility information to consumers. NHTSA plans to use this information to meet a requirement by Congress that it study and report...

48 CFR 239.7406 - Cost or pricing data and information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost or pricing data and information other than cost or pricing data. 239.7406 Section 239.7406 Federal Acquisition Regulations System... ACQUISITION OF INFORMATION TECHNOLOGY Telecommunications Services 239.7406 Cost or pricing data and...

COSTS OF BEST MANAGEMENT PRACTICES AND ASSOCIATED LAND FOR URBAN STORMWATER CONTROL

EPA Science Inventory

The purpose of this paper is to present information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these stu...

Safe, Cost Effective Management of Inactive Facilities at the Savannah River Site

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

Austin, W. E.; Yannitell, D. M.; Freeman, D. W.

The Savannah River Site is part of the U.S. Department of Energy complex. It was constructed during the early 1950s to produce basic materials (such as plutonium-239 and tritium) used in the production of nuclear weapons. The 310-square-mile site is located in South Carolina, about 12 miles south of Aiken, South Carolina, and about 15 miles southeast of Augusta, Georgia. Savannah River Site (SRS) has approximately 200 facilities identified as inactive. These facilities range in size and complexity from large nuclear reactors to small storage buildings. These facilities are located throughout the site including three reactor areas, the heavy watermore » plant area, the manufacturing area, and other research and support areas. Unlike DOE Closure Sites such as Hanford and Rocky Flats, SRS is a Project Completion Site with continuing missions. As facilities complete their defined mission, they are shutdown and transferred from operations to the facility disposition program. At the SRS, Facilities Decontamination and Decommissioning (FDD) personnel manage the disposition phase of a inactive facility's life cycle in a manner that minimizes life cycle cost without compromising (1) the health or safety of workers and the public or (2) the quality of the environment. The disposition phase begins upon completion of operations shutdown and extends through establishing the final end-state. FDD has developed innovative programs to manage their responsibilities within a constrained budget.« less

Cost-assessment Analysis of Local Vehicle Scrapping Facility

NASA Astrophysics Data System (ADS)

Grabowski, Lukasz; Gliniak, Maciej; Polek, Daria; Gruca, Maria

2017-12-01

The purpose of the paper was to analyse the costs of recycling vehicles at local vehicle scrapping facility. The article contains regulations concerning vehicle decommissioning, describes the types of recovery, vehicles recycling networks, analyses the structure of a disassembly station, as well as the financial and institutional system in charge of dealing with the recycling of vehicles in Poland. The authors present the number of scrapped vehicles at local recycling company and the level of achieved recovery and recycling. The research presented in the article shows financial situation of the vehicle scrapping industry. In addition, it has been observed that the number of subsidies are directly proportional to the number of scrapped vehicles, and achieved levels of recycling and recovery depends on the percentage of incomplete vehicles.

5 CFR 1655.3 - Information concerning the cost of a loan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Information concerning the cost of a loan... § 1655.3 Information concerning the cost of a loan. Information concerning the cost of a loan is provided... office or service, or from the TSP record keeper). From this information, a participant can determine the...

Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

PubMed

Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

2017-01-01

Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 2. User's Manual and Program Documentation for the User Delay Cost Model

DOT National Transportation Integrated Search

1978-05-01

The User Delay Cost Model (UDCM) is a Monte Carlo simulation of certain classes of movement of air traffic in the Boston Terminal Control Area (TCA). It incorporates a weather module, an aircraft generation module, a facilities module, and an air con...

Estimating the costs of psychiatric hospital services at a public health facility in Nigeria.

PubMed

Ezenduka, Charles; Ichoku, Hyacinth; Ochonma, Ogbonnia

2012-09-01

Information on the cost of mental health services in Africa is very limited even though mental health disorders represent a significant public health concern, in terms of health and economic impact. Cost analysis is important for planning and for efficiency in the provision of hospital services. The study estimated the total and unit costs of psychiatric hospital services to guide policy and psychiatric hospital management efficiency in Nigeria. The study was exploratory and analytical, examining 2008 data. A standard costing methodology based on ingredient approach was adopted combining top-down method with step-down approach to allocate resources (overhead and indirect costs) to the final cost centers. Total and unit cost items related to the treatment of psychiatric patients (including the costs of personnel, overhead and annualised costs of capital items) were identified and measured on the basis of outpatients' visits, inpatients' days and inpatients' admissions. The exercise reflected the input-output process of hospital services where inputs were measured in terms of resource utilisation and output measured by activities carried out at both the outpatient and inpatient departments. In the estimation process total costs were calculated at every cost center/department and divided by a measure of corresponding patient output to produce the average cost per output. This followed a stepwise process of first allocating the direct costs of overhead to the intermediate and final cost centers and from intermediate cost centers to final cost centers for the calculation of total and unit costs. Costs were calculated from the perspective of the healthcare facility, and converted to the US Dollars at the 2008 exchange rate. Personnel constituted the greatest resource input in all departments, averaging 80% of total hospital cost, reflecting the mix of capital and recurrent inputs. Cost per inpatient day, at $56 was equivalent to 1.4 times the cost per outpatient visit at

Cutting the Cost of New Community College Facilities: Streamlining the Facilities Approval Process. Commission on Innovation Policy Discussion Paper Number 3.

ERIC Educational Resources Information Center

BW Associates, Berkeley, CA.

Intended to provide background information and preliminary options for the California Community Colleges' Commission on Innovation, this document proposes that approval processes for new facilities be simplified and that restrictions on the lease or purchase of off-campus facilities be eased. Following introductory materials detailing the…

The cost of postabortion care and legal abortion in Colombia.

PubMed

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

2013-09-01

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

48 CFR 1515.305-72 - Release of cost information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Release of cost information. 1515.305-72 Section 1515.305-72 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY...) These individuals would then use this information to perform a cost realism analysis as described in FAR...

48 CFR 1515.305-72 - Release of cost information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Release of cost information. 1515.305-72 Section 1515.305-72 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION... Release of cost information. (a) In accordance with FAR 15.305(a)(4), the contracting officer may release...

10 CFR 72.79 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Facility information and verification. 72.79 Section 72.79 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR THE INDEPENDENT STORAGE OF... the International Atomic Energy Agency (IAEA) and take other action as necessary to implement the US...

Hanford facility dangerous waste permit application, general information portion. Revision 3

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

Sonnichsen, J.C.

1997-08-21

For purposes of the Hanford facility dangerous waste permit application, the US Department of Energy`s contractors are identified as ``co-operators`` and sign in that capacity (refer to Condition I.A.2. of the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit). Any identification of these contractors as an ``operator`` elsewhere in the application is not meant to conflict with the contractors` designation as co-operators but rather is based on the contractors` contractual status with the U.S. Department of Energy, Richland Operations Office. The Dangerous Waste Portion of the initial Hanford Facility Resource Conservation and Recovery Act Permit,more » which incorporated five treatment, storage, and/or disposal units, was based on information submitted in the Hanford Facility Dangerous Waste Permit Application and in closure plan and closure/postclosure plan documentation. During 1995, the Dangerous Waste Portion was modified twice to incorporate another eight treatment, storage, and/or disposal units; during 1996, the Dangerous Waste Portion was modified once to incorporate another five treatment, storage, and/or disposal units. The permit modification process will be used at least annually to incorporate additional treatment, storage, and/or disposal units as permitting documentation for these units is finalized. The units to be included in annual modifications are specified in a schedule contained in the Dangerous Waste Portion of the Hanford Facility Resource Conservation and Recovery Act Permit. Treatment, storage, and/or disposal units will remain in interim status until incorporated into the Permit. The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (this document, DOE/RL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion is limited to individual operating treatment, storage, and/or disposal units

19 CFR 10.21 - Updating cost data and other information.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

19 CFR 10.21 - Updating cost data and other information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

19 CFR 10.21 - Updating cost data and other information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

19 CFR 10.21 - Updating cost data and other information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Updating cost data and other information. 10.21... Articles Assembled Abroad with United States Components § 10.21 Updating cost data and other information. When a claim for the exemption is predicated on estimated cost data furnished either in advance of or...

47 CFR 25.111 - Additional information and ITU cost recovery.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Additional information and ITU cost recovery....111 Additional information and ITU cost recovery. (a) The Commission may request from any party at any time additional information concerning any application, or any other submission or pleading regarding...

Indirect Costs and Other Uses of Facilities Data at Institutions

ERIC Educational Resources Information Center

Watt, Catherine E.; Higerd, Thomas B.

2007-01-01

The purpose of this chapter is to examine possible uses for facilities data as they relate to three academic issues: classroom management, personnel management, and research activity. The number of institutions actively using space information to improve decision making is unknown. Most articles available in professional publications such as…

78 FR 79008 - Proposed Information Collection; Application for Waiver of Surface Sanitary Facilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... Information Collection; Application for Waiver of Surface Sanitary Facilities' Requirements (Pertaining to... for Waiver of Surface Sanitary Facilities' Requirements (Pertaining to Coal Mines). DATES: All...-3 require coal mine operators to provide bathing facilities, clothing change rooms, and sanitary...

17 CFR 37.8 - Information relating to transactions on derivatives transaction execution facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... transactions on derivatives transaction execution facilities. 37.8 Section 37.8 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION DERIVATIVES TRANSACTION EXECUTION FACILITIES § 37.8 Information relating to transactions on derivatives transaction execution facilities. (a) Special calls for...

Controlling information technology costs.

PubMed

Honan, Tom; Ciotti, Vince

2002-01-01

Health care executives are increasingly frustrated by Information Technology (IT). Although our industry is often accused of underinvesting in technology (hospitals average 2-3 percent of their costs in IT, compared to other industry's 8-10 percent), when IT investments are made, they fail to reflect demonstrable return to the bottom line. Yet the effective deployment of technology is so critical to the success of the organization and can in itself cause the failure of a health care system.

Cost effective nuclear commercial grade dedication

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

Maletz, J.J.; Marston, M.J.

1991-01-01

This paper describes a new computerized database method to create/edit/view specification technical data sheets (mini-specifications) for procurement of spare parts for nuclear facility maintenance and to develop information that could support possible future facility life extension efforts. This method may reduce cost when compared with current manual methods. The use of standardized technical data sheets (mini-specifications) for items of the same category improves efficiency. This method can be used for a variety of tasks, including: Nuclear safety-related procurement; Non-safety related procurement; Commercial grade item procurement/dedication; Evaluation of replacement items. This program will assist the nuclear facility in upgrading its procurementmore » activities consistent with the recent NUMARC Procurement Initiative. Proper utilization of the program will assist the user in assuring that the procured items are correct for the applications, provide data to assist in detecting fraudulent materials, minimize human error in withdrawing database information, improve data retrievability, improve traceability, and reduce long-term procurement costs.« less

Moly99 Production Facility: Report on Beamline Components, Requirements, Costs

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

Bishofberger, Kip A.

2015-12-23

In FY14 we completed the design of the beam line for the linear accelerator production design concept. This design included a set of three bending magnets, quadrupole focusing magnets, and octopoles to flatten the beam on target. This design was generic and applicable to multiple different accelerators if necessary. In FY15 we built on that work to create specifications for the individual beam optic elements, including power supply requirements. This report captures the specification of beam line components with initial cost estimates for the NorthStar production facility.This report is organized as follows: The motivation of the beamline design is introducedmore » briefly, along with renderings of the design. After that, a specific list is provided, which accounts for each beamline component, including part numbers and costs, to construct the beamline. After that, this report details the important sections of the beamline and individual components. A final summary and list of follow-on activities completes this report.« less

Building Information Modeling (BIM) Primer. Report 1: Facility Life-Cycle Process and Technology Innovation

DTIC Science & Technology

2012-08-01

Building Information Modeling ( BIM ) Primer Report 1: Facility Life-cycle Process and Technology Innovation In fo...is unlimited. ERDC/ITL TR-12-2 August 2012 Building Information Modeling ( BIM ) Primer Report 1: Facility Life-cycle Process and Technology...and to enhance the quality of projects through the design, construction, and handover phases. Building Information Modeling ( BIM ) is a

Information on the Advanced Plant Experiment (APEX) Test Facility

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

Smith, Curtis Lee

The purpose of this report provides information related to the design of the Oregon State University Advanced Plant Experiment (APEX) test facility. Information provided in this report have been pulled from the following information sources: Reference 1: R. Nourgaliev and et.al, "Summary Report on NGSAC (Next-Generation Safety Analysis Code) Development and Testing," Idaho National Laboratory, 2011. Note that this is report has not been released as an external report. Reference 2: O. Stevens, Characterization of the Advanced Plant Experiment (APEX) Passive Residual Heat Removal System Heat Exchanger, Master Thesis, June 1996. Reference 3: J. Reyes, Jr., Q. Wu, and J.more » King, Jr., Scaling Assessment for the Design of the OSU APEX-1000 Test Facility, OSU-APEX-03001 (Rev. 0), May 2003. Reference 4: J. Reyes et al, Final Report of the NRC AP600 Research Conducted at Oregon State University, NUREG/CR-6641, July 1999. Reference 5: K. Welter et al, APEX-1000 Confirmatory Testing to Support AP1000 Design Certification (non-proprietary), NUREG-1826, August 2005.« less

[Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan].

PubMed

Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

2012-01-01

DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year.

Facilities maintenance handbook

NASA Technical Reports Server (NTRS)

1991-01-01

This handbook is a guide for facilities maintenance managers. Its objective is to set minimum facilities maintenance standards. It also provides recommendations on how to meet the standards to ensure that NASA maintains its facilities in a manner that protects and preserves its investment in the facilities in a cost-effective manner while safely and efficiently performing its mission. This handbook implements NMI 8831.1, which states NASA facilities maintenance policy and assigns organizational responsibilities for the management of facilities maintenance activities on all properties under NASA jurisdiction. It is a reference for facilities maintenance managers, not a step-by-step procedural manual. Because of the differences in NASA Field Installation organizations, this handbook does not assume or recommend a typical facilities maintenance organization. Instead, it uses a systems approach to describe the functions that should be included in any facilities maintenance management system, regardless of its organizational structure. For documents referenced in the handbook, the most recent version of the documents is applicable. This handbook is divided into three parts: Part 1 specifies common definitions and facilities maintenance requirements and amplifies the policy requirements contained in NMI 8831. 1; Part 2 provides guidance on how to meet the requirements of Part 1, containing recommendations only; Part 3 contains general facilities maintenance information. One objective of this handbook is to fix commonality of facilities maintenance definitions among the Centers. This will permit the application of uniform measures of facilities conditions, of the relationship between current replacement value and maintenance resources required, and of the backlog of deferred facilities maintenance. The utilization of facilities maintenance system functions will allow the Centers to quantitatively define maintenance objectives in common terms, prepare work plans, and

Performance and cost evaluation of health information systems using micro-costing and discrete-event simulation.

PubMed

Rejeb, Olfa; Pilet, Claire; Hamana, Sabri; Xie, Xiaolan; Durand, Thierry; Aloui, Saber; Doly, Anne; Biron, Pierre; Perrier, Lionel; Augusto, Vincent

2018-06-01

Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach. The methodology is applied to the consultation for cancer treatment process. Simulation scenarios are established to conclude about the impact of HIS on patient pathway. We demonstrated that although high level HIS lengthen the consultation, occupation rate of oncologists are lower and quality of service is higher (through the number of available information accessed during the consultation to formulate the diagnostic). The provided method allows also to determine the most cost-effective ICT elements to improve the care process quality while minimizing costs. The methodology is flexible enough to be applied to other health-care systems.

A cost-benefit analysis for materials management information systems.

PubMed

Slapak-Iacobelli, L; Wilde, A H

1993-02-01

The cost-benefit analysis provided the system planners with valuable information that served many purposes. It answered the following questions: Why was the CCF undertaking this project? What were the alternatives? How much was it going to cost? And what was the expected outcome? The process of developing cost-benefit the document kept the project team focused. It also motivated them to involve additional individuals from materials management and accounts payable in its development. A byproduct of this involvement was buy-in and commitment to the project by everyone in these areas. Consequently, the project became a team effort championed by many and not just one. We were also able to introduce two new information system processes: 1) a management review process with goals and anticipated results, and 2) a quality assurance process that ensured the CCF had a better product in the end. The cost-benefit analysis provided a planning tool that assisted in successful implementation of an integrated materials management information system.

Development of Facility Type Information Packages for Design of Air Force Facilities.

DTIC Science & Technology

1983-03-01

solution. For example, the optimum size and loca- 19 tion of windows for the incorporation of a passive solar *l . heating system varies with location, time...conditioning load estimate M. Energy impact statement N. Majcom review comments 0. Solar energy systems 61 4 Information which could help in the development...and Passive solar systems. All facilities should have Scme aspects of passive solar incor- por3ted into the iesign. Active sclar systems should ze con

33 CFR 154.1041 - Specific response information to be maintained on mobile MTR facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... be maintained on mobile MTR facilities. 154.1041 Section 154.1041 Navigation and Navigable Waters... maintained on mobile MTR facilities. (a) Each mobile MTR facility must carry the following information as... respond to a discharge from the mobile MTR facility. (3) List of the appropriate persons and agencies...

A facile and low-cost micro fabrication material: flash foam.

PubMed

He, Yong; Xiao, Xiao; Wu, Yan; Fu, Jian-zhong

2015-08-28

Although many microfabrication methods have been reported, the preliminary replication templates used in most microfabrication still depend on the expensive and long-period photolithography. This paper explores an alternative replication templates based on a daily used material, flash foam (FF), and proposes a facile microfabrication method, flash foam stamp lithography (FFSL). When FF is exposed with a desired pattern mask, the negative of the pattern is transferred to its surface and micro structures are formed due to the shrinkage of the exposed area. As FF is commonly used in personal stamps, FFSL is very simple and cost-effective. In this paper, we demonstrated that FF is a good and low-cost template for many micro fabrication methods, such as micro casting and soft lithography. Thus, designing and fabricating micro structures at personal office immediately become possible with FFSL. Furthermore, we demonstrated that multi-scale micro structures can be easily fabricated by double exposure with FFSL. Skin textures is used as another case to demonstrate that FFSL can fabricate structures with different depth in a single exposure. As a result, FF shows a promising future in biology, and analytical chemistry, such as rapid fabrication of point of care diagnostics and microfluidic analytical devices with low cost.

A facile and low-cost micro fabrication material: flash foam

PubMed Central

He, Yong; Xiao, Xiao; Wu, Yan; Fu, Jian-zhong

2015-01-01

Although many microfabrication methods have been reported, the preliminary replication templates used in most microfabrication still depend on the expensive and long-period photolithography. This paper explores an alternative replication templates based on a daily used material, flash foam (FF), and proposes a facile microfabrication method, flash foam stamp lithography (FFSL). When FF is exposed with a desired pattern mask, the negative of the pattern is transferred to its surface and micro structures are formed due to the shrinkage of the exposed area. As FF is commonly used in personal stamps, FFSL is very simple and cost-effective. In this paper, we demonstrated that FF is a good and low-cost template for many micro fabrication methods, such as micro casting and soft lithography. Thus, designing and fabricating micro structures at personal office immediately become possible with FFSL. Furthermore, we demonstrated that multi-scale micro structures can be easily fabricated by double exposure with FFSL. Skin textures is used as another case to demonstrate that FFSL can fabricate structures with different depth in a single exposure. As a result, FF shows a promising future in biology, and analytical chemistry, such as rapid fabrication of point of care diagnostics and microfluidic analytical devices with low cost. PMID:26314247

Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.

PubMed

Hennessee, Ian; Chinkhumba, Jobiba; Briggs-Hagen, Melissa; Bauleni, Andy; Shah, Monica P; Chalira, Alfred; Moyo, Dubulao; Dodoli, Wilfred; Luhanga, Misheck; Sande, John; Ali, Doreen; Gutman, Julie; Lindblade, Kim A; Njau, Joseph; Mathanga, Don P

2017-10-02

With 71% of Malawians living on < $1.90 a day, high household costs associated with severe malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic

21 CFR 1.235 - How and when do you cancel your facility's registration information?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false How and when do you cancel your facility's... for Registration of Food Facilities § 1.235 How and when do you cancel your facility's registration information? (a) Notification of registration cancellation. A facility canceling its registration must do so...

Cost of Information Handling in Hospitals

PubMed Central

Jydstrup, Ronald A.; Gross, Malvern J.

1966-01-01

Cost of information handling (noncomputerized) in hospitals was studied in detail from an industrial engineering point of view at Rochester General, Highland, and Geneva General hospitals. Activities were observed, personnel questioned, and time studies carried out. It was found that information handling comprises about one fourth of the hospitals' operating cost—a finding strongly recommending revision and streamlining of both forms and inefficient operations. In an Appendix to this study are presented 15 items that would improve information handling in one area of the hospital, nursing units, where this activity is greater than in any other in a hospital. PMID:5971636

Costs and financing of routine immunization: Approach and selected findings of a multi-country study (EPIC).

PubMed

Brenzel, Logan; Young, Darwin; Walker, Damian G

2015-05-07

Few detailed facility-based costing studies of routine immunization (RI) programs have been conducted in recent years, with planners, managers and donors relying on older information or data from planning tools. To fill gaps and improve quality of information, a multi-country study on costing and financing of routine immunization and new vaccines (EPIC) was conducted in Benin, Ghana, Honduras, Moldova, Uganda and Zambia. This paper provides the rationale for the launch of the EPIC study, as well as outlines methods used in a Common Approach on facility sampling, data collection, cost and financial flow estimation for both the routine program and new vaccine introduction. Costing relied on an ingredients-based approach from a government perspective. Estimating incremental economic costs of new vaccine introduction in contexts with excess capacity are highlighted. The use of more disaggregated System of Health Accounts (SHA) coding to evaluate financial flows is presented. The EPIC studies resulted in a sample of 319 primary health care facilities, with 65% of facilities in rural areas. The EPIC studies found wide variation in total and unit costs within each country, as well as between countries. Costs increased with level of scale and socio-economic status of the country. Governments are financing an increasing share of total RI financing. This study provides a wealth of high quality information on total and unit costs and financing for RI, and demonstrates the value of in-depth facility approaches. The paper discusses the lessons learned from using a standardized approach, as well as proposes further areas of methodology development. The paper discusses how results can be used for resource mobilization and allocation, improved efficiency of services at the country level, and to inform policies at the global level. Efforts at routinizing cost analysis to support sustainability efforts would be beneficial. Copyright © 2015 Elsevier Ltd. All rights reserved.

Displaying radiation exposure and cost information at order entry for outpatient diagnostic imaging: a strategy to inform clinician ordering.

PubMed

Kruger, Jenna F; Chen, Alice Hm; Rybkin, Alex; Leeds, Kiren; Guzman, David; Vittinghoff, Eric; Goldman, L Elizabeth

2016-12-01

Displaying radiation exposure and cost information at electronic order entry may encourage clinicians to consider the value of diagnostic imaging. An urban safety-net health system displayed radiation exposure information for CT and cost information for CT, MRI and ultrasound on an electronic referral system for outpatient ordering. We assessed whether there were differences in numbers of outpatient CT scans and MRIs per month relative to ultrasounds before and after the intervention, and evaluated primary care clinicians' responses to the intervention. There were 23 171 outpatient CTs, 15 052 MRIs and 43 266 ultrasounds from 2011 to 2014. The ratio of CTs to ultrasounds decreased by 15% (95% CI 9% to 21%), from 58.2 to 49.6 CTs per 100 ultrasounds; the ratio of MRIs to ultrasounds declined by 13% (95% CI 7% to 19%), from 37.5 to 32.5 per 100. Of 300 invited, 190 (63%) completed the web-based survey in 17 clinics. 154 (81%) noticed the radiation exposure information and 158 (83.2%) noticed the cost information. Clinicians believed radiation exposure information was more influential than cost information: when unsure clinically about ordering a test (radiation=69.7%; cost=46.4%), when a patient wanted a test not clinically indicated (radiation=77.5%; cost=54.8%), when they had a choice between imaging modalities (radiation=77.9%; cost=66.6%), in patient care discussions (radiation=71.9%; cost=43.2%) and in trainee discussions (radiation=56.5%; cost=53.7%). Resident physicians and nurse practitioners were more likely to report that the cost information influenced them (p<0.05). Displaying radiation exposure and cost information at order entry may improve clinician awareness about diagnostic imaging safety risks and costs. More clinicians reported the radiation information influenced their clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An Analysis of Medical Imaging Costs in Military Treatment Facilities

DTIC Science & Technology

2014-09-01

authority to completely control the medical systems of each service, the DHA 7 was given management responsibility for specific shared services , functions...efficient health operations through enhanced enterprise-wide shared services . • Deliver more comprehensive primary care and integrated health...of shared services that will fall under central control: • facility planning • medical logistics • health information technology • Tricare health

Information technology facilitates cost-effectiveness analysis in developing countries: an observational study of breast cancer chemotherapy in Taiwan.

PubMed

Shih, Ya-Chen Tina; Pan, I-Wen; Tsai, Yi-Wen

2009-01-01

Health information technology offers a powerful tool to monitor the performance of a healthcare system. Advances in computer technology and capacity combined with lower start-up costs will allow developing countries to achieve greater impact when they initiate electronic health information systems. We focused on the integrated health information system that was established in Taiwan in conjunction with the launch of the National Health Insurance (NHI) programme. We used data from that health information system to conduct a cost-effectiveness analysis of chemotherapy use among breast cancer patients. We then used this analysis to discuss what policy makers can learn from this type of analysis. We identified a cohort of patients in the NHI Research Database who had been diagnosed with breast cancer in 2001 and had received chemotherapy following surgical removal of the tumour. We followed these patients for 3 years and conducted a cost-effectiveness analysis from the payer's perspective. Using the net benefit regression approach, we compared the cost effectiveness of the two most commonly prescribed first-line chemotherapy regimens for the treatment of breast cancer in 2001 in Taiwan. The dependent variable of the regression model was the individual-level net benefit, and the independent variables included a binary variable indicating the choice of chemotherapy regimen, the patients' age, co-morbidity, type of surgery, geographic region and type of treatment facility. We employed both frequentist and Bayesian approaches in our net benefit regression analyses. In the Bayesian analysis, we applied non-informative priors to all parameters in the base-case analyses. We then explored the use of informative priors in the sensitivity analysis, using cost-effectiveness data published in the literature to form the prior distributions for the relevant parameters. Over 60% of surgically treated breast cancer patients received either CMF (cyclophosphamide, methotrexate

36 CFR 14.22 - Reimbursement of costs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... paragraph (a)(3)(i) of this section (e.g., for communication sites, reservoir sites, plant sites, and other non-linear facilities)—$250 for each 40 acres or fraction thereof. (iii) If a project has the features... applicant an estimate, based on the best available cost information, of the costs which would be incurred by...

36 CFR 14.22 - Reimbursement of costs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... paragraph (a)(3)(i) of this section (e.g., for communication sites, reservoir sites, plant sites, and other non-linear facilities)—$250 for each 40 acres or fraction thereof. (iii) If a project has the features... applicant an estimate, based on the best available cost information, of the costs which would be incurred by...

36 CFR 14.22 - Reimbursement of costs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... paragraph (a)(3)(i) of this section (e.g., for communication sites, reservoir sites, plant sites, and other non-linear facilities)—$250 for each 40 acres or fraction thereof. (iii) If a project has the features... applicant an estimate, based on the best available cost information, of the costs which would be incurred by...

36 CFR 14.22 - Reimbursement of costs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... paragraph (a)(3)(i) of this section (e.g., for communication sites, reservoir sites, plant sites, and other non-linear facilities)—$250 for each 40 acres or fraction thereof. (iii) If a project has the features... applicant an estimate, based on the best available cost information, of the costs which would be incurred by...

42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

24 CFR 1710.114 - Recreational facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

...'s annual cost or assessments (1) Facility. Identify each recreational facility. Identify closely... chart state “none”. (6) Buyer's annual cost or assessments. State the lot buyer's annual cost or assessments for using the facility. These costs should include any applicable property owners' association...

Facilities Standards and Planning Manual for New Jersey County Community Colleges.

ERIC Educational Resources Information Center

New Jersey State Dept. of Higher Education, Trenton. Office of Community Coll. Programs.

After some general comments concerning all guidelines, planning standards are described for--(1) various types of new facilities, (2) expansion of present facilities, (3) minimum space requirements for a college, (4) net-to-gross space ratios, and (5) total project costs. Information regarding capital construction project submissions procedure is…

12 CFR 555.300 - Must I inform OTS before I use electronic means or facilities?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Must I inform OTS before I use electronic means... I inform OTS before I use electronic means or facilities? (a) General. A savings association (“you”) are not required to inform OTS before you use electronic means or facilities, except as provided in...

Cost and unit cost calculations using step-down accounting.

PubMed

Conteh, Lesong; Walker, Damian

2004-03-01

There is paucity of unit cost data from low- and middle-income countries, although recent initiatives have emerged to help rectify this. The limited budgets assigned to health care facilities mean that health planners and managers must be able to account for the resources used in health facilities as well as use them efficiently. Step-down cost accounting (SDCA) offers a relatively simple method for generating cost and unit cost data at the facility level. However, to the best of our knowledge, there is a lack of clear and concise guidance on how to undertake SDCA. Therefore, this paper, using a worked example, illustrates the different steps involved to generate cost and unit costs for a small hospital.

A Cost Benefit Technique for R & D Based Information.

ERIC Educational Resources Information Center

Stern, B. T.

A cost benefit technique consisting of the following five phases is proposed: (a) specific objectives of the service, (b) measurement of work flow, (c) work costing, (d) charge to users of the information service, and (e) equating demand and cost. In this approach, objectives are best stated by someone not routinely concerned with the individual…

An initial assessment of the cost and utilization of the Integrated Academic Information System (IAIMS) at Columbia Presbyterian Medical Center.

PubMed Central

Clayton, P. D.; Anderson, R. K.; Hill, C.; McCormack, M.

1991-01-01

The concept of "one stop information shopping" is becoming a reality at Columbia Presbyterian Medical Center (CPMC). The goal of our effort is to provide access to university and hospital administrative systems as well as clinical and library applications from a single workstation, which also provides utility functions such as word processing and mail. Since June 1987, CPMC has invested the equivalent of $23 million dollars to install a digital communications network that encompasses 18 buildings at seven geographically separate sites and to develop clinical and library applications that are integrated with the existing hospital and university administrative and research computing facilities. During June 1991, 2425 different individuals used the clinical information system, 425 different individuals used the library applications, and 900 different individuals used the hospital administrative applications via network access. If we were to freeze the system in its current state, amortize the development and network installation costs, and add projected maintenance costs for the clinical and library applications, our integrated information system would cost $2.8 million on an annual basis. This cost is 0.3% of the medical center's annual budget. These expenditures could be justified by very small improvements in time savings for personnel and/or decreased length of hospital stay and/or more efficient use of resources. In addition to the direct benefits which we detail, a major benefit is the ease with which additional computer-based applications can be added incrementally at an extremely modest cost. PMID:1666966

Information sampling behavior with explicit sampling costs

PubMed Central

Juni, Mordechai Z.; Gureckis, Todd M.; Maloney, Laurence T.

2015-01-01

The decision to gather information should take into account both the value of information and its accrual costs in time, energy and money. Here we explore how people balance the monetary costs and benefits of gathering additional information in a perceptual-motor estimation task. Participants were rewarded for touching a hidden circular target on a touch-screen display. The target’s center coincided with the mean of a circular Gaussian distribution from which participants could sample repeatedly. Each “cue” — sampled one at a time — was plotted as a dot on the display. Participants had to repeatedly decide, after sampling each cue, whether to stop sampling and attempt to touch the hidden target or continue sampling. Each additional cue increased the participants’ probability of successfully touching the hidden target but reduced their potential reward. Two experimental conditions differed in the initial reward associated with touching the hidden target and the fixed cost per cue. For each condition we computed the optimal number of cues that participants should sample, before taking action, to maximize expected gain. Contrary to recent claims that people gather less information than they objectively should before taking action, we found that participants over-sampled in one experimental condition, and did not significantly under- or over-sample in the other. Additionally, while the ideal observer model ignores the current sample dispersion, we found that participants used it to decide whether to stop sampling and take action or continue sampling, a possible consequence of imperfect learning of the underlying population dispersion across trials. PMID:27429991

77 FR 69441 - Federal Acquisition Regulation; Information Collection; Cost Accounting Standards Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

...; Information Collection; Cost Accounting Standards Administration AGENCY: Department of Defense (DOD), General... collection requirement concerning cost accounting standards administration. Public comments are particularly... Information Collection 9000- 0129, Cost Accounting Standards Administration by any of the following methods...

Costs and benefits of health information technology.

PubMed

Shekelle, Paul G; Morton, Sally C; Keeler, Emmett B

2006-04-01

An evidence report was prepared to assess the evidence base regarding benefits and costs of health information technology (HIT) systems, that is, the value of discrete HIT functions and systems in various healthcare settings, particularly those providing pediatric care. PubMed, the Cochrane Controlled Clinical Trials Register, and the Cochrane Database of Reviews of Effectiveness (DARE) were electronically searched for articles published since 1995. Several reports prepared by private industry were also reviewed. Of 855 studies screened, 256 were included in the final analyses. These included systematic reviews, meta-analyses, studies that tested a hypothesis, and predictive analyses. Each article was reviewed independently by two reviewers; disagreement was resolved by consensus. Of the 256 studies, 156 concerned decision support, 84 assessed the electronic medical record, and 30 were about computerized physician order entry (categories are not mutually exclusive). One hundred twenty four of the studies assessed the effect of the HIT system in the outpatient or ambulatory setting; 82 assessed its use in the hospital or inpatient setting. Ninety-seven studies used a randomized design. There were 11 other controlled clinical trials, 33 studies using a pre-post design, and 20 studies using a time series. Another 17 were case studies with a concurrent control. Of the 211 hypothesis-testing studies, 82 contained at least some cost data. We identified no study or collection of studies, outside of those from a handful of HIT leaders, that would allow a reader to make a determination about the generalizable knowledge of the study's reported benefit. Beside these studies from HIT leaders, no other research assessed HIT systems that had comprehensive functionality and included data on costs, relevant information on organizational context and process change, and data on implementation. A small body of literature supports a role for HIT in improving the quality of pediatric

Drug prescribing in rural health facilities in China: implications for service quality and cost.

PubMed

Zhan, S K; Tang, S L; Guo, Y D; Bloom, G

1998-01-01

Overuse of drugs in rural areas of China has led to a growing concern regarding service quality and cost. The study found evidence of high levels of drug use in some rural health facilities in comparison with a number of other developing countries. Such a result was significantly associated with the government policy of financing health care, regulation and monitoring of health services, and users' attitudes and behaviour. It underlines the need for measures to be taken in China to improve drug use in order to allow its population access to effective care at reasonable cost.

Compendium of Low-Cost Pacific Salmon and Steelhead Trout Production Facilities and Practices in the Pacific Northwest.

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

Senn, Harry G.

1984-09-01

The purpose was to research low capital cost salmon and steelhead trout production facilities and identify those that conform with management goals for the Columbia Basin. The species considered were chinook salmon (Oncorhynchus tshawytscha), coho salmon (O. kisutch), sockeye salmon (O. nerka), and steelhead trout (Salmo gairdneri). This report provides a comprehensive listing of the facilities, techniques, and equipment used in artificial production in the Pacific Northwest. (ACR)

Effect of prospective reimbursement on nursing home costs.

PubMed

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

75 FR 5169 - Insurance Cost Information Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... 2008 text and data for the annual insurance cost information booklet that all car dealers must make... different makes and models of passenger cars based on differences in damage susceptibility. Pursuant to 49...

Fall-Related Hospitalization and Facility Costs among Residents of Institutions Providing Long-Term Care

ERIC Educational Resources Information Center

Carroll, Norman V.; Delafuente, Jeffrey C.; Cox, Fred M.; Narayanan, Siva

2008-01-01

Purpose: The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs). Design and Methods: The study used a retrospective, pre/post with comparison group design. We used matching, based on propensity scores, to control for baseline differences between fallers and non-fallers.…

World Energy Data System (WENDS). Volume X. Nuclear facility profiles, PO--ZA. [Brief tabulated information

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

Not Available

1979-06-01

In this compendium each profile of a nuclear facility is a capsule summary of pertinent facts regarding that particular installation. The facilities described include the entire fuel cycle in the broadest sense, encompassing resource recovery through waste management. Power plants and all US facilities have been excluded. To facilitate comparison the profiles have been recorded in a standard format. Because of the breadth of the undertaking some data fields do not apply to the establishment under discussion and accordingly are blank. The set of nuclear facility profiles occupies four volumes; the profiles are ordered by country name, and then bymore » facility code. Each nuclear facility profile volume contains two complete indexes to the information. The first index aggregates the facilities alphabetically by country. It is further organized by category of facility, and then by the four-character facility code. It provides a quick summary of the nuclear energy capability or interest in each country and also an identifier, the facility code, which can be used to access the information contained in the profile.« less

Skilled nursing facilities reform.

PubMed

1998-06-01

The Medicare prospective payment system for skilled nursing facilities will take effect with cost reporting years beginning on or after July 1, 1998. HCFA is working on the implementation details. While final details are not expected to be published until Summer 1998, the following information has been provided through HCFA and/or the Nursing Home Case-Mix and Quality (NHCMQ) Demonstration project (RUGs-III) procedures.

How to implement security controls for an information security program at CBRN facilities

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

Lenaeus, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.

This document was prepared by PNNL within the framework of Project 19 of the European Union Chemical Biological Radiological and Nuclear Risk Mitigation Centres of Excellence Initiative entitled, ''Development of procedures and guidelines to create and improve secure information management systems and data exchange mechanisms for CBRN materials under regulatory control.'' It provides management and workers at CBRN facilities, parent organization managers responsible for those facilities, and regulatory agencies (governmental and nongovernmental) with guidance on the best practices for protecting information security. The security mitigation approaches presented in this document were chosen because they present generally accepted guidance in anmore » easy-to-understand manner, making it easier for facility personnel to grasp key concepts and envision how security controls could be implemented by the facility. This guidance is presented from a risk management perspective.« less

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2013 CFR

2013-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2010 CFR

2010-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2014 CFR

2014-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2011 CFR

2011-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2012 CFR

2012-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

Estimating the cost of informal caregiving for elderly patients with cancer.

PubMed

Hayman, J A; Langa, K M; Kabeto, M U; Katz, S J; DeMonner, S M; Chernew, M E; Slavin, M B; Fendrick, A M

2001-07-01

As the United States population ages, the increasing prevalence of cancer is likely to result in higher direct medical and nonmedical costs. Although estimates of the associated direct medical costs exist, very little information is available regarding the prevalence, time, and cost associated with informal caregiving for elderly cancer patients. To estimate these costs, we used data from the first wave (1993) of the Asset and Health Dynamics (AHEAD) Study, a nationally representative longitudinal survey of people aged 70 or older. Using a multivariable, two-part regression model to control for differences in health and functional status, social support, and sociodemographics, we estimated the probability of receiving informal care, the average weekly number of caregiving hours, and the average annual caregiving cost per case (assuming an average hourly wage of $8.17) for subjects who reported no history of cancer (NC), having a diagnosis of cancer but not receiving treatment for their cancer in the last year (CNT), and having a diagnosis of cancer and receiving treatment in the last year (CT). Of the 7,443 subjects surveyed, 6,422 (86%) reported NC, 718 (10%) reported CNT, and 303 (4%) reported CT. Whereas the adjusted probability of informal caregiving for those respondents reporting NC and CNT was 26%, it was 34% for those reporting CT (P <.05). Those subjects reporting CT received an average of 10.0 hours of informal caregiving per week, as compared with 6.9 and 6.8 hours for those who reported NC and CNT, respectively (P <.05). Accordingly, cancer treatment was associated with an incremental increase of 3.1 hours per week, which translates into an additional average yearly cost of $1,200 per patient and just over $1 billion nationally. Informal caregiving costs are substantial and should be considered when estimating the cost of cancer treatment in the elderly.

Modelling the cost-effectiveness of impact-absorbing flooring in Swedish residential care facilities.

PubMed

Ryen, Linda; Svensson, Mikael

2016-06-01

Fall-related injuries among the elderly, specifically hip fractures, cause significant morbidity and mortality as well as imposing a substantial financial cost on the health care system. Impact-absorbing flooring has been advocated as an effective method for preventing hip fractures resulting from falls. This study identifies the cost-effectiveness of impact-absorbing flooring compared to standard flooring in residential care facilities for the elderly in a Swedish setting. An incremental cost-effectiveness analysis was performed comparing impact-absorbing flooring to standard flooring using a Markov decision model. A societal perspective was adopted and incremental costs were compared to incremental gains in quality-adjusted life years (QALYs). Data on costs, probability transitions and health-related quality of life measures were retrieved from the published literature and from Swedish register data. Probabilistic sensitivity analysis was performed through a Monte Carlo simulation. The base-case analysis indicates that the impact-absorbing flooring reduces costs and increases QALYs. When allowing for uncertainty we find that 60% of the simulations indicate that impact-absorbing flooring is cost-saving compared to standard flooring and an additional 20% that it has a cost per QALY below a commonly used threshold value : Using a modelling approach, we find that impact-absorbing flooring is a dominant strategy at the societal level considering that it can save resources and improve health in a vulnerable population. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The administrative costs of community-based health insurance: a case study of the community health fund in Tanzania

PubMed Central

Borghi, Josephine; Makawia, Suzan; Kuwawenaruwa, August

2015-01-01

Community-based health insurance expansion has been proposed as a financing solution for the sizable informal sector in low-income settings. However, there is limited evidence of the administrative costs of such schemes. We assessed annual facility and district-level costs of running the Community Health Fund (CHF), a voluntary health insurance scheme for the informal sector in a rural and an urban district from the same region in Tanzania. Information on resource use, CHF membership and revenue was obtained from district managers and health workers from two facilities in each district. The administrative cost per CHF member household and the cost to revenue ratio were estimated. Revenue collection was the most costly activity at facility level (78% of total costs), followed by stewardship and management (13%) and pooling of funds (10%). Stewardship and management was the main activity at district level. The administration cost per CHF member household ranged from USD 3.33 to USD 12.12 per year. The cost to revenue ratio ranged from 50% to 364%. The cost of administering the CHF was high relative to revenue generated. Similar studies from other settings should be encouraged. PMID:24334331

77 FR 63804 - Federal Acquisition Regulation; Information Collection; Indirect Cost Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... cost accounting information normally prepared by organizations under sound management and accounting...; Information Collection; Indirect Cost Rates AGENCY: Department of Defense (DOD), General Services... Paperwork Reduction Act, the Regulatory Secretariat will be submitting to the Office of Management and...

A comparative cost analysis of polytrauma and neurosurgery Intensive Care Units at an apex trauma care facility in India.

PubMed

Kumar, Parmeshwar; Jithesh, V; Gupta, Shakti Kumar

2016-07-01

Although Intensive Care Units (ICUs) only account for 10% of the hospital beds, they consume nearly 22% of the hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. The aim of this study was to evaluate and compare the cost of intensive care delivery between multispecialty and neurosurgery ICUs at an apex trauma care facility in India. The study was conducted in a polytrauma and neurosurgery ICU at a 203-bedded Level IV trauma care facility in New Delhi, India, from May 1, 2012 to June 30, 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in the study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical analysis was performed by Fisher's two tailed t-test. Total cost/bed/day for the multispecialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU, it was Rs. 14,306.7/-, workforce constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Quantification of expenditure in running an ICU in a trauma center would assist health-care decision makers in better allocation of resources. Although multispecialty ICUs are more cost-effective, other factors will also play a role in defining the kind of ICU that needs to be designed.

The costs of accessing abortion in South Africa: women's costs associated with second-trimester abortion services in Western Cape Province.

PubMed

Lince-Deroche, Naomi; Constant, Deborah; Harries, Jane; Blanchard, Kelly; Sinanovic, Edina; Grossman, Daniel

2015-10-01

To assess women's costs of accessing second-trimester labor induction and dilation and evacuation (D&E) services at four public hospitals in Western Cape Province, South Africa. From April to August 2010, in interviews immediately after completion of their abortion, we asked women about specific direct and indirect costs incurred. We collected information on recurring costs (i.e., per visit) and one-time expenditures and calculated total costs. In total, 194 patients participated (136 D&E; 58 induction). Their median age was 26; 37.6% reported being employed or doing paid work. Most (73.2%) women visited two different facilities, including the study facility, while seeking the procedure. Induction women reported a median of three required visits [interquartile range (IQR) 2.0-3.0] to the study facility, while D&E women reported two required visits [IQR 1.0-2.0]. Twenty-seven percent of women missed work due to the procedure, and few (4.6%) paid for childcare. At each visit, almost all women (180, 92.8%) paid for transportation costs and reported additional one-time costs (177, 91.2%) such as sanitary supplies or doctor's fees. The total median cost incurred per woman was $21.23 [IQR 11.94-44.68]. Roughly half (49.0%) received help with these costs. Although technically offered freely or low cost in the public sector, women accessing second-trimester abortion lost income and incurred costs for transport, fees, supplies and childcare. Their total costs could be reduced by minimizing the number of required visits to facilities and freely offering supplies such as sanitary pads and pregnancy tests. Limited access to second-trimester, safe abortion services in South Africa may result in some women incurring unnecessary costs. Women make multiple visits in attempting to obtain an abortion, often because of facility or health systems requirements, and incur costs for lost income, child care, transport, fees and supplies. Copyright © 2015 Elsevier Inc. All rights reserved.

Forum Guide to Facilities Information Management: A Resource for State and Local Education Agencies. NFES 2012-808

ERIC Educational Resources Information Center

National Forum on Education Statistics, 2012

2012-01-01

Safe and secure facilities that foster learning are crucial to providing quality education services, and developing and maintaining these facilities requires considerable resources and organization. Facility information systems allow education organizations to collect and manage data that can be used to inform and guide decisionmaking about the…

17 CFR 37.8 - Information relating to transactions on derivatives transaction execution facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Information relating to transactions on derivatives transaction execution facilities. 37.8 Section 37.8 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION DERIVATIVES TRANSACTION EXECUTION FACILITIES § 37.8...

The neglected topic: presentation of cost information in patient decision AIDS.

PubMed

Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

2015-05-01

Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. © The Author(s) 2015.

Direct Allocation Costing: Informed Management Decisions in a Changing Environment.

ERIC Educational Resources Information Center

Mancini, Cesidio G.; Goeres, Ernest R.

1995-01-01

It is argued that colleges and universities can use direct allocation costing to provide quantitative information needed for decision making. This method of analysis requires institutions to modify traditional ideas of costing, looking to the private sector for examples of accurate costing techniques. (MSE)

What Do Information Technology Support Services Really Cost?

ERIC Educational Resources Information Center

Leach, Karen; Smallen, David

1998-01-01

A study examined the cost of information-technology support services in higher education institutions. The report describes the project's origins and work to date and reports initial results in three areas: network services, desktop repair services, and administrative information systems, looking in each case at economies of scale, outsourcing…

Synthetic fiber production facilities: Background information for proposed standards

NASA Astrophysics Data System (ADS)

Goodwin, D. R.

1982-10-01

Standards of performance to control emissions of volatile organic compounds (VOC) from new, modified, and reconstructed synthetic fiber production facilities are being proposed under section III of the Clean Air Act. This document contains information on the background and authority, regulatory alternatives considered, and environmental and economic impacts of the regulatory alternatives.

TU-G-BRCD-01: Will the High Cost of Proton Therapy Facilities Limit the Availability of Proton Therapy Treatment?

PubMed

Maughan, R

2012-06-01

The potential dose distribution advantages associated with proton therapy, and particularly with pencil beam scanning (PBS) techniques, have lead to considerable interest in this modality in recent years. However, the large capital expenditure necessary for such a project requires careful financial consideration and business planning. The complexity of the beam delivery systems impacts the capital expenditure and the PBS only systems presently being advocated can reduce these costs. Also several manufacturers are considering "one-room" facilities as less expensive alternatives to multi-room facilities. This presentation includes a brief introduction to beam delivery options (passive scattering, uniform and modulated scanning) and some of the new technologies proposed for providing less expensive proton therapy systems. Based on current experience, data on proton therapy center start-up costs, running costs and the financial challenges associated with making this highly conformal therapy more widely available will be discussed. Issues associated with proton therapy implementation that are key to project success include strong project management, vendor cooperation and collaboration, staff recruitment and training. Time management during facility start up is a major concern, particularly in multi-room systems, where time must be shared between continuing vendor system validation, verification and acceptance testing, and user commissioning and patient treatments. The challenges associated with facility operation during this period and beyond are discussed, focusing on how standardization of process, downtime and smart scheduling can influence operational efficiency. 1. To understand the available choices for proton therapy facilities, the different beam delivery systems and the financial implications associated with these choices. 2. To understand the key elements necessary for successfully implementing a proton therapy program. 3. To understand the challenges

The energy cost of quantum information losses

NASA Astrophysics Data System (ADS)

Romanelli, Alejandro; de Lima Marquezino, Franklin; Portugal, Renato; Donangelo, Raul

2018-05-01

We explore the energy cost of the information loss resulting from the passage of an initial density operator to a reduced one. We use the concept of entanglement temperature in order to obtain a lower bound for the energy change associated with this operation. We determine the minimal energy required for the case of the information losses associated with the trace over the space coordinates of a two-dimensional quantum walk.

Space Infrared Telescope Facility (SIRTF) - Operations concept. [decreasing development and operations cost

NASA Technical Reports Server (NTRS)

Miller, Richard B.

1992-01-01

The development and operations costs of the Space IR Telescope Facility (SIRTF) are discussed in the light of minimizing total outlays and optimizing efficiency. The development phase cannot extend into the post-launch segment which is planned to only support system verification and calibration followed by operations with a 70-percent efficiency goal. The importance of reducing the ground-support staff is demonstrated, and the value of the highly sensitive observations to the general astronomical community is described. The Failure Protection Algorithm for the SIRTF is designed for the 5-yr lifetime and the continuous venting of cryogen, and a science driven ground/operations system is described. Attention is given to balancing cost and performance, prototyping during the development phase, incremental development, the utilization of standards, and the integration of ground system/operations with flight system integration and test.

Transient Dissipation and Structural Costs of Physical Information Transduction

NASA Astrophysics Data System (ADS)

Boyd, Alexander B.; Mandal, Dibyendu; Riechers, Paul M.; Crutchfield, James P.

2017-06-01

A central result that arose in applying information theory to the stochastic thermodynamics of nonlinear dynamical systems is the information-processing second law (IPSL): the physical entropy of the Universe can decrease if compensated by the Shannon-Kolmogorov-Sinai entropy change of appropriate information-carrying degrees of freedom. In particular, the asymptotic-rate IPSL precisely delineates the thermodynamic functioning of autonomous Maxwellian demons and information engines. How do these systems begin to function as engines, Landauer erasers, and error correctors? We identify a minimal, and thus inescapable, transient dissipation of physical information processing, which is not captured by asymptotic rates, but is critical to adaptive thermodynamic processes such as those found in biological systems. A component of transient dissipation, we also identify an implementation-dependent cost that varies from one physical substrate to another for the same information processing task. Applying these results to producing structured patterns from a structureless information reservoir, we show that "retrodictive" generators achieve the minimal costs. The results establish the thermodynamic toll imposed by a physical system's structure as it comes to optimally transduce information.

Using Executive Information Systems to Manage Capital Projects and Facilities.

ERIC Educational Resources Information Center

Kaynor, Robert

1993-01-01

In higher education, facilities data are essential for long-term capital and financial planning and for testing assumptions underlying anticipated policy change. Executive information systems should incorporate life-cycle considerations (planning, construction, renovation, and management) and resource linkages (describing interrelationships of…

Effect of prospective reimbursement on nursing home costs.

PubMed Central

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-01-01

OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. STUDY DESIGN. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. PRINCIPAL FINDINGS. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. CONCLUSIONS. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems. PMID:8463109

Trends in U.S. Oil and Natural Gas Upstream Costs

EIA Publications

2016-01-01

Average 2015 well drilling and completion costs in five onshore areas decline 25% and 30% below their level in 2012 The U.S. Energy Information Administration (EIA) commissioned IHS Global Inc. (IHS) to perform a study of upstream drilling and production costs. The IHS report assesses capital and operating costs associated with drilling, completing, and operating wells and facilities.

Thermodynamic Costs of Information Processing in Sensory Adaptation

PubMed Central

Sartori, Pablo; Granger, Léo; Lee, Chiu Fan; Horowitz, Jordan M.

2014-01-01

Biological sensory systems react to changes in their surroundings. They are characterized by fast response and slow adaptation to varying environmental cues. Insofar as sensory adaptive systems map environmental changes to changes of their internal degrees of freedom, they can be regarded as computational devices manipulating information. Landauer established that information is ultimately physical, and its manipulation subject to the entropic and energetic bounds of thermodynamics. Thus the fundamental costs of biological sensory adaptation can be elucidated by tracking how the information the system has about its environment is altered. These bounds are particularly relevant for small organisms, which unlike everyday computers, operate at very low energies. In this paper, we establish a general framework for the thermodynamics of information processing in sensing. With it, we quantify how during sensory adaptation information about the past is erased, while information about the present is gathered. This process produces entropy larger than the amount of old information erased and has an energetic cost bounded by the amount of new information written to memory. We apply these principles to the E. coli's chemotaxis pathway during binary ligand concentration changes. In this regime, we quantify the amount of information stored by each methyl group and show that receptors consume energy in the range of the information-theoretic minimum. Our work provides a basis for further inquiries into more complex phenomena, such as gradient sensing and frequency response. PMID:25503948

Cost-Benefit Analysis of the Officer Career Information and Planning System

DTIC Science & Technology

1980-08-01

information without the use of a computer. - vii COST-BENEFIT ANALYSIS OF THE OFFICER CAREER INFOýKATTON AND PLANNING SYSTEM CONTENTS Page INTRODUCTION ...OF THE OFFICER CAREER INFORMATION AND PLANNING SYSTEM INTRODUCTION The implementation of the Officer Personnel Management System (OPMS) has...Research Report 1256 I / COST-BENEFIT ANALYSIS OF THE OFFICER CAREER INFORMATION AND PLANNING SYSTEM Roger A. Myers, Peter C. Cairo, K - Jon A

National facilities study. Volume 5: Space research and development facilities task group

NASA Technical Reports Server (NTRS)

1994-01-01

With the beginnings of the U.S. space program, there was a pressing need to develop facilities that could support the technology research and development, testing, and operations of evolving space systems. Redundancy in facilities that was once and advantage in providing flexibility and schedule accommodation is instead fast becoming a burden on scarce resources. As a result, there is a clear perception in many sectors that the U.S. has many space R&D facilities that are under-utilized and which are no longer cost-effective to maintain. At the same time, it is clear that the U.S. continues to possess many space R&D facilities which are the best -- or among the best -- in the world. In order to remain world class in key areas, careful assessment of current capabilities and planning for new facilities is needed. The National Facility Study (NFS) was initiated in 1992 to develop a comprehensive and integrated long-term plan for future aerospace facilities that meets current and projected government and commercial needs. In order to assess the nation's capability to support space research and development (R&D), a Space R&D Task Group was formed. The Task Group was co-chaired by NASA and DOD. The Task Group formed four major, technologically- and functionally- oriented working groups: Human and Machine Operations; Information and Communications; Propulsion and Power; and Materials, Structures, and Flight Dynamics. In addition to these groups, three supporting working groups were formed: Systems Engineering and Requirements; Strategy and Policy; and Costing Analysis. The Space R&D Task Group examined several hundred facilities against the template of a baseline mission and requirements model (developed in common with the Space Operations Task Group) and a set of excursions from the baseline. The model and excursions are described in Volume 3 of the NFS final report. In addition, as a part of the effort, the group examined key strategic issues associated with space R

A comparative cost analysis of polytrauma and neurosurgery Intensive Care Units at an apex trauma care facility in India

PubMed Central

Kumar, Parmeshwar; Jithesh, V.; Gupta, Shakti Kumar

2016-01-01

Context: Although Intensive Care Units (ICUs) only account for 10% of the hospital beds, they consume nearly 22% of the hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: The aim of this study was to evaluate and compare the cost of intensive care delivery between multispecialty and neurosurgery ICUs at an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203-bedded Level IV trauma care facility in New Delhi, India, from May 1, 2012 to June 30, 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in the study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Statistical analysis was performed by Fisher's two tailed t-test. Results: Total cost/bed/day for the multispecialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU, it was Rs. 14,306.7/-, workforce constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist health-care decision makers in better allocation of resources. Although multispecialty ICUs are more cost-effective, other factors will also play a role in defining the kind of ICU that needs to be designed. PMID:27555693

Information system technologies' role in augmenting dermatologists' knowledge of prescription medication costs.

PubMed

DeMarco, Sebastian S; Paul, Ravi; Kilpatrick, Russell J

2015-12-01

Despite the recent rising costs of once affordable dermatologic prescription medications, a survey measuring dermatologists' attitudes, beliefs, and knowledge of the cost of drugs they commonly prescribe has not been conducted. Awareness of drug costs is hindered by a lack of access to data about the prices of medicines. No surveys of physicians have addressed this issue by proposing new information system technologies that augment prescription medication price transparency and measuring how receptive physicians are to using these novel solutions in their daily clinical practice. Our research aims to investigate these topics with a survey of physicians in dermatology. Members of the North Carolina Dermatology Association were contacted through their electronic mailing list and asked to take an online survey. The survey asked several questions about dermatologists' attitudes and beliefs about drug costs. To measure their knowledge of prescription medications, the National Average Drug Acquisition Cost was used as an authoritative price that was compared to the survey takers' price estimates of drugs commonly used in dermatology. Physicians' willingness to use four distinct information system technologies that increase drug price transparency was also assessed. Dermatologists believe drug costs are an important factor in patient care and believe access to price information would allow them to provide a higher quality of care. Dermatologists' knowledge of the costs of medicines they commonly prescribe is poor, but they want to utilize information system technologies that increase access to drug pricing information. There is an unmet demand for information system technologies which increase price transparency of medications in dermatology. Physicians and IT professionals have the opportunity to create novel information systems that can be utilized to help guide cost conscious clinical decision making. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The prediction of engineering cost for green buildings based on information entropy

NASA Astrophysics Data System (ADS)

Liang, Guoqiang; Huang, Jinglian

2018-03-01

Green building is the developing trend in the world building industry. Additionally, construction costs are an essential consideration in building constructions. Therefore, it is necessary to investigate the problems of cost prediction in green building. On the basis of analyzing the cost of green building, this paper proposes the forecasting method of actual cost in green building based on information entropy and provides the forecasting working procedure. Using the probability density obtained from statistical data, such as labor costs, material costs, machinery costs, administration costs, profits, risk costs a unit project quotation and etc., situations can be predicted which lead to cost variations between budgeted cost and actual cost in constructions, through estimating the information entropy of budgeted cost and actual cost. The research results of this article have a practical significance in cost control of green building. Additionally, the method proposed in this article can be generalized and applied to a variety of other aspects in building management.

48 CFR 215.403-5 - Instructions for submission of cost or pricing data or information other than cost or pricing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... submission of cost or pricing data or information other than cost or pricing data. 215.403-5 Section 215.403... DEFENSE CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 215.403-5 Instructions for submission of cost or pricing data or information other than cost or pricing data. When the...

Organ Donor Recovery Performed at an Organ Procurement Organization-Based Facility Is an Effective Way to Minimize Organ Recovery Costs and Increase Organ Yield.

PubMed

Doyle, Majella; Subramanian, Vijay; Vachharajani, Neeta; Collins, Kelly; Wellen, Jason R; Stahlschmidt, Emily; Brockmeier, Diane; Coleman, Jason; Kappel, Dean; Chapman, William C

2016-04-01

A new era in organ donation with national redistricting is being proposed. With these proposals, costs of organ acquisition are estimated to more than double. Traditionally, organ recoveries occur in the donor hospital setting, incurring premium hospital expenses. The aim of the study was to determine organ recovery costs and organ yield for donor recoveries performed at an organ procurement organization (OPO) facility. In 2001, we established an OPO facility and in 2008 began transferring the donor expeditiously when brain death was declared. The OPO donor and hospital costs on a per donor basis were calculated. Donation after cardiac death donors cannot be transferred and were included in the hospital cost analysis. From January 2009 to December 2014, nine hundred and sixty-three donors originating in our OPO had organs recovered and transplanted. Seven hundred and sixty-six (79.5%) donors were transferred to the OPO facility 8.6 hours (range 0.6 to 23.6 hours) after declaration of brain death. Donor recovery cost was 51% less when donors were transferred to the OPO facility ($16,153 OPO recovery vs $33,161 hospital recovery; p < 0.0001). Organ yield was 27.5% better (3.43 organs) from OPO-recovered donors vs an organ yield of 2.69 from hospital-recovered donors (p < 0.0001). Standard criteria donor organ yield from our OPO was 6% higher than the national average (3.92 vs 3.7 nationally; p = 0.012) and expanded criteria donor organ yield was 18% higher (2.2 vs 1.87 nationally; p = 0.03). An OPO facility for donor organ recovery increases efficiency and organ yield, reduces costs, and minimizes organ acquisition charge. As we face new considerations with broader sharing, increased efficiencies, cost. and organ use should be considered. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Cost comparison of unit dose and traditional drug distribution in a long-term-care facility.

PubMed

Lepinski, P W; Thielke, T S; Collins, D M; Hanson, A

1986-11-01

Unit dose and traditional drug distribution systems were compared in a 352-bed long-term-care facility by analyzing nursing time, medication-error rate, medication costs, and waste. Time spent by nurses in preparing, administering, charting, and other tasks associated with medications was measured with a stop-watch on four different nursing units during six-week periods before and after the nursing home began using unit dose drug distribution. Medication-error rate before and after implementation of the unit dose system was determined by patient profile audits and medication inventories. Medication costs consisted of patient billing costs (acquisition cost plus fee) and cost of medications destroyed. The unit dose system required a projected 1507.2 hours less nursing time per year. Mean medication-error rates were 8.53% and 0.97% for the traditional and unit dose systems, respectively. Potential annual savings because of decreased medication waste with the unit dose system were $2238.72. The net increase in cost for the unit dose system was estimated at $615.05 per year, or approximately $1.75 per patient. The unit dose system appears safer and more time-efficient than the traditional system, although its costs are higher.

Organizational factors influencing health information technology adoption in long-term-care facilities.

PubMed

Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

2014-01-01

Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary.

Variation in the costs of delivering routine immunization services in Peru.

PubMed Central

Walker, D.; Mosqueira, N. R.; Penny, M. E.; Lanata, C. F.; Clark, A. D.; Sanderson, C. F. B.; Fox-Rushby, J. A.

2004-01-01

OBJECTIVE: Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). METHODS: We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. FINDINGS: The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. CONCLUSION: This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation. PMID:15628205

Variation in the costs of delivering routine immunization services in Peru.

PubMed

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

Detecting New Pedestrian Facilities from VGI Data Sources

NASA Astrophysics Data System (ADS)

Zhong, S.; Xie, Z.

2017-12-01

Pedestrian facility (e.g. footbridge, pedestrian crossing and underground passage) information is an important basic data of location based service (LBS) for pedestrians. However, timely updating pedestrian facility information challenges due to facilities change frequently. Previous pedestrian facility information collecting and updating tasks are mainly completed by highly trained specialized persons. However, this conventional approach has several disadvantages such as high cost, long update cycle and so on. Volunteered Geographic Information (VGI) has proven efficiency to provide new, free and fast growing spatial data. Pedestrian trajectory, which can be seen as measurements of real pedestrian road, is one of the most valuable information of VGI data. Although the accuracy of the trajectories is not too high, due to the large number of measurements, an improvement of quality of the road information can be achieved. Thus, we develop a method for detecting new pedestrian facilities based on the current road network and pedestrian trajectories. Specifically, 1) by analyzing speed, distance and direction, those outliers of pedestrian trajectories are removed, 2) a road network matching algorithm is developed for eliminating redundant trajectories, and 3) a space-time cluster algorithm is adopted for detecting new walking facilities. The performance of the method is evaluated with a series of experiments conducted on a part of the road network of Heifei and a large number of real pedestrian trajectories, and verified the results by using Tencent Street map. The results show that the proposed method is able to detecting new pedestrian facilities from VGI data accurately. We believe that the proposed method provides an alternative way for general road data acquisition, and can improve the quality of LBS for pedestrians.

Use of information technology for medication management in residential care facilities: correlates of facility characteristics.

PubMed

Bhuyan, Soumitra S; Chandak, Aastha; Powell, M Paige; Kim, Jungyoon; Shiyanbola, Olayinka; Zhu, He; Shiyanbola, Oyewale

2015-06-01

The effectiveness of information technology in resolving medication problems has been well documented. Long-term care settings such as residential care facilities (RCFs) may see the benefits of using such technologies in addressing the problem of medication errors among their resident population, who are usually older and have numerous chronic conditions. The aim of this study was two-fold: to examine the extent of use of Electronic Medication Management (EMM) in RCFs and to analyze the organizational factors associated with the use of EMM functionalities in RCFs. Data on RCFs were obtained from the 2010 National Survey of Residential Care Facilities. The association between facility, director and staff, and resident characteristics of RCFs and adoption of four EMM functionalities was assessed through multivariate logistic regression. The four EMM functionalities included were maintaining lists of medications, ordering for prescriptions, maintaining active medication allergy lists, and warning of drug interactions or contraindications. About 12% of the RCFs adopted all four EMM functionalities. Additionally, maintaining lists of medications had the highest adoption rate (34.5%), followed by maintaining active medication allergy lists (31.6%), ordering for prescriptions (19.7%), and warning of drug interactions or contraindications (17.9%). Facility size and ownership status were significantly associated with adoption of all four EMM functionalities. Medicaid certification status, facility director's age, education and license status, and the use of personal care aides in the RCF were significantly associated with the adoption of some of the EMM functionalities. EMM is expected to improve the quality of care and patient safety in long-term care facilities including RCFs. The extent of adoption of the four EMM functionalities is relatively low in RCFs. Some RCFs may strategize to use these functionalities to cater to the increasing demands from the market and also to

A DDC Bibliography on Cost/Benefits of Technical Information Services and Technology Transfer.

ERIC Educational Resources Information Center

Defense Documentation Center, Alexandria, VA.

This bibliography is a compilation of literature existing in both the government and public sectors and concerning Cost/Benefits of Technical information Services and Technology Transfer. Not only was the cost-benefit to the user reflected, but consideration was given to the initial cost of information collections, the cost of processing the…

Determinants of quality of shared sanitation facilities in informal settlements: case study of Kisumu, Kenya.

PubMed

Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy; Rheingans, Richard

2017-01-11

Shared facilities are not recognised as improved sanitation due to challenges of maintenance as they easily can be avenues for the spread of diseases. Thus there is need to evaluate the quality of shared facilities, especially in informal settlements, where they are commonly used. A shared facility can be equated to a common good whose management depends on the users. If users do not work collectively towards keeping the facility clean, it is likely that the quality may depreciate due to lack of maintenance. This study examined the quality of shared sanitation facilities and used the common pool resource (CPR) management principles to examine the determinants of shared sanitation quality in the informal settlements of Kisumu, Kenya. Using a multiple case study design, the study employed both quantitative and qualitative methods. In both phases, users of shared sanitation facilities were interviewed, while shared sanitation facilities were inspected. Shared sanitation quality was a score which was the dependent variable in a regression analysis. Interviews during the qualitative stage were aimed at understanding management practices of shared sanitation users. Qualitative data was analysed thematically by following the CPR principles. Shared facilities, most of which were dirty, were shared by an average of eight households, and their quality decreased with an increase in the number of households sharing. The effect of numbers on quality is explained by behaviour reflected in the CPR principles, as it was easier to define boundaries of shared facilities when there were fewer users who cooperated towards improving their shared sanitation facility. Other factors, such as defined management systems, cooperation, collective decision making, and social norms, also played a role in influencing the behaviour of users towards keeping shared facilities clean and functional. Apart from hardware factors, quality of shared sanitation is largely due to group behaviour of users

Facility cost analysis in outpatient plastic surgery: implications for the academic health center.

PubMed

Pacella, Salvatore J; Comstock, Matthew C; Kuzon, William M

2008-04-01

The authors examined the economic patterns of outpatient aesthetic and reconstructive plastic surgical procedures performed within an academic health center. For fiscal years 2003 and 2004, the University of Michigan Health System's accounting database was queried to identify all outpatient plastic surgery cases (aesthetic and reconstructive) from four surgical facilities. Total facility charges, cost, revenue, and margin were calculated for each case. Contribution margin (total revenue minus variable direct cost) was compared with total case time to determine average contribution margin per operating suite case minute for subsets of aesthetic and reconstructive procedures. A total of 3603 cases (3457 reconstructive and 146 aesthetic) were identified. Payer mix included Blue Cross (36.7 percent), health maintenance organization (28.7 percent), other commercial payers (17.4 percent), Medicare/Medicaid (13.5 percent), and self-pay (3.7 percent). The most profitable cases were reconstructive laser procedures ($66.20; n = 361), scar revision ($36.01; n = 25), and facial trauma ($32.17; n = 64). The least profitable were hand arthroplasty ($13.93; n = 35), arthroscopy ($17.25; n = 15), and breast reduction ($17.46; n = 210). Aesthetic procedures (n = 144) yielded a significantly higher contribution margin per case minute ($24.21) compared with reconstructive procedures ($22.28; n = 3093) (p = 0.01). Plastic surgical cases performed at dedicated ambulatory surgery centers ($28.60; n = 1477) yielded significantly higher contribution margin per case minute compared with those performed at hospital-based facilities ($25.58; n = 2123) (p < 0.01). Use of standardized accounting (contribution margin per case minute) can be a strategically effective method for determining the most profitable and appropriate case mix. Within academic health centers, aesthetic surgery can be a profitable enterprise; dedicated ambulatory surgery centers yield higher profitability.

SAMICS support study. Volume 1: Cost account catalog

NASA Technical Reports Server (NTRS)

1977-01-01

The Jet Propulsion Laboratory (JPL) is examining the feasibility of a new industry to produce photovoltaic solar energy collectors similar to those used on spacecraft. To do this, a standardized costing procedure was developed. The Solar Array Manufacturing Industry Costing Standards (SAMICS) support study supplies the following information: (1) SAMICS critique; (2) Standard data base--cost account structure, expense item costs, inflation rates, indirect requirements relationships, and standard financial parameter values; (3) Facilities capital cost estimating relationships; (4) Conceptual plant designs; (5) Construction lead times; (6) Production start-up times; (7) Manufacturing price estimates.

Examining the cost of delivering routine immunization in Honduras.

PubMed

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

Cost-effectiveness of the treatment of uncomplicated severe acute malnutrition by community health workers compared to treatment provided at an outpatient facility in rural Mali.

PubMed

Rogers, Eleanor; Martínez, Karen; Morán, Jose Luis Alvarez; Alé, Franck G B; Charle, Pilar; Guerrero, Saul; Puett, Chloe

2018-02-20

The Malian Nutrition Division of the Ministry of Health and Action Against Hunger tested the feasibility of integrating treatment of severe acute malnutrition (SAM) into the existing Integrated Community Case Management package delivered by community health workers (CHWs). This study assessed costs and cost-effectiveness of CHW-delivered care compared to outpatient facility-based care. Activity-based costing methods were used, and a societal perspective employed to include all relevant costs incurred by institutions, beneficiaries and communities. The intervention and control arm enrolled different numbers of children so a modelled scenario sensitivity analysis was conducted to assess the cost-effectiveness of the two arms, assuming equal numbers of children enrolled. In the base case, with unequal numbers of children in each arm, for CHW-delivered care, the cost per child treated was 244 USD and cost per child recovered was 259 USD. Outpatient facility-based care was less cost-effective at 442 USD per child and 501 USD per child recovered. The conclusions of the analysis changed in the modelled scenario sensitivity analysis, with outpatient facility-based care being marginally more cost-effective (cost per child treated is 188 USD, cost per child recovered is 214 USD), compared to CHW-delivered care. This suggests that achieving good coverage is a key factor influencing cost-effectiveness of CHWs delivering treatment for SAM in this setting. Per week of treatment, households receiving CHW-delivered care spent half of the time receiving treatment and three times less money compared with those receiving treatment from the outpatient facility. This study supports existing evidence that the delivery of treatment by CHWs is a cost-effective intervention, provided that good coverage is achieved. A major benefit of this strategy was the lower cost incurred by the beneficiary household when treatment is available in the community. Further research is needed on the

Cashless childbirth, but at a cost: A grounded theory study on quality of intrapartum care in public health facilities in India.

PubMed

Jha, Paridhi; Christensson, Kyllike; Svanberg, Agneta Skoog; Larsson, Margareta; Sharma, Bharati; Johansson, Eva

2016-08-01

this study aimed to explore and understand the perceptions and experiences of women regarding quality of care received during childbirth in public health facilities. qualitative in-depth interviews were conducted and analysed using the Grounded Theory approach. thirteen women who had given vaginal birth to a healthy newborn infant. participants were interviewed in their homes in one district of Chhattisgarh, India. the interview followed a pre-tested guide comprising one key question: How did the women experience and perceive the care provided during labour and childbirth? 'cashless childbirth but at a cost: subordination during childbirth' was identified as the core category. Women chose a public health facility due to their socio-economic limitations, and to have a cashless and safe childbirth. Participants expressed a sense of trust in public health facilities, and verbalised that free food and ambulance services provided by the government were appreciated. Care during normal birth was medicalised, and women lacked control over the process of their labour. Often, the women experienced verbal and physical abuse, which led to passive acceptance of all the services provided to avoid confrontation with the providers. increasingly higher numbers of women give birth in public health facilities in Chhattisgarh, India, and women who have no alternative place to have a safe and normal birth are the main beneficiaries. The labour rooms are functional, but there is a need for improvement of interpersonal processes, information-sharing, and sensitive treatment of women seeking childbirth services in public health facilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Low Cost Course Information Syndication System

ERIC Educational Resources Information Center

Ajayi, A. O.; Olajubu, E. A.; Bello, S. A.; Soriyan, H. A.; Obamuyide, A. V.

2011-01-01

This study presents a cost effective, reliable, and convenient mobile web-based system to facilitate the dissemination of course information to students, to support interaction that goes beyond the classroom. The system employed the Really Simple Syndication (RSS) technology and was developed using Rapid Application Development (RAD) methodology.…

A “Cookbook” Cost Analysis Procedure for Medical Information Systems*

PubMed Central

Torrance, Janice L.; Torrance, George W.; Covvey, H. Dominic

1983-01-01

A costing procedure for medical information systems is described. The procedure incorporates state-of-the-art costing methods in an easy to follow “cookbook” format. Application of the procedure consists of filling out a series of Mac-Tor EZ-Cost forms. The procedure and forms have been field tested by application to a cardiovascular database system. This article describes the major features of the costing procedure. The forms and other details are available upon request.

Comparison of Informal Care Time and Costs in Different Age-Related Dementias: A Review

PubMed Central

Costa, Nadège; Ferlicoq, Laura; Derumeaux-Burel, Hélène; Rapp, Thomas; Garnault, Valérie; Gillette-Guyonnet, Sophie; Andrieu, Sandrine; Vellas, Bruno; Lamure, Michel; Grand, Alain; Molinier, Laurent

2013-01-01

Objectives. Age-related dementia is a progressive degenerative brain syndrome whose prevalence increases with age. Dementias cause a substantial burden on society and on families who provide informal care. This study aims to review the relevant papers to compare informal care time and costs in different dementias. Methods. A bibliographic search was performed on an international medical literature database (MEDLINE). All studies which assessed the social economic burden of different dementias were selected. Informal care time and costs were analyzed in three care settings by disease stages. Results. 21 studies met our criteria. Mean informal care time was 55.73 h per week for Alzheimer disease and 15.8 h per week for Parkinson disease (P = 0.0076), and the associated mean annual informal costs were $17,492 versus $3,284, respectively (P = 0.0393). Conclusion. There is a lack of data about informal care time and costs among other dementias than AD or PD. Globally, AD is the most costly in terms of informal care costs than PD, $17,492 versus $3,284, respectively. PMID:23509789

Space facilities: Meeting future needs for research, development, and operations

NASA Technical Reports Server (NTRS)

1994-01-01

The National Facilities Study (NFS) represents an interagency effort to develop a comprehensive and integrated long-term plan for world-class aeronautical and space facilities that meet current and projected needs for commercial and government aerospace research and development and space operations. At the request of NASA and the DOD, the National Research Council's Committee on Space Facilities has reviewed the space related findings of the NFS. The inventory of more than 2800 facilities will be an important resource, especially if it continues to be updated and maintained as the NFS report recommends. The data in the inventory provide the basis for a much better understanding of the resources available in the national facilities infrastructure, as well as extensive information on which to base rational decisions about current and future facilities needs. The working groups have used the inventory data and other information to make a set of recommendations that include estimates of cast savings and steps for implementation. While it is natural that the NFS focused on cost reduction and consolidations, such a study is most useful to future planning if it gives equal weight to guiding the direction of future facilities needed to satisfy legitimate national aspirations. Even in the context of cost reduction through facilities closures and consolidations, the study is timid about recognizing and proposing program changes and realignments of roles and missions to capture what could be significant savings and increased effectiveness. The recommendations of the Committee on Space Facilities are driven by the clear need to be more realistic and precise both in recognizing current incentives and disincentives in the aerospace industry and in forecasting future conditions for U.S. space activities.

Space facilities: Meeting future needs for research, development, and operations

NASA Astrophysics Data System (ADS)

The National Facilities Study (NFS) represents an interagency effort to develop a comprehensive and integrated long-term plan for world-class aeronautical and space facilities that meet current and projected needs for commercial and government aerospace research and development and space operations. At the request of NASA and the DOD, the National Research Council's Committee on Space Facilities has reviewed the space related findings of the NFS. The inventory of more than 2800 facilities will be an important resource, especially if it continues to be updated and maintained as the NFS report recommends. The data in the inventory provide the basis for a much better understanding of the resources available in the national facilities infrastructure, as well as extensive information on which to base rational decisions about current and future facilities needs. The working groups have used the inventory data and other information to make a set of recommendations that include estimates of cast savings and steps for implementation. While it is natural that the NFS focused on cost reduction and consolidations, such a study is most useful to future planning if it gives equal weight to guiding the direction of future facilities needed to satisfy legitimate national aspirations. Even in the context of cost reduction through facilities closures and consolidations, the study is timid about recognizing and proposing program changes and realignments of roles and missions to capture what could be significant savings and increased effectiveness. The recommendations of the Committee on Space Facilities are driven by the clear need to be more realistic and precise both in recognizing current incentives and disincentives in the aerospace industry and in forecasting future conditions for U.S. space activities.

The Canadian STOP-PAIN project - Part 2: What is the cost of pain for patients on waitlists of multidisciplinary pain treatment facilities?

PubMed

Guerriere, Denise N; Choinière, Manon; Dion, Dominique; Peng, Philip; Stafford-Coyte, Emma; Zagorski, Brandon; Banner, Robert; Barton, Pamela M; Boulanger, Aline; Clark, Alexander J; Gordon, Allan S; Guertin, Marie-Claude; Intrater, Howard M; Lefort, Sandra M; Lynch, Mary E; Moulin, Dwight E; Ong-Lam, May; Racine, Mélanie; Rashiq, Saifee; Shir, Yoram; Taenzer, Paul; Ware, Mark

2010-06-01

The Canadian STOP-PAIN Project was designed to document the human and economic burden of chronic pain in individuals on waitlists of Multidisciplinary Pain Treatment Facilities (MPTF). This paper describes the societal costs of their pain. A subgroup of 370 patients was selected randomly from The Canadian STOP-PAIN Project. Participants completed a self-administered costing tool (the Ambulatory and Home Care Record) on a daily basis for three months. They provided information about publicly financed resources, such as health care professional consultations and diagnostic tests as well as privately financed costs, including out-of-pocket expenditures and time devoted to seeking, receiving, and providing care. To determine the cost of care, resources were valued using various costing methods, and multivariate linear regression was used to predict total cost. Overall, the median monthly cost of care was $1,462 (CDN) per study participant. Ninety-five percent of the total expenditures were privately financed. The final regression model consisted of the following determinants: educational level, employment status, province, pain duration, depression, and health-related quality of life. This model accounted for 35% of the variance in total expenditure (P < 0.001). The economic burden of chronic pain is substantial in patients on waitlists of MPTFs. Consequently, it is essential to consider this burden when making decisions regarding resource allocation and waitlist assignment for a MPTF. Resource allocation decision-making should include the economic implications of having patients wait for an assessment and for care.

Standard guide for developing a cost-effective risk mitigation plan for new and existing constructed facilities

Treesearch

Jeffrey Prestemon

2011-01-01

Protecting constructed facilities from damages from natural and man-made hazards in a costeffective manner is a challenging task. Several measures of economic performance are available for evaluating building-related investments. These measures include, but are not limited to, life-cycle cost, present value net savings, savings-to-investment ratio, and adjusted...

77 FR 33479 - Information Collection Activities: Oil-Spill Response Requirements for Facilities Located Seaward...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-06

...-0010; OMB Control Number 1014-0007] Information Collection Activities: Oil-Spill Response Requirements... regulations under Part 254, ``Oil-Spill Response Requirements for Facilities Located Seaward of the Coast Line... 254, Oil-Spill Response Requirements for Facilities Located Seaward of the Coast Line. OMB Control...

The costs of turnover in nursing homes.

PubMed

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

2009-10-01

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

Contamination Sources Effects Analysis (CSEA) - A Tool to Balance Cost/Schedule While Managing Facility Availability

NASA Technical Reports Server (NTRS)

Wilcox, Margaret

2008-01-01

A CSEA is similar to a Failure Modes Effects Analysis (FMEA). A CSEA tracks risk, deterrence, and occurrence of sources of contamination and their mitigation plans. Documentation is provided spanning mechanical and electrical assembly, precision cleaning, thermal vacuum bake-out, and thermal vacuum testing. These facilities all may play a role in contamination budgeting and reduction ultimately affecting test and flight. With a CSEA, visibility can be given to availability of these facilities, test sequencing and trade-offs. A cross-functional team including specialty engineering, contamination control, electrostatic dissipation, manufacturing, testing, and material engineering participate in an exercise that identifies contaminants and minimizes the complexity of scheduling these facilities considering their volatile schedules. Care can be taken in an efficient manner to insure correct cleaning processes are employed. The result is reduction in cycle time ("schedule hits"), reduced cost due to rework, reduced risk and improved communication and quality while achieving adherence to the Contamination Control Plan.

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

PubMed

Barnett, P G

1997-06-01

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

Media reporting, carbon information disclosure, and the cost of equity financing: evidence from China.

PubMed

Li, Li; Liu, Quanqi; Tang, Dengli; Xiong, Jucheng

2017-04-01

By using Shanghai and Shenzhen A-share listed companies in heavy polluting industry as research object from 2009 to 2014, this paper examines the relationship between media reporting, carbon information disclosure, and the cost of equity financing. The results show that media reporting can improve the quality of carbon information disclosure, and carbon information disclosure level is negatively associated with the cost of equity financing. This study also finds that financial carbon information disclosure and non-financial carbon information disclosure have significant negative relationship with the cost of equity financing respectively. Moreover, this paper shows that media reporting can strengthen the relationship between carbon information disclosure and the cost of equity financing.

Better Informing Decision Making with Multiple Outcomes Cost-Effectiveness Analysis under Uncertainty in Cost-Disutility Space

PubMed Central

McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon

2015-01-01

Introduction Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA) is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses—where outcomes are considered separately, with their joint relationship under uncertainty ignored—lead to incorrect inference regarding preferred strategies. Objective The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison. Methods Multiple outcomes CEA of a home-based palliative care model (PEACH) relative to usual care is undertaken in cost disutility (CDU) space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL) planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL. Results Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home ( 1) exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home), with a 51.6% chance of PEACH being cost-effective. Conclusion Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding

Cost-Effectiveness Analysis of Interventions to Reduce Risk of Aspiration in Elderly Cancer Survivors Residing in Skilled Nursing Facilities.

PubMed

Mantravadi, S

2017-04-01

Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death. Analyses of cost, decision-tree modeling, and cost effectiveness were performed to compare a hypothetical, interventional model based on best practices with usual (standard) care. A societal perspective was used as the economic view point. Direct costs, caregiver time, and market values for wages were estimated for the 2 interventions. Effectiveness values for the cost-effectiveness and decision-tree analyses were obtained from the literature. The incremental-cost-effectiveness ratio was calculated and used to compare the intervention with usual care. The interventional method was more costly but more effective than usual care. A sensitivity analysis considered the uncertainty of event probability (aspiration vs no aspiration). The interventional protocol for aspiration reduction continued to be more cost effective than usual care. Aspiration takes a financial toll on all facets of health care, including on nurses, skilled nursing facilities, patients, their families, and insurers, among others. Implementing guidelines that describe best practices for aspiration appears to be a cost-effective strategy for reducing aspirations among cancer survivors - especially elderly patients - who live in skilled nursing facilities.

Cardiac rehabilitation costs.

PubMed

Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L

2017-10-01

Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.

Defense Remote Handled Transuranic Waste Cost/Schedule Optimization Study

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

Pierce, G.D.; Beaulieu, D.H.; Wolaver, R.W.

1986-11-01

The purpose of this study is to provide the DOE information with which it can establish the most efficient program for the long management and disposal, in the Waste Isolation Pilot Plant (WIPP), of remote handled (RH) transuranic (TRU) waste. To fulfill this purpose, a comprehensive review of waste characteristics, existing and projected waste inventories, processing and transportation options, and WIPP requirements was made. Cost differences between waste management alternatives were analyzed and compared to an established baseline. The result of this study is an information package that DOE can use as the basis for policy decisions. As part ofmore » this study, a comprehensive list of alternatives for each element of the baseline was developed and reviewed with the sites. The principle conclusions of the study follow. A single processing facility for RH TRU waste is both necessary and sufficient. The RH TRU processing facility should be located at Oak Ridge National Laboratory (ORNL). Shielding of RH TRU to contact handled levels is not an economic alternative in general, but is an acceptable alternative for specific waste streams. Compaction is only cost effective at the ORNL processing facility, with a possible exception at Hanford for small compaction of paint cans of newly generated glovebox waste. It is more cost effective to ship certified waste to WIPP in 55-gal drums than in canisters, assuming a suitable drum cask becomes available. Some waste forms cannot be packaged in drums, a canister/shielded cask capability is also required. To achieve the desired disposal rate, the ORNL processing facility must be operational by 1996. Implementing the conclusions of this study can save approximately $110 million, compared to the baseline, in facility, transportation, and interim storage costs through the year 2013. 10 figs., 28 tabs.« less

National facilities study. Volume 2A: Facility Study Office on the National Wind Tunnel Complex

NASA Technical Reports Server (NTRS)

1994-01-01

The Facility Study Office (FSO) has completed its assigned activities. The results of the FSO efforts, studies, and assessments are documented. An overview of the FSO activities as well as a general comparison of all concepts considered are provided. Detailed information is also provided for the selected concept, Concept D-Option 5. Only findings are presented. The FSO developed recommendations only as a consequence of assumptions for cost and schedule assessments.

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

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

Code of Federal Regulations, 2011 CFR

2011-01-01

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

Screensaver: an open source lab information management system (LIMS) for high throughput screening facilities

PubMed Central

2010-01-01

Background Shared-usage high throughput screening (HTS) facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. Results We have developed Screensaver, a free, open source, web-based lab information management system (LIMS), to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. Conclusions The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities. PMID:20482787

Screensaver: an open source lab information management system (LIMS) for high throughput screening facilities.

PubMed

Tolopko, Andrew N; Sullivan, John P; Erickson, Sean D; Wrobel, David; Chiang, Su L; Rudnicki, Katrina; Rudnicki, Stewart; Nale, Jennifer; Selfors, Laura M; Greenhouse, Dara; Muhlich, Jeremy L; Shamu, Caroline E

2010-05-18

Shared-usage high throughput screening (HTS) facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. We have developed Screensaver, a free, open source, web-based lab information management system (LIMS), to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities.

Cost estimation and analysis using the Sherpa Automated Mine Cost Engineering System

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

Stebbins, P.E.

1993-09-01

The Sherpa Automated Mine Cost Engineering System is a menu-driven software package designed to estimate capital and operating costs for proposed surface mining operations. The program is engineering (as opposed to statistically) based, meaning that all equipment, manpower, and supply requirements are determined from deposit geology, project design and mine production information using standard engineering techniques. These requirements are used in conjunction with equipment, supply, and labor cost databases internal to the program to estimate all associated costs. Because virtually all on-site cost parameters are interrelated within the program, Sherpa provides an efficient means of examining the impact of changesmore » in the equipment mix on total capital and operating costs. If any aspect of the operation is changed, Sherpa immediately adjusts all related aspects as necessary. For instance, if the user wishes to examine the cost ramifications of selecting larger trucks, the program not only considers truck purchase and operation costs, it also automatically and immediately adjusts excavator requirements, operator and mechanic needs, repair facility size, haul road construction and maintenance costs, and ancillary equipment specifications.« less

First-dollar cost-sharing for skilled nursing facility care in medicare advantage plans.

PubMed

Keohane, Laura M; Grebla, Regina C; Rahman, Momotazur; Mukamel, Dana B; Lee, Yoojin; Mor, Vincent; Trivedi, Amal

2017-08-29

The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010. Copays began on the first day of a SNF admission. We matched these plans to seven matched control plans that did not introduce first-dollar cost-sharing. In a difference-in-differences analysis, we compared changes in SNF and inpatient utilization for the 172,958 members of intervention and control plans. In intervention plans the mean annual number of SNF days per 100 continuously enrolled inpatients decreased from 768.3 to 750.6 days when cost-sharing changes took effect. Control plans experienced a concurrent increase: 721.7 to 808.1 SNF days per 100 inpatients (adjusted difference-in-differences: -87.0 days [95% CI (-112.1,-61.9)]). In intervention plans, we observed no significant changes in the probability of any SNF service use or the number of inpatient days per hospitalized member relative to concurrent trends among control plans. Among several strategies Medicare Advantage plans can employ to moderate SNF use, first-dollar SNF cost-sharing may be one influential factor. Not applicable.

An Information System for the Council of Educational Facility Planners International Membership Information Network. Volume 1: Background Report and Implementation Models. Volume 2: Appendices.

ERIC Educational Resources Information Center

Hruday, Connie; And Others

This document is designed to assist the Council of Educational Facility Planners International (CEFP/I) in planning for the establishment of an information system for its members and other stakeholders who need information on educational facilities. The report focuses on the major activities to be accomplished and the issues to be considered when…

Information Technology: A Tool to Cut Health Care Costs

NASA Technical Reports Server (NTRS)

Mukkamala, Ravi; Maly, K. J.; Overstreet, C. M.; Foudriat, E. C.

1996-01-01

Old Dominion University embarked on a project to see how current computer technology could be applied to reduce the cost and or to improve the efficiency of health care services. We designed and built a prototype for an integrated medical record system (MRS). The MRS is written in Tool control language/Tool kit (Tcl/Tk). While the initial version of the prototype had patient information hard coded into the system, later versions used an INGRES database for storing patient information. Currently, we have proposed an object-oriented model for implementing MRS. These projects involve developing information systems for physicians and medical researchers to enhance their ability for improved treatment at reduced costs. The move to computerized patient records is well underway, several standards exist for laboratory records, and several groups are working on standards for other portions of the patient record.

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

24 CFR 960.205 - Drug use by applicants: Obtaining information from drug treatment facility.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... This section addresses a PHA's authority to request and obtain information from drug abuse treatment... household member. (2) Drug abuse treatment facility. An entity: (i) That holds itself out as providing, and... consent forms signed by such household member that: (i) Requests any drug abuse treatment facility to...

Biological Information Document, Radioactive Liquid Waste Treatment Facility

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

Biggs, J.

1995-12-31

This document is intended to act as a baseline source material for risk assessments which can be used in Environmental Assessments and Environmental Impact Statements. The current Radioactive Liquid Waste Treatment Facility (RLWTF) does not meet current General Design Criteria for Non-reactor Nuclear Facilities and could be shut down affecting several DOE programs. This Biological Information Document summarizes various biological studies that have been conducted in the vicinity of new Proposed RLWTF site and an Alternative site. The Proposed site is located on Mesita del Buey, a mess top, and the Alternative site is located in Mortandad Canyon. The Proposedmore » Site is devoid of overstory species due to previous disturbance and is dominated by a mixture of grasses, forbs, and scattered low-growing shrubs. Vegetation immediately adjacent to the site is a pinyon-juniper woodland. The Mortandad canyon bottom overstory is dominated by ponderosa pine, willow, and rush. The south-facing slope was dominated by ponderosa pine, mountain mahogany, oak, and muhly. The north-facing slope is dominated by Douglas fir, ponderosa pine, and oak. Studies on wildlife species are limited in the vicinity of the proposed project and further studies will be necessary to accurately identify wildlife populations and to what extent they utilize the project area. Some information is provided on invertebrates, amphibians and reptiles, and small mammals. Additional species information from other nearby locations is discussed in detail. Habitat requirements exist in the project area for one federally threatened wildlife species, the peregrine falcon, and one federal candidate species, the spotted bat. However, based on surveys outside of the project area but in similar habitats, these species are not expected to occur in either the Proposed or Alternative RLWTF sites. Habitat Evaluation Procedures were used to evaluate ecological functioning in the project area.« less

The impact of health information technology adoption by outpatient facilities on pregnancy outcomes.

PubMed

Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D

2013-02-01

Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Administrative claims data on 491,832 births in Pennsylvania during 1998-2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. © Health Research and Educational Trust.

The Impact of Health Information Technology Adoption by Outpatient Facilities on Pregnancy Outcomes

PubMed Central

Deily, Mary E; Hu, Tianyan; Terrizzi, Sabrina; Chou, Shin-Yi; Meyerhoefer, Chad D

2013-01-01

Objective Examine whether health information technology (HIT) at nonhospital facilities (NHFs) improves health outcomes and decreases resource use at hospitals within the same heath care network, and whether the impact of HIT varies as providers gain experience using the technologies. Data Sources Administrative claims data on 491,832 births in Pennsylvania during 1998–2004 from the Pennsylvania Health Care Cost Containment Council and HIT applications data from the Dorenfest Institute. Study Design Fixed-effects regression analysis of the impact of HIT at NHFs on adverse birth outcomes and resource use. Principal Findings Greater use of clinical HIT applications by NHFs is associated with reduced incidence of obstetric trauma and preventable complications, as well as longer lengths of stay. In addition, the beneficial effects of HIT increase the longer that technologies have been in use. However, we find no consistent evidence on whether or how nonclinical HIT in NHFs affects either resource use or health outcomes. Conclusions Clinical HIT applications at NHFs may reduce the likelihood of adverse birth outcomes, particularly after physicians and staff gain experience using the technologies. PMID:22742682

Dairy farm cost efficiency.

PubMed

Tauer, L W; Mishra, A K

2006-12-01

A stochastic cost equation was estimated for US dairy farms using national data from the production year 2000 to determine how farmers might reduce their cost of production. Cost of producing a unit of milk was estimated into separate frontier (efficient) and inefficiency components, with both components estimated as a function of management and causation variables. Variables were entered as impacting the frontier component as well as the efficiency component of the stochastic curve because a priori both components could be impacted. A factor that has an impact on the cost frontier was the number of hours per day the milking facility is used. Using the milking facility for more hours per day decreased frontier costs; however, inefficiency increased with increased hours of milking facility use. Thus, farmers can decrease costs with increased utilization of the milking facility, but only if they are efficient in this strategy. Parlors compared with stanchions used for milking did not decrease frontier costs, but decreased costs because of increased efficiency, as did the use of a nutritionist. Use of rotational grazing decreased frontier costs but also increased inefficiency. Older farmers were less efficient.

Indoor Athletic Facilities.

ERIC Educational Resources Information Center

Fleming, E. Scott

2000-01-01

Examines the concept of shared-use facilities to help financially support and meet the demand for athletic facilities. Shared-use considerations are explored including cost sharing of ongoing operations, aesthetics, locker rooms, support facilities, parking and site access, and building access and security. (GR)

Controlling information technology costs, Part 3.

PubMed

Honan, Tom; Ciotti, Vince

2002-01-01

Health care executives are increasingly frustrated by Information Technology (IT). Although our industry is often accused of underinvesting in technology (hospitals average 2-3 percent of their costs in IT, compared to other industry's 8-10 percent), when IT investments are made, they fail to reflect demonstrable return to the bottom line. Yet the effective deployment of technology is so critical to the success of the organization and can in itself cause the failure of a health care system.

Application of a Bimetallic Treatment System (BTS) for PCB Removal from Older Structures on DoD Facilities. Cost and Performance Report

DTIC Science & Technology

2011-11-01

Bimetallic Treatment System (BTS) for PCB Removal from Older Structures on DoD Facilities By Thomas Krug and Suzanne O’Hara, Geosyntec...COST AND PERFORMANCE REPORT FOR: Application of a Bimetallic Treatment System (BTS) for PCB Removal from Older Structures on DOD Facilities...11 3.4 Reduction in PCB concentrations in treated paint to less

Using cost-analyses to inform health professions education - The economic cost of pre-clinical failure.

PubMed

Foo, Jonathan; Ilic, Dragan; Rivers, George; Evans, Darrell J R; Walsh, Kieran; Haines, Terry P; Paynter, Sophie; Morgan, Prue; Maloney, Stephen

2017-12-07

Student failure creates additional economic costs. Knowing the cost of failure helps to frame its economic burden relative to other educational issues, providing an evidence-base to guide priority setting and allocation of resources. The Ingredients Method is a cost-analysis approach which has been previously applied to health professions education research. In this study, the Ingredients Method is introduced, and applied to a case study, investigating the cost of pre-clinical student failure. The four step Ingredients Method was introduced and applied: (1) identify and specify resource items, (2) measure volume of resources in natural units, (3) assign monetary prices to resource items, and (4) analyze and report costs. Calculations were based on a physiotherapy program at an Australian university. The cost of failure was £5991 per failing student, distributed across students (70%), the government (21%), and the university (8%). If the cost of failure and attrition is distributed among the remaining continuing cohort, the cost per continuing student educated increases from £9923 to £11,391 per semester. The economics of health professions education is complex. Researchers should consider both accuracy and feasibility in their costing approach, toward the goal of better informing cost-conscious decision-making.

78 FR 48076 - Facility Security Clearance and Safeguarding of National Security Information and Restricted Data

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... facility's involvement with classified information and may include a Facility Security Officer Orientation... procedures and duties applicable to the employee's job. (g) Refresher Briefings. The licensee or other.... (j) Records reflecting an individual's initial and refresher security orientations and security...

78 FR 48037 - Facility Security Clearance and Safeguarding of National Security Information and Restricted Data

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... facility's involvement with classified information and may include a Facility Security Officer Orientation... procedures and duties applicable to the employee's job. (g) Refresher Briefings. The licensee or other.... (j) Records reflecting an individual's initial and refresher security orientations and security...

Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.

PubMed Central

Boulanger, L. L.; Lee, L. A.; Odhacha, A.

1999-01-01

Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used. PMID:10593034

Information Cost, Memory Length and Market Instability.

PubMed

Diks, Cees; Li, Xindan; Wu, Chengyao

2018-07-01

In this article, we study the instability of a stock market with a modified version of Diks and Dindo's (2008) model where the market is characterized by nonlinear interactions between informed traders and uninformed traders. In the interaction of heterogeneous agents, we replace the replicator dynamics for the fractions by logistic strategy switching. This modification makes the model more suitable for describing realistic price dynamics, as well as more robust with respect to parameter changes. One goal of our paper is to use this model to explore if the arrival of new information (news) and investor behavior have an effect on market instability. A second, related, goal is to study the way markets absorb new information, especially when the market is unstable and the price is far from being fully informative. We find that the dynamics become locally unstable and prices may deviate far from the fundamental price, routing to chaos through bifurcation, with increasing information costs or decreasing memory length of the uninformed traders.

Integrating Sustainability Programs into the Facilities Capital Planning Process

ERIC Educational Resources Information Center

Buchanan, Susan

2011-01-01

With detailed information about the costs and benefits of potential green investments, educational facilities can effectively evaluate which initiatives will ultimately provide the greatest results over the short and long term. Based on its overall goals, every school, college, or university will have different values and therefore different…

Design and Evaluation of Wood Processing Facilities Using Object-Oriented Simulation

Treesearch

D. Earl Kline; Philip A. Araman

1992-01-01

Managers of hardwood processing facilities need timely information on which to base important decisions such as when to add costly equipment or how to improve profitability subject to time-varying demands. The overall purpose of this paper is to introduce a tool that can effectively provide such timely information. A simulation/animation modeling procedure is described...

40 CFR 270.290 - What general types of information must I keep at my facility?

Code of Federal Regulations, 2011 CFR

2011-07-01

... and power outages, (5) Prevent undue exposure of personnel to hazardous waste (for example, requiring.... (n) [Reserved] (o) The most recent closure cost estimate for your facility prepared under 40 CFR 267... land uses (residential, commercial, agricultural, recreational). (5) A wind rose (i.e., prevailing wind...

40 CFR 270.290 - What general types of information must I keep at my facility?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and power outages, (5) Prevent undue exposure of personnel to hazardous waste (for example, requiring.... (n) [Reserved] (o) The most recent closure cost estimate for your facility prepared under 40 CFR 267... land uses (residential, commercial, agricultural, recreational). (5) A wind rose (i.e., prevailing wind...

Rates of trauma-informed counseling at substance abuse treatment facilities: reports from over 10,000 programs.

PubMed

Capezza, Nicole M; Najavits, Lisa M

2012-04-01

Trauma-informed treatment increasingly is recognized as an important component of service delivery. This study examined differences in treatment-related characteristics of facilities that offer moderate or high levels of trauma-informed counseling versus those that offer no or low levels of such counseling. Responses from 13,223 substance abuse treatment facilities surveyed in 2009 by the National Survey of Substance Abuse Treatment Services (NSSATS) were used. A majority (66.6%) of facilities reported using trauma counseling sometimes or always or often. Facilities that provided moderate or high levels of trauma counseling were more likely to provide additional treatment services, such as disease testing and specialized group therapy, as well as child care, employment counseling, and other ancillary services. A majority of facilities reported provision of trauma counseling. Additional training and resources may be needed for programs that reported low rates of trauma counseling.

Facilities Information Management: A Guide for State and Local Education Agencies. NCES 2003-400

ERIC Educational Resources Information Center

National Center for Education Statistics (ED), Washington, DC.

This Guide has been developed to provide a framework for decision makers, school facility managers, and the public to identify a basic set of school facilities data elements, including definitions that will meet their information needs. Chapter 1 describes the purpose, scope, and intended audience for this guide. Chapter 2 describes how to use the…

[Information and facilities recommendations concerning trial of labour in the context of scarred womb].

PubMed

Gallot, D; Delabaere, A; Desvignes, F; Vago, C; Accoceberry, M; Lémery, D

2012-12-01

To precise key elements concerning facilities and patient information prior to trial of labour in the context of scarred womb. Bibliographic search restricted to French and English languages using Medline database and recommendations of medical societies. Only expert's opinions are available. Patient information should present both trial of labour and elective cesarean section. Counselling should be influenced by individual risk of failed vaginal birth and uterine rupture. Mode of delivery should be planned the latest at 8 months of gestation. Patient should be aware of obstetrical and anesthetic facilities. Trial of labour should be presented as the first option for patients with no additional risk factors. Immediate presence of obstetrician and anesthesiologist is not required except in the context of increased risk for failed trial of labour or uterine rupture. Elective cesarean section on maternal request is acceptable after extensive counselling and delay of reflexion. Individual patient information should be initiated early and mode of delivery should be planned at 8 months of gestation. Resources and facilities recommendations aim to facilitate prompt cesarean section. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

The costs of turnover in nursing homes

PubMed Central

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

2009-01-01

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

Need low-cost networking? Consider DeviceNet

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

Moss, W.H.

1996-11-01

The drive to reduce production costs and optimize system performance in manufacturing facilities causes many end users to invest in network solutions. Because of distinct differences between the way tasks are performed and the way data are handled for various applications, it is clear than more than one network will be needed in most facilities. What is not clear is which network is most appropriate for a given application. The information layer is the link between automation and information environments via management information systems (MISs) and manufacturing execution systems (MESs) and manufacturing execution systems (MESs). Here the market has chosenmore » a de facto standard in Ethernet, primarily transmission control protocol/internet protocol (TCP/IP) and secondarily manufacturing messaging system (MMS). There is no single standard at the device layer. However, the DeviceNet communication standard has made strides to reach this goal. This protocol eliminates expensive hardwiring and provides improved communication between devices and important device-level diagnostics not easily accessible or available through hardwired I/O interfaces. DeviceNet is a low-cost communications link connecting industrial devices to a network. Many original equipment manufacturers and end users have chosen the DeviceNet platform for several reasons, but most frequently because of four key features: interchangeability; low cost; advanced diagnostics; insert devices under power.« less

Chemical Laser Facility Study. Volume III. Cost Analysis.

DTIC Science & Technology

Chemical Laser Test Facility. The design criteria for the architectural and engineering design of the facility are presented in Volume I and the design requirements for the Laser Test System are presented in Volume II.

Cost-volume-profit and net present value analysis of health information systems.

PubMed

McLean, R A

1998-08-01

The adoption of any information system should be justified by an economic analysis demonstrating that its projected benefits outweigh its projected costs. Analysis differ, however, on which methods to employ for such a justification. Accountants prefer cost-volume-profit analysis, and economists prefer net present value analysis. The article explains the strengths and weaknesses of each method and shows how they can be used together so that well-informed investments in information systems can be made.

Whatever the cost? Information integration in memory-based inferences depends on cognitive effort.

PubMed

Hilbig, Benjamin E; Michalkiewicz, Martha; Castela, Marta; Pohl, Rüdiger F; Erdfelder, Edgar

2015-05-01

One of the most prominent models of probabilistic inferences from memory is the simple recognition heuristic (RH). The RH theory assumes that judgments are based on recognition in isolation, such that other information is ignored. However, some prior research has shown that available knowledge is not generally ignored. In line with the notion of adaptive strategy selection--and, thus, a trade-off between accuracy and effort--we hypothesized that information integration crucially depends on how easily accessible information beyond recognition is, how much confidence decision makers have in this information, and how (cognitively) costly it is to acquire it. In three experiments, we thus manipulated (a) the availability of information beyond recognition, (b) the subjective usefulness of this information, and (c) the cognitive costs associated with acquiring this information. In line with the predictions, we found that RH use decreased substantially, the more easily and confidently information beyond recognition could be integrated, and increased substantially with increasing cognitive costs.

PCS: a pallet costing system for wood pallet manufacturers (version 1.0 for Windows®)

Treesearch

A. Jefferson, Jr. Palmer; Cynthia D. West; Bruce G. Hansen; Marshall S. White; Hal L. Mitchell

2002-01-01

The Pallet Costing System (PCS) is a computer-based, Microsoft Windows® application that computes the total and per-unit cost of manufacturing an order of wood pallets. Information about the manufacturing facility, along with the pallet-order requirements provided by the customer, is used in determining production cost. The major cost factors addressed by PCS...

Financing strategic healthcare facilities: the growing attraction of alternative capital.

PubMed

Zismer, Daniel K; Fox, James; Torgerson, Paul

2013-05-01

Community health system leaders often dismiss use of alternative capital to finance strategic facilities as being too expensive and less strategically useful, preferring to follow historical precedent and use tax-exempt bonding to finance such facilities. Proposed changes in accounting rules should cause third-party-financed facility lease arrangements to be treated similarly to tax-exempt debt financings with respect to the income statement and balance sheet, increasing their appeal to community health systems. An in-depth comparison of the total costs associated with each financing approach can help inform the choice of financing approaches by illuminating their respective advantages and disadvantages.

The minimal work cost of information processing

NASA Astrophysics Data System (ADS)

Faist, Philippe; Dupuis, Frédéric; Oppenheim, Jonathan; Renner, Renato

2015-07-01

Irreversible information processing cannot be carried out without some inevitable thermodynamical work cost. This fundamental restriction, known as Landauer's principle, is increasingly relevant today, as the energy dissipation of computing devices impedes the development of their performance. Here we determine the minimal work required to carry out any logical process, for instance a computation. It is given by the entropy of the discarded information conditional to the output of the computation. Our formula takes precisely into account the statistically fluctuating work requirement of the logical process. It enables the explicit calculation of practical scenarios, such as computational circuits or quantum measurements. On the conceptual level, our result gives a precise and operational connection between thermodynamic and information entropy, and explains the emergence of the entropy state function in macroscopic thermodynamics.

75 FR 57284 - Agency Information Collection Activities: Cost Submission

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... respondents or record keepers from the collection of information (a total capital/startup costs and operations... Respondent: 1. Estimated time per Response: 50 hours. Estimated Total Annual Burden Hours: 50,000. [[Page...

Modelling energy costs for different operational strategies of a large water resource recovery facility.

PubMed

Póvoa, P; Oehmen, A; Inocêncio, P; Matos, J S; Frazão, A

2017-05-01

The main objective of this paper is to demonstrate the importance of applying dynamic modelling and real energy prices on a full scale water resource recovery facility (WRRF) for the evaluation of control strategies in terms of energy costs with aeration. The Activated Sludge Model No. 1 (ASM1) was coupled with real energy pricing and a power consumption model and applied as a dynamic simulation case study. The model calibration is based on the STOWA protocol. The case study investigates the importance of providing real energy pricing comparing (i) real energy pricing, (ii) weighted arithmetic mean energy pricing and (iii) arithmetic mean energy pricing. The operational strategies evaluated were (i) old versus new air diffusers, (ii) different DO set-points and (iii) implementation of a carbon removal controller based on nitrate sensor readings. The application in a full scale WRRF of the ASM1 model coupled with real energy costs was successful. Dynamic modelling with real energy pricing instead of constant energy pricing enables the wastewater utility to optimize energy consumption according to the real energy price structure. Specific energy cost allows the identification of time periods with potential for linking WRRF with the electric grid to optimize the treatment costs, satisfying operational goals.

Optimal decoding and information transmission in Hodgkin-Huxley neurons under metabolic cost constraints.

PubMed

Kostal, Lubomir; Kobayashi, Ryota

2015-10-01

Information theory quantifies the ultimate limits on reliable information transfer by means of the channel capacity. However, the channel capacity is known to be an asymptotic quantity, assuming unlimited metabolic cost and computational power. We investigate a single-compartment Hodgkin-Huxley type neuronal model under the spike-rate coding scheme and address how the metabolic cost and the decoding complexity affects the optimal information transmission. We find that the sub-threshold stimulation regime, although attaining the smallest capacity, allows for the most efficient balance between the information transmission and the metabolic cost. Furthermore, we determine post-synaptic firing rate histograms that are optimal from the information-theoretic point of view, which enables the comparison of our results with experimental data. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Control and Information Systems for the National Ignition Facility

DOE PAGES

Brunton, Gordon; Casey, Allan; Christensen, Marvin; ...

2017-03-23

Orchestration of every National Ignition Facility (NIF) shot cycle is managed by the Integrated Computer Control System (ICCS), which uses a scalable software architecture running code on more than 1950 front-end processors, embedded controllers, and supervisory servers. The ICCS operates laser and industrial control hardware containing 66 000 control and monitor points to ensure that all of NIF’s laser beams arrive at the target within 30 ps of each other and are aligned to a pointing accuracy of less than 50 μm root-mean-square, while ensuring that a host of diagnostic instruments record data in a few billionths of a second.more » NIF’s automated control subsystems are built from a common object-oriented software framework that distributes the software across the computer network and achieves interoperation between different software languages and target architectures. A large suite of business and scientific software tools supports experimental planning, experimental setup, facility configuration, and post-shot analysis. Standard business services using open-source software, commercial workflow tools, and database and messaging technologies have been developed. An information technology infrastructure consisting of servers, network devices, and storage provides the foundation for these systems. Thus, this work is an overview of the control and information systems used to support a wide variety of experiments during the National Ignition Campaign.« less

Control and Information Systems for the National Ignition Facility

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

Brunton, Gordon; Casey, Allan; Christensen, Marvin

Orchestration of every National Ignition Facility (NIF) shot cycle is managed by the Integrated Computer Control System (ICCS), which uses a scalable software architecture running code on more than 1950 front-end processors, embedded controllers, and supervisory servers. The ICCS operates laser and industrial control hardware containing 66 000 control and monitor points to ensure that all of NIF’s laser beams arrive at the target within 30 ps of each other and are aligned to a pointing accuracy of less than 50 μm root-mean-square, while ensuring that a host of diagnostic instruments record data in a few billionths of a second.more » NIF’s automated control subsystems are built from a common object-oriented software framework that distributes the software across the computer network and achieves interoperation between different software languages and target architectures. A large suite of business and scientific software tools supports experimental planning, experimental setup, facility configuration, and post-shot analysis. Standard business services using open-source software, commercial workflow tools, and database and messaging technologies have been developed. An information technology infrastructure consisting of servers, network devices, and storage provides the foundation for these systems. Thus, this work is an overview of the control and information systems used to support a wide variety of experiments during the National Ignition Campaign.« less

Role of information and communication technology in promoting oral health at residential aged care facilities.

PubMed

Adebayo, Bola; Durey, Angela; Slack-Smith, Linda M

2017-07-01

Information and communication technology (ICT) can provide knowledge and clinical support to those working in residential aged care facilities (RACFs). This paper aims to: (1) review literature on ICT targeted at residents, staff and external providers in RACFs including general practitioners, dental and allied health professionals on improving residents' oral health; (2) identify barriers and enablers to using ICT in promoting oral health at RACFs; and (3) investigate evidence of effectiveness of these approaches in promoting oral health. Findings from this narrative literature review indicate that ICT is not widely used in RACFs, with barriers to usage identified as limited training for staff, difficulties accessing the Internet, limited computer literacy particularly in older staff, cost and competing work demands. Residents also faced barriers including impaired cognitive and psychosocial functioning, limited computer literacy and Internet use. Findings suggest that more education and training in ICT to upskill staff and residents is needed to effectively promote oral health through this medium.

40 CFR 2.311 - Special rules governing certain information obtained under the Motor Vehicle Information and Cost...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Special rules governing certain information obtained under the Motor Vehicle Information and Cost Savings Act. 2.311 Section 2.311 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PUBLIC INFORMATION Confidentiality of Business Information § 2.311 Special rules governing...

Comparing Sanitation Delivery Modalities in Urban Informal Settlement Schools: A Randomized Trial in Nairobi, Kenya

PubMed Central

Bohnert, Kate; Chard, Anna N.; Mwaki, Alex; Kirby, Amy E.; Muga, Richard; Nagel, Corey L.; Thomas, Evan A.; Freeman, Matthew C.

2016-01-01

The provision of safely managed sanitation in informal settlements is a challenge, especially in schools that require durable, clean, sex-segregated facilities for a large number of children. In informal settlements in Nairobi, school sanitation facilities demand considerable capital costs, yet are prone to breakage and often unhygienic. The private sector may be able to provide quality facilities and services to schools at lower costs as an alternative to the sanitation that is traditionally provided by the government. We conducted a randomized trial comparing private sector service delivery (PSSD) of urine-diverting dry latrines with routine waste collection and maintenance and government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. The primary outcomes were facility maintenance, use, exposure to fecal contamination, and cost. Schools were followed for one school year. There were few differences in maintenance and pathogen exposure between PSSD and GSD toilets. Use of the PSSD toilets was 128% higher than GSD toilets, as measured with electronic motion detectors. The initial cost of private sector service delivery was USD 2053 (KES 210,000) per school, which was lower than the average cost of rehabilitating the government standard flush-type toilets (USD 9306 (KES 922,638)) and constructing new facilities (USD 114,889 (KES 1,169,668)). The private sector delivery of dry sanitation provided a feasible alternative to the delivery of sewage sanitation in Nairobi informal settlements and might elsewhere in sub-Saharan Africa. PMID:27916914

Comparing Sanitation Delivery Modalities in Urban Informal Settlement Schools: A Randomized Trial in Nairobi, Kenya.

PubMed

Bohnert, Kate; Chard, Anna N; Mwaki, Alex; Kirby, Amy E; Muga, Richard; Nagel, Corey L; Thomas, Evan A; Freeman, Matthew C

2016-11-30

The provision of safely managed sanitation in informal settlements is a challenge, especially in schools that require durable, clean, sex-segregated facilities for a large number of children. In informal settlements in Nairobi, school sanitation facilities demand considerable capital costs, yet are prone to breakage and often unhygienic. The private sector may be able to provide quality facilities and services to schools at lower costs as an alternative to the sanitation that is traditionally provided by the government. We conducted a randomized trial comparing private sector service delivery (PSSD) of urine-diverting dry latrines with routine waste collection and maintenance and government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. The primary outcomes were facility maintenance, use, exposure to fecal contamination, and cost. Schools were followed for one school year. There were few differences in maintenance and pathogen exposure between PSSD and GSD toilets. Use of the PSSD toilets was 128% higher than GSD toilets, as measured with electronic motion detectors. The initial cost of private sector service delivery was USD 2053 (KES 210,000) per school, which was lower than the average cost of rehabilitating the government standard flush-type toilets (USD 9306 (KES 922,638)) and constructing new facilities (USD 114,889 (KES 1,169,668)). The private sector delivery of dry sanitation provided a feasible alternative to the delivery of sewage sanitation in Nairobi informal settlements and might elsewhere in sub-Saharan Africa.

10 CFR 75.10 - Facility information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... features of the facility relating to material accounting, containment, and surveillance; (4) A description of the existing and proposed procedures at the facility for nuclear material accounting and control, with special reference to material balance areas established by the licensee, measurement of flow, and...

Costs and cost-effectiveness of vector control in Eritrea using insecticide-treated bed nets.

PubMed

Yukich, Joshua O; Zerom, Mehari; Ghebremeskel, Tewolde; Tediosi, Fabrizio; Lengeler, Christian

2009-03-30

While insecticide-treated nets (ITNs) are a recognized effective method for preventing malaria, there has been an extensive debate in recent years about the best large-scale implementation strategy. Implementation costs and cost-effectiveness are important elements to consider when planning ITN programmes, but so far little information on these aspects is available from national programmes. This study uses a standardized methodology, as part of a larger comparative study, to collect cost data and cost-effectiveness estimates from a large programme providing ITNs at the community level and ante-natal care facilities in Eritrea. This is a unique model of ITN implementation fully integrated into the public health system. Base case analysis results indicated that the average annual cost of ITN delivery (2005 USD 3.98) was very attractive when compared with past ITN delivery studies at different scales. Financing was largely from donor sources though the Eritrean government and net users also contributed funding. The intervention's cost-effectiveness was in a highly attractive range for sub-Saharan Africa. The cost per DALY averted was USD 13 - 44. The cost per death averted was USD 438-1449. Distribution of nets coincided with significant increases in coverage and usage of nets nationwide, approaching or exceeding international targets in some areas. ITNs can be cost-effectively delivered at a large scale in sub-Saharan Africa through a distribution system that is highly integrated into the health system. Operating and sustaining such a system still requires strong donor funding and support as well as a functional and extensive system of health facilities and community health workers already in place.

Hanford Facility dangerous waste permit application, liquid effluent retention facility and 200 area effluent treatment facility

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

Coenenberg, J.G.

1997-08-15

The Hanford Facility Dangerous Waste Permit Application is considered to 10 be a single application organized into a General Information Portion (document 11 number DOE/RL-91-28) and a Unit-Specific Portion. The scope of the 12 Unit-Specific Portion is limited to Part B permit application documentation 13 submitted for individual, `operating` treatment, storage, and/or disposal 14 units, such as the Liquid Effluent Retention Facility and 200 Area Effluent 15 Treatment Facility (this document, DOE/RL-97-03). 16 17 Both the General Information and Unit-Specific portions of the Hanford 18 Facility Dangerous Waste Permit Application address the content of the Part B 19 permit applicationmore » guidance prepared by the Washington State Department of 20 Ecology (Ecology 1987 and 1996) and the U.S. Environmental Protection Agency 21 (40 Code of Federal Regulations 270), with additional information needs 22 defined by the Hazardous and Solid Waste Amendments and revisions of 23 Washington Administrative Code 173-303. For ease of reference, the Washington 24 State Department of Ecology alpha-numeric section identifiers from the permit 25 application guidance documentation (Ecology 1996) follow, in brackets, the 26 chapter headings and subheadings. A checklist indicating where information is 27 contained in the Liquid Effluent Retention Facility and 200 Area Effluent 28 Treatment Facility permit application documentation, in relation to the 29 Washington State Department of Ecology guidance, is located in the Contents 30 Section. 31 32 Documentation contained in the General Information Portion is broader in 33 nature and could be used by multiple treatment, storage, and/or disposal units 34 (e.g., the glossary provided in the General Information Portion). Wherever 35 appropriate, the Liquid Effluent Retention Facility and 200 Area Effluent 36 Treatment Facility permit application documentation makes cross-reference to 37 the General Information Portion, rather than

EPA Facility Registry Service (FRS): Facility Interests Dataset

EPA Pesticide Factsheets

This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers of haz

Shared Use of School Facilities with Community Organizations and Afterschool Physical Activity Program Participation: A Cost-Benefit Assessment

ERIC Educational Resources Information Center

Kanters, Michael A.; Bocarro, Jason N.; Filardo, Mary; Edwards, Michael B.; McKenzie, Thomas L.; Floyd, Myron F.

2014-01-01

Background: Partnerships between school districts and community-based organizations to share school facilities during afterschool hours can be an effective strategy for increasing physical activity. However, the perceived cost of shared use has been noted as an important reason for restricting community access to schools. This study examined…

Measuring the cost impact of hospital information systems: 1987-1994.

PubMed

Borzekowski, Ron

2009-09-01

This study measures the impact of information technology (IT) use on hospital operating costs during the late 1980s and early 1990s. Using a proprietary eight-year panel dataset (1987-1994) that catalogues application-level automation for the complete census of the 3000 U.S. hospitals with more than 100 beds, this study finds that both financial/administrative and clinical IT systems at the most thoroughly automated hospitals are associated with declining costs three and five years after adoption. At the application level, declining costs are associated with the adoption of some of the newest technologies, including systems designed for cost management, the administration of managed care contracts, and for both financial and clinical decision support. The association of cost declines with lagged IT as well as the cost patterns at the less automated hospitals both provide some evidence of learning effects.

In search of the economic sustainability of Hadron therapy: the real cost of setting up and operating a Hadron facility.

PubMed

Vanderstraeten, Barbara; Verstraete, Jan; De Croock, Roger; De Neve, Wilfried; Lievens, Yolande

2014-05-01

To determine the treatment cost and required reimbursement for a new hadron therapy facility, considering different technical solutions and financing methods. The 3 technical solutions analyzed are a carbon only (COC), proton only (POC), and combined (CC) center, each operating 2 treatment rooms and assumed to function at full capacity. A business model defines the required reimbursement and analyzes the financial implications of setting up a facility over time; activity-based costing (ABC) calculates the treatment costs per type of patient for a center in a steady state of operation. Both models compare a private, full-cost approach with public sponsoring, only taking into account operational costs. Yearly operational costs range between €10.0M (M = million) for a publicly sponsored POC to €24.8M for a CC with private financing. Disregarding inflation, the average treatment cost calculated with ABC (COC: €29,450; POC: €46,342; CC: €46,443 for private financing; respectively €16,059, €28,296, and €23,956 for public sponsoring) is slightly lower than the required reimbursement based on the business model (between €51,200 in a privately funded POC and €18,400 in COC with public sponsoring). Reimbursement for privately financed centers is very sensitive to a delay in commissioning and to the interest rate. Higher throughput and hypofractionation have a positive impact on the treatment costs. Both calculation methods are valid and complementary. The financially most attractive option of a publicly sponsored COC should be balanced to the clinical necessities and the sociopolitical context. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost-Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infection in Long-Term Care Facilities: Economic Evaluation with a Randomized Controlled Trial

PubMed Central

van den Hout, Wilbert B; Caljouw, Monique A A; Putter, Hein; Cools, Herman J M; Gussekloo, Jacobijn

2014-01-01

Objectives To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk. Design Economic evaluation with a randomized controlled trial. Setting Long-term care facilities. Participants LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk. Measurements UTI incidence (clinically or strictly defined), survival, quality of life, quality-adjusted life years (QALYs), and costs. Results In the weeks after a clinical UTI, participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high-UTI-risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3,800 per prevented clinically defined UTI (95% confidence interval = €1,300–infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTIs. Taking cranberry capsules had a 22% probability of being cost-effective compared with placebo (at a willingness to pay of €40,000 per QALY). In low-UTI-risk participants, use of cranberry capsules was only 3% likely to be cost-effective. Conclusion In high-UTI-risk residents, taking cranberry capsules may be effective in preventing UTIs but is not likely to be cost-effective in the investigated dosage, frequency, and setting. In low-UTI-risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost-effective. PMID:25180379

78 FR 47723 - Information Collection: Forms for Oil Spill Financial Responsibility for Offshore Facilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

...; MMAA104000] Information Collection: Forms for Oil Spill Financial Responsibility for Offshore Facilities...) concerns the forms used for paperwork requirements under 30 CFR 553, Oil Spill Financial Responsibility for... send your comments on this ICR to the BOEM Information Collection Clearance Officer, Arlene Bajusz...

78 FR 66763 - Information Collection: Oil Spill Financial Responsibility for Offshore Facilities; Submitted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

...] Information Collection: Oil Spill Financial Responsibility for Offshore Facilities; Submitted for OMB Review... information collection request (ICR) concerns the paperwork requirements for 30 CFR 553, Oil Spill Financial... 6, 2013 ADDRESSES: Submit comments on this ICR to the Desk Officer for the Department of the...

EPA Facility Registry Service (FRS): Facility Interests Dataset Download

EPA Pesticide Factsheets

This downloadable data package consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers

The costs of accessible quality assured syphilis diagnostics: informing quality systems for rapid syphilis tests in a Tanzanian setting.

PubMed

Sweeney, Sedona; Mosha, Jacklin F; Terris-Prestholt, Fern; Sollis, Kimberly A; Kelly, Helen; Changalucha, John; Peeling, Rosanna W

2014-08-01

To determine the costs of Rapid Syphilis Test (RSTs) as compared with rapid plasma reagin (RPR) when implemented in a Tanzanian setting, and to determine the relative impact of a quality assurance (QA) system on the cost of RST implementation. The incremental costs for RPR and RST screening programmes in existing antenatal care settings in Geita District, Tanzania were collected for 9 months in subsequent years from nine health facilities that varied in size, remoteness and scope of antenatal services. The costs per woman tested and treated were estimated for each facility. A sensitivity analysis was constructed to determine the impact of parameter and model uncertainty. In surveyed facilities, a total of 6362 women were tested with RSTs compared with 224 tested with RPR. The range of unit costs was $1.76-$3.13 per woman screened and $12.88-$32.67 per woman treated. Unit costs for the QA system came to $0.51 per woman tested, of which 50% were attributed to salaries and transport for project personnel. Our results suggest that rapid syphilis diagnostics are very inexpensive in this setting and can overcome some critical barriers to ensuring universal access to syphilis testing and treatment. The additional costs for implementation of a quality system were found to be relatively small, and could be reduced through alterations to the programme design. Given the potential for a quality system to improve quality of diagnosis and care, we recommend that QA activities be incorporated into RST roll-out. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Implications of Transaction Costs for Acquisition Program Cost Breaches

DTIC Science & Technology

2013-06-01

scope of the work, communicating the basis on which the estimate is built, identifying the quality of the data, determining the level of risk, and...projects such as bases, schools, missile storage facilities, maintenance facilities, medical/ dental clinics, libraries, and military family housing...was established as a threshold for measuring cost growth. This prevents a program from rebaselining to avoid a Nunn- McCurdy cost threshold breach. In

Counting the costs of accreditation in acute care: an activity-based costing approach

PubMed Central

Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

2015-01-01

Objectives To assess the costs of hospital accreditation in Australia. Design Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Setting Acute care hospitals accredited by the Australian Council for Health Care Standards. Participants Six acute public hospitals across four States. Results Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. Conclusions This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. PMID:26351190

Information logistics: A production-line approach to information services

NASA Technical Reports Server (NTRS)

Adams, Dennis; Lee, Chee-Seng

1991-01-01

Logistics can be defined as the process of strategically managing the acquisition, movement, and storage of materials, parts, and finished inventory (and the related information flow) through the organization and its marketing channels in a cost effective manner. It is concerned with delivering the right product to the right customer in the right place at the right time. The logistics function is composed of inventory management, facilities management, communications unitization, transportation, materials management, and production scheduling. The relationship between logistics and information systems is clear. Systems such as Electronic Data Interchange (EDI), Point of Sale (POS) systems, and Just in Time (JIT) inventory management systems are important elements in the management of product development and delivery. With improved access to market demand figures, logisticians can decrease inventory sizes and better service customer demand. However, without accurate, timely information, little, if any, of this would be feasible in today's global markets. Information systems specialists can learn from logisticians. In a manner similar to logistics management, information logistics is concerned with the delivery of the right data, to the ring customer, at the right time. As such, information systems are integral components of the information logistics system charged with providing customers with accurate, timely, cost-effective, and useful information. Information logistics is a management style and is composed of elements similar to those associated with the traditional logistics activity: inventory management (data resource management), facilities management (distributed, centralized and decentralized information systems), communications (participative design and joint application development methodologies), unitization (input/output system design, i.e., packaging or formatting of the information), transportations (voice, data, image, and video communication systems

47 CFR 69.120 - Line information database.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Line information database. 69.120 Section 69...) ACCESS CHARGES Computation of Charges § 69.120 Line information database. (a) A charge that is expressed... from a local exchange carrier database to recover the costs of: (1) The transmission facilities between...

47 CFR 69.120 - Line information database.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Line information database. 69.120 Section 69...) ACCESS CHARGES Computation of Charges § 69.120 Line information database. (a) A charge that is expressed... from a local exchange carrier database to recover the costs of: (1) The transmission facilities between...

47 CFR 69.120 - Line information database.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Line information database. 69.120 Section 69...) ACCESS CHARGES Computation of Charges § 69.120 Line information database. (a) A charge that is expressed... from a local exchange carrier database to recover the costs of: (1) The transmission facilities between...

47 CFR 69.120 - Line information database.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Line information database. 69.120 Section 69...) ACCESS CHARGES Computation of Charges § 69.120 Line information database. (a) A charge that is expressed... from a local exchange carrier database to recover the costs of: (1) The transmission facilities between...

47 CFR 69.120 - Line information database.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Line information database. 69.120 Section 69...) ACCESS CHARGES Computation of Charges § 69.120 Line information database. (a) A charge that is expressed... from a local exchange carrier database to recover the costs of: (1) The transmission facilities between...

Cost-Effectiveness of Management Training in the Informal Sector. Discussion Paper No. 101.

ERIC Educational Resources Information Center

Nubler, Irmgard

A research project in the Ivory Coast, Kenya, and Tanzania evaluated the cost effectiveness of management training seminars for women entrepreneurs in the informal sector. Women, a large and growing part of entrepreneurs, had less access to needed resources, skills, and information than men. Reasons for failure to study the cost effectiveness and…

48 CFR 1830.7002 - Facilities capital employed for facilities under construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Facilities capital employed for facilities under construction. 1830.7002 Section 1830.7002 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND SPACE ADMINISTRATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING...

How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money. Energy-Smart Building Choices.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC.

This guide addresses contributions that school facility administrators and business officials can make in an effort to reduce operating costs and free up money for capital improvements. The guide explores opportunities available to utilize energy-saving strategies at any stage in a building's life, from its initial design phase through renovation.…

The earnings of informal carers: wage differentials and opportunity costs.

PubMed

Heitmueller, Axel; Inglis, Kirsty

2007-07-01

A substantial proportion of working age individuals in Britain are looking after sick, disabled or elderly people, often combining their work and caring responsibilities. Previous research has shown that informal care is linked with substantial opportunity costs for the individual due to forgone wages as a result of non-labour market participation. In this paper we show that informal carers exhibit further disadvantages even when participating. Using the British Household Panel Study (BHPS) we decompose wage differentials and show that carers can expect lower returns for a given set of characteristics, with this wage penalty varying along the pay distribution and by gender. Furthermore, opportunity costs from forgone wages and wage penalties are estimated and found to be substantial.

Facility-Level Variation in Hospitalization, Mortality, and Costs in the 30 Days After Percutaneous Coronary Intervention: Insights on Short-Term Healthcare Value From the Veterans Affairs Clinical Assessment, Reporting, and Tracking System (VA CART) Program.

PubMed

Bradley, Steven M; O'Donnell, Colin I; Grunwald, Gary K; Liu, Chuan-Fen; Hebert, Paul L; Maddox, Thomas M; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S; Ho, P Michael

2015-07-14

Policies to reduce unnecessary hospitalizations after percutaneous coronary intervention (PCI) are intended to improve healthcare value by reducing costs while maintaining patient outcomes. Whether facility-level hospitalization rates after PCI are associated with cost of care is unknown. We studied 32,080 patients who received PCI at any 1 of 62 Veterans Affairs hospitals from 2008 to 2011. We identified facility outliers for 30-day risk-standardized hospitalization, mortality, and cost. Compared with the risk-standardized average, 2 hospitals (3.2%) had a lower-than-expected hospitalization rate, and 2 hospitals (3.2%) had a higher-than-expected hospitalization rate. We observed no statistically significant variation in facility-level risk-standardized mortality. The facility-level unadjusted median per patient 30-day total cost was $23,820 (interquartile range, $19,604-$29,958). Compared with the risk-standardized average, 17 hospitals (27.4%) had lower-than-expected costs, and 14 hospitals (22.6%) had higher-than-expected costs. At the facility level, the index PCI accounted for 83.1% of the total cost (range, 60.3%-92.2%), whereas hospitalization after PCI accounted for only 5.8% (range, 2.0%-12.7%) of the 30-day total cost. Facilities with higher hospitalization rates were not more expensive (Spearman ρ=0.16; 95% confidence interval, -0.09 to 0.39; P=0.21). In this national study, hospitalizations in the 30 day after PCI accounted for only 5.8% of 30-day cost, and facility-level cost was not correlated with hospitalization rates. This challenges the focus on reducing hospitalizations after PCI as an effective means of improving healthcare value. Opportunities remain to improve PCI value by reducing the variation in total cost of PCI without compromising patient outcomes. © 2015 American Heart Association, Inc.

77 FR 61633 - Information Collection: Renewable Energy and Alternate Uses of Existing Facilities on the Outer...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

...] Information Collection: Renewable Energy and Alternate Uses of Existing Facilities on the Outer Continental... requirements in the regulations under ``Renewable Energy and Alternate Uses of Existing Facilities on the Outer..., transportation, or transmission of energy from sources other than oil and gas (renewable energy). Specifically...

10 CFR 76.119 - Security facility approval and safeguarding of National Security Information and Restricted Data.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Security facility approval and safeguarding of National Security Information and Restricted Data. 76.119 Section 76.119 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safeguards and Security § 76.119 Security facility...

10 CFR 76.119 - Security facility approval and safeguarding of National Security Information and Restricted Data.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Security facility approval and safeguarding of National Security Information and Restricted Data. 76.119 Section 76.119 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safeguards and Security § 76.119 Security facility...

10 CFR 76.119 - Security facility approval and safeguarding of National Security Information and Restricted Data.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Security facility approval and safeguarding of National Security Information and Restricted Data. 76.119 Section 76.119 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safeguards and Security § 76.119 Security facility...

10 CFR 76.119 - Security facility approval and safeguarding of National Security Information and Restricted Data.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Security facility approval and safeguarding of National Security Information and Restricted Data. 76.119 Section 76.119 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safeguards and Security § 76.119 Security facility...

10 CFR 76.119 - Security facility approval and safeguarding of National Security Information and Restricted Data.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Security facility approval and safeguarding of National Security Information and Restricted Data. 76.119 Section 76.119 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) CERTIFICATION OF GASEOUS DIFFUSION PLANTS Safeguards and Security § 76.119 Security facility...

48 CFR 1830.7001 - Facilities capital employed for facilities in use.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Facilities capital employed for facilities in use. 1830.7001 Section 1830.7001 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND SPACE ADMINISTRATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION...

Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

PubMed

Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

2003-01-01

To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

EPA Facility Registry Service (FRS): Facility Interests Dataset - Intranet

EPA Pesticide Factsheets

This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for all sites that are available in the FRS individual feature layers. The layers comprise the FRS major program databases, including:Assessment Cleanup and Redevelopment Exchange System (ACRES) : brownfields sites ; Air Facility System (AFS) : stationary sources of air pollution ; Air Quality System (AQS) : ambient air pollution data from monitoring stations; Bureau of Indian Affairs (BIA) : schools data on Indian land; Base Realignment and Closure (BRAC) facilities; Clean Air Markets Division Business System (CAMDBS) : market-based air pollution control programs; Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) : hazardous waste sites; Integrated Compliance Information System (ICIS) : integrated enforcement and compliance information; National Compliance Database (NCDB) : Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and the Toxic Substances Control Act (TSCA); National Pollutant Discharge Elimination System (NPDES) module of ICIS : NPDES surface water permits; Radiation Information Database (RADINFO) : radiation and radioactivity facilities; RACT/BACT/LAER Clearinghouse (RBLC) : best available air pollution technology requirements; Resource Conservation and Recovery Act Information System (RCRAInfo) : tracks generators, transporters, treaters, storers, and disposers of haz

Suture cost savings in the OR.

PubMed

Walsh, Susanna S

2012-05-01

Materials management personnel at a health care facility in Baltimore, Maryland, were stocking too much suture. They stocked suture requested by surgeons or recommended by suture company representatives, and, because the facility is a teaching institution, they stocked suture requested by residents. No master suture database was available to determine what was needed and what was not. As a result, some suture was rarely used, which cost the facility money and took up inventory space. In response, I created a list of the existing inventory and coordinated with the specialty surgical service coordinators to determine which suture was typically used and in what quantities. I used this information to create a master list, with the goal of eliminating the purchase of suture that was not on this list. I gave the staff members and surgeons two months to assess the list and determine whether the suggested suture was sufficient for their needs. I then asked the materials management personnel to order and maintain suture stock based on the master list. This process took approximately four months and shows how health care providers can take a high-volume item, such as suture, and create cost-saving processes that will serve surgeons' and patients' needs while reducing costs and streamlining stock. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Facility Accounting: Hammering Out a Capital Replacement Budget.

ERIC Educational Resources Information Center

Readinger, Jay

1996-01-01

Most facility and finance managers cannot adequately handle school infrastructure issues because they lack the tools to describe the problem appropriately. Facility accounting gives managers accurate deferral and projected replacement costs, using nationally recognized life-cycle and cost data. Facility accounting enables proper management of…

Exploring the Cost and Value of Private versus Shared Bedrooms in Nursing Homes

ERIC Educational Resources Information Center

Calkins, Margaret; Cassella, Christine

2007-01-01

Purpose: There is debate about the relative merits and costs of private versus shared bedrooms in nursing homes, particularly in light of the current efforts at creating both cost-efficient and person-centered care facilities. The purpose of this project was to explore the extent to which there is evidence-based information that supports the…

The cost of acute respiratory infections in Northern India: a multi-site study.

PubMed

Peasah, Samuel K; Purakayastha, Debjani Ram; Koul, Parvaiz A; Dawood, Fatima S; Saha, Siddhartha; Amarchand, Ritvik; Broor, Shobha; Rastogi, Vaibhab; Assad, Romana; Kaul, Kaisar Ahmed; Widdowson, Marc-Alain; Lal, Renu B; Krishnan, Anand

2015-04-07

Despite the high mortality and morbidity resulting from acute respiratory infections (ARI) globally, there are few data from low-income countries on costs of ARI to inform public health policy decisions We conducted a prospective survey to assess costs of ARI episodes in selected primary, secondary, and tertiary healthcare facilities in north India where no respiratory pathogen vaccine is routinely recommended. Face-to-face interviews were conducted among a purposive sample of patients with ARI from healthcare facilities. Data were collected on out-of-pocket costs of hospitalization, medical consultations, medications, diagnostics, transportation, lodging, and missed work days. Telephone surveys were conducted two weeks after medical encounters to ask about subsequent missed work and costs incurred. Costs of prescriptions and diagnostics in public facilities were supplemented with WHO-CHOICE estimates of hospital bed costs. Missed work days were assigned cost based on the national annual per capita income (US$1,104). Non-medically attended ARI cases were identified from an ongoing community-based ARI surveillance project in Faridabad. During September 2012-March 2013, 1766 patients with ARI were enrolled, including 451 hospitalized patients, 1056 outpatients, and 259 non-medically attended patients. The total direct cost of an ARI episode requiring outpatient care was US$4- $6 for public and $3-$10 for private institutions based on age groups. The total direct cost of an ARI episode requiring hospitalized care was $54-$120 in public and $135-$355 in private institutions. The cost of ARI among those hospitalized was highest among persons aged > = 65 years and lowest among children aged < 5 years. Indirect costs due to missed work days were 16-25% of total costs. The direct out-of-pocket cost of hospitalized ARI was 34% of annual per capita income. The cost of hospitalized ARI episodes in India is high relative to median per capita income. Data from this