A microcontroller platform for the rapid prototyping of functional electrical stimulation-based gait neuroprostheses.

PubMed

Luzio de Melo, Paulo; da Silva, Miguel Tavares; Martins, Jorge; Newman, Dava

2015-05-01

Functional electrical stimulation (FES) has been used over the last decades as a method to rehabilitate lost motor functions of individuals with spinal cord injury, multiple sclerosis, and post-stroke hemiparesis. Within this field, researchers in need of developing FES-based control solutions for specific disabilities often have to choose between either the acquisition and integration of high-performance industry-level systems, which are rather expensive and hardly portable, or develop custom-made portable solutions, which despite their lower cost, usually require expert-level electronic skills. Here, a flexible low-cost microcontroller-based platform for rapid prototyping of FES neuroprostheses is presented, designed for reduced execution complexity, development time, and production cost. For this reason, the Arduino open-source microcontroller platform was used, together with off-the-shelf components whenever possible. The developed system enables the rapid deployment of portable FES-based gait neuroprostheses, being flexible enough to allow simple open-loop strategies but also more complex closed-loop solutions. The system is based on a modular architecture that allows the development of optimized solutions depending on the desired FES applications, even though the design and testing of the platform were focused toward drop foot correction. The flexibility of the system was demonstrated using two algorithms targeting drop foot condition within different experimental setups. Successful bench testing of the device in healthy subjects demonstrated these neuroprosthesis platform capabilities to correct drop foot. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

29 CFR 25.7 - Fees; cost; expenses; decisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Fees; cost; expenses; decisions. 25.7 Section 25.7 Labor... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses... entirely by the agency. (b) The standard fee for the services of an arbitrator should be $100 per day...

Strain actuated aeroelastic control

NASA Technical Reports Server (NTRS)

Lazarus, Kenneth B.

1992-01-01

Viewgraphs on strain actuated aeroelastic control are presented. Topics covered include: structural and aerodynamic modeling; control law design methodology; system block diagram; adaptive wing test article; bench-top experiments; bench-top disturbance rejection: open and closed loop response; bench-top disturbance rejection: state cost versus control cost; wind tunnel experiments; wind tunnel gust alleviation: open and closed loop response at 60 mph; wind tunnel gust alleviation: state cost versus control cost at 60 mph; wind tunnel command following: open and closed loop error at 60 mph; wind tunnel flutter suppression: open loop flutter speed; and wind tunnel flutter suppression: closed loop state cost curves.

Practice expenses in the MFS (Medicare fee schedule): the service-class approach.

PubMed

Latimer, E A; Kane, N M

1995-01-01

The practice expense component of the Medicare fee schedule (MFS), which is currently based on historical charges and rewards physician procedures at the expense of cognitive services, is due to be changed by January 1, 1998. The Physician Payment Review Commission (PPRC) and others have proposed microcosting direct costs and allocating all indirect costs on a common basis, such as physician time or work plus direct costs. Without altering the treatment of direct costs, the service-class approach disaggregates indirect costs into six practice function costs. The practice function costs are then allocated to classes of services using cost-accounting and statistical methods. This approach would make the practice expense component more resource-based than other proposed alternatives.

Automated array assembly

NASA Technical Reports Server (NTRS)

Williams, B. F.

1976-01-01

Manufacturing techniques are evaluated using expenses based on experience and studying basic cost factors for each step to evaluate expenses from a first-principles point of view. A formal cost accounting procedure is developed which is used throughout the study for cost comparisons. The first test of this procedure is a comparison of its predicted costs for array module manufacturing with costs from a study which is based on experience factors. A manufacturing cost estimate for array modules of $10/W is based on present-day manufacturing techniques, expenses, and materials costs.

Allocation of Home Office Expenses to Segments and Business Unit General and Administrative Expenses to Final Cost Objectives

DTIC Science & Technology

1992-02-16

3 0 B. Cost Accounting Standard 418 ..................................................... 3 1 1. D efinitio n s ...objective" as an activity for which a separate measurement of cost is desired. C. Horngren , Cost Accounting . A Managerial Emphasis 21 (5th ed. 1982...Segments and Business Unit General and Administrative Expenses to Final Cost Objectives 6. AUTHOR( S ) Stephen Thomas Lynch, Major 7. PERFORMING

Hospital Supply Expenses: An Important Ingredient in Health Services Research.

PubMed

Abdulsalam, Yousef; Schneller, Eugene

2017-07-01

The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician-hospital arrangements, and value-based purchasing.

48 CFR 9904.403 - Allocation of home office expenses to segments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... expenses to segments. 9904.403 Section 9904.403 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.403 Allocation of home office expenses to...

41 CFR 105-60.608 - Fees, expenses, and costs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Demands in Judicial or Administrative Proceedings § 105-60.608 Fees, expenses, and costs. (a) In... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Fees, expenses, and costs. 105-60.608 Section 105-60.608 Public Contracts and Property Management Federal Property...

48 CFR 9904.403 - Allocation of home office expenses to segments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Allocation of home office expenses to segments. 9904.403 Section 9904.403 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.403 Allocation of home office expenses to...

Example of cost calculations for an operating room and a post-anaesthesia care unit.

PubMed

Raft, J; Millet, F; Meistelman, C

2015-08-01

The aim of this study was to evaluate the cost of an operating room using data from our hospital. Using an accounting-based method helped us. Over the year 2012, the sum of direct and indirect expenses with cost sharing expenses allowed us to calculate the cost of the operating room (OR) and of the post-anaesthesia care unit (PACU). The cost of the OR and PACU was €10.8 per minute of time offered. Two thirds of the direct expenses were allocated to surgery and one third to anaesthesia. Indirect expenses were 25% of the direct expenses. The cost of medications and single use medical devises was €111.45 per anaesthesia. The total cost of anaesthesia (taking into account wages and indirect expenses) was €753.14 per anaesthesia as compared to the total cost of the anaesthesia. The part of medications and single use devices for anaesthesia was 14.8% of the total cost. Despite the difficulties facing cost evaluation, this model of calculation, assisted by the cost accounting controller, helped us to have a concrete financial vision. It also shows that a global reflexion is necessary during financial decision-making. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Is ambulatory monitoring for "community-acquired" syncope economically attractive? A cost-effectiveness analysis of a randomized trial of external loop recorders versus Holter monitoring.

PubMed

Rockx, Marie Antoinette; Hoch, Jeffrey S; Klein, George J; Yee, Raymond; Skanes, Allan C; Gula, Lorne J; Krahn, Andrew D

2005-11-01

Out patient ambulatory monitoring is often performed in patients with syncope that present in the primary care setting to include or exclude an arrhythmia. The cost-effectiveness of 2 monitoring strategies was assessed in a prospective randomized trial. One hundred patients referred for ambulatory monitoring with syncope or presyncope were randomized to a 1-month external loop recorder (n = 49) or 48-hour Holter monitor (n = 51). Patients were offered crossover if there was failed activation or no symptom recurrence. The primary end point was symptom-rhythm correlation during monitoring. Direct costs were calculated based on the 2003 Ontario Health Insurance Plan fee schedule, combined with calculation of labor, materials, service, and overhead for diagnostic testing and related equipment. Before enrollment, the cost of all previous health care resource use was USD 472 +/- USD 397 (range USD 21-USD 1965). In the loop recorder group, 63% of patients had symptom recurrence and successful activation, compared with 24% in the Holter group (P < .0001). The cost per Holter was USD 177.64, and per loop recorder, USD 533.56, with a similar cost per diagnosis with the 2 techniques. The incremental cost-effectiveness ratio of the loop recorder was USD 901.74 per extra successful diagnosis. A strategy of Holter followed by offered loop recorder trended toward lower cost than initial loop recorder followed by Holter (USD 481 +/- USD 267 vs USD 551 +/- USD 83, P = .08), but was associated with a lower overall diagnostic yield (49% vs 63%) and a resultant higher cost per diagnosis (USD 982 vs USD 871, P = .08). Bootstrapping suggested that 90% of incremental cost-effectiveness ratios were less than USD 1250. Despite the increased upfront cost of external loop recorders, the marked improvement in diagnostic yield offsets the cost. External loop recorders are an economically attractive alternative. First-line use of external loop recorders in patients with "community-acquired" syncope and presyncope should be considered to optimize diagnostic yield given its value.

26 CFR 1.709-1T - Treatment of organizational expenses and syndication costs (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... syndication costs (temporary). 1.709-1T Section 1.709-1T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Treatment of organizational expenses and syndication costs (temporary). (a) [Reserved] For further guidance... organizational expenses for two or more taxable years. (3) Liquidation of partnership. If there is a winding up...

Looped suture versus stapler device in pediatric laparoscopic appendectomy: a comparative outcomes and intraoperative cost analysis.

PubMed

Parikh, Punam P; Tashiro, Jun; Wagenaar, Amy E; Curbelo, Miosotys; Perez, Eduardo A; Neville, Holly L; Hogan, Anthony R; Sola, Juan E

2018-04-01

Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations. Two hundred thirty-eight cases were analyzed where looped suture versus stapler LA was performed in 46% and 54% of patients, respectively. Operating room costs were $317.10 and $707.12/person for looped suture and stapler LA, respectively (P<0.0001). Difference in cost of $390.02/person was attributed solely to ligation type. On bivariate analysis, rate of in-hospital complications, length of stay, return-to-ER and readmission within 30 days did not significantly differ between groups. A comparative analysis of looped suture versus stapler device during LA for pediatric appendicitis revealed that postoperative complications, length of stay, ER visits and readmissions were not significantly different. Looped suture LA was significantly more cost efficient than stapler LA. In pediatric appendicitis, appendiceal ligation during LA may be performed safely and cost effectively with looped suture versus stapler. Cost effectiveness LEVEL OF EVIDENCE: III. Copyright © 2017 Elsevier Inc. All rights reserved.

29 CFR 25.7 - Fees; cost; expenses; decisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... limited to per diem, travel expenses and services on a time-worked basis. (e) Upon request, the Secretary... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses.... Travel and per diem should be paid at the maximum rate payable to Government employees under the...

29 CFR 25.7 - Fees; cost; expenses; decisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... limited to per diem, travel expenses and services on a time-worked basis. (e) Upon request, the Secretary... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses.... Travel and per diem should be paid at the maximum rate payable to Government employees under the...

Characteristics and healthcare utilisation patterns of high-cost beneficiaries in the Netherlands: a cross-sectional claims database study

PubMed Central

Wammes, Joost Johan Godert; Tanke, Marit; Jonkers, Wilma; Westert, Gert P; Van der Wees, Philip; Jeurissen, Patrick PT

2017-01-01

Objective To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%–5% high-cost beneficiaries in the Netherlands. Design Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most cost-incurring condition per beneficiary and expensive treatment use. Setting Dutch curative health system, a health system with universal coverage. Participants 4.5 million beneficiaries of one health insurer. Measures Annual total costs through hospital, intensive care unit use, expensive drugs, other pharmaceuticals, mental care and others; demographics; most cost-incurring and secondary conditions; inpatient stay; number of morbidities; costs per ICD10-chapter (International Statistical Classification of Diseases, 10th revision); and expensive treatment use (including dialysis, transplant surgery, expensive drugs, intensive care unit and diagnosis-related groups >€30 000). Results The top 1% and top 2%–5% beneficiaries accounted for 23% and 26% of total expenditures, respectively. Among top 1% beneficiaries, hospital care represented 76% of spending, of which, respectively, 9.0% and 9.1% were spent on expensive drugs and ICU care. We found that 54% of top 1% beneficiaries were aged 65 years or younger and that average costs sharply decreased with higher age within the top 1% group. Expensive treatments contributed to high costs in one-third of top 1% beneficiaries and in less than 10% of top 2%–5% beneficiaries. The average number of conditions was 5.5 and 4.0 for top 1% and top 2%–5% beneficiaries, respectively. 53% of top 1% beneficiaries were treated for circulatory disorders but for only 22% of top 1% beneficiaries this was their most cost-incurring condition. Conclusions Expensive treatments, most cost-incurring condition and age proved to be informative variables for studying this heterogeneous population. Expensive treatments play a substantial role in high-costs beneficiaries. Interventions need to be aimed at beneficiaries of all ages; a sole focus on the elderly would leave many high-cost beneficiaries unaddressed. Tailored interventions are needed to meet the needs of high-cost beneficiaries and to avoid waste of scarce resources. PMID:29133323

38 CFR 14.700 - Court cost and expenses; commitment, restoration, fiduciary appointments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... appointment of fiduciaries. To this end certain expenses such as court costs, publication fees, recording fees, transportation expenses and fees for medical testimony may be authorized by the Regional Counsel. Payment of...

26 CFR 1.709-1T - Treatment of organizational expenses and syndication costs (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

... syndication costs (temporary). 1.709-1T Section 1.709-1T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... § 1.709-1T Treatment of organizational expenses and syndication costs (temporary). (a) [Reserved] For... organizational expenses for two or more taxable years. (3) Liquidation of partnership. If there is a winding up...

[Cost accounting for gastrectomy under critical path--the usefulness of direct accounting of personnel expenses and a guide to shortening hospital stay].

PubMed

Nozue, M; Maruyama, T; Imamura, F; Fukue, M

2000-08-01

In this study, cost accounting was made for a surgical case of gastrectomy according to critical path (path) and the economic contribution of the path was determined. In addition, changes in the cost percentage with changes in number of hospital days were simulated. Basically, cost accounting was done by means of cost accounting by departments, which meets the concept of direct cost accounting of administered accounts. Personnel expenses were calculated by means of both direct and indirect calculations. In the direct method, the total hours personnel participated were recorded for calculation. In the indirect method, personnel expenses were calculated from the ratio of the income of the surgical department to that of other departments. Purchase prices for all materials and drugs used were recorded to check buying costs. According to the direct calculating method, the personnel expenses came to approximately 300,000 yen, total cost was approximately 700,000 yen, and the cost percentage was 59%. According to the indirect method, the personnel expenses were approximately 540,000 yen and the total cost was approximately 940,000 yen, the cost percentage being 80%. A simulation study of changes in the cost with changes in hospital days revealed that the cost percentages were assessed to be approximately 53% in 19 hospital days and approximately 45% in 12 hospital days.

A New Tool for Industry

NASA Technical Reports Server (NTRS)

1981-01-01

Ultrasonic P2L2 bolt monitor is a new industrial tool, developed at Langley Research Laboratory, which is lightweight, portable, extremely accurate because it is not subject to friction error, and it is cost-competitive with the least expensive of other types of accurate strain monitors. P2L2 is an acronym for Pulse Phase Locked Loop. The ultrasound system which measures the stress that occurs when a bolt becomes elongated in the process of tightening, transmits sound waves to the bolt being fastened and receives a return signal indicating changes in bolt stress. Results are translated into a digital reading of the actual stress on the bolt. Device monitors the bolt tensioning process on mine roof bolts that provide increased safety within the mine. Also has utility in industrial applications.

48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

Code of Federal Regulations, 2010 CFR

2010-10-01

... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

School-related expenses, living expenses, and income sources for graduate students in nurse anesthesia programs.

PubMed

Heikkila, Dianna

2002-02-01

Nurse anesthesia programs (NAPs) are the highest priced programs for graduate students compared with 7 other nursing master's degree programs. Not only are nurse anesthesia programs expensive, but also most students are encouraged by the policies within their individual programs to terminate full-time employment before matriculation. The purpose of this study was to determine school-related and living expenses, as well as the income and sources of income for graduate students in the second year of their NAP. To obtain the information, a student cost survey was designed and administered to participants attending NAPs across the United States during the 2001 school year. In addition, total degree costs were analyzed using a cost model assessing 4 components: educational costs, living expenses, net income foregone, and loan costs. The results showed that total degree costs incurred by graduate students in NAPs to complete their nurse anesthesia education totals $173,007. The analysis of the sources of income showed the following sources were used by respondents: guaranteed student loans; a spouse's income; agreements with future employers; stipends from universities, hospitals, and/or the military; grants; family support; and self-income. Completing a nurse anesthesia education program is expensive, although the expected return on the investment is high. Nevertheless, the expense may keep qualified graduate students from entering NAPs.

Visual detection of Potato Leafroll virus by loop-mediated isothermal amplification of DNA with the GeneFinder™ dye.

PubMed

Almasi, Mohammad Amin; Erfan Manesh, Maryam; Jafary, Hossein; Dehabadi, Seyed Mohammad Hosseini

2013-09-01

The most common virus affecting potatoes in the field worldwide is Potato Leafroll virus (PLRV), belonging to the family Luteoviridae, genius Plerovirus. There are several molecular methods to detect PLRV including polymerase chain reaction (PCR), Multiplex AmpliDet RNA and double antibody sandwich ELISA (DAS-ELISA). But these techniques take a long time for 3h to two days, requiring sophisticated tools. The aim of this study was to reduce the time required to detect PLRV, using a newly designed loop-mediated isothermal amplification (LAMP) technique requiring only an ordinary water bath or thermoblock. PLRV RNA was extracted from overall 80 infected naturally potato leaves. A set of six novel primers for the LAMP reaction was designed according to the highly conserved sequence of the viral coat protein (CP) gene. LAMP was carried out under isothermal conditions, applying the Bst DNA polymerase enzyme; the LAMP products were detected visually using the GeneFinder™ florescence dye. A positive result using the GeneFinder™ dye was a color change from the original orange to green. Results confirmed LAMP with GeneFinder™ provides a rapid and safe assay for detection of PLRV. Since with other molecular methods, equipping laboratories with a thermocycler or expensive detector systems is unavoidable, this assay was found to be a simple, cost-effective molecular method that has the potential to replace other diagnostic methods in primary laboratories without the need for expensive equipment or specialized techniques. It can also be considered as a reliable alternative viral detection system in further investigations. Copyright © 2013 Elsevier B.V. All rights reserved.

Understanding Costs of Care in the Operating Room.

PubMed

Childers, Christopher P; Maggard-Gibbons, Melinda

2018-04-18

Increasing value requires improving quality or decreasing costs. In surgery, estimates for the cost of 1 minute of operating room (OR) time vary widely. No benchmark exists for the cost of OR time, nor has there been a comprehensive assessment of what contributes to OR cost. To calculate the cost of 1 minute of OR time, assess cost by setting and facility characteristics, and ascertain the proportion of costs that are direct and indirect. This cross-sectional and longitudinal analysis examined annual financial disclosure documents from all comparable short-term general and specialty care hospitals in California from fiscal year (FY) 2005 to FY2014 (N = 3044; FY2014, n = 302). The analysis focused on 2 revenue centers: (1) surgery and recovery and (2) ambulatory surgery. Mean cost of 1 minute of OR time, stratified by setting (inpatient vs ambulatory), teaching status, and hospital ownership. The proportion of cost attributable to indirect and direct expenses was identified; direct expenses were further divided into salary, benefits, supplies, and other direct expenses. In FY2014, a total of 175 of 302 facilities (57.9%) were not for profit, 78 (25.8%) were for profit, and 49 (16.2%) were government owned. Thirty facilities (9.9%) were teaching hospitals. The mean (SD) cost for 1 minute of OR time across California hospitals was $37.45 ($16.04) in the inpatient setting and $36.14 ($19.53) in the ambulatory setting (P = .65). There were no differences in mean expenditures when stratifying by ownership or teaching status except that teaching hospitals had lower mean (SD) expenditures than nonteaching hospitals in the inpatient setting ($29.88 [$9.06] vs $38.29 [$16.43]; P = .006). Direct expenses accounted for 54.6% of total expenses ($20.40 of $37.37) in the inpatient setting and 59.1% of total expenses ($20.90 of $35.39) in the ambulatory setting. Wages and benefits accounted for approximately two-thirds of direct expenses (inpatient, $14.00 of $20.40; ambulatory, $14.35 of $20.90), with nonbillable supplies accounting for less than 10% of total expenses (inpatient, $2.55 of $37.37; ambulatory, $3.33 of $35.39). From FY2005 to FY2014, expenses in the OR have increased faster than the consumer price index and medical consumer price index. Teaching hospitals had slower growth in costs than nonteaching hospitals. Over time, the proportion of expenses dedicated to indirect costs has increased, while the proportion attributable to salary and supplies has decreased. The mean cost of OR time is $36 to $37 per minute, using financial data from California's short-term general and specialty hospitals in FY2014. These statewide data provide a generalizable benchmark for the value of OR time. Furthermore, understanding the composition of costs will allow those interested in value improvement to identify high-yield targets.

Reconfigurable HIL Testing of Earth Satellites

NASA Technical Reports Server (NTRS)

2008-01-01

In recent years, hardware-in-the-loop (HIL) testing has carved a strong niche in several industries, such as automotive, aerospace, telecomm, and consumer electronics. As desktop computers have realized gains in speed, memory size, and data storage capacity, hardware/software platforms have evolved into high performance, deterministic HIL platforms, capable of hosting the most demanding applications for testing components and subsystems. Using simulation software to emulate the digital and analog I/O signals of system components, engineers of all disciplines can now test new systems in realistic environments to evaluate their function and performance prior to field deployment. Within the Aerospace industry, space-borne satellite systems are arguably some of the most demanding in terms of their requirement for custom engineering and testing. Typically, spacecraft are built one or few at a time to fulfill a space science or defense mission. In contrast to other industries that can amortize the cost of HIL systems over thousands, even millions of units, spacecraft HIL systems have been built as one-of-a-kind solutions, expensive in terms of schedule, cost, and risk, to assure satellite and spacecraft systems reliability. The focus of this paper is to present a new approach to HIL testing for spacecraft systems that takes advantage of a highly flexible hardware/software architecture based on National Instruments PXI reconfigurable hardware and virtual instruments developed using LabVIEW. This new approach to HIL is based on a multistage/multimode spacecraft bus emulation development model called Reconfigurable Hardware In-the-Loop or RHIL.

Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations. A cost-effectiveness analysis

NASA Technical Reports Server (NTRS)

Zimetbaum, P. J.; Kim, K. Y.; Josephson, M. E.; Goldberger, A. L.; Cohen, D. J.

1998-01-01

BACKGROUND: Continuous-loop event recorders are widely used for the evaluation of palpitations, but the optimal duration of monitoring is unknown. OBJECTIVE: To determine the yield, timing, and incremental cost-effectiveness of each week of event monitoring for palpitations. DESIGN: Prospective cohort study. PATIENTS: 105 consecutive outpatients referred for the placement of a continuous-loop event recorder for the evaluation of palpitations. MEASUREMENTS: Diagnostic yield, incremental cost, and cost-effectiveness for each week of monitoring. RESULTS: The diagnostic yield of continuous-loop event recorders was 1.04 diagnoses per patient in week 1, 0.15 diagnoses per patient in week 2, and 0.01 diagnoses per patient in week 3 and beyond. Over time, the cost-effectiveness ratio increased from $98 per new diagnosis in week 1 to $576 per new diagnosis in week 2 and $5832 per new diagnosis in week 3. CONCLUSIONS: In patients referred for evaluation of palpitations, the diagnostic yield of continuous-loop event recording decreases rapidly after 2 weeks of monitoring. A 2-week monitoring period is reasonably cost-effective for most patients and should be the standard period for continuous-loop event recording for the evaluation of palpitations.

48 CFR 2131.205-71 - Reinsurer administrative expense costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 2131.205-71... as set forth in the contract is an allowable cost when documented through an internal accounting... expense costs. 2131.205-71 Section 2131.205-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL...

25 CFR 215.12 - Advertising costs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Advertising costs. 215.12 Section 215.12 Indians BUREAU... LEASES, QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising and...

25 CFR 215.12 - Advertising costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Advertising costs. 215.12 Section 215.12 Indians BUREAU... LEASES, QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising and...

25 CFR 215.12 - Advertising costs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Advertising costs. 215.12 Section 215.12 Indians BUREAU... LEASES, QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising and...

25 CFR 215.12 - Advertising costs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Advertising costs. 215.12 Section 215.12 Indians BUREAU... LEASES, QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising and...

12 CFR 1206.3 - Annual assessments.

Code of Federal Regulations, 2014 CFR

2014-01-01

...'s costs and expenses, including, but not limited to: (1) Expenses of any examinations under 12 U.S.C... wind up the affairs of the Office of Federal Housing Enterprise Oversight and the Federal Housing... shall not exceed amounts sufficient to provide for payment of the costs and expenses relating to the...

12 CFR 1206.3 - Annual assessments.

Code of Federal Regulations, 2012 CFR

2012-01-01

...'s costs and expenses, including, but not limited to: (1) Expenses of any examinations under 12 U.S.C... wind up the affairs of the Office of Federal Housing Enterprise Oversight and the Federal Housing... shall not exceed amounts sufficient to provide for payment of the costs and expenses relating to the...

12 CFR 1206.3 - Annual assessments.

Code of Federal Regulations, 2013 CFR

2013-01-01

...'s costs and expenses, including, but not limited to: (1) Expenses of any examinations under 12 U.S.C... wind up the affairs of the Office of Federal Housing Enterprise Oversight and the Federal Housing... shall not exceed amounts sufficient to provide for payment of the costs and expenses relating to the...

12 CFR 1206.3 - Annual assessments.

Code of Federal Regulations, 2011 CFR

2011-01-01

...'s costs and expenses, including, but not limited to: (1) Expenses of any examinations under 12 U.S.C... wind up the affairs of the Office of Federal Housing Enterprise Oversight and the Federal Housing... shall not exceed amounts sufficient to provide for payment of the costs and expenses relating to the...

12 CFR 1206.3 - Annual assessments.

Code of Federal Regulations, 2010 CFR

2010-01-01

...'s costs and expenses, including, but not limited to: (1) Expenses of any examinations under 12 U.S.C... wind up the affairs of the Office of Federal Housing Enterprise Oversight and the Federal Housing... shall not exceed amounts sufficient to provide for payment of the costs and expenses relating to the...

75 FR 20388 - International Business Machines Corporation, Global Technology Services Business Unit, Integrated...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... Expense Team, Working From Various States in the United States, Including On-Site Leased Workers From... Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team working from various... Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team. The Department has...

The effects of stochastic demand and expense preference behaviour on public hospital costs and excess capacity.

PubMed

Lovell, C A Knox; Rodríguez-Alvarez, Ana; Wall, Alan

2009-02-01

The literature to date on the effect of demand uncertainty on public hospital costs and excess capacity has not taken into account the role of expense preference behaviour. Similarly, the research on expense preference behaviour has not taken demand uncertainty into account. In this paper, we argue that both demand uncertainty and expense preference behaviour may affect public hospital costs and excess capacity and that ignoring either of these effects may lead to biased parameter estimates and misleading inference. To show this, we extend the analysis of Rodríguez-Alvarez and Lovell (Health Econ. 2004; 13: 157-169) by incorporating demand uncertainty into the technology to account for the hospital activity of providing standby capacity or insurance against the unexpected demand. We find that demand uncertainty in Spanish public hospitals affects hospital production decisions and increases costs. Our results also show that overcapitalization in these hospitals can be explained by hospitals providing insurance demand when faced with demand uncertainty. We also find evidence of expense preference behaviour. We conclude that both stochastic demand and expense preference behaviour should be taken into account when analysing hospital costs and production. Copyright (c) 2008 John Wiley & Sons, Ltd.

25 CFR 215.12 - Advertising costs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Advertising costs. 215.12 Section 215.12 Indians BUREAU OF..., QUAPAW AGENCY § 215.12 Advertising costs. All advertising costs, publication fees, expenses incurred for abstracts of lease title, and other expenses incurred in connection with the advertising and sale of leases...

20 CFR 627.435 - Cost principles and allowable costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... system, including the costs of hearings and appeals, and related expenses such as lawyers' fees. Legal...) Legal expenses for the prosecution of claims against the Federal Government, including appeals to an... incurred by the SJTCC, HRIC, PIC's, and other advisory councils or committees; (3) Advertising costs; (4...

Discussing Out-of-Pocket Expenses During Clinical Appointments: An Observational Study of Patient-Psychiatrist Interactions.

PubMed

Brown, Gregory D; Hunter, Wynn G; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Barnett, Jamison A; Byelmac, Dmytro; Ubel, Peter A

2017-06-01

High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs. The authors conducted content analysis from 422 outpatient psychiatrist-patient visits for medication management of major depressive disorder in community-based private practices nationwide from 2010 to 2014. Patients' health care expenses were discussed in 38% of clinic visits (95% confidence interval [CI]= 33%-43%). Uninsured patients were significantly more likely to discuss expenses than were patients enrolled in private or public plans (64%, 44%, and 30%, respectively; p<.001). Sixty-nine percent of cost conversations lasted less than one minute (median=36 seconds; interquartile range [IQR]=16-81 seconds). Cost conversations most frequently addressed psychotropic medications (51%). Physicians initiated 50% of cost conversations and brought up costs for psychotropic medications more often than did patients (62% versus 38%, p=.009). Conversely, a greater percentage of patient-initiated cost conversations addressed provider visit costs (27% versus 10%, p=.008). Overall, 45% of cost conversations mentioned cost-reducing strategies (CI=37%-53%). The most frequently discussed cost-reducing strategies were lowering cost by changing the source or timing of an intervention (for example, changing pharmacies), providing free samples, and switching to a lower-cost therapy or diagnostic test. Psychiatrists and patients regularly discuss patients' health care costs in visits for depression. These discussions cover a variety of clinical topics and frequently include strategies to lower patients' costs.

Enhanced ABC costing for hospitals: directed expense costing.

PubMed

Ryan, J

1997-10-01

Space limitations do not allow a complete discussion of all the topics and many of the obvious questions that the preceding brief introduction to directed expense costing probably raised in the reader's mind. These include how errors in accounting practices like posting expenses to the wrong period are handled; and how the system automatically adjusts costs for expenses benefiting several periods but posted to the acquisition month. As was mentioned above, underlying this overtly simple costing method are a number of sophisticated and sometimes complex processes that are hidden from the normal user and designed to automatically protect the integrity and accuracy of the costing process. From a user's viewpoint, the system is straightforward, understandable, and easy to use and audit. From a software development perspective, it is not quite that effortless. By using a system that is understood by all users at all levels, these users can now communicate with each other in a new and effective way. This new communication channel only occurs after each user is satisfied as to the overall costing quality achieved by the process. However, not all managers or physicians are always happy that the institution is using this "understandable" cost accounting system. During one of the weekly meetings of a hospital's administrative council, complaints from several powerful department heads concerning the impact that the use of cost data was having on them were brought up for discussion. In defending the continued use of the system, one vice president stated to the group that cost accounting does not get any easier than this, or any less expensive, or any more accurate. The directed expense process works and works very well. Our department heads and physicians will have to come to grips with the accountably it provides us to assess their value to the hospital.

Cost consideration for aircraft configuration changes, 1

NASA Technical Reports Server (NTRS)

Tumlinson, R. R.

1975-01-01

The costs of improvements in aircraft drag reduction design changes are outlined in the context of production decisions. A drag reduction design with increased airframe weight requires cost increases for direct labor, overhead and direct expenses, plus general and administrative expenses.

Public Response to Cost-Quality Tradeoffs in Clinical Decisions

PubMed Central

Beach, Mary Catherine; Asch, David A.; Jepson, Christopher; Hershey, John C.; Mohr, Tara; McMorrow, Stacey; Ubel, Peter A.

2011-01-01

Purpose To explore public attitudes toward the incorporation of cost-effectiveness analysis into clinical decisions. Methods The authors presented 781 jurors with a survey describing 1 of 6 clinical encounters in which a physician has to choose between cancer screening tests. They provided cost-effectiveness data for all tests, and in each scenario, the most effective test was more expensive. They instructed respondents to imagine that he or she was the physician in the scenario and asked them to choose which test to recommend and then explain their choice in an open-ended manner. The authors then qualitatively analyzed the responses by identifying themes and developed a coding scheme. Two authors separately coded the statements with high overall agreement (kappa = 0.76). Categories were not mutually exclusive. Results Overall, 410 respondents (55%) chose the most expensive option, and 332 respondents (45%) choose a less expensive option. Explanatory comments were given by 82% respondents. Respondents who chose the most expensive test focused on the increased benefit (without directly acknowledging the additional cost) (39%), a general belief that life is more important than money (22%), the significance of cancer risk for the patient in the scenario (20%), the belief that the benefit of the test was worth the additional cost (8%), and personal anecdotes/preferences (6%). Of the respondents who chose the less expensive test, 40% indicated that they did not believe that the patient in the scenario was at significant risk for cancer, 13% indicated that they thought the less expensive test was adequate or not meaningfully different from the more expensive test, 12% thought the cost of the test was not worth the additional benefit, 9% indicated that the test was too expensive (without mention of additional benefit), and 7% responded that resources were limited. Conclusions Public response to cost-quality tradeoffs is mixed. Although some respondents justified their decision based on the cost-effectiveness information provided, many focused instead on specific features of the scenario or on general beliefs about whether cost should be incorporated into clinical decisions. PMID:14570295

48 CFR 9904.410-50 - Techniques for application.

Code of Federal Regulations, 2012 CFR

2012-10-01

... segment incurred by another segment shall be removed from the incurring segment's G&A expense pool. They... whole, shall be included in the receiving segment's G&A expense pool. (2) Any separate allocation of the... from the G&A expense pool required by 9904.410-40(a), and the particular final cost objective's cost...

48 CFR 9904.410-50 - Techniques for application.

Code of Federal Regulations, 2014 CFR

2014-10-01

... segment incurred by another segment shall be removed from the incurring segment's G&A expense pool. They... whole, shall be included in the receiving segment's G&A expense pool. (2) Any separate allocation of the... from the G&A expense pool required by 9904.410-40(a), and the particular final cost objective's cost...

48 CFR 9904.410-50 - Techniques for application.

Code of Federal Regulations, 2013 CFR

2013-10-01

... segment incurred by another segment shall be removed from the incurring segment's G&A expense pool. They... whole, shall be included in the receiving segment's G&A expense pool. (2) Any separate allocation of the... from the G&A expense pool required by 9904.410-40(a), and the particular final cost objective's cost...

Boeing’s Integrated Defense Systems Restructuring: Significant and Preventable Cost Impacts to Army Aviation Programs

DTIC Science & Technology

2005-03-18

IDS, the treatment and handling of Boeing World Headquarters (BWHQ) costs, common or shared systems costs, Shared Services Group costs, fringe...these expenses.15 One such example is the addition of the Shared Services Group (SSG) expense to the Mesa and Philadelphia accounting ledgers. Under

7 CFR 1822.265 - Loan purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the payment of necessary engineering fees, legal fees, and closing costs. (c) For the payment of actual cash cost of incidental administrative expenses such as postage, telephone, advertising, and temporary secretarial help, if funds to pay these expenses are not otherwise available. The estimated cost...

Total Health-Related Costs Due to Absenteeism, Presenteeism, and Medical and Pharmaceutical Expenses in Japanese Employers

PubMed Central

Nagata, Tomohisa; Mori, Koji; Ohtani, Makoto; Nagata, Masako; Kajiki, Shigeyuki; Fujino, Yoshihisa; Matsuda, Shinya; Loeppke, Ronald

2018-01-01

Objective: This study aimed to examine a detailed breakdown of costs (absenteeism, presenteeism, and medical/pharmaceutical expenses), of the employees in four pharmaceutical companies in Japan. Methods: This is a cross-sectional study. Absenteeism and presenteeism were measured by a self-administered questionnaire for workers, and their costs were estimated using the human capital approach. Presenteeism was evaluated by the degree affected quality and quantity of work. Medical and pharmaceutical expenses were obtained by insurance claims. Results: The monetary value due to absenteeism was $520 per person per year (11%), that of presenteeism was $3055 (64%), and medical/pharmaceutical expenses were $1165 (25%). Two of the highest total cost burdens from chronic illness were related to mental (behavioral) health conditions and musculoskeletal disorders. Conclusion: A total cost approach can help employers set priorities for occupational health, safety, and population health management initiatives. PMID:29394196

Family Expense Manager Application in Android

NASA Astrophysics Data System (ADS)

Rajaprabha, M. N.

2017-11-01

FAMILY EXPENSES MANAGER is an android application. This monitors your own costs, family costs and incidental costs. This resembles a present day costs day book in your versatile. This application helps you to monitor your every day costs, settlement points of interest, general rundown, report in detail and periodic costs subtle elements. Every one of the information is put away in database and can be recovered by the client and their relatives.

78 FR 60281 - Media Bureau Seeks Comment on Catalog of Eligible Expenses and Other Issues Related to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... Spectrum Act, the Commission seeks comment on the types of expenses broadcasters might incur, the price of... specific types of expenses within cost categories that broadcasters might incur following channel...'' costs, such as legal and engineering services. The Notice seeks comment not only on the types of...

Revenue and Expenses of Ontario Universities, 1981-82. Volume IV, Physical Plant Operating Expenses.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto. Research Div.

Results of an annual survey provide an analysis of physical plant costs by major functional area and object of expense, as reported in each university's operating fund. The principles observed in reporting, definitions, and explanatory comments on the cost categories and their scopes precede a series of summary tables for: total and percentage…

Enterprise Content Buying--The New Landscape

ERIC Educational Resources Information Center

Noorlander, Bill

2009-01-01

Content is both a key ingredient for business and a major expense. Market research shows that the investment in content and data is generally one of the top expense items within a firm. For some firms, within the financial industry, for example, content costs are the second or third level of expense behind the cost of employees. While there has…

Establishment of reference costs for occupational health services and implementation of cost management in Japanese manufacturing companies.

PubMed

Nagata, Tomohisa; Mori, Koji; Aratake, Yutaka; Ide, Hiroshi; Nobori, Junichiro; Kojima, Reiko; Odagami, Kiminori; Kato, Anna; Hiraoka, Mika; Shiota, Naoki; Kobayashi, Yuichi; Ito, Masato; Tsutsumi, Akizumi; Matsuda, Shinya

2016-07-22

We developed a standardized cost estimation method for occupational health (OH) services. The purpose of this study was to set reference OH services costs and to conduct OH services cost management assessments in two workplaces by comparing actual OH services costs with the reference costs. Data were obtained from retrospective analyses of OH services costs regarding 15 OH activities over a 1-year period in three manufacturing workplaces. We set the reference OH services costs in one of the three locations and compared OH services costs of each of the two other workplaces with the reference costs. The total reference OH services cost was 176,654 Japanese yen (JPY) per employee. The personnel cost for OH staff to conduct OH services was JPY 47,993, and the personnel cost for non-OH staff was JPY 38,699. The personnel cost for receipt of OH services-opportunity cost-was JPY 19,747, expense was JPY 25,512, depreciation expense was 34,849, and outsourcing cost was JPY 9,854. We compared actual OH services costs from two workplaces (the total OH services costs were JPY 182,151 and JPY 238,023) with the reference costs according to OH activity. The actual costs were different from the reference costs, especially in the case of personnel cost for non-OH staff, expense, and depreciation expense. Using our cost estimation tool, it is helpful to compare actual OH services cost data with reference cost data. The outcomes help employers make informed decisions regarding investment in OH services.

Establishment of reference costs for occupational health services and implementation of cost management in Japanese manufacturing companies

PubMed Central

Nagata, Tomohisa; Mori, Koji; Aratake, Yutaka; Ide, Hiroshi; Nobori, Junichiro; Kojima, Reiko; Odagami, Kiminori; Kato, Anna; Hiraoka, Mika; Shiota, Naoki; Kobayashi, Yuichi; Ito, Masato; Tsutsumi, Akizumi; Matsuda, Shinya

2016-01-01

Objectives: We developed a standardized cost estimation method for occupational health (OH) services. The purpose of this study was to set reference OH services costs and to conduct OH services cost management assessments in two workplaces by comparing actual OH services costs with the reference costs. Methods: Data were obtained from retrospective analyses of OH services costs regarding 15 OH activities over a 1-year period in three manufacturing workplaces. We set the reference OH services costs in one of the three locations and compared OH services costs of each of the two other workplaces with the reference costs. Results: The total reference OH services cost was 176,654 Japanese yen (JPY) per employee. The personnel cost for OH staff to conduct OH services was JPY 47,993, and the personnel cost for non-OH staff was JPY 38,699. The personnel cost for receipt of OH services-opportunity cost-was JPY 19,747, expense was JPY 25,512, depreciation expense was 34,849, and outsourcing cost was JPY 9,854. We compared actual OH services costs from two workplaces (the total OH services costs were JPY 182,151 and JPY 238,023) with the reference costs according to OH activity. The actual costs were different from the reference costs, especially in the case of personnel cost for non-OH staff, expense, and depreciation expense. Conclusions: Using our cost estimation tool, it is helpful to compare actual OH services cost data with reference cost data. The outcomes help employers make informed decisions regarding investment in OH services. PMID:27170449

Cost of post-stroke outpatient care in Malaysia.

PubMed

Akhavan Hejazi, Seyed Majid; Mazlan, Mazlina; Abdullah, Saini Jeffery Freddy; Engkasan, Julia Patrick

2015-02-01

This study aimed to investigate the direct cost of outpatient care for patients with stroke, as well as the relationship between the aforementioned cost and the sociodemographic and stroke characteristics of the patients. This was a cross-sectional study involving patients with first-ever stroke who were attending outpatient stroke rehabilitation, and their family members. Participants were interviewed using a structured questionnaire designed to obtain information regarding the cost of outpatient care. Stroke severity was measured using the National Institute of Health Stroke Scale. This study comprised 49 patients (28 men, 21 women) with a mean age of 60.2 (range 35-80) years. The mean total cost incurred was USD 547.10 (range USD 53.50-4,591.60), of which 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses. Stroke severity, age > 70 years and haemorrhagic stroke were associated with increased cost. The mean cost of attending outpatient therapy per patient was USD 17.50 per session (range USD 6.60-30.60), with travelling expenses (41.8%) forming the bulk of the cost, followed by medical fees (38.1%) and out-of-pocket expenses (10.9%). Multiple regression analysis showed that stroke severity was the main determinant of post-stroke outpatient care cost (p < 0.001). Post-stroke outpatient care costs are significantly influenced by stroke severity. The cost of attendant care was the main cost incurred during the first three months after hospital discharge, while travelling expenses was the main cost incurred when attending outpatient stroke rehabilitation therapy.

Patients' annual income adequacy, insurance premiums and out-of-pocket expenses related to heart failure care.

PubMed

Piamjariyakul, Ubolrat; Yadrich, Donna Macan; Russell, Christy; Myer, Jane; Prinyarux, Chanawee; Vacek, James L; Ellerbeck, Edward F; Smith, Carol E

2014-01-01

To (1) identify the amount patients spend for insurance premiums, co-payments, deductibles, and other out-of-pocket costs related to HF and chronic health care services and estimate their annual non-reimbursed and out-of-pocket costs; and (2) identify patients' concerns about nonreimbursed and out-of-pocket expenses. HF is one of the most expensive illnesses for our society with multiple health services and financial burdens for families. Mixed methods with quantitative questionnaires and qualitative interviews. Patients (N = 149) reported annual averages for non-reimbursed health services co-payments and out-of-pocket costs ranging from $3913 to $5829 depending on insurance coverage. Thirty one patients (21%) reported inadequate health coverage related to their non-reimbursed costs. Non-reimbursed costs related to HF care are substantial and vary depending on their insurance, health services use, and out-of-pocket costs. Patient referral to social services to assist with expenses could provide some relief from the burden of high HF-related costs. Copyright © 2014 Elsevier Inc. All rights reserved.

7 CFR 1767.28 - Customer accounts expenses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Reading Expenses 903Customer Records and Collection Expenses 904Uncollectible Accounts 905Miscellaneous... the cost of labor, employee pensions and benefits, social security and other payroll taxes, injuries... Reading Expenses, or Account 903, Customer Records and Collection Expenses, as appropriate. (See § 1767.17...

7 CFR 1767.28 - Customer accounts expenses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Reading Expenses 903Customer Records and Collection Expenses 904Uncollectible Accounts 905Miscellaneous... the cost of labor, employee pensions and benefits, social security and other payroll taxes, injuries... Reading Expenses, or Account 903, Customer Records and Collection Expenses, as appropriate. (See § 1767.17...

7 CFR 1767.28 - Customer accounts expenses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Reading Expenses 903Customer Records and Collection Expenses 904Uncollectible Accounts 905Miscellaneous... the cost of labor, employee pensions and benefits, social security and other payroll taxes, injuries... Reading Expenses, or Account 903, Customer Records and Collection Expenses, as appropriate. (See § 1767.17...

Economic analysis of medical management applied for left colostomy.

PubMed

Savlovschi, C; Serban, D; Andreescu, Cv; Dascalu, Am; Pantu, H

2013-01-01

This paper presents an analysis of surgical treatment costs for left colostomy, aiming to calculate a medium cost per procedure and to identify the means to maximize the economic management of this type of surgicale procedure. A retrospective study was conducted on a group of 8 patients hospitalized in the 4th Surgery Department,Emergency University Hospital Bucharest, during the year 2012 for left colic neoplasms with obstruction signs that were operated on with a left colostomy. The followed parameters in the studied group of patients were represented by medical expenses, divided in: preoperative, intra-operative and immediate postoperative (postop. hospitalization). Two major types of colostomy were performed: left loop colostomy with intact tumour for 6 patients and left end colostomy and tumour resection (Hartmann's procedure) for 2 patients. The medium cost of this type of surgical intervention was 4396.807 RON, representing 1068.742 euro. Statistic data analysis didn't reveal average costs to vary with the type of procedure. The age of the study subjects was between 49 and 88, with an average of 61 years, without it being possible to establish a correlation between patient age and the level of medical spendings. Reducing the costs involved by left colostomy can be efficiently done by decreasing the number of days of hospitalisation in the following ways: preoperative preparation and assessment of the subject in an outpatient regimen; the accuracy of the surgical procedure with the decrease of early postoperative complications and antibiotherapy- the second major cause of increased postoperative costs. Celsius.

11 CFR 9004.9 - Net outstanding qualified campaign expenses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the necessary winding down costs, as defined under 11 CFR 9004.4(a)(4), submitted in the format... amount submitted as an estimate of necessary winding down costs under paragraph (a)(1)(iii) of this... shall include estimated costs for office space rental, staff salaries, legal expenses, accounting...

11 CFR 9004.9 - Net outstanding qualified campaign expenses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of the necessary winding down costs, as defined under 11 CFR 9004.4(a)(4), submitted in the format... amount submitted as an estimate of necessary winding down costs under paragraph (a)(1)(iii) of this... shall include estimated costs for office space rental, staff salaries, legal expenses, accounting...

11 CFR 9004.9 - Net outstanding qualified campaign expenses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of the necessary winding down costs, as defined under 11 CFR 9004.4(a)(4), submitted in the format... amount submitted as an estimate of necessary winding down costs under paragraph (a)(1)(iii) of this... shall include estimated costs for office space rental, staff salaries, legal expenses, accounting...

11 CFR 9004.9 - Net outstanding qualified campaign expenses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of the necessary winding down costs, as defined under 11 CFR 9004.4(a)(4), submitted in the format... amount submitted as an estimate of necessary winding down costs under paragraph (a)(1)(iii) of this... shall include estimated costs for office space rental, staff salaries, legal expenses, accounting...

47 CFR 32.6123 - Office equipment expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... equipment expense. This account shall be charged only with costs incurred in connection with the office equipment itself. The costs of operators of this equipment shall be charged to accounts appropriate for the...

41 CFR 302-11.306 - How can I know if my expenses are reasonable and will be reimbursed by the Government?

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS Request... locality in which your expenses will be incurred and request: (a) The current schedule of closing costs... and practices with respect to charging of closing costs which relate to either your sale or purchase...

An Advanced Microcosting System for Forecasting and Managing Radiology Expenses

PubMed Central

Arenson, Ronald; Viale, Richard; van der Voorde, Frans

1985-01-01

The new prospective payment system encourages hospital cost containment and necessitates understanding actual costs for radiology procedures. The automated microcosting system described here, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning.

Research on the man in the loop control system of the robot arm based on gesture control

NASA Astrophysics Data System (ADS)

Xiao, Lifeng; Peng, Jinbao

2017-03-01

The Man in the loop control system of the robot arm based on gesture control research complex real-world environment, which requires the operator to continuously control and adjust the remote manipulator, as the background, completes the specific mission human in the loop entire system as the research object. This paper puts forward a kind of robot arm control system of Man in the loop based on gesture control, by robot arm control system based on gesture control and Virtual reality scene feedback to enhance immersion and integration of operator, to make operator really become a part of the whole control loop. This paper expounds how to construct a man in the loop control system of the robot arm based on gesture control. The system is a complex system of human computer cooperative control, but also people in the loop control problem areas. The new system solves the problems that the traditional method has no immersion feeling and the operation lever is unnatural, the adjustment time is long, and the data glove mode wears uncomfortable and the price is expensive.

47 CFR 36.381 - Carrier access charge billing and collecting expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Customer Operations Expenses § 36.381 Carrier access charge billing and... in a particular state, one-half of such expense shall be apportioned to interstate operations. If no...

47 CFR 36.391 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Corporate Operations Expense § 36.391 General. Corporate Operations Expenses are included in the following account: General and...

17 CFR 256.930.1 - General advertising expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false General advertising expenses... UTILITY HOLDING COMPANY ACT OF 1935 2. Expense § 256.930.1 General advertising expenses. This account shall include the cost of materials used and expenses incurred in advertising and related activities...

17 CFR 256.930.1 - General advertising expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false General advertising expenses... UTILITY HOLDING COMPANY ACT OF 1935 2. Expense § 256.930.1 General advertising expenses. This account shall include the cost of materials used and expenses incurred in advertising and related activities...

20 CFR 416.1133 - What is a pro rata share of household operating expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., water, sewerage, and garbage collection service. (The term does not include the cost of these items if... of household operating expenses is the average monthly household operating expenses (based on a..., regardless of age. (c) Average household operating expenses. Household operating expenses are the household's...

20 CFR 416.1133 - What is a pro rata share of household operating expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., water, sewerage, and garbage collection service. (The term does not include the cost of these items if... of household operating expenses is the average monthly household operating expenses (based on a..., regardless of age. (c) Average household operating expenses. Household operating expenses are the household's...

20 CFR 416.1133 - What is a pro rata share of household operating expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., water, sewerage, and garbage collection service. (The term does not include the cost of these items if... of household operating expenses is the average monthly household operating expenses (based on a..., regardless of age. (c) Average household operating expenses. Household operating expenses are the household's...

20 CFR 416.1133 - What is a pro rata share of household operating expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., water, sewerage, and garbage collection service. (The term does not include the cost of these items if... of household operating expenses is the average monthly household operating expenses (based on a..., regardless of age. (c) Average household operating expenses. Household operating expenses are the household's...

Controlling supply expenses through capitated supply contracting.

PubMed

Kowalski, J C

1997-07-01

Some providers dealing with the financial challenges of managed care are attempting to control supply expenses through capitated supply contracting and similar risk/reward sharing arrangements. Under such arrangements, a supplier sells products and services to a provider for a fixed, prospective price in exchange for the provider's exclusive business. If expenses exceed the prospectively established amount, the supplier and provider share the loss. Conversely, if expenses are less than the fixed amount, they share the savings. For a capitated supply arrangement to be successful, providers must be able to identify and track supply expense drivers, such as clinical pathways, technology utilization, and product selection and utilization. Sophisticated information systems are needed to capture data, such as total and per-transaction product usage/volume; unit price per item; average and cost per item; average and total cost per transaction; and total cost per outcome. Providers also will need to establish mutually cooperative relationships with the suppliers with whom they contract.

A Cost Analysis of the Iowa Medicaid Primary Care Case Management Program

PubMed Central

Momany, Elizabeth T; Flach, Stephen D; Nelson, Forrest D; Damiano, Peter C

2006-01-01

Objective To determine the cost savings attributable to the implementation and expansion of a primary care case management (PCCM) program on Medicaid costs per member in Iowa from 1989 to 1997. Data Sources Medicaid administrative data from Iowa aggregated at the county level. Study Design Longitudinal analysis of costs per member per month, analyzed by category of medical expense using weighted least squares. We compared the actual costs with the expected costs (in the absence of the PCCM program) to estimate cost savings attributable to the PCCM program. Principal Findings We estimated that the PCCM program was associated with a savings of $66 million to the state of Iowa over the study period. Medicaid expenses were 3.8 percent less than what they would have been in the absence of the PCCM program. Effects of the PCCM program appeared to grow stronger over time. Use of the PCCM program was associated with increases in outpatient care and pharmaceutical expenses, but a decrease in hospital and physician expenses. Conclusions Use of a Medicaid PCCM program was associated with substantial aggregate cost savings over an 8-year period, and this effect became stronger over time. Cost reductions appear to have been mediated by substituting outpatient care for inpatient care. PMID:16899012

47 CFR 36.380 - Other billing and collecting expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Customer Operations Expenses § 36.380 Other billing and collecting expense. (a) This classification...

47 CFR 36.374 - Telephone operator services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Customer Operations Expenses § 36.374 Telephone operator services. (a) Expenses in this classification include costs incurred for operators in call completion service and number services. This includes...

Diagnostic potential of multi-targeted LAMP (loop-mediated isothermal amplification) for osteoarticular tuberculosis.

PubMed

Sharma, Kusum; Sharma, Megha; Batra, Nitya; Sharma, Aman; Dhillon, Mandeep Singh

2017-02-01

Delay in diagnosing osteoarticular tuberculosis (OATB) contributes significantly to morbidity by causing disfiguration and neurological sequelae. The delay caused by conventional culture and the expertise and expense involved in other nucleic acid based tests, make LAMP (loop-mediated isothermal amplification) assay a favorable middle path. We evaluated LAMP assay using IS6110 and MPB64 for rapid diagnosis of OATB by comparing with IS6110 PCR and culture. LAMP assay was performed on 140 synovial fluid and pus samples (10 culture-positive proven cases, 80 culture-negative probable cases, and 50 negative controls) using three set of primer pairs each for IS6110 and MPB64. LAMP assay, using two-target approach, had an overall sensitivity and specificity of 90% and 100% in detecting OATB. Sensitivity of IS6110 PCR, IS6110 LAMP, and MPB64 LAMP was 80%, 100%, and 100%, respectively, for confirmed cases and 72.5%, 81.75%, and 86.25%, respectively, for probable cases. Six additional cases were picked using two-target approach. LAMP assay utilizing IS6110 and MPB64 is a cost-effective technique for an early and reliable diagnosis of OATB. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:361-365, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

[Cost and effectiveness of exercise therapy for patients with essential hypertension].

PubMed

Harada, A; Kawakubo, K; Lee, J S; Fukuda, T; Kobayashi, Y

2001-09-01

While exercise therapy is established as an appropriate treatment for essential hypertension, its economic profile has not been fully evaluated. The purpose of this study is to evaluate cost and effectiveness in comparison with drug therapy. The study subjects were hypertensive patients under treatment at an outpatient clinic. Fifty-seven were selected on a non-randomized manner for exercise therapy and the same number of patients was chosen for drug therapy after matching age, sex, medication and complications. The following data were collected during three months of intervention. 1) Effectiveness: Change of systolic blood pressure before and after the intervention. 2) Cost: equipment, personnel expenses for exercise therapy and fees for health check-ups (exercise therapy); fees for consultation, laboratory examination and medications (drug therapy), 3) Cost-effectiveness: cost per 1 mmHg systolic blood pressure reduction. We evaluated the variance of cost-effectiveness by controlling the number of program participants, personnel expenses, and equipment expenses of exercise therapy. We also simulated how the cost-effectiveness of exercise therapy would improve by modifying the number of exercise participants, personnel and equipment expenses. The cost-effectiveness per 1 mmHg systolic blood pressure reduction was yen 11,268 for exercise therapy and yen 2,441 for drug therapy. Extending program facilities and increasing the number of participants would improve the cost-effectiveness of exercise therapy, but there were limitations to how far this could be achieved in the hospital setting. Differences in cost-effectiveness between exercise and drug therapies are attributed to differences in personnel expenses. Although they could be reduced by managerial effort of the hospital to some extent, outsourcing of exercise therapy to community-based facilities should be considered.

Mental Depreciation and Marginal Decision Making

PubMed

Heath; Fennema

1996-11-01

We propose that individuals practice "mental depreciation," that is, they implicitly spread the fixed costs of their expenses over time or use. Two studies explore how people spread fixed costs on durable goods. A third study shows that depreciation can lead to two distinct errors in marginal decisions: First, people sometimes invest too much effort to get their money's worth from an expense (e.g., they may use a product a lot to spread the fixed expense across more uses). Second, people sometimes invest too little effort to get their money's worth: When people add a portion of the fixed cost to the current costs, their perceived marginal (i.e., incremental) costs exceed their true marginal costs. In response, they may stop investing because their perceived costs surpass the marginal benefits they are receiving. The latter effect is supported by two field studies that explore real board plan decisions by university students.

Medicine expenses and obesity in Brazil: an analysis based on the household budget survey.

PubMed

Canella, Daniela S; Novaes, Hillegonda M D; Levy, Renata B

2016-01-20

Obesity can be considered a global public health problem that affects virtually all countries worldwide and results in greater use of healthcare services and higher healthcare costs. We aimed to describe average monthly household medicine expenses according to source of funding, public or private, and to estimate the influence of the presence of obese residents in households on total medicine expenses. This study was based on data from the 2008-2009 Brazilian Household Budget Survey, with a representative population sample of 55,970 households as study units. Information on nutritional status and medicines acquired and their cost in the past 30 days were analyzed. A two-part model was employed to assess the influence of obesity on medicine expenses, with monthly household medicine expenses per capita as outcome, presence of obese in the household as explanatory variable, and adjustment for confounding variables. Out-of-pocket expenses on medicines were always higher than the cost of medicines obtained through the public sector, and 32 % of households had at least one obese as resident. Monthly household expenses on medicines per capita in households with obese was US$ 20.40, 16 % higher than in households with no obese. An adjusted model confirmed that the presence of obese in the households increased medicine expenses. Obesity is associated with additional medicine expenses, increasing the negative impact on household budgets and public expenditure.

The 'fixed cost effect' on practice management.

PubMed

Tipton, E F; Finley, J B

1999-01-01

To obtain a better understanding of the behavior of "non-professional" costs in a medical practice, the authors analyzed the expenses of a 19-doctor practice. The analysis revealed that 80 percent of these expenses were fixed costs. Fixed costs, as opposed to variable costs, remain static in total but vary on a per unit basis as volume changes. Organizations with high fixed cost must maximize capacity to achieve profitability. Thus, the relationship among volume, capacity, cost and profit must be understood by medical practices negotiating rates for service units.

Position Tracking During Human Walking Using an Integrated Wearable Sensing System.

PubMed

Zizzo, Giulio; Ren, Lei

2017-12-10

Progress has been made enabling expensive, high-end inertial measurement units (IMUs) to be used as tracking sensors. However, the cost of these IMUs is prohibitive to their widespread use, and hence the potential of low-cost IMUs is investigated in this study. A wearable low-cost sensing system consisting of IMUs and ultrasound sensors was developed. Core to this system is an extended Kalman filter (EKF), which provides both zero-velocity updates (ZUPTs) and Heuristic Drift Reduction (HDR). The IMU data was combined with ultrasound range measurements to improve accuracy. When a map of the environment was available, a particle filter was used to impose constraints on the possible user motions. The system was therefore composed of three subsystems: IMUs, ultrasound sensors, and a particle filter. A Vicon motion capture system was used to provide ground truth information, enabling validation of the sensing system. Using only the IMU, the system showed loop misclosure errors of 1% with a maximum error of 4-5% during walking. The addition of the ultrasound sensors resulted in a 15% reduction in the total accumulated error. Lastly, the particle filter was capable of providing noticeable corrections, which could keep the tracking error below 2% after the first few steps.

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

PubMed

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

2009-02-01

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

[Cost analysis of home care with activity-based costing (ABC)].

PubMed

Lee, Su-Jeong

2004-10-01

This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. The HHC activities were classified into 70 activities. In resource, the labor cost was 245 won per minute, operating cost was 9,570 won per visit and traffic expense was an average of 12,750 won. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741 won and the cost ranged from 55,560 won to 74,016 won. The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.

47 CFR 32.6531 - Power expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Power expense. 32.6531 Section 32.6531... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6531 Power expense. This account shall include the cost of electrical power used to operate the telecommunications network. ...

47 CFR 32.6531 - Power expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Power expense. 32.6531 Section 32.6531... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6531 Power expense. This account shall include the cost of electrical power used to operate the telecommunications network. ...

47 CFR 32.6535 - Engineering expense.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Engineering expense. 32.6535 Section 32.6535... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6535 Engineering expense. (a) This account shall include costs incurred in the general engineering of the telecommunications plant...

47 CFR 32.6535 - Engineering expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Engineering expense. 32.6535 Section 32.6535... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6535 Engineering expense. (a) This account shall include costs incurred in the general engineering of the telecommunications plant...

47 CFR 32.6535 - Engineering expense.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Engineering expense. 32.6535 Section 32.6535... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6535 Engineering expense. (a) This account shall include costs incurred in the general engineering of the telecommunications plant...

47 CFR 32.6535 - Engineering expense.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Engineering expense. 32.6535 Section 32.6535... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6535 Engineering expense. (a) This account shall include costs incurred in the general engineering of the telecommunications plant...

47 CFR 32.6535 - Engineering expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Engineering expense. 32.6535 Section 32.6535... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6535 Engineering expense. (a) This account shall include costs incurred in the general engineering of the telecommunications plant...

E. coli electroeradication on a closed loop circuit by using milli-, micro- and nanosecond pulsed electric fields: comparison between energy costs.

PubMed

Guionet, Alexis; David, Fabienne; Zaepffel, Clément; Coustets, Mathilde; Helmi, Karim; Cheype, Cyril; Packan, Denis; Garnier, Jean-Pierre; Blanckaert, Vincent; Teissié, Justin

2015-06-01

One of the different ways to eradicate microorganisms, and particularly bacteria that might have an impact on health consists in the delivery of pulsed electric fields (PEFs). The technologies of millisecond (ms) or microsecond (μs) PEF are still well known and used for instance in the process of fruit juice sterilization. However, this concept is costly in terms of delivered energy which might be too expensive for some other industrial processes. Nanosecond pulsed electric fields (nsPEFs) might be an alternative at least for lower energetic cost. However, only few insights were available and stipulate a gain in cost and in efficiency as well. Using Escherichia coli, the impact of frequency and low rate on eradication and energy consumption by msPEF, μsPEF and nsPEF have been studied and compared. While a 1 log10 was reached with an energy cost of 100 and 158 kJ/L with micro- and millisecond PEFs respectively, nsPEF reached the reduction for similar energy consumption. The best condition was obtained for a 1 log10 deactivation in 0.5h, for energy consumption of 143 kJ/L corresponding to 0.04 W · h when the field was around 100 kV/cm. Improvement can also be expected by producing a generator capable to increase the electric field. Copyright © 2014 Elsevier B.V. All rights reserved.

Complex Home Care: Part II-Family Annual Income, Insurance Premium and Out-of- Pocket Expenses

PubMed Central

Piamjariyakul, Ubolrat; Yadrich, Donna Macan; Ross, Vicki M.; Smith, Carol E.; Clements, Faye; Williams, Arthur R.

2011-01-01

The goals of this study were to provide data on the annual family income and payment for health insurance coverage and out-of-pocket expenses that are not reimbursed by third-party payers for managing complex home care. Costs reported for annual insurance premiums varied widely as did costs of deductibles, co-payments, non-reimbursed supplies, travel, or child care. The mean total out-of-pocket non-reimbursed expenses averaged $17, 923 per year per family. This series of articles presents these financial costs in relation to complex home care outcomes. PMID:21158253

Out-of-pocket fertility patient expense: data from a multicenter prospective infertility cohort.

PubMed

Wu, Alex K; Odisho, Anobel Y; Washington, Samuel L; Katz, Patricia P; Smith, James F

2014-02-01

The high costs of fertility care may deter couples from seeking care. Urologists often are asked about the costs of these treatments. To our knowledge previous studies have not addressed the direct out-of-pocket costs to couples. We characterized these expenses in patients seeking fertility care. Couples were prospectively recruited from 8 community and academic reproductive endocrinology clinics. Each participating couple completed face-to-face or telephone interviews and cost diaries at study enrollment, and 4, 10 and 18 months of care. We determined overall out-of-pocket costs, in addition to relationships between out-of-pocket costs and treatment type, clinical outcomes and socioeconomic characteristics on multivariate linear regression analysis. A total of 332 couples completed cost diaries and had data available on treatment and outcomes. Average age was 36.8 and 35.6 years in men and women, respectively. Of this cohort 19% received noncycle based therapy, 4% used ovulation induction medication only, 22% underwent intrauterine insemination and 55% underwent in vitro fertilization. The median overall out-of-pocket expense was $5,338 (IQR 1,197-19,840). Couples using medication only had the lowest median out-of-pocket expenses at $912 while those using in vitro fertilization had the highest at $19,234. After multivariate adjustment the out-of-pocket expense was not significantly associated with successful pregnancy. On multivariate analysis couples treated with in vitro fertilization spent an average of $15,435 more than those treated with intrauterine insemination. Couples spent about $6,955 for each additional in vitro fertilization cycle. These data provide real-world estimates of out-of-pocket costs, which can be used to help couples plan for expenses that they may incur with treatment. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

47 CFR 27.5 - Frequencies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... spectrum is available and that the BRS entity bears the expenses of the migration. Suitability of spectrum... responsible for all costs connected with the migration, including purchasing, testing and installing new... expenses necessary to prepare and file the migration application, and other reasonable documented costs...

11 CFR 9004.4 - Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... to the beginning of the expenditure report period; (4) To defray winding down costs pursuant to 11 CFR 9004.11; (5) To defray costs associated with the candidate's general election campaign paid after... payable pursuant to paragraph (a)(5) of this section and winding down costs pursuant to 11 CFR 9004.11...

11 CFR 9004.4 - Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... to the beginning of the expenditure report period; (4) To defray winding down costs pursuant to 11 CFR 9004.11; (5) To defray costs associated with the candidate's general election campaign paid after... payable pursuant to paragraph (a)(5) of this section and winding down costs pursuant to 11 CFR 9004.11...

11 CFR 9004.4 - Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... to the beginning of the expenditure report period; (4) To defray winding down costs pursuant to 11 CFR 9004.11; (5) To defray costs associated with the candidate's general election campaign paid after... payable pursuant to paragraph (a)(5) of this section and winding down costs pursuant to 11 CFR 9004.11...

11 CFR 9004.4 - Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... to the beginning of the expenditure report period; (4) To defray winding down costs pursuant to 11 CFR 9004.11; (5) To defray costs associated with the candidate's general election campaign paid after... payable pursuant to paragraph (a)(5) of this section and winding down costs pursuant to 11 CFR 9004.11...

11 CFR 9004.4 - Use of payments; examples of qualified campaign expenses and non-qualified campaign expenses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... to the beginning of the expenditure report period; (4) To defray winding down costs pursuant to 11 CFR 9004.11; (5) To defray costs associated with the candidate's general election campaign paid after... payable pursuant to paragraph (a)(5) of this section and winding down costs pursuant to 11 CFR 9004.11...

44 CFR 206.131 - Individual and Family Grant Program for major disasters declared on or before October 14, 2002.

Code of Federal Regulations, 2014 CFR

2014-10-01

... percent of the actual cost of meeting necessary expenses or serious needs of individuals and families... actual cost of meeting individuals' or families' necessary expenses or serious needs is paid from funds... cost of a serious need. (2) Serious need means the requirement for an item or service essential to an...

44 CFR 206.131 - Individual and Family Grant Program for major disasters declared on or before October 14, 2002.

Code of Federal Regulations, 2011 CFR

2011-10-01

... percent of the actual cost of meeting necessary expenses or serious needs of individuals and families... actual cost of meeting individuals' or families' necessary expenses or serious needs is paid from funds... cost of a serious need. (2) Serious need means the requirement for an item or service essential to an...

Strain Insensitive Optical Phase Locked Loop

NASA Technical Reports Server (NTRS)

Egalon, Claudio Oliviera (Inventor); Rogowski, Robert S. (Inventor)

1996-01-01

An apparatus is provided to allow for quasi distributed sensing of strain within a test object. Strain insensitive fiber is used to deliver a light signal to a strain sensitive fiber in an optical phase locked loop sensor configuration. The use of strain insensitive delivery fiber allows for non-integrated measurements of strain without the use of expensive electronics such as those employed in ODTR techniques. The novelty of the present invention lies in the use of strain insensitive multimode fiber. The inventors had previously developed a similar sensor with strain insensitive fiber, however it was restricted to the use of single or few mode fibers. The use of an optical phase locked loop arrangement allows for the use of multimode strain insensitive fiber.

7 CFR 1767.31 - Administrative and general expenses.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., shall be included in Account 930.2, Miscellaneous General Expenses. Items 1. Automobile service... injuries. (See Note A.) 8. Cost of safety, accident prevention, and similar educational activities. Note A: Payments to or in behalf of employees for accident or death benefits, hospital expenses, medical expenses...

18 CFR 367.9100 - Account 910, Miscellaneous customer service and informational expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Miscellaneous customer service and informational expenses. 367.9100 Section 367.9100 Conservation of Power and... Account 910, Miscellaneous customer service and informational expenses. (a) This account must include the cost of labor, materials used and expenses incurred in connection with customer service and...

Financial modeling of current surgical robotic system in outpatient laparoscopic cholecystectomy: how should we think about the expense?

PubMed

Schwaitzberg, S D

2016-05-01

More than 500,000 robotically assisted procedures were performed worldwide in 2013. Despite broad adoption, there remains a lack of clarity concerning the added cost of the robotic system to the procedure especially in light of an increasing number of ambulatory procedures which are now marketed by hospitals, surgeons and the manufacturer. These procedures are associated with much less reimbursement than inpatient procedures. It is unclear whether these added expenses can be absorbed in these scenarios. Reports vary in opinion concerning the added net costs during robotically assisted laparoscopic hernia or cholecystectomy. The worldwide revenues, procedures, and the installed base of robotic system data were reviewed and reanalyzed from the 2013 Intuitive Surgical Investors report. This provided an opportunity to look cost per case projections from the vantage point of actual revenue. This analysis was based on revenue of 2.27 billion US dollars in the three categories of capital acquisition, instrumentation and accessories, and service revenue. These revenues were then spread across 523,000 cases with varying assumptions. Without regard to expense offsets, the additional cost ranges from $2908 to $8675 depending on what system was purchased and the ability to distribute costs against case volume. Estimates of commercial and government revenue were then compared against these expenses. The use of the extraordinary technology in the face of low-morbidity low-cost established minimally invasive procedures needs to withstand scrutiny of outcome assessment, revenue and expense considerations and appropriateness review in order to create financially viable approaches to high-volume minimally invasive procedures. Revenue estimates associated with outpatient reimbursement make it difficult to support these expenses, recognizing inpatient procedures represent a different net financial picture.

The benefits of redesigning Benin's vaccine supply chain.

PubMed

Brown, Shawn T; Schreiber, Benjamin; Cakouros, Brigid E; Wateska, Angela R; Dicko, Hamadou M; Connor, Diana L; Jaillard, Philippe; Mvundura, Mercy; Norman, Bryan A; Levin, Carol; Rajgopal, Jayant; Avella, Mélanie; Lebrun, Caroline; Claypool, Erin; Paul, Proma; Lee, Bruce Y

2014-07-07

New vaccine introductions have put strains on vaccine supply chains around the world. While increasing storage and transportation may be the most straightforward options, it is also important to consider what financial and operational benefits can be incurred. In 2012, suboptimal vaccine coverage and impending vaccine introductions prompted the Republic of Benin's Ministry of Health (MOH) to explore ways to improve their vaccine supply chain. Working alongside the Beninese MOH, we utilized our computational model, HERMES, to explore the impact on cost and vaccine availability of three possible options: (1) consolidating the Commune level to a Health Zone level, (2) removing the Commune level completely, and (3) removing the Commune level and expanding to 12 Department Stores. We also analyzed the impact of adding shipping loops during delivery. At baseline, new vaccine introductions without any changes to the current system increased the logistics cost per dose ($0.23 to $0.26) and dropped the vaccine availability to 71%. While implementing the Commune level removal scenario had the same capital costs as implementing the Health Zone scenario, the Health Zone scenario had lower operating costs. This increased to an overall cost savings of $504,255 when implementing shipping loops. The best redesign option proved to be the synergistic approach of converting to the Health Zone design and using shipping loops (serving ten Health Posts/loop). While a transition to either redesign or only adding shipping loops was beneficial, implementing a redesign option and shipping loops can yield both lower capital expenditures and operating costs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A New Activity-Based Financial Cost Management Method

NASA Astrophysics Data System (ADS)

Qingge, Zhang

The standard activity-based financial cost management model is a new model of financial cost management, which is on the basis of the standard cost system and the activity-based cost and integrates the advantages of the two. It is a new model of financial cost management with more accurate and more adequate cost information by taking the R&D expenses as the accounting starting point and after-sale service expenses as the terminal point and covering the whole producing and operating process and the whole activities chain and value chain aiming at serving the internal management and decision.

A feasibility study to determine if there is a market for automatic meter-reading devices

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

Hilberg, G.R.

1996-08-01

For many utilities the cost of manually reading meters is increasing due to personnel expenses and equipment costs. The current system of manual meters provides little ability for the utility to reduce costs. To reduce meter reading costs the utility must automate the manual system and reduce personnel expenses. A water utility in San Diego county was studied to calculate the cost of reading individual water meters. This would allow for the selective replacement of {open_quotes}high-cost{close_quotes} meters to quickly reduce meter-reading costs while limiting the necessary capital investments. As the {open_quotes}high-cost{close_quotes} meters are selectively replaced, a utility with a significantmore » difference in individual meter reading costs could save three to five dollars per meter per year. This study showed that the {open_quotes}high-cost{close_quotes} meters were six times more expensive to read than the average meter. Additionally, AMR systems increase the information available to consumers and to the utility on usage patterns and problems. The challenge was to cost effectively identify the {open_quotes}high-cost{close_quotes} meters. The costs to collect these data were less than $500.« less

Terrestrial central station array life-cycle analysis support study

NASA Technical Reports Server (NTRS)

1978-01-01

Plant elements evaluated included designs for module, panel and array structures, as well as balance-of-plant systems. Installation and maintenance procedures and the impact of site environment were also evaluated. In terms of the cost of energy produced, the horizontal array configuration was found to be less expensive than the tandem array at latitudes less than 40 deg. Both of these configurations are less expensive than the rack design. However, the costs of energy for all three configurations are within approximately ?10 percent of each other. For flat plate panels, the seasonally adjusted and tracking array configurations are not economically attractive when compared to the three other designs. Balance-of-plant costs are approximately equal to (goal) module costs. The array structures and foundations are the most expensive items in the balance-of-plant costs.

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

47 CFR 27.5 - Frequencies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the expenses of the migration. Suitability of spectrum will be determined on a case-by-base basis; at... be moved. The initiating party will be responsible for all costs connected with the migration... equipment, administrative costs, legal and engineering expenses necessary to prepare and file the migration...

26 CFR 1.471-11 - Inventories of manufacturers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... production costs may be classified as to kind or type in accordance with acceptable accounting principles so... generally accepted accounting principles. For the treatment of indirect production costs described in... taxpayer in his financial reports) include: (a) Marketing expenses, (b) Advertising expenses, (c) Selling...

The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP) Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi.

PubMed

Nliwasa, Marriott; MacPherson, Peter; Chisala, Palesa; Kamdolozi, Mercy; Khundi, McEwen; Kaswaswa, Kruger; Mwapasa, Mphatso; Msefula, Chisomo; Sohn, Hojoon; Flach, Clare; Corbett, Elizabeth L

2016-01-01

Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence. To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP) assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy. Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard), and costs were estimated. Of 273 adults recruited, 44.3% (121/273) were HIV-positive and 19.4% (53/273) had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4%) with 100% (95% CI: 98.0% to 100%) specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2%) was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8%) was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98); this was lower than Xpert® MTB/RIF (US$ 13.38) but higher than fluorescence smear microscopy (US$ 0.65). The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis.

The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP) Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi

PubMed Central

Nliwasa, Marriott; MacPherson, Peter; Chisala, Palesa; Kamdolozi, Mercy; Khundi, McEwen; Kaswaswa, Kruger; Mwapasa, Mphatso; Msefula, Chisomo; Sohn, Hojoon; Flach, Clare; Corbett, Elizabeth L.

2016-01-01

Background Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence. Objective To investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP) assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy. Methods Between October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard), and costs were estimated. Results Of 273 adults recruited, 44.3% (121/273) were HIV-positive and 19.4% (53/273) had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4%) with 100% (95% CI: 98.0% to 100%) specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2%) was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8%) was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98); this was lower than Xpert® MTB/RIF (US$ 13.38) but higher than fluorescence smear microscopy (US$ 0.65). Conclusion The sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis. PMID:27171380

47 CFR 32.6112 - Motor vehicle expense.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Motor vehicle expense. 32.6112 Section 32.6112... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6112 Motor vehicle expense. (a... motor vehicles, such as chauffeurs and shuttle bus drivers. The costs of users of motor vehicles whose...

47 CFR 32.6112 - Motor vehicle expense.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Motor vehicle expense. 32.6112 Section 32.6112... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6112 Motor vehicle expense. (a... motor vehicles, such as chauffeurs and shuttle bus drivers. The costs of users of motor vehicles whose...

47 CFR 32.6112 - Motor vehicle expense.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Motor vehicle expense. 32.6112 Section 32.6112... FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6112 Motor vehicle expense. (a... motor vehicles, such as chauffeurs and shuttle bus drivers. The costs of users of motor vehicles whose...

Severely Disabled Elderly Persons with Financially Catastrophic Health Care Expenses: Sources and Determinants.

ERIC Educational Resources Information Center

Coughlin, Teresa A.; And Others

1992-01-01

Using data from 1981-82 Channeling Demonstration project, examined types of health care costs (hospital, physician and ancillary care, nursing home, and prescription medicine) that contributed to overall expenses to determine sources of financially catastrophic health care expenses among disabled elderly persons. Found expenses for prescription…

47 CFR 1.1513 - Documentation of fees and expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Documentation of fees and expenses. 1.1513... Applicants § 1.1513 Documentation of fees and expenses. The application shall be accompanied by full documentation of the fees and expenses, including the cost of any study, analysis, engineering report, test...

18 CFR 367.9020 - Account 902, Meter reading expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Account 902, Meter reading expenses. 367.9020 Section 367.9020 Conservation of Power and Water Resources FEDERAL ENERGY... expenses. (a) This account must include the cost of labor, materials used and expenses incurred in reading...

18 CFR 367.9020 - Account 902, Meter reading expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Account 902, Meter reading expenses. 367.9020 Section 367.9020 Conservation of Power and Water Resources FEDERAL ENERGY... expenses. (a) This account must include the cost of labor, materials used and expenses incurred in reading...

18 CFR 367.9020 - Account 902, Meter reading expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Account 902, Meter reading expenses. 367.9020 Section 367.9020 Conservation of Power and Water Resources FEDERAL ENERGY... expenses. (a) This account must include the cost of labor, materials used and expenses incurred in reading...

18 CFR 367.9020 - Account 902, Meter reading expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Account 902, Meter reading expenses. 367.9020 Section 367.9020 Conservation of Power and Water Resources FEDERAL ENERGY... expenses. (a) This account must include the cost of labor, materials used and expenses incurred in reading...

Simulation and Analysis of the AFLC Bulk Data Network Using Abstract Data Types.

DTIC Science & Technology

1981-12-01

performs. Simulation is more expensive than queueing, but it is often ə the only way to study complex funtional relationships in a large system. Unlike... relationship between through- put, response and cost is shown in Figure 2. At a given cost level, additional throughput can be obtained at the expense...improved by adding resources, but this increases the total cost of the system. Network models are used to study the relationship between cost

Study of high-performance canonical molecular orbitals calculation for proteins

NASA Astrophysics Data System (ADS)

Hirano, Toshiyuki; Sato, Fumitoshi

2017-11-01

The canonical molecular orbital (CMO) calculation can help to understand chemical properties and reactions in proteins. However, it is difficult to perform the CMO calculation of proteins because of its self-consistent field (SCF) convergence problem and expensive computational cost. To certainly obtain the CMO of proteins, we work in research and development of high-performance CMO applications and perform experimental studies. We have proposed the third-generation density-functional calculation method of calculating the SCF, which is more advanced than the FILE and direct method. Our method is based on Cholesky decomposition for two-electron integrals calculation and the modified grid-free method for the pure-XC term evaluation. By using the third-generation density-functional calculation method, the Coulomb, the Fock-exchange, and the pure-XC terms can be given by simple linear algebraic procedure in the SCF loop. Therefore, we can expect to get a good parallel performance in solving the SCF problem by using a well-optimized linear algebra library such as BLAS on the distributed memory parallel computers. The third-generation density-functional calculation method is implemented to our program, ProteinDF. To achieve computing electronic structure of the large molecule, not only overcoming expensive computation cost and also good initial guess for safe SCF convergence are required. In order to prepare a precise initial guess for the macromolecular system, we have developed the quasi-canonical localized orbital (QCLO) method. The QCLO has the characteristics of both localized and canonical orbital in a certain region of the molecule. We have succeeded in the CMO calculations of proteins by using the QCLO method. For simplified and semi-automated calculation of the QCLO method, we have also developed a Python-based program, QCLObot.

42 CFR 412.100 - Special treatment: Renal transplantation centers.

Code of Federal Regulations, 2011 CFR

2011-10-01

....2170 and 405.2171 of this chapter) to remove the estimated net expenses associated with kidney acquisition. (2) Kidney acquisition costs are treated apart from the prospective payment rate for inpatient... necessary to compensate the hospital for reasonable expenses of kidney acquisition. (b) Costs of kidney...

42 CFR 412.100 - Special treatment: Renal transplantation centers.

Code of Federal Regulations, 2010 CFR

2010-10-01

....2170 and 405.2171 of this chapter) to remove the estimated net expenses associated with kidney acquisition. (2) Kidney acquisition costs are treated apart from the prospective payment rate for inpatient... necessary to compensate the hospital for reasonable expenses of kidney acquisition. (b) Costs of kidney...

76 FR 53377 - Cost Accounting Standards; Allocation of Home Office Expenses to Segments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Accounting Standards; Allocation of Home Office Expenses to Segments AGENCY: Office of Management and Budget (OMB), Office of Federal Procurement Policy (OFPP), Cost Accounting Standards Board (Board). ACTION... Accounting Standards (CAS) Board, is providing public notification of the decision to discontinue the...

Open Ephys electroencephalography (Open Ephys  +  EEG): a modular, low-cost, open-source solution to human neural recording

NASA Astrophysics Data System (ADS)

Black, Christopher; Voigts, Jakob; Agrawal, Uday; Ladow, Max; Santoyo, Juan; Moore, Christopher; Jones, Stephanie

2017-06-01

Objective. Electroencephalography (EEG) offers a unique opportunity to study human neural activity non-invasively with millisecond resolution using minimal equipment in or outside of a lab setting. EEG can be combined with a number of techniques for closed-loop experiments, where external devices are driven by specific neural signals. However, reliable, commercially available EEG systems are expensive, often making them impractical for individual use and research development. Moreover, by design, a majority of these systems cannot be easily altered to the specification needed by the end user. We focused on mitigating these issues by implementing open-source tools to develop a new EEG platform to drive down research costs and promote collaboration and innovation. Approach. Here, we present methods to expand the open-source electrophysiology system, Open Ephys (www.openephys.org), to include human EEG recordings. We describe the equipment and protocol necessary to interface various EEG caps with the Open Ephys acquisition board, and detail methods for processing data. We present applications of Open Ephys  +  EEG as a research tool and discuss how this innovative EEG technology lays a framework for improved closed-loop paradigms and novel brain-computer interface experiments. Main results. The Open Ephys  +  EEG system can record reliable human EEG data, as well as human EMG data. A side-by-side comparison of eyes closed 8-14 Hz activity between the Open Ephys  +  EEG system and the Brainvision ActiCHamp EEG system showed similar average power and signal to noise. Significance. Open Ephys  +  EEG enables users to acquire high-quality human EEG data comparable to that of commercially available systems, while maintaining the price point and extensibility inherent to open-source systems.

Open Ephys electroencephalography (Open Ephys  +  EEG): a modular, low-cost, open-source solution to human neural recording.

PubMed

Black, Christopher; Voigts, Jakob; Agrawal, Uday; Ladow, Max; Santoyo, Juan; Moore, Christopher; Jones, Stephanie

2017-06-01

Electroencephalography (EEG) offers a unique opportunity to study human neural activity non-invasively with millisecond resolution using minimal equipment in or outside of a lab setting. EEG can be combined with a number of techniques for closed-loop experiments, where external devices are driven by specific neural signals. However, reliable, commercially available EEG systems are expensive, often making them impractical for individual use and research development. Moreover, by design, a majority of these systems cannot be easily altered to the specification needed by the end user. We focused on mitigating these issues by implementing open-source tools to develop a new EEG platform to drive down research costs and promote collaboration and innovation. Here, we present methods to expand the open-source electrophysiology system, Open Ephys (www.openephys.org), to include human EEG recordings. We describe the equipment and protocol necessary to interface various EEG caps with the Open Ephys acquisition board, and detail methods for processing data. We present applications of Open Ephys  +  EEG as a research tool and discuss how this innovative EEG technology lays a framework for improved closed-loop paradigms and novel brain-computer interface experiments. The Open Ephys  +  EEG system can record reliable human EEG data, as well as human EMG data. A side-by-side comparison of eyes closed 8-14 Hz activity between the Open Ephys  +  EEG system and the Brainvision ActiCHamp EEG system showed similar average power and signal to noise. Open Ephys  +  EEG enables users to acquire high-quality human EEG data comparable to that of commercially available systems, while maintaining the price point and extensibility inherent to open-source systems.

A Low-Cost Multielectrode System for Data Acquisition Enabling Real-Time Closed-Loop Processing with Rapid Recovery from Stimulation Artifacts

PubMed Central

Rolston, John D.; Gross, Robert E.; Potter, Steve M.

2009-01-01

Commercially available data acquisition systems for multielectrode recording from freely moving animals are expensive, often rely on proprietary software, and do not provide detailed, modifiable circuit schematics. When used in conjunction with electrical stimulation, they are prone to prolonged, saturating stimulation artifacts that prevent the recording of short-latency evoked responses. Yet electrical stimulation is integral to many experimental designs, and critical for emerging brain-computer interfacing and neuroprosthetic applications. To address these issues, we developed an easy-to-use, modifiable, and inexpensive system for multielectrode neural recording and stimulation. Setup costs are less than US$10,000 for 64 channels, an order of magnitude lower than comparable commercial systems. Unlike commercial equipment, the system recovers rapidly from stimulation and allows short-latency action potentials (<1 ms post-stimulus) to be detected, facilitating closed-loop applications and exposing neural activity that would otherwise remain hidden. To illustrate this capability, evoked activity from microstimulation of the rodent hippocampus is presented. System noise levels are similar to existing platforms, and extracellular action potentials and local field potentials can be recorded simultaneously. The system is modular, in banks of 16 channels, and flexible in usage: while primarily designed for in vivo use, it can be combined with commercial preamplifiers to record from in vitro multielectrode arrays. The system's open-source control software, NeuroRighter, is implemented in C#, with an easy-to-use graphical interface. As C# functions in a managed code environment, which may impact performance, analysis was conducted to ensure comparable speed to C++ for this application. Hardware schematics, layout files, and software are freely available. Since maintaining wired headstage connections with freely moving animals is difficult, we describe a new method of electrode-headstage coupling using neodymium magnets. PMID:19668698

Cost of illness among patients with diabetic foot ulcer in Turkey

PubMed Central

Oksuz, Ergun; Malhan, Simten; Sonmez, Bilge; Numanoglu Tekin, Rukiye

2016-01-01

AIM To evaluate the annual cost of patients with Wagner grade 3-4-5 diabetic foot ulcer (DFU) from the public payer’s perspective in Turkey. METHODS This study was conducted focused on a time frame of one year from the public payer’s perspective. Cost-of-illness (COI) methodology, which was developed by the World Health Organization, was used in the generation of cost data. By following a clinical path with the COI method, the main total expenses were reached by multiplying the number of uses of each expense item, the percentage of cases that used them and unit costs. Clinical guidelines and real data specific to Turkey were used in the calculation of the direct costs. Monte Carlo Simulation was used in the study as a sensitivity analysis. RESULTS The following were calculated in DFU treatment from the public payer’s perspective: The annual average per patient outpatient costs $579.5 (4.1%), imaging test costs $283.2 (2.0%), laboratory test costs $284.8 (2.0%), annual average per patient cost of intervention, rehabilitation and trainings $2291.7 (16.0%), annual average per patient cost of drugs used $2545.8 (17.8%) and annual average per patient cost of medical materials used in DFU treatment $735.0 (5.1%). The average annual per patient cost for hospital admission is $7357.4 (51.5%). The average per patient complication cost for DFU is $210.3 (1.5%). The average annual per patient cost of DFU treatment in Turkey is $14287.70. As a result of the sensitivity analysis, the standard deviation of the analysis was $5706.60 (n = 5000, mean = $14146.8, 95%CI: $13988.6-$14304.9). CONCLUSION The health expenses per person are $-PPP 1045 in 2014 in Turkey and the average annual per patient cost for DFU is 14-fold of said amount. The total health expense in 2014 in Turkey is $-PPP 80.3 billion and the total DFU cost has a 3% share in the total annual health expenses for Turkey. Hospital costs are the highest component in DFU disease costs. In order to prevent DFU, training of the patients at risk and raising consciousness in patients with diabetes mellitus (DM) will provide benefits in terms of economy. Appropriate and efficient treatment of DM is a health intervention that can prevent complications. PMID:27795820

Low-cost microcontroller platform for studying lymphatic biomechanics in vitro

PubMed Central

Kornuta, Jeffrey A.; Nipper, Matthew E.; Dixon, J. Brandon

2012-01-01

The pumping innate to collecting lymphatic vessels routinely exposes the endothelium to oscillatory wall shear stress and other dynamic forces. However, studying the mechanical sensitivity of the lymphatic endothelium remains a difficult task due to limitations of commercial or custom systems to apply a variety of time-varying stresses in vitro. Current biomechanical in vitro testing devices are very expensive, limited in capability, or highly complex; rendering them largely inaccessible to the endothelial cell biology community. To address these short-comings, the authors propose a reliable, low-cost platform for augmenting the capabilities of commercially available pumps to produce a wide variety of flow rate waveforms. In particular, the Arduino Uno, a microcontroller development board, is used to provide open-loop control of a digital peristaltic pump using precisely-timed serial commands. In addition, the flexibility of this platform is further demonstrated through its support of a custom-built cell-straining device capable of producing oscillatory strains with varying amplitudes and frequencies. Hence, this microcontroller development board is shown to be an inexpensive, precise, and easy-to-use tool for supplementing in vitro assays to quantify the effects of biomechanical forces on lymphatic endothelial cells. PMID:23178036

Low-cost microcontroller platform for studying lymphatic biomechanics in vitro.

PubMed

Kornuta, Jeffrey A; Nipper, Matthew E; Dixon, J Brandon

2013-01-04

The pumping innate to collecting lymphatic vessels routinely exposes the endothelium to oscillatory wall shear stress and other dynamic forces. However, studying the mechanical sensitivity of the lymphatic endothelium remains a difficult task due to limitations of commercial or custom systems to apply a variety of time-varying stresses in vitro. Current biomechanical in vitro testing devices are very expensive, limited in capability, or highly complex; rendering them largely inaccessible to the endothelial cell biology community. To address these shortcomings, the authors propose a reliable, low-cost platform for augmenting the capabilities of commercially available pumps to produce a wide variety of flow rate waveforms. In particular, the Arduino Uno, a microcontroller development board, is used to provide open-loop control of a digital peristaltic pump using precisely timed serial commands. In addition, the flexibility of this platform is further demonstrated through its support of a custom-built cell-straining device capable of producing oscillatory strains with varying amplitudes and frequencies. Hence, this microcontroller development board is shown to be an inexpensive, precise, and easy-to-use tool for supplementing in vitro assays to quantify the effects of biomechanical forces on lymphatic endothelial cells. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using risk-adjustment models to identify high-cost risks.

PubMed

Meenan, Richard T; Goodman, Michael J; Fishman, Paul A; Hornbrook, Mark C; O'Keeffe-Rosetti, Maureen C; Bachman, Donald J

2003-11-01

We examine the ability of various publicly available risk models to identify high-cost individuals and enrollee groups using multi-HMO administrative data. Five risk-adjustment models (the Global Risk-Adjustment Model [GRAM], Diagnostic Cost Groups [DCGs], Adjusted Clinical Groups [ACGs], RxRisk, and Prior-expense) were estimated on a multi-HMO administrative data set of 1.5 million individual-level observations for 1995-1996. Models produced distributions of individual-level annual expense forecasts for comparison to actual values. Prespecified "high-cost" thresholds were set within each distribution. The area under the receiver operating characteristic curve (AUC) for "high-cost" prevalences of 1% and 0.5% was calculated, as was the proportion of "high-cost" dollars correctly identified. Results are based on a separate 106,000-observation validation dataset. For "high-cost" prevalence targets of 1% and 0.5%, ACGs, DCGs, GRAM, and Prior-expense are very comparable in overall discrimination (AUCs, 0.83-0.86). Given a 0.5% prevalence target and a 0.5% prediction threshold, DCGs, GRAM, and Prior-expense captured $963,000 (approximately 3%) more "high-cost" sample dollars than other models. DCGs captured the most "high-cost" dollars among enrollees with asthma, diabetes, and depression; predictive performance among demographic groups (Medicaid members, members over 64, and children under 13) varied across models. Risk models can efficiently identify enrollees who are likely to generate future high costs and who could benefit from case management. The dollar value of improved prediction performance of the most accurate risk models should be meaningful to decision-makers and encourage their broader use for identifying high costs.

A cost analysis of first-line chemotherapy for low-risk gestational trophoblastic neoplasia.

PubMed

Shah, Neel T; Barroilhet, Lisa; Berkowitz, Ross S; Goldstein, Donald P; Horowitz, Neil

2012-01-01

To determine the optimal approach to first-line treatment for low-risk gestational trophoblastic neoplasia (GTN) using a cost analysis of 3 commonly used regimens. A decision tree of the 3 most commonly used first-line low-risk GTN treatment strategies was created, accounting for toxicities, response rates and need for second- or third-line therapy. These strategies included 8-day methotrexate (MTX)/folinic acid, weekly MTX, and pulsed actinomycin-D (act-D). Response rates, average number of cycles needed for remission, and toxicities were determined by review of the literature. Costs of each strategy were examined from a societal perspective, including the direct total treatment costs as well as the indirect lost labor production costs from work absences. Sensitivity analysis on these costs was performed using both deterministic and probabilistic cost-minimization models with the aid of decision tree software (TreeAge Pro 2011, TreeAge Inc., Williamstown, Massachusetts). We found that 8-day MTX/folinic acid is the least expensive to society, followed by pulsed act-D ($4,867 vs. $6,111 average societal cost per cure, respectively), with act-D becoming more favorable only with act-D per-cycle cost <$231, or response rate to first-line therapy > 99%. Weekly MTX is the most expensive first-line treatment strategy to society ($9,089 average cost per cure), despite being least expensive to administer per cycle, based on lower first-line response rate. Absolute societal cost of each strategy is driven by the probability of needing expensive third-line multiagent chemotherapy, however relative cost differences are robust to sensitivity analysis over the reported range of cycle number and response rate for all therapies. Based on similar efficacy and lower societal cost, we recommend 8-day MTX/folinic acid for first-line treatment of low-risk GTN.

Hospitalization costs associated with diarrhea among children during the period of rotavirus circulation in the Northwest region of Argentina.

PubMed

Giglio, Norberto D; Caruso, Martín; Castellano, Vanesa E; Choque, Liliana; Sandoval, Silvia; Micone, Paula; Gentile, Ángela

2017-12-01

To assess direct medical costs, outof-pocket expenses, and indirect costs in cases of hospitalizations for acute diarrhea among children <5 years of age at Hospital de Niños "Héctor Quintana" in the province of Jujuy during the period of rotavirus circulation in the Northwest region of Argentina. Cross-sectional study on diseaserelated costs. All children <5 years of age, hospitalized with the diagnosis of acute diarrhea and dehydration during the period of rotavirus circulation between May 1st and October 31st of 2013, were included. The assessment of direct medical costs was done by reviewing medical records whereas out-of-pocket expenses and indirect costs were determined using a survey. For the 95% confidence interval of the average cost per patient, a probabilistic bootstrapping analysis of 10 000 simulations by resampling was done. One hundred and five patients were enrolled. Their average age was 18 months (standard deviation: 12); 62 (59%) were boys. The average direct medical cost, out-of-pocket expense, and lost income per case was ARS 3413.6 (2856.35-3970.93) (USD 577.59), ARS 134.92 (85.95-213.57) (USD 22.82), and ARS 301 (223.28-380.02) (USD 50.93), respectively. The total cost per hospitalization event was ARS 3849.52 (3298-4402.25) (USD 651.35). The total cost per hospitalization event was within what is expected for Latin America. Costs are broken down into direct medical costs (significant share), compared to out-of-pocket expenses (3.5%) and indirect costs (7.8%). Sociedad Argentina de Pediatría

The College Cost Book, 1986-87. Seventh Edition.

ERIC Educational Resources Information Center

College Entrance Examination Board, New York, NY. Coll. Scholarship Service.

Information on financial aid, estimating financial need, managing money, and expenses at over 3,500 colleges is provided. College costs are based on the following: tuition and fees, books and supplies, room and board, transportation, and personal expenses. The following financial aid sources are examined; the Pell Grant Program, the Supplemental…

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

14 CFR Appendix - Example of SIFL Adjustment

Code of Federal Regulations, 2014 CFR

2014-01-01

... expense per ASM (dollars) .05442 .05483 Year ended September 1978 Total operating expense 1 (millions) 14... nonfuel expense from April 1, 1979 to April 1, 1980 6 8.13 N.A. Estimated change in fuel cost, year ended... September 1979 Trunks Locals Trunks plus locals Total passenger/cargo 16 Total operating expense 1 (millions...

14 CFR Appendix - Example of SIFL Adjustment

Code of Federal Regulations, 2011 CFR

2011-01-01

... expense per ASM (dollars) .05442 .05483 Year ended September 1978 Total operating expense 1 (millions) 14... nonfuel expense from April 1, 1979 to April 1, 1980 6 8.13 N.A. Estimated change in fuel cost, year ended... September 1979 Trunks Locals Trunks plus locals Total passenger/cargo 16 Total operating expense 1 (millions...

48 CFR 9904.410-60 - Illustrations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... budgets for the other segment should be removed from B's G&A expense pool and transferred to the other...; all home office expenses allocated to Segment H are included in Segment H's G&A expense pool. (2) This... cost of scientific computer operations in its G&A expense pool. The scientific computer is used...

48 CFR 9904.410-60 - Illustrations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... budgets for the other segment should be removed from B's G&A expense pool and transferred to the other...; all home office expenses allocated to Segment H are included in Segment H's G&A expense pool. (2) This... cost of scientific computer operations in its G&A expense pool. The scientific computer is used...

An Analysis of Airline Costs. Lecture Notes for MIT Courses. 16.73 Airline Management and Marketing

NASA Technical Reports Server (NTRS)

Simpson, R. W.

1972-01-01

The cost analyst must understand the operations of the airline and how the activities of the airline are measured, as well as how the costs are incurred and recorded. The data source is usually a cost accounting process. This provides data on the cumulated expenses in various categories over a time period like a quarter, or year, and must be correlated by the analyst with cumulated measures of airline activity which seem to be causing this expense.

How Do Students Meet the Cost of Attending a State University? Information Brief. Volume 4, Issue 2

ERIC Educational Resources Information Center

Florida Board of Governors, State University System, 2007

2007-01-01

Students and their families must cover, on average, 83% of the roughly $16,000 cost of attendance for a full-time, in-state undergraduate at a state university in Florida. On average, 75% of the cost of attendance in Florida's public universities is from expenses other than tuition and fees and books. The largest expense is room and board,…

Reimbursement and costs of pediatric ambulatory diabetes care by using the resource-based relative value scale: is multidisciplinary care financially viable?

PubMed

Melzer, Sanford M; Richards, Gail E; Covington, Maxine L

2004-09-01

The ambulatory care for children with diabetes mellitus (DM) within an endocrinology specialty practice typically includes services provided by a multidisciplinary team. The resource-based relative value scale (RBRVS) is increasingly used to determine payments for ambulatory services in pediatrics. It is not known to what extent resource-based practice expenses and physician work values as allocated through the RBRVS for physician and non-physician practice expenses cover the actual costs of multidisciplinary ambulatory care for children with DM. A pediatric endocrinology and diabetes clinic staffed by faculty physicians and hospital support staff in a children's hospital. Data from a faculty practice plan billing records and income and expense reports during the period from 1 July 2000 to 30 June 2001 were used to determine endocrinologist physician ambulatory productivity, revenue collection, and direct expenses (salary, benefits, billing, and professional liability (PLI)). Using the RBRVS, ambulatory care revenue was allocated between physician, PLI, and practice expenses. Applying the activity-based costing (ABC) method, activity logs were used to determine non-physician and facility practice expenses associated with endocrine (ENDO) or diabetes visits. Of the 4735 ambulatory endocrinology visits, 1420 (30%) were for DM care. Physicians generated $866,582 in gross charges. Cash collections of 52% of gross charges provided revenue of $96 per visit. Using the actual Current Procedural Terminology (CPT)-4 codes reported for these services and the RBRVS system, the revenue associated with the 13,007 total relative value units (TRVUs) produced was allocated, with 58% going to cover physician work expenses and 42% to cover non-physician practice salary, facility, and PLI costs. Allocated revenue of $40.60 per visit covered 16 and 31% of non-physician and facility practice expenses per DM and general ENDO visit, respectively. RBRVS payments ($35/RVU) covered 46% of all expenses ($76.74/RVU), including 132% of physician expenses for the time worked in the clinic ($27/RVU), and only 23% of actual incurred practice expenses ($152/TRVU). Clinical revenues in a pediatric endocrinology practice, allocated by using the RBRVS system, do cover physician expenses for the time spent working in a hospital ENDO and DM clinic, but do not closely approximate non-physician and facility practice expenses while delivering multidisciplinary care to children with DM. Using payment based on the RBRVS system, and without additional payments to compensate for increased practice expenses incurred in the delivery of multidisciplinary care, this care model may not be financially viable.

47 CFR 32.6532 - Network administration expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Network administration expense. 32.6532 Section 32.6532 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Network administration expense. This account shall include costs incurred in network administration. This...

47 CFR 32.6532 - Network administration expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network administration expense. 32.6532 Section 32.6532 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Network administration expense. This account shall include costs incurred in network administration. This...

Costs, charges, and revenues for hospital diagnostic imaging procedures: differences by modality and hospital characteristics.

PubMed

Sistrom, Christopher Lee; McKay, Niccie L

2005-06-01

This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services. Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices. The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size. Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.

The evolution of the simulation environment in the ALMA Observatory

NASA Astrophysics Data System (ADS)

Shen, Tzu-Chiang; Soto, Ruben; Saez, Norman; Velez, Gaston; Staig, Tomas; Sepulveda, Jorge; Saez, Alejandro; Ovando, Nicolas; Ibsen, Jorge

2016-07-01

The Atacama Large Millimeter /submillimeter Array (ALMA) has entered into operation phase since 2013. This transition changed the priorities within the observatory, in which, most of the available time will be dedicated to science observations at the expense of technical time. Therefore, it was planned to design and implement a new simulation environment, which must be comparable - or at least- be representative of the production environment. Concepts of model in the loop and hardware in the loop were explored. In this paper we review experiences gained and lessons learnt during the design and implementation of the new simulation environment.

Structural tailoring of counter rotation propfans

NASA Technical Reports Server (NTRS)

Brown, Kenneth W.; Hopkins, D. A.

1989-01-01

The STAT program was designed for the optimization of single rotation, tractor propfan designs. New propfan designs, however, generally consist of two counter rotating propfan rotors. STAT is constructed to contain two levels of analysis. An interior loop, consisting of accurate, efficient approximate analyses, is used to perform the primary propfan optimization. Once an optimum design has been obtained, a series of refined analyses are conducted. These analyses, while too computer time expensive for the optimization loop, are of sufficient accuracy to validate the optimized design. Should the design prove to be unacceptable, provisions are made for recalibration of the approximate analyses, for subsequent reoptimization.

Financial and educational costs of the residency interview process for urology applicants.

PubMed

Kerfoot, B Price; Asher, Kevin P; McCullough, David L

2008-06-01

To investigate the financial and educational costs of the urology residency interview process, we performed a survey of the applicants to the 2006 urology match. All applicants registered for the 2006 urology match were invited to participate. In January 2006 prior to the match, an anonymous online survey containing 8 questions on the financial and educational costs of the interview process was distributed via email. Survey response rate was 61% (287/468). The median educational debt of the applicants was $125,000 (IQR 65,000 to 160,000). Respondents reported having a median 12 interviews (IQR 8 to 15) with urology residencies and spending a median 20 days (IQR 14 to 30) on the interview trail. The total cost of the interview process was a median $4000 (IQR 2000 to 5200) with a median expense per interview of $330 (IQR 211 to 455). Applicants reported that travel expenses accounted for a median 60% of overall interview expenses, whereas the remainder of the expense was accounted for by lodging (25%), food (10%) and clothing (5%). The money to cover these interview-related expenses was obtained primarily by loans. Forty-six percent of the applicants reported that skipping medical school clerkships and classes for urology interviews was "not at all detrimental" to their medical education, whereas 1% reported that it was "greatly detrimental." The financial cost of the interview process for urology applicants is substantial, although the educational cost appears to be limited. Efforts to reduce the financial impact of the interview process should be initiated at both a regional and national level.

Estimating medical practice expenses from administering adult influenza vaccinations.

PubMed

Coleman, Margaret S; Fontanesi, John; Meltzer, Martin I; Shefer, Abigail; Fishbein, Daniel B; Bennett, Nancy M; Stryker, David

2005-01-04

Potential business losses incurred vaccinating adults against influenza have not been defined because of a lack of estimates for medical practice costs incurred delivering vaccines. We collected data on vaccination labor time and other associated expenses. We modeled estimates of per-vaccination medical practice business costs associated with delivering adult influenza vaccine in different sized practices. Per-shot costs ranged from USD 13.87 to USD 46.27 (2001 dollars). When compared with average Medicare payments of USD 11.71, per-shot losses ranged from US$ 2.16 to USD 34.56. More research is needed to determine less expensive delivery settings and/or whether third-party payers need to make higher payments for adult vaccinations.

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

N. Mittereder, A. Poerschke

This report presents a cold-climate project that examines an alternative approach to ground source heat pump (GSHP) ground loop design. The innovative ground loop design is an attempt to reduce the installed cost of the ground loop heat exchange portion of the system by containing the entire ground loop within the excavated location beneath the basement slab.

Run-time parallelization and scheduling of loops

NASA Technical Reports Server (NTRS)

Saltz, Joel H.; Mirchandaney, Ravi; Baxter, Doug

1988-01-01

The class of problems that can be effectively compiled by parallelizing compilers is discussed. This is accomplished with the doconsider construct which would allow these compilers to parallelize many problems in which substantial loop-level parallelism is available but cannot be detected by standard compile-time analysis. We describe and experimentally analyze mechanisms used to parallelize the work required for these types of loops. In each of these methods, a new loop structure is produced by modifying the loop to be parallelized. We also present the rules by which these loop transformations may be automated in order that they be included in language compilers. The main application area of the research involves problems in scientific computations and engineering. The workload used in our experiment includes a mixture of real problems as well as synthetically generated inputs. From our extensive tests on the Encore Multimax/320, we have reached the conclusion that for the types of workloads we have investigated, self-execution almost always performs better than pre-scheduling. Further, the improvement in performance that accrues as a result of global topological sorting of indices as opposed to the less expensive local sorting, is not very significant in the case of self-execution.

76 FR 56401 - Stainless Steel Bar from India: Final Results of the Antidumping Duty Administrative Review, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... Sieves' general and administrative expense rate to exclude from the numerator the portion of the director remuneration expense reported as a selling expense; (11) we increased Hindustan's reported cost of manufacture...

47 CFR 32.6534 - Plant operations administration expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Plant operations administration expense. 32....6534 Plant operations administration expense. (a) This account shall include costs incurred in the general administration of plant operations. This includes supervising plant operations (except as...

47 CFR 32.6534 - Plant operations administration expense.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Plant operations administration expense. 32....6534 Plant operations administration expense. (a) This account shall include costs incurred in the general administration of plant operations. This includes supervising plant operations (except as...

47 CFR 32.6534 - Plant operations administration expense.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Plant operations administration expense. 32....6534 Plant operations administration expense. (a) This account shall include costs incurred in the general administration of plant operations. This includes supervising plant operations (except as...

47 CFR 32.6534 - Plant operations administration expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Plant operations administration expense. 32....6534 Plant operations administration expense. (a) This account shall include costs incurred in the general administration of plant operations. This includes supervising plant operations (except as...

47 CFR 36.379 - Message processing expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Customer Operations Expenses § 36.379 Message processing expense. (a) This classification includes the... exchange operation. (1) Effective July 1, 2001 through June 30, 2011, study areas subject to price cap...

Comparison of clinical outcome and costs with CC + gonadotropins and gnrha + gonadotropins during Ivf/ICSI cycles.

PubMed

Kovacs, Peter; Matyas, Szabolcs; Bernard, l Artur; Kaali, Steven G

2004-06-01

To compare clinical outcome and costs of CC + gonadotropins with GnRHa + gonadotropins during IVF/ICSI cycles. Clinical outcome and expenses of 382 CC + gonadotropin and 964 GnRHa + gonadotropin cycles were compared. Medication costs were calculated on the basis of the mean number of ampoules and the proportion of various gonadotropins. Costs per clinical pregnancy were calculated on the basis of expenses and clinical pregnancy rates. Women in the CC + gonadotropin group were younger, and had fewer follicles, oocytes, embryos, and embryos transferred. Clinical pregnancy rates were higher in the GnRHa group (35.9 % vs 26.2%, p < 0.001). More ampoules of gonadotropins were used in the GnRHa group (24.0 +/- 0.3 vs 20.0 +/- 0.5, p < 0.001). Medication costs per cycle were higher in the GnRHa group (US dollars 357 vs 248). Expenses per pregnancy however were lower in the GnRHa group (USdollars 4197 vs 5335 with IVF; USdollars 5590 vs 7244 with ICSI). When different age subgroups with similar baseline characteristics and stimulation parameters were compared, pregnancy rates were significantly higher in the GnRHa groups. Medication cost per cycle was higher in the GnRHa subgroups, and the expense per pregnancy was lower with GnRHa protocol. Cost per cycle is higher with GnRHa + gonadotropin. However, because of the better performance of the GnRHa + gonadotropin stimulation, the cumulative costs are reduced by the time a clinical pregnancy is achieved.

48 CFR 1631.203-71 - Business unit General and Administrative (G&A) expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Business unit General and Administrative (G&A) expenses. G&A expenses shall be allocated to final cost... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Business unit General and Administrative (G&A) expenses. 1631.203-71 Section 1631.203-71 Federal Acquisition Regulations System OFFICE OF...

11 CFR 106.5 - Allocation of expenses between federal and non-federal activities by national party committees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... national party committees; (iii) Methods for allocation of administrative expenses, costs of generic voter... 11 Federal Elections 1 2010-01-01 2010-01-01 false Allocation of expenses between federal and non... COMMISSION GENERAL ALLOCATIONS OF CANDIDATE AND COMMITTEE ACTIVITIES § 106.5 Allocation of expenses between...

A HWIL test facility of infrared imaging laser radar using direct signal injection

NASA Astrophysics Data System (ADS)

Wang, Qian; Lu, Wei; Wang, Chunhui; Wang, Qi

2005-01-01

Laser radar has been widely used these years and the hardware-in-the-loop (HWIL) testing of laser radar become important because of its low cost and high fidelity compare with On-the-Fly testing and whole digital simulation separately. Scene generation and projection two key technologies of hardware-in-the-loop testing of laser radar and is a complicated problem because the 3D images result from time delay. The scene generation process begins with the definition of the target geometry and reflectivity and range. The real-time 3D scene generation computer is a PC based hardware and the 3D target models were modeled using 3dsMAX. The scene generation software was written in C and OpenGL and is executed to extract the Z-buffer from the bit planes to main memory as range image. These pixels contain each target position x, y, z and its respective intensity and range value. Expensive optical injection technologies of scene projection such as LDP array, VCSEL array, DMD and associated scene generation is ongoing. But the optical scene projection is complicated and always unaffordable. In this paper a cheaper test facility was described that uses direct electronic injection to provide rang images for laser radar testing. The electronic delay and pulse shaping circuits inject the scenes directly into the seeker's signal processing unit.

11 CFR 106.5 - Allocation of expenses between federal and non-federal activities by national party committees.

Code of Federal Regulations, 2014 CFR

2014-01-01

...; (ii) Percentages to be allocated for administrative expenses and costs of generic voter drives by... drives, and of fundraising costs by national party committees; and (iv) Procedures for payment of... one committee through such program or event; and (iii) [Reserved] (iv) Generic voter drives including...

11 CFR 106.5 - Allocation of expenses between federal and non-federal activities by national party committees.

Code of Federal Regulations, 2011 CFR

2011-01-01

...; (ii) Percentages to be allocated for administrative expenses and costs of generic voter drives by... drives, and of fundraising costs by national party committees; and (iv) Procedures for payment of... one committee through such program or event; and (iii) [Reserved] (iv) Generic voter drives including...

11 CFR 106.5 - Allocation of expenses between federal and non-federal activities by national party committees.

Code of Federal Regulations, 2012 CFR

2012-01-01

...; (ii) Percentages to be allocated for administrative expenses and costs of generic voter drives by... drives, and of fundraising costs by national party committees; and (iv) Procedures for payment of... one committee through such program or event; and (iii) [Reserved] (iv) Generic voter drives including...

18 CFR 367.4160 - Account 416, Costs and expenses of merchandising, jobbing and contract work.

Code of Federal Regulations, 2010 CFR

2010-04-01

... associated company's facilities. (11) Stationery and office supplies and expenses. (12) Losses from... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 416, Costs and... Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC...

28 CFR Appendix to Subpart A - International Terrorism Victim Expense Reimbursement Program (ITVERP); Chart of Expense...

Code of Federal Regulations, 2012 CFR

2012-07-01

... dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and replacement; (4...,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12 months, but not to exceed $5,000...

28 CFR Appendix to Subpart A of... - International Terrorism Victim Expense Reimbursement Program (ITVERP); Chart of Expense...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., including dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and... would be appropriate Up to $50,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12...

28 CFR Appendix to Subpart A of... - International Terrorism Victim Expense Reimbursement Program (ITVERP); Chart of Expense...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., including dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and... would be appropriate Up to $50,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12...

28 CFR Appendix to Subpart A - International Terrorism Victim Expense Reimbursement Program (ITVERP); Chart of Expense...

Code of Federal Regulations, 2010 CFR

2010-07-01

... dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and replacement; (4...,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12 months, but not to exceed $5,000...

28 CFR Appendix to Subpart A - International Terrorism Victim Expense Reimbursement Program (ITVERP); Chart of Expense...

Code of Federal Regulations, 2011 CFR

2011-07-01

... dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and replacement; (4...,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12 months, but not to exceed $5,000...

New Ways Of Doing Business (NWODB) cost quantification analysis

NASA Technical Reports Server (NTRS)

Hamaker, Joseph W.; Rosmait, Russell L.

1992-01-01

The cost of designing, producing, and operating typical aerospace flight hardware is necessarily more expensive than most other human endeavors. Because of the more stringent environment of space, hardware designed to operate there will probably always be more expensive than similar hardware which is designed for less taxing environments. It is the thesis of this study that there are very significant improvements that can be made in the cost of aerospace flight hardware.

Costs of Multidisciplinary Parenteral Nutrition Care Provided at a Distance via Mobile Tablets

PubMed Central

Kim, Heejung; Spaulding, Ryan; Werkowitch, Marilyn; Yadrich, Donna; Piamjariyakul, Ubolrat; Gilroy, Richard; Smith, Carol E.

2014-01-01

Background Determining the costs of healthcare delivery is a key step for providing efficient nutrition-based care. This analysis tabulates the costs of delivering home parenteral nutrition (HPN) interventions and clinical assessments through encrypted mobile technologies to increase patients’ access to healthcare providers, reduce their travel expenses, and allow early detection of infection and other complications. Methods A traditional cost-accounting method was used to tabulate all expenses related to mobile distance HPN clinic appointments, including (1) personnel time of multidisciplinary healthcare professionals, (2) supply of HPN intervention materials, and (3) equipment, connection, and delivery expenses. Results A total of 20 mobile distance clinic appointments were conducted for an average of 56 minutes each with 45 patients who required HPN infusion care. The initial setup costs included mobile tablet devices, 4G data plans, and personnel's time as well as intervention materials. The initial costs were on average $916.64 per patient, while the follow-up clinic appointments required $361.63 a month, with these costs continuing to decline as the equipment was used by multiple patients more frequently over time. Patients reported high levels of satisfaction with cost savings in travel expenses and rated the quality of care comparable to traditional in-person examinations. Conclusion This study provides important aspects of the initial cost tabulation for visual assessment for HPN appointments. These findings will be used to generate a decision algorithm for scheduling mobile distance clinic appointments intermittent with in-person visits to determine how to lower costs of nutrition assessments. To maximize the cost benefits, clinical trials must continue to collect clinical outcomes. PMID:25245253

Melanoma costs: a dynamic model comparing estimated overall costs of various clinical stages.

PubMed

Alexandrescu, Doru Traian

2009-11-15

The rapidly increasing incidence of melanoma occurs at the same time as an increase in general healthcare costs, particularly the expenses associated with cancer care. Previous cost estimates in melanoma have not utilized a dynamic model considering the evolution of the disease and have not integrated the multiple costs associated with different aspects of medical interventions and patient-related factors. Futhermore, previous calculations have not been updated to reflect the modern tendencies in healthcare costs. We designed a comprehensive model of expenses in melanoma that considers the dynamic costs generated by the natural progression of the disease, which produces costs associated with treatment, surveillance, loss of income, and terminal care. The complete range of initial clinical (TNM) stages of the disease and initial tumor stages were analyzed in this model and the total healthcare costs for the five years following melanoma presentation at each particular stage were calculated. We have observed dramatic incremental total costs associated with progressively higher initial stages of the disease, ranging from a total of $4,648.48 for in situ tumors to $159,808.17 for Stage IV melanoma. By stage, early lesions associate 30-55 percent of their costs for the treatment of the primary tumor, due to a low rate of recurrence (local, regional, or distant), which limits the need for additional interventions. For in situ melanoma, T1a, and T1b, surveillance is an important contributor to the medical costs, accounting for more than 25 percent of the total cost over 5 years. In contrast, late lesions incur a much larger proportion of their associated costs (up to 80-85%) from the diagnosis and treatment of metastatic disease because of the increased propensity of those lesions to disseminate. This cost increases with increasing tumor stage (from $2,442.17 for T1a to $6,678.00 for T4b). The most expensive items in the medical care of patients with melanoma consist of adjuvant treatment with IFN-alpha ($75,955.18), palliative care ($14,500), and administration of chemotherapy ($1,967.10 for a triple combination of agents); there are even higher costs for biochemotherapy, the new tyrosine kinase and antiangiogenic drugs, and hospital treatment of neutropenic fever ($1,535.00 to $1,800.00/day). There is a significant cost decrement when melanoma is diagnosed at an earlier stage, with a T4b lesion being approximately 2200 percent more expensive to diagnose and treat than an early in situ melanoma and 1000 percent more expensive than a stage T1a tumor. Although a direct comparison with other cancers would require the use of the same dynamic model, it is apparent that the high costs of melanoma care places it at the top of the most expensive cancers to diagnose, follow, and treat. These high costs for advanced-stage melanoma warrant an increased emphasis on developing effective strategies for its early diagnosis and treatment.

47 CFR 36.376 - All other.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Customer Operations...

Competition and quality in health care markets: a differential-game approach.

PubMed

Brekke, Kurt R; Cellini, Roberto; Siciliani, Luigi; Straume, Odd Rune

2010-07-01

We investigate the effect of competition on quality in health care markets with regulated prices taking a differential game approach, in which quality is a stock variable. Using a Hotelling framework, we derive the open-loop solution (health care providers set the optimal investment plan at the initial period) and the feedback closed-loop solution (providers move investments in response to the dynamics of the states). Under the closed-loop solution competition is more intense in the sense that providers observe quality in each period and base their investment on this information. If the marginal provision cost is constant, the open-loop and closed-loop solutions coincide, and the results are similar to the ones obtained by static models. If the marginal provision cost is increasing, investment and quality are lower in the closed-loop solution (when competition is more intense). In this case, static models tend to exaggerate the positive effect of competition on quality.

47 CFR 54.803 - Universal service zones.

Code of Federal Regulations, 2013 CFR

2013-10-01

... developing this transitional estimate, the loop and port costs estimated by the FCC cost model, or other... chapter. (b) In a price cap study area where the price cap local exchange carrier has not established state-approved prices for UNE loops by zone, the Administrator shall develop an estimate of the local...

47 CFR 54.803 - Universal service zones.

Code of Federal Regulations, 2011 CFR

2011-10-01

... developing this transitional estimate, the loop and port costs estimated by the FCC cost model, or other... chapter. (b) In a price cap study area where the price cap local exchange carrier has not established state-approved prices for UNE loops by zone, the Administrator shall develop an estimate of the local...

47 CFR 54.803 - Universal service zones.

Code of Federal Regulations, 2014 CFR

2014-10-01

... developing this transitional estimate, the loop and port costs estimated by the FCC cost model, or other... chapter. (b) In a price cap study area where the price cap local exchange carrier has not established state-approved prices for UNE loops by zone, the Administrator shall develop an estimate of the local...

47 CFR 54.803 - Universal service zones.

Code of Federal Regulations, 2012 CFR

2012-10-01

... developing this transitional estimate, the loop and port costs estimated by the FCC cost model, or other... chapter. (b) In a price cap study area where the price cap local exchange carrier has not established state-approved prices for UNE loops by zone, the Administrator shall develop an estimate of the local...

47 CFR 54.803 - Universal service zones.

Code of Federal Regulations, 2010 CFR

2010-10-01

... developing this transitional estimate, the loop and port costs estimated by the FCC cost model, or other... chapter. (b) In a price cap study area where the price cap local exchange carrier has not established state-approved prices for UNE loops by zone, the Administrator shall develop an estimate of the local...

[The cost of polypharmacy in patients with type 2 diabetes mellitus].

PubMed

García A, Luz María; Villarreal R, Enrique; Galicia R, Liliana; Martínez G, Lidia; Vargas D, Emma Rosa

2015-05-01

Polypharmacy or the concomitant use of three or more medications, may increase the complexity of health care and its costs. To determine the costs of polypharmacy in patients with Type 2 Diabetes Mellitus in a Mexican population sample. Analysis of health care costs in 257 patients with Type 2 Diabetes Mellitus from two family care facilities, who had at least five consultations during one year. The cost of professional care by family physicians, pharmacological care and medications were considered to calculate the total expenses. The price of medications and the number of units consumed in one year were used to determine pharmacological expenses. Medications were grouped to determine costs derived from complications and concomitant diseases. Costs were calculated in US dollars (USD). The mean cost derived from family physician fees was USD 82.32 and from pharmacy fees USD 29.37. The mean cost of medications for diabetes treatment was USD 33.31, for the management of complications USD 13.9 and for management of concomitant diseases USD 23.7, rendering a total cost of USD 70.92. Thus, the total annual care cost of a diabetic patient was USD 182.61. Medications represent less than 50% of total expenses of diabetic patients with polypharmacy.

Reducing the cost of headache medication.

PubMed

Solomon, Glen D

2009-06-01

Although medication costs make up one of the smallest portions of the overall expense of headache care, it is the segment of expense that often impacts the patient most directly. The advent of triptans marked a major advance in migraine therapy, but their high cost has limited their widespread use. Four options can be considered as potential means to reduce the cost of triptans. These include compulsory licensing, exclusive contracting, over-the-counter -availability, and the introduction of generic triptans. Each method impacts the consumer, third-party payer, or pharmaceutical company in a different manner.

Cost Analysis of 48 Burn Patients in a Mass Casualty Explosion Treated at Chang Gung Memorial Hospital.

PubMed

Mathews, Alexandra L; Cheng, Ming-Huei; Muller, John-Michael; Lin, Miffy Chia-Yu; Chang, Kate W C; Chung, Kevin C

2017-01-01

Little is known about the costs of treating burn patients after a mass casualty event. A devastating Color Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This study was performed to investigate the economic effects of treating burn patients at a single medical center after an explosion disaster. A detailed retrospective analysis on 48 patient expense records at Chang Gung Memorial Hospital after the Color Dust explosion was performed. Data were collected during the acute treatment period between June 27, 2015 and September 30, 2015. The distribution of cost drivers for the entire patient cohort (n=48), patients with a percent total body surface area burn (%TBSA)≥50 (n=20), and those with %TBSA <50 (n=28) were analyzed. The total cost of 48 burn patients over the acute 3-month time period was $2,440,688, with a mean cost per patient of $50,848 ±36,438. Inpatient ward fees (30%), therapeutic treatment fees (22%), and medication fees (11%) were found to be the three highest cost drivers. The 20 patients with a %TBSA ≥50 consumed $1,559,300 (63.8%) of the total expenses, at an average cost of $77,965±34,226 per patient. The 28 patients with a %TBSA <50 consumed $881,387 (36.1%) of care expenses, at an average cost of $31,478±23,518 per patient. In response to this mass casualty event, inpatient ward fees represented the largest expense. Hospitals can reduce this fee by ensuring wound dressing and skin substitute materials are regionally stocked and accessible. Medication fees may be higher than expected when treating a mass burn cohort. In preparation for a future event, hospitals should anticipate patients with a %TBSA≥50 will contribute the majority of inpatient expenses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost Analysis of 48 Burn Patients in a Mass Casualty Explosion Treated at Chang Gung Memorial Hospital

PubMed Central

Mathews, Alexandra L.; Cheng, Ming-Huei; Muller, John-Michael; Lin, Miffy Chia-Yu; Chang, Kate W.C.; Chung, Kevin C.

2016-01-01

Introduction Little is known about the costs of treating burn patients after a mass casualty event. A devastating Color Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This study was performed to investigate the economic effects of treating burn patients at a single medical center after an explosion disaster. Methods A detailed retrospective analysis on 48 patient expense records at Chang Gung Memorial Hospital after the Color Dust explosion was performed. Data were collected during the acute treatment period between June 27, 2015 and September 30, 2015. The distribution of cost drivers for the entire patient cohort (n=48), patients with a percent total body surface area burn (%TBSA) ≥ 50 (n=20), and those with %TBSA <50 (n=28) were analyzed. Results The total cost of 48 burn patients over the acute 3-month time period was $2,440,688, with a mean cost per patient of $50,848 ±36,438. Inpatient ward fees (30%), therapeutic treatment fees (22%), and medication fees (11%) were found to be the three highest cost drivers. The 20 patients with a %TBSA ≥50 consumed $1,559,300 (63.8%) of the total expenses, at an average cost of $77,965 ± 34,226 per patient. The 28 patients with a %TBSA <50 consumed $881,387 (36.1%) of care expenses, at an average cost of $31,478 ± 23,518 per patient. Conclusions In response to this mass casualty event, inpatient ward fees represented the largest expense. Hospitals can reduce this fee by ensuring wound dressing and skin substitute materials are regionally stocked and accessible. Medication fees may be higher than expected when treating a mass burn cohort. In preparation for a future event, hospitals should anticipate patients with a %TBSA ≥ 50 will contribute the majority of inpatient expenses. PMID:27553390

47 CFR 36.377 - Category 1-Local business office expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Category 1-Local business office expense. 36.377 Section 36.377 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND...

Numerical Analysis of Combined Well and Open-Closed Loops Geothermal (CWG) Systems

NASA Astrophysics Data System (ADS)

Park, Yu-Chul

2016-04-01

Open-loop geothermal heat pump (GHP) system and closed-loop heat pump systems have been used in Korea to reduce emission of greenhouse gases such as carbon dioxide (CO2). The GHP systems have the pros and cons, for example, the open-loop GHP system is good energy-efficient and the closed-loop GHP system requires minimum maintenance costs. The open-loop GHP system can be used practically only with large amount of groundwater supply. The closed-loop GHP system can be used with high costs of initial installation. The performance and efficiency of the GHP system depend on the characteristics of the GHP system itself in addition to the geologic conditions. To overcome the cons of open-loop or closed-loop GHP system, the combined well and open-closed loops geothermal (CWG) system was designed. The open-loop GHP system is surrounded with closed-loop GHP systems in the CWG system. The geothermal energy in closed-loop GHP systems is supplied by the groundwater pumped by the open-loop GHP system. In this study, 2 different types of the CWG systems (small aperture hybrid CWG system and large aperture CWG system) are estimated using numerical simulation models in the aspect of energy efficiency. This work was supported by the New & Renewable Energy Core Technology Program of the Korea Institute of Energy Technology Evaluation and Planning (KETEP), granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea. (No.20153030111120).

Projected financial impact of noncoverage of elective circumcision by Louisiana medicaid in boys 0 to 5 years old.

PubMed

Ortenberg, Joseph; Roth, Christopher C

2013-10-01

Several states, including Louisiana since 2005, no longer cover elective circumcision under Medicaid programs. The recent AAP (American Academy of Pediatrics) policy statement recognizes the medical benefits of circumcision and recommends the removal of financial barriers to this procedure. Cost savings are a factor in the limitation of circumcision coverage, although to our knowledge the actual cost savings to Medicaid programs have not been reported. We analyzed the number of circumcisions performed before and after the policy change to determine an accurate cost of such procedures and whether the increased procedure expense mitigates the initial savings. We analyzed the number of neonatal and nonneonatal circumcisions in boys 0 to 5 years old to determine trends during the selected period. A cost model for each procedure was created. Neonatal procedure cost was based on professional fees. Nonneonatal procedure cost was based on professional (surgeon and anesthesia) plus facility fees. The number and cost of procedures were compared before (2002 to 2004) and after (2006 to 2010) the policy change. Linear regression was used to predict future costs. The average annual number and expense of neonatal circumcisions were significantly decreased after the policy change. There was no significant decrease in nonneonatal procedures and expense. Cost per procedure ranged from $88.34 for neonatal to $486.76 for nonneonatal circumcision. Secondary to the increasing number of more costly nonneonatal procedures, the annual expense was predicted to exceed pre-policy levels by 2015. The number of nonneonatal circumcisions is increasing and such procedures place a higher financial burden on the health care system. As a result, the financial benefits of noncoverage of elective circumcision are decreasing. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The Cost of Interlibrary Loan Services in a Medium-Sized Academic Library.

ERIC Educational Resources Information Center

Naylor, Ted F.

1997-01-01

A one-year study of interlibrary loan expense was conducted at Wichita State University (KS) to identify areas of interlibrary loan expense, compare results of cost studies from large research libraries, and provide a reference point in determining how to best balance Interlibrary loans and commercial document delivery systems. Analyzes salary,…

A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive?

PubMed

Rowe, Courtney K; Pierce, Michael W; Tecci, Katherine C; Houck, Constance S; Mandell, James; Retik, Alan B; Nguyen, Hiep T

2012-07-01

Cost in healthcare is an increasing and justifiable concern that impacts decisions about the introduction of new devices such as the da Vinci(®) surgical robot. Because equipment expenses represent only a portion of overall medical costs, we set out to make more specific cost comparisons between open and robot-assisted laparoscopic surgery. We performed a retrospective, observational, matched cohort study of 146 pediatric patients undergoing either open or robot-assisted laparoscopic urologic surgery from October 2004 to September 2009 at a single institution. Patients were matched based on surgery type, age, and fiscal year. Direct internal costs from the institution were used to compare the two surgery types across several procedures. Robot-assisted surgery direct costs were 11.9% (P=0.03) lower than open surgery. This cost difference was primarily because of the difference in hospital length of stay between patients undergoing open vs robot-assisted surgery (3.8 vs 1.6 days, P<0.001). Maintenance fees and equipment expenses were the primary contributors to robotic surgery costs, while open surgery costs were affected most by room and board expenses. When estimates of the indirect costs of robot purchase and maintenance were included, open surgery had a lower total cost. There were no differences in follow-up times or complication rates. Direct costs for robot-assisted surgery were significantly lower than equivalent open surgery. Factors reducing robot-assisted surgery costs included: A consistent and trained robotic surgery team, an extensive history of performing urologic robotic surgery, selection of patients for robotic surgery who otherwise would have had longer hospital stays after open surgery, and selection of procedures without a laparoscopic alternative. The high indirect costs of robot purchase and maintenance remain major factors, but could be overcome by high surgical volume and reduced prices as competitors enter the market.

Can households earning minimum wage in Nova Scotia afford a nutritious diet?

PubMed

Williams, Patricia L; Johnson, Christine P; Kratzmann, Meredith L V; Johnson, C Shanthi Jacob; Anderson, Barbara J; Chenhall, Cathy

2006-01-01

To assess the affordability of a nutritious diet for households earning minimum wage in Nova Scotia. Food costing data were collected in 43 randomly selected grocery stores throughout NS in 2002 using the National Nutritious Food Basket (NNFB). To estimate the affordability of a nutritious diet for households earning minimum wage, average monthly costs for essential expenses were subtracted from overall income to see if enough money remained for the cost of the NNFB. This was calculated for three types of household: 1) two parents and two children; 2) lone parent and two children; and 3) single male. Calculations were also made for the proposed 2006 minimum wage increase with expenses adjusted using the Consumer Price Index (CPI). The monthly cost of the NNFB priced in 2002 for the three types of household was 572.90 dollars, 351.68 dollars, and 198.73 dollars, respectively. Put into the context of basic living, these data showed that Nova Scotians relying on minimum wage could not afford to purchase a nutritious diet and meet their basic needs, placing their health at risk. These basic expenses do not include other routine costs, such as personal hygiene products, household and laundry cleaners, and prescriptions and costs associated with physical activity, education or savings for unexpected expenses. People working at minimum wage in Nova Scotia have not had adequate income to meet basic needs, including a nutritious diet. The 2006 increase in minimum wage to 7.15 dollars/hr is inadequate to ensure that Nova Scotians working at minimum wage are able to meet these basic needs. Wage increases and supplements, along with supports for expenses such as childcare and transportation, are indicated to address this public health problem.

Site-specific investigations on aquifer thermal energy storage for space and process cooling

NASA Astrophysics Data System (ADS)

Brown, D. R.

1991-08-01

The Pacific Northwest Laboratory (PNL) has completed three preliminary site-specific feasibility studies that investigated aquifer thermal energy storage (ATES) for reducing space and process cooling costs. Chilled water stored in an ATES system could be used to meet all or part of the process and/or space cooling loads at the three facilities investigated. Seasonal or diurnal chill ATES systems could be significantly less expensive than a conventional electrically-driven, load-following chiller system at one of the three sites, depending on the cooling water loop return temperature and presumed future electricity escalation rate. For the other two sites investigated, a chill ATES system would be economically competitive with conventional chillers if onsite aquifer characteristics were improved. Well flow rates at one of the sites were adequate, but the expected thermal recovery efficiency was too low. The reverse of this situation was found at the other site, where the thermal recovery efficiency was expected to be adequate, but well flow rates were too low.

Financial Burden Borne by Laparoscopic Living Kidney Donors.

PubMed

Wiseman, Jennifer F; Jacobs, Cheryl L; Larson, Dawn B; Berglund, Danielle M; Garvey, Catherine A; Ibrahim, Hassan N; Matas, Arthur J

2017-09-01

Living kidney donors have donation-related out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs). Yet there is little information about how much of a subjective burden these constitute for the donors. From December 2003 through December 2014, we surveyed donors 6 months postdonation to determine their financial burden related to donation (on a scale of 1 to 10) and what resources were used to cover expenses. Of 1136 surveyed, 796 (70%) responded. Among respondents, mean age at donation was 43.6 ± 10.6 years, 64% were women, 96% were white, and 53% were related by blood to their recipient. Overall, 26% scored their financial burden as 5 or higher; 8% scored it as 8 or higher. Increased expenses were associated with a higher reported burden; however, significant burden was reported by some with no out-of-pocket expenses (presumably due to lost wages and continuing expenses). The burden was scored as 5 or higher by 27% of those employed outside the home (n = 660), 15% homemakers, 13% retirees, 40% students; 28% unemployed; and 26% whose occupation was unknown. Over half (51%) of those receiving a local or (means-tested) national grant still reported moderate to severe burden. Besides grants, donors used a variety of sources to help offset expenses: dipped into savings, borrowed from friends or family, took out a loan, and/or had a fundraiser. Those with the highest burden reported using the most additional sources. Donors should not have to incur costs or a financial burden to donate; the transplant community should strive to make donation financially neutral.

47 CFR 69.415 - Reallocation of certain transport expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reallocation of certain transport expenses. 69... SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Expenses § 69.415 Reallocation of certain transport... of the costs otherwise assigned to the transport category to the common line, local switching...

47 CFR 69.415 - Reallocation of certain transport expenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Reallocation of certain transport expenses. 69... SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Expenses § 69.415 Reallocation of certain transport... of the costs otherwise assigned to the transport category to the common line, local switching...

47 CFR 32.6121 - Land and building expense.

Code of Federal Regulations, 2013 CFR

2013-10-01

... operate the telecommunications network shall be charged to Account 6531, Power Expense, and the cost of separately metered electricity used for operating specific types of equipment, such as computers, shall be... SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6121 Land and...

47 CFR 32.6121 - Land and building expense.

Code of Federal Regulations, 2012 CFR

2012-10-01

... operate the telecommunications network shall be charged to Account 6531, Power Expense, and the cost of separately metered electricity used for operating specific types of equipment, such as computers, shall be... SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6121 Land and...

47 CFR 32.6121 - Land and building expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... operate the telecommunications network shall be charged to Account 6531, Power Expense, and the cost of separately metered electricity used for operating specific types of equipment, such as computers, shall be... SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6121 Land and...

47 CFR 32.6121 - Land and building expense.

Code of Federal Regulations, 2014 CFR

2014-10-01

... operate the telecommunications network shall be charged to Account 6531, Power Expense, and the cost of separately metered electricity used for operating specific types of equipment, such as computers, shall be... SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6121 Land and...

47 CFR 32.6121 - Land and building expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... operate the telecommunications network shall be charged to Account 6531, Power Expense, and the cost of separately metered electricity used for operating specific types of equipment, such as computers, shall be... SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Expense Accounts § 32.6121 Land and...

48 CFR 31.205-28 - Other business expenses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Other business expenses. 31.205-28 Section 31.205-28 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-28 Other business expenses. The following types of recurring costs are allowable (a...

48 CFR 31.205-28 - Other business expenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Other business expenses. 31.205-28 Section 31.205-28 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-28 Other business expenses. The following types of recurring costs are allowable (a...

18 CFR 367.9090 - Account 909, Informational and instructional advertising expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Informational and instructional advertising expenses. 367.9090 Section 367.9090 Conservation of Power and Water... Account 909, Informational and instructional advertising expenses. (a) This account must include the cost... related to billings. (3) Printing of informational booklets, dodgers, bulletins, and other similar items...

48 CFR 31.205-28 - Other business expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Other business expenses. 31.205-28 Section 31.205-28 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Organizations 31.205-28 Other business expenses. The following types of recurring costs are allowable (a...

Energy Systems Integration Facility to Transform U.S. Energy Infrastructure

Science.gov Websites

operations center. Fully integrated with hardware-in-the-loop at power capabilities, an experimental hardware- and systems-in-the-loop capability. Hardware-in-the-Loop at Power ESIF Snapshot Cost : $135M 2013 Hardware-in-the-loop simulation is not a new concept, but adding megawatt-scale power takes

47 CFR 36.354 - Access expenses-Account 6540.

Code of Federal Regulations, 2010 CFR

2010-10-01

... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Network Operations Expenses § 36.354 Access expenses—Account 6540. (a) This account includes access...

Florida's model of nursing home Medicaid reimbursement for disaster-related expenses.

PubMed

Thomas, Kali S; Hyer, Kathryn; Brown, Lisa M; Polivka-West, LuMarie; Branch, Laurence G

2010-04-01

This study describes Florida's model of Medicaid nursing home (NH) reimbursement to compensate NHs for disaster-related expenses incurred as a result of 8 hurricanes within a 2-year period. This Florida model can serve as a demonstration for a national model for disaster-related reimbursement. Florida reimburses NHs for approved disaster-related costs through hurricane interim rate requests (IRRs). The state developed its unique Medicaid per diem rate temporary add-on by adapting its standard rate-setting reimbursement methodology. To understand the payment mechanisms and the costs that facilities incurred as a result of natural disasters, we examined the IRRs and cost reports for facilities requesting and receiving reimbursement. Cost reports and IRR applications indicated that Florida Medicaid spent close to $16 million to pay for hurricane-related costs to NHs. Without Florida's Hurricane IRR program, many facilities would have not been reimbursed for their hurricane-related costs. Florida's model is one that Medicare and other states should consider adopting to ensure that NHs receive adequate reimbursement for disaster-related expenses, including tornadoes, earthquakes, floods, blizzards, and other catastrophic events.

The Milieu Manager: A Nursing Staffing Strategy to Reduce Observer Use in the Acute Psychiatric Inpatient Setting.

PubMed

Triplett, Patrick; Dearholt, Sandra; Cooper, Mary; Herzke, John; Johnson, Erin; Parks, Joyce; Sullivan, Patricia; Taylor, Karin F; Rohde, Judith

Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.

Hospital economics of primary total knee arthroplasty at a teaching hospital.

PubMed

Healy, William L; Rana, Adam J; Iorio, Richard

2011-01-01

The hospital cost of total knee arthroplasty (TKA) in the United States is a major growing expense for the Centers for Medicare & Medicaid Services (CMS). Many hospitals are unable to deliver TKA with profitable or breakeven economics under the current Diagnosis-Related Group (DRG) hospital reimbursement system. The purposes of the current study were to (1) determine revenue, expenses, and profitability (loss) for TKA for all patients and for different payors; (2) define changes in utilization and unit costs associated with this operation; and (3) describe TKA cost control strategies to provide insight for hospitals to improve their economic results for TKA. From 1991 to 2009, Lahey Clinic converted a $2172 loss per case on primary TKA in 1991 to a $2986 profit per case in 2008. The improved economics was associated with decreasing revenue in inflation-adjusted dollars and implementation of hospital cost control programs that reduced hospital expenses for TKA. Reduction of hospital length of stay and reduction of knee implant costs were the major drivers of hospital expense reduction. During the last 25 years, our economic experience with TKA is concerning. Hospital revenues have lagged behind inflation, hospital expenses have been reduced, and our institution is earning a profit. However, the margin for TKA is decreasing and Managed Medicare patients do not generate a profit. The erosion of hospital revenue for TKA will become a critical issue if it leads to economic losses for hospitals or reduced access to TKA. Level III, Economic and Decision Analyses. See Guidelines for Authors for a complete description of levels of evidence.

Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis.

PubMed

Neuner, Joan M; Hamel, Mary Beth; Phillips, Russell S; Bona, Kira; Aronson, Mark D

2003-07-15

Rheumatic fever has become uncommon in the United States while rapid diagnostic test technology for streptococcal antigens has improved. However, little is known about the effectiveness or cost-effectiveness of various strategies for managing pharyngitis caused by group A beta-hemolytic streptococcus (GAS) in U.S. adults. To examine the cost-effectiveness of several diagnostic and management strategies for patients with suspected GAS pharyngitis. Cost-effectiveness analysis. Published literature, including systematic reviews where possible. When costs were not available in the literature, we estimated them from our institution and Medicare charges. Adults in the general U.S. population. 1 year. Societal. Five strategies for the management of adult patients with pharyngitis: 1) observation without testing or treatment, 2) empirical treatment with penicillin, 3) throat culture using a two-plate selective culture technique, 4) optical immunoassay (OIA) followed by culture to confirm negative OIA test results, or 5) OIA alone. Cost per lost quality-adjusted life-days (converted to life-years where appropriate) and incremental cost-effectiveness. Empirical treatment was the least effective strategy at a GAS pharyngitis prevalence of 10% (resulting in 0.41 lost quality-adjusted life-day). Although the other four strategies had similar effectiveness (all resulted in about 0.27 lost quality-adjusted life-day), culture was the least expensive strategy. Results were sensitive to the prevalence of GAS pharyngitis: OIA followed by culture was most effective when GAS pharyngitis prevalence was greater than 20%. Observation was least expensive when prevalence was less than 6%, and empirical treatment was least expensive when prevalence was greater than 71%. The effectiveness of strategies was also very sensitive to the probability of anaphylaxis: When the probability of anaphylaxis was about half the baseline probability, OIA/culture was most effective; when the probability was 1.6 times that of baseline, observation was most effective. Only at an OIA cost less than half of baseline did the OIA alone strategy become less expensive than culture. Results were not sensitive to other variations in probabilities or costs of diagnosis or treatment of GAS pharyngitis. Observation, culture, and two rapid antigen test strategies for diagnostic testing and treatment of suspected GAS pharyngitis in adults have very similar effectiveness and costs, although culture is the least expensive and most effective strategy when the GAS pharyngitis prevalence is 10%. Empirical treatment was not the most effective or least expensive strategy at any prevalence of GAS pharyngitis in adults, although it may be reasonable for individual patients at very high risk for GAS pharyngitis as assessed by a clinical decision rule.

Tax Breaks for Law Students.

ERIC Educational Resources Information Center

Button, Alan L.

1981-01-01

A guide to federal income tax law as it affects law students is presented. Some costs that may constitute valuable above-the-line deductions are identified: moving expenses, educational expenses, job-seeking expenses, and income averaging. Available from Washington and Lee University School of Law, Lexington, VA 24450, $5.50 sc) (MLW)

18 CFR 367.9050 - Account 905, Miscellaneous customer accounts expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 905, Miscellaneous customer accounts expenses. 367.9050 Section 367.9050 Conservation of Power and Water Resources..., Miscellaneous customer accounts expenses. (a) This account must include the cost of labor, materials used and...

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the energy conservation measures and other direct costs related to the energy project under the... for energy conservation/rate reduction. 990.185 Section 990.185 Housing and Urban Development... Calculating Formula Expenses § 990.185 Utilities expense level: Incentives for energy conservation/rate...

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the energy conservation measures and other direct costs related to the energy project under the... for energy conservation/rate reduction. 990.185 Section 990.185 Housing and Urban Development... Calculating Formula Expenses § 990.185 Utilities expense level: Incentives for energy conservation/rate...

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the energy conservation measures and other direct costs related to the energy project under the... for energy conservation/rate reduction. 990.185 Section 990.185 Housing and Urban Development... Calculating Formula Expenses § 990.185 Utilities expense level: Incentives for energy conservation/rate...

48 CFR 970.3102-05-28 - Other business expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Other business expenses. 970.3102-05-28 Section 970.3102-05-28 Federal Acquisition Regulations System DEPARTMENT OF ENERGY... Procedures 970.3102-05-28 Other business expenses. (i) Reasonable costs associated with the establishment and...

48 CFR 970.3102-05-28 - Other business expenses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Other business expenses. 970.3102-05-28 Section 970.3102-05-28 Federal Acquisition Regulations System DEPARTMENT OF ENERGY... Procedures 970.3102-05-28 Other business expenses. (i) Reasonable costs associated with the establishment and...

40 CFR 304.41 - Administrative fees, expenses, and Arbitrator's fee.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Arbitrator's fee. 304.41 Section 304.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... SUPERFUND COST RECOVERY CLAIMS Other Provisions § 304.41 Administrative fees, expenses, and Arbitrator's fee... Association (see § 304.21(e) of this part), all fees and expenses of the arbitral proceeding, including the...

Magnetic Shield for Adiabatic Demagnetization Refrigerators (ADR)

NASA Technical Reports Server (NTRS)

Chui, Talso C.; Haddad, Nicolas E.

2013-01-01

A new method was developed for creating a less expensive shield for ADRs using 1018 carbon steel. This shield has been designed to have similar performance to the expensive vanadium permendur shields, but the cost is 30 to 50% less. Also, these shields can be stocked in a variety of sizes, eliminating the need for special forgings, which also greatly reduces cost.

Lumber Cost Minimization through Optimum Grade-Mix Selection

Treesearch

Xiaoqiu Zuo; Urs Buehlmann; R. Edward Thomas; R. Edward Thomas

2003-01-01

Rough mills process kiln-dried lumber into components for the furniture and wood products industries, Lumber is a significant portion of total rough mill costs and lumber quality can have a serious impact on mill productivity. Lower quality lumber is less expensive yet is harder to process. Higher quality lumber is more expensive yet easier to process. The problem of...

Cost and robotic surgery in gynecology.

PubMed

Knight, Jason; Escobar, Pedro F

2014-01-01

Since the introduction of robotic technology, there have been significant changes to the field of gynecology. The number of minimally invasive procedures has drastically increased, with robotic procedures rising remarkably. To date several authors have published cost analyses demonstrating that robotic hysterectomy for benign and oncologic indications is more costly compared to the laparoscopic approach. Despite being more expensive than laparoscopy, other studies have found robotics to be less expensive and more effective than laparotomy. In this review, controversies surrounding cost-effectiveness studies are explored. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

Hospital cost-containment strategies that earn the respect of rating agencies.

PubMed

Dopoulos, Jason

2016-01-01

To confirm that hospitals have the necessary structures and strategies in place to reduce costs and secure future market share, credit rating agencies analyze a variety of quantitative and qualitative criteria, including: Salaries and benefits, bad debt, age of plant and depreciation, and other line items that may point to inefficiencies in a hospital's expense structure. Cost-benefit analyses, strategic plans, and leadership qualities that show the long-term value of expense cuts, capital investments, and mergers and acquisitions. Cost-effective and clinically appropriate shifts in a hospital's outpatient-to-inpatient ratio. Liquidity and market share.

[Social costs of the most common inflammatory rheumatic diseases in Mexico from the patient's perspective].

PubMed

Mould-Quevedo, Joaquín; Peláez-Ballestas, Ingris; Vázquez-Mellado, Janitzia; Terán-Estrada, Leobardo; Esquivel-Valerio, Jorge; Ventura-Ríos, Lucio; Aceves-Avila, Francisco J; Bernard-Medina, Ana G; Goycochea-Robles, María V; Hernández-Garduño, Adolfo; Burgos-Vargas, Rubén; Shumski, Clara; Garza-Elizondo, Mario; Ramos-Remus, César; Espinoza-Villalpando, Jesús; Alvarez-Hernández, Everardo; Flores-Alvarado, Diana; Rodríguez-Amado, Jaquelin; Casasola-Vargas, Julio; Skinner-Taylor, Cassandra

2008-01-01

To estimate the social costs of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and gout from the patient's perspective. We carried out a cross-sectional analysis of the cost and resource utilization of 690 RA, AS, and gout patients from 10 medical centers and private facilities in five cities of Mexico. The information was obtained from the baseline of a dynamic cohort. We estimated out-of-pocket expenses, institutional direct costs, and direct medical costs. The mean (SD) annual out-of-pocket expense (USD) was $610.0 ($302.2) for RA, $578.6 ($220.5) for AS, and $245.3 ($124.0) for gout. Figures correspond to 15%, 9.6%, and 2.5% of the family income. They also represented 26.1%, 25.3%, and 24.4% of the total annual cost per RA, AS, and gout patients, respectively. The expected direct institutional patient/year costs were 1,724.2 for RA, $1,710.8 for AS, and $760.7 for gout. The total patient annual costs were $2,334.3 for RA, $2,289.4 for AS, and $1,006.1 for gout. Most out-of-pocket expenses were used to purchase drugs, pay for laboratory tests, imaging studies, and alternative therapies. From the patient's perspective, the cost of RA, AS, and gout represents 25% of direct medical costs. The cost of RA is higher than that for AS and gout.

Comparative financial analysis of laparoscopic pelvic lymph node dissection performed in 1990-1992 v 1993-1994.

PubMed

Troxel, S A; Winfield, H N

1996-08-01

In 1994, it was reported that laparoscopic pelvic lymph node dissection (L-PLND) was US $1350 more expensive than open pelvic lymph node dissection (O-PLND) for the staging of prostate cancer. Despite the lower postoperative expenses associated with L-PLND, the intraoperative expenditures were 52% higher, primarily because of the prolonged operating time and the cost of disposable instrumentation. The objective of the present study was to determine if, with increasing laparoscopic experience and a more competitive surgical supply market, the intraoperative as well as the overall hospital expenses would diminish. The study population consisted of 105 men who underwent staging L-PLND for cancer of the prostate. Group I was composed of 50 patients who underwent surgery between 1990 and 1992, and Group II consisted of 55 patients operated on in 1993 and 1994. All hospital-related expenses were reorganized into preoperative, intraoperative, and postoperative and subsequently corrected for inflationary changes to a base year of 1993-1994. The total overall expenses of the two groups were similar, differing by only $65. Despite a lowering of preoperative and postoperative expenses in the 1993-1994 group by 112% and 31%, respectively, the intraoperative expenses were still $571 higher. The operative time decreased by 19 minutes in the contemporary group, but the expense of surgical supplies continued to increase up to $910 (104%) more than the 1990-1992 group. It is hoped that the use of "laparoscopic kits" as well hospital equipment consortiums will help slow the escalating costs of surgical care. However, it is the responsibility of the laparoscopic surgeon to demonstrate that these procedures are as safe, efficient, and cost-effective as their open counterpart.

Innovative hybrid pile oscillator technique in the Minerve reactor: open loop vs. closed loop

NASA Astrophysics Data System (ADS)

Geslot, Benoit; Gruel, Adrien; Bréaud, Stéphane; Leconte, Pierre; Blaise, Patrick

2018-01-01

Pile oscillator techniques are powerful methods to measure small reactivity worth of isotopes of interest for nuclear data improvement. This kind of experiments has long been implemented in the Mineve experimental reactor, operated by CEA Cadarache. A hybrid technique, mixing reactivity worth estimation and measurement of small changes around test samples is presented here. It was made possible after the development of high sensitivity miniature fission chambers introduced next to the irradiation channel. A test campaign, called MAESTRO-SL, took place in 2015. Its objective was to assess the feasibility of the hybrid method and investigate the possibility to separate mixed neutron effects, such as fission/capture or scattering/capture. Experimental results are presented and discussed in this paper, which focus on comparing two measurements setups, one using a power control system (closed loop) and another one where the power is free to drift (open loop). First, it is demonstrated that open loop is equivalent to closed loop. Uncertainty management and methods reproducibility are discussed. Second, results show that measuring the flux depression around oscillated samples provides valuable information regarding partial neutron cross sections. The technique is found to be very sensitive to the capture cross section at the expense of scattering, making it very useful to measure small capture effects of highly scattering samples.

Experiment Needs and Facilities Study Appendix A Transient Reactor Test Facility (TREAT) Upgrade

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

None

The TREAT Upgrade effort is designed to provide significant new capabilities to satisfy experiment requirements associated with key LMFBR Safety Issues. The upgrade consists of reactor-core modifications to supply the physics performance needed for the new experiments, an Advanced TREAT loop with size and thermal-hydraulics capabilities needed for the experiments, associated interface equipment for loop operations and handling, and facility modifications necessary to accommodate operations with the Loop. The costs and schedules of the tasks to be accomplished under the TREAT Upgrade project are summarized. Cost, including contingency, is about 10 million dollars (1976 dollars). A schedule for execution ofmore » 36 months has been established to provide the new capabilities in order to provide timely support of the LMFBR national effort. A key requirement for the facility modifications is that the reactor availability will not be interrupted for more than 12 weeks during the upgrade. The Advanced TREAT loop is the prototype for the STF small-bundle package loop. Modified TREAT fuel elements contain segments of graphite-matrix fuel with graded uranium loadings similar to those of STF. In addition, the TREAT upgrade provides for use of STF-like stainless steel-UO{sub 2} TREAT fuel for tests of fully enriched fuel bundles. This report will introduce the Upgrade study by presenting a brief description of the scope, performance capability, safety considerations, cost schedule, and development requirements. This work is followed by a "Design Description". Because greatly upgraded loop performance is central to the upgrade, a description is given of Advanced TREAT loop requirements prior to description of the loop concept. Performance requirements of the upgraded reactor system are given. An extensive discussion of the reactor physics calculations performed for the Upgrade concept study is provided. Adequate physics performance is essential for performance of experiments with the Advanced TREAT loop, and the stress placed on these calculations reflects this. Additional material on performance and safety is provided. Backup calculations on calculations of plutonium-release limits are described. Cost and schedule information for the Upgrade are presented.« less

11 CFR 106.4 - Allocation of polling expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 11 Federal Elections 1 2010-01-01 2010-01-01 false Allocation of polling expenses. 106.4 Section... ACTIVITIES § 106.4 Allocation of polling expenses. (a) The purchase of opinion poll results by a candidate or... cost allocation formula of the polling firm from which the results are purchased. Under this method the...

25 CFR 700.165 - Ineligible moving and related expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... expenses. A displaced person is not entitled to payment for— (a) The cost of moving any structure or other...) Physical changes at replacement location of business, farm or nonprofit organization, except as provided at § 700.157; or (g) Any additional expense of a business, farm, or nonprofit organization incurred because...

Assessing present and future capital expense levels under PPS.

PubMed

Cleverley, W O

1986-09-01

The expected shift in the method of payment for capital costs will affect the way decisions are made by hospital executives. The capital expense ratio model is one way executives can better assess their present and future capital expense levels as payments begin to be made under a prospective payment system.

9 CFR 354.106 - Travel expenses and other charges.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Travel expenses and other charges. 354.106 Section 354.106 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... § 354.106 Travel expenses and other charges. Charges are to be made to cover the cost of travel and...

20 CFR 416.976 - Impairment-related work expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Impairment-related work expenses. 416.976... Impairment-related work expenses. (a) General. When we figure your earnings in deciding if you have done...), you need and use to enable you to work. The costs are deductible even though you also need or use the...

20 CFR 404.1576 - Impairment-related work expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Impairment-related work expenses. 404.1576... Impairment-related work expenses. (a) General. When we figure your earnings in deciding if you have done..., because of your impairment(s), you need and use to enable you to work. The costs are deductible even...

34 CFR 21.33 - Allowable fees and expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Allowable fees and expenses. 21.33 Section 21.33 Education Office of the Secretary, Department of Education EQUAL ACCESS TO JUSTICE How Does One Apply for an... expenses. (3) The cost of any study, analysis, engineering report, test, or project related to the...

Developmental Education: The Cost Literature and What We Can Learn from It

ERIC Educational Resources Information Center

Saxon, D. Patrick

2017-01-01

Developmental education is often criticized for its expense. Some believe that it represents a failure of secondary education and is, therefore, a redundant expense. Others believe that developmental education serves a vital role in preparing students for college and is, therefore, a necessary expense. This article provides a review of the…

11 CFR 104.10 - Reporting by separate segregated funds and nonconnected committees of expenses allocated among...

Code of Federal Regulations, 2010 CFR

2010-01-01

... administrative expenses and its costs for fundraising, generic voter drives, and certain public communications... voter drives and public communications that refer to any political party. In each report disclosing a disbursement for administrative expenses, generic voter drives, or public communications that refer to any...

11 CFR 104.10 - Reporting by separate segregated funds and nonconnected committees of expenses allocated among...

Code of Federal Regulations, 2012 CFR

2012-01-01

... administrative expenses and its costs for fundraising, generic voter drives, and certain public communications... voter drives and public communications that refer to any political party. In each report disclosing a disbursement for administrative expenses, generic voter drives, or public communications that refer to any...

11 CFR 104.10 - Reporting by separate segregated funds and nonconnected committees of expenses allocated among...

Code of Federal Regulations, 2013 CFR

2013-01-01

... administrative expenses and its costs for fundraising, generic voter drives, and certain public communications... voter drives and public communications that refer to any political party. In each report disclosing a disbursement for administrative expenses, generic voter drives, or public communications that refer to any...

11 CFR 104.10 - Reporting by separate segregated funds and nonconnected committees of expenses allocated among...

Code of Federal Regulations, 2014 CFR

2014-01-01

... administrative expenses and its costs for fundraising, generic voter drives, and certain public communications... voter drives and public communications that refer to any political party. In each report disclosing a disbursement for administrative expenses, generic voter drives, or public communications that refer to any...

11 CFR 104.10 - Reporting by separate segregated funds and nonconnected committees of expenses allocated among...

Code of Federal Regulations, 2011 CFR

2011-01-01

... administrative expenses and its costs for fundraising, generic voter drives, and certain public communications... voter drives and public communications that refer to any political party. In each report disclosing a disbursement for administrative expenses, generic voter drives, or public communications that refer to any...

18 CFR 367.9030 - Account 903, Customer records and collection expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Account 903, Customer records and collection expenses. 367.9030 Section 367.9030 Conservation of Power and Water Resources..., Customer records and collection expenses. (a) This account must include the cost of labor, materials used...

18 CFR 367.9030 - Account 903, Customer records and collection expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Account 903, Customer records and collection expenses. 367.9030 Section 367.9030 Conservation of Power and Water Resources..., Customer records and collection expenses. (a) This account must include the cost of labor, materials used...

18 CFR 367.9030 - Account 903, Customer records and collection expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Account 903, Customer records and collection expenses. 367.9030 Section 367.9030 Conservation of Power and Water Resources..., Customer records and collection expenses. (a) This account must include the cost of labor, materials used...

18 CFR 367.9030 - Account 903, Customer records and collection expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Account 903, Customer records and collection expenses. 367.9030 Section 367.9030 Conservation of Power and Water Resources..., Customer records and collection expenses. (a) This account must include the cost of labor, materials used...

Preoperative localization strategies for primary hyperparathyroidism: an economic analysis.

PubMed

Lubitz, Carrie C; Stephen, Antonia E; Hodin, Richard A; Pandharipande, Pari

2012-12-01

Strategies for localizing parathyroid pathology preoperatively vary in cost and accuracy. Our purpose was to compute and compare comprehensive costs associated with common localization strategies. A decision-analytic model was developed to evaluate comprehensive, short-term costs of parathyroid localization strategies for patients with primary hyperparathyroidism. Eight strategies were compared. Probabilities of accurate localization were extracted from the literature, and costs associated with each strategy were based on 2011 Medicare reimbursement schedules. Differential cost considerations included outpatient versus inpatient surgeries, operative time, and costs of imaging. Sensitivity analyses were performed to determine effects of variability in key model parameters upon model results. Ultrasound (US) followed by 4D-CT was the least expensive strategy ($5,901), followed by US alone ($6,028), and 4D-CT alone ($6,110). Strategies including sestamibi (SM) were more expensive, with associated expenditures of up to $6,329 for contemporaneous US and SM. Four-gland, bilateral neck exploration (BNE) was the most expensive strategy ($6,824). Differences in cost were dependent upon differences in the sensitivity of each strategy for detecting single-gland disease, which determined the proportion of patients able to undergo outpatient minimally invasive parathyroidectomy. In sensitivity analysis, US alone was preferred over US followed by 4D-CT only when both the sensitivity of US alone for detecting an adenoma was ≥ 94 %, and the sensitivity of 4D-CT following negative US was ≤ 39 %. 4D-CT alone was the least costly strategy when US sensitivity was ≤ 31 %. Among commonly used strategies for preoperative localization of parathyroid pathology, US followed by selective 4D-CT is the least expensive.

Distributed Kalman filtering compared to Fourier domain preconditioned conjugate gradient for laser guide star tomography on extremely large telescopes.

PubMed

Gilles, Luc; Massioni, Paolo; Kulcsár, Caroline; Raynaud, Henri-François; Ellerbroek, Brent

2013-05-01

This paper discusses the performance and cost of two computationally efficient Fourier-based tomographic wavefront reconstruction algorithms for wide-field laser guide star (LGS) adaptive optics (AO). The first algorithm is the iterative Fourier domain preconditioned conjugate gradient (FDPCG) algorithm developed by Yang et al. [Appl. Opt.45, 5281 (2006)], combined with pseudo-open-loop control (POLC). FDPCG's computational cost is proportional to N log(N), where N denotes the dimensionality of the tomography problem. The second algorithm is the distributed Kalman filter (DKF) developed by Massioni et al. [J. Opt. Soc. Am. A28, 2298 (2011)], which is a noniterative spatially invariant controller. When implemented in the Fourier domain, DKF's cost is also proportional to N log(N). Both algorithms are capable of estimating spatial frequency components of the residual phase beyond the wavefront sensor (WFS) cutoff frequency thanks to regularization, thereby reducing WFS spatial aliasing at the expense of more computations. We present performance and cost analyses for the LGS multiconjugate AO system under design for the Thirty Meter Telescope, as well as DKF's sensitivity to uncertainties in wind profile prior information. We found that, provided the wind profile is known to better than 10% wind speed accuracy and 20 deg wind direction accuracy, DKF, despite its spatial invariance assumptions, delivers a significantly reduced wavefront error compared to the static FDPCG minimum variance estimator combined with POLC. Due to its nonsequential nature and high degree of parallelism, DKF is particularly well suited for real-time implementation on inexpensive off-the-shelf graphics processing units.

F-16 Instructional Sequencing Plan Report.

DTIC Science & Technology

1981-03-01

information). 2. Interference (learning of some tasks interferes with the learning of other tasks when they possess similar but confusing differences ...profound effect on the total training expense. This increases the desirability of systematic, precise methods of syllabus generation. Inherent in a given...the expensive to acquire. resource. Least cost The syllabus must Select sequences which provide a least total make maximum use of cost method of

Getting It Right: An Assessment of Several Methods for Calculating Regional School Costs across New York State.

ERIC Educational Resources Information Center

Widerquist, Karl

Despite having its most expensive district spend 1.56 times more than its least expensive district, the state of New York has not used a cost index to determine the distribution of aid to school districts, except for Building Aid. The Consumer Price Index (as suggested by the Regents, Governor Pataki, State Comptroller McCall, and the Midstate…

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

Fang, Xiao; Blazek, Jonathan A.; McEwen, Joseph E.

Cosmological perturbation theory is a powerful tool to predict the statistics of large-scale structure in the weakly non-linear regime, but even at 1-loop order it results in computationally expensive mode-coupling integrals. Here we present a fast algorithm for computing 1-loop power spectra of quantities that depend on the observer's orientation, thereby generalizing the FAST-PT framework (McEwen et al., 2016) that was originally developed for scalars such as the matter density. This algorithm works for an arbitrary input power spectrum and substantially reduces the time required for numerical evaluation. We apply the algorithm to four examples: intrinsic alignments of galaxies inmore » the tidal torque model; the Ostriker-Vishniac effect; the secondary CMB polarization due to baryon flows; and the 1-loop matter power spectrum in redshift space. Code implementing this algorithm and these applications is publicly available at https://github.com/JoeMcEwen/FAST-PT.« less

Cost Comparison of Fundamentals of Laparoscopic Surgery Training Completed With Standard Fundamentals of Laparoscopic Surgery Equipment versus Low-Cost Equipment.

PubMed

Franklin, Brenton R; Placek, Sarah B; Wagner, Mercy D; Haviland, Sarah M; O'Donnell, Mary T; Ritter, E Matthew

Training for the Fundamentals of Laparoscopic Surgery (FLS) skills test can be expensive. Previous work demonstrated that training on an ergonomically different, low-cost platform does not affect FLS skills test outcomes. This study compares the average training cost with standard FLS equipment and medical-grade consumables versus training on a lower cost platform with non-medical-grade consumables. Subjects were prospectively randomized to either the standard FLS training platform (n = 19) with medical-grade consumables (S-FLS), or the low-cost platform (n = 20) with training-grade products (LC-FLS). Both groups trained to proficiency using previously established mastery learning standards on the 5 FLS tasks. The fixed and consumable cost differences were compared. Training occurred in a surgical simulation center. Laparoscopic novice medical student and resident physician health care professionals who had not completed the national FLS proficiency curriculum and who had performed less than 10 laparoscopic cases. The fixed cost of the platform was considerably higher in the S-FLS group (S-FLS, $3360; LC-FLS, $879), and the average consumable training cost was significantly higher for the S-FLS group (S-FLS, $1384.52; LC-FLS, $153.79; p < 0.001). The LC-FLS group had a statistically discernable cost reduction for each consumable (Gauze $9.24 vs. $0.39, p = 0.002; EndoLoop $540.00 vs. $40.60, p < 0.001; extracorporeal suture $216.45 vs. $25.20, p < 0.001; intracorporeal suture $618.83 vs. $87.60, p < 0.001). The annual fixed and consumable cost to train 5 residents is $10,282.60 in the S-FLS group versus $1647.95 in the LC-FLS group. This study shows that the average cost to train a single trainee to proficiency using a lower fixed-cost platform and non-medical-grade equipment results in significant financial savings. A 5-resident program will save approximately $8500 annually. Residency programs should consider adopting this strategy to reduce the cost of FLS training. Published by Elsevier Inc.

40 CFR 304.41 - Administrative fees, expenses, and Arbitrator's fee.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS ARBITRATION PROCEDURES FOR SMALL SUPERFUND COST RECOVERY CLAIMS Other Provisions § 304.41 Administrative fees, expenses, and Arbitrator's fee...

40 CFR 304.41 - Administrative fees, expenses, and Arbitrator's fee.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS ARBITRATION PROCEDURES FOR SMALL SUPERFUND COST RECOVERY CLAIMS Other Provisions § 304.41 Administrative fees, expenses, and Arbitrator's fee...

40 CFR 304.41 - Administrative fees, expenses, and Arbitrator's fee.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS ARBITRATION PROCEDURES FOR SMALL SUPERFUND COST RECOVERY CLAIMS Other Provisions § 304.41 Administrative fees, expenses, and Arbitrator's fee...

Building America Case Study: Simplified Air Distribution, Desuperheaters, and Sub-Slab Geothermal Heat Exchangers, Pittsburgh, Pennsylvania

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

This report presents a cold-climate project that examines an alternative approach to ground source heat pump (GSHP) ground loop design. The innovative ground loop design is an attempt to reduce the installed cost of the ground loop heat exchange portion of the system by containing the entire ground loop within the excavated location beneath the basement slab.

Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis.

PubMed

Cabot, Jennifer C; Lee, Cho Rok; Brunaud, Laurent; Kleiman, David A; Chung, Woong Youn; Fahey, Thomas J; Zarnegar, Rasa

2012-12-01

This study presents a cost analysis of the standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy approaches based on medical costs in the United States. A retrospective review of 140 patients who underwent standard cervical, transaxillary endoscopic, or transaxillary robotic thyroidectomy at 2 tertiary centers was conducted. The cost model included operating room charges, anesthesia fee, consumables cost, equipment depreciation, and maintenance cost. Sensitivity analyses assessed individual cost variables. The mean operative times for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were 121 ± 18.9, 185 ± 26.0, and 166 ± 29.4 minutes, respectively. The total cost for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were $9,028 ± $891, $12,505 ± $1,222, and $13,670 ± $1,384, respectively. Transaxillary approaches were significantly more expensive than the standard cervical technique (standard cervical/transaxillary endoscopic, P < .0001; standard cervical/transaxillary robotic, P < .0001; and transaxillary endoscopic/transaxillary robotic, P = .001). The transaxillary and standard cervical techniques became equivalent in cost when transaxillary endoscopic operative time decreased to 111 minutes and transaxillary robotic operative time decreased to 68 minutes. Increasing the case load did not resolve the cost difference. Transaxillary endoscopic and transaxillary robotic thyroidectomies are significantly more expensive than the standard cervical approach. Decreasing operative times reduces this cost difference. The greater expense may be prohibitive in countries with a flat reimbursement schedule. Copyright © 2012 Mosby, Inc. All rights reserved.

Physician Awareness of Drug Cost: A Systematic Review

PubMed Central

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

2007-01-01

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

Physician awareness of drug cost: a systematic review.

PubMed

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

2007-09-01

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

Competition in health care. Where it has failed and why.

PubMed

Mittler, B S

1988-12-01

During the 1980s, it was expected that competition and deregulation would render health care more efficient and less expensive, but these measures have not worked. Rather, hospitals have become more expensive, HMO costs are increasing as fast as those for fee-for-service practices, access to care has deteriorated, cost-containment policies have reduced quality of care, and government regulation has increased instead of decreased. Examined in detail is the failure of supermeds (giant hospital corporations), HMOs, and marketing and advertising to lower costs and increase efficiency. The author discusses reasons why these methods failed and proposes solutions to the problems of rising health care costs.

Understanding and Controlling Cost in Total Joint Arthroplasty.

PubMed

Alvarado, Carlos M; Bosco, Joseph

2015-06-01

Total joint arthrosplasty (TJA) is both a commonly performed successful intervention and an expensive procedure.As our population ages, the expense of these interventions is expected to grow and hence its impact on healthcare costs will also grow. To ensure that TJA is available to all those who would benefit, it is incumbent that healthcare providers control the cost of these procedures. As orthopaedic surgeons, we must be at the forefront of this effort. The purpose of this review is to outline strategies to control or even decrease TJA cost without negatively affecting outcomes.This concept is at the center of value-based medicine and must guide our decision-making processes.

Cost-effectiveness of alternative outpatient pelvic inflammatory disease treatment strategies.

PubMed

Smith, Kenneth J; Ness, Roberta B; Wiesenfeld, Harold C; Roberts, Mark S

2007-12-01

Effectiveness differences between outpatient pelvic inflammatory disease (PID) treatment regimens are uncertain, but significant differences in cost exist. To examine the influence of antibiotic costs on PID therapy cost-effectiveness. The authors used a Markov decision model to estimate the cost-effectiveness of recommended antibiotic regimens for PID and performed a value of information analysis to guide future research. Antibiotic costs vary between USD 43 and USD188. Pairwise comparisons, assuming a hypothetical 1% relative risk reduction in PID complications with the more expensive regimen, showed economically reasonable cost-effectiveness ratios. Value of information and sample size considerations support further investigation to detect 10% PID complication rate differences between regimens with >or=USD 50 cost differences. Within the cost range of recommended regimens, use of more expensive antibiotics would be economically reasonable if relatively small decreases in PID complication rates exist. Further investigation of effectiveness differences between regimens is needed.

Current trends in health insurance systems: OECD countries vs. Japan.

PubMed

Sasaki, Toshiyuki; Izawa, Masahiro; Okada, Yoshikazu

2015-01-01

Over the past few decades, the longest extension in life expectancy in the world has been observed in Japan. However, the sophistication of medical care and the expansion of the aging society, leads to continuous increase in health-care costs. Medical expenses as a part of gross domestic product (GDP) in Japan are exceeding the current Organization for Economic Co-operation and Development (OECD) average, challenging the universally, equally provided low cost health care existing in the past. A universal health insurance system is becoming a common system currently in developed countries, currently a similar system is being introduced in the United States. Medical care in Japan is under a social insurance system, but the injection of public funds for medical costs becomes very expensive for the Japanese society. In spite of some urgently decided measures to cover the high cost of advanced medical treatment, declining birthrate and aging population and the tendency to reduce hospital and outpatients' visits numbers and shorten hospital stays, medical expenses of Japan continue to be increasing.

The immediate economic impact of maternal deaths on rural Chinese households.

PubMed

Ye, Fang; Wang, Haijun; Huntington, Dale; Zhou, Hong; Li, Yan; You, Fengzhi; Li, Jinhua; Cui, Wenlong; Yao, Meiling; Wang, Yan

2012-01-01

To identify the immediate economic impact of maternal death on rural Chinese households. Results are reported from a study that matched 195 households who had suffered a maternal death to 384 households that experienced a childbirth without maternal death in rural areas of three provinces in China, using quantitative questionnaire to compare differences of direct and indirect costs between two groups. The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001). More than 40% of the direct costs were attributed to funeral expenses. Hospitalization and emergency care expenses were the largest proportion of non-funeral direct costs and were higher in households with maternal death than the comparison group (US$2,248 vs. $305, p<0.001). To cover most of the high direct costs, 44.1% of affected households utilized compensation from hospitals, and the rest affected households (55.9%) utilized borrowing money or taking loans as major source of money to offset direct costs. The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic. The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.

[Financial impact of introducing filmless CRT diagnosis].

PubMed

Kusakabe, Yukihiro

2002-09-01

There has been a great deal of discussion as to the cost and benefit of introducing filmless CRT diagnosis for radiological exams. Although the various advantages of the filmless system tend to be highlighted, very few studies have attempted to provide a quantitative estimate of the degree of impact. We analyzed the potential financial impact on the cost of film management (film development, maintenance, and transportation) if CRT diagnosis were to be introduced in Seirei Hamamatsu Hospital. In conducting this analysis, we assumed that CRT diagnosis initially would be limited to CT and MR. The analysis demonstrated that the actual yearly cost of managing films amounts to about 240 million yen. As individual items, the cost of film materials, labor, and depreciation of assets were the three largest cost sectors, with the cost of film accounting for more than 30% of the total. The expense attributable to CT and MR exams was roughly half of the total cost. Against this level of expense, the expected savings in the first year after shifting to the filmless system would be 100 million yen, or a 36% reduction in current expenses. This savings reflects various effects of system change, including lack of need for related materials, reduction in staff workload, elimination of unnecessary equipment, etc. Under the simulation we conducted, 70% of savings occurred in the area of variable costs and 30% in the area of fixed costs.

Ultra-low-cost 3D gaze estimation: an intuitive high information throughput compliment to direct brain-machine interfaces

NASA Astrophysics Data System (ADS)

Abbott, W. W.; Faisal, A. A.

2012-08-01

Eye movements are highly correlated with motor intentions and are often retained by patients with serious motor deficiencies. Despite this, eye tracking is not widely used as control interface for movement in impaired patients due to poor signal interpretation and lack of control flexibility. We propose that tracking the gaze position in 3D rather than 2D provides a considerably richer signal for human machine interfaces by allowing direct interaction with the environment rather than via computer displays. We demonstrate here that by using mass-produced video-game hardware, it is possible to produce an ultra-low-cost binocular eye-tracker with comparable performance to commercial systems, yet 800 times cheaper. Our head-mounted system has 30 USD material costs and operates at over 120 Hz sampling rate with a 0.5-1 degree of visual angle resolution. We perform 2D and 3D gaze estimation, controlling a real-time volumetric cursor essential for driving complex user interfaces. Our approach yields an information throughput of 43 bits s-1, more than ten times that of invasive and semi-invasive brain-machine interfaces (BMIs) that are vastly more expensive. Unlike many BMIs our system yields effective real-time closed loop control of devices (10 ms latency), after just ten minutes of training, which we demonstrate through a novel BMI benchmark—the control of the video arcade game ‘Pong’.

Association of prescription abandonment with cost share for high-cost specialty pharmacy medications.

PubMed

Gleason, Patrick P; Starner, Catherine I; Gunderson, Brent W; Schafer, Jeremy A; Sarran, H Scott

2009-10-01

In 2008, specialty medications accounted for 15.1% of total pharmacy benefit medication spending, and per member expenditures have increased by 11.1% annually from 2004 to 2008 within a commercially insured population of 8 million members. Insurers face increasing pressure to control specialty medication expenditures and to rely on increasing member cost share through creation of a fourth copayment tier within the incentive-based formulary pharmacy benefit system. Data are needed on the influence that member out-of-pocket (OOP) expense may have on prescription abandonment (defined as the patient never actually taking possession of the medication despite evidence of a written prescription generated by a prescriber). To explore the relationship between prescription abandonment and OOP expense among individuals newly initiating high-cost medication therapy with a tumor necrosis factor (TNF) blocker or multiple sclerosis (MS) biologic agent. This observational cross-sectional study queried a midwestern and southern U.S. database of 13,172,480 commercially insured individuals to find members with a pharmacy benefit-adjudicated claim for a TNF blocker or MS specialty medication during the period from July 2006 through June 2008. Prescription abandonment was assessed among continuously enrolled members newly initiating TNF blocker or MS therapy. Prescription abandonment was defined as reversal of the adjudicated claim with no evidence of a subsequent additional adjudicated paid claim in the ensuing 90 days. Separate analyses for MS and TNF blocker therapy were performed to assess the association between member OOP expense and abandonment rate using the Cochran-Armitage test for trend and multivariate logistic regression. Members were placed into 1 of the 7 following OOP expense groups per claim: $0-$100, $101-$150, $151-$200, $201-$250, $251-$350, $351-$500, or more than $500. The association of MS or TNF blocker abandonment rate with OOP expense was tested with logistic regression models using the $0-$100 OOP as the reference group and adjusting for age, gender, formulary status, ZIP code-level income and education, earliest specialty medication claim, and methotrexate use for the TNF blocker analysis. Of 2,791 members presenting a prescription to newly initiate high-cost MS therapy, 1,985 (71.1%) of the claims were for a 1-month supply with most of the remainder for a 3-month supply; 2,303 (82.5%) had an OOP expense of $0-$100, and 5.4% had an OOP expense greater than $500. The abandonment rate increased as OOP increased (test for trend, P < 0.001). Members with an OOP expense of $100 or less had an abandonment rate of 5.7%. Among members in all OOP expense groups greater than $200, the abandonment rate was significantly higher, with more than 1 in 4 members abandoning their MS claims (P < 0.001). In the multivariate logistic regression analysis, the abandonment rate became significantly higher at OOP expenses of $201 to $250 compared with an OOP expense of $100 or less (odds ratio [OR] = 7.3, 95% confidence interval [CI] = 3.3- 16.2). The odds ratios ranged between 6.1 and 7.3 for OOP expense groups greater than $200. Of 7,313 members presenting a prescription to newly initiate TNF blocker therapy, 5,809 (79.4%) of claims were for a 1-month supply with most of the remainder for a 3-month supply; 6,123 (83.7%) had an OOP expense of $0-$100 and 5.7% had an OOP expense greater than $500. The abandonment rate increased as OOP expense increased (test for trend, P < 0.001). In the multivariate logistic regression analysis, the TNF blocker medication abandonment rate was significantly higher for all OOP expense groups greater than $100, with abandonment odds ratios of 2.3 to 4.4 for OOP expense between $101 and $500 compared with OOP expense of $0-$100. The odds of abandonment at OOP expense of greater than $500 were 7-fold higher (OR = 7.0, 95% CI = 5.4-9.1). This is the first study to perform a focused assessment of an association between specialty medication OOP expense and new therapy prescription abandonment. The study found that per claim OOP expenses greater than $100 for TNF blocker medication and greater than $200 for MS medication were associated with increased prescription abandonment. These findings coupled with previous research identifying a negative relationship between OOP expense above $100 per month and adherence, and the commercial insurance market response to fourth-tier OOP expenses, suggests that insurers should consider the impact that specialty OOP expense may have on adherence and member satisfaction. Further prospective research should be performed to confirm these findings and assess the clinical outcomes associated with prescription abandonment.

Superheat recovery system shakes savings out of A/C systems

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

Not Available

1985-09-01

One of the most productive and least expensive methods of recovering waste heat is a system that reclaims the excess energy or superheat generated by closed-loop-air conditioning or refrigeration cycles. Installed recently in 72 Steak N' Shakes restaurants as part of a total energy conservation package, it has helped cut gas bills by more than 70%.

7 CFR 28.120 - Expenses to be borne by party requesting classification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... United States Cotton Standards Act Fees and Costs § 28.120 Expenses to be borne by party requesting...

26 CFR 1.162-6 - Professional expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... expenses. A professional man may claim as deductions the cost of supplies used by him in the practice of... the hire of office assistance. Amounts currently paid or accrued for books, furniture, and...

Out-of-pocket expenses for maternity care in rural Bangladesh: a public-private comparison.

PubMed

Rahman, Moshiur; Rob, Ubaidur; Noor, Forhana Rahman; Bellows, Benjamin

Out-of-pocket expenses incurred by women for availing maternal healthcare services at public and private health facilities in Bangladesh were examined using a baseline household survey evaluating the impact of demand side financing vouchers on utilization and service delivery for maternal healthcare. The survey was conducted in 2010 among 3,300 women who gave birth in the previous 12 months from the start of data collection. Information on costs incurred to receive antenatal, delivery, and postnatal care services was collected. Findings reveal that the majority of women reported paying out-of-pocket expenses for availing maternal healthcare services both at public and private health facilities. Out-of-pocket expenses include registration, consultation, laboratory examination, medicine, transportation, and other associated costs incurred for receiving maternal healthcare services. On average, women paid US$3.60 out-of-pocket expenses for receiving antenatal care at public health facilities and US$12.40 at private health facilities. Similarly, women paid one and half times more for normal (US$42.30) and cesarean deliveries (US$136.20) at private health facilities compared to public health facilities. On the other hand, costs for postnatal care services did not vary significantly between public and private health facilities. Utilization of maternal healthcare services can be improved if out-of-pocket expenses can be minimized. At the same time, effective demand generation strategies are necessary to encourage women to utilize health facilities.

26 CFR 20.2053-3 - Deduction for expenses of administering estate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Taxable Estate... permitted by § 20.2053-1 even though the deduction, as such, was not claimed on the estate tax return or in... expenses include such expenses as court costs, surrogates' fees, accountants' fees, appraisers' fees, clerk...

A Study of Ship Acquisition Cost Estimating in the Naval Sea Systems Command. Appendices

DTIC Science & Technology

1977-10-01

Shipbuilding Is A Heovy Fabrication Industry Pro- ducing Small Numbers Of Expensive, Complex Units Of Output PAGE A-2 (1) Due to its heavy ...estimate future ship construction costs. - A-l 1. SHIPBUILDING IS A HEAVY FABRICATION INDUSTRY PRODUCING SMALL NUMBERS OF EXPENSIVE, COMPLEX...extensively in production line industries such as automotive products and the airframe industry. (1) Due To Its Heavy Construction Orientation

Digital Phase Meter for a Laser Heterodyne Interferometer

NASA Technical Reports Server (NTRS)

Loya, Frank

2008-01-01

The Digital Phase Meter is based on a modified phase-locked loop. When phase alignment between the reference input and the phase-shifted metrological input is achieved, the loop locks and the phase shift of the digital phase shifter equals the phase difference that one seeks to measure. This digital phase meter is being developed for incorporation into a laser heterodyne interferometer in a metrological apparatus, but could also be adapted to other uses. Relative to prior phase meters of similar capability, including digital ones, this digital phase meter is smaller, less complex, and less expensive. The phase meter has been constructed and tested in the form of a field-programmable gate array (FPGA).

A comparative study of orphan drug prices in Europe

PubMed Central

Young, Katherine Eve; Soussi, Imen; Hemels, Michiel; Toumi, Mondher

2017-01-01

ABSTRACT Background and Objective: This study assessed price differences by comparing annual treatment costs of similarly available orphan drugs in France, Germany, Italy, Norway, Spain, Sweden, and UK. Methods: Annual treatment costs per drug were calculated using ex-factory prices from IHS POLI and country price databases. The treatment cost in the comparator country was compared to the UK and ratios were analysed. Subanalyses were done on disease areas and UK cost quartiles. Results: 120 orphan drugs were included. Compared to the UK, the average costs were more expensive in France (1.13), Germany (1.11), Italy (1.08), Spain (1.07), and were cheaper in Sweden (0.99) and Norway (0.88). The average ratios offered a restrictive view as ratios were greatly heterogeneous (0.26 to 1.92) which was also seen in the different disease areas. The averaged ratios varied minimally among the cost quartiles which shows that cost differences were similar for the most expensive and least expensive orphan drugs in the UK. Conclusions: Individual orphan drug prices can vary widely across European countries, although on average these differences are relatively minor. This study suggests that in Europe, we may not be able predict which country may have higher or lower prices for orphan drugs. PMID:28473887

Economic implications of resistance to antimalarial drugs.

PubMed

Phillips, M; Phillips-Howard, P A

1996-09-01

The widespread evolution of drug resistance in malarial parasites has seriously hampered efforts to control this debilitating disease. Chloroquine, the mainstay of malaria treatment for many decades, is now proving largely ineffective in many parts of the world, particularly against the most severe form of malaria--falciparum. Alternative drugs have been developed, but they are frequently less safe and are all between 50 and 700% more expensive than chloroquine. Choice of drug clearly has important budgetary implications and national malaria control programmes need to weigh up the costs and benefits in deciding whether to change to more effective but more expensive drugs. The growth in drug resistance also has implications for the choice of diagnostic tool. Clinical diagnosis of malaria is relatively cheap, but less specific than some technological approaches. As more expensive drugs are employed, the cost of wasted treatment on suspected cases who do not in fact have malaria rises and the more worthwhile it becomes to invest in more specific diagnostic techniques. This paper presents an economic framework for analysing the various malaria drug and diagnostic tool options available. It discusses the nature of the key factors that need to be considered when making choices of malaria treatment (including treatment costs, drug resistance, the costs of treatment failure and compliance) and diagnosis (including diagnosis cost and accuracy, and the often overlooked costs associated with delayed treatment), and uses some simple equations to illustrate the impact of these on the relative cost effectiveness of the alternatives being considered. On the basis of some simplifying assumptions and illustrative calculations, it appears that in many countries more effective drugs and more specific and rapid diagnostic approaches will be worth adopting even although they imply additional expense.

Estimating patient-borne water and electricity costs in home hemodialysis: a simulation

PubMed Central

Nickel, Matthew; Rideout, Wes; Shah, Nikhil; Reintjes, Frances; Chen, Justin Z.; Burrell, Robert; Pauly, Robert P.

2017-01-01

Background: Home hemodialysis is associated with lower costs to the health care system compared with conventional facility-based hemodialysis because of lower staffing and overhead costs, and by transferring the treatment cost of utilities (water and power) to the patient. The purpose of this study was to determine the utility costs of home hemodialysis and create a formula such that patients and renal programs can estimate the annual patient-borne costs involved with this type of treatment. Methods: Seven common combinations of treatment duration and dialysate flows were replicated 5 times using various combinations of home hemodialysis and reverse osmosis machines. Real-time utility (electricity and water) consumption was monitored during these simulations. A generic formula was developed to allow patients and programs to calculate a more precise estimate of utility costs based on individual combinations of dialysis intensity, frequency and utility costs unique to any patient. Results: Using typical 2014 utility costs for Edmonton, the most expensive prescription was for nocturnal home hemodialysis (8 h at 300 mL/min, 6 d/wk), which resulted in a utility cost of $1269 per year; the least expensive prescription was for conventional home hemodialysis (4 h at 500 mL/min, 3 d/wk), which cost $420 per year. Water consumption makes up most of this expense, with electricity accounting for only 12% of the cost. Interpretation: We show that a substantial cost burden is transferred to the patient on home hemodialysis, which would otherwise be borne by the renal program. PMID:28401120

Cost Utility Analysis of Topical Steroids Compared With Dietary Elimination for Treatment of Eosinophilic Esophagitis.

PubMed

Cotton, Cary C; Erim, Daniel; Eluri, Swathi; Palmer, Sarah H; Green, Daniel J; Wolf, W Asher; Runge, Thomas M; Wheeler, Stephanie; Shaheen, Nicholas J; Dellon, Evan S

2017-06-01

Topical corticosteroids or dietary elimination are recommended as first-line therapies for eosinophilic esophagitis, but data to directly compare these therapies are scant. We performed a cost utility comparison of topical corticosteroids and the 6-food elimination diet (SFED) in treatment of eosinophilic esophagitis, from the payer perspective. We used a modified Markov model based on current clinical guidelines, in which transition between states depended on histologic response simulated at the individual cohort-member level. Simulation parameters were defined by systematic review and meta-analysis to determine the base-case estimates and bounds of uncertainty for sensitivity analysis. Meta-regression models included adjustment for differences in study and cohort characteristics. In the base-case scenario, topical fluticasone was about as effective as SFED but more expensive at a 5-year time horizon ($9261.58 vs $5719.72 per person). SFED was more effective and less expensive than topical fluticasone and topical budesonide in the base-case scenario. Probabilistic sensitivity analysis revealed little uncertainty in relative treatment effectiveness. There was somewhat greater uncertainty in the relative cost of treatments; most simulations found SFED to be less expensive. In a cost utility analysis comparing topical corticosteroids and SFED for first-line treatment of eosinophilic esophagitis, the therapies were similar in effectiveness. SFED was on average less expensive, and more cost effective in most simulations, than topical budesonide and topical fluticasone, from a payer perspective and not accounting for patient-level costs or quality of life. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Development of a method to analyze orthopaedic practice expenses.

PubMed

Brinker, M R; Pierce, P; Siegel, G

2000-03-01

The purpose of the current investigation was to present a standard method by which an orthopaedic practice can analyze its practice expenses. To accomplish this, a five-step process was developed to analyze practice expenses using a modified version of activity-based costing. In this method, general ledger expenses were assigned to 17 activities that encompass all the tasks and processes typically performed in an orthopaedic practice. These 17 activities were identified in a practice expense study conducted for the American Academy of Orthopaedic Surgeons. To calculate the cost of each activity, financial data were used from a group of 19 orthopaedic surgeons in Houston, Texas. The activities that consumed the largest portion of the employee work force (person hours) were service patients in office (25.0% of all person hours), maintain medical records (13.6% of all person hours), and resolve collection disputes and rebill charges (12.3% of all person hours). The activities that comprised the largest portion of the total expenses were maintain facility (21.4%), service patients in office (16.0%), and sustain business by managing and coordinating practice (13.8%). The five-step process of analyzing practice expenses was relatively easy to perform and it may be used reliably by most orthopaedic practices.

26 CFR 1.263(a)-6T - Election to deduct or capitalize certain expenditures (temporary).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 195 (start-up expenditures); (16) Section 198 (expensing of environmental remediation costs); (17... environmental protection agency sulfur regulations); (7) Section 179C (election to expense certain refineries...

26 CFR 1.263(a)-6T - Election to deduct or capitalize certain expenditures (temporary).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 195 (start-up expenditures); (16) Section 198 (expensing of environmental remediation costs); (17... environmental protection agency sulfur regulations); (7) Section 179C (election to expense certain refineries...

Natural selection for costly nutrient recycling in simulated microbial metacommunities.

PubMed

Boyle, Richard A; Williams, Hywel T P; Lenton, Timothy M

2012-11-07

Recycling of essential nutrients occurs at scales from microbial communities to global biogeochemical cycles, often in association with ecological interactions in which two or more species utilise each others' metabolic by-products. However, recycling loops may be unstable; sequences of reactions leading to net recycling may be parasitised by side-reactions causing nutrient loss, while some reactions in any closed recycling loop are likely to be costly to participants. Here we examine the stability of nutrient recycling loops in an individual-based ecosystem model based on microbial functional types that differ in their metabolism. A supplied nutrient is utilised by a "source" functional type, generating a secondary nutrient that is subsequently used by two other types-a "mutualist" that regenerates the initial nutrient at a growth rate cost, and a "parasite" that produces a refractory waste product but does not incur any additional cost. The three functional types are distributed across a metacommunity in which separate patches are linked by a stochastic diffusive migration process. Regions of high mutualist abundance feature high levels of nutrient recycling and increased local population density leading to greater export of individuals, allowing the source-mutualist recycling loop to spread across the system. Individual-level selection favouring parasites is balanced by patch-level selection for high productivity, indirectly favouring mutualists due to the synergistic productivity benefits of the recycling loop they support. This suggests that multi-level selection may promote nutrient cycling and thereby help to explain the apparent ubiquity and stability of nutrient recycling in nature.

12 CFR 347.302 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... cost means those costs which are specifically identified with negotiating, processing and consummating the loan. These costs include, but are not necessarily limited to: legal fees; costs of preparing and... indirect expenses such as occupancy and other similar overhead costs shall be included. (b) Banking...

Theoretical Design of a Depolarized Interferometric Fiber-Optic Gyroscope (IFOG) on SMF-28 Single-Mode Standard Optical Fiber Based on Closed-Loop Sinusoidal Phase Modulation with Serrodyne Feedback Phase Modulation Using Simulation Tools for Tactical and Industrial Grade Applications

PubMed Central

Pérez, Ramón José; Álvarez, Ignacio; Enguita, José María

2016-01-01

This article presents, by means of computational simulation tools, a full analysis and design of an Interferometric Fiber-Optic Gyroscope (IFOG) prototype based on a closed-loop configuration with sinusoidal bias phase- modulation. The complete design of the different blocks, optical and electronic, is presented, including some novelties as the sinusoidal bias phase-modulation and the use of an integrator to generate the serrodyne phase-modulation signal. The paper includes detailed calculation of most parameter values, and the plots of the resulting signals obtained from simulation tools. The design is focused in the use of a standard single-mode optical fiber, allowing a cost competitive implementation compared to commercial IFOG, at the expense of reduced sensitivity. The design contains an IFOG model that accomplishes tactical and industrial grade applications (sensitivity ≤ 0.055 °/h). This design presents two important properties: (1) an optical subsystem with advanced conception: depolarization of the optical wave by means of Lyot depolarizers, which allows to use a sensing coil made by standard optical fiber, instead by polarization maintaining fiber, which supposes consequent cost savings and (2) a novel and simple electronic design that incorporates a linear analog integrator with reset in feedback chain, this integrator generating a serrodyne voltage-wave to apply to Phase-Modulator (PM), so that it will be obtained the interferometric phase cancellation. This particular feedback design with sawtooth-wave generated signal for a closed-loop configuration with sinusoidal bias phase modulation has not been reported till now in the scientific literature and supposes a considerable simplification with regard to previous designs based on similar configurations. The sensing coil consists of an 8 cm average diameter spool that contains 300 m of standard single-mode optical-fiber (SMF-28 type) realized by quadrupolar winding. The working wavelength will be 1310 nm. The theoretical calculated values of threshold sensitivity and dynamic range for this prototype are 0.052 °/h and 101.38 dB (from ±1.164 × 10−5 °/s up to ±78.19 °/s), respectively. The Scale-Factor (SF) non-linearity for this model is 5.404% relative to full scale, this value being obtained from data simulation results. PMID:27128924

Theoretical Design of a Depolarized Interferometric Fiber-Optic Gyroscope (IFOG) on SMF-28 Single-Mode Standard Optical Fiber Based on Closed-Loop Sinusoidal Phase Modulation with Serrodyne Feedback Phase Modulation Using Simulation Tools for Tactical and Industrial Grade Applications.

PubMed

Pérez, Ramón José; Álvarez, Ignacio; Enguita, José María

2016-04-27

This article presents, by means of computational simulation tools, a full analysis and design of an Interferometric Fiber-Optic Gyroscope (IFOG) prototype based on a closed-loop configuration with sinusoidal bias phase- modulation. The complete design of the different blocks, optical and electronic, is presented, including some novelties as the sinusoidal bias phase-modulation and the use of an integrator to generate the serrodyne phase-modulation signal. The paper includes detailed calculation of most parameter values, and the plots of the resulting signals obtained from simulation tools. The design is focused in the use of a standard single-mode optical fiber, allowing a cost competitive implementation compared to commercial IFOG, at the expense of reduced sensitivity. The design contains an IFOG model that accomplishes tactical and industrial grade applications (sensitivity ≤ 0.055 °/h). This design presents two important properties: (1) an optical subsystem with advanced conception: depolarization of the optical wave by means of Lyot depolarizers, which allows to use a sensing coil made by standard optical fiber, instead by polarization maintaining fiber, which supposes consequent cost savings and (2) a novel and simple electronic design that incorporates a linear analog integrator with reset in feedback chain, this integrator generating a serrodyne voltage-wave to apply to Phase-Modulator (PM), so that it will be obtained the interferometric phase cancellation. This particular feedback design with sawtooth-wave generated signal for a closed-loop configuration with sinusoidal bias phase modulation has not been reported till now in the scientific literature and supposes a considerable simplification with regard to previous designs based on similar configurations. The sensing coil consists of an 8 cm average diameter spool that contains 300 m of standard single-mode optical-fiber (SMF-28 type) realized by quadrupolar winding. The working wavelength will be 1310 nm. The theoretical calculated values of threshold sensitivity and dynamic range for this prototype are 0.052 °/h and 101.38 dB (from ±1.164 × 10(-5) °/s up to ±78.19 °/s), respectively. The Scale-Factor (SF) non-linearity for this model is 5.404% relative to full scale, this value being obtained from data simulation results.

Investigation of comparative effectiveness research in Asia, Europe, and North America.

PubMed

Patel, Isha; Rarus, Rachel; Tan, Xi; Lee, E K; Guy, Jason; Ahmad, Akram; Chang, Jongwha

2015-01-01

Comparative effectiveness research (CER) is an important branch of pharmacoeconomics that systematically studies and evaluates the cost-effectiveness of medical interventions. CER plays instrumental roles in guiding government public health policy programs and insurance. Countries throughout the world use different methods of CER to help make medical decisions based on providing optimal therapy at a reduced cost. Expenses to the healthcare system continue to rise, and CER is one-way in which expenses could be curbed in the future by applying cost-effectiveness evidence to clinical decisions. China, India, South Korea, and the United Kingdom are of essential focus because these country's economies and health care expenses continue to expand. The structures and use of CER are diverse throughout these countries, and each is of prime importance. By conducting this thorough comparison of CER in different nations, strategies and organizational setups from different countries can be applied to help guide public health and medical decision-making in order to continue to expand the establishment and role of CER programs. The patient-centered medical home has been created to help reduce costs in the primary care sector and to help improve the effectiveness of therapy. Barriers to CER are also important as many stakeholders need to be able to work together to provide the best CER evidence. The advancement of CER in multiple countries throughout the world provides a possible way of reducing costs to the healthcare system in an age of expanding expenses.

77 FR 13275 - Certain Frozen Warmwater Shrimp From India: Preliminary Results of Antidumping Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

... of selling expenses for each type of sale. \\15\\ Id; see also Certain Orange Juice From Brazil: Final... conversion for the foreign like product, plus amounts for G&A expenses and interest expenses (see ``Test of... based on the sum of the cost of materials and fabrication for the imported merchandise, plus amounts for...

13 CFR 307.14 - Revolving Loan Fund semi-annual report and Income and Expense Statement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RLF Plan to ensure effective use of the RLF as a strategic financing tool. (c) RLF Income and Expense... for administrative costs in a six-month (6) Reporting Period must submit to EDA a completed Income and Expense Statement (Form ED-209I or any successor form) for that Reporting Period in electronic format...

13 CFR 307.14 - Revolving Loan Fund semi-annual report and Income and Expense Statement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RLF Plan to ensure effective use of the RLF as a strategic financing tool. (c) RLF Income and Expense... for administrative costs in a six-month (6) Reporting Period must submit to EDA a completed Income and Expense Statement (Form ED-209I or any successor form) for that Reporting Period in electronic format...

13 CFR 307.14 - Revolving Loan Fund semi-annual report and Income and Expense Statement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RLF Plan to ensure effective use of the RLF as a strategic financing tool. (c) RLF Income and Expense... for administrative costs in a six-month (6) Reporting Period must submit to EDA a completed Income and Expense Statement (Form ED-209I or any successor form) for that Reporting Period in electronic format...

The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

PubMed Central

Baird, Katherine E

2016-01-01

Background: This article compares the burden that medical cost-sharing requirements place on households in the United States and Canada. It estimates the probability that individuals with similar demographic features in the two countries have large medical expenses relative to income. Method: The study uses 2010 nationally representative household survey data harmonized for cross-national comparisons to identify individuals with high medical expenses relative to income. Using logistic regression, it estimates the probability of high expenses occurring among 10 different demographic groups in the two countries. Results: The results show the risk of large medical expenses in the United States is 1.5–4 times higher than it is in Canada, depending on the demographic group and spending threshold used. The United States compares least favorably when evaluating poorer citizens and when using a higher spending threshold. Conclusion: Recent health care reforms can be expected to reduce Americans’ catastrophic health expenses, but it will take very large reductions in out-of-pocket expenditures—larger than can be expected—if poorer and middle-class families are to have the financial protection from high health care costs that their counterparts in Canada have. PMID:26985389

The Canadian elder standard - pricing the cost of basic needs for the Canadian elderly.

PubMed

MacDonald, Bonnie-Jeanne; Andrews, Doug; Brown, Robert L

2010-03-01

We determined the after-tax income required to finance basic needs for Canadian elders living with different circumstances in terms of age, gender, city of residence, household size, homeowner or renter status, means of transportation, and health status. Using 2001 as our base year, we priced the typical expenses for food, shelter, medical, transportation, miscellaneous basic living items and home-based long-term care for elders living in five Canadian cities. This is the first Canadian study of basic living expenses tailored to elders instead of adults in general, prepared on an absolute rather than a relative basis. We also accounted for an individual's unique life circumstances and established the varying effect that they have on the cost of basic expenses, particularly for home care. We found that the maximum Guaranteed Income Supplement and Old Age Security benefit did not meet the cost of basic needs for an elder living in poor circumstances.

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

Direct costs of preventive headache treatments: comparison of behavioral and pharmacologic approaches.

PubMed

Schafer, Allison M; Rains, Jeanetta C; Penzien, Donald B; Groban, Leanne; Smitherman, Todd A; Houle, Timothy T

2011-06-01

This study provides preliminary data and a framework to facilitate cost comparisons for pharmacologic vs behavioral approaches to headache prophylactic treatment. There are few empirical demonstrations of cumulative costs for pharmacologic and behavioral headache treatments, and there are no direct comparisons of short- and long-range (5-year) costs for pharmacologic vs behavioral headache treatments. Two separate pilot surveys were distributed to a convenience sample of behavioral specialists and physicians identified from the membership of the American Headache Society. Costs of prototypical regimens for preventive pharmacologic treatment (PPT), clinic-based behavioral treatment (CBBT), minimal contact behavioral treatment (MCBT), and group behavioral treatment were assessed. Each survey addressed total cost accumulated during treatment (ie, intake, professional fees) excluding costs of acute medications. The total costs of preventive headache therapy by type of treatment were then evaluated and compared over time. During the initial months of treatment, PPT with inexpensive mediations (<0.75 $/day) represents the least costly regimen and is comparable to MCBT in expense until 6 months. After 6 months, PPT is expected to become more costly, particularly when medication cost exceeds 0.75$ a day. When using an expensive medication (>3 $/day), preventive drug treatment becomes more expensive than CBBT after the first year. Long-term, and within year 1, MCBT was found to be the least costly approach to migraine prevention. Through year 1 of treatment, inexpensive prophylactic medications (such as generically available beta-blocker or tricyclic antidepressant medications) and behavioral interventions utilizing limited delivery formats (MCBT) are the least costly of the empirically validated interventions. This analysis suggests that, relative to pharmacologic options, limited format behavioral interventions are cost-competitive in the early phases of treatment and become more cost-efficient as the years of treatment accrue. © 2011 American Headache Society.

Integrated Vehicle Thermal Management - Combining Fluid Loops in Electric Drive Vehicles (Presentation)

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

Rugh, J. P.

2013-07-01

Plug-in hybrid electric vehicles and electric vehicles have increased vehicle thermal management complexity, using separate coolant loop for advanced power electronics and electric motors. Additional thermal components result in higher costs. Multiple cooling loops lead to reduced range due to increased weight. Energy is required to meet thermal requirements. This presentation for the 2013 Annual Merit Review discusses integrated vehicle thermal management by combining fluid loops in electric drive vehicles.

Ground Source Heat Pumps vs. Conventional HVAC: A Comparison of Economic and Environmental Costs

DTIC Science & Technology

2009-03-26

of systems are surface water heat pumps (SWHPs), ground water heat pumps (GWHPs), and ground coupled heat pumps ( GCHPs ) (Kavanaugh & Rafferty, 1997...Kavanaugh & Rafferty, 1997). Ground Coupled Heat Pumps (Closed-Loop Ground Source Heat Pumps) GCHPs , otherwise known as closed-loop GSHPs, are the...Significant confusion has arisen through the use of GCHP and closed-loop GSHP terminology. Closed-loop GSHP is the preferred nomenclature for this

Weather forecasts, users' economic expenses and decision strategies

NASA Technical Reports Server (NTRS)

Carter, G. M.

1972-01-01

Differing decision models and operational characteristics affecting the economic expenses (i.e., the costs of protection and losses suffered if no protective measures have been taken) associated with the use of predictive weather information have been examined.

Financial Burden Faced by Families due to Out-of-pocket Expenses during the Treatment of their Cancer Children: An Indian Perspective.

PubMed

Sneha, Latha M; Sai, Jeyanth; Ashwini, S; Ramaswamy, Sunitha; Rajan, Mahalakshmi; Scott, Julius X

2017-01-01

Life-saving cancer therapy is costly and may result in financial burden for these families. Financial costs for treating childhood cancer care are traditionally assessed based on the amount spent for diagnostic tests, hospitalization, and chemotherapy. The financial costs for travel, accommodation, out-of-pocket expenses for food, phone bills, and loss of income due to reduction or termination of parental employment are hidden nonmedical expenses that are rarely accounted for. Studies on the financial implications of pediatric cancer treatment are based on the Western model of healthcare with good government/state insurance coverage and hence literature on lifestyle implications for families in developing nations with limited resources is still scarce. The aim of this study is to find out the details of out-of-pocket expenses incurred by the families during their treatment of cancer children and its implications on their quality of life. Settings and Design: This study was conducted in a tertiary care center for pediatric malignancies for over 1-year period. About seventy families whose children were diagnosed with acute leukemia and undergoing treatment at our center were asked to fill a questionnaire detailing their out-of-pocket expenses. Nonmedical expenses accounts for about 46% of their monthly household income of parents from rural areas and 22% of their household income from urban areas. On an average, a family from rural area spends four times the normal amount spent on home for their daily food expenditure. Thirty-eight percent of families have borrowed money from money lenders with an average interest rate of about 12.5% which pushes them to a state of debt for the next few years. Out-of-pocket expenses contribute a significant proportion to the financial burden of the families with childhood malignancies and these invisible expenses should be recognized and provide adequate support to lessen the burden of this economic impact.

A benders decomposition approach to multiarea stochastic distributed utility planning

NASA Astrophysics Data System (ADS)

McCusker, Susan Ann

Until recently, small, modular generation and storage options---distributed resources (DRs)---have been installed principally in areas too remote for economic power grid connection and sensitive applications requiring backup capacity. Recent regulatory changes and DR advances, however, have lead utilities to reconsider the role of DRs. To a utility facing distribution capacity bottlenecks or uncertain load growth, DRs can be particularly valuable since they can be dispersed throughout the system and constructed relatively quickly. DR value is determined by comparing its costs to avoided central generation expenses (i.e., marginal costs) and distribution investments. This requires a comprehensive central and local planning and production model, since central system marginal costs result from system interactions over space and time. This dissertation develops and applies an iterative generalized Benders decomposition approach to coordinate models for optimal DR evaluation. Three coordinated models exchange investment, net power demand, and avoided cost information to minimize overall expansion costs. Local investment and production decisions are made by a local mixed integer linear program. Central system investment decisions are made by a LP, and production costs are estimated by a stochastic multi-area production costing model with Kirchhoff's Voltage and Current Law constraints. The nested decomposition is a new and unique method for distributed utility planning that partitions the variables twice to separate local and central investment and production variables, and provides upper and lower bounds on expected expansion costs. Kirchhoff's Voltage Law imposes nonlinear, nonconvex constraints that preclude use of LP if transmission capacity is available in a looped transmission system. This dissertation develops KVL constraint approximations that permit the nested decomposition to consider new transmission resources, while maintaining linearity in the three individual models. These constraints are presented as a heuristic for the given examples; future research will investigate conditions for convergence. A ten-year multi-area example demonstrates the decomposition approach and suggests the ability of DRs and new transmission to modify capacity additions and production costs by changing demand and power flows. Results demonstrate that DR and new transmission options may lead to greater capacity additions, but resulting production cost savings more than offset extra capacity costs.

SOP 98-5 brings uniformity to reporting start-up costs.

PubMed

Luecke, R W; Meeting, D T

1999-08-01

The American Institute of Certified Public Accountants (AICPA) issued Statement of Position (SOP) No. 98-5, Reporting on the Costs of Start-Up Activities, in April 1998 to provide organizations with guidance on how to report start-up and organization costs. Because some companies were expensing start-up costs while other companies were capitalizing start-up costs with a variety of periods over which to amortize costs, it was difficult to compare companies' financial statements. SOP No. 98-5 will bring uniformity to the treatment of start-up and organization costs by dictating that these costs be expensed as incurred. AICPA's Accounting Standards Executive Committee adopted an intentionally broad definition of start-up costs to capture the vast majority of costs associated with starting up an organization. SOP No. 98-5 takes effect for financial statements for fiscal years beginning after December 15, 1998, but can be applied earlier for fiscal years for which financial statements have not been issued.

The cost of caring for end-stage kidney disease patients: an analysis based on hospital financial transaction records.

PubMed

Bruns, F J; Seddon, P; Saul, M; Zeidel, M L

1998-05-01

The costs of care for end-stage renal disease patients continue to rise because of increased numbers of patients. Efforts to contain these costs have focused on the development of capitated payment schemes, in which all costs for the care of these patients are covered in a single payment. To determine the effect of a capitated reimbursement scheme on care of dialysis patients (both hemodialysis [HD] and peritoneal dialysis [PD]), complete financial records (all reimbursements for inpatient and outpatient care, as well as physician collections) of dialysis patients at a single medical center over 1 year were analyzed. For the period from July 1994 to July 1995, annualized cost per dialysis patient-year averaged $63,340, or 9.8% higher than the corrected estimate from the U.S. Renal Data Service (USRDS; $57,660). The "most expensive" 25% of patients engendered 44 to 48% of the total costs, and inpatient costs accounted for 37 to 40% of total costs. Nearly half of the inpatient costs resulted from only two categories (room charges and inpatient dialysis), whereas other categories each made up a small fraction of the inpatient costs. PD patients were far less expensive to care for than HD patients, due to reduced hospital days and lower cost of outpatient dialysis. Care for a university-based dialysis population was only slightly more expensive than estimates predicted from the USRDS. These results validate the USRDS spending data and suggest that they can be used effectively for setting capitated rates. Efforts to control costs without sacrificing quality of care must center on reducing inpatient costs, particularly room charges and the cost of inpatient dialysis.

Finding future high-cost cases: comparing prior cost versus diagnosis-based methods.

PubMed Central

Ash, A S; Zhao, Y; Ellis, R P; Schlein Kramer, M

2001-01-01

OBJECTIVE: To examine the value of two kinds of patient-level dat a (cost and diagnoses) for identifying a very small subgroup of a general population with high future costs that may be mitigated with medical management. DATA SOURCES: The study used the MEDSTAT Market Scan (R) Research Database, consisting of inpatient and ambulatory health care encounter records for individuals covered by employee- sponsored benefit plans during 1997 and 1998. STUDY DESIGN: Prior cost and a diagnostic cost group (DCG) risk model were each used with 1997 data to identify 0.5-percent-sized "top groups" of people most likely to be expensive in 1998. We compared the distributions of people, cost, and diseases commonly targeted for disease management for people in the two top groups and, as a bench mark, in the full population. PRINCIPAL FINDINGS: the prior cost- and DCG-identified top groups overlapped by only 38 percent. Each top group consisted of people with high year-two costs and high rates of diabetes, heart failure, major lung disease, and depression. The DCG top group identified people who are both somewhat more expensive ($27,292 vs. $25,981) and more likely ( 49.4 percent vs. 43.8 percent ) th an the prior-cost top group to have at least one of the diseases commonly targeted for disease management. The overlap group average cost was $46,219. CONCLUSIONS: Diagnosis-based risk models are at least as powerful as prior cost for identifying people who will be expensive. Combined cost and diagnostic data are even more powerful and more operation ally useful, especially because the diagnostic information identifies the medical problems that may be managed to achieve better out comes and lower costs. PMID:16148969

Not simply more of the same: distinguishing between patient heterogeneity and parameter uncertainty.

PubMed

Vemer, Pepijn; Goossens, Lucas M A; Rutten-van Mölken, Maureen P M H

2014-11-01

In cost-effectiveness (CE) Markov models, heterogeneity in the patient population is not automatically taken into account. We aimed to compare methods of dealing with heterogeneity on estimates of CE, using a case study in chronic obstructive pulmonary disease (COPD). We first present a probabilistic sensitivity analysis (PSA) in which we sampled only from distributions representing parameter uncertainty. This ignores any heterogeneity. Next, we explored heterogeneity by presenting results for subgroups, using a method that samples parameter uncertainty simultaneously with heterogeneity in a single-loop PSA. Finally, we distinguished parameter uncertainty from heterogeneity in a double-loop PSA by performing a nested simulation within each PSA iteration. Point estimates and uncertainty differed substantially between methods. The incremental CE ratio (ICER) ranged from € 4900 to € 13,800. The single-loop PSA led to a substantially different shape of the CE plane and an overestimation of the uncertainty compared with the other 3 methods. The CE plane for the double-loop PSA showed substantially less uncertainty and a stronger negative correlation between the difference in costs and the difference in effects compared with the other methods. This came at the cost of higher calculation times. Not accounting for heterogeneity, subgroup analysis and the double-loop PSA can be viable options, depending on the decision makers' information needs. The single-loop PSA should not be used in CE research. It disregards the fundamental differences between heterogeneity and sampling uncertainty and overestimates uncertainty as a result. © The Author(s) 2014.

Analysis of hospitalization expenditures and influencing factors for inpatients with coronary heart disease in a tier-3 hospital in Xi'an, China: A retrospective study.

PubMed

Ding, Jing-Mei; Zhang, Xian-Zhi; Hu, Xue-Jun; Chen, Huo-Liang; Yu, Min

2017-12-01

The medical costs for inpatients with coronary heart disease (CHD) have risen to unprecedented levels, putting tremendous financial pressure on their families and the entire society. The objective of this study was to examine the actual direct medical costs of inpatients with CHD and to analyze the influencing factors of those costs, to provide advice on the prevention and control of high medical costs of patients with CHD. A retrospective descriptive analysis of hospitalization expenditures data examined 10,301 inpatients with coronary heart disease of a tier-3 hospital in Xi'an from January 1, 2015 to December 31, 2015. The data included demographic information, the average length of stay, and different types of expenses incurred during the hospitalization period. The difference between different groups was analyzed using a univariate analysis, and the influencing factors of hospitalization expenditures were explored by the multiple linear stepwise regression analysis. The average age of these patients was 60.0 years old, the average length of stay was 4.0 days, and the majority were males (7172, 69.6%). The average hospitalization expenses were $6791.38 (3294.16-9, 732.59), and the top 3 expenses were medical consumables, operation fees, and drugs. The influencing factors of hospitalization expenditures included the length of stay, the number of times of admission, the type of medical insurance schemes, whether have a surgery or not, the gender, the age, and the marriage status. The inpatients with CHD in this tier-3 hospital were mostly over 45 years old. The average medical cost of males was much higher than that of females. Our findings suggest that the solution for tremendous hospitalization expenditures should be that more attention is paid to controlling the high expense of medical consumables and that the traditional method of reducing medical expenses by shortening the length of stay is still important in nowadays. Furthermore, the type of medical insurance schemes has different impacts on medical expenses. Reducing or controlling high hospitalization expenditures is a complicated process that needs multifaceted cooperation. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Cost-benefit analysis of childhood asthma management through school-based clinic programs.

PubMed

Tai, Teresa; Bame, Sherry I

2011-04-01

Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

Development of near real time performance measurements for closed-loop signal systems (CLS) using historical traffic data from existing loop detectors and signal timing data.

DOT National Transportation Integrated Search

2014-10-01

The overarching goal of this research project was to investigate the potential for the NCDOT Central Office Signal Timing : (COST) Section to monitor and assess the quality of field deployed closed-loop signal system plans using the data inherent in ...

18 CFR 367.52 - Overhead construction costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ACT Service Company Property Instructions § 367.52 Overhead construction costs. (a) All overhead construction costs, such as engineering, supervision, general office salaries and expenses, construction... costs. 367.52 Section 367.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY...

18 CFR 367.52 - Overhead construction costs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACT Service Company Property Instructions § 367.52 Overhead construction costs. (a) All overhead construction costs, such as engineering, supervision, general office salaries and expenses, construction... costs. 367.52 Section 367.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY...

13 CFR 303.5 - Eligible administrative expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... 303.5 Section 303.5 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE PLANNING INVESTMENTS AND COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGIES § 303.5 Eligible administrative expenses. In accordance with applicable Federal cost principles, Planning Investments may be used...

9 CFR 203.5 - Statement with respect to market agencies paying the expenses of livestock buyers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... sales conducted by such market agencies, such as, expenses for meals, lodging, travel, entertainment and... competition between similarly engaged market agencies and results in undue and unreasonable cost burdens on...

18 CFR 367.4160 - Account 416, Costs and expenses of merchandising, jobbing and contract work.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Receiving and handling customer orders for merchandise or for jobbing services. (7) Cleaning and tidying... sales rooms or of equipment. (10) Transportation expense in delivery and pick-up of appliances by the...

Operations Expenditures: Historical Trends and Continuing Challenges (Presentation)

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

Lantz, E.

2013-05-01

In this presentation for the American Wind Energy Association 2013 conference, NREL's Eric Lantz examines historical trends and continuing challenges of wind power operating expenses. Lowering such expenses could increase profitability and contribute to lowering the cost of energy.

48 CFR 9905.505-60 - Illustrations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... category, takes several business associates on what is clearly a business entertainment trip. The entertainment costs of such trips is expressly unallowable because it constitutes entertainment expense... identification with the unallowable entertainment expense. However, unless this type of activity constituted a...

48 CFR 9905.505-60 - Illustrations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... category, takes several business associates on what is clearly a business entertainment trip. The entertainment costs of such trips is expressly unallowable because it constitutes entertainment expense... identification with the unallowable entertainment expense. However, unless this type of activity constituted a...

48 CFR 9905.505-60 - Illustrations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... category, takes several business associates on what is clearly a business entertainment trip. The entertainment costs of such trips is expressly unallowable because it constitutes entertainment expense... identification with the unallowable entertainment expense. However, unless this type of activity constituted a...

47 CFR 36.373 - Services-Account 6620.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Customer Operations... among the operations for groups of exchanges. A group of exchanges may include all exchanges in the...

Health-based risk adjustment: improving the pharmacy-based cost group model by adding diagnostic cost groups.

PubMed

Prinsze, Femmeke J; van Vliet, René C J A

Since 1991, risk-adjusted premium subsidies have existed in the Dutch social health insurance sector, which covered about two-thirds of the population until 2006. In 2002, pharmacy-based cost groups (PCGs) were included in the demographic risk adjustment model, which improved the goodness-of-fit, as measured by the R2, to 11.5%. The model's R2 reached 22.8% in 2004, when inpatient diagnostic information was added in the form of diagnostic cost groups (DCGs). PCGs and DCGs appear to be complementary in their ability to predict future costs. PCGs particularly improve the R2 for outpatient expenses, whereas DCGs improve the R2 for inpatient expenses. In 2006, this system of risk-adjusted premium subsidies was extended to cover the entire population.

30 CFR 1220.013 - Unallowable costs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR Natural... OIL AND GAS LEASES § 1220.013 Unallowable costs. The following costs shall not be charged as direct or... inventory; (e) Research and development costs; (f) The following legal expenses: (1) The costs of litigation...

Cost Differential Analysis: Providing Data for Added Cost Funding

ERIC Educational Resources Information Center

Nystrom, Dennis C.; Hennessy, James V.

1975-01-01

A 1972-73 statewide study conducted in Illinois to develop a cost accounting system which facilitates cost differential ratios for secondary vocational education courses indicated that vocational programs are approximately twice as expensive as nonvocational. Specific cost elements identified in the study provided essential information regarding…

Parallel Digital Phase-Locked Loops

NASA Technical Reports Server (NTRS)

Sadr, Ramin; Shah, Biren N.; Hinedi, Sami M.

1995-01-01

Wide-band microwave receivers of proposed type include digital phase-locked loops in which band-pass filtering and down-conversion of input signals implemented by banks of multirate digital filters operating in parallel. Called "parallel digital phase-locked loops" to distinguish them from other digital phase-locked loops. Systems conceived as cost-effective solution to problem of filtering signals at high sampling rates needed to accommodate wide input frequency bands. Each of M filters process 1/M of spectrum of signal.

Survey on the Assessment of the Current Actual Expenses Incurred by Students on the Meals and Accommodation within and around the Campuses: The Case of Tanzania Higher Education Students' Loans Beneficiaries

ERIC Educational Resources Information Center

Nyahende, Veronica R.; Bangu, Asangye N.; Chakaza, Benedicto C.

2015-01-01

This Survey analyses the current actual expenses incurred by students on the meals and accommodation within and around the campuses. The study was geared towards achieving the following objectives: (i) to examine the current cost incurred by a students for meals In Campus, (ii) to examine the current cost incurred by a students for accommodation…

Fleet Readiness Center Mid-Atlantic Worker Cost Comparison

DTIC Science & Technology

2012-06-01

benefits of tracking this data would need to be balanced against the costs of doing so. The retirement, life/ health insurance, and workers ...Retirement, Life/ Health Insurance (32% of 2080× $30.74) $20,460.54 13 Workers ’ Compensation (2% of 2080 × $30.74) $1,278.78 Total Other Annual Expenses...Overhead Analysis: Civilian Other Annual Expenses 23 Retirement, Life/ Health Insurance (32% of 2080 × $30.74) $20,460.54 24 Workers ’ Compensation (2

Current Trends in Health Insurance Systems: OECD Countries vs. Japan

PubMed Central

SASAKI, Toshiyuki; IZAWA, Masahiro; OKADA, Yoshikazu

2015-01-01

Over the past few decades, the longest extension in life expectancy in the world has been observed in Japan. However, the sophistication of medical care and the expansion of the aging society, leads to continuous increase in health-care costs. Medical expenses as a part of gross domestic product (GDP) in Japan are exceeding the current Organization for Economic Co-operation and Development (OECD) average, challenging the universally, equally provided low cost health care existing in the past. A universal health insurance system is becoming a common system currently in developed countries, currently a similar system is being introduced in the United States. Medical care in Japan is under a social insurance system, but the injection of public funds for medical costs becomes very expensive for the Japanese society. In spite of some urgently decided measures to cover the high cost of advanced medical treatment, declining birthrate and aging population and the tendency to reduce hospital and outpatients’ visits numbers and shorten hospital stays, medical expenses of Japan continue to be increasing. PMID:25797778

48 CFR 42.603 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Fully utilize the responsible contract audit agency financial and advisory accounting services... cost rates for cost-reimbursement contracts, (2) establishment of advance agreements or recommendations on corporate/home office expense allocations, and (3) administration of Cost Accounting Standards...

24 CFR 1003.300 - Application requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... pertinent to the application process. (b) Costs incurred by applicant. Costs incurred by an applicant prior... eligible ICDBG expenses. (c) HUD will not normally reimburse or recognize costs incurred before HUD... and approve written requests to recognize and reimburse costs incurred after submission of the...

47 CFR 27.1164 - The cost-sharing formula.

Code of Federal Regulations, 2010 CFR

2010-10-01

... control equipment; engineering costs (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works; zoning costs; training; disposal of old equipment; test equipment... a replacement system, such as equipment and engineering expenses. C may not exceed $250,000 per...

Cost structure and clinical outcome of a stem cell transplantation program in a developing country: the experience in northeast Mexico.

PubMed

Jaime-Pérez, José Carlos; Heredia-Salazar, Alberto Carlos; Cantú-Rodríguez, Olga G; Gutiérrez-Aguirre, Homero; Villarreal-Villarreal, César Daniel; Mancías-Guerra, Consuelo; Herrera-Garza, José Luís; Gómez-Almaguer, David

2015-04-01

Hematopoietic stem cell transplantation (HSCT) in developing countries is cost-limited. Our primary goal was to determine the cost structure for the HSCT program model developed over the last decade at our public university hospital and to assess its clinical outcomes. Adults and children receiving an allogeneic hematopoietic stem cell transplant from January 2010 to February 2011 at our hematology regional reference center were included. Laboratory tests, medical procedures, chemotherapy drugs, other drugs, and hospitalization costs were scrutinized to calculate the total cost for each patient and the median cost for the procedure. Data regarding clinical evolution were incorporated into the analysis. Physician fees are not charged at the institution and therefore were not included. Fifty patients were evaluated over a 1-year period. The total estimated cost for an allogeneic HSCT was $12,504. The two most expensive diseases to allograft were non-Hodgkin lymphoma ($11,760 ± $2,236) for the malignant group and thalassemia ($12,915 ± $5,170) for the nonmalignant group. Acute lymphoblastic leukemia ($11,053 ± 2,817) and acute myeloblastic leukemia ($10,251 ± $1,538) were the most frequent indications for HSCT, with 11 cases each. Median out-of-pocket expenses were $1,605, and 1-year follow-up costs amounted to $1,640, adding up to a total cost of $15,749 for the first year. The most expensive components were drugs and laboratory tests. Applying the cost structure described, HSCT is an affordable option for hematological patients living in a developing country. ©AlphaMed Press.

COST MODEL FOR LARGE URBAN SCHOOLS.

ERIC Educational Resources Information Center

O'BRIEN, RICHARD J.

THIS DOCUMENT CONTAINS A COST SUBMODEL OF AN URBAN EDUCATIONAL SYSTEM. THIS MODEL REQUIRES THAT PUPIL POPULATION AND PROPOSED SCHOOL BUILDING ARE KNOWN. THE COST ELEMENTS ARE--(1) CONSTRUCTION COSTS OF NEW PLANTS, (2) ACQUISITION AND DEVELOPMENT COSTS OF BUILDING SITES, (3) CURRENT OPERATING EXPENSES OF THE PROPOSED SCHOOL, (4) PUPIL…

Instructional Support Costs Related to Faculty Salary Costs. Report No. 79-02.

ERIC Educational Resources Information Center

Hample, Stephen R.

Nonfaculty salary (instructional support) costs for Montana State University (MSU) are examined with specific reference to the adequacy of the 25 percent nonfaculty salary allowance for other costs. Two concepts are examined: nonfaculty salary expenses within the instruction program (direct instructional support costs) and both direct support…

24 CFR 92.205 - Eligible activities: General.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., reconstruction, or rehabilitation of non-luxury housing with suitable amenities, including real property..., relocation expenses of any displaced persons, families, businesses, or organizations; to provide tenant-based... planning costs; and to provide for the payment of operating expenses of community housing development...

24 CFR 92.205 - Eligible activities: General.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., reconstruction, or rehabilitation of non-luxury housing with suitable amenities, including real property..., relocation expenses of any displaced persons, families, businesses, or organizations; to provide tenant-based... planning costs; and to provide for the payment of operating expenses of community housing development...

Commuting expenses : disparity for the working poor

DOT National Transportation Integrated Search

2003-03-01

The working poor spent a fraction of what other workers spent on commuting expenses, but those costs amounted to a significantly higher proportion of their income. The working poor who drove their own vehicle spent a higher percentage of their income...

47 CFR 36.412 - Apportionment procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Operating Taxes § 36.412... groups as follows: (1) Operating Federal, State and local income taxes and (2) all other operating taxes...

Teacher Tax Tips.

ERIC Educational Resources Information Center

Freeman, Paul

1979-01-01

Discusses income tax deductions for vocational agriculture teachers for expenses incurred through automobiles used for school business, course work expenses, professional dues, classroom supplies, books, cost of bus driving license, liability insurance, and special clothing. A specific example for claiming the deductions on an automobile is…

Cost analysis of the development and implementation of a spatial decision support system for malaria elimination in Solomon Islands.

PubMed

Marston, Luke; Kelly, Gerard C; Hale, Erick; Clements, Archie C A; Hodge, Andrew; Jimenez-Soto, Eliana

2014-08-18

The goal of malaria elimination faces numerous challenges. New tools are required to support the scale up of interventions and improve national malaria programme capacity to conduct detailed surveillance. This study investigates the cost factors influencing the development and implementation of a spatial decision support system (SDSS) for malaria elimination in the two elimination provinces of Isabel and Temotu, Solomon Islands. Financial and economic costs to develop and implement a SDSS were estimated using the Solomon Islands programme's financial records. Using an ingredients approach, verified by stakeholders and operational reports, total costs for each province were quantified. A budget impact sensitivity analysis was conducted to investigate the influence of variations in standard budgetary components on the costs and to identify potential cost savings. A total investment of US$ 96,046 (2012 constant dollars) was required to develop and implement the SDSS in two provinces (Temotu Province US$ 49,806 and Isabel Province US$ 46,240). The single largest expense category was for computerized equipment totalling approximately US$ 30,085. Geographical reconnaissance was the most expensive phase of development and implementation, accounting for approximately 62% of total costs. Sensitivity analysis identified different cost factors between the provinces. Reduced equipment costs would deliver a budget saving of approximately 10% in Isabel Province. Combined travel costs represented the greatest influence on the total budget in the more remote Temotu Province. This study provides the first cost analysis of an operational surveillance tool used specifically for malaria elimination in the South-West Pacific. It is demonstrated that the costs of such a decision support system are driven by specialized equipment and travel expenses. Such factors should be closely scrutinized in future programme budgets to ensure maximum efficiencies are gained and available resources are allocated effectively.

The Psychological Costs of Knowledge Specialization in Groups: Unique Expertise Leaves You out of the Loop

ERIC Educational Resources Information Center

Jones, Eric E.; Kelly, Janice R.

2013-01-01

Knowledge specialization, such as that present in cross-functional teams, produces both positive and negative outcomes. Our research investigated how unique expertise can lead to feelings of ostracism in the form of being out of the loop. Compared to group members with shared expertise, members with unique expertise felt out of the loop and…

Optimal pipe size design for looped irrigation water supply system using harmony search: Saemangeum project area.

PubMed

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

2015-01-01

Water supply systems are mainly classified into branched and looped network systems. The main difference between these two systems is that, in a branched network system, the flow within each pipe is a known value, whereas in a looped network system, the flow in each pipe is considered an unknown value. Therefore, an analysis of a looped network system is a more complex task. This study aims to develop a technique for estimating the optimal pipe diameter for a looped agricultural irrigation water supply system using a harmony search algorithm, which is an optimization technique. This study mainly serves two purposes. The first is to develop an algorithm and a program for estimating a cost-effective pipe diameter for agricultural irrigation water supply systems using optimization techniques. The second is to validate the developed program by applying the proposed optimized cost-effective pipe diameter to an actual study region (Saemangeum project area, zone 6). The results suggest that the optimal design program, which applies an optimization theory and enhances user convenience, can be effectively applied for the real systems of a looped agricultural irrigation water supply.

Optimal Pipe Size Design for Looped Irrigation Water Supply System Using Harmony Search: Saemangeum Project Area

PubMed Central

Lee, Ho Min; Sadollah, Ali

2015-01-01

Water supply systems are mainly classified into branched and looped network systems. The main difference between these two systems is that, in a branched network system, the flow within each pipe is a known value, whereas in a looped network system, the flow in each pipe is considered an unknown value. Therefore, an analysis of a looped network system is a more complex task. This study aims to develop a technique for estimating the optimal pipe diameter for a looped agricultural irrigation water supply system using a harmony search algorithm, which is an optimization technique. This study mainly serves two purposes. The first is to develop an algorithm and a program for estimating a cost-effective pipe diameter for agricultural irrigation water supply systems using optimization techniques. The second is to validate the developed program by applying the proposed optimized cost-effective pipe diameter to an actual study region (Saemangeum project area, zone 6). The results suggest that the optimal design program, which applies an optimization theory and enhances user convenience, can be effectively applied for the real systems of a looped agricultural irrigation water supply. PMID:25874252

Design and simulation of a sensor for heliostat field closed loop control

NASA Astrophysics Data System (ADS)

Collins, Mike; Potter, Daniel; Burton, Alex

2017-06-01

Significant research has been completed in pursuit of capital cost reductions for heliostats [1],[2]. The camera array closed loop control concept has potential to radically alter the way heliostats are controlled and installed by replacing high quality open loop targeting systems with low quality targeting devices that rely on measurement of image position to remove tracking errors during operation. Although the system could be used for any heliostat size, the system significantly benefits small heliostats by reducing actuation costs, enabling large numbers of heliostats to be calibrated simultaneously, and enabling calibration of heliostats that produce low irradiance (similar or less than ambient light images) on Lambertian calibration targets, such as small heliostats that are far from the tower. A simulation method for the camera array has been designed and verified experimentally. The simulation tool demonstrates that closed loop calibration or control is possible using this device.

A low noise and ultra-narrow bandwidth frequency-locked loop based on the beat method.

PubMed

Gao, Wei; Sui, Jianping; Chen, Zhiyong; Yu, Fang; Sheng, Rongwu

2011-06-01

A novel frequency-locked loop (FLL) based on the beat method is proposed in this paper. Compared with other frequency feedback loops, this FLL is a digital loop with simple structure and very low noise. As shown in the experimental results, this FLL can be used to reduce close-in phase noise on atomic frequency standards, through which a composite frequency standard with ultra-low phase noise and low cost can be easily realized.

Playing Hardball with Facilities Expenses.

ERIC Educational Resources Information Center

Fickes, Michael

1997-01-01

Describes one school district manager's tactics for successfully controlling district costs and increasing capital improvements while only marginally increasing the facilities maintenance budget. Highlights guidelines for controlling personnel requirements and cost-reduction methods. Discusses specific cost-control measures involving telephone…

Complex home care: Part 2- family annual income, insurance premium, and out-of-pocket expenses.

PubMed

Piamjariyakul, Ubolrat; Yadrich, Donna Macan; Ross, Vicki M; Smith, Carol E; Clements, Faye; Williams, Arthur R

2010-01-01

Annual costs paid by families for intravenous infusion of home parenteral nutrition (HPN) health insurance premiums, deductibles, co-payments for health services, and the wide range of out-of-pocket home health care expenses are significant. The costs of managing complex chronic care at home cannot be completely understood until all out-of-pocket costs have been defined, described, and tabulated. Non-reimbursed and out-of-pocket costs paid by families over years for complex chronic care negatively impact the financial stability of families. National health care reform must take into account the long-term financial burdens of families caring for those with complex home care. Any changes that may increase the out-of-pocket costs or health insurance costs to these families can also have a negative long-term impact on society when greater numbers of patients declare bankruptcy or qualify for medical disability.

Sensitivity analysis to aid shelter management decisions: how does altering expenditure affect operational viability?

PubMed

Widmar, Nicole Olynk; Lord, Emily; Litster, Annette

2015-01-01

Streamlining purchasing in nonhuman animal shelters can provide multiple financial benefits. Streamlining shelter inputs and thus reducing shelter costs can include trading paid labor and management for fewer, more involved volunteers or purchasing large quantities of medical supplies from fewer vendors to take advantage of bulk-purchasing discounts. Beyond direct savings, time and energy spent on purchasing and inventory control can be reduced through careful management. Although cost-cutting measures may seem attractive, shelter managers are cautioned to consider the potential unintended consequences of short-term cost reduction measures that could limit revenues or increase costs in the future. This analysis illustrates an example of the impact of cost reductions in specific expense categories and the impact on shelter net revenue, as well as the share of expenses across categories. An in-depth discussion of labor and purchasing cost-reducing strategies in the real world of animal shelter management is provided.

The use of a resource-based relative value scale (RBRVS) to determine practice expense costs: a novel technique of practice management for the vascular surgeon.

PubMed

Mabry, C D

2001-03-01

Vascular surgeons have had to contend with rising costs while their reimbursements have undergone steady reductions. The use of newer accounting techniques can help vascular surgeons better manage their practices, plan for future expansion, and control costs. This article reviews traditional accounting methods, together with activity-based costing (ABC) principles that have been used in the past for practice expense analysis. The main focus is on a new technique-resource-based costing (RBC)-which uses the widely available Resource-Based Relative Value Scale (RBRVS) as its basis. The RBC technique promises easier implementation as well as more flexibility in determining true costs of performing various procedures, as opposed to more traditional accounting methods. It is hoped that RBC will assist vascular surgeons in coping with decreasing reimbursement. Copyright 2001 by W.B. Saunders Company

Mechatronics Education: From Paper Design to Product Prototype Using LEGO NXT Parts

NASA Astrophysics Data System (ADS)

Lofaro, Daniel M.; Le, Tony Truong Giang; Oh, Paul

The industrial design cycle starts with design then simulation, prototyping, and testing. When the tests do not match the design requirements the design process is started over again. It is important for students to experience this process before they leave their academic institution. The high cost of the prototype phase, due to CNC/Rapid Prototype machine costs, makes hands on study of this process expensive for students and the academic institutions. This document shows that the commercially available LEGO NXT Robot kit is a viable low cost surrogate to the expensive industrial CNC/Rapid Prototype portion of the industrial design cycle.

Relative Economy of Different Methods of Airplane Construction

NASA Technical Reports Server (NTRS)

Herrmann, H

1931-01-01

A comparison of the relative economy of airplane construction shows that monoplanes are cheaper than biplanes; that all-metal construction is much more expensive than mixed construction; that multi-engine airplanes are more expensive than single-engine types of the same carrying capacity and speed;that the cost of airplanes is materially reduced by increasing their size without increasing the number of engines. The greatest economy usually coincides with the best aerodynamic and static conditions and the cost is always increased by safety requirements.

Transfusion medicine's role in hospital performance improvement. An administrator's view.

PubMed

Krempel, G; Jarosz, C

1999-06-01

Historically, hospital administrators have viewed all laboratory sections as cost centers. The major expenses in the transfusion service are those associated with labor and blood products. However, few administrators take the time to look past this cost to see the impact of an active transfusion medicine section in other areas of the hospital. This article examines the impact of inventory management, blood component utilization and waste, group purchasing, and new program implementation on transfusion service expense and revenue.

The cost of the district hospital: a case study in Malawi.

PubMed

Mills, A J; Kapalamula, J; Chisimbi, S

1993-01-01

Described in an analysis of the cost to the Ministry of Health of providing district health services in Malawi, with particular emphasis on the district hospital. District resource allocation patterns were assessed by carefully disaggregating district costs by level of care and hospital department. A strikingly low proportion of district recurrent costs was absorbed by salaries and wages (27-39%, depending on the district) and a surprisingly high proportion by medical supplies (24-37%). The most expensive cost centre in the hospital was the pharmacy. A total of 27-39% of total recurrent costs were spent outside the hospital and 61-73% on hospital services. The secondary care services absorbed 40-58% of district recurrent costs. Unit costs by hospital department varied considerably by district, with one hospital being consistently the most expensive and another the cheapest. A total of 3-10 new outpatients could be treated for the average cost of 1 inpatient-day, while 34-55 could be treated for the average cost of 1 inpatient. The efficiency of hospital operations, the scope for redistributing resources districtwide, and the costing methodology are discussed.

The cost of the district hospital: a case study in Malawi.

PubMed Central

Mills, A. J.; Kapalamula, J.; Chisimbi, S.

1993-01-01

Described in an analysis of the cost to the Ministry of Health of providing district health services in Malawi, with particular emphasis on the district hospital. District resource allocation patterns were assessed by carefully disaggregating district costs by level of care and hospital department. A strikingly low proportion of district recurrent costs was absorbed by salaries and wages (27-39%, depending on the district) and a surprisingly high proportion by medical supplies (24-37%). The most expensive cost centre in the hospital was the pharmacy. A total of 27-39% of total recurrent costs were spent outside the hospital and 61-73% on hospital services. The secondary care services absorbed 40-58% of district recurrent costs. Unit costs by hospital department varied considerably by district, with one hospital being consistently the most expensive and another the cheapest. A total of 3-10 new outpatients could be treated for the average cost of 1 inpatient-day, while 34-55 could be treated for the average cost of 1 inpatient. The efficiency of hospital operations, the scope for redistributing resources districtwide, and the costing methodology are discussed. PMID:8324852

Research Advances: Less Expensive and More Convenient Gaucher's Disease Treatment; Structural Loop Regions: Key to Multidrug-Resistance Transporters?; New Method Identifies Proteins in Old Artwork

ERIC Educational Resources Information Center

King, Angela G.

2006-01-01

The X-ray structure of EmrD, a multidrug transporter protein from Escherichia coli, common bacteria known to cause several food-borne illnesses was determined by scientists at The Scripps Research Institute. The hydrophobic residues in the EmrD internal cavity are likely to contribute to the general mechanism transporting various compounds through…

Finding a Voice

ERIC Educational Resources Information Center

Stuart, Shannon

2012-01-01

Schools have struggled for decades to provide expensive augmentative and alternative communication (AAC) resources for autistic students with communication challenges. Clunky voice output devices, often included in students' individualized education plans, cost about $8,000, a difficult expense to cover in hard times. However, mobile technology is…

7 CFR 1767.28 - Customer accounts expenses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the cost of labor, employee pensions and benefits, social security and other payroll taxes, injuries... benefits, social security and other payroll taxes, injuries and damages, materials used, and expenses..., employee pensions and benefits, social security and other payroll taxes, injuries and damages, materials...

[Costs of operation of an urban reinforced community health post (Senegal)].

PubMed

Guèye, Dramé B; Gueye, A S; Wone, I; Sall, F L; Tal, Dia A

2007-01-01

In Senegal, the public funding in community health post is low. Resources are mainly obtained from the sale of services. The aim of this study is to analyse the operating cost of a community health post and to propose a relevant tariffing that would assure sustainable activities. We used the method of complete costs. It comes out from our study that the total cost is 20 870 920F. Wages represent 70% of total expenses, operating costs represent 27% and 4% are investment. The public funding represents a value of 12 257 325F (60% of the total) in which 88% correspond to expenses induced by civil servant wages. The health committee participates for 33% and the other participants (7%). At the end of our study, a sustainable and social tariffing, was proposed.

[Opened vs. laparoscopic radical nephrectomy in renal adenocarcinoma cost comparison].

PubMed

Herranz Amo, F; Subirá Ríos, D; Hernández Fernández, C; Martínez Salamanca, J I; Monzó, J I; Cabello Benavente, R

2006-10-01

To undertake a cost comparison (cost minimization) between transperitoneal laparoscopic and opened nephrectomy in renal adenocarcinoma treatment. Retrospective study on the first 26 patients submitted to LN without intra or postoperative complications in the period 2002-2003, using as control 22 patients treated with ON with the same characteristics and in the same period. Demographic variables were evaluated (age, sex, tumor size, etc.), intraoperative (operative time and fungible material used) and postoperative (length of stay in Postanaesthesic Care Unit, Acute Pain Unit needs and hospital stay). Our Hospital costs plus those imputed during year 2003 to the Urology Service, as well as the cost of fungible material for the same year were applied, carrying out a comparison of costs between both groups. There were no differences between the demographic variables between both groups except in the tumor, bigger size in the opened nephrectomy (p=0,001). Transperitoneal laparoscopic was 29,4% globally more expensive than opened nephrectomy. The transperitoneal laparoscopic intraoperative cost (operating room, anesthesia and fungibles) the exceeded in 151,6% to that of the opened nephrectomy, whereas in the opened nephrectomy the postoperative cost was a 63 % higher than in the transperitoneal laparoscopic cases. Transperitoneal laparoscopic in our Center is more expensive than opened nephrectomy due to a major occupation of operating room and that the specific fungible material used at the surgical act has a very high cost. It would be necessary to drastically reduce surgical time and decrease fungible material expenses, thus transperitoneal laparoscopic procedure could be competitive in our Hospital.

Variation in prescription use and spending for lipid-lowering and diabetes medications in the Veterans Affairs Healthcare System.

PubMed

Gellad, Walid F; Good, Chester B; Lowe, John C; Donohue, Julie M

2010-10-01

To examine variation in outpatient prescription use and spending for hyperlipidemia and diabetes mellitus in the Veterans Affairs Healthcare System (VA) and its association with quality measures for these conditions. Cross-sectional. We compared outpatient prescription use, spending, and quality of care across 135 VA medical centers (VAMCs) in fiscal year 2008, including 2.3 million patients dispensed lipid-lowering medications and 981,031 patients dispensed diabetes medications. At each facility, we calculated VAMC-level cost per patient for these medications, the proportion of patients taking brand-name drugs, and Healthcare Effectiveness Data and Information Set (HEDIS) scores for hyperlipidemia (low-density lipoprotein cholesterol level <100 mg/dL) and for diabetes (glycosylated hemoglobin level >9% or not measured). The median cost per patient for lipid-lowering agents in fiscal year 2008 was $49.60 and varied from $39.68 in the least expensive quartile of VAMCs to $69.57 in the most expensive quartile (P < .001). For diabetes agents, the median cost per patient was $158.34 and varied from $123.34 in the least expensive quartile to $198.31 in the most expensive quartile (P < .001). The proportion of patients dispensed brand-name oral drugs among these classes in the most expensive quartile of VAMCs was twice that in the least expensive quartile (P < .001). There was no correlation between VAMC-level prescription spending and performance on HEDIS measures for lipid-lowering drugs (r = 0.12 and r = 0.07) or for diabetes agents (r = -0.10). Despite the existence of a closely managed formulary, significant variation in prescription spending and use of brand-name drugs exists in the VA. Although we could not explicitly risk-adjust, there appears to be no relationship between prescription spending and quality of care.

Analysis of Commuter Rail Costs and Cost Allocation Methods

DOT National Transportation Integrated Search

1983-07-01

The report addresses the issues of commuter rail service costs and the compensation methods used to allocate railroad expenses to the commuter service function. The report consists of six sections. Section 1 describes the study purpose, scope, method...

47 CFR 27.1180 - The cost-sharing formula.

Code of Federal Regulations, 2010 CFR

2010-10-01

...); towers and/or modifications; back-up power equipment; monitoring or control equipment; engineering costs (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works... as equipment and engineering expenses. There is no cap on the actual costs of relocation. (c) An AWS...

The cost of healthy food in rural Victoria.

PubMed

Palermo, Claire E; Walker, Karen Z; Hill, Peta; McDonald, Jessica

2008-01-01

The cost of healthy food has been associated previously with the degree of remoteness and socioeconomic status. This study aimed to investigate the factors that influence the cost of food in rural Victoria, Australia. It also aimed to compare the cost of nutritious foods with less healthy foods, and to identify the population sub-groups most vulnerable to economic food insecurity. A cross-sectional survey of the cost of food was undertaken in 2007 in a convenience sample of 34 supermarkets in rural areas across Victoria using the Victorian Healthy Food Basket (VHFB). The VHFB was designed to meet the nutritional needs of four different family types for a fortnight. The cost of the VHFB for a 'typical family' (2 adults, 2 children) was (mean [interquartile range]) AU $402.81 ($26.36). No association was evident between food cost and remoteness as indicated by the Accessibility/Remoteness Index for Australia (ARIA) score, socioeconomic status as indicated by the Socio-Economic Indices for Areas (SEIFA), population size or density, or distance of the town from the state capital, Melbourne. It was more expensive to purchase the VHFB at an independent store (median cost $406.66 [$29.39]) than at a supermarket chain (median cost $394.93 [$26.64]), p<0.05. Vegetables and legumes were the most expensive component of the VHFB to purchase and this food group showed significantly greater variation in food price than cereals (p<0.05), non-core foods (p<0.05) and unhealthy foods (p<0.001). The median cost of the VHFB was most expensive for a typical family and 'single parent family' (40% and 37% of welfare income) and least expensive for a single man (29% of income) and elderly pensioner (19% income). The VHFB is an effective tool for assessing economic food security for different population groups. The cost of food in rural Victoria varies in a manner that appears unrelated to remoteness, population, socioeconomic status or distance from the metropolitan centre. Purchase of healthy food requires a considerable proportion of welfare income and may thus be unaffordable for some groups. Food cost must be monitored at a national level to provide a knowledge base to inform development of food and nutrition policies for improved population health.

Much Lower Launch Costs Make Resupply Cheaper than Recycling for Space Life Support

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2017-01-01

The development of commercial launch vehicles by SpaceX has greatly reduced the cost of launching mass to Low Earth Orbit (LEO). Reusable launch vehicles may further reduce the launch cost per kilogram. The new low launch cost makes open loop life support much cheaper than before. Open loop systems resupply water and oxygen in tanks for crew use and provide disposable lithium hydroxide (LiOH) in canisters to remove carbon dioxide. Short human space missions such as Apollo and shuttle have used open loop life support, but the long duration International Space Station (ISS) recycles water and oxygen and removes carbon dioxide with a regenerative molecular sieve. These ISS regenerative and recycling life support systems have significantly reduced the total launch mass needed for life support. But, since the development cost of recycling systems is much higher than the cost of tanks and canisters, the relative cost savings have been much less than the launch mass savings. The Life Cycle Cost (LCC) includes development, launch, and operations. If another space station was built in LEO, resupply life support would be much cheaper than the current recycling systems. The mission most favorable to recycling would be a long term lunar base, since the resupply mass would be large, the proximity to Earth would reduce the need for recycling reliability and spares, and the launch cost would be much higher than for LEO due to the need for lunar transit and descent propulsion systems. For a ten-year lunar base, the new low launch costs make resupply cheaper than recycling systems similar to ISS life support.

Estimated annual cost of arterial hypertension treatment in Brazil.

PubMed

Dib, Murilo W; Riera, Rachel; Ferraz, Marcos B

2010-02-01

To estimate the direct annual cost of systemic arterial hypertension (SAH) treatment in Brazil's public and private health care systems, assess its economic impact on the total health care budget, and determine its proportion of the 2005 gross domestic product (GDP). A decision tree model was used to determine direct costs based on estimated use of various resources in SAH diagnosis and care, including treatment (medication and non-medication), complementary exams, doctor visits, nutritional assessments, and emergency room visits. Estimated direct annual cost of SAH treatment was approximately US$ 398.9 million for the public health care system and US$ 272.7 million for the private system, representing 0.08% of the 2005 GDP (ranging from 0.05% to 0.16%). With total health care expenses comprising about 7.6% of Brazil's GDP, this cost represented 1.11% of overall health care costs (0.62% to 2.06%)-1.43% of total expenses for the Unified Healthcare System (Sistema Unico de Saúde, SUS) (0.79% to 2.75%) and 0.83% of expenses for the private health care system (0.47% to 1.48%). Conclusion. To guarantee public or private health care based on the principles of universality and equality, with limited available resources, efforts must be focused on educating the population on prevention and treatment compliance in diseases such as SAH that require significant health resources.

Economic competitiveness of III-V on silicon tandem one-sun photovoltaic solar modules in favorable future scenarios

DOE PAGES

Bobela, David C.; Gedvilas, Lynn; Woodhouse, Michael; ...

2016-09-05

Here, tandem modules combining a III-V top cell with a Si bottom cell offer the potential to increase the solar energy conversion efficiency of one-sun photovoltaic modules beyond 25%, while fully utilizing the global investment that has been made in Si photovoltaics manufacturing. At present, the cost of III-V cells is far too high for this approach to be competitive for one-sun terrestrial power applications. We investigated the system-level economic benefits of both GaAs/Si and InGaP/Si tandem modules in favorable future scenarios where the cost of III-V cells is substantially reduced, perhaps to less than the cost of Si cells.more » We found, somewhat unexpectedly, that these tandems can reduce installed system cost only when the area-related balance-of-system cost is high, such as for area-constrained residential rooftop systems in the USA. When area-related balance-of-system cost is lower, such as for utility-scale systems, the tandem module offers no benefit. This is because a system using tandem modules is more expensive than one using single-junction Si modules when III-V cells are expensive, and a system using tandem modules is more expensive than one using single-junction III-V modules when III-V cells are inexpensive.« less

Economic competitiveness of III-V on silicon tandem one-sun photovoltaic solar modules in favorable future scenarios

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

Bobela, David C.; Gedvilas, Lynn; Woodhouse, Michael

Here, tandem modules combining a III-V top cell with a Si bottom cell offer the potential to increase the solar energy conversion efficiency of one-sun photovoltaic modules beyond 25%, while fully utilizing the global investment that has been made in Si photovoltaics manufacturing. At present, the cost of III-V cells is far too high for this approach to be competitive for one-sun terrestrial power applications. We investigated the system-level economic benefits of both GaAs/Si and InGaP/Si tandem modules in favorable future scenarios where the cost of III-V cells is substantially reduced, perhaps to less than the cost of Si cells.more » We found, somewhat unexpectedly, that these tandems can reduce installed system cost only when the area-related balance-of-system cost is high, such as for area-constrained residential rooftop systems in the USA. When area-related balance-of-system cost is lower, such as for utility-scale systems, the tandem module offers no benefit. This is because a system using tandem modules is more expensive than one using single-junction Si modules when III-V cells are expensive, and a system using tandem modules is more expensive than one using single-junction III-V modules when III-V cells are inexpensive.« less

38 CFR 36.4504 - Loan closing expenses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Loan closing expenses. 36.4504 Section 36.4504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... finance the cost of construction, repairs, alterations, or improvements necessitating disbursements of the...

38 CFR 36.4504 - Loan closing expenses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Loan closing expenses. 36.4504 Section 36.4504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... finance the cost of construction, repairs, alterations, or improvements necessitating disbursements of the...

38 CFR 36.4504 - Loan closing expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Loan closing expenses. 36.4504 Section 36.4504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... finance the cost of construction, repairs, alterations, or improvements necessitating disbursements of the...

38 CFR 36.4504 - Loan closing expenses.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Loan closing expenses. 36.4504 Section 36.4504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... finance the cost of construction, repairs, alterations, or improvements necessitating disbursements of the...

12 CFR 608.811 - Special review.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Special review. 608.811 Section 608.811 Banks... (costs incurred for food, housing, clothing, transportation, and medical care), the employee shall submit... for food, housing, clothing, and transportation; (6) Medical expenses; and (7) Exceptional expenses...

A snapshot of catastrophic post-disaster health expenses after Typhoon Haiyan.

PubMed

Espallardo, Noel; Geroy, Lester Sam; Villanueva, Raul; Gavino, Roy; Nievera, Lucille Angela; Hall, Julie Lyn

2015-01-01

This paper provides a snapshot of the health-care costs, out-of-pocket expenditures and available safety nets post-Typhoon Haiyan. This descriptive study used a survey and document review to report direct and indirect health-care costs and existing financial protection mechanisms used by households in two municipalities in the Philippines at one week and at seven months post-Haiyan. Reported out-of-pocket health-care expenses were high immediately after the disaster and increased after seven months. The mean reported out-of-pocket expenses were higher than the reported average household income (US$ 24 to US$ 59). The existing local and national mechanisms for health financing were promising and should be strengthened to reduce out-of-pocket expenses and protect people from catastrophic expenditures. Longer-term mechanisms are needed to ensure financial protection, especially among the poorest, beyond three months when most free services and medicines have ended. Preparedness should include prior registration of households that would ensure protection when a disaster comes.

Financial Neutrality for Living Organ Donors: Reasoning, Rationale, Definitions, and Implementation Strategies.

PubMed

Hays, R; Rodrigue, J R; Cohen, D; Danovitch, G; Matas, A; Schold, J; LaPointe Rudow, D

2016-07-01

In the United States, live organ donation can be a costly and burdensome undertaking for donors. While most donation-related medical expenses are covered, many donors still face lost wages, travel expenses, incidentals, and potential for future insurability problems. Despite widespread consensus that live donors (LD) should not be responsible for the costs associated with donation, little has changed to alleviate financial burdens for LDs in the last decade. To achieve this goal, the transplant community must actively pursue strategies and policies to eliminate unreimbursed out-of-pocket costs to LDs. Costs should be more appropriately distributed across all stakeholders; this will also make live donation possible for people who, in the current system, cannot afford to proceed. We propose the goal of LD "financial neutrality," offer an operational definition to include the coverage/reimbursement of all medical, travel, and lodging costs, along with lost wages, related to the act of donating an organ, and guidance for consideration of medical care coverage, and wage and other expense reimbursement. The intent of this report is to provide a foundation to inform discussion within the transplant community and to advance initiatives for policy and resource allocation. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

The cost effectiveness of laparoscopic versus open gastric bypass surgery.

PubMed

Paxton, James H; Matthews, Jeffrey B

2005-01-01

Over the last decade, laparoscopic gastric bypass (LGBP) has been proven to be a safe and well-tolerated approach to the Roux-en-Y gastric bypass, despite its increased cost when compared to the open approach (OGBP). This increased expense has led many to question whether LGBP is a cost effective alternative to OGBP. The aim of this study is to determine which approach is most cost effective, considering costs associated with the operation itself, perioperative complications, and income lost during convalescence. A PubMed search of the National Library of Medicine online journal database was conducted. Studies that met predetermined criteria for selection were included in the analyses of patient demographics, perioperative complications, length of hospital stay, excess weight loss, and time to recovery. Data on 6,425 OGBP and 5,867 LGBP patients were used to compare the outcomes associated with each approach. Significant differences were found in the perioperative complication profiles, time to recovery, and overall expense of the two approaches. OGBP was associated with an increased incidence of major perioperative complications, especially extraintestinal complications, and greater perioperative mortality. LGBP was associated with shorter hospital stays, increased incidence of intestinal complications, and a 2.25% incidence of conversion to OGBP. Patient demographics and percent excess weight loss (%EWL) at 3 years follow-up were found to be similar with both OGBP and LGBP. LGBP is a cost effective alternative to OGBP for surgical weight loss. Despite the increased cost of LGBP, patients suffer fewer expensive and lifethreatening perioperative complications.

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

Chatterton, Mike

The Recovery Act: Districtwide Geothermal Heating Conversion project performed by the Blaine County School District was part of a larger effort by the District to reduce operating costs, address deferred maintenance items, and to improve the learning environment of the students. This project evaluated three options for the ground source which were Open-Loop Extraction/Re-injection wells, Closed-Loop Vertical Boreholes, and Closed-Loop Horizontal Slinky approaches. In the end the Closed-Loop Horizontal Slinky approach had the lowest total cost of ownership but the majority of the sites associated with this project did not have enough available ground area to install the system somore » the second lowest option was used (Open-Loop). In addition to the ground source, this project looked at ways to retrofit existing HVAC systems with new high efficiency systems. The end result was the installation of distributed waterto- air heat pumps with water-to-water heat pumps installed to act as boilers/chillers for areas with a high ventilation demand such as they gymnasiums. A number of options were evaluated and the lowest total cost of ownership approach was implemented in the majority of the facilities. The facilities where the lowest total cost of ownership approaches was not selected were done to maintain consistency of the systems from facility to facility. This project had a number of other benefits to the Blaine County public. The project utilizes guaranteed energy savings to justify the levy funds expended. The project also developed an educational dashboard that can be used in the classrooms and to educate the community on the project and its performance. In addition, the majority of the installation work was performed by contractors local to Blaine County which acted as an economic stimulus to the area during a period of recession.« less

A Comparative Study on the Cost of New Antibiotics and Drugs of Other Therapeutic Categories

PubMed Central

Falagas, Matthew E.; Fragoulis, Konstantinos N.; Karydis, Ioannis

2006-01-01

Background Drug treatment is becoming more expensive due to the increased cost for the introduction of new drugs, and there seems to be an uneven distribution of medication cost for different therapeutic categories. We hypothesized that the cost of new antimicrobial agents may differ from that of other therapeutic categories and this may play a role in the stagnation of development of new antibiotics. Methodology/Principal Findings We performed a pharmaco-economical comparative analysis of the drug cost of treatment for new agents introduced in the United States drug market in various therapeutic categories. We calculated the drug cost (in US dollars) of a ten-day treatment of all new drugs approved by the FDA during the period between January 1997 and July 2003, according to the 2004 Red Book Pharmacy's Fundamental Reference. New anti-neoplastic agents were found to be the most expensive drugs in comparison to all other therapeutic categories, with a median ten-day drug-treatment cost of US$848 compared to the median ten-day drug-treatment costs of all other categories ranging from US$29 to US$301. On the other hand, new antimicrobial drugs were found to be much less expensive, with a median ten-day drug-treatment cost of US$137 and $US85 for all anti-microbial agents and for anti-microbial agents excluding anti-HIV medications, respectively. Conclusions/Significance The drug-treatment cost of new medications varies considerably by different therapeutic categories. This fact may influence industry decisions regarding the development of new drugs and may play a role in the shortage of new antimicrobial agents in the fight against the serious problem of antimicrobial resistance. PMID:17183637

A comparative study on the cost of new antibiotics and drugs of other therapeutic categories.

PubMed

Falagas, Matthew E; Fragoulis, Konstantinos N; Karydis, Ioannis

2006-12-20

Drug treatment is becoming more expensive due to the increased cost for the introduction of new drugs, and there seems to be an uneven distribution of medication cost for different therapeutic categories. We hypothesized that the cost of new antimicrobial agents may differ from that of other therapeutic categories and this may play a role in the stagnation of development of new antibiotics. We performed a pharmaco-economical comparative analysis of the drug cost of treatment for new agents introduced in the United States drug market in various therapeutic categories. We calculated the drug cost (in US dollars) of a ten-day treatment of all new drugs approved by the FDA during the period between January 1997 and July 2003, according to the 2004 Red Book Pharmacy's Fundamental Reference. New anti-neoplastic agents were found to be the most expensive drugs in comparison to all other therapeutic categories, with a median ten-day drug-treatment cost of US$848 compared to the median ten-day drug-treatment costs of all other categories ranging from US$29 to US$301. On the other hand, new antimicrobial drugs were found to be much less expensive, with a median ten-day drug-treatment cost of US$137 and $US85 for all anti-microbial agents and for anti-microbial agents excluding anti-HIV medications, respectively. The drug-treatment cost of new medications varies considerably by different therapeutic categories. This fact may influence industry decisions regarding the development of new drugs and may play a role in the shortage of new antimicrobial agents in the fight against the serious problem of antimicrobial resistance.

Cost Structure and Clinical Outcome of a Stem Cell Transplantation Program in a Developing Country: The Experience in Northeast Mexico

PubMed Central

Heredia-Salazar, Alberto Carlos; Cantú-Rodríguez, Olga G.; Gutiérrez-Aguirre, Homero; Villarreal-Villarreal, César Daniel; Mancías-Guerra, Consuelo; Herrera-Garza, José Luís; Gómez-Almaguer, David

2015-01-01

Background and Objective. Hematopoietic stem cell transplantation (HSCT) in developing countries is cost-limited. Our primary goal was to determine the cost structure for the HSCT program model developed over the last decade at our public university hospital and to assess its clinical outcomes. Materials and Methods. Adults and children receiving an allogeneic hematopoietic stem cell transplant from January 2010 to February 2011 at our hematology regional reference center were included. Laboratory tests, medical procedures, chemotherapy drugs, other drugs, and hospitalization costs were scrutinized to calculate the total cost for each patient and the median cost for the procedure. Data regarding clinical evolution were incorporated into the analysis. Physician fees are not charged at the institution and therefore were not included. Results. Fifty patients were evaluated over a 1-year period. The total estimated cost for an allogeneic HSCT was $12,504. The two most expensive diseases to allograft were non-Hodgkin lymphoma ($11,760 ± $2,236) for the malignant group and thalassemia ($12,915 ± $5,170) for the nonmalignant group. Acute lymphoblastic leukemia ($11,053 ± 2,817) and acute myeloblastic leukemia ($10,251 ± $1,538) were the most frequent indications for HSCT, with 11 cases each. Median out-of-pocket expenses were $1,605, and 1-year follow-up costs amounted to $1,640, adding up to a total cost of $15,749 for the first year. The most expensive components were drugs and laboratory tests. Conclusion. Applying the cost structure described, HSCT is an affordable option for hematological patients living in a developing country. PMID:25746343

Indirect, out-of-pocket and medical costs from influenza-related illness in young children.

PubMed

Ortega-Sanchez, Ismael R; Molinari, Noelle-Angelique M; Fairbrother, Gerry; Szilagyi, Peter G; Edwards, Kathryn M; Griffin, Marie R; Cassedy, Amy; Poehling, Katherine A; Bridges, Carolyn; Staat, Mary Allen

2012-06-13

Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza. To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children. Using a population-based surveillance network, we evaluated a representative group of children aged <5 years with laboratory-confirmed, medically attended influenza during the 2003-2004 season. Children hospitalized or seen in emergency department (ED) or outpatient settings in surveillance counties with laboratory-confirmed influenza were identified and data were collected from medical records, accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications. Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p>0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients. Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination. Published by Elsevier Ltd.

Effectiveness and Cost-effectiveness of School-based Dissemination Strategies of an Internet-based Program for the Prevention and Early Intervention in Eating Disorders: A Randomized Trial.

PubMed

Moessner, Markus; Minarik, Carla; Ozer, Fikret; Bauer, Stephanie

2016-04-01

Only little is known about costs and effects (i.e., success) of dissemination strategies, although cost-effective dissemination strategies are crucial for the transfer of interventions into routine care. This study investigates the effects and cost-effectiveness of five school-based dissemination strategies for an Internet-based intervention for the prevention and early intervention of eating disorders. Three-hundred ninety-five schools were randomly assigned to one of five dissemination strategies. Strategies varied with respect to intensity from only sending advertisement materials and asking the school to distribute them among students to organizing presentations and workshops at schools. Effects were defined as the number of page visits, the number of screenings conducted, and the number of registrations to the Internet-based intervention. More expensive strategies proved to be more cost-effective. Cost per page visit ranged from 2.83€ (introductory presentation plus workshop) to 20.37€ (dissemination by student representatives/peers). Costs per screening ranged from 3.30€ (introductory presentation plus workshop) to 75.66€ (dissemination by student representatives/peers), and costs per registration ranged from 6.86€ (introductory presentation plus workshop) to 431.10€ (advertisement materials only). Dissemination of an Internet-based intervention for prevention and early intervention is challenging and expensive. More intense, expensive strategies with personal contact proved to be more cost-effective. The combination of an introductory presentation on eating disorders and a workshop in the high school was most effective and had the best cost-effectiveness ratio. The sole distribution of advertisement materials attracted hardly any participants to the Internet-based program.

18 CFR 367.83 - Training costs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Training costs. 367.83... Expense Instructions § 367.83 Training costs. When it is necessary that employees be trained to... functional accounts currently as they are incurred. However, when the training costs involved relate to...

24 CFR 200.97 - Adjustments resulting from cost certification.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Adjustments resulting from cost certification. (a) Fee simple site. Upon receipt of the mortgagor's... held under a leasehold or other interest less than a fee, the cost, if any, of acquiring the leasehold or other interest is considered an allowable expense which may be added to actual cost provided that...

Enough to Go 'Round? Thinking Smart about Total Cost of Ownership

ERIC Educational Resources Information Center

McIntire, Todd

2006-01-01

Total cost of ownership or TCO refers to the life cycle of costs for technology, including both direct and indirect expenses. TCO includes costs incurred by capital (hardware, software, and facilities); administration and operation (planning, upgrade, replacement, and technical support); and end-user operation (staff development and user…

2 CFR 200.457 - Plant and security costs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Plant and security costs. 200.457 Section... Cost § 200.457 Plant and security costs. Necessary and reasonable expenses incurred for routine and.... Capital expenditures for plant security purposes are subject to § 200.439 Equipment and other capital...

Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider's Choice.

PubMed

Quan-Hoang, Vuong

2016-10-01

Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's < 0.01), indicating that both information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.

A capital cost comparison of commercial ground-source heat pump systems

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

Rafferty, K.

1994-06-01

The purpose of the report is to compare capital costs associated with the three designs of ground source heat pumps. Specifically, the costs considered are those associated with the heat source/heat sink or ground source portion of the system. In order to standardize the heat rejection over the three designs, it was assumed that the heat pump loop would operate at a temperature range of 85{degree} (to the heat pumps) to 95{degree} (from the heat pumps) under peak conditions. The assumption of constant loop temperature conditions for all three permits an apples-to-apples comparison of the alternatives.

18 CFR 367.9010 - Account 901, Supervision.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., Supervision. 367.9010 Section 367.9010 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9010 Account 901, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9110 - Account 911, Supervision.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Supervision. 367.9110 Section 367.9110 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9110 Account 911, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9110 - Account 911, Supervision.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., Supervision. 367.9110 Section 367.9110 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9110 Account 911, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9010 - Account 901, Supervision.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., Supervision. 367.9010 Section 367.9010 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9010 Account 901, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9010 - Account 901, Supervision.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., Supervision. 367.9010 Section 367.9010 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9010 Account 901, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9070 - Account 907, Supervision.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., Supervision. 367.9070 Section 367.9070 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9070 Account 907, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9110 - Account 911, Supervision.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., Supervision. 367.9110 Section 367.9110 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9110 Account 911, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9110 - Account 911, Supervision.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., Supervision. 367.9110 Section 367.9110 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9110 Account 911, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9070 - Account 907, Supervision.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., Supervision. 367.9070 Section 367.9070 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9070 Account 907, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9070 - Account 907, Supervision.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., Supervision. 367.9070 Section 367.9070 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9070 Account 907, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9010 - Account 901, Supervision.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., Supervision. 367.9010 Section 367.9010 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9010 Account 901, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9110 - Account 911, Supervision.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., Supervision. 367.9110 Section 367.9110 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9110 Account 911, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

18 CFR 367.9070 - Account 907, Supervision.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., Supervision. 367.9070 Section 367.9070 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... ACT Operation and Maintenance Expense Chart of Accounts § 367.9070 Account 907, Supervision. This account must include the cost of labor and expenses incurred in the general direction and supervision of...

44 CFR 295.31 - Reimbursement of claim expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... § 295.31 Reimbursement of claim expenses. (a) FEMA will reimburse Claimants for the reasonable costs they incur in copying documentation requested by OCGFC. FEMA will also reimburse Claimants for the... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of claim...

Material costs of anterior cruciate ligament reconstruction with hamstring tendons by two different techniques.

PubMed

Cournapeau, J; Klouche, S; Hardy, P

2013-04-01

In France, approximately 36,000 anterior cruciate ligament (ACL) reconstruction surgical procedures are performed every year. Technical progress, in particular arthroscopy, has made surgery more precise, but more expensive. In a context of healthcare cost containment, the increase in the cost of technology must be compared to the improved outcome for the patients. The main aim of this study was to determine all material costs related to ACL reconstruction using hamstring tendons. This study also compared the material costs between the two arthroscopic techniques: standard or "all-inside". A retrospective study of material costs was performed in 2011. With the standard technique, the tibial tunnel was drilled from outside to inside, while with the all-inside technique two tunnels were drilled from inside to outside. All of the material used from the first swab to the final bandage was reported. It was classified into three categories: reusable arthroscopy material, disposable arthroscopic material, and disposable surgical supplies. The costs were those of our supplier in 2011 (Arthrex™) and based on Public Hospitals of Paris (AP-HP) public contract tariffs. Standard ligament reconstruction was less expensive than the all-inside technique: 791.59€ versus 931.06€ excluding taxes (hors taxes [HT]), respectively. The largest percentage of expenses was allocated to disposable material use (81 and 84%). Possible avenues of savings are limited: all the material used was necessary. To control costs, correct use and good maintenance of instruments are the most important elements. Level IV. Economic and decision analyses, retrospective study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Why Are Diabetes Medications So Expensive and What Can Be Done to Control Their Cost?

PubMed

McEwen, Laura N; Casagrande, Sarah Stark; Kuo, Shihchen; Herman, William H

2017-09-01

The purposes of this study were to describe how medication prices are established, to explain why antihyperglycemic medications have become so expensive, to show trends in expenditures for antihyperglycemic medications, and to highlight strategies to control expenditures in the USA. In the U.S., pharmaceutical manufacturers set the prices for new products. Between 2002 and 2012, expenditures for antihyperglycemic medications increased from $10 billion to $22 billion. This increase was primarily driven by expenditures for insulin which increased sixfold. The increase in insulin expenditures may be attributed to several factors: the shift from inexpensive beef and pork insulins to more expensive genetically engineered human insulins and insulin analogs, dramatic price increases for the available insulins, physician prescribing practices, policies that limit payers' abilities to negotiate prices, and nontransparent negotiation of rebates and discounts. The costs of antihyperglycemic medications, especially insulin, have become a barrier to diabetes treatment. While clinical interventions to shift physician prescribing practices towards lower cost drugs may provide some relief, we will ultimately need policy interventions such as more stringent requirements for patent exclusivity, greater transparency in medication pricing, greater opportunities for price negotiation, and outcomes-based pricing models to control the costs of antihyperglycemic medications.

The effects of recycling loops in food waste management in Japan: based on the environmental and economic evaluation of food recycling.

PubMed

Takata, Miki; Fukushima, Kazuyo; Kino-Kimata, Noriko; Nagao, Norio; Niwa, Chiaki; Toda, Tatsuki

2012-08-15

In Japan, a revised Food Recycling Law went into effect in 2007 to promote a "recycling loop" that requires food industries to purchase farm products that are grown using food waste-derived compost/animal feed. To realize and expand food recycling, it is necessary to evaluate how the recycling facilities work in the recycling loop. The purpose of this study is to assess the environmental and economic efficiency of the food recycling facilities that are involved in the recycling loop, which are also known as looped facilities. The global warming potential and running cost of five looped facilities were evaluated by LCA (life cycle assessment) and LCC (life cycle cost) approaches: machine integrated compost, windrow compost, liquid feed, dry feed, and bio-gasification. The LCA results showed low total GHG (greenhouse gas) emissions of -126 and -49 kg-CO(2)/t-waste, respectively, for dry feed and bio-gasification facilities, due to a high substitution effect. The LCC study showed a low running cost for composting facilities of -15,648 and -18,955 yen/t-waste, respectively, due to high revenue from the food waste collection. It was found that the mandatory reporting of food waste emitters to the government increased collection fees; however, the collection fee in animal feed facilities was relatively low because food waste was collected at a low price or nutritious food waste was purchased to produce quality feed. In the characterisation survey of various treatment methods, the composting facilities showed a relatively low environmental impact and a high economic efficiency. Animal feed facilities had a wide distribution of the total GHG emissions, depending on both the energy usage during the drying process and the substitution effect, which were related to the water content of the food waste and the number of recycled products. In comparison with incineration, the majority of the food recycling facilities showed low GHG emissions and economic effectiveness. This paper also reported on the effects of recycling loops by comparing looped and non-looped animal feed facilities, and confirmed that the looped facilities were economically effective, due to an increased amount of food waste collection. Copyright © 2012 Elsevier B.V. All rights reserved.

The relative importance of factors that determine log-hauling costs

Treesearch

A. Jeff Martin; A. Jeff Martin

1971-01-01

Hauling costs are a major expense to lumbermen, but little is known about which factors affect hauling costs the most. A recent Forest Service study of hauling costs on 34 logging operations sheds light on whmich factors of cost are important and which might require less attention. These results should help lumbermen adopt a cost accounting procedure and help them with...

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

PubMed

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

2010-12-01

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

The financial impact of a clinical academic practice partnership.

PubMed

Greene, Mary Ann; Turner, James

2014-01-01

New strategies to provide clinical experiences for nursing students have caused nursing schools and hospitals to evaluate program costs. A Microsoft Excel model, which captures costs and associated benefits, was developed and is described here. The financial analysis shows that the Clinical Academic Practice Program framework for nursing clinical education, often preferred by students, can offer financial advantages to participating hospitals and schools of nursing. The model is potentially a tool for schools of nursing to enlist hospitals and to help manage expenses of clinical education. Hospitals may also use the Hospital Nursing Unit Staffing and Expense Worksheet in planning staffing when students are assigned to units and the cost/benefit findings to enlist management support.

VINE: A Variational Inference -Based Bayesian Neural Network Engine

DTIC Science & Technology

2018-01-01

networks are trained using the same dataset and hyper parameter settings as discussed. Table 1 Performance evaluation of the proposed transfer learning...multiplication/addition/subtraction. These operations can be implemented using nested loops in which various iterations of a loop are independent of...each other. This introduces an opportunity for optimization where a loop may be unrolled fully or partially to increase parallelism at the cost of

Simple system for locating ground loops.

PubMed

Bellan, P M

2007-06-01

A simple low-cost system for rapid identification of the cables causing ground loops in complex instrumentation configurations is described. The system consists of an exciter module that generates a 100 kHz ground loop current and a detector module that determines which cable conducts this test current. Both the exciter and detector are magnetically coupled to the ground circuit so there is no physical contact to the instrumentation system under test.

Medical education, cost and policy: what are the drivers for change? Commentary.

PubMed

Walsh, Kieran

2014-01-01

Medical education is expensive. Its expense has led many stakeholders to speculate on how costs could be reduced. In an ideal world such decisions would be made on sound evidence; however this is impossible in the absence of evidence. Sometimes practice will be informed by policy, but policy will not always be evidence based. So how is policy in the field of cost and value in medical education actually developed? The foremost influence on policy in cost and value should be evidence-based knowledge. Unfortunately policy is sometimes influenced by what might at best be termed tradition and at worst inertia. Another influence on policy will be people--but some individuals may have more influence than others. A further influence on policy in this field is events, and mainly events that have gone wrong. One final influence on emerging policy in medical education cost analysis is that of the media.

Issues in formulary management: therapeutic interchange. The value, cost, and quality of therapeutic interchange.

PubMed

Mahoney, C D

1992-10-01

Therapeutic interchange is a process of substituting a prescribed medication with one that offers therapeutic and cost benefits. The practice not only provides short-term savings but also is associated with decreases in lengths of stay in hospitals and total hospital drug expenses. There may be medicolegal implications when FDA-approved indications differ for interchanged drugs. The potential for liability is decreased when a standard of care is met, but since standards can change, guidelines should be reviewed regularly. High-tech, high-cost drugs are sometimes appropriate for therapeutic interchange. Pharmacy and therapeutics committees should assure best value by considering indirect expenses, quality, and therapeutic outcome, as well as product cost. Therapeutic interchange programs enable pharmacy managers to neutralize or at least slow the rate of drug cost increases, ensuring appropriate utilization of resources and more favorable patient outcomes.

The Impact of an Electronic Expensive Test Notification.

PubMed

Riley, Jacquelyn D; Stanley, Glenn; Wyllie, Robert; Kottke-Marchant, Kandice; Procop, Gary W

2018-04-25

The impact of clinical decision support tools (CDSTs) that display test cost information has been variable. We retrospectively analyzed the 3-year impact of a passive CDST that notified providers when the test order cost was $1,000 or more. We determined the most common expensive tests ordered, the frequency with which providers abandoned the order after notification, and the costs saved through this intervention. The average monthly abandonment rate was 12.5% (2014), 12.9% (2015), and 14.3% (2016). The cost savings from tests not performed for this 3-year period was $696,007. Molecular hematopathology assays were the most frequently ordered tests, with variable abandonment rates. Although this CDST was passive (ie, could be overridden at the point of order entry) and was associated with a relatively low abandonment rate, it achieved a considerable cost savings each year since each abandoned test saved the institution $1,000 or more.

Pilot-in-the-Loop CFD Method Development

DTIC Science & Technology

2015-02-01

expensive alternatives [1]. ALM represents the blades as a set of segments along with each blade axis and the ADM represents the entire rotor as...fine grid, Δx = 1.00 m Figure 4 – Time-averaged vertical velocity distributions on downwash and rotor disk plane for hybrid and loose coupling...cases with fine and coarse grid refinement levels. Figure 4 shows the time-averaged distributions of vertical velocities on both downwash and rotor disk

Utilisation of the Magnetic Sensor in a Smartphone for Facile Magnetostatics Experiment: Magnetic Field Due to Electrical Current in Straight and Loop Wires

ERIC Educational Resources Information Center

Septianto, R. D.; Suhendra, D.; Iskandar, F.

2017-01-01

This paper reports on the result of a research into the utilisation of a smartphone for the study of magnetostatics on the basis of experiments. The use of such a device gives great measurement result and thus it can replace magnetic sensor tools that are relatively expensive. For the best experimental result, firstly the position of the magnetic…

Pursuing cost-effectiveness in mental health service delivery for youth with complex needs.

PubMed

Grimes, Katherine E; Schulz, Margaret F; Cohen, Steven A; Mullin, Brian O; Lehar, Sophie E; Tien, Shelly

2011-06-01

Mental health advocates seek to expand children's services, noting widespread failure to meet the needs of public sector youth suffering from serious emotional disturbance (SED). However, state and national budgets face deepening cuts, with rising health care costs taking the blame. As the gap between needs and finances widens, identification of cost-effective treatments that will benefit children with SED and their families is of increasing importance. Community-based interventions for this population, such as the wraparound approach and systems-of-care, are being disseminated but literature is scant regarding effects on expense. The Mental Health Services Program for Youth (MHSPY) model is aligned philosophically with wraparound and systems-of-care but unique in blending public agency dollars to deliver integrated medical, mental health and social services. MHSPY's linked clinical and expense data is useful to study community-based treatment cost-effectiveness. To examine the cost-effectiveness of an intensively integrated, family and community-based clinical intervention for youth with mental health needs in comparison to "usual care.'' Study and reference populations were matched on age, gender, community, psychiatric diagnosis, morbidity and insurance type. Claims analyses included patterns of service utilization and medical expense for both groups. Using propensity score matching, results for study youth are compared with results for the population receiving "usual care.'' Clinical functioning was measured for the intervention group at baseline and 12 months. The intervention group used lower intensity services and had substantially lower claims expense (e.g. 32% lower for emergency room, 74% lower for inpatient psychiatry) than their matched counterparts in the "usual care'' group. Intervention youth were consistently maintained in least restrictive settings, with over 88% of days spent at home and showed improved clinical functioning on standard measures. The intensive MHSPY model of service delivery offers potential as a cost-effective intervention for complex youth. Its integrated approach, recognizing needs across multiple life domains, appears to enhance engagement and the effectiveness of mental health treatment, resulting in statistically significant clinical improvements. Functional measures are not collected in "usual care,'' limiting comparisons. However, claims expense for intervention youth was substantially lower than claims expense for Medicaid comparison youth, suggesting clinical needs for intervention youth post-enrollment were lower than for those receiving "usual care.'' The MHSPY model, which intentionally engages families in "clustered'' traditional and non-traditional services, represents a replicable strategy for enhancing the impact of clinical interventions, thereby reducing medical expense. Blending categorical state agency dollars and insurance funds creates flexibility to support community-based care, including individualized services for high-risk youth. Resulting expenses total no more, and are often less, than "treatment as usual'' but yield greater clinical benefits. Further research is needed regarding which intervention elements contribute the most towards improved clinical functioning, as well as which patients are most likely to benefit. A randomized trial of MHSPY vs. "usual care,'' including examination of the sustainability of effects post-disenrollment, would provide a chance to further test this innovative model.

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

28 CFR 100.15 - Disallowed costs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... limited to: (1) Accounting and Finance, External Relations, Human Resources, Information Management, Legal...) costs are disallowed. G&A costs include, but are not limited to, any management, financial, and other... include, but are not limited to, any Marketing, Sales, Product Management, and Advertising expenses. (c...

Improving bladder cancer patient care: a pharmacoeconomic perspective.

PubMed

Gore, John L; Gilbert, Scott M

2013-06-01

Bladder cancer is the most expensive cancer per capita to treat in the US healthcare system. Substantial costs associated with the diagnosis, management and surveillance of bladder cancer account for the bulk of the expense; yet, for that cost, patients may not receive high-quality care. Herein the authors review the sources of expenditure associated with bladder cancer care, review population-level analyses of the quality of bladder cancer care in the USA, and discuss opportunities for quality improvement that may yield greater value for men and women newly diagnosed with bladder cancer.

Medicare program; clarification of Medicare's accrual basis of accounting policy--HCFA. Final rule.

PubMed

1995-06-27

This final rule revises the Medicare regulations to clarify the concept of "accrual basis of accounting" to indicate that expenses must be incurred by a provider of health care services before Medicare will pay its share of those expenses. This rule does not signify a change in policy but, rather, incorporates into the regulations Medicare's longstanding policy regarding the circumstances under which we recognize, for the purposes of program payment, a provider's claim for costs for which it has not actually expended funds during the current cost reporting period.

12 CFR 1071.202 - Documentation of fees and expenses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... initiation of the adversary adjudication, including the cost of any study, engineering report, test, or... incurred after initiation of the adversary adjudication, including the cost of any study, engineering...

The incidence of high medical expenses by health status in seven developed countries.

PubMed

Baird, Katherine Elizabeth

2016-01-01

Health care policy seeks to ensure that citizens are protected from the financial risk associated with needing health care. Yet rising health care costs in many countries are leading to a greater reliance on out-of-pocket (OOP) measures. This paper uses 2010 household survey data from seven countries to measure and compare the burden OOP expenses place on individuals. It compares countries based on the extent to which citizens with health problems devote a large share of their income to OOP expenses. The paper finds that in all countries but France, and to a lesser extent Slovenia, citizens with health problems face considerably higher medical costs than do those without. As many as one-quarter of less healthy citizens in the US, Poland, Russia and Israel devote a large share of their income to OOP expenses. The paper also finds a strong cross-national correlation between the degree to which citizens face high OOP expenses, and the disparities in OOP expenses between those with and without health problems. The levels of high OOP spending uncovered, and their inequitable impact on those with health problems in the seven countries, underscore the potential for OOP measures to undermine core objectives of health care systems, including those of equitable financing, equal access, and improved health among the population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

29 CFR 16.203 - Documentation of fees and expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documentation of the fees and expenses, including the cost of any study, analysis, engineering report, test... each professional firm or individual whose services are covered by the application, showing the hours... date, number of hours per date and the services performed during those hours. In order to establish the...

40 CFR 17.13 - Documentation of fees and expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documentation of fees and expenses, including the cost of any study, engineering report, test, or project, for...) The affidavit shall itemize in detail the services performed by the date, number of hours per date, and the services performed during those hours. In order to establish the hourly rate, the affidavit...

29 CFR 16.203 - Documentation of fees and expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documentation of the fees and expenses, including the cost of any study, analysis, engineering report, test... each professional firm or individual whose services are covered by the application, showing the hours... date, number of hours per date and the services performed during those hours. In order to establish the...

40 CFR 17.13 - Documentation of fees and expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documentation of fees and expenses, including the cost of any study, engineering report, test, or project, for...) The affidavit shall itemize in detail the services performed by the date, number of hours per date, and the services performed during those hours. In order to establish the hourly rate, the affidavit...

Genome-wide association study for feed efficiency traits using SNP and haplotype models

USDA-ARS?s Scientific Manuscript database

Feed costs comprise the majority of variable expenses in beef cattle systems making feed efficiency an important economic consideration within the beef industry. Due to the expense of recording individual feed intake phenotypes, a genomic-enabled approach could be advantageous towards improving this...

38 CFR 21.9585 - Travel expenses.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

38 CFR 21.9585 - Travel expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

38 CFR 21.9585 - Travel expenses.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

38 CFR 21.9585 - Travel expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9585 Travel expenses. VA will not pay for any costs of travel to and from the place of counseling regardless of whether the individual requests educational and vocational counseling or whether the counseling is required. (Authority: 38 U.S.C...

41 CFR 105-57.005 - Hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... personal and travel expenses incurred by the debtor in connection with an in-person hearing will be borne... fees for attorneys, travel expenses, or costs for reproducing documents. (4) In those cases when an... a written hearing. (f) Burden of proof. (1) GSA will have the burden of establishing the existence...

13 CFR 134.609 - What is the difference between a fee and an expense?

Code of Federal Regulations, 2010 CFR

2010-01-01

... connection with your case. An expense is the cost to you of any study, analysis, engineering report, test, project, or similar matter prepared in connection with your case. ... ADMINISTRATION RULES OF PROCEDURE GOVERNING CASES BEFORE THE OFFICE OF HEARINGS AND APPEALS Implementation of the...

New Wrinkles on Retirement: Program Notes.

ERIC Educational Resources Information Center

Wray, Robert P.; Thorson, James A.

The program notes were prepared to accompany the television series "New Wrinkles on Retirement." The eight units in the series are: facing inflation, which covers the decreasing value of the dollar, transportation costs, medical expenses, cutting expenses, family budgeting, investments, and places to live; vigor regained, which covers exercise and…

29 CFR 553.106 - Payment of expenses, benefits, or fees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... payment for expenses without being deemed an employee for purposes of the FLSA. A school guard does not become an employee because he or she receives a uniform allowance, or reimbursement for reasonable... service. (A uniform allowance must be reasonably limited to relieving the volunteer of the cost of...

29 CFR 553.106 - Payment of expenses, benefits, or fees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... payment for expenses without being deemed an employee for purposes of the FLSA. A school guard does not become an employee because he or she receives a uniform allowance, or reimbursement for reasonable... service. (A uniform allowance must be reasonably limited to relieving the volunteer of the cost of...

29 CFR 553.106 - Payment of expenses, benefits, or fees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... payment for expenses without being deemed an employee for purposes of the FLSA. A school guard does not become an employee because he or she receives a uniform allowance, or reimbursement for reasonable... service. (A uniform allowance must be reasonably limited to relieving the volunteer of the cost of...

Time to Tell the Whole Story: Uncovering the True Cost of University Athletics.

ERIC Educational Resources Information Center

Hughes, Peter

1992-01-01

Many university athletics departments are running significant deficits, making critical full reporting on all expenses, by sport. Anything less than full disclosure by sport of all related expenses misleads institutional leaders, students, alumni, and legislators into believing that football and men's basketball teams can bankroll…

5 CFR 2610.107 - Allowable fees and expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Allowable fees and expenses. 2610.107 Section 2610.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES... factors as may bear on the value of the services provided. (d) The reasonable cost of any study, analysis...

20 CFR 220.145 - Impairment-related work expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ACT DETERMINING DISABILITY Substantial Gainful Activity § 220.145 Impairment-related work expenses. (a... gainful activity, the Board will subtract the reasonable costs to the claimant of certain items and... adverse impact on the claimant's ability to function in his or her work activity. In this situation, the...

20 CFR 220.145 - Impairment-related work expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ACT DETERMINING DISABILITY Substantial Gainful Activity § 220.145 Impairment-related work expenses. (a... gainful activity, the Board will subtract the reasonable costs to the claimant of certain items and... adverse impact on the claimant's ability to function in his or her work activity. In this situation, the...

20 CFR 220.145 - Impairment-related work expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ACT DETERMINING DISABILITY Substantial Gainful Activity § 220.145 Impairment-related work expenses. (a... gainful activity, the Board will subtract the reasonable costs to the claimant of certain items and... adverse impact on the claimant's ability to function in his or her work activity. In this situation, the...

20 CFR 220.145 - Impairment-related work expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACT DETERMINING DISABILITY Substantial Gainful Activity § 220.145 Impairment-related work expenses. (a... gainful activity, the Board will subtract the reasonable costs to the claimant of certain items and... adverse impact on the claimant's ability to function in his or her work activity. In this situation, the...

18 CFR 35.24 - Tax normalization for public utilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the Natural Gas Act. (7) Tax effect means the tax reduction or addition associated with a specific... purposes; (v) Differences that arise from recognition of research, development, and demonstration... purchased gas costs as a current expense for tax purposes but as a deferred expense for book purposes. (See...

24 CFR 92.208 - Eligible community housing development organization (CHDO) operating expense and capacity...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Eligible community housing development organization (CHDO) operating expense and capacity building costs. 92.208 Section 92.208 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME...

41 CFR 302-16.2 - What are miscellaneous expenses?

Code of Federal Regulations, 2012 CFR

2012-07-01

... relocating that are not covered by other relocation benefits detailed in Chapter 302. (b) Expenses allowable... use taxes imposed when bringing vehicles into certain jurisdictions Transportation of pets The only... other house pets, as well as costs due to stringent air carrier rules. Other animals (horses, fish...

41 CFR 302-16.2 - What are miscellaneous expenses?

Code of Federal Regulations, 2014 CFR

2014-07-01

... relocating that are not covered by other relocation benefits detailed in chapter 302. (b) Expenses allowable... use taxes imposed when bringing vehicles into certain jurisdictions Transportation of pets The only... other house pets, as well as costs due to stringent air carrier rules. Other animals (horses, fish...

41 CFR 302-16.1 - What are miscellaneous expenses?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Transportations of pets Only costs associated with dogs, cats and other house pets are included. Other animals... relocating that are not covered by other relocation benefits detailed in Chapter 302. (b) Expenses allowable... use taxes imposed when bringing vehicles into certain jurisdictions Transportation of pets The only...

41 CFR 302-16.2 - What are miscellaneous expenses?

Code of Federal Regulations, 2013 CFR

2013-07-01

... relocating that are not covered by other relocation benefits detailed in Chapter 302. (b) Expenses allowable... use taxes imposed when bringing vehicles into certain jurisdictions Transportation of pets The only... other house pets, as well as costs due to stringent air carrier rules. Other animals (horses, fish...

[Cost analysis for navigation in knee endoprosthetics].

PubMed

Cerha, O; Kirschner, S; Günther, K-P; Lützner, J

2009-12-01

Total knee arthroplasty (TKA) is one of the most frequent procedures in orthopaedic surgery. The outcome depends on a range of factors including alignment of the leg and the positioning of the implant in addition to patient-associated factors. Computer-assisted navigation systems can improve the restoration of a neutral leg alignment. This procedure has been established especially in Europe and North America. The additional expenses are not reimbursed in the German DRG system (Diagnosis Related Groups). In the present study a cost analysis of computer-assisted TKA compared to the conventional technique was performed. The acquisition expenses of various navigation systems (5 and 10 year depreciation), annual costs for maintenance and software updates as well as the accompanying costs per operation (consumables, additional operating time) were considered. The additional operating time was determined on the basis of a meta-analysis according to the current literature. Situations with 25, 50, 100, 200 and 500 computer-assisted TKAs per year were simulated. The amount of the incremental costs of the computer-assisted TKA depends mainly on the annual volume and the additional operating time. A relevant decrease of the incremental costs was detected between 50 and 100 procedures per year. In a model with 100 computer-assisted TKAs per year an additional operating time of 14 mins and a 10 year depreciation of the investment costs, the incremental expenses amount to 300-395 depending on the navigation system. Computer-assisted TKA is associated with additional costs. From an economical point of view an amount of more than 50 procedures per year appears to be favourable. The cost-effectiveness could be estimated if long-term results will show a reduction of revisions or a better clinical outcome.

Cost savings of home bortezomib injection in patients with multiple myeloma treated by a combination care in Outpatient Hospital and Hospital care at Home.

PubMed

Touati, Mohamed; Lamarsalle, Ludovic; Moreau, Stéphane; Vergnenègre, Françoise; Lefort, Sophie; Brillat, Catherine; Jeannet, Laetitia; Lagarde, Aline; Daulange, Annick; Jaccard, Arnaud; Vergnenègre, Alain; Bordessoule, Dominique

2016-12-01

At home injectable chemotherapy for patients receiving treatment for hematological diseases is still in debate. Given the expense of new innovative medicines, at home treatment has been proposed as a suitable option for improving patient quality of life and decreasing treatment costs. We decided to assess the cost of bortezomib administration in France among multiple myeloma patients from an economic standpoint. Patients in this study were treated within a regional hematological network combining outpatient hospital care and Hospital care at Home administration. To make the cost comparison, our team simulated outpatient hospital care expenses. Fifty-four consecutive multiple myeloma patients who received at least one injection of bortezomib in Hospital care at Home from January 2009 to December 2011 were included in the study. The median number of injections was 12 (range 1-44) at home and 6 (range 0-30) in the outpatient care unit. When compared with the cost simulation of outpatient hospital care alone, bortezomib administration with combined care was significantly less expensive for the National Health Insurance (NHI) budget. The mean total cost per patient and per injection was 954.20 € for combined outpatient and Hospital care at Home vs 1143.42 € for outpatient hospital care alone. This resulted in an estimated 16.5 % cost saving (Wilcoxon signed-rank test, p < 0.0001). The greatest savings were observed in administration costs (37.5 % less) and transportation costs (68.1 % less). This study reflects results for a regionally implemented program for multiple myeloma patients treated with bortezomib in routine practice in a large rural area.

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study.

PubMed

Kim, Eugene; Kwon, Hye-Young; Baek, Sang Hong; Lee, Haeyoung; Yoo, Byung-Su; Kang, Seok-Min; Ahn, Youngkeun; Yang, Bong-Min

2018-03-01

This study investigated annual medical costs using real-world data focusing on acute heart failure. The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed. On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%. Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated. It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.

Cost-effectiveness analysis of intracameral cefuroxime use for prophylaxis of endophthalmitis after cataract surgery.

PubMed

Sharifi, Emile; Porco, Travis C; Naseri, Ayman

2009-10-01

To evaluate the cost-effectiveness of intracameral cefuroxime for postoperative endophthalmitis prophylaxis, and to determine the efficacy threshold necessary for alternative antibiotics to attain cost-effective equivalence with intracameral cefuroxime. Cost-effectiveness analysis. We study a hypothetical cohort of 100,000 patients undergoing cataract surgery as a part of the cost analysis. A cost-effectiveness model was constructed to analyze different antibiotic prophylactic regimens for postoperative endophthalmitis with intracameral cefuroxime as our base case. Efficacy was defined as the absolute reduction in rate of infection from background rate of infection, which was sourced from the literature. Antibiotic cost data were derived from the Red Book 2007 edition, and salary data were taken from the United States Bureau of Labor Statistics. Multivariate sensitivity analysis assessed the performance of antibiotic options under different scenarios. Cost per case of endophthalmitis prevented; theoretical maximal cost-effectiveness; efficacy threshold necessary to achieve cost-effective equivalence with intracameral cefuroxime; ratio indicating how many times more effective or less expensive alternative antibiotics would have to be to achieve cost-effective equivalence with intracameral cefuroxime. The cost-effectiveness ratio for intracameral cefuroxime is $1403 per case of postoperative endophthalmitis prevented. By comparison, the least expensive topical fluoroquinolone in our study, ciprofloxacin, would have to be >8 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. The most expensive topical fluoroquinolones studied, gatifloxacin and moxifloxacin, would have to be > or =19 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. A sensitivity analysis reveals that even in the worst case scenario for intracameral cefuroxime efficacy and with a 50% reduction in the cost of 4th-generation fluoroquinolones, gatifloxacin and moxifloxacin would have to be > or =9 times more effective than intracameral cefuroxime to achieve cost-effective equivalence. Administration of intracameral cefuroxime is relatively cost-effective in preventing endophthalmitis after cataract surgery. Owing to their high costs, many commonly used topical antibiotics are not cost-effective compared with intracameral cefuroxime, even under optimistic assumptions about their efficacy.

Machine cost analysis using the traditional machine-rate method and ChargeOut!

Treesearch

E. M. (Ted) Bilek

2009-01-01

Forestry operations require ever more use of expensive capital equipment. Mechanization is frequently necessary to perform cost-effective and safe operations. Increased capital should mean more sophisticated capital costing methodologies. However the machine rate method, which is the costing methodology most frequently used, dates back to 1942. CHARGEOUT!, a recently...

7 CFR 28.115 - Fees and costs; payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees and costs; payment. 28.115 Section 28.115... Fees and Costs § 28.115 Fees and costs; payment. All charges for practical forms of cotton standards and all fees and expenses for services of inspection of bales and supervision of sampling...

Cost Analysis of an Office-based Surgical Suite

PubMed Central

LaBove, Gabrielle

2016-01-01

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

2 CFR 200.442 - Fund raising and investment management costs.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., including financial campaigns, endowment drives, solicitation of gifts and bequests, and similar expenses incurred to raise capital or obtain contributions are unallowable. Fund raising costs for the purposes of...

Utilities Expense Report.

ERIC Educational Resources Information Center

Moore, Deborah P.

2001-01-01

Examines how deregulation has affected school district utility costs. Offers ideas that can help school districts save money and energy. Provides several examples of state-wide initiatives intended to help school districts control utility costs. (GR)

Implications of workforce and financing changes for primary care practice utilization, revenue, and cost: a generalizable mathematical model for practice management.

PubMed

Basu, Sanjay; Landon, Bruce E; Song, Zirui; Bitton, Asaf; Phillips, Russell S

2015-02-01

Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation model estimating clinic-level utilization, revenues, and expenses using user-specified or public input data detailing practice staffing levels, salaries and overhead expenditures, patient characteristics, clinic workload, and reimbursements. We assessed whether the model could accurately estimate clinic utilization, revenues, and expenses across the nation using labor compensation, medical expenditure, and reimbursements databases, as well as cost and revenue data from independent practices of varying size. We demonstrated the model's utility in a simulation of how utilization, revenue, and expenses would change after hiring a nurse practitioner (NP) compared with hiring a part-time physician. Modeled practice utilization and revenue closely matched independent national utilization and reimbursement data, disaggregated by patient age, sex, race/ethnicity, insurance status, and ICD diagnostic group; the model was able to estimate independent revenue and cost estimates, with highest accuracy among larger practices. A demonstration analysis revealed that hiring an NP to work independently with a subset of patients diagnosed with diabetes or hypertension could increase net revenues, if NP visits involve limited MD consultation or if NP reimbursement rates increase. A model of utilization, revenue, and expenses in primary care practices may help policymakers and managers understand the implications of workforce and financing changes.

Chemical Looping Gasification for Hydrogen Enhanced Syngas Production with In-Situ CO 2 Capture

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

Kathe, Mandar; Xu, Dikai; Hsieh, Tien-Lin

2014-12-31

This document is the final report for the project titled “Chemical Looping Gasification for Hydrogen Enhanced Syngas Production with In-Situ CO 2 Capture” under award number FE0012136 for the performance period 10/01/2013 to 12/31/2014.This project investigates the novel Ohio State chemical looping gasification technology for high efficiency, cost efficiency coal gasification for IGCC and methanol production application. The project developed an optimized oxygen carrier composition, demonstrated the feasibility of the concept and completed cold-flow model studies. WorleyParsons completed a techno-economic analysis which showed that for a coal only feed with carbon capture, the OSU CLG technology reduced the methanol requiredmore » selling price by 21%, lowered the capital costs by 28%, increased coal consumption efficiency by 14%. Further, using the Ohio State Chemical Looping Gasification technology resulted in a methanol required selling price which was lower than the reference non-capture case.« less

23 CFR 140.807 - Reimbursable costs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Reimbursable costs. 140.807 Section 140.807 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.807 Reimbursable costs. (a) Federal funds may be used to reimburse an...

23 CFR 140.807 - Reimbursable costs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Reimbursable costs. 140.807 Section 140.807 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.807 Reimbursable costs. (a) Federal funds may be used to reimburse an...