Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

PubMed

Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M

2015-04-01

(1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Analysis of space tug operating techniques (study 2.4). Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1972-01-01

The costs of tug refurbishment were studied, using existing cost estimating relationships, to establish the cost of maintaining the reusable third stage of the space transportation system. Refurbishment operations sheets which describe the actual tasks that are necessary to keep the equipment functioning properly were used along with refurbishment operations sheets which contain all of the pertinent descriptive information for each of the major vehicle areas. Tug refurbishment costs per mission are tabulated.

A white paper: Operational efficiency. New approaches to future propulsion systems

NASA Technical Reports Server (NTRS)

Rhodes, Russel; Wong, George

1991-01-01

Advanced launch systems for the next generation of space transportation systems (1995 to 2010) must deliver large payloads (125,000 to 500,000 lbs) to low earth orbit (LEO) at one tenth of today's cost, or 300 to 400 $/lb of payload. This cost represents an order of magnitude reduction from the Titan unmanned vehicle cost of delivering payload to orbit. To achieve this sizable reduction, the operations cost as well as the engine cost must both be lower than current engine system. The Advanced Launch System (ALS) is studying advanced engine designs, such as the Space Transportation Main Engine (STME), which has achieved notable reduction in cost. The results are presented of a current study wherein another level of cost reduction can be achieved by designing the propulsion module utilizing these advanced engines for enhanced operations efficiency and reduced operations cost.

Space tug economic analysis study. Volume 3: Cost estimates

NASA Technical Reports Server (NTRS)

1972-01-01

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

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

NASA Technical Reports Server (NTRS)

1975-01-01

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

Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers

PubMed Central

Nocon, Robert S.; Sharma, Ravi; Birnberg, Jonathan M.; Ngo-Metzger, Quyen; Lee, Sang Mee; Chin, Marshall H.

2013-01-01

Context Little is known about the cost associated with a health center’s rating as a patient-centered medical home (PCMH). Objective To determine whether PCMH rating is associated with operating cost among health centers funded by the US Health Resources and Services Administration. Design, Setting, and Participants Cross-sectional study of PCMH rating and operating cost in 2009. PCMH rating was assessed through surveys of health center administrators conducted by Harris Interactive of all 1009 Health Resources and Services Administration–funded community health centers. The survey provided scores from 0 (worst) to 100 (best) for total PCMH score and 6 subscales: access/communication, care management, external coordination, patient tracking, test/referral tracking, and quality improvement. Costs were obtained from the Uniform Data System reports submitted to the Health Resources and Services Administration. We used generalized linear models to determine the relationship between PCMH rating and operating cost. Main Outcome Measures Operating cost per physician full-time equivalent, operating cost per patient per month, and medical cost per visit. Results Six hundred sixty-nine health centers (66%) were included in the study sample, with 340 excluded because of nonresponse or incomplete data. Mean total PCMH score was 60 (SD,12; range, 21–90). For the average health center, a 10-point higher total PCMH score was associated with a $2.26 (4.6%) higher operating cost per patient per month (95% CI, $0.86–$4.12). Among PCMH subscales, a 10-point higher score for patient tracking was associated with higher operating cost per physician full-time equivalent ($27 300; 95% CI,$3047–$57 804) and higher operating cost per patient per month ($1.06;95%CI,$0.29–$1.98). A 10-point higher score for quality improvement was also associated with higher operating cost per physician full-time equivalent ($32 731; 95% CI, $1571–$73 670) and higher operating cost per patient per month ($1.86; 95% CI, $0.54–$3.61). A 10-point higher PCMH subscale score for access/communication was associated with lower operating cost per physician full-time equivalent ($39 809; 95% CI, $1893–$63 169). Conclusions According to a survey of health center administrators, higher scores on a scale that assessed 6 aspects of the PCMH were associated with higher health center operating costs. Two subscales of the medical home were associated with higher cost and 1 with lower cost. PMID:22729481

Payload analysis for space shuttle applications (study 2.2). Volume 3: Payload system operations analysis (task 2.2.1). [payload system operations analysis for shuttles and space tugs

NASA Technical Reports Server (NTRS)

1972-01-01

The technical and cost analysis that was performed for the payload system operations analysis is presented. The technical analysis consists of the operations for the payload/shuttle and payload/tug, and the spacecraft analysis which includes sortie, automated, and large observatory type payloads. The cost analysis includes the costing tradeoffs of the various payload design concepts and traffic models. The overall objectives of this effort were to identify payload design and operational concepts for the shuttle which will result in low cost design, and to examine the low cost design concepts to identify applicable design guidelines. The operations analysis examined several past and current NASA and DoD satellite programs to establish a shuttle operations model. From this model the analysis examined the payload/shuttle flow and determined facility concepts necessary for effective payload/shuttle ground operations. The study of the payload/tug operations was an examination of the various flight timelines for missions requiring the tug.

Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects

PubMed Central

O’Byrne, Michael L.; Gillespie, Matthew J.; Shinohara, Russell T.; Dori, Yoav; Rome, Jonathan J.; Glatz, Andrew C.

2015-01-01

Background Clinical outcomes for transcatheter and operative closures of atrial septal defects (ASDs) are similar. Economic cost for each method has not been well described. Methods A single-center retrospective cohort study of children and adults <30 years of age undergoing closure for single secundum ASD from January 1, 2007, to April 1, 2012, was performed to measure differences in inflation-adjusted cost of operative and transcatheter closures of ASD. A propensity score weight-adjusted multivariate regression model was used in an intention-to-treat analysis. Costs for reintervention and crossover admissions were included in primary analysis. Results A total of 244 subjects were included in the study (64% transcatheter and 36% operative), of which 2% (n = 5) were ≥18 years. Crossover rate from transcatheter to operative group was 3%. Risk of reintervention (P = .66) and 30-day mortality (P = .37) were not significantly different. In a multivariate model, adjusted cost of operative closure was 2012 US $60,992 versus 2012 US $55,841 for transcatheter closure (P < .001). Components of total cost favoring transcatheter closure were length of stay, medications, and follow-up radiologic and laboratory testing, overcoming higher costs of procedure and echocardiography. Professional costs did not differ. The rate of 30-day readmission was greater in the operative cohort, further increasing the cost advantage of transcatheter closure. Sensitivity analyses demonstrated that costs of follow-up visits influenced relative cost but that device closure remained favorable over a broad range of crossover and reintervention rates. Conclusion For single secundum ASD, cost comparison analysis favors transcatheter closure over the short term. The cost of follow-up regimens influences the cost advantage of transcatheter closure. PMID:25965721

Entanglement cost under positive-partial-transpose-preserving operations.

PubMed

Audenaert, K; Plenio, M B; Eisert, J

2003-01-17

We study the entanglement cost under quantum operations preserving the positivity of the partial transpose (PPT operations). We demonstrate that this cost is directly related to the logarithmic negativity, thereby providing the operational interpretation for this entanglement measure. As examples we discuss general Werner states and arbitrary bipartite Gaussian states. Then we prove that for the antisymmetric Werner state PPT cost and PPT entanglement of distillation coincide. This is the first example of a truly mixed state for which entanglement manipulation is asymptotically reversible, which points towards a unique entanglement measure under PPT operations.

Coming Up Short: 35th Annual M&O Cost Study

ERIC Educational Resources Information Center

Agron, Joe

2006-01-01

As the nation's school buildings age and deteriorate, spending on maintenance and operations (M&O) remains paltry, especially when compared with historical figures. This article presents the findings of "American School & University's" 35th annual Maintenance and Operations Cost Study. According to the M&O Cost Study, the median school district…

A study of commuter airline economics

NASA Technical Reports Server (NTRS)

Summerfield, J. R.

1976-01-01

Variables are defined and cost relationships developed that describe the direct and indirect operating costs of commuter airlines. The study focused on costs for new aircraft and new aircraft technology when applied to the commuter airline industry. With proper judgement and selection of input variables, the operating costs model was shown to be capable of providing economic insight into other commuter airline system evaluations.

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

PubMed

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

2011-07-01

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

Control of dispatch dynamics for lowering the cost of distributed generation in the built environment

NASA Astrophysics Data System (ADS)

Flores, Robert Joseph

Distributed generation can provide many benefits over traditional central generation such as increased reliability and efficiency while reducing emissions. Despite these potential benefits, distributed generation is generally not purchased unless it reduces energy costs. Economic dispatch strategies can be designed such that distributed generation technologies reduce overall facility energy costs. In this thesis, a microturbine generator is dispatched using different economic control strategies, reducing the cost of energy to the facility. Several industrial and commercial facilities are simulated using acquired electrical, heating, and cooling load data. Industrial and commercial utility rate structures are modeled after Southern California Edison and Southern California Gas Company tariffs and used to find energy costs for the simulated buildings and corresponding microturbine dispatch. Using these control strategies, building models, and utility rate models, a parametric study examining various generator characteristics is performed. An economic assessment of the distributed generation is then performed for both the microturbine generator and parametric study. Without the ability to export electricity to the grid, the economic value of distributed generation is limited to reducing the individual costs that make up the cost of energy for a building. Any economic dispatch strategy must be built to reduce these individual costs. While the ability of distributed generation to reduce cost depends of factors such as electrical efficiency and operations and maintenance cost, the building energy demand being serviced has a strong effect on cost reduction. Buildings with low load factors can accept distributed generation with higher operating costs (low electrical efficiency and/or high operations and maintenance cost) due to the value of demand reduction. As load factor increases, lower operating cost generators are desired due to a larger portion of the building load being met in an effort to reduce demand. In addition, buildings with large thermal demand have access to the least expensive natural gas, lowering the cost of operating distributed generation. Recovery of exhaust heat from DG reduces cost only if the buildings thermal demand coincides with the electrical demand. Capacity limits exist where annual savings from operation of distributed generation decrease if further generation is installed. For low operating cost generators, the approximate limit is the average building load. This limit decreases as operating costs increase. In addition, a high capital cost of distributed generation can be accepted if generator operating costs are low. As generator operating costs increase, capital cost must decrease if a positive economic performance is desired.

Cost accounting in a surgical unit in a teaching hospital--a pilot study.

PubMed

Malalasekera, A P; Ariyaratne, M H; Fernando, R; Perera, D; Deen, K I

2003-09-01

Economic constraints remain one of the major limitations on the quality of health care even in industrialised countries. Improvement of quality will require optimising facilities within available resources. Our objective was to determine costs of surgery and to identify areas where cost reduction is possible. 80 patients undergoing routine major and intermediate surgery during a period of 6 months were selected at random. All consumables used and procedures carried out were documented. A unit cost was assigned to each of these. Costing was based on 3 main categories: preoperative (investigations, blood product related costs), operative (anaesthetic charges, consumables and theatre charges) and post-operative (investigations, consumables, hospital stay). Theatre charges included two components: fixed (consumables) and variable (dependent on time per operation). The indirect costs (e.g. administration costs, 'hotel' costs), accounted for 30%, of the total and were lower than similar costs in industrialised nations. The largest contributory factors (median, range) towards total cost were, basic hospital charges (30%; 15 to 63%); theatre charges fixed (23%; 6 to 35%) and variable (14%; 8 to 27%); and anaesthetic charges (15%; 1 to 36%). Cost reduction in patients undergoing surgery should focus on decreasing hospital stay, operating theatre time and anaesthetic expenditure. Although definite measures can be suggested from the study, further studies on these variables are necessary to optimise cost effectiveness of surgical units.

The Perceived Effect of Hidden Costs on the Operational Management of Information Technology Outsourcing: A Qualitative Study

ERIC Educational Resources Information Center

Swift, Ian

2011-01-01

Information technology (IT) outsourcing is a business trend aimed at reducing costs and enabling companies to concentrate on their core competencies. This qualitative multiple case design research study explored the effects of hidden costs on the operational management of IT outsourcing. The study involved analyzing IT outsourcing agreements as…

The costs and quality of operative training for residents in tympanoplasty type I.

PubMed

Wang, Mao-Che; Yu, Eric Chen-Hua; Shiao, An-Suey; Liao, Wen-Huei; Liu, Chia-Yu

2009-05-01

A teaching hospital would incur more operation room costs on training surgical residents. To evaluate the increased operation time and the increased operation room costs of operations performed by surgical residents. As a model we used a very common surgical otology procedure -- tympanoplasty type I. From January 1, 2004 to December 31, 2004, we included in this study 100 patients who received tympanoplasty type I in Taipei Veterans General Hospital. Fifty-six procedures were performed by a single board-certified surgeon and 44 procedures were performed by residents. We analyzed the operation time and surgical outcomes in these two groups of patients. The operation room cost per minute was obtained by dividing the total operation room expenses by total operation time in the year 2004. The average operation time of residents was 116.47 min, which was significantly longer (p<0.0001) than that of the board-certified surgeon (average 81.07 min). It cost USD $40.36 more for each operation performed by residents in terms of operation room costs. The surgical success rate of residents was 81.82%, which was significantly lower (p=0.016) than that of the board-certified surgeon (96.43%).

Shuttle Ground Operations Efficiencies/Technologies (SGOE/T) study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Scholz, A. L.; Hart, M. T.; Lowry, D. J.

1987-01-01

Methods and technolgoy were defined to reduce the overall operations cost of a major space program. Space Shuttle processing at Kennedy Space Center (KSC) was designed as the working model that would be the source of the operational information. Methods of improving efficiency of ground operations were assessed and technology elements that could reduce cost identified. Emphasis is on: (1) specific technology items and (2) management approaches required to develop and support efficient ground operations. Prime study results are to be recommendations on how to achieve more efficient operations and identification of existing or new technology that would make vehicle processing in both the current program and future programs more efficient and, therefore, less costly.

[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.

Hospital costs of complications after a pancreatoduodenectomy

PubMed Central

Santema, Trientje B; Visser, Annelies; Busch, Olivier R C; Dijkgraaf, Marcel G W; Goslings, J Carel; Gouma, D J; Ubbink, Dirk T

2015-01-01

Background A pancreatoduodenectomy (PD) is a highly advanced procedure associated with considerable post-operative complications and substantial costs. In this study the hospital costs associated with complications after PD were assessed. Methods A retrospective cohort study was conducted on 100 consecutive patients who underwent a pylorus-preserving (PP)PD between January 2012 and July 2013. Per patient, all complications occurring during admission or in the 30-day period after discharge were documented. All hospital costs related to the (PP)PD were defined as the costs of all medical interventions and resources during the hospitalisation period as recorded by the electronic supply tracking system. Results The median hospital costs ranged from €17 482 for a patient without complications to €55 623 for a patient with a post-operative haemorrhage. A post-operative haemorrhage was associated with a 39.6% increase in total hospital costs after adjusting for patient characteristics. Other factors significantly associated with an increase in total hospital costs were: the presence of a malignancy other than a pancreatic adenocarcinoma (29.4% cost increase), the severity grade of a complication (34.3–70.6% increase) and the presence of a post-operative infection (32.4% increase). Conclusions This study provides an in-depth analysis of hospital costs and identifies factors that are associated with substantial cost consequences of specific complications occurring after a PD. PMID:26082095

Operations analysis (study 2.1): Shuttle upper stage software requirements

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1974-01-01

An investigation of software costs related to space shuttle upper stage operations with emphasis on the additional costs attributable to space servicing was conducted. The questions and problem areas include the following: (1) the key parameters involved with software costs; (2) historical data for extrapolation of future costs; (3) elements of the basic software development effort that are applicable to servicing functions; (4) effect of multiple servicing on complexity of the operation; and (5) are recurring software costs significant. The results address these questions and provide a foundation for estimating software costs based on the costs of similar programs and a series of empirical factors.

Hysteroscopic polypectomy prior to infertility treatment: A cost analysis and systematic review.

PubMed

Mouhayar, Youssef; Yin, Ophelia; Mumford, Sunni L; Segars, James H

2017-06-01

The cost of fertility treatment is expensive and interventions that reduce cost can lead to greater efficiency and fewer embryos transferred. Endometrial polyps contribute to infertility and are frequently removed prior to infertility treatment. It is unclear whether polypectomy reduces fertility treatment cost and if so, the magnitude of cost reduction afforded by the procedure. The aim of this study was to determine whether performing office or operative hysteroscopic polypectomy prior to infertility treatment would be cost-effective. PubMed, Embase, and Cochrane libraries were used to identify publications reporting pregnancy rates after hysteroscopic polypectomy. Studies were required to have a polypectomy treatment group and control group of patients with polyps that were not resected. The charges of infertility treatments and polypectomy were obtained through infertility organizations and a private healthcare cost reporting website. These charges were applied to a decision tree model over the range of pregnancy rates observed in the representative studies to calculate an average cost per clinical or ongoing pregnancy. A sensitivity analysis was conducted to assess cost savings of polypectomy over a range of pregnancy rates and polypectomy costs. Pre-treatment office or operative hysteroscopic polypectomy ultimately saved €6658 ($7480) and €728 ($818), respectively, of the average cost per clinical pregnancy in women treated with four cycles of intrauterine insemination. Polypectomy prior to intrauterine insemination was cost-effective for clinical pregnancy rates greater than 30.2% for office polypectomy and 52.6% for operative polypectomy and for polypectomy price <€4414 ($4959). Office polypectomy or operative polypectomy saved €15,854 ($17,813) and €6644 ($7465), respectively, from the average cost per ongoing pregnancy for in vitro fertilization/intracytoplasmic sperm injection treated women and was cost-effective for ongoing pregnancy rates greater than 26.4% (office polypectomy) and 31.7% (operative polypectomy) and polypectomy price <€6376 ($7164). These findings suggested that office or operative hysteroscopic polypectomy was cost-effective when performed prior to both intrauterine insemination and in vitro fertilization over a range of plausible pregnancy rates and procedural costs. Copyright © 2017 Elsevier B.V. All rights reserved.

ITOS/space shuttle study

NASA Technical Reports Server (NTRS)

1971-01-01

The results are reported of a study to explore the potential cost reductions in the operational ITOS weather satellite program as a consequence of shuttle/bug availability for satellite placement and retrieval, and satellite servicing and maintenance. The study program was divided into shuttle impact on equipment and testing costs, and shuttle impact on overall future ITOS operational program costs, and shuttle impact on configuration. It is concluded that savings in recurring spacecraft costs can be realized in the 1978 ITOS program, if a space shuttle is utilized.

38th Annual Maintenance & Operations Cost Study for Colleges

ERIC Educational Resources Information Center

Agron, Joe

2009-01-01

The nation's colleges are feeling the pinch of the economic downturn, and maintenance and operations (M&O) budgets especially are under pressure. This article presents data from the 38th annual Maintenance & Operations Cost Study for colleges that can help one in benchmarking expenditures at one's institution. Data provided only targets two-year…

38th Annual Maintenance & Operations Cost Study for Schools

ERIC Educational Resources Information Center

Agron, Joe

2009-01-01

Despite the worst economic environment in generations, spending by K-12 institutions on maintenance and operations (M&O) held its own--defying historical trends that have shown M&O spending among the most affected in times of budget tightening. This article presents data from the 38th annual Maintenance & Operations Cost Study for…

Higher cost of single incision laparoscopic cholecystectomy due to longer operating time. A study of opportunity cost based on meta-analysis

PubMed Central

GIRABENT-FARRÉS, M.

2018-01-01

Background We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC). Methods We identified studies comparing use of both techniques during the period 2008–2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences. We subsequently calculated the opportunity cost of these time differences based on the design of a cost/time variable using the data from the second literature review. Results Twenty-seven articles were selected from the first review: 26 for operating time (3.138 patients) and 3 for the cost of surgery (831 patients), and 3 articles from the second review. Both techniques have similar operating costs. Single incision laparoscopy surgery takes longer (16.90min) to perform (p <0.00001) and this difference represents an opportunity cost of 755.97 € (cost/time unit factor of 44.73 €/min). Conclusions SILC costs the same as CLC, but the surgery takes longer to perform, and this difference involves an opportunity cost that increases the total cost of SILC. The value of the opportunity cost of the operating time can vary the total cost of a surgical technique and it should be included in the economic evaluation to support the decision to adopt a new surgical technique. PMID:29549678

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 3: Operations technology

NASA Technical Reports Server (NTRS)

Vilja, John O.

1990-01-01

The study was initiated to identify operational problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advanced Launch System (ALS) program, the results of the OEPSS study were organized into a series of OEPSS Data Books. This volume describes operations technologies that will enhance operational efficiency of propulsion systems. A total of 15 operations technologies were identified that will eliminate or mitigate operations problems described in Volume 2. A recommended development plan is presented for eight promising technologies that will simplify the propulsion system and reduce operational requirements.

Geostationary platform systems concepts definition study. Volume 2: Technical, book 1

NASA Technical Reports Server (NTRS)

1980-01-01

The initial selection and definition of operational geostationary platform concepts is discussed. Candidate geostationary platform missions and payloads were identified from COMSAT, Aerospace, and NASA studies. These missions and payloads were cataloged; classified with to communications, military, or scientific uses; screened for application and compatibility with geostationary platforms; and analyzed to identify platform requirements. Two platform locations were then selected (Western Hemisphere - 110 deg W, and Atlantic - 15 deg W), and payloads allocated based on nominal and high traffic models. Trade studies were performed leading to recommendation of selected concepts. Of 30 Orbit Transfer Vehicle (0TV) configuration and operating mode options identified, 18 viable candidates compatible with the operational geostationary platform missions were selected for analysis. Each was considered using four platform operational modes - 8 or 16 year life, and serviced or nonserviced, providing a total of 72 OTV/platform-mode options. For final trade study concept selection, a cost program was developed considering payload and platform costs and weight; transportation unit and total costs for the shuttle and OTV; and operational costs such as assembly or construction time, mating time, and loiter time. Servicing costs were added for final analysis and recommended selection.

A description of morbidly obese state employees requesting a bariatric operation.

PubMed

Martin, Louis F; Lundberg, Anna Paone; Juneau, Francine; Raum, William J; Hartman, Sandra J

2005-10-01

The federal government, the medical insurance industry, and the academic medical community have disagreed over what treatments are appropriate and cost effective for morbid obesity. This debate is hindered by inadequate data regarding the true costs of diseases and who chooses an operation as a treatment option. The purpose of this study was to obtain these costs and to describe this population. Louisiana's managed medical insurance program created primarily for its civil service employees contracted to offer a small random group of morbidly obese employees the option of a bariatric operation. This observational study examined the subpopulation who requested consideration for the operation. We present historic cost data from all medical expenses paid by the insurance company, a telephone survey of the volunteers in the study to determine their medical problems, and diagnostic evaluation data on those employees randomized to proceed for possible bariatric operation. A total of 911 of 189,398 adult members of the insurance plan wanted to be considered for this study. Only 397, however, completed the informed-consent process. Of the 248 employees who met the age requirement, body mass index criteria, and health criteria to be considered for a bariatric operation and were randomized, 20 withdrew before obtaining 40 committed operative candidates. The 773 morbidly obese female members had used a mean of dollar 11,145 in medical insurance expenses in the year 2003 versus a mean of dollar 8,096 for the other 106,908 adult women. Similar values for the men were dollar 16,720 for the 138 morbidly obese men versus dollar 5,943 for the other 82,490 men. The morbidly obese members of this medical insurance plan who requested a bariatric operation are costing their plan 1.4 to 2.8 times the yearly amount of the other adult members in medical expenses. The yearly mean amount the insurance plan spends on these members suggests that operative treatment would pay for itself in a relatively few number of years if it could significantly reduce these costs. Even in those who consider bariatric operation, many withdraw, further limiting the costs of operative therapy.

Post-bariatric surgery body contouring treatment in the public health system: cost study and perception by patients.

PubMed

Vilà, Jordi; Balibrea, José María; Oller, Benjamí; Alastrué, Antonio; Poyatos, Jordi Vilà; Balibrea del Castillo, José María; Sales, Benjamí Oller; Vidal, Antonio Alastrué

2014-09-01

Post-bariatric, body contouring surgery to treat the sequelae of massive weight loss is an undervalued topic by patients and in most of the literature. The objective of this study was to determine the mean cost per patient of this treatment in a public morbid obesity unit, and compare it with the perception by the patients. Costs were estimated using a specific Diagnosis-Related Group-based method and a questionnaire in a sample of 100 patients who had completed body contouring treatment. This study included 23 men and 77 women with a mean age of 48.5 years, a mean reduction of body mass index of 20.77 kg/m, and a median follow-up of 58 months. These patients had undergone surgery, as needed, as follows: on the lower part of the trunk (109 operations; mean cost, &OV0556;6348.6), cruroplasty (43 operations; mean cost, &OV0556;3490), brachioplasty (28 operations; mean cost &OV0556;3150), and the upper part of the trunk (10 operations; mean cost, &OV0556;4290). The rate of complications has been high (up to 50 percent) and, although the more severe complications are rare (10.5 percent Clavien grade IIIb), these represent high costs (mean, &OV0556;24462.6). Forty-five patients answered the questionnaire. Although they think that this surgery improves their quality of life, they have undervalued its total cost (17.58 percent; &OV0556;2034) (p = 0.16). The average cost of post-bariatric surgery body contouring treatment in this unit is &OV0556;8263.95 (1.66 operations per patient). The severe complications increase by 2.96 times the average cost per patient.

36th Annual Maintenance & Operations Cost Study: Schools

ERIC Educational Resources Information Center

Agron, Joe

2007-01-01

Spending by school districts on maintenance and operations increased in 2006-2007, reversing years of historic low expenditures. According to "American School & University's" 36th annual Maintenance and Operations (M&O) Cost Study, the median school district spends 9.19% of total district expenditures (TDE) on M&O, up from 7.58% the year before.…

Interpreting cost of ownership for mix-and-match lithography

NASA Astrophysics Data System (ADS)

Levine, Alan L.; Bergendahl, Albert S.

1994-05-01

Cost of ownership modeling is a critical and emerging tool that provides significant insight into the ways to optimize device manufacturing costs. The development of a model to deal with a particular application, mix-and-match lithography, was performed in order to determine the level of cost savings and the optimum ways to create these savings. The use of sensitivity analysis with cost of ownership allows the user to make accurate trade-offs between technology and cost. The use and interpretation of the model results are described in this paper. Parameters analyzed include several manufacturing considerations -- depreciation, maintenance, engineering and operator labor, floorspace, resist, consumables and reticles. Inherent in this study is the ability to customize this analysis for a particular operating environment. Results demonstrate the clear advantages of a mix-and-match approach for three different operating environments. These case studies also demonstrate various methods to efficiently optimize cost savings strategies.

[Estimated operational costs of vaccination campaign to combat yellow fever in Abidjan].

PubMed

Zengbe-Acray, Pétronille; Douba, Alfred; Traore, Youssouf; Dagnan, Simplice; Attoh-Toure, Harvey; Ekra, Daniel

2009-01-01

A cost effectiveness study was conducted with the main objective to assess the operational costs of a vaccination campaign against yellow fever organised and implemented in Abidjan from September 21st to October 2nd, 2001. The study was carried out from the perspective of the health authorities. Data was collected retrospectively on all information related to resources needed and required activities. The justification of the monetary value of resources was provided with written proof and receipts as well as other supporting documents. The coverage achieved was 91.33% with 2 584 360 doses of vaccine having been administered. Spending on vaccines and vaccine supplies amounted to 1 123 177 128 FCFA; the average cost per dose was 539.40 FCFA. Human resource costs amounted to 2590 people who were mobilized for a total cost of 125 678 400 FCFA. The total operational cost of the vaccination campaign was 1 394 010 829 FCFA. Vaccines and supplies were the largest item of expenditure, or 80.57% of the total spent. The results of this study could serve as a tool for decision-making related to funding a vaccination campaign. Taking account of these results could contribute to the development of strategies to effectively reduce the operational cost of a vaccination campaign.

[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.

Study of short-haul aircraft operating economics, volume 1

NASA Technical Reports Server (NTRS)

1975-01-01

A short-haul air transportation operating cost model is developed. The effect is identified of such factors as level of service provided, traffic density of the market, stage length, number of flight cycles, level of automation, as well as aircraft type and other operational factors on direct and indirect operating costs.

Cost of Surgery for Symptomatic Spinal Metastases in the United Kingdom.

PubMed

Turner, Isobel; Minhas, Zulfiqar; Kennedy, Joanne; Morris, Stephen; Crockard, Alan; Choi, David

2015-11-01

Spinal metastases represent a significant health and economic burden. The average cost of surgical management varies between institutions and countries, partially a result of differences in health care system billing. This study assessed hospital costs from a single institute in the United Kingdom National Healthcare Service and identified patient factors associated with these costs. This prospective study recruited patients with confirmed symptomatic spinal metastases who presented for surgical treatment. The primary outcome was cost of inpatient treatment collected using the Patient Level Costing and Information System; preoperative details collected included patient demographics, primary tumor type, Tomita and Tokuhashi scores, pain level, EuroQol 5 dimension score, Frankel, Karnofsky, and American Society of Anesthesiologists' physical status classification system scores, and operative details. Costs were analyzed for 74 patients. The mean cost of treatment (standard deviation, SD) per patient was £ 16,885 (£ 10,687); which was mainly comprised of operating theater (25% of the total) and ward costs (27%). Better health status at presentation significantly increased total and ward costs (Frankel score P = 0.006, and EuroQol 5 dimension index P = 0.014 respectively); male sex also increased total and ward costs (P < 0.01 and P = 0.06). Operation cost showed a trend to increased costs with less impairment on American Society of Anesthesiologists' physical status classification system scores. The cost of surgical management of spinal metastases is associated with several factors but is greater in patients presenting with better health status, probably because of their suitability for larger operations, whereas those with poor health status undergo smaller, palliative operations, resulting in shorter inpatient postoperative recovery. Copyright © 2015 Elsevier Inc. All rights reserved.

Centaur operations at the space station: Cost and transportation analysis

NASA Technical Reports Server (NTRS)

1988-01-01

A study was conducted to expand on the results of an initial study entitled Centaur Operations at the Space Station. The previous study developed technology demonstration missions (TDMs) that utilized the Centaur G-prime upper stage to advance OTV technologies required for accomodations and operations at the Space Station. An initial evaluation was performed of the cost to NASA for TDM implementation. Due to the potential for commercial communication satellite operation utilizing the TDM hardware, an evaluation of the Centaur's transportation potential was also performed.

IUS/TUG orbital operations and mission support study. Volume 2: Interim upper stage operations

NASA Technical Reports Server (NTRS)

1975-01-01

Background data and study results are presented for the interim upper stage (IUS) operations phase of the IUS/tug orbital operations study. The study was conducted to develop IUS operational concepts and an IUS baseline operations plan, and to provide cost estimates for IUS operations. The approach used was to compile and evaluate baseline concepts, definitions, and system, and to use that data as a basis for the IUS operations phase definition, analysis, and costing analysis. Both expendable and reusable IUS configurations were analyzed and two autonomy levels were specified for each configuration. Topics discussed include on-orbit operations and interfaces with the orbiter, the tracking and data relay satellites and ground station support capability analysis, and flight control center sizing to support the IUS operations.

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

EIA Publications

2016-01-01

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

Comparative health technology assessment of robotic-assisted, direct manual laparoscopic and open surgery: a prospective study.

PubMed

Turchetti, Giuseppe; Pierotti, Francesca; Palla, Ilaria; Manetti, Stefania; Freschi, Cinzia; Ferrari, Vincenzo; Cuschieri, Alfred

2017-02-01

Despite many publications reporting on the increased hospital cost of robotic-assisted surgery (RAS) compared to direct manual laparoscopic surgery (DMLS) and open surgery (OS), the reported health economic studies lack details on clinical outcome, precluding valid health technology assessment (HTA). The present prospective study reports total cost analysis on 699 patients undergoing general surgical, gynecological and thoracic operations between 2011 and 2014 in the Italian Public Health Service, during which period eight major teaching hospitals treated the patients. The study compared total healthcare costs of RAS, DMLS and OS based on prospectively collected data on patient outcome in addition to healthcare costs incurred by the three approaches. The cost of RAS operations was significantly higher than that of OS and DMLS for both gynecological and thoracic operations (p < 0.001). The study showed no significant difference in total costs between OS and DMLS. Total costs of general surgery RAS were significantly higher than those of OS (p < 0.001), but not against DMLS general surgery. Indirect costs were significantly lower in RAS compared to both DMLS general surgery and OS gynecological surgery due to the shorter length of hospital stay of RAS approach (p < 0.001). Additionally, in all specialties compared to OS, patients treated by RAS experienced a quicker recovery and significantly less pain during the hospitalization and after discharge. The present HTA while confirming higher total healthcare costs for RAS operations identified significant clinical benefits which may justify the increased expenditure incurred by this approach.

Operationally Efficient Propulsion System Study (OEPSS) data book. Executive summary

NASA Technical Reports Server (NTRS)

Wong, George S.

1990-01-01

The study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advanced Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. Summarized here are the salient results of the first year. A synopsis of each volume listed above is presented.

Forestry BMP Implementation Costs for Virginia

Treesearch

R.M. Shaffer; H.L. Haney; E.G. Worrell; W.M. Aust

1998-01-01

Forestry Best Management Practices (BMPs) are operational techniques used to protect water quality during timber harvesting operations. The implementation cost of BMPs is important to loggers, forest landowners, and the forest industry. This study provides an estimate of BMP implementation cost on a per harvested acre basis for the coastal plain, Piedmont, and...

Operative outcome and hospital cost.

PubMed

Ferraris, V A; Ferraris, S P; Singh, A

1998-03-01

Because of concern about increasing health care costs, we undertook a study to find patient risk factors associated with increased hospital costs and to evaluate the relationship between increased cost and in-hospital mortality and serious morbidity. More than 100 patient variables were screened in 1221 patients undergoing cardiac procedures. Simultaneously, patient hospital costs were computed from the cost-to-charge ratio. Univariate and multivariate statistics were used to explore the relationship between hospital cost and patient outcomes, including operative death, in-hospital morbidity, and length of stay. The greatest costs were for 31 patients who did not survive operation ($74,466, 95% confidence interval $27,102 to $198,025), greater than the costs for 120 patients who had serious, nonfatal morbidity ($60,335, 95% confidence interval $28,381 to $130,897, p = 0.02) and those for 1070 patients who survived operation without complication ($31,459, 95% confidence interval $21,944 to $49,849, p = 0.001). Breakdown of the components of hospital costs in fatalities and in cases with nonfatal complications revealed that the greatest contributions were in anesthesia and operating room costs. Significant (by stepwise linear regression analysis) independent risks for increased hospital cost were as follows (in order of decreasing importance): (1) preoperative congestive heart failure, (2) serum creatinine level greater than 2.5 mg/dl, (3) New York state predicted mortality risk, (4), type of operation (coronary artery bypass grafting, valve, valve plus coronary artery bypass grafting, or other), (5) preoperative hematocrit, (6) need for reoperative procedure, (7) operative priority, and (8) sex. These risks were different than those for in-hospitality death or increased length of stay. Hospital cost correlated with length of stay (r = 0.63, p < 0.001), but there were many outliers at the high end of the hospital cost spectrum. We conclude that operative death is the most costly outcome; length of stay is an unreliable indicator of hospital cost, especially at the high end of the cost spectrum; risks of increased hospital cost are different than those for perioperative mortality or increased length of stay; and ventricular dysfunction in elderly patients undergoing urgent operations for other than coronary disease is associated with increased cost. Certain patient factors, such as preoperative anemia and congestive heart failure, are amenable to preoperative intervention to reduce costs, and a high-risk patient profile can serve as a target for cost-reduction strategies.

Integrating Solar PV in Utility System Operations: Analytical Framework and Arizona Case Study

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

Wu, Jing; Botterud, Audun; Mills, Andrew

2015-06-01

A systematic framework is proposed to estimate the impact on operating costs due to uncertainty and variability in renewable resources. The framework quantifies the integration costs associated with subhourly variability and uncertainty as well as day-ahead forecasting errors in solar PV (photovoltaics) power. A case study illustrates how changes in system operations may affect these costs for a utility in the southwestern United States (Arizona Public Service Company). We conduct an extensive sensitivity analysis under different assumptions about balancing reserves, system flexibility, fuel prices, and forecasting errors. We find that high solar PV penetrations may lead to operational challenges, particularlymore » during low-load and high solar periods. Increased system flexibility is essential for minimizing integration costs and maintaining reliability. In a set of sensitivity cases where such flexibility is provided, in part, by flexible operations of nuclear power plants, the estimated integration costs vary between $1.0 and $4.4/MWh-PV for a PV penetration level of 17%. The integration costs are primarily due to higher needs for hour-ahead balancing reserves to address the increased sub-hourly variability and uncertainty in the PV resource. (C) 2015 Elsevier Ltd. All rights reserved.« less

IUS/TUG orbital operations and mission support study. Volume 3: Space tug operations

NASA Technical Reports Server (NTRS)

1975-01-01

A study was conducted to develop space tug operational concepts and baseline operations plan, and to provide cost estimates for space tug operations. Background data and study results are presented along with a transition phase analysis (the transition from interim upper state to tug operations). A summary is given of the tug operational and interface requirements with emphasis on the on-orbit checkout requirements, external interface operational requirements, safety requirements, and system operational interface requirements. Other topics discussed include reference missions baselined for the tug and details for the mission functional flows and timelines derived for the tug mission, tug subsystems, tug on-orbit operations prior to the tug first burn, spacecraft deployment and retrieval by the tug, operations centers, mission planning, potential problem areas, and cost data.

Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

PubMed

Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

2015-04-02

Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a "know-do gap" where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Our study presents financial and economic cost estimates of installing and operating an electronic CDSS for maternal health care in six rural health centres. From these findings one can understand exactly what goes into a similar investment and thus determine sorts of input modification needed to fit their context.

Space construction system analysis. Part 2: Cost and programmatics

NASA Technical Reports Server (NTRS)

Vonflue, F. W.; Cooper, W.

1980-01-01

Cost and programmatic elements of the space construction systems analysis study are discussed. The programmatic aspects of the ETVP program define a comprehensive plan for the development of a space platform, the construction system, and the space shuttle operations/logistics requirements. The cost analysis identified significant items of cost on ETVP development, ground, and flight segments, and detailed the items of space construction equipment and operations.

Are critical pathways and implant standardization programs effective in reducing costs in total knee replacement operations?

PubMed

Ho, David M; Huo, Michael H

2007-07-01

Total knee replacement (TKR) operation is one of the most effective procedures, both clinically and in terms of cost. Because of increased volume and cost for this procedure during the past 3 decades, TKRs are often targeted for cost reduction. The purpose of this study was to evaluate the efficacy of two cost reducing methodologies, establishment of critical clinical pathways, and standardization of implant costs. Ninety patients (90 knees) were randomly selected from a population undergoing primary TKR during a 2-year period at a tertiary teaching hospital. Patients were assigned to three groups that corresponded to different strategies implemented during the evolution of the joint-replacement program. Medical records were reviewed for type of anesthesia, operative time, length of stay, and any perioperative complications. Financial information for each patient was compared among the three groups. Data analysis demonstrated that the institution of a critical pathway significantly shortened length of hospital stay and was effective in reducing the hospital costs by 18% (p < 0.05). In addition, standardization of surgical techniques under the care of a single surgeon substantially reduced the operative time. Selection of implants from a single vendor did not have any substantial effect in additionally reducing the costs. Standardized postoperative management protocols and critical clinical pathways can reduce costs and operative time. Future efforts must focus on lowering the costs of the prostheses, particularly with competitive bidding or capitation of prostheses costs. Although a single-vendor approach was not effective in this study, it is possible that a cost reduction could have been realized if more TKRs were performed, because the pricing contract was based on projected volume of TKRs to be done by the hospital.

Analysis of the U.S. geological survey streamgaging network

USGS Publications Warehouse

Scott, A.G.

1987-01-01

This paper summarizes the results from the first 3 years of a 5-year cost-effectiveness study of the U.S. Geological Survey streamgaging network. The objective of the study is to define and document the most cost-effective means of furnishing streamflow information. In the first step of this study, data uses were identified for 3,493 continuous-record stations currently being operated in 32 States. In the second step, evaluation of alternative methods of providing streamflow information, flow-routing models, and regression models were developed for estimating daily flows at 251 stations of the 3,493 stations analyzed. In the third step of the analysis, relationships were developed between the accuracy of the streamflow records and the operating budget. The weighted standard error for all stations, with current operating procedures, was 19.9 percent. By altering field activities, as determined by the analyses, this could be reduced to 17.8 percent. The existing streamgaging networks in four Districts were further analyzed to determine the impacts that satellite telemetry would have on the cost effectiveness. Satellite telemetry was not found to be cost effective on the basis of hydrologic data collection alone, given present cost of equipment and operation.This paper summarizes the results from the first 3 years of a 5-year cost-effectiveness study of the U. S. Geological Survey streamgaging network. The objective of the study is to define and document the most cost-effective means of furnishing streamflow information. In the first step of this study, data uses were identified for 3,493 continuous-record stations currently being operated in 32 States. In the second step, evaluation of alternative methods of providing streamflow information, flow-routing models, and regression models were developed for estimating daily flows at 251 stations of the 3, 493 stations analyzed. In the third step of the analysis, relationships were developed between the accuracy of the streamflow records and the operating budget. The weighted standard error for all stations, with current operating procedures, was 19. 9 percent. By altering field activities, as determined by the analyses, this could be reduced to 17. 8 percent. Additional study results are discussed.

A System for Analyzing the Cost of Operating Vocational Education Programs at the Secondary Level in Ohio. A Study of School Year 1973-1974.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus.

As a part of Ohio's program review and evaluation of vocational education, the report is concerned with a study of the costs of operating vocational education programs throughout the State. A cost analysis system for secondary level vocational education instructional programs was developed in 1970 and has been restudied each succeeding year. The…

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

PubMed

Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

2018-02-01

To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p < 0.001). The mean operating theatre time, surgeon procedure time and length of stay were all significantly lower under local anaesthesia compared to general anaesthesia. Time variables such as operating theatre time and length of stay were the most significant predictors of the total costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

PubMed Central

Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

2018-01-01

Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P < .05) and greater in the following costs: hospital operating direct cost (29.2% greater), hospital operating total cost (28.8% greater), direct hospital cost (24.7% greater), and total hospital cost (26.4% greater). Conclusions Based on greater hospital operating direct cost, hospital operating total cost, direct hospital cost, and total hospital cost, conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

Industry survey of space system cost benefits from New Ways Of Doing Business

NASA Technical Reports Server (NTRS)

Rosmait, Russell L.

1992-01-01

The cost of designing, building and operating space system hardware has always been expensive. Small quantities of specialty parts escalate engineering design, production and operations cost. Funding cutbacks and shrinking revenues dictate aggressive cost saving programs. NASA's highest priority is providing economical transportation to and from space. Over the past three decades NASA has seen technological advances that provide grater efficiencies in designing, building, and operating of space system hardware. As future programs such as NLS, LUTE and SEI begin, these greater efficiencies and cost savings should be reflected in the cost models. There are several New Ways Of Doing Business (NWODB) which, when fully implemented will reduce space system costs. These philosophies and/or culture changes are integrated in five areas: (1) More Extensive Pre-Phase C/D & E, (2) Multi Year Funding Stability, (3) Improved Quality, Management and Procurement Processes, (4) Advanced Design Methods, and (5) Advanced Production Methods. Following is an overview of NWODB and the Cost Quantification Analysis results using an industry survey, one of the four quantification techniques used in the study. The NWODB Cost Quantification Analysis is a study performed at Marshall Space Flight Center by the Engineering Cost Group, Applied Research Incorporated and Pittsburg State University. This study took place over a period of four months in mid 1992. The purpose of the study was to identify potential NWODB which could lead to improved cost effectiveness within NASA and to quantify potential cost benefits that might accrue if these NWODB were implemented.

Cost comparison and safety of emergency department conscious sedation for the removal of ear foreign bodies.

PubMed

Olson, Michael D; Saw, Jessica; Visscher, Sue L; Balakrishnan, Karthik

2018-07-01

The purpose of this study is to investigate the relative cost and safety of ear foreign body (FB) removal via conscious sedation in the emergency department. A retrospective review of patients presenting from 2000 to 2015 to the emergency department at Mayo Clinic, Rochester, Minnesota was performed. 63 patients requiring sedation for ear foreign body removal were identified. Descriptive data, safety data, and costs were obtained for the study. There were no appreciable differences in patient safety outcomes and otologic outcomes in patients who received sedation in the emergency department or anesthesia in the operating room for FB removal. Cost analysis demonstrated increased cost associated with operating room utilization verses conscious sedation in the emergency department, with the greatest cost increase being in patients evaluated first in the emergency department and then sent to the operating room. Ear foreign body removal in the emergency department is shows a similar safety profile to removal in the operating room, but at a markedly lower cost. Emergency department conscious sedation should be considered a viable option in appropriately selected patients with this common problem given these results. Copyright © 2018. Published by Elsevier B.V.

Low-cost forest operation systems that minimize environmental impacts of harvesting

Treesearch

Thomas F. Lloyd; Thomas A. Waldrop

1995-01-01

Forest operation systems have been developed for mixed pine and hardwood stands in the Piedmont region of the southeastern United States that reduce the cost and environmental impacts of forest operations. This has been done by studying the interrelations of forest operations with site edaphic properties and the biology of plant communities that reside on each site. In...

Operations and support cost modeling of conceptual space vehicles

NASA Technical Reports Server (NTRS)

Ebeling, Charles

1994-01-01

The University of Dayton is pleased to submit this annual report to the National Aeronautics and Space Administration (NASA) Langley Research Center which documents the development of an operations and support (O&S) cost model as part of a larger life cycle cost (LCC) structure. It is intended for use during the conceptual design of new launch vehicles and spacecraft. This research is being conducted under NASA Research Grant NAG-1-1327. This research effort changes the focus from that of the first two years in which a reliability and maintainability model was developed to the initial development of an operations and support life cycle cost model. Cost categories were initially patterned after NASA's three axis work breakdown structure consisting of a configuration axis (vehicle), a function axis, and a cost axis. A revised cost element structure (CES), which is currently under study by NASA, was used to established the basic cost elements used in the model. While the focus of the effort was on operations and maintenance costs and other recurring costs, the computerized model allowed for other cost categories such as RDT&E and production costs to be addressed. Secondary tasks performed concurrent with the development of the costing model included support and upgrades to the reliability and maintainability (R&M) model. The primary result of the current research has been a methodology and a computer implementation of the methodology to provide for timely operations and support cost analysis during the conceptual design activities.

Cost Analysis for Large Civil Transport Rotorcraft

NASA Technical Reports Server (NTRS)

Coy, John J.

2006-01-01

This paper presents cost analysis of purchase price and DOC+I (direct operating cost plus interest) that supports NASA s study of three advanced rotorcraft concepts that could enter commercial transport service within 10 to 15 years. The components of DOC+I are maintenance, flight crew, fuel, depreciation, insurance, and finance. The cost analysis aims at VTOL (vertical takeoff and landing) and CTOL (conventional takeoff and landing) aircraft suitable for regional transport service. The resulting spreadsheet-implemented cost models are semi-empirical and based on Department of Transportation and Army data from actual operations of such aircraft. This paper describes a rationale for selecting cost tech factors without which VTOL is more costly than CTOL by a factor of 10 for maintenance cost and a factor of two for purchase price. The three VTOL designs selected for cost comparisons meet the mission requirement to fly 1,200 nautical miles at 350 knots and 30,000 ft carrying 120 passengers. The lowest cost VTOL design is a large civil tilt rotor (LCTR) aircraft. With cost tech factors applied, the LCTR is reasonably competitive with the Boeing 737-700 when operated in economy regional service following the business model of the selected baseline operation, that of Southwest Airlines.

Relationship between implant use, operative time, and costs associated with distal biceps tendon reattachment.

PubMed

Grant, John A; Bissell, Benjamin; Hake, Mark E; Miller, Bruce S; Hughes, Richard E; Carpenter, James E

2012-11-01

The suture anchor and transosseous drill hole techniques for reattachment of the distal biceps tendon to the radius have been found to have similar clinical and biomechanical outcomes. However, a comparison of the cost effectiveness of these techniques is lacking. The purpose of this study was to determine whether the use of suture anchors decreases operative time enough to offset the additional cost of the implants. The records of all patients undergoing a distal biceps tendon reattachment were reviewed to determine the method of fixation, operative time, and associated surgical costs. Two surgeons used a technique of fixing the tendon directly to the bone (transosseous group), whereas 3 surgeons used suture anchors. Given the standard nature of the surgical procedure (other than the fixation technique), only the costs that differed between the 2 groups were included. Surgical center costs were obtained from the local outpatient surgical center in 2011 US dollars. Five surgeons treated 70 men (mean age, 45.9±9.2 years). Mean time from injury to surgery was 14 days. Mean operative times for the transosseous and suture anchor groups were 97.6±14.9 and 95.8±25.8 minutes, respectively (P=.74). Two anchors were used in 79% of the anchor cases. The use of anchors cost $474.33 more per patient. However, this value is sensitive to the cost of the individual anchors, intersurgeon variation in operative time, and per-minute value of saved operative time. No operative time was saved with the use of suture anchors. This cost comparison framework can be used to evaluate the balance in surgical resource use due to implant cost vs savings in operative time. Copyright 2012, SLACK Incorporated.

School Lunch and Breakfast Cost Study. Final Report.

ERIC Educational Resources Information Center

Glantz, Frederic B.; And Others

This document presents findings of a study that examined in detail the cost of producing reimbursable meals in the National School Lunch and School Breakfast Programs (NSL and SBP) during school year 1992-93. The study examined the costs charged to SFAs (reported costs) and those costs incurred by the school district in support of SFA operations,…

Small-scale nuclear reactors for remote military operations: opportunities and challenges

DTIC Science & Technology

2015-08-25

study – Report was published in March 2011  CNA study identified challenges to deploy small modular reactors (SMRs) at a base – Identified First-of...forward operating bases. The availability of deployable, cost-effective, regulated, and secure small modular reactors with a modest output electrical...defense committees on the challenges, operational requirements, constraints, cost, and life cycle analysis for a small modular reactor of less than 10

The financial implications of endovascular aneurysm repair in the cost containment era.

PubMed

Stone, David H; Horvath, Alexander J; Goodney, Philip P; Rzucidlo, Eva M; Nolan, Brian W; Walsh, Daniel B; Zwolak, Robert M; Powell, Richard J

2014-02-01

Endovascular aneurysm repair (EVAR) is associated with significant direct device costs. Such costs place EVAR at odds with efforts to constrain healthcare expenditures. This study examines the procedure-associated costs and operating margins associated with EVAR at a tertiary care academic medical center. All infrarenal EVARs performed from April 2011 to March 2012 were identified (n = 127). Among this cohort, 49 patients met standard commercial instruction for use guidelines, were treated using a single manufacturer device, and billed to Medicare diagnosis-related group (DRG) 238. Of these 49 patients, net technical operating margins (technical revenue minus technical cost) were calculated in conjunction with the hospital finance department. EVAR implant costs were determined for each procedure. DRG 238-associated costs and length of stay were benchmarked against other academic medical centers using University Health System Consortium 2012 data. Among the studied EVAR cohort (age 75, 82% male, mean length of stay, 1.7 days), mean technical costs totaled $31,672. Graft implants accounted for 52% of the allocated technical costs. Institutional overhead was 17% ($5495) of total technical costs. Net mean total technical EVAR-associated operating margins were -$4015 per procedure. Our institutional costs and length of stay, when benchmarked against comparable centers, remained in the lowest quartile nationally using University Health System Consortium costs for DRG 238. Stent graft price did not correlate with total EVAR market share. EVAR is currently associated with significant negative operating margins among Medicare beneficiaries. Currently, device costs account for over 50% of EVAR-associated technical costs and did not impact EVAR market share, reflecting an unawareness of cost differential among surgeons. These data indicate that EVAR must undergo dramatic care delivery redesign for this practice to remain sustainable. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Cost of marking hardwood sawtimber in West Virginia

Treesearch

George R., Jr. Trimble; G. W. Wendel

1963-01-01

Marking trees for felling or deadening was one of the important operations when an economic study of forest-management costs and returns was begun in 1959 on a 600-acre management unit of the U. S. Forest Service's Fernow Experimental Forest near Parsons, W. Va. This is a report on the cost of marking for the initial cutting operation.

The Cost of Quality Out-of-School-Time Programs

ERIC Educational Resources Information Center

Grossman, Jean Baldwin; Lind, Christianne; Hayes, Cheryl; McMaken, Jennifer; Gersick, Andrew

2009-01-01

Funders and program planners want to know: What does it cost to operate a high-quality after-school or summer program? This study answers that question, discovering that there is no "right" number. Cost varies substantially, depending on the characteristics of the participants, the goals of the program, who operates it and where it is located.…

A strategy for low cost development of incremental oil in legacy reservoirs

USGS Publications Warehouse

Attanasi, E.D.

2016-01-01

The precipitous decline in oil prices during 2015 has forced operators to search for ways to develop low-cost and low-risk oil reserves. This study examines strategies to low cost development of legacy reservoirs, particularly those which have already implemented a carbon dioxide enhanced oil recovery (CO2 EOR) program. Initially the study examines the occurrence and nature of the distribution of the oil resources that are targets for miscible and near-miscible CO2 EOR programs. The analysis then examines determinants of technical recovery through the analysis of representative clastic and carbonate reservoirs. The economic analysis focusses on delineating the dominant components of investment and operational costs. The concluding sections describe options to maximize the value of assets that the operator of such a legacy reservoir may have that include incremental expansion within the same producing zone and to producing zones that are laterally or stratigraphically near main producing zones. The analysis identified the CO2 recycle plant as the dominant investment cost item and purchased CO2 and liquids management as a dominant operational cost items. Strategies to utilize recycle plants for processing CO2 from multiple producing zones and multiple reservoir units can significantly reduce costs. Industrial sources for CO2 should be investigated as a possibly less costly way of meeting EOR requirements. Implementation of tapered water alternating gas injection schemes can partially mitigate increases in fluid lifting costs.

A Cost Analysis of a Community Health Worker Program in Rural Vermont

PubMed Central

Wang, Guijing; Ruggles, Laural; Dunet, Diane O.

2015-01-01

Studies have shown that community health workers (CHWs) can improve the effectiveness of health care systems; however, little has been reported about CHW program costs. We examined the costs of a program staffed by three CHWs associated with a small, rural hospital in Vermont. We used a standardized data collection tool to compile cost information from administrative data and personal interviews. We analyzed personnel and operational costs from October 2010 to September 2011. The estimated total program cost was $420,348, a figure comprised of $281,063 (67 %) for personnel and $139,285 (33 %) for operations. CHW salaries and office space were the major cost components. Our cost analysis approach may be adapted by others to conduct cost analyses of their CHW program. Our cost estimates can help inform future economic studies of CHW programs and resource allocation decisions. PMID:23794072

Investments and costs of oral health care for Family Health Care

PubMed Central

Macêdo, Márcia Stefânia Ribeiro; Chaves, Sônia Cristina Lima; Fernandes, Antônio Luis de Carvalho

2016-01-01

ABSTRACT OBJECTIVE To estimate the investments to implement and operational costs of a type I Oral Health Care Team in the Family Health Care Strategy. METHODS This is an economic assessment study, for analyzing the investments and operational costs of an oral health care team in the city of Salvador, BA, Northeastern Brazil. The amount worth of investments for its implementation was obtained by summing up the investments in civil projects and shared facilities, in equipments, furniture, and instruments. Regarding the operational costs, the 2009-2012 time series was analyzed and the month of December 2012 was adopted for assessing the monetary values in effect. The costs were classified as direct variable costs (consumables) and direct fixed costs (salaries, maintenance, equipment depreciation, instruments, furniture, and facilities), besides the indirect fixed costs (cleaning, security, energy, and water). The Ministry of Health’s share in funding was also calculated, and the factors that influence cost behavior were described. RESULTS The investment to implement a type I Oral Health Care Team was R$29,864.00 (US$15,236.76). The operational costs of a type I Oral Health Care Team were around R$95,434.00 (US$48,690.82) a year. The Ministry of Health’s financial incentives for investments accounted for 41.8% of the implementation investments, whereas the municipality contributed with a 59.2% share of the total. Regarding operational costs, the Ministry of Health contributed with 33.1% of the total, whereas the municipality, with 66.9%. Concerning the operational costs, the element of heaviest weight was salaries, which accounted for 84.7%. CONCLUSIONS Problems with the regularity in the supply of inputs and maintenance of equipment greatly influence the composition of costs, besides reducing the supply of services to the target population, which results in the service probably being inefficient. States are suggested to partake in funding, especially to cover the team’s operational cost. PMID:27463254

Reducing operating costs for struvite formation with a carbon dioxide stripper.

PubMed

Fattah, K P; Sabrina, N; Mavinic, D S; Koch, F A

2008-01-01

One of the major operational costs of phosphorus recovery as struvite is the cost of caustic chemical that is added to maintain a desired level of operative pH. A study was conducted at the Lulu Island Wastewater Treatment Plant (LIWWTP), Richmond, BC, using a struvite crystallizer and a cascade stripper designed at the University of British Columbia (UBC). The stripper was tested under different operating conditions to determine the effectiveness of CO(2) stripping in increasing the pH of the water matrix and thereby reducing caustic chemical use. This reduction is expected to reduce the operational costs of struvite production. Throughout the project, a high percentage (90%) of phosphorus removal was achieved under each condition. The cascade stripper was very effective in saving caustic usage, ranging from 35% to 86%, depending on the operating conditions. However, the stripper showed relatively poor performance regarding ammonia stripping. Copyright IWA Publishing 2008.

Study 2.6 operations analysis mission characterization

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1973-01-01

An analysis of the current operations concepts of NASA and DoD is presented to determine if alternatives exist which may improve the utilization of resources. The final product is intended to show how sensitive these ground rules and design approaches are relative to the total cost of doing business. The results are comparative in nature, and assess one concept against another as opposed to establishing an absolute cost value for program requirements. An assessment of the mission characteristics is explained to clarify the intent, scope, and direction of this effort to improve the understanding of what is to be accomplished. The characterization of missions is oriented toward grouping missions which may offer potential economic benefits by reducing overall program costs. Program costs include design, development, testing, and engineering, recurring unit costs for logistic vehicles, payload costs. and direct operating costs.

Satellite Power Systems (SPS) concept definition study. Volume 2, part 2: System engineering. [cost and programmatics

NASA Technical Reports Server (NTRS)

Hanley, G. M.

1980-01-01

The latest technical and programmatic developments are considered as well as expansions of the Rockwell SPS cost model covering each phase of the program through the year 2030. Comparative cost/economic analyses cover elements of the satellite, construction system, space transportation vehicles and operations, and the ground receiving station. System plans to define time phased costs and planning requirements that support major milestones through the year 2000. A special analysis is included on natural resources required to build the SPS reference configuration. An appendix contains the SPS Work Breakdown Structure and dictionary along with detail cost data sheet on each system and main element of the program. Over 200 line items address DDT&E, theoretical first unit, investment cost per satellite, and operations charges for replacement capital and normal operations and maintenance costs.

Study of Advanced Propulsion Systems for Small Transport Aircraft Technology (STAT) Program

NASA Technical Reports Server (NTRS)

Baerst, C. F.; Heldenbrand, R. W.; Rowse, J. H.

1981-01-01

Definitions of takeoff gross weight, performance, and direct operating cost for both a 30 and 50 passenger airplane were established. The results indicate that a potential direct operating cost benefit, resulting from advanced technologies, of approximately 20 percent would be achieved for the 1990 engines. Of the numerous design features that were evaluated, only maintenance-related items contributed to a significant decrease in direct operating cost. Recommendations are made to continue research and technology programs for advanced component and engine development.

Operation and maintenance cost data for residential photovoltaic modules/panels

NASA Technical Reports Server (NTRS)

Oster, J. R., Jr.; Zaremski, D. R., Jr.; Albert, E. M.; Hawkins, S. L.

1980-01-01

Costs associated with the operation and maintenance of residential photovoltaic modules and arrays are studied. Six basic topics related to operation and maintenance to photovoltaic arrays are investigated: maintenance; cleaning; panel replacement; gasket repair/replacement; wiring repair/replacement; and termination repair/replacement. The effects of the mounting types (rack mount, stand off mount, direct mount and integral mount) and the installation/replacement type (sequential, partial interruption and independent) are identified and described. Methods of reducing maintenance costs are suggested.

Methanator Fueled Engines for Pollution Control

NASA Technical Reports Server (NTRS)

Cagliostro, D. E.; Winkler, E. L.

1973-01-01

A methanator fueled Otto-cycle engine is compared with other methods proposed to control pollution due to automobile exhaust emissions. The comparison is made with respect to state of development, emission factors, capital cost, operational and maintenance costs, performance, operational limitations, and impact on the automotive industries. The methanator fueled Otto-cycle engine is projected to meet 1975 emission standards and operate at a lower relative total cost compared to the catalytic muffler system and to have low impact. Additional study is required for system development.

Cost-efficiency of highway operations and maintenance of public-private partnerships.

DOT National Transportation Integrated Search

2014-08-01

While the literature on public-private partnerships (PPPs) argues that the private sectors life-cycle : approach to design and construction results in operational cost efficiencies, empirical support is : missing. This study explored that issue by...

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.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 2: Ground operations problems

NASA Technical Reports Server (NTRS)

Waldrop, Glen S.

1990-01-01

Operations problems and cost drivers were identified for current propulsion systems and design and technology approaches were identified to increase the operational efficiency and to reduce operations costs for future propulsion systems. To provide readily usable data for the ALS program, the results of the OEPSS study were organized into a series of OEPSS Data Books. This volume presents a detailed description of 25 major problems encountered during launch processing of current expendable and reusable launch vehicles. A concise description of each problem and its operational impact on launch processing is presented, along with potential solutions and technology recommendation.

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

PubMed

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

2005-07-01

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

The pharmacoeconomics of peri-operative beta-blocker therapy.

PubMed

Biccard, B M; Sear, J W; Foëx, P

2006-01-01

It is widely recommended that beta-blockade be used peri-operatively as it may reduce the incidence of postoperative cardiovascular complications including death. However, there are few data concerning the cost-effectiveness of such strategies. We have analysed the pharmacoeconomics of acute beta-blockade using data from eight prospective peri-operative studies in which patients underwent elective non-cardiac surgery, and in which the incidence of adverse side-effects of treatment, as well as clinical outcomes, have been reported. The costs of treatment were based on the NHS reference costs for 2004. From these data, the number-needed-to-treat (NNT) to prevent a major cardiovascular complication (including cardiovascular death) in high-risk patients was 18.5. This is comparable to the NNT for peri-operative statin therapy. The incremental cost of peri-operative beta-blockade (costs of drug acquisition and of treating associated adverse drug events) was 67.80 pounds sterling per patient. This results in a total cost of 1254.30 pounds sterling per peri-operative cardiovascular complication prevented. However, there is evidence that in patients at lower cardiovascular risk, beta-blockers may be potentially harmful, since their adverse effects (hypotension, bradycardia) may outweigh their potential cardioprotective effects.

Utilization and cost of log production from animal loging operations

Treesearch

Suraj P. Shrestha; Bobby L. Lanford; Robert B. Rummer; Mark Dubois

2006-01-01

Forest harvesting with animals is a labor-intensive operation. It is expensive to use machines on smaller woodlots, which require frequent moves if mechanically logged. So, small logging systems using animals may be more cost effective. In this study, work sampling was used for five animal logging operations in Alabama to measure productive and non-productive time...

Manned geosynchronous mission requirements and systems analysis study extension

NASA Technical Reports Server (NTRS)

1981-01-01

Turnaround requirements for the manned orbital transfer vehicle (MOTV) baseline and alternate concepts with and without a space operations center (SOC) are defined. Manned orbital transfer vehicle maintenance, refurbishment, resupply, and refueling are considered as well as the most effective combination of ground based and space based turnaround activities. Ground and flight operations requirements for abort are identified as well as low cost approaches to space and ground operations through maintenance and missions sensitivity studies. The recommended turnaround mix shows that space basing MOTV at SOC with periodic return to ground for overhaul results in minimum recurring costs. A pressurized hangar at SOC reduces labor costs by approximately 50%.

On intra-supply chain system with an improved distribution plan, multiple sales locations and quality assurance.

PubMed

Chiu, Singa Wang; Huang, Chao-Chih; Chiang, Kuo-Wei; Wu, Mei-Fang

2015-01-01

Transnational companies, operating in extremely competitive global markets, always seek to lower different operating costs, such as inventory holding costs in their intra- supply chain system. This paper incorporates a cost reducing product distribution policy into an intra-supply chain system with multiple sales locations and quality assurance studied by [Chiu et al., Expert Syst Appl, 40:2669-2676, (2013)]. Under the proposed cost reducing distribution policy, an added initial delivery of end items is distributed to multiple sales locations to meet their demand during the production unit's uptime and rework time. After rework when the remaining production lot goes through quality assurance, n fixed quantity installments of finished items are then transported to sales locations at a fixed time interval. Mathematical modeling and optimization techniques are used to derive closed-form optimal operating policies for the proposed system. Furthermore, the study demonstrates significant savings in stock holding costs for both the production unit and sales locations. Alternative of outsourcing product delivery task to an external distributor is analyzed to assist managerial decision making in potential outsourcing issues in order to facilitate further reduction in operating costs.

The cost-effectiveness of nonoperative management versus laparoscopic appendectomy for the treatment of acute, uncomplicated appendicitis in children.

PubMed

Wu, James X; Sacks, Greg D; Dawes, Aaron J; DeUgarte, Daniel; Lee, Steven L

2017-07-01

Several studies have demonstrated the safety and short-term success of nonoperative management in children with acute, uncomplicated appendicitis. Nonoperative management spares the patients and their family the upfront cost and discomfort of surgery, but also risks recurrent appendicitis. Using decision-tree software, we evaluated the cost-effectiveness of nonoperative management versus routine laparoscopic appendectomy. Model variables were abstracted from a review of the literature, Healthcare Cost and Utilization Project, and Medicare Physician Fee schedule. Model uncertainty was assessed using both one-way and probabilistic sensitivity analyses. We used a $100,000 per quality adjusted life year (QALY) threshold for cost-effectiveness. Operative management cost $11,119 and yielded 23.56 quality-adjusted life months (QALMs). Nonoperative management cost $2277 less than operative management, but yielded 0.03 fewer QALMs. The incremental cost-to-effectiveness ratio of routine laparoscopic appendectomy was $910,800 per QALY gained. This greatly exceeds the $100,000/QALY threshold and was not cost-effective. One-way sensitivity analysis found that operative management would become cost-effective if the 1-year recurrence rate of acute appendicitis exceeded 39.8%. Probabilistic sensitivity analysis indicated that nonoperative management was cost-effective in 92% of simulations. Based on our model, nonoperative management is more cost-effective than routine laparoscopic appendectomy for children with acute, uncomplicated appendicitis. Cost-Effectiveness Study: Level II. Published by Elsevier Inc.

Launch Vehicle Production and Operations Cost Metrics

NASA Technical Reports Server (NTRS)

Watson, Michael D.; Neeley, James R.; Blackburn, Ruby F.

2014-01-01

Traditionally, launch vehicle cost has been evaluated based on $/Kg to orbit. This metric is calculated based on assumptions not typically met by a specific mission. These assumptions include the specified orbit whether Low Earth Orbit (LEO), Geostationary Earth Orbit (GEO), or both. The metric also assumes the payload utilizes the full lift mass of the launch vehicle, which is rarely true even with secondary payloads.1,2,3 Other approaches for cost metrics have been evaluated including unit cost of the launch vehicle and an approach to consider the full program production and operations costs.4 Unit cost considers the variable cost of the vehicle and the definition of variable costs are discussed. The full program production and operation costs include both the variable costs and the manufacturing base. This metric also distinguishes operations costs from production costs, including pre-flight operational testing. Operations costs also consider the costs of flight operations, including control center operation and maintenance. Each of these 3 cost metrics show different sensitivities to various aspects of launch vehicle cost drivers. The comparison of these metrics provides the strengths and weaknesses of each yielding an assessment useful for cost metric selection for launch vehicle programs.

Cost-effectiveness of simultaneous versus sequential surgery in head and neck reconstruction.

PubMed

Wong, Kevin K; Enepekides, Danny J; Higgins, Kevin M

2011-02-01

To determine whether simultaneous (ablation and reconstruction overlaps by two teams) head and neck reconstruction is cost effective compared to sequentially (ablation followed by reconstruction) performed surgery. Case-controlled study. Tertiary care hospital. Oncology patients undergoing free flap reconstruction of the head and neck. A match paired comparison study was performed with a retrospective chart review examining the total time of surgery for sequential and simultaneous surgery. Nine patients were selected for both the sequential and simultaneous groups. Sequential head and neck reconstruction patients were pair matched with patients who had undergone similar oncologic ablative or reconstructive procedures performed in a simultaneous fashion. A detailed cost analysis using the microcosting method was then undertaken looking at the direct costs of the surgeons, anesthesiologist, operating room, and nursing. On average, simultaneous surgery required 3 hours 15 minutes less operating time, leading to a cost savings of approximately $1200/case when compared to sequential surgery. This represents approximately a 15% reduction in the cost of the entire operation. Simultaneous head and neck reconstruction is more cost effective when compared to sequential surgery.

Ship Operating and Support Cost Estimating Guide.

DTIC Science & Technology

1982-07-13

and Support, Cost Estimating Guide." Please substitute it for the document now on file at DTIC with the AD number of A 132442. Geraldine W. Asher I...replaces the CAIG memorandum on Operating and Sup- port Cos y Structures dated August 1977. 1.2 AUTHORITY. The foundation for development and review of...during the acquisition process, including cost effec- tiveness trade-off studies . The guide is generally expressed at the ship level of cost but is

Assessment of the financial implications for laparoscopic liver surgery: a single-centre UK cost analysis for minor and major hepatectomy.

PubMed

Abu Hilal, Mohammed; Di Fabio, Francesco; Syed, Shareef; Wiltshire, Robert; Dimovska, Eleonora; Turner, David; Primrose, John N; Pearce, Neil W

2013-07-01

Laparoscopic hepatectomy is progressively gaining popularity. However, it is still unclear whether the laparoscopic approach offers cost advantages compared with the open approach, especially when major hepatectomies are required. Data providing useful insights into the costs of the laparoscopic approach for clinicians and hospitals are needed. The aim of this study is to assess the financial implications of the laparoscopic approach for two standardized minor and major hepatectomies: left lateral sectionectomy and right hepatectomy. A cost comparison analysis of patients undergoing laparoscopic right hepatectomy (LRH) and laparoscopic left lateral sectionectomy (LLLS) versus the open counterparts was performed. Data considered for the comparison analysis were operative costs (theatre cost, consumables and surgeon/anaesthetic labour cost), postoperative costs (hospital stay, complication management and readmissions) and overall costs. A total of 149 patients were included: 38 patients underwent LRH and 46 open right hepatectomy (ORH); 46 patients underwent LLLS and 19 open left lateral sectionectomy (OLLS). For LRH the mean operative, postoperative and overall costs were £10,181, £4,037 and £14,218; for ORH the mean operative, postoperative and overall costs were £6,483 (p < 0.0001), £10,304 (p < 0.0001) and £16,787 (p = 0.886). Regarding LLLS, the mean operative, postoperative and overall costs were £5,460, £2,599 and £8,059; for OLLS the mean operative, postoperative and overall costs were £5,841 (p = 0.874), £5,796 (p < 0.0001) and £11,637 (p = 0.0001). Our data support the cost advantage of the laparoscopic approach for left lateral sectionectomy and the cost neutrality for right hepatectomy.

Costs to Automate Demand Response - Taxonomy and Results from Field Studies and Programs

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

Piette, Mary A.; Schetrit, Oren; Kiliccote, Sila

During the past decade, the technology to automate demand response (DR) in buildings and industrial facilities has advanced significantly. Automation allows rapid, repeatable, reliable operation. This study focuses on costs for DR automation in commercial buildings with some discussion on residential buildings and industrial facilities. DR automation technology relies on numerous components, including communication systems, hardware and software gateways, standards-based messaging protocols, controls and integration platforms, and measurement and telemetry systems. This report compares cost data from several DR automation programs and pilot projects, evaluates trends in the cost per unit of DR and kilowatts (kW) available from automated systems,more » and applies a standard naming convention and classification or taxonomy for system elements. Median costs for the 56 installed automated DR systems studied here are about $200/kW. The deviation around this median is large with costs in some cases being an order of magnitude great or less than the median. This wide range is a result of variations in system age, size of load reduction, sophistication, and type of equipment included in cost analysis. The costs to automate fast DR systems for ancillary services are not fully analyzed in this report because additional research is needed to determine the total cost to install, operate, and maintain these systems. However, recent research suggests that they could be developed at costs similar to those of existing hot-summer DR automation systems. This report considers installation and configuration costs and does include the costs of owning and operating DR automation systems. Future analysis of the latter costs should include the costs to the building or facility manager costs as well as utility or third party program manager cost.« less

Economic analysis and assessment of syngas production using a modeling approach

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

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

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

Immersion frying for the thermal drying of sewage sludge: an economic assessment.

PubMed

Peregrina, Carlos; Rudolph, Victor; Lecomte, Didier; Arlabosse, Patricia

2008-01-01

This paper presents an economic study of a novel thermal fry-drying technology which transforms sewage sludge and recycled cooking oil (RCO) into a solid fuel. The process is shown to have significant potential advantage in terms of capital costs (by factors of several times) and comparable operating costs. Three potential variants of the process have been simulated and costed in terms of both capital and operating requirements for a commercial scale of operation. The differences are in the energy recovery systems, which include a simple condensation of the evaporated water and two different heat pump configurations. Simple condensation provides the simplest process, but the energy efficiency gain of an open heat pump offset this, making it economically somewhat more attractive. In terms of operating costs, current sludge dryers are dominated by maintenance and energy requirements, while for fry-drying these are comparatively small. Fry-drying running costs are dominated by provision of makeup waste oil. Cost reduction could focus on cheaper waste oil, e.g. from grease trap waste.

Feasibility Study of a Rotorcraft Health and Usage Monitoring System (HUMS): Results of Operator's Evaluation

NASA Technical Reports Server (NTRS)

Romero, Raylund; Summers, Harold; Cronkhite, James

1996-01-01

The objective was to evaluate the feasibility of a state-of-the-art health and usage monitoring system (HUMS) to provide monitoring of critical mechanical systems on the helicopter, including motors, drive train, engines, and life-limited components. The implementation of HUMS and cost integration with current maintenance procedures was assessed from the operator's viewpoint in order to achieve expected benefits from these systems, such as enhanced safety, reduced maintenance cost, and increased availability. An operational HUMS that was installed and operated under an independent flight trial program was used as a basis for this study. The HUMS equipment and software were commercially available. Based on the results of the feasibility study, the HUMS used in the flight trial program generally demonstrated a high level of reliability in monitoring the rotor system, engines, drive train, and life-limited components. The system acted as a sentinel to warn of impending failures. A worn tail rotor pitch bearing was detected by HUMS, which had the capability for self testing to diagnose system and sensor faults. Examples of potential payback to the operator with HUMS were identified, including reduced insurance cost through enhanced safety, lower operating costs derived from maintenance credits, increased aircraft availability, and improved operating efficiency. The interfacing of HUMS with current operational procedures was assessed to require only minimal revisions to the operator's maintenance manuals. Finally the success in realizing the potential benefits from HUMS technology was found to depend on the operator, helicopter manufacturer, regulator (FAA), and HUMS supplier working together.

A Study of Operating Costs of Branch Campuses and Centers at State Universities and Community Colleges. Report and Recommendations of the Postsecondary Education Planning Commission, 1988, Report 2.

ERIC Educational Resources Information Center

Florida State Postsecondary Education Planning Commission, Tallahassee.

In 1988, a study was conducted of the operating costs of the 15 branch campuses and centers operated by the six Florida State universities and of nine representative community colleges in the state. Information provided by the colleges revealed that: (1) in comparison to their main campuses, branch campuses and centers tended to be less expensive…

Harvest operations for density management: planning requirements, production, costs, stand damage, and recommendations

Treesearch

Loren D. Kellogg; Stephen J. Pilkerton

2013-01-01

Since the early 1990s, several studies have been undertaken to determine the planning requirements, productivity, costs, and residual stand damage of harvest operations in thinning treatments designed to promote development of complex forest structure in order to enhance ecological functioning and biological diversity. Th ese studies include the Oregon State...

36th Annual Maintenance & Operations Cost Study: Colleges

ERIC Educational Resources Information Center

Agron, Joe

2007-01-01

Colleges are focusing increased effort--and money--to improve the physical condition of existing facilities and address a huge backlog of deferred maintenance. According to "American School & University's" 36th annual Maintenance and Operations (M&O) Cost Study, the median college spends 16.4% of total college budget on M&O, up from 11% the year…

Estimating the Cost of Neurosurgical Procedures in a Low-Income Setting: An Observational Economic Analysis.

PubMed

Abdelgadir, Jihad; Tran, Tu; Muhindo, Alex; Obiga, Doomwin; Mukasa, John; Ssenyonjo, Hussein; Muhumza, Michael; Kiryabwire, Joel; Haglund, Michael M; Sloan, Frank A

2017-05-01

There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). During the study period, October 2014 to September 2015, 1440 charts were reviewed. Of these patients, 434 had surgery, whereas the other 1006 were treated nonsurgically. Thirteen types of procedures were performed at the hospital. The estimated mean cost of a neurosurgical procedure was $542.14 (standard deviation [SD], $253.62). The mean cost of different procedures ranged from $291 (SD, $101) for burr hole evacuations to $1,221 (SD, $473) for excision of brain tumors. For most surgeries, overhead costs represented the largest proportion of the total cost (29%-41%). This is the first study using primary data to determine the cost of neurosurgery in a low-resource setting. Operating theater capacity is likely the binding constraint on operative volume, and thus, investing in operating theaters should achieve a higher level of efficiency. Findings from this study could be used by stakeholders and policy makers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. Copyright © 2017 Elsevier Inc. All rights reserved.

Direct Cost Analysis of Outpatient Arthroscopic Rotator Cuff Repair in Medicare and Non-Medicare Populations.

PubMed

Narvy, Steven J; Didinger, Tracey C; Lehoang, David; Vangsness, C Thomas; Tibone, James E; Hatch, George F Rick; Omid, Reza; Osorno, Felipe; Gamradt, Seth C

2016-10-01

Providing high-quality care while also containing cost is a paramount goal in orthopaedic surgery. Increasingly, insurance providers in the United States, including government payers, are requiring financial and performance accountability for episodes of care, including a push toward bundled payments. The direct cost of outpatient arthroscopic rotator cuff repair was assessed to determine whether, due to an older population, rotator cuff surgery was more costly in Medicare-insured patients than in patients covered by other insurers. We hypothesized that operative time, implant cost, and overall higher cost would be observed in Medicare patients. Cohort study; Level of evidence, 3. Billing and operative reports from 184 outpatient arthroscopic rotator cuff repairs performed by 5 fellowship-trained arthroscopic surgeons were reviewed. Operative time, number and cost of implants, hospital reimbursement, surgeon reimbursement, and insurance type were determined from billing records and operative reports. Patients were stratified by payer (Medicare vs non-Medicare), and these variables were compared. There were no statistically significant differences in the number of suture anchors used, implant cost, surgical duration, or overall cost of arthroscopic rotator cuff repair between Medicare and other insurers. Reimbursement was significantly higher for other payers when compared with Medicare, resulting in a mean per case deficit of $263.54 between billing and reimbursement for Medicare patients. Operating room time, implant cost, and total procedural cost was the same for Medicare patients as for patients with private payers. Further research needs to be conducted to understand the patient-specific factors that affect the cost of an episode of care for rotator cuff surgery.

IEA Wind Task 26 - Multi-national Case Study of the Financial Cost of Wind Energy; Work Package 1 Final Report

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

Schwabe, P.; Lensink, S.; Hand, M.

2011-03-01

The lifetime cost of wind energy is comprised of a number of components including the investment cost, operation and maintenance costs, financing costs, and annual energy production. Accurate representation of these cost streams is critical in estimating a wind plant's cost of energy. Some of these cost streams will vary over the life of a given project. From the outset of project development, investors in wind energy have relatively certain knowledge of the plant's lifetime cost of wind energy. This is because a wind energy project's installed costs and mean wind speed are known early on, and wind generation generallymore » has low variable operation and maintenance costs, zero fuel cost, and no carbon emissions cost. Despite these inherent characteristics, there are wide variations in the cost of wind energy internationally, which is the focus of this report. Using a multinational case-study approach, this work seeks to understand the sources of wind energy cost differences among seven countries under International Energy Agency (IEA) Wind Task 26 - Cost of Wind Energy. The participating countries in this study include Denmark, Germany, the Netherlands, Spain, Sweden, Switzerland, and the United States. Due to data availability, onshore wind energy is the primary focus of this study, though a small sample of reported offshore cost data is also included.« less

A life cycle cost economics model for projects with uniformly varying operating costs. [management planning

NASA Technical Reports Server (NTRS)

Remer, D. S.

1977-01-01

A mathematical model is developed for calculating the life cycle costs for a project where the operating costs increase or decrease in a linear manner with time. The life cycle cost is shown to be a function of the investment costs, initial operating costs, operating cost gradient, project life time, interest rate for capital and salvage value. The results show that the life cycle cost for a project can be grossly underestimated (or overestimated) if the operating costs increase (or decrease) uniformly over time rather than being constant as is often assumed in project economic evaluations. The following range of variables is examined: (1) project life from 2 to 30 years; (2) interest rate from 0 to 15 percent per year; and (3) operating cost gradient from 5 to 90 percent of the initial operating costs. A numerical example plus tables and graphs is given to help calculate project life cycle costs over a wide range of variables.

Fuzzy multi-objective optimization case study based on an anaerobic co-digestion process of food waste leachate and piggery wastewater.

PubMed

Choi, Angelo Earvin Sy; Park, Hung Suck

2018-06-20

This paper presents the development and evaluation of fuzzy multi-objective optimization for decision-making that includes the process optimization of anaerobic digestion (AD) process. The operating cost criteria which is a fundamental research gap in previous AD analysis was integrated for the case study in this research. In this study, the mixing ratio of food waste leachate (FWL) and piggery wastewater (PWW), calcium carbonate (CaCO 3 ) and sodium chloride (NaCl) concentrations were optimized to enhance methane production while minimizing operating cost. The results indicated a maximum of 63.3% satisfaction for both methane production and operating cost under the following optimal conditions: mixing ratio (FWL: PWW) - 1.4, CaCO 3 - 2970.5 mg/L and NaCl - 2.7 g/L. In multi-objective optimization, the specific methane yield (SMY) was 239.0 mL CH 4 /g VS added , while 41.2% volatile solids reduction (VSR) was obtained at an operating cost of 56.9 US$/ton. In comparison with the previous optimization study that utilized the response surface methodology, the SMY, VSR and operating cost of the AD process were 310 mL/g, 54% and 83.2 US$/ton, respectively. The results from multi-objective fuzzy optimization proves to show the potential application of this technique for practical decision-making in the process optimization of AD process. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Cost Simulation Tool for Estimating the Cost of Operating Government Owned and Operated Ships

DTIC Science & Technology

1994-09-01

Horngren , C.T., Foster, G., Datar, S.M., Cost Accounting : A Management Emphasis, Prentice-Hall, Englewood Cliffs, NJ, 1994 IBM Corporation, A Graphical...4. TITLE AND SUBTITLE A COST SIMULATION TOOL FOR 5. FUNDING NUMBERS ESTIMATING THE COST OF OPERATING GOVERNMENT OWNED AND OPERATED SHIPS 6. AUTHOR( S ...normally does not present a problem to the accounting department. The final category, the cost of operating the government owned and operated ships is

Spacelab cost reduction alternatives study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1976-01-01

Alternative approaches to payload operations planning and control and flight crew training are defined for spacelab payloads with the goal of: lowering FY77 and FY 78 costs for new starts; lowering costs to achieve Spacelab operational capability; and minimizing the cost per Spacelab flight. These alternatives attempt to minimize duplication of hardware, software, and personnel, and the investment in supporting facility and equipment. Of particular importance is the possible reduction of equipment, software, and manpower resources such as comtational systems, trainers, and simulators.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 1: Generic ground operations data

NASA Technical Reports Server (NTRS)

Byrd, Raymond J.

1990-01-01

This study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advance Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. This volume presents ground processing data for a generic LOX/LH2 booster and core propulsion system based on current STS experience. The data presented includes: top logic diagram, process flow, activities bar-chart, loaded timelines, manpower requirements in terms of duration, headcount and skill mix per operations and maintenance instruction (OMI), and critical path tasks and durations.

Space Station Freedom operations costs

NASA Technical Reports Server (NTRS)

Accola, Anne L.; Williams, Gregory J.

1988-01-01

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

An investigation into the cost, coverage and activities of Helicopter Emergency Medical Services in the state of New South Wales, Australia.

PubMed

Taylor, Colman B; Stevenson, Mark; Jan, Stephen; Liu, Bette; Tall, Gary; Middleton, Paul M; Fitzharris, Michael; Myburgh, John

2011-10-01

Helicopter Emergency Medical Services (HEMS) have been incorporated into modern health systems for their speed and coverage. In the state of New South Wales (NSW), nine HEMS operate from various locations around the state and currently there is no clear picture of their resource implications. The aim of this study was to assess the cost of HEMS in NSW and investigate the factors linked with the variation in the costs, coverage and activities of HEMS. We undertook a survey of HEMS costs, structures and operations in NSW for the 2008/2009 financial year. Costs were estimated from annual reports and contractual agreements. Data related to the structure and operation of services was obtained by face-to-face interviews, from operational data extracted from individual HEMS, from the NSW Ambulance Computer Aided Despatch system and from the Aeromedical Operations Centre database. In order to estimate population coverage for each HEMS, we used GIS mapping techniques with Australian Bureau of Statistics census information. Across HEMS, cost per mission estimates ranged between $9300 and $19,000 and cost per engine hour estimates ranged between $5343 and $15,743. Regarding structural aspects, six HEMS were run by charities or not-for-profit companies (with partial government funding) and three HEMS were run (and fully funded) by the state government through NSW Ambulance. Two HEMS operated as 'hub' services in conjunction with three associated 'satellite' services and in contrast, four services operated independently. Variation also existed between the HEMS in the type of helicopter used, the clinical staffing and the hours of operation. The majority of services undertook both primary scene responses and secondary inter-facility transfers, although the proportion of each type of transport contributing to total operations varied across the services. This investigation highlighted the cost of HEMS operations in NSW which in total equated to over $50 million per annum. Across services, we found large variation in the cost estimates which was underscored by variation in the structure and operations of HEMS. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

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

Specialty hospitals emulating focused factories: a case study.

PubMed

Kumar, Sameer

2010-01-01

For 15 years general hospital managers faced new competition from for-profit specialty hospitals that operate on a "focused factory" model, which threaten to siphon-off the most profitable patients. This paper aims to discuss North American specialty hospitals and to review rising costs impact on general hospital operations. The focus is to discover whether specialty hospitals are more efficient than general hospitals; if so, how significant is the difference and also what can general hospitals do in light of the rising specialty hospitals. The case study involves stochastic frontier regression analysis using Cobb-Douglas and Translog cost functions to compare Minnesota general and specialty hospital efficiency. Analysis is based on data from 117 general and 19 specialty hospitals. The results suggest that specialty hospitals are significantly more efficient than general hospitals. Overall, general hospitals were found to be more than twice as inefficient compared with specialty hospitals in the sample. Some cost-cutting factors highlighted can be implemented to trim rising costs. The case study highlights some managerial levers that general hospital operational managers might use to control rising costs. This also helps them compete with specialty hospitals by reducing overheads and other major costs. The study is based on empirical modeling for an important healthcare operational challenge and provides additional in-depth information that has health policy implications. The analysis and findings enable healthcare managers to guide their institutions in a new direction during a time of change within the industry.

Nurse staffing patterns and hospital efficiency in the United States.

PubMed

Bloom, J R; Alexander, J A; Nuchols, B A

1997-01-01

The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.

An Ownership/Lease Cost Comparison Analysis of Heavy Equipment Motor Vehicles in Air Force Materiel Command

DTIC Science & Technology

1994-09-01

costs are the costs associated with a particular piece of equipment that do not change despite change in variable operating cost ( Horngren and Foster...The Operating and maintenance costs account for direct and indirect costs associated with their respective functions and vary with the utilization of...each vehicle. The operating direct cost includes all on-base and off- base fuel cost . Indirect operations costs account for bench 28 stock items

Optimizing conceptual aircraft designs for minimum life cycle cost

NASA Technical Reports Server (NTRS)

Johnson, Vicki S.

1989-01-01

A life cycle cost (LCC) module has been added to the FLight Optimization System (FLOPS), allowing the additional optimization variables of life cycle cost, direct operating cost, and acquisition cost. Extensive use of the methodology on short-, medium-, and medium-to-long range aircraft has demonstrated that the system works well. Results from the study show that optimization parameter has a definite effect on the aircraft, and that optimizing an aircraft for minimum LCC results in a different airplane than when optimizing for minimum take-off gross weight (TOGW), fuel burned, direct operation cost (DOC), or acquisition cost. Additionally, the economic assumptions can have a strong impact on the configurations optimized for minimum LCC or DOC. Also, results show that advanced technology can be worthwhile, even if it results in higher manufacturing and operating costs. Examining the number of engines a configuration should have demonstrated a real payoff of including life cycle cost in the conceptual design process: the minimum TOGW of fuel aircraft did not always have the lowest life cycle cost when considering the number of engines.

Systems Operations Studies for Automated Guideway Transit Systems : Quantitative Analysis of Alternative AGT Operational Control Strategies

DOT National Transportation Integrated Search

1981-10-01

The objectives of the Systems Operation Studies (SOS) for automated guideway transit (AGT) systems are to develop models for the analysis of system operations, to evaluate performance and cost, and to establish guidelines for the design and operation...

Low-Cost SIRTF Flight Operations

NASA Astrophysics Data System (ADS)

Deutsch, M.-J.; Ebersole, M.; Nichols, J.

1997-12-01

The Space Infrared Telescope Facility (SIRTF) , the fourth of the Great Observatories, will be placed in a unique solar orbit trailing the Earth, in 2001. SIRTF will acquire both imaging and spectral data using large infrared detector arrays from 3.5mm to 160mm. The primary science objectives are (1) search for and study of brown dwarfs and super planets, (2) discovery and study of protoplanetary debris disks, (3) study of ultraluminous galaxies and active galactic nuclei, and (4) study of the early Universe. Driven by the limited cryogenic lifetime of 2.5 years, with a goal of 5 years, and the severely cost-capped development, a Mission Planning and Operations system is being designed that will result in high on-board efficiency (>90%) and low-cost operation, yet will accommodate rapid response science requirements . SIRTF is designing an architecture for an operations system that will be shared between science and flight operations. Crucial to this effort is the philosophy of an integrated science and engineering plan, co-location, cross-training of teams and common planning tools. The common tool set will enable the automatic generation of an integrated and conflict free planned schedule accommodating 20 000 observations and engineering activities a year. The shared tool set will help generate standard observations , (sometimes non-standard) engineering activities and manage the ground and flight resources and constraints appropriately. The ground software will allow the development from the ground of robust event driven sequences. Flexibility will be provided to incorporate newly discovered science opportunities or health issues late in the process and via quick links. This shared science and flight operations process if used from observation selection through sequence and command generation, will provide a low-cost operations system. Though SIRTF is a 'Great Observatory', its annual mission operations costs will more closely resemble those of an Explorer class mission.

Nursing home cost and ownership type: evidence of interaction effects.

PubMed

Arling, G; Nordquist, R H; Capitman, J A

1987-06-01

Due to steadily increasing public expenditures for nursing home care, much research has focused on factors that influence nursing home costs, especially for Medicaid patients. Nursing home cost function studies have typically used a number of predictor variables in a multiple regression analysis to determine the effect of these variables on operating cost. Although several authors have suggested that nursing home ownership types have different goal orientations, not necessarily based on economic factors, little attention has been paid to this issue in empirical research. In this study, data from 150 Virginia nursing homes were used in multiple regression analysis to examine factors accounting for nursing home operating costs. The context of the study was the Virginia Medicaid reimbursement system, which has intermediate care and skilled nursing facility (ICF and SNF) facility-specific per diem rates, set according to facility cost histories. The analysis revealed interaction effects between ownership and other predictor variables (e.g., percentage Medicaid residents, case mix, and region), with predictor variables having different effects on cost depending on ownership type. Conclusions are drawn about the goal orientations and behavior of chain-operated, individual for-profit, and public and nonprofit facilities. The implications of these findings for long-term care reimbursement policies are discussed.

Nursing home cost and ownership type: evidence of interaction effects.

PubMed Central

Arling, G; Nordquist, R H; Capitman, J A

1987-01-01

Due to steadily increasing public expenditures for nursing home care, much research has focused on factors that influence nursing home costs, especially for Medicaid patients. Nursing home cost function studies have typically used a number of predictor variables in a multiple regression analysis to determine the effect of these variables on operating cost. Although several authors have suggested that nursing home ownership types have different goal orientations, not necessarily based on economic factors, little attention has been paid to this issue in empirical research. In this study, data from 150 Virginia nursing homes were used in multiple regression analysis to examine factors accounting for nursing home operating costs. The context of the study was the Virginia Medicaid reimbursement system, which has intermediate care and skilled nursing facility (ICF and SNF) facility-specific per diem rates, set according to facility cost histories. The analysis revealed interaction effects between ownership and other predictor variables (e.g., percentage Medicaid residents, case mix, and region), with predictor variables having different effects on cost depending on ownership type. Conclusions are drawn about the goal orientations and behavior of chain-operated, individual for-profit, and public and nonprofit facilities. The implications of these findings for long-term care reimbursement policies are discussed. PMID:3301746

A Positive Move: 12th Annual College M&O Cost Study

ERIC Educational Resources Information Center

Agron, Joe

2006-01-01

Colleges placed more of an emphasis on maintenance and operations (M&O) this school year by increasing the amount spent on M&O as a percentage of total budget. According to "American School & University's" 12th annual College Maintenance and Operations Cost Study, spending on M&O as a percentage of total college budget increased to 11 percent from…

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

NASA Technical Reports Server (NTRS)

1983-01-01

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

FINANCIAL ANALYSIS OF CURRENT OPERATIONS OF COLLEGES AND UNIVERSITIES.

ERIC Educational Resources Information Center

SWANSON, JOHN E.; AND OTHERS

TECHNIQUES FOR DEVELOPING FINANCIAL AND RELATED COST-EFFECTIVENESS DATA FOR PUBLIC AND PRIVATELY SUPPORTED AMERICAN COLLEGES AND UNIVERSITIES WERE STUDIED TO FORMULATE PRINCIPLES, PROCEDURES, AND STANDARDS FOR THE ACCUMULATION AND ANALYSES OF CURRENT OPERATING COSTS. AFTER SEPARATE ANALYSES OF INSTITUTIONAL PROCEDURES AND REPORTS, ANALYTIC UNITS…

Comparison of alternative relative weights for diagnosis-related groups

PubMed Central

Cotterill, Philip; Bobula, Joel; Connerton, Rose

1986-01-01

During this study, we investigated the extent to which diagnosis-related group (DRG) relative weights based exclusively on charge data differ from DRG weights constructed according to the methodology used in deriving the original relative weights for the Medicare prospective payment system (PPS). The PPS operating cost weights were based on a combination of cost and adjusted charge information (Pettengill and Vertrees, 1982). The results of this study reveal only minor differences between the two sets of weights. Interhospital differences in cost-to-charge ratios do not produce large, arbitrary differences between charge-based and operating cost weights. Whether the data are standardized for differences in capital and medical education costs also appears to make little difference. PMID:10311495

Post-operative bracing after pedicle screw fixation for thoracolumbar burst fractures: A cost-effectiveness study.

PubMed

Piazza, Matthew; Sinha, Saurabh; Agarwal, Prateek; Mallela, Arka; Nayak, Nikhil; Schuster, James; Stein, Sherman

2017-11-01

While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures. Additionally, a database of neurosurgical patients operated on within the authors institution was also used in the analysis. Incidences of significant adverse events (wound revision for either dehiscence or infection or re-operation for non-union or instability due to hardware failure) were determined. Pooled means and variances of reported parameters were obtained using a random-effects, inverse variance meta-analytic model for observational data. Utilities for surgical outcome and complications were assigned using previously published values. Of the 225 abstracts reviewed, 48 articles were included in the study, yielding a total of 1957 patients. After including patients from the institutional registry, together a total of 2081 patients were included in the final analysis, 1328 of whom were braced. Non-braced patients were older then braced patients, although this only approached significance (p=0.051). Braced patients had significantly lower rates of re-operation for non-union or clinically significant hardware failure (1.3% vs. 1.8%, p<0.001) although the groups had comparable rates of operative wound dehiscence and infection (p=1.000). These two approaches yielded comparable utility scores (p=0.120). Costs between braced and non-braced patients were comparable excluding the cost of the brace (p=0.256); hence, the added cost of the brace suggests that bracing post-operatively is not a cost effective measure. Bracing following operative stabilization of thoracolumbar fracture does not significantly improve stability, nor does it increase wound complications. Moreover, our data suggests that post-operative bracing may not be a cost-effective measure. Copyright © 2017. Published by Elsevier Ltd.

Cost of an informatics-based diabetes management program.

PubMed

Blanchfield, Bonnie B; Grant, Richard W; Estey, Greg A; Chueh, Henry C; Gazelle, G Scott; Meigs, James B

2006-01-01

The relatively high cost of information technology systems may be a barrier to hospitals thinking of adopting this technology. The experiences of early adopters may facilitate decision making for hospitals less able to risk their limited resources. This study identifies the costs to design, develop, implement, and operate an innovative informatics-based registry and disease management system (POPMAN) to manage type 2 diabetes in a primary care setting. The various cost components of POPMAN were systematically identified and collected. POPMAN cost 450,000 dollars to develop and operate over 3.5 years (1999-2003). Approximately 250,000 dollars of these costs are one-time expenditures or sunk costs. Annual operating costs are expected to range from 90,000 dollars to 110,000 dollars translating to approximately 90 dollars per patient for a 1,200 patient registry. The cost of POPMAN is comparable to the costs of other quality-improving interventions for patients with diabetes. Modifications to POPMAN for adaptation to other chronic diseases or to interface with new electronic medical record systems will require additional investment but should not be as high as initial development costs. POPMAN provides a means of tracking progress against negotiated quality targets, allowing hospitals to negotiate pay for performance incentives with insurers that may exceed the annual operating cost of POPMAN. As a result, the quality of care of patients with diabetes through use of POPMAN could be improved at a minimal net cost to hospitals.

Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India.

PubMed

Gajuryal, S H; Daga, A; Siddharth, V; Bal, C S; Satpathy, S

2017-01-01

PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. The study aims to determine the cost of providing PET/CT Scan services in a hospital. This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64).

Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

PubMed

Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

2017-01-01

Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P < .05). PSI demonstrated similar postoperative accuracy to SR in coronal tibial-plafond alignment (1.1 vs 0.3 degrees varus, P = .06), tibial-plafond alignment (0.3 ± 2.1 vs 1.1 ± 2.1 degrees varus, P = .06), and tibial component sagittal alignment (0.7 vs 0.9 degrees plantarflexion, P = .14). The TDABC method estimated a PSI cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold of $863 was identified for PSI pricing at our institution below which PSI was less costly than SR. Similar internal cost accounting may benefit health care systems for identifying cost drivers and obtaining leverage during price negotiations. Level III, therapeutic study.

Analysis on logistic company action toward the access restriction policy on freight vehicle

NASA Astrophysics Data System (ADS)

Nur, Muhammad; Hadiwardoyo, Sigit P.; Nahry, Nahdalina

2017-06-01

The high volume of freight vehicles that enters, leaves or passes through the urban areas, especially Jakarta, has caused traffic congestion. Local authority plans to perform the access restriction on freight vehicles on the Jakarta Outer Ring Road (JORR) to reduce the congestion on that toll road. The study aims to analyze the alternative solutions of the logistics companies to overcome the impact of such policy. The data collection is done by interviewing 102 truck drivers and 7 staffs of logistic companies that use JORR. The results show that the most preferred action is shifting the operating time. Based on the open test, access restriction policy on JORR may cause a significant impact on the operational costs of delivery. Shifting the operational time will increase the operating cost by 1.71%, while turning the route will increase the operating costs by 4.35%. Moreover, changing the mode will reduce the operating expenses by 50%, and the combination action of shifting the route and the time will increase the operating costs by 5.39%.

A strategic decision-making model considering the social costs of carbon dioxide emissions for sustainable supply chain management.

PubMed

Tseng, Shih-Chang; Hung, Shiu-Wan

2014-01-15

Incorporating sustainability into supply chain management has become a critical issue driven by pressures from governments, customers, and various stakeholder groups over the past decade. This study proposes a strategic decision-making model considering both the operational costs and social costs caused by the carbon dioxide emissions from operating such a supply chain network for sustainable supply chain management. This model was used to evaluate carbon dioxide emissions and operational costs under different scenarios in an apparel manufacturing supply chain network. The results showed that the higher the social cost rate of carbon dioxide emissions, the lower the amount of the emission of carbon dioxide. The results also suggested that a legislation that forces the enterprises to bear the social costs of carbon dioxide emissions resulting from their economic activities is an effective approach to reducing carbon dioxide emissions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Resource utilization and costs before and after total joint arthroplasty.

PubMed

Bozic, Kevin J; Stacey, Brett; Berger, Ariel; Sadosky, Alesia; Oster, Gerry

2012-03-23

The purpose of this study was to compare pre- and post-surgical healthcare costs in commercially insured total joint arthroplasty (TJA) patients with osteoarthritis (OA) in the United States (U.S.). Using a large healthcare claims database, we identified patients over age 39 with hip or knee OA who underwent unilateral primary TJA (hip or knee) between 1/1/2006 and 9/30/2007. Utilization of healthcare services and costs were aggregated into three periods: 12 months "pre-surgery," 91 days "peri-operative," and 3 to 15 month "follow-up," Mean total pre-surgery costs were compared with follow-up costs using Wilcoxon signed-rank test. 14,912 patients met inclusion criteria for the study. The mean total number of outpatient visits declined from pre-surgery to follow-up (18.0 visits vs 17.1), while the percentage of patients hospitalized increased (from 7.5% to 9.8%) (both p < 0.01). Mean total costs during the follow-up period were 18% higher than during pre-surgery ($11,043 vs. $9,632, p < 0.01), largely due to an increase in the costs of inpatient care associated with hospital readmissions ($3,300 vs. $1,817, p < 0.01). Pharmacotherapy costs were similar for both periods ($2013 [follow-up] vs. $1922 [pre-surgery], p = 0.33); outpatient care costs were slightly lower in the follow-up period ($4338 vs. $4571, p < 0.01). Mean total costs for the peri-operative period were $36,553. Mean total utilization of outpatient healthcare services declined slightly in the first year following TJA (exclusive of the peri-operative period), while mean total healthcare costs increased during the same time period, largely due to increased costs associated with hospital readmissions. Further study is necessary to determine whether healthcare costs decrease in subsequent years.

Effect of Resident Involvement on Operative Time and Operating Room Staffing Costs.

PubMed

Allen, Robert William; Pruitt, Mark; Taaffe, Kevin M

The operating room (OR) is a major driver of hospital costs; therefore, operative time is an expensive resource. The training of surgical residents must include time spent in the OR, but that experience comes with a cost to the surgeon and hospital. The objective of this article is to determine the effect of surgical resident involvement in the OR on operative time and subsequent hospital labor costs. The Kruskal-Wallis statistical test is used to determine whether or not there is a difference in operative times between 2 groups of cases (with residents and without residents). This difference leads to an increased cost in associated hospital labor costs for the group with the longer operative time. Cases were performed at Greenville Memorial Hospital. Greenville Memorial Hospital is part of the larger healthcare system, Greenville Health System, located in Greenville, SC and is a level 1 trauma center with up to 33 staffed ORs. A total of 84,997 cases were performed at the partnering hospital between January 1st, 2011 and July 31st, 2015. Cases were only chosen for analysis if there was only one CPT code associated with the case and there were more than 5 observations for each group being studied. This article presents a comprehensive retrospective analysis of 29,134 cases covering 246 procedures. The analysis shows that 45 procedures took significantly longer with a resident present in the room. The average increase in operative time was 4.8 minutes and the cost per minute of extra operative time was determined to be $9.57 per minute. OR labor costs at the partnering hospital was found to be $2,257,433, or $492,889 per year. Knowing the affect on operative time and OR costs allows managers to make smart decisions when considering alternative educational and training techniques. In addition, knowing the connection between residents in the room and surgical duration could help provide better estimates of surgical time in the future and increase the predictability of procedure duration. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures.

PubMed

Hanselman, Andrew E; Murphy, Timothy R; Bal, George K; McDonough, E Barry

2016-09-01

Although clavicle fractures often heal well with nonoperative management, current literature has shown improved outcomes with operative intervention for specific fracture patterns in specific patient types. The 2 most common methods of midshaft clavicle fracture fixation are intramedullary and plate devices. Through retrospective analysis, this study performed a direct cost comparison of these 2 types of fixation at a single institution over a 5-year period. Outcome measures included operative costs for initial surgery and any hardware removal surgeries. This study reviewed 154 patients (157 fractures), and of these, 99 had intramedullary fixation and 58 had plate fixation. A total of 80% (79 of 99) of intramedullary devices and 3% (2 of 58) of plates were removed. Average cost for initial intramedullary placement was $2955 (US dollars) less than that for initial plate placement (P<.001); average cost for removal was $1874 less than that for plate removal surgery (P=.2). Average total cost for all intramedullary surgeries was $1392 less than the average cost for all plating surgeries (P<.001). Average cost for all intramedullary surgeries requiring plate placement and removal was $653 less than the average cost for all plating surgeries that involved only placement (P=.04). Intramedullary fixation of clavicle fractures resulted in a statistically significant cost reduction compared with plate fixation, despite the incidence of more frequent removal surgeries. [Orthopedics.2016; 39(5):e877-e882.]. Copyright 2016, SLACK Incorporated.

Developing and testing a cost data collection instrument for noncommunicable disease registry planning.

PubMed

Subramanian, Sujha; Tangka, Florence; Edwards, Patrick; Hoover, Sonja; Cole-Beebe, Maggie

2016-12-01

This article reports on the methods and framework we have developed to guide economic evaluation of noncommunicable disease registries. We developed a cost data collection instrument, the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool (IntRegCosting Tool), based on established economics methods We performed in-depth case studies, site visit interviews, and pilot testing in 11 registries from multiple countries including India, Kenya, Uganda, Colombia, and Barbados to assess the overall quality of the data collected from cancer and cardiovascular registries. Overall, the registries were able to use the IntRegCosting Tool to assign operating expenditures to specific activities. We verified that registries were able to provide accurate estimation of labor costs, which is the largest expenditure incurred by registries. We also identified several factors that can influence the cost of registry operations, including size of the geographic area served, data collection approach, local cost of living, presence of rural areas, volume of cases, extent of consolidation of records to cases, and continuity of funding. Internal and external registry factors reveal that a single estimate for the cost of registry operations is not feasible; costs will vary on the basis of factors that may be beyond the control of the registries. Some factors, such as data collection approach, can be modified to improve the efficiency of registry operations. These findings will inform both future economic data collection using a web-based tool and cost and cost-effectiveness analyses of registry operations in low- and middle-income countries (LMICs) and other locations with similar characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ninth Annual Maintenance & Operations Cost Study.

ERIC Educational Resources Information Center

American School and University, 1980

1980-01-01

School districts during 1979-80 were faced with a dramatic reallocation of maintenance and operations funds from salaries (a 25 percent reduction from that budgeted) to cover energy costs, with the balance used in a discretionary manner to purchase equipment and supplies and contract salaries as the year evolved. (Author/MLF)

Man Versus Machine: Comparing Double Data Entry and Optical Mark Recognition for Processing CAHPS Survey Data.

PubMed

Fifolt, Matthew; Blackburn, Justin; Rhodes, David J; Gillespie, Shemeka; Bennett, Aleena; Wolff, Paul; Rucks, Andrew

Historically, double data entry (DDE) has been considered the criterion standard for minimizing data entry errors. However, previous studies considered data entry alternatives through the limited lens of data accuracy. This study supplies information regarding data accuracy, operational efficiency, and cost for DDE and Optical Mark Recognition (OMR) for processing the Consumer Assessment of Healthcare Providers and Systems 5.0 survey. To assess data accuracy, we compared error rates for DDE and OMR by dividing the number of surveys that were arbitrated by the total number of surveys processed for each method. To assess operational efficiency, we tallied the cost of data entry for DDE and OMR after survey receipt. Costs were calculated on the basis of personnel, depreciation for capital equipment, and costs of noncapital equipment. The cost savings attributed to this method were negated by the operational efficiency of OMR. There was a statistical significance between rates of arbitration between DDE and OMR; however, this statistical significance did not create a practical significance. The potential benefits of DDE in terms of data accuracy did not outweigh the operational efficiency and thereby financial savings of OMR.

Distributed Generation Energy Technology Operations and Maintenance Costs |

Science.gov Websites

Costs Distributed Generation Energy Technology Operations and Maintenance Costs Transparent Cost Database Button The following charts indicate recent operations and maintenance (O&M) cost estimates available national-level cost data from a variety of sources. Costs in your specific location will vary. The

Cost Savings and Patient Experiences of a Clinic-Based, Wide-Awake Hand Surgery Program at a Military Medical Center: A Critical Analysis of the First 100 Procedures.

PubMed

Rhee, Peter C; Fischer, Michelle M; Rhee, Laura S; McMillan, Ha; Johnson, Anthony E

2017-03-01

Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon. Cost savings analysis was performed by using the Medical Expense and Performance Reporting System, the standard cost accounting system for the MHS, to compare procedures performed in the clinic versus the operating room during the study period. A study specific questionnaire was obtained for 66 procedures to evaluate the patient's experience. For carpal tunnel release (n = 34) and A1 pulley release (n = 33), there were 85% and 70% cost savings by having the procedures performed in clinic under WALANT compared with the main operating room, respectively. During the study period, carpal tunnel release, A1 pulley release, and de Quervain release performed in the clinic instead of the operating room amounted to $393,100 in cost savings for the MHS. There were no adverse events during the WALANT procedure. A clinic-based WALANT hand surgery program at a military medical center results in considerable cost savings for the MHS. Economic/Decision Analysis IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

An assessment of the economic aspects of CO2 sequestration in a route for biodiesel production from microalgae.

PubMed

Soares, Fabio Rubens; Martins, Gilberto; Seo, Emília Satoshi Miyamaru

2013-01-01

Photosynthetic microalgae are unicellular organisms that, during their cultivation, can fix carbon dioxide efficiently from various sources, including the air and exhaust gases from industrial processes. This feature can lead to economic benefits in the production process of biodiesel by way of the clean development mechanism, for which carbon credits for environmental benefits may be granted and which will contribute towards reducing costs in the production process. This study seeks to quantify the contribution of carbon credits in the operating costs of a route for biodiesel production from microalgae, as proposed by Davis et al. [Techno-economic analysis ofautotrophic microalgae for fuel production. Appl Energy. 2011; 88:3524-3531]. The results showed a reduction in annual operating costs by around 5%. This figure may be conservative, since the production process considered can be further improved to reduce operating costs and thus increase the contribution margin of carbon credits, which will reduce costs. On the other hand, the price of carbon may also rise in the future, thereby increasing its contribution towards a reduction in operating costs.

Study to establish cost predictions for the production of Redox chemicals

NASA Technical Reports Server (NTRS)

Ammann, P. R.; Loreth, M.; Harvey, W. W.

1982-01-01

The chromium and iron chloride chemicals are significant first costs for NASA Redox energy storage systems. This study was performed to determine the lowest cost at which chromium and iron chlorides could be obtained for a complex of redox energy storage systems. In addition, since the solutions gradually become intermixed during the course of operation of Redox units, it was an objective to evaluate schemes for regeneration of the operating solutions. Three processes were evaluated for the production of chromium and iron chlorides. As a basis for the preliminary plant design and economic evaluation, it was assumed that the plant would produce about 25,000 tons of contained chromium as CrCl3 and an equivalent molar quantity of FeCl2. Preliminary plant designs, including materials and energy balances and sizing of major equipment, were prepared, and capital and operating costs were estimated.

Study of the cost/benefit tradeoffs for reducing the energy consumption of the commercial air transportation system

NASA Technical Reports Server (NTRS)

Hopkins, J. P.

1976-01-01

Practical means were assessed for achieving reduced fuel consumption in commercial air transportation. Five areas were investigated: current aircraft types, revised operational procedures, modifications to current aircraft, derivatives of current aircraft and new near-term fuel conservative aircraft. As part of a multiparticipant coordinated effort, detailed performance and operating cost data in each of these areas were supplied to the contractor responsible for the overall analysis of the cost/benefit tradeoffs for reducing the energy consumption of the domestic commercial air transportation system. A follow-on study was performed to assess the potential of an advanced turboprop transport aircraft concept. To provide a valid basis for comparison, an equivalent turbofan transport aircraft concept incorporating equal technology levels was also derived. The aircraft as compared on the basis of weight, size, fuel utilization, operational characteristics and costs.

Fuel cycle cost reduction through Westinghouse fuel design and core management

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

Frank, F.J.; Scherpereel, L.R.

1985-11-01

This paper describes advances in Westinghouse nuclear fuel and their impact on fuel cycle cost. Recent fabrication development has been aimed at maintaining high integrity, increased operating flexibility, longer operating cycles, and improved core margins. Development efforts at Westinghouse toward meeting these directions have culminated in VANTAGE 5 fuel. The current trend toward longer operating cycles provides a further driving force to minimize the resulting inherent increase in fuel cycle costs by further increases in region discharge burnup. Westinghouse studies indicate the capability of currently offered products to meet cycle lengths up to 24 months.

Ballast Water Treatment, U.S. Great Lakes Bulk Carrier Engineering and Cost Study. Volume 2: Analysis of On-Board Treatment Methods, Alternative Ballast Water Management Practices, and Implementation Costs

DTIC Science & Technology

2013-11-01

flushing filter, disinfection with injected chlorine dioxide (chlorine dioxide is generated onboard from two component chemicals, sulfuric acid...Management System 400 80 250-8000 (10000) Sulfuric Acid and Purate for ClO2 generation Yes 0.005-0.028 8-18 Decreased sediment, potential corrosion...feed chemicals, Purate and sulfuric acid. 5. Operational and Maintenance Cost: Estimated operating and maintenance cost is $80/1000 m3 of ballast

Cost Analysis of Spinal Versus General Anesthesia for Lumbar Diskectomy and Laminectomy Spine Surgery.

PubMed

Agarwal, Prateek; Pierce, John; Welch, William C

2016-05-01

Lumbar spine surgery can be performed using various anesthetic modalities, most notably general or spinal anesthesia. Because data comparing the cost of these anesthetic modalities in spine surgery are scarce, this study asks whether spinal anesthesia is less costly than general anesthesia. A total of 542 patients who underwent elective lumbar diskectomy or laminectomy spine surgery between 2007 and 2011 were retrospectively identified, with 364 having received spinal anesthesia and 178 having received general anesthesia. Mean direct operating cost, indirect cost (general support staff, insurance, taxes, floor space, facility, and administrative costs), and total cost were compared among patients who received general and spinal anesthesia. Linear multiple regression analysis was used to identify the effect of anesthesia type on cost and determine the factors underlying this effect, while controlling for patient and procedure characteristics. When controlling for patient and procedure characteristics, use of spinal anesthesia was associated with a 41.1% lower direct operating cost (-$3629 ± $343, P < 0.001), 36.6% lower indirect cost (-$1603 ± $168, P < 0.001), and 39.6% lower total cost (-$5232 ± $482, P < 0.001) compared with general anesthesia. Shorter hospital stay, shorter duration of anesthesia, shorter duration of operation, and lower estimated blood loss contributed to lower costs for spinal anesthesia, but other factors beyond these were also responsible for lower direct operating and total costs. When comparing the benefits of spinal and general anesthesia, spinal anesthesia is less costly when used in patients undergoing lumbar diskectomy and laminectomy spine surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Pros, Cons, and Alternatives to Weight Based Cost Estimating

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

Low Cost Airline Service Revolution

DOT National Transportation Integrated Search

1996-04-01

This study concentrates on new entry by airlines with low cost operating : strategies. Low cost strategies have been the most successful in competing : with network carriers whose very size confers certain competitive advantages. : The purposes of th...

24 CFR 583.125 - Grants for operating costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Operating costs are those associated with the day-to-day operation of the supportive housing. They also... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Grants for operating costs. 583.125... for operating costs. (a) General. HUD will provide grants to pay a portion (as described in § 583.130...

Preliminary Findings of the South Africa Power System Capacity Expansion and Operational Modelling Study: Preprint

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

Reber, Timothy J; Chartan, Erol Kevin; Brinkman, Gregory L

Wind and solar power contract prices have recently become cheaper than many conventional new-build alternatives in South Africa and trends suggest a continued increase in the share of variable renewable energy (vRE) on South Africa's power system with coal technology seeing the greatest reduction in capacity, see 'Figure 6: Percentage share by Installed Capacity (MW)' in [1]. Hence it is essential to perform a state-of-the-art grid integration study examining the effects of these high penetrations of vRE on South Africa's power system. Under the 21st Century Power Partnership (21CPP), funded by the U.S. Department of Energy, the National Renewable Energymore » Laboratory (NREL) has significantly augmented existing models of the South African power system to investigate future vRE scenarios. NREL, in collaboration with Eskom's Planning Department, further developed, tested and ran a combined capacity expansion and operational model of the South African power system including spatially disaggregated detail and geographical representation of system resources. New software to visualize and interpret modelling outputs has been developed, and scenario analysis of stepwise vRE build targets reveals new insight into associated planning and operational impacts and costs. The model, built using PLEXOS, is split into two components, firstly a capacity expansion model and secondly a unit commitment and economic dispatch model. The capacity expansion model optimizes new generation decisions to achieve the lowest cost, with a full understanding of capital cost and an approximated understanding of operational costs. The operational model has a greater set of detailed operational constraints and is run at daily resolutions. Both are run from 2017 through 2050. This investigation suggests that running both models in tandem may be the most effective means to plan the least cost South African power system as build plans seen to be more expensive than optimal by the capacity expansion model can produce greater operational cost savings seen only in the operational model.« less

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

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

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

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

Adherence to infection control guidelines in surgery on MRSA positive patients : A cost analysis.

PubMed

Saegeman, V; Schuermans, A

2016-09-01

In surgical units, similar to other healthcare departments, guidelines are used to curb transmission of methicillin resistant Staphylococcus aureus (MRSA). The aim of this study was to calculate the extra costs for material and extra working hours for compliance to MRSA infection control guidelines in the operating rooms of a University Hospital. The study was based on observations of surgeries on MRSA positive patients. The average cost per surgery was calculated utilizing local information on unit costs. Robustness of the calculations was evaluated with a sensitivity analysis. The total extra costs of adherence to MRSA infection control guidelines averaged € 340.46 per surgical procedure (range € 207.76- € 473.15). A sensitivity analysis based on a standardized operating room hourly rate reached a cost of € 366.22. The extra costs of adherence to infection control guidelines are considerable. To reduce costs, the logistical planning of surgeries could be improved by for instance a dedicated room.

Production cost analysis of Euphorbia lathyris. Final report

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

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

1979-08-01

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

Study to evaluate the effect of EVA on payload systems. Volume 1: Executive summary. [project planning of space missions employing extravehicular activity as a means of cost reduction

NASA Technical Reports Server (NTRS)

Patrick, J. W.; Kraly, E. F.

1975-01-01

Programmatic benefits to payloads are examined which can result from the routine use of extravehicular activity (EVA) during space missions. Design and operations costs were compared for 13 representative baseline payloads to the costs of those payloads adapted for EVA operations. The EVA-oriented concepts developed in the study were derived from these baseline concepts and maintained mission and program objectives as well as basic configurations. This permitted isolation of cost saving factors associated specifically with incorporation of EVA in a variety of payload designs and operations. The study results were extrapolated to a total of 74 payload programs. Using appropriate complexity and learning factors, net EVA savings were extrapolated to over $551M for NASA and U.S. civil payloads for routine operations. Adding DOD and ESRO payloads increases the net estimated savings of $776M. Planned maintenance by EVA indicated an estimated $168M savings due to elimination of automated service equipment. Contingency problems of payloads were also analyzed to establish expected failure rates for shuttle payloads. The failure information resulted in an estimated potential for EVA savings of $1.9 B.

Final report on evaluation of cyclocraft support of oil and gas operations in wetland areas

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

Eggington, W.J.; Stevens, P.M.; John, C.J.

1994-10-01

The cyclocraft is a proven hybrid aircraft, capable of VTOL, lifting heavy and bulky loads, highly controllable, having high safety characteristics and low operating costs. Mission Research Corporation (MRC), under Department of Energy sponsorship, is evaluating the potential use of cyclocraft in the transport of drill rigs, mud, pipes and other materials and equipment, in a cost effective and environmentally safe manner, to support oil and gas drilling, production, and transportation operations in wetland areas. Based upon the results of an earlier parametric study, a cyclocraft design, having a payload capacity of 45 tons and designated H.1 Cyclocraft, was selectedmore » for further study, including the preparation of a preliminary design and a development plan, and the determination of operating costs. This report contains all of the results derived from the program to evaluate the use of cyclocraft in the support of oil and gas drilling and production operations in wetland areas.« less

Mandible reconstruction with free fibula flaps: Outcome of a cost-effective individual planning concept compared with virtual surgical planning.

PubMed

Rommel, Niklas; Kesting, Marco Rainer; Rohleder, Nils Hagen; Bauer, Florian Martin Josef; Wolff, Klaus-Dietrich; Weitz, Jochen

2017-08-01

The free osteomyocutaneous fibular flap has become one of the primary options for mandibular reconstruction, because of the later introduction and development of virtual surgical planning (VSP). However, VSP is associated with high additional pre-operative effort and costs. Therefore, the purpose of the study was to develop a new individual cost-effective pre-operative planning concept for free fibula mandible reconstruction and to compare it with VSP regarding clinical parameters and post-operative outcome. 31 patients undergoing mandibular reconstruction with a microvascular free fibular flap were divided into two groups and retrospectively reviewed. For the first group A (18 of 31 patients), an individual method with stererolithographic (STL) models, silicon templates and hand-made cutting guides was used (about 250 € planning costs/patient). For the second group B (13 of 31 patients), VSP including pre-fabricated cutting guides was used (about 2500 € planning costs/patient). We found no statistically significant differences with respect to intra-operative time of mandibular reconstruction, duration of hospitalisation or post-operative complications between the two groups (p ≥ 0.05). The surgical outcomes and operative efficiency of this individual and cost-effective planning concept are comparable with the much more expensive complete VSP concept. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

Eichman, Josh; Flores-Espino, Francisco

Flexible operation of electrolysis systems represents an opportunity to reduce the cost of hydrogen for a variety of end-uses while also supporting grid operations and thereby enabling greater renewable penetration. California is an ideal location to realize that value on account of growing renewable capacity and markets for hydrogen as a fuel cell electric vehicle (FCEV) fuel, refineries, and other end-uses. Shifting the production of hydrogen to avoid high cost electricity and participation in utility and system operator markets along with installing renewable generation to avoid utility charges and increase revenue from the Low Carbon Fuel Standard (LCFS) program canmore » result in around $2.5/kg (21%) reduction in the production and delivery cost of hydrogen from electrolysis. This reduction can be achieved without impacting the consumers of hydrogen. Additionally, future strategies for reducing hydrogen cost were explored and include lower cost of capital, participation in the Renewable Fuel Standard program, capital cost reduction, and increased LCFS value. Each must be achieved independently and could each contribute to further reductions. Using the assumptions in this study found a 29% reduction in cost if all future strategies are realized. Flexible hydrogen production can simultaneously improve the performance and decarbonize multiple energy sectors. The lessons learned from this study should be used to understand near-term cost drivers and to support longer-term research activities to further improve cost effectiveness of grid integrated electrolysis systems.« less

The Costs of Critical Care Telemedicine Programs

PubMed Central

Falk, Derik M.; Bonello, Robert S.; Kahn, Jeremy M.; Perencevich, Eli; Cram, Peter

2013-01-01

Background: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. Methods: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Results: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. Conclusions: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology. PMID:22797291

The costs of critical care telemedicine programs: a systematic review and analysis.

PubMed

Kumar, Gaurav; Falk, Derik M; Bonello, Robert S; Kahn, Jeremy M; Perencevich, Eli; Cram, Peter

2013-01-01

Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.

Cost and Economic Benefit of Clinical Decision Support Systems (CDSS) for Cardiovascular Disease Prevention: A Community Guide Systematic Review

PubMed Central

Jacob, Verughese; Thota, Anilkrishna B.; Chattopadhyay, Sajal K.; Njie, Gibril J.; Proia, Krista K.; Hopkins, David P.; Ross, Murray N.; Pronk, Nicolaas P.; Clymer, John M.

2017-01-01

Objective This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSS) to prevent cardiovascular disease (CVD). Materials and Methods Methods developed for The Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. Results It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSS to prevent CVD from the available studies (n=12) due to considerable heterogeneity. Several studies (n=11) indicated healthcare costs were averted by using CDSS but many were partial assessments that did not consider all components of healthcare. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSS based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Discussion Intervention costs were not negligible but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted healthcare cost could not be determined with confidence because many studies did not fully account for all components of healthcare. Conclusion We were unable to conclude whether CDSS for CVD prevention is either cost-beneficial or cost effective. Several evidence gaps are identified, most prominently the lack of information about major drivers of cost and benefit; the lack of standard metrics for the cost of CDSS; and not allowing for useful life of CDSS that generally extends beyond one accounting period. PMID:28049635

Extended System Operations Studies for Automated Guideway Transit Systems

DOT National Transportation Integrated Search

1982-02-01

The objectives of the System Operations Studies (SOS) of the Automated Guideway Transit Technology (AGTT) program was to develop models for the analysis of system operations, to evaluate AGT system performance and cost, and to establish guidelines fo...

Integrated operations/payloads/fleet analysis. Volume 3: System costs. Appendix A: Program direct costs

NASA Technical Reports Server (NTRS)

1971-01-01

Individualized program direct costs for each satellite program are presented. This breakdown provides the activity level dependent costs for each satellite program. The activity level dependent costs, or, more simply, program direct costs, are comprised of the total payload costs (as these costs are strictly program dependent) and the direct launch vehicle costs. Only those incremental launch vehicle costs associated directly with the satellite program are considered. For expendable launch vehicles the direct costs include the vehicle investment hardware costs and the launch operations costs. For the reusable STS vehicles the direct costs include only the launch operations, recovery operations, command and control, vehicle maintenance, and propellant support. The costs associated with amortization of reusable vehicle investment, RDT&E range support, etc., are not included.

Low energy stage study. Volume 5: Program study cost elements and appendices. [orbital launching of space shuttle payloads

NASA Technical Reports Server (NTRS)

1978-01-01

The methodology and rationale used in the development of costs for engineering, manufacturing, testing and operating a low thrust system for placing automated shuttle payloads into earth orbits are described. Cost related information for the recommended propulsion approach is included.

Space Operations Center system analysis study extension. Volume 2: Programmatics and cost

NASA Technical Reports Server (NTRS)

1982-01-01

A summary of Space Operations Center (SOC) orbital space station costs, program options and program recommendations is presented. Program structure, hardware commonality, schedules and program phasing are considered. Program options are analyzed with respect to mission needs, design and technology options, and anticipated funding constraints. Design and system options are discussed.

The Relationship between Return on Profitability and Costs of Outsourcing Information Technology Technical Support

ERIC Educational Resources Information Center

Odion, Segun

2011-01-01

The purpose of this quantitative correlational research study was to examine the relationship between costs of operation and total return on profitability of outsourcing information technology technical support in a two-year period of outsourcing operations. United States of America list of Fortune 1000 companies' chief information officers…

Analysis of Student Loan Special Rate Allowances and Servicing Costs.

ERIC Educational Resources Information Center

Technology Management, Inc., Cambridge, MA.

This document addresses two separate, though related aspects of the operation of the Guaranteed Student Loan Program (GSLP): (1) the mechanism for setting the special rate allowance (SRA); and (2) the effect of the operating requirements of the program on lender servicing costs. The study develops recommendations for improving both aspects of the…

Study of a dry room in a battery manufacturing plant using a process model

NASA Astrophysics Data System (ADS)

Ahmed, Shabbir; Nelson, Paul A.; Dees, Dennis W.

2016-09-01

The manufacture of lithium ion batteries requires some processing steps to be carried out in a dry room, where the moisture content should remain below 100 parts per million. The design and operation of such a dry room adds to the cost of the battery. This paper studied the humidity management of the air to and from the dry room to understand the impact of design and operating parameters on the energy demand and the cost contribution towards the battery manufacturing cost. The study was conducted with the help of a process model for a dry room with a volume of 16,000 cubic meters. For a defined base case scenario it was found that the dry room operation has an energy demand of approximately 400 kW. The paper explores some tradeoffs in design and operating parameters by looking at the humidity reduction by quenching the make-up air vs. at the desiccant wheel, and the impact of the heat recovery from the desiccant regeneration cycle.

Defining the cost of care for lobectomy and segmentectomy: a comparison of open, video-assisted thoracoscopic, and robotic approaches.

PubMed

Deen, Shaun A; Wilson, Jennifer L; Wilshire, Candice L; Vallières, Eric; Farivar, Alexander S; Aye, Ralph W; Ely, Robson E; Louie, Brian E

2014-03-01

Knowledge about the cost of open, video-assisted thoracoscopic (VATS), or robotic lung resection and drivers of cost is crucial as the cost of care comes under scrutiny. This study aims to define the cost of anatomic lung resection and evaluate potential cost-saving measures. A retrospective review of patients who had anatomic resection for early stage lung cancer, carcinoid, or metastatic foci between 2008 and 2012 was performed. Direct hospital cost data were collected from 10 categories. Capital depreciation was separated for the robotic and VATS cases. Key costs were varied in a sensitivity analysis. In all, 184 consecutive patients were included: 69 open, 57 robotic, and 58 VATS. Comorbidities and complication rates were similar. Operative time was statistically different among the three modalities, but length of stay was not. There was no statistically significant difference in overall cost between VATS and open cases (Δ = $1,207) or open and robotic cases (Δ = $1,975). Robotic cases cost $3,182 more than VATS (p < 0.001) owing to the cost of robotic-specific supplies and depreciation. The main opportunities to reduce cost in open cases were the intensive care unit, respiratory therapy, and laboratories. Lowering operating time and supply costs were targets for VATS and robotic cases. VATS is the least expensive surgical approach. Robotic cases must be shorter in operative time or reduce supply costs, or both, to be competitive. Lessening operating time, eradicating unnecessary laboratory work, and minimizing intensive care unit stays will help decrease direct hospital costs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Analyzing and Comparing Biomass Feedstock Supply Systems in China: Corn Stover and Sweet Sorghum Case Studies

DOE PAGES

Ren, Lantian; Cafferty, Kara; Roni, Mohammad; ...

2015-06-11

This paper analyzes the rural Chinese biomass supply system and models supply chain operations according to U.S. concepts of logistical unit operations: harvest and collection, storage, transportation, preprocessing, and handling and queuing. In this paper, we quantify the logistics cost of corn stover and sweet sorghum in China under different scenarios. We analyze three scenarios of corn stover logistics from northeast China and three scenarios of sweet sorghum stalks logistics from Inner Mongolia in China. The case study estimates that the logistics cost of corn stover and sweet sorghum stalk to be $52.95/dry metric ton and $52.64/dry metric ton, respectively,more » for the current labor-based biomass logistics system. However, if the feedstock logistics operation is mechanized, the cost of corn stover and sweet sorghum stalk decreases to $36.01/dry metric ton and $35.76/dry metric ton, respectively. The study also includes a sensitivity analysis to identify the cost factors that cause logistics cost variation. Results of the sensitivity analysis show that labor price has the most influence on the logistics cost of corn stover and sweet sorghum stalk, with a variation of $6 to $12/dry metric ton.« less

Analyzing and Comparing Biomass Feedstock Supply Systems in China: Corn Stover and Sweet Sorghum Case Studies

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

Ren, Lantian; Cafferty, Kara; Roni, Mohammad

This paper analyzes the rural Chinese biomass supply system and models supply chain operations according to U.S. concepts of logistical unit operations: harvest and collection, storage, transportation, preprocessing, and handling and queuing. In this paper, we quantify the logistics cost of corn stover and sweet sorghum in China under different scenarios. We analyze three scenarios of corn stover logistics from northeast China and three scenarios of sweet sorghum stalks logistics from Inner Mongolia in China. The case study estimates that the logistics cost of corn stover and sweet sorghum stalk to be $52.95/dry metric ton and $52.64/dry metric ton, respectively,more » for the current labor-based biomass logistics system. However, if the feedstock logistics operation is mechanized, the cost of corn stover and sweet sorghum stalk decreases to $36.01/dry metric ton and $35.76/dry metric ton, respectively. The study also includes a sensitivity analysis to identify the cost factors that cause logistics cost variation. Results of the sensitivity analysis show that labor price has the most influence on the logistics cost of corn stover and sweet sorghum stalk, with a variation of $6 to $12/dry metric ton.« less

National trends of perioperative outcomes and costs for open, laparoscopic and robotic pediatric pyeloplasty.

PubMed

Varda, Briony K; Johnson, Emilie K; Clark, Curtis; Chung, Benjamin I; Nelson, Caleb P; Chang, Steven L

2014-04-01

We performed a population based study comparing trends in perioperative outcomes and costs for open, laparoscopic and robotic pediatric pyeloplasty. Specific billing items contributing to cost were also investigated. Using the Perspective database (Premier, Inc., Charlotte, North Carolina), we identified 12,662 pediatric patients who underwent open, laparoscopic and robotic pyeloplasty (ICD-9 55.87) in the United States from 2003 to 2010. Univariate and multivariate statistics were used to evaluate perioperative outcomes, complications and costs for the competing surgical approaches. Propensity weighting was used to minimize selection bias. Sampling weights were used to yield a nationally representative sample. A decrease in open pyeloplasty and an increase in minimally invasive pyeloplasty were observed. All procedures had low complication rates. Compared to open pyeloplasty, laparoscopic and robotic pyeloplasty had longer median operative times (240 minutes, p <0.0001 and 270 minutes, p <0.0001, respectively). There was no difference in median length of stay. Median total cost was lower among patients undergoing open vs robotic pyeloplasty ($7,221 vs $10,780, p <0.001). This cost difference was largely attributable to robotic supply costs. During the study period open pyeloplasty made up a declining majority of cases. Use of laparoscopic pyeloplasty plateaued, while robotic pyeloplasty increased. Operative time was longer for minimally invasive pyeloplasty, while length of stay was equivalent across all procedures. A higher cost associated with robotic pyeloplasty was driven by operating room use and robotic equipment costs, which nullified low room and board cost. This study reflects an adoption period for robotic pyeloplasty. With time, perioperative outcomes and cost may improve. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

19 CFR 10.178 - Direct costs of processing operations performed in the beneficiary developing country.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Direct costs of processing operations performed in... processing operations performed in the beneficiary developing country. (a) Items included in the direct costs of processing operations. As used in § 10.176, the words “direct costs of processing operations...

The unwritten price of cosmetic tourism: an observational study and cost analysis.

PubMed

Miyagi, K; Auberson, D; Patel, A J; Malata, C M

2012-01-01

Cosmetic tourism, driven by the promise of inexpensive operations abroad, is increasingly popular despite warnings from professional bodies regarding associated risks. Increasing numbers of individuals have presented to our department requesting NHS treatment of complications from such surgery. We set out to characterize these patients and evaluate costs incurred through their assessment and management. An observational study was conducted from 2007 to 2009 on patients presenting to a tertiary referral Plastic Surgery practice with complications of cosmetic tourism surgery. Demographic characteristics, as well as those related to the operation, were recorded. Hospital patient flow pathways were constructed, cost analysis performed using Patient Level Costing, and expenditure and profitability calculated. Nineteen patients presented within the study period. Most operations were performed in Europe or Asia, and were primarily breast augmentation procedures (n=13). The principal complications were wound infection or dehiscence, and poor cosmetic results. Eleven patients received NHS treatment, at a cost of £120,841. The mean cost for all patients' management was £6360 (range: £114-£57,968), rising to £10,878 for those accepted for treatment. For 8 of the 9 patients (89%) for whom full patient level costing was available, the hospital incurred a financial loss. The costs to the NHS of managing complications of cosmetic tourism are substantial, and underestimated by central funding agencies. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Cost assessment of robotics in gynecologic surgery: a systematic review.

PubMed

Iavazzo, Christos; Papadopoulou, Eleni K; Gkegkes, Ioannis D

2014-11-01

The application of robotics is an innovation in the field of gynecologic surgery. Our objective was to evaluate the currently available literature on the cost assessment of robotic surgery of various operations in the field of gynecologic surgery. PubMed and Scopus databases were systematically searched in order to retrieve the included studies in our review. We retrieved 23 studies on a variety of gynecologic operations. The mean cost for robotic, open and laparoscopic surgery ranged from 1731 to 48,769, 894 to 20,277 and 411 to 41,836 Euros, respectively. Operative charges, in hysterectomy, for robotic, open and laparoscopic technique ranged from 936 to 33,920, 684 to 25,616 and 858 to 25,578 Euros, respectively. In sacrocolpopexy, these costs ranged from 2067 to 7275, 2904 to 69,792 and 1482 to 2000 Euros, respectively. Non-operative charges ranged from 467 to 39,121 Euros. The mean total costs for myomectomy ranged from 27,342 to 42,497 and 13,709 to 20,277 Euros, respectively, for the robotic and open methods, while the mean total cost of the laparoscopic technique was 26,181 Euros. Conversions to laparotomy were present in 79/36,185 (0.2%) cases of laparoscopic surgery and in 21/3345 (0.62%) cases of robotic technique. Duration of robotic, open and laparoscopic surgery ranged from 50 to 445, 83.7 to 701 and 74 to 330 min, respectively. Robotic surgery has the potential to become cost-effective in centers with many patients while industry competition could reduce the cost of the robotic instrumentation, making robotic technology more affordable and cost-effective. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Study of the application of advanced technologies to laminar flow control systems for subsonic transports. Volume 1: Summary

NASA Technical Reports Server (NTRS)

Sturgeon, R. F.; Bennett, J. A.; Etchberger, F. R.; Ferrill, R. S.; Meade, L. E.

1976-01-01

A study was conducted to evaluate the technical and economic feasibility of applying laminar flow control to the wings and empennage of long-range subsonic transport aircraft compatible with initial operation in 1985. For a design mission range of 10,186 km (5500 n mi), advanced technology laminar-flow-control (LFC) and turbulent-flow (TF) aircraft were developed for both 200 and 400-passenger payloads, and compared on the basis of production costs, direct operating costs, and fuel efficiency. Parametric analyses were conducted to establish the optimum geometry for LFC and TF aircraft, advanced LFC system concepts and arrangements were evaluated, and configuration variations maximizing the effectiveness of LFC were developed. For the final LFC aircraft, analyses were conducted to define maintenance costs and procedures, manufacturing costs and procedures, and operational considerations peculiar to LFC aircraft. Compared to the corresponding advanced technology TF transports, the 200- and 400-passenger LFC aircraft realized reductions in fuel consumption up to 28.2%, reductions in direct operating costs up to 8.4%, and improvements in fuel efficiency, in ssm/lb of fuel, up to 39.4%. Compared to current commercial transports at the design range, the LFC study aircraft demonstrate improvements in fuel efficiency up to 131%. Research and technology requirements requisite to the development of LFC transport aircraft were identified.

Autonomous Commanding of the WIRE Spacecraft

NASA Technical Reports Server (NTRS)

Prior, Mike; Walyus, Keith; Saylor, Rick

1999-01-01

This paper presents the end-to-end design architecture for an autonomous commanding capability to be used on the Wide Field Infrared Explorer (WIRE) mission for the uplink of command loads during unattended station contacts. The WIRE mission is the fifth and final mission of NASA's Goddard Space Flight Center Small Explorer (SMEX) series to be launched in March of 1999. Its primary mission is the targeting of deep space fields using an ultra-cooled infrared telescope. Due to its mission design WIRE command loads are large (approximately 40 Kbytes per 24 hours) and must be performed daily. To reduce the cost of mission operations support that would be required in order to uplink command loads, the WIRE Flight Operations Team has implemented an autonomous command loading capability. This capability allows completely unattended operations over a typical two- day weekend period. The key factors driving design and implementation of this capability were: 1) Integration with already existing ground system autonomous capabilities and systems, 2) The desire to evolve autonomous operations capabilities based upon previous SMEX operations experience 3) Integration with ground station operations - both autonomous and man-tended, 4) Low cost and quick implementation, and 5) End-to-end system robustness. A trade-off study was performed to examine these factors in light of the low-cost, higher-risk SMEX mission philosophy. The study concluded that a STOL (Spacecraft Test and Operations Language) based script, highly integrated with other scripts used to perform autonomous operations, was best suited given the budget and goals of the mission. Each of these factors is discussed to provide an overview of the autonomous operations capabilities implemented for the mission. The capabilities implemented on the WIRE mission are an example of a low-cost, robust, and efficient method for autonomous command loading when implemented with other autonomous features of the ground system. They can be used as a design and implementation template by other small satellite missions interested in evolving toward autonomous and lower cost operations.

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...

Operating cost model for local service airlines

NASA Technical Reports Server (NTRS)

Anderson, J. L.; Andrastek, D. A.

1976-01-01

Several mathematical models now exist which determine the operating economics for a United States trunk airline. These models are valuable in assessing the impact of new aircraft into an airline's fleet. The use of a trunk airline cost model for the local service airline does not result in representative operating costs. A new model is presented which is representative of the operating conditions and resultant costs for the local service airline. The calculated annual direct and indirect operating costs for two multiequipment airlines are compared with their actual operating experience.

Case for Deploying Complex Systems Utilizing Commodity Components

NASA Technical Reports Server (NTRS)

Bryant, Barry S.; Pitts, R. Lee

2003-01-01

When the International Space Station (ISS) finally reached an operational state, many of the Payload Operations and Integration Facility (POIF) hardware components were reaching end of life, COTS product costs were soaring, and the ISS budget was becoming severely constrained. However, most requirement development was complete. In addition, the ISS program is a fully functioning program with at least fifteen years of operational life remaining. Therefore it is critical that any upgrades, refurbishments, or enhancements be accomplished in realtime with minimal disruptions to service. For these and other reasons, it was necessary to ensure the viability of the POIF. Due to the to the breadth of capability of the POIF (a NASA ground station), it is believed that the lessons to be learned by other complex systems are applicable and any solutions garnered by the POIF are applicable to other complex systems as well. With that in mind, a number of new approaches have been investigated to increase the portability of the POIF and reduce the cost of refurbishment, operations, and maintenance. These new approaches were directed at the Total Cost of Ownership (TCO); not only the refurbishment but also current operational difficulties, licensing, and anticipation of the next refurbishment. Our basic premise is that technology had evolved dramatically since the concept of the POIF ground system and we should leverage our experience on this new technological landscape. Fortunately, Moore's law and market forces have changed the landscape considerably. These changes are manifest in five (5) ways that are particularly relevant to POIF: 1. Complex Instruction Set Computing (CISC) processors have advanced to unprecedented levels of compute capacity with a dramatic cost break, 2. Linux has become a major operating system supported by most vendors on a broad range of platforms, 3. Windows(TradeMark) based desktops are pervasive in the office environment, 4. Stable and affordable WindowsTM development environments and tools are available and offer a rich set of capabilities, 5. The WindowsTM 2000 provides a stable client platform, Therefore, five studies were proposed, developed, and are in the current process of deployment which dramatically reduces the cost of operations, maintenance, refurbishment, and deployment of a ground system. Restating and refining the basic premise stated earlier, it is possible to enhance operations through the replacement of hardware and software components with commodity based items wherever applicable. This will dramatically reduce the overall lifecycle cost of the project. The first study leveraged the POIF S secure, three-tier, web architecture to replace the client workstations with lower cost PC platforms. A second study initiated a review of COTS products to examine the level of added value of each product. This study included replacement of some COTS products with custom code, deletions, substitutions, and consolidation of COTS products. Studies three and four reviewed the server architectures of the data distribution systems and Enhanced HOSC System (EHS) command and telemetry system to propose migration to new platforms, both software and hardware. The final study reviewed current IP communication technologies, developed an operational model for flight operations, and demonstrated that voice over IP was practical and could be integrated into operations.

A pragmatic multi-centre randomised controlled trial of fluid loading in high-risk surgical patients undergoing major elective surgery--the FOCCUS study.

PubMed

Cuthbertson, Brian H; Campbell, Marion K; Stott, Stephen A; Elders, Andrew; Hernández, Rodolfo; Boyers, Dwayne; Norrie, John; Kinsella, John; Brittenden, Julie; Cook, Jonathan; Rae, Daniela; Cotton, Seonaidh C; Alcorn, David; Addison, Jennifer; Grant, Adrian

2011-01-01

Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery. The control group had no pre-operative fluid loading. The primary outcome was the number of hospital days after surgery with cost-effectiveness as a secondary outcome. A total of 111 patients were recruited within the study time frame in agreement with the funder. The median pre-operative fluid loading volume was 1,875 ml (IQR 1,375 to 2,025) in the fluid group compared to 0 (IQR 0 to 0) in controls with days in hospital after surgery 12.2 (SD 11.5) days compared to 17.4 (SD 20.0) and an adjusted mean difference of 5.5 days (median 2.2 days; 95% CI -0.44 to 11.44; P = 0.07). There was a reduction in adverse events in the fluid intervention group (P = 0.048) and no increase in fluid based complications. The intervention was less costly and more effective (adjusted average cost saving: £2,047; adjusted average gain in benefit: 0.0431 quality adjusted life year (QALY)) and has a high probability of being cost-effective. Pre-operative intravenous fluid loading leads to a non-significant reduction in hospital length of stay after high-risk major surgery and is likely to be cost-effective. Confirmatory work is required to determine whether these effects are reproducible, and to confirm whether this simple intervention could allow more cost-effective delivery of care. Prospective Clinical Trials, ISRCTN32188676.

A pragmatic multi-centre randomised controlled trial of fluid loading in high-risk surgical patients undergoing major elective surgery - the FOCCUS study

PubMed Central

2011-01-01

Introduction Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. Methods This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery. The control group had no pre-operative fluid loading. The primary outcome was the number of hospital days after surgery with cost-effectiveness as a secondary outcome. Results A total of 111 patients were recruited within the study time frame in agreement with the funder. The median pre-operative fluid loading volume was 1,875 ml (IQR 1,375 to 2,025) in the fluid group compared to 0 (IQR 0 to 0) in controls with days in hospital after surgery 12.2 (SD 11.5) days compared to 17.4 (SD 20.0) and an adjusted mean difference of 5.5 days (median 2.2 days; 95% CI -0.44 to 11.44; P = 0.07). There was a reduction in adverse events in the fluid intervention group (P = 0.048) and no increase in fluid based complications. The intervention was less costly and more effective (adjusted average cost saving: £2,047; adjusted average gain in benefit: 0.0431 quality adjusted life year (QALY)) and has a high probability of being cost-effective. Conclusions Pre-operative intravenous fluid loading leads to a non-significant reduction in hospital length of stay after high-risk major surgery and is likely to be cost-effective. Confirmatory work is required to determine whether these effects are reproducible, and to confirm whether this simple intervention could allow more cost-effective delivery of care. Trial registration Prospective Clinical Trials, ISRCTN32188676 PMID:22177541

24 CFR 891.150 - Operating cost standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... through 891.790, the operating cost standard for group homes shall be based on the number of residents... as differences in costs based on location within the field office jurisdiction. The operating cost...

Ulipristal acetate for pre-operative treatment of moderate-to-severe uterine fibroids in women of reproductive age in The Netherlands: cost minimization analysis and budget impact analysis.

PubMed

Zakiyah, N; van Asselt, A D I; Postma, M J

2017-03-01

Ulipristal acetate has been found to be non-inferior to other pre-operative treatments of uterine fibroids, particularly leuprolide. The objective of this study was to assess the pharmacoeconomic profile of ulipristal acetate compared to leuprolide for the pre-operative treatment of moderate-to-severe uterine fibroids in women of reproductive age in The Netherlands. The analysis was performed and applied within the framework of the ulipristal acetate submission for reimbursement in 2012. A decision model was developed to compare the total costs of ulipristal acetate compared to leuprolide, the standard care in The Netherlands. The target population of this study corresponded to the type of patients included in the PEARL II clinical trial; i.e. women of reproductive age requiring pre-operative treatment for uterine fibroids. Sensitivity analysis was implemented to assess uncertainties. Data regarding costs, effects, and other input parameters were obtained from relevant published literatures, the Dutch Healthcare Insurance Board, and expert opinion obtained by means of a panel of experts from several medical centers in The Netherlands. In The Netherlands, the total costs of ulipristal acetate and leuprolide were estimated at €4,216,027 and €4,218,095, respectively. The annual savings of ulipristal acetate were, therefore, estimated at €2,068. The major driver of this cost difference was the cost of administration for leuprolide. Sensitivity analyses showed that ulipristal acetate mostly remained cost-saving over a range of assumptions. The budget impact analysis indicated that the introduction of ulipristal acetate was estimated to result in cost savings in the first 3 years following the introduction. The results of this study were used in the decision on reimbursement of ulipristal acetate according to the Dutch Reference Pricing system in 2012. Ulipristal acetate was cost saving compared to leuprolide and has the potential to provide substantial savings on the healthcare budget in The Netherlands.

Modeling Imperfect Generator Behavior in Power System Operation Models

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

Krad, Ibrahim

A key component in power system operations is the use of computer models to quickly study and analyze different operating conditions and futures in an efficient manner. The output of these models are sensitive to the data used in them as well as the assumptions made during their execution. One typical assumption is that generators and load assets perfectly follow operator control signals. While this is a valid simulation assumption, generators may not always accurately follow control signals. This imperfect response of generators could impact cost and reliability metrics. This paper proposes a generator model that capture this imperfect behaviormore » and examines its impact on production costs and reliability metrics using a steady-state power system operations model. Preliminary analysis shows that while costs remain relatively unchanged, there could be significant impacts on reliability metrics.« less

Data Flow in Relation to Life-Cycle Costing of Construction Projects in the Czech Republic

NASA Astrophysics Data System (ADS)

Biolek, Vojtěch; Hanák, Tomáš; Marović, Ivan

2017-10-01

Life-cycle costing is an important part of every construction project, as it makes it possible to take into consideration future costs relating to the operation and demolition phase of a built structure. In this way, investors can optimize the project design to minimize the total project costs. Even though there have already been some attempts to implement BIM software in the Czech Republic, the current state of affairs does not support automated data flow between the bill of costs and applications that support building facility management. The main aim of this study is to critically evaluate the current situation and outline a future framework that should allow for the use of the data contained in the bill of costs to manage building operating costs.

Optimal synthesis and design of the number of cycles in the leaching process for surimi production.

PubMed

Reinheimer, M Agustina; Scenna, Nicolás J; Mussati, Sergio F

2016-12-01

Water consumption required during the leaching stage in the surimi manufacturing process strongly depends on the design and the number and size of stages connected in series for the soluble protein extraction target, and it is considered as the main contributor to the operating costs. Therefore, the optimal synthesis and design of the leaching stage is essential to minimize the total annual cost. In this study, a mathematical optimization model for the optimal design of the leaching operation is presented. Precisely, a detailed Mixed Integer Nonlinear Programming (MINLP) model including operating and geometric constraints was developed based on our previous optimization model (NLP model). Aspects about quality, water consumption and main operating parameters were considered. The minimization of total annual costs, which considered a trade-off between investment and operating costs, led to an optimal solution with lesser number of stages (2 instead of 3 stages) and higher volumes of the leaching tanks comparing with previous results. An analysis was performed in order to investigate how the optimal solution was influenced by the variations of the unitary cost of fresh water, waste treatment and capital investment.

Structures, performance, benefit, cost study. [gas turbine engines

NASA Technical Reports Server (NTRS)

Feder, E.

1981-01-01

Aircraft engine structures were studied to identify the advanced structural technologies that would provide the most benefits to future aircraft operations. A series of studies identified engine systems with the greatest potential for improvements. Based on these studies, six advanced generic structural concepts were selected and conceptually designed. The benefits of each concept were quantitatively assessed in terms of thrust specific fuel consumption, weight, cost, maintenance cost, fuel burned and direct operating cost plus interest. The probability of success of each concept was also determined. The concepts were ranked and the three most promising were selected for further study which consisted of identifying and comprehensively outlining the advanced technologies required to develop these concepts for aircraft engine application. Analytic, fabrication, and test technology developments are required. The technology programs outlined emphasize the need to provide basic, fundamental understanding of technology to obtain the benefit goals.

A 20 Year Lifecycle Study for Launch Facilities at the Kennedy Space Center

NASA Technical Reports Server (NTRS)

Kolody, Mark R.; Li. Wenyan; Hintze, Paul E.; Calle, Luz-Marina

2009-01-01

The lifecycle cost analysis was based on corrosion costs for the Kennedy Space Center's Launch Complexes and Mobile Launch Platforms. The first step in the study involved identifying the relevant assets that would be included. Secondly, the identification and collection of the corrosion control cost data for the selected assets was completed. Corrosion control costs were separated into four categories. The sources of cost included the NASA labor for civil servant personnel directly involved in overseeing and managing corrosion control of the assets, United Space Alliance (USA) contractual requirements for performing planned corrosion control tasks, USA performance of unplanned corrosion control tasks, and Testing and Development. Corrosion control operations performed under USA contractual requirements were the most significant contributors to the total cost of corrosion. The operations include the inspection of the pad, routine maintenance of the pad, medium and large scale blasting and repainting activities, and the repair and replacement of structural metal elements. Cost data was collected from the years between 2001 and 2007. These costs were then extrapolated to future years to calculate the 20 year lifecycle costs.

On- and off-grid operation of hybrid renewable power plants: When are the economics favorable?

NASA Astrophysics Data System (ADS)

Petrakopoulou, F.; Santana, D.

2016-12-01

Hybrid renewable energy conversion systems offer a good alternative to conventional systems in locations where the extension of the electrical grid is difficult or not economical or where the cost of electricity is high. However, stand-alone operation implies net energy output restrictions (limited to exclusively serve the energy demand of a region), capacity oversizing and large storage facilities. In interconnected areas, on the other hand, the operational restrictions of the power stations change significantly and the efficiencies and costs of renewable technologies become more favorable. In this paper, the operation of three main renewable technologies (CSP, PV and wind) is studied assuming both hybrid and individual operation for both autonomous and inter-connected operation. The case study used is a Mediterranean island of ca. 3,000 inhabitants. Each system is optimized to fully cover the energy demand of the community. In addition, in the on-grid operation cases, it is required that the annual energy generated from the renewable sources is net positive (i.e., the island generates at least as much energy as it uses). It is found that when connected to the grid, hybridization of more than one technology is not required to satisfy the energy demand, as expected. Each of the renewable technologies investigated can satisfy the annual energy demand individually, without significant complications. In addition, the cost of electricity generated with the three studied technologies drops significantly for on-grid applications, when compared to off-grid operation. However, when compared to business-as-usual scenarios in both the on- and off-grid cases, both investigated hybrid and single-technology renewable scenarios are found to be economically viable. A sensitivity analysis reveals the limits of the acceptable costs that make the technologies favorable when compared to conventional alternatives.

Barwood CNG Cab Fleet Study: Final Results

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

Whalen, P.; Kelly, K.; John, M.

1999-05-03

This report describes a fleet study conducted over a 12-month period to evaluate the operation of dedicated compress natural gas (CNG) Ford Crown Victoria sedans in a taxicab fleet. In the study, we assess the performance and reliability of the vehicles and the cost of operating the CNG vehicles compared to gasoline vehicles. The study results reveal that the CNG vehicles operated by this fleet offer both economic and environmental advantages. The total operating costs of the CNG vehicles were about 25% lower than those of the gasoline vehicles. The CNG vehicles performed as well as the gasoline vehicles, andmore » were just as reliable. Barwood representatives and drivers have come to consider the CNG vehicles an asset to their business and to the air quality of the local community.« less

41 CFR 102-33.190 - What are the aircraft operations and ownership costs for which we must account?

Code of Federal Regulations, 2010 CFR

2010-07-01

... operations and ownership costs for which we must account? 102-33.190 Section 102-33.190 Public Contracts and... Parts Accounting for the Cost of Government Aircraft § 102-33.190 What are the aircraft operations and ownership costs for which we must account? You must account for the operations and ownership costs of your...

Costs of disposable material in the operating room do not show high correlation with surgical time: Implications for hospital payment.

PubMed

Delo, Caroline; Leclercq, Pol; Martins, Dimitri; Pirson, Magali

2015-08-01

The objectives of this study are to analyze the variation of the surgical time and of disposable costs per surgical procedure and to analyze the association between disposable costs and the surgical time. The registration of data was done in an operating room of a 419 bed general hospital, over a period of three months (n = 1556 surgical procedures). Disposable material per procedure used was recorded through a barcode scanning method. The average cost (standard deviation) of disposable material is €183.66 (€183.44). The mean surgical time (standard deviation) is 96 min (63). Results have shown that the homogeneity of operating time and DM costs was quite good per surgical procedure. The correlation between the surgical time and DM costs is not high (r = 0.65). In a context of Diagnosis Related Group (DRG) based hospital payment, it is important that costs information systems are able to precisely calculate costs per case. Our results show that the correlation between surgical time and costs of disposable materials is not good. Therefore, empirical data or itemized lists should be used instead of surgical time as a cost driver for the allocation of costs of disposable materials to patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2003-04-01

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

Community College Finance: A Cost Analysis of Community College Expenditures Related to Maintenance and Operations

ERIC Educational Resources Information Center

Collins, Michael T.

2011-01-01

The purpose of this study is to develop a costing model for maintenance and operations expenditures among 16 single-campus California community college districts and assess the impact of a variety of variables including size of student enrollment, physical plant age, acreage, gross square footage, and general obligation facility bonds on district…

Safety and cost-effectiveness analysis of laparoscopic splenectomy by secondary pedicle division using monopolar electrocautery.

PubMed

Zhou, Jianyin; Liu, Pingguo; Yin, Zhenyu; Zhao, Yilin; Wang, Xiaomin

2013-09-01

The expense of laparoscopic splenectomy (LS) has limited its use in developing countries, while medical costs are increasing worldwide. In this study, we performed LS by secondary pedicle division using monopolar electrocautery to achieve cost savings. Over seven years, we performed 45 consecutive LSs by secondary pedicle division using monopolar electrocautery (n=17) or ultrasonic shears (n=28) at a single center. These were reviewed to assess outcome and cost. Mean operating time was 179.7min, 7 conversions to open operation (15.6%) were necessary. There were four postoperative complications (8.9%) and no deaths. Twenty-three of 28 (82.1%) patients with idiopathic thrombocytopenic purpura developed a long-term positive response; and mean operative cost was RMB6,577 (US$1,034), which was much lower than that of Endo-GIATM in published reports. Between the monopolar electrocautery and ultrasonic shears groups, there were no significant differences in demographic characteristics or intraoperative and postoperative details, but operative cost was significantly lower in the former (RMB4,416, US$696 vs. RMB7,889, US$1,243; p<0.01). LS by secondary pedicle division using monopolar electrocautery is safe, efficacious and economical.

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

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

Stebbins, P.E.

1993-09-01

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

Can re-regulation reservoirs and batteries cost-effectively mitigate sub-daily hydropeaking?

NASA Astrophysics Data System (ADS)

Haas, J.; Nowak, W.; Anindito, Y.; Olivares, M. A.

2017-12-01

To compensate for mismatches between generation and load, hydropower plants frequently operate in strong hydropeaking schemes, which is harmful to the downstream ecosystem. Furthermore, new power market structures and variable renewable systems may exacerbate this behavior. Ecological constraints (minimum flows, maximum ramps) are frequently used to mitigate hydropeaking, but these stand in direct tradeoff with the operational flexibility required for integrating renewable technologies. Fortunately, there are also physical methods (i.e. re-regulation reservoirs and batteries) but to date, there are no studies about their cost-effectiveness for hydropeaking mitigation. This study aims to fill that gap. For this, we formulate an hourly mixed-integer linear optimization model to plan the weekly operation of a hydro-thermal-renewable power system from southern Chile. The opportunity cost of water (needed for this weekly scheduling) is obtained from a mid-term programming solved with dynamic programming. We compare the current (unconstrained) hydropower operation with an ecologically constrained operation. The resulting cost increase is then contrasted with the annual payments necessary for the physical hydropeaking mitigation options. For highly constrained operations, both re-regulation reservoirs and batteries show to be economically attractive for hydropeaking mitigation. For intermediate constrained scenarios, re-regulation reservoirs are still economic, whereas batteries can be a viable solution only if they become cheaper in future. Given current cost projections, their break-even point (for hydropeaking mitigation) is expected within the next ten years. Finally, less stringent hydropeaking constraints do not justify physical mitigation measures, as the necessary flexibility can be provided by other power plants of the system.

Characteristics of future air cargo demand and impact on aircraft development - A report on the Cargo/Logistic Airlift Systems Study /CLASS/ project

NASA Technical Reports Server (NTRS)

Whitehead, A. H., Jr.

1978-01-01

The considered study has been conducted to evaluate the future potential for an advanced air cargo transport. A current operations analysis is discussed, taking into account the traffic structure, modal cost comparisons, terminal operations, containerization, and institutional factors. Attention is also given to case studies, a demand forecast, and an advanced air cargo systems analysis. The effects of potential improvements on reducing costs are shown. Improvement to the current infrastructure can occur from 1978 to 1985 with off-the-shelf technology, which when combined with higher load factors for aircraft and containers, can provide up to a 16 percent reduction in total operating costs and a 15 percent rate reduction. The results of the analysis indicate that the proposed changes in the infrastructure and improved cargo loading efficiencies are as important to improving the airlines' financial posture as is the anticipated large dedicated cargo aircraft.

Time-driven activity based costing of total knee replacement surgery at a London teaching hospital.

PubMed

Chen, Alvin; Sabharwal, Sanjeeve; Akhtar, Kashif; Makaram, Navnit; Gupte, Chinmay M

2015-12-01

The aim of this study was to conduct a time-driven activity based costing (TDABC) analysis of the clinical pathway for total knee replacement (TKR) and to determine where the major cost drivers lay. The in-patient pathway was prospectively mapped utilising a TDABC model, following 20 TKRs. The mean age for these patients was 73.4 years. All patients were ASA grade I or II and their mean BMI was 30.4. The 14 varus knees had a mean deformity of 5.32° and the six valgus knee had a mean deformity of 10.83°. Timings were prospectively collected as each patient was followed through the TKR pathway. Pre-operative costs including pre-assessment and joint school were £ 163. Total staff costs for admission and the operating theatre were £ 658. Consumables cost for the operating theatre were £ 1862. The average length of stay was 5.25 days at a total cost of £ 910. Trust overheads contributed £ 1651. The overall institutional cost of a 'noncomplex' TKR in patients without substantial medical co-morbidities was estimated to be £ 5422, representing a profit of £ 1065 based on a best practice tariff of £ 6487. The major cost drivers in the TKR pathway were determined to be theatre consumables, corporate overheads, overall ward cost and operating theatre staffing costs. Appropriate discounting of implant costs, reduction in length of stay by adopting an enhanced recovery programme and control of corporate overheads through the use of elective orthopaedic treatment centres are proposed approaches for reducing the overall cost of treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

42 CFR 417.930 - Initial costs of operation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Initial costs of operation. 417.930 Section 417.930... PREPAYMENT PLANS Administration of Outstanding Loans and Loan Guarantees § 417.930 Initial costs of operation. Under section 1305 of the PHS, loans and loan guarantees were awarded for initial costs of operation of...

Estimating the Cost to do a Cost Estimate

NASA Technical Reports Server (NTRS)

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

1998-01-01

This article provides a model for estimating the cost required to do a cost estimate. Overruns may lead to concellation of a project. In 1991, we completed a study on the cost of doing cost estimates for the class of projects normally encountered in the development and implementation of equipment at the network of tracking stations operated by the Jet Propulsion Laboratory (JPL) for NASA.

Start-up and operating costs for artisan cheese companies.

PubMed

Bouma, Andrea; Durham, Catherine A; Meunier-Goddik, Lisbeth

2014-01-01

Lack of valid economic data for artisan cheese making is a serious impediment to developing a realistic business plan and obtaining financing. The objective of this study was to determine approximate start-up and operating costs for an artisan cheese company. In addition, values are provided for the required size of processing and aging facilities associated with specific production volumes. Following in-depth interviews with existing artisan cheese makers, an economic model was developed to predict costs based on input variables such as production volume, production frequency, cheese types, milk types and cost, labor expenses, and financing. Estimated values for start-up cost for processing and aging facility ranged from $267,248 to $623,874 for annual production volumes of 3,402 kg (7,500 lb) and 27,216 kg (60,000 lb), respectively. First-year production costs ranged from $65,245 to $620,094 for the above-mentioned production volumes. It is likely that high start-up and operating costs remain a significant entry barrier for artisan cheese entrepreneurs. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Experiences of operational costs of HPV vaccine delivery strategies in Gavi-supported demonstration projects.

PubMed

Botwright, Siobhan; Holroyd, Taylor; Nanda, Shreya; Bloem, Paul; Griffiths, Ulla K; Sidibe, Anissa; Hutubessy, Raymond C W

2017-01-01

From 2012 to 2016, Gavi, the Vaccine Alliance, provided support for countries to conduct small-scale demonstration projects for the introduction of the human papillomavirus vaccine, with the aim of determining which human papillomavirus vaccine delivery strategies might be effective and sustainable upon national scale-up. This study reports on the operational costs and cost determinants of different vaccination delivery strategies within these projects across twelve countries using a standardized micro-costing tool. The World Health Organization Cervical Cancer Prevention and Control Costing Tool was used to collect costing data, which were then aggregated and analyzed to assess the costs and cost determinants of vaccination. Across the one-year demonstration projects, the average economic and financial costs per dose amounted to US$19.98 (standard deviation ±12.5) and US$8.74 (standard deviation ±5.8), respectively. The greatest activities representing the greatest share of financial costs were social mobilization at approximately 30% (range, 6-67%) and service delivery at about 25% (range, 3-46%). Districts implemented varying combinations of school-based, facility-based, or outreach delivery strategies and experienced wide variation in vaccine coverage, drop-out rates, and service delivery costs, including transportation costs and per diems. Size of target population, number of students per school, and average length of time to reach an outreach post influenced cost per dose. Although the operational costs from demonstration projects are much higher than those of other routine vaccine immunization programs, findings from our analysis suggest that HPV vaccination operational costs will decrease substantially for national introduction. Vaccination costs may be decreased further by annual vaccination, high initial investment in social mobilization, or introducing/strengthening school health programs. Our analysis shows that drivers of cost are dependent on country and district characteristics. We therefore recommend that countries carry out detailed planning at the national and district levels to define a sustainable strategy for national HPV vaccine roll-out, in order to achieve the optimal balance between coverage and cost.

Cost and economic benefit of clinical decision support systems for cardiovascular disease prevention: a community guide systematic review.

PubMed

Jacob, Verughese; Thota, Anilkrishna B; Chattopadhyay, Sajal K; Njie, Gibril J; Proia, Krista K; Hopkins, David P; Ross, Murray N; Pronk, Nicolaas P; Clymer, John M

2017-05-01

This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSSs) to prevent cardiovascular disease (CVD). Methods developed for the Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSSs to prevent CVD from the available studies ( n  = 12) due to considerable heterogeneity. Several studies ( n  = 11) indicated that health care costs were averted by using CDSSs but many were partial assessments that did not consider all components of health care. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSSs based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Intervention costs were not negligible, but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted health care cost could not be determined with confidence because many studies did not fully account for all components of health care. We were unable to conclude whether CDSSs for CVD prevention is either cost-beneficial or cost-effective. Several evidence gaps are identified, most prominently a lack of information about major drivers of cost and benefit, a lack of standard metrics for the cost of CDSSs, and not allowing for useful life of a CDSS that generally extends beyond one accounting period. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

Technoeconomic analysis of large scale production of pre-emergent Pseudomonas fluorescens microbial bioherbicide in Canada.

PubMed

Mupondwa, Edmund; Li, Xue; Boyetchko, Susan; Hynes, Russell; Geissler, Jon

2015-01-01

The study presents an ex ante technoeconomic analysis of commercial production of Pseudomonas fluorescens BRG100 bioherbicide in Canada. An engineering economic model is designed in SuperPro Designer® to investigate capital investment scaling and profitability. Total capital investment for a stand-alone BRG100 fermentation plant at baseline capacity (two 33,000L fermenters; 3602tonnesannum(-1)) is $17.55million. Total annual operating cost is $14.76million. Raw materials account for 50% of operating cost. The fermentation plant is profitable over wide operating scale, evaluated over a range of BRG100 prices and costs of capital. Smaller plants require higher NPV breakeven prices. However, larger plants are more sensitive to changes in the cost of capital. Unit production costs decrease as plant capacity increases, indicating scale economies. A plant operating for less than one year approaches positive NPV for periods as low as 2months. These findings can support bioherbicide R&D investment and commercialization strategies. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

North of the 46° parallel: Obstacles and challenges to recycling in Ontario's rural and northern communities.

PubMed

Lakhan, Calvin

2015-10-01

This study examines the economic challenges of recycling in Ontario's rural and northern areas. Specifically, this study quantifies the economic and diversion impact of operating recycling programs in these regions. Using a systems based cost model, focus is placed on analyzing: (1) What would happen to provincial recycling costs and diversion levels if recycling programs were eliminated in "high cost" northern and rural communities? (2) Is it possible to increase the provincial recycling rate by focusing investments in low cost, high performance regions (while simultaneously eliminating recycling programs in rural and northern areas)? (3) How would the mix of material recovered change if recycling programs were eliminated in rural and northern areas? The results of this analysis show that eliminating recycling programs in high cost regions significantly decreased system costs without negatively impacting overall recycling rates. This study also found that it was possible to increase the provincial recycling rate while simultaneously reducing program costs by targeting specific regions for recovery. The findings of this study suggest that Ontario reevaluate whether rural and northern municipalities be legislatively required to operate household recycling programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Two-tier charging in Maputo Central Hospital: costs, revenues and effects on equity of access to hospital services.

PubMed

McPake, Barbara; Hongoro, Charles; Russo, Giuliano

2011-06-02

Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total), where capital and drug costs were surprisingly low (2 and 4% respectively). We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a) the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b) because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic operations, rather than the other way around. We conclude that the observed lack of transparency may create scope for an inequitable cross subsidy of private customers by public resources.

A feasibility study for conducting unattended night-time operations at WMKO

NASA Astrophysics Data System (ADS)

Stomski, Paul J.; Gajadhar, Sarah; Dahm, Scott; Jordan, Carolyn; Nordin, Tom

2016-08-01

In 2015, W. M. Keck Observatory conducted a study of the feasibility of conducting nighttime operations on Maunakea without any staff on the mountain. The study was motivated by the possibility of long term operational costs savings as well as other expected benefits. The goals of the study were to understand the technical feasibility and risk as well as to provide labor and cost estimates for implementation. The results of the study would be used to inform a decision about whether or not to fund and initiate a formal project aimed at the development of this new unattended nighttime operating capability. In this paper we will describe the study process as well as a brief summary of the results including the identified viable design alternative, the risk analysis, and the scope of work. We will also share the decisions made as a result of the study and current status of related follow-on activity.

California-Specific Power-to-Hydrogen and Power-to-Gas Business Case Evaluation

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

Eichman, Joshua D.; Flores-Espino, Francisco

Flexible operation of electrolysis systems represents an opportunity to reduce the cost of hydrogen for a variety of end-uses while also supporting grid operations and thereby enabling greater renewable penetration. California is an ideal location to realize that value on account of growing renewable capacity and markets for hydrogen as a fuel cell electric vehicle (FCEV) fuel, refineries, and other end-uses. Shifting the production of hydrogen to avoid high cost electricity and participation in utility and system operator markets along with installing renewable generation to avoid utility charges and increase revenue from the Low Carbon Fuel Standard (LCFS) program canmore » result in around $2.5/kg (21%) reduction in the production and delivery cost of hydrogen from electrolysis. This reduction can be achieved without impacting the consumers of hydrogen. Additionally, future strategies for reducing hydrogen cost were explored and include lower cost of capital, participation in the Renewable Fuel Standard program, capital cost reduction, and increased LCFS value. Each must be achieved independently and could each contribute to further reductions. Using the assumptions in this study found a 29% reduction in cost if all future strategies are realized. Flexible hydrogen production can simultaneously improve the performance and decarbonize multiple energy sectors. The lessons learned from this study should be used to understand near-term cost drivers and to support longer-term research activities to further improve cost effectiveness of grid integrated electrolysis systems.« less

Study of selected tether applications in space, phase 3, volume 2

NASA Technical Reports Server (NTRS)

1986-01-01

The results of a Phase 3 study of two Selected Tether Applications in Space (STAIS); deorbit of a Shuttle and launch of an Orbital Transfer Vehicle (OTV), both from the space station using a tether were examined. The study objectives were to: perform a preliminary engineering design, define operational scenarios, develop a common cost model, perform cost benefits analyses, and develop a Work Breakdown Structure (WBS). Key features of the performance analysis were to identify the net increases in effective Shuttle cargo capability if tethers are used to assist in the deorbit of Shuttles and the launching of the OTVs from the space station and to define deployer system designs required to accomplish these tasks. Deployer concepts were designed and discussed. Operational scenarios, including timelines, for both tethered and nontethered Shuttle and OTV operations at the space station were evaluated. A summary discussion of the Selected Tether Applications Cost Model (STACOM) and the results of the cost benefits analysis are presented. Several critical technologies needed to implement tether assisted deployment of payloads are also discussed. Conclusions and recommendations are presented.

Low-cost and no-cost practice to achieve energy efficiency of government office buildings: A case study in federal territory of Malaysia

NASA Astrophysics Data System (ADS)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Ibrahim, Amlus

2016-08-01

This paper presents the findings of a case study to achieve energy-efficient performance of conventional office buildings in Malaysia. Two multi-storey office buildings in Federal Territory of Malaysia have been selected. The aim is to study building energy saving potential then to highlight the appropriate measures that can be implemented. Data was collected using benchmarking method by comparing the measured consumption to other similar office buildings and a series of preliminary audit which involves interviews, a brief review of utility and operating data as well as a walkthrough in the buildings. Additionally, in order to get a better understanding of major energy consumption in the selected buildings, general audit have been conducted to collect more detailed information about building operation. In the end, this study emphasized low-cost and no-cost practice to achieve energy efficiency with significant results in some cases.

An 8-year follow-up study of 221 consecutive hip fracture patients in Finland: analysis of reoperations and their direct medical costs.

PubMed

Lüthje, P; Helkamaa, T; Nurmi-Lüthje, I; Kaukonen, J-P; Kataja, M

2014-03-01

Some hip fracture patients need one or more reoperations because of complications following initial operative treatment. The aim of this study was to identify all further surgical interventions in a cohort of patients with hip fractures over a period of 8 years after index fracture. Immediate direct costs of these reoperations were also calculated. This retrospective study investigated 221 consecutive patients with hip fractures operated on at two different hospitals in southeastern Finland. The study period in hospital A was from 1 February 2003 to 31 January 2004, and in hospital B from 1 February 2003 to 30 April 2004. About 50% were femoral neck fractures, 41% trochanteric fractures, and 9% subtrochanteric fractures. Patients' medical records were checked from the hospital records and confirmed manually. Short- and long-term complications were recorded. Survival analysis was performed using a life-table method. The actual costs for reoperations and other further procedures for each patient were calculated using diagnosis-related groups-based costs for both hospitals in 2012. A total of 20 patients (9%) needed reoperations. Overall, 10 patients (8.9%) with a femoral neck fracture (n = 112), 8 patients (8.7%) with trochanteric fracture (n = 92), and 2 patients (10.5%) with subtrochanteric fracture (n = 19) were reoperated on. The median interval between the primary operation of the acute hip fracture (n = 20) and the first reoperation was about 300 days (range: 2 weeks to 82 months). Among the women reoperated on, the excess mortality was lower than among those undergoing a single operation. The median costs of treatment per patient with one or more reoperations were €13,422 in hospital A (range: €1616-€61,755), €11,076 in hospital B (range: €1540-€17,866), and €12,850 in the total study group (p = 0.43). In the case of infections (3 patients), the mean costs per patient were €28,751 (range: €11,076-€61,755). Almost 10% of hip fracture patients required reoperations, and these reoperations caused significant direct costs to health care. However, direct costs account for only approximately 25% of the first year's total costs. These costs should be taken into account when evaluating the economics of hip fractures and the burden of health care.

Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case-control study.

PubMed

Sarlos, Dimitri; Kots, Lavonne; Stevanovic, Nebojsa; Schaer, Gabriel

2010-05-01

Robotic surgery, with its technical advances, promises to open a new window to minimally invasive surgery in gynaecology. Feasibility and safety of this surgical innovation have been demonstrated in several studies, and now a critical analysis of these new developments regarding outcome and costs is in place. So far only a few studies compare robotic with conventional laparoscopic surgery in gynaecology. Our objective was to evaluate our initial experience performing total robot-assisted hysterectomy with the da Vinci surgical system and compare peri-operative outcome and costs with total laparoscopic hysterectomy. For this prospective matched case-control study at our institution, peri-operative data from our first 40 consecutive total robot-assisted hysterectomies for benign indications were recorded and matched 1:1 with total laparoscopic hysterectomies according to age, BMI and uterus weight. Surgical costs were calculated for both procedures. Surgeons' subjective impressions of robotics were evaluated with a self-developed questionnaire. No conversions to laparotomy or severe peri-operative complications occurred. Mean operating time was 109 (113; 50-170) min for the robotic group and 83 (80; 55-165) min for the conventional laparoscopic group. Mean postoperative hospitalisation for robotic surgery was 3.3 (3; 2-6) days versus 3.9 (4; 2-7) days for the conventional laparoscopic group. Average surgical cost of a robot-assisted laparoscopic hysterectomy was 4067 euros compared to 2151 euros for the conventional laparoscopic procedure at our institution. For the robotic group wider range of motion of the instruments and better ergonomics were considered to be an advantage, and lack of direct access to the patient was stated as a disadvantage. Robot-assited hysterectomy is a feasible and interesting new technique with comparable outcome to total laparoscopic hysterectomy. Operating times of total laparoscopic hysterectomy seem to be achieved quickly especially for experienced laparoscopic surgeons. However, costs of robotic surgery are still higher than for conventional laparoscopy. Randomised clinical trials need to be conducted to further evaluate benefits of this new technology for patients and surgeons and analyse its cost-effectiveness in gynaecology. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Optimization study on multiple train formation scheme of urban rail transit

NASA Astrophysics Data System (ADS)

Xia, Xiaomei; Ding, Yong; Wen, Xin

2018-05-01

The new organization method, represented by the mixed operation of multi-marshalling trains, can adapt to the characteristics of the uneven distribution of passenger flow, but the research on this aspect is still not perfect enough. This paper introduced the passenger sharing rate and congestion penalty coefficient with different train formations. On this basis, this paper established an optimization model with the minimum passenger cost and operation cost as objective, and operation frequency and passenger demand as constraint. The ideal point method is used to solve this model. Compared with the fixed marshalling operation model, the overall cost of this scheme saves 9.24% and 4.43% respectively. This result not only validates the validity of the model, but also illustrate the advantages of the multiple train formations scheme.

[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.

Operational and Clinical Strategies to Address Drug Cost Containment in the Acute Care Setting.

PubMed

McConnell, Karen J; Guzman, Oscar E; Pherwani, Nisha; Spencer, Dustin D; Van Cura, Jennifer D; Shea, Katherine M

2017-01-01

To provide clinical and operational strategies to generate drug cost savings in the hospital setting. A search of the PubMed database was performed with no time limit through July 2016. All original prospective and retrospective studies, peer-reviewed guidelines, consensus statements, review articles, and accompanying references were evaluated for inclusion. Only articles published in the English language were included. Investigators reviewed 937 abstracts. The review of the literature showed that acute care hospitals are under increasing financial pressures, and the pharmacy is often responsible for opportunities to manage drug costs. The literature also indicated that cost-containment strategies in the acute care setting range from pharmacy-directed activities to initiatives requiring interdisciplinary collaboration and strategic planning. Hospital pharmacies should consider establishing an interdisciplinary team that is responsible for systematically reviewing drug cost implications and leading any initiatives that are deemed necessary. Acute care settings can use various operational and clinical strategies to lower their expenditures on high-cost drugs. Operational strategies include various activities that pharmacy staff implement related to contracting, purchasing, and inventory management. Clinical strategies utilize clinical pharmacists working with interdisciplinary teams to develop and maintain a formulary, implement established-use criteria for select drugs, use dose optimization, and implement other clinical tactics aimed at cost containment. After initiatives are implemented, assessing the outcomes of the initiatives is important to determine how successful they were at lowering costs safely and effectively. Acute care hospitals can use various operational and clinical strategies to lower overall drug costs. A systematic stepwise approach is recommended to ensure relevant drugs are regularly reviewed and addressed as needed. © 2016 Pharmacotherapy Publications, Inc.

Direct cost comparison of minimally invasive punch technique versus traditional approaches for percutaneous bone anchored hearing devices.

PubMed

Sardiwalla, Yaeesh; Jufas, Nicholas; Morris, David P

2017-06-12

Minimally Invasive Ponto Surgery (MIPS) was recently described as a new technique to facilitate the placement of percutaneous bone anchored hearing devices. The procedure has resulted in a simplification of the surgical steps and a dramatic reduction in surgical time while maintaining excellent patient outcomes. Given these developments, our group sought to move the procedure from the main operating suite where they have traditionally been performed. This study aims to test the null hypothesis that MIPS and open approaches have the same direct costs for the implantation of percutaneous bone anchored hearing devices in a Canadian public hospital setting. A retrospective direct cost comparison of MIPS and open approaches for the implantation of bone conduction implants was conducted. Indirect and future costs were not included in the fiscal analysis. A simple cost comparison of the two approaches was made considering time, staff and equipment needs. All 12 operations were performed on adult patients from 2013 to 2016 by the same surgeon at a single hospital site. MIPS has a total mean reduction in cost of CAD$456.83 per operation from the hospital perspective when compared to open approaches. The average duration of the MIPS operation was 7 min, which is on average 61 min shorter compared with open approaches. The MIPS technique was more cost effective than traditional open approaches. This primarily reflects a direct consequence of a reduction in surgical time, with further contributions from reduced staffing and equipment costs. This simple, quick intervention proved to be feasible when performed outside the main operating room. A blister pack of required equipment could prove convenient and further reduce costs.

The Effects of Very Light Jet Air Taxi Operations on Commercial Air Traffic

NASA Technical Reports Server (NTRS)

Smith, Jeremy C.; Dollyhigh, Samuel M.

2006-01-01

This study investigates the potential effects of Very Light Jet (VLJ) air taxi operations adding to delays experienced by commercial passenger air transportation in the year 2025. The affordable cost relative to existing business jets and ability to use many of the existing small, minimally equipped, but conveniently located airports is projected to stimulate a large demand for the aircraft. The resulting increase in air traffic operations will mainly be at smaller airports, but this study indicates that VLJs have the potential to increase further the pressure of demand at some medium and large airports, some of which are already operating at or near capacity at peak times. The additional delays to commercial passenger air transportation due to VLJ air taxi operations are obtained from simulation results using the Airspace Concepts Evaluation System (ACES) simulator. The direct increase in operating cost due to additional delays is estimated. VLJs will also cause an increase in traffic density, and this study shows increased potential for conflicts due to VLJ operations.

A cost-effective analysis of fibrin sealants versus no sealant following open right hemihepatectomy for colorectal liver metastases.

PubMed

Pandanaboyana, Sanjay; Bell, Richard; Shah, Nehal; Lodge, J Peter A; Hidalgo, Ernest; Toogood, Giles J; Prasad, K Raj

2017-06-01

There is paucity of data regarding the cost-effectiveness of fibrin sealants during liver surgery. This study aimed to assess the cost-effectiveness of fibrin sealants following right hemihepatectomy for colorectal liver metastases. A prospectively maintained database between 2004 and 2013 was reviewed to identify patients who underwent a right hemihepatectomy with and without fibrin sealant application. Perioperative and post-operative outcomes were analysed to assess its cost-effectiveness. One hundred and sixty-three right hemihepatectomies were performed, of which 79 were in the fibrin sealant treatment group and 84 were in the no sealant group. No difference was seen between fibrin sealant and no sealant with regard to bile leak (P = 0.366), intra-abdominal collections (P = 0.200) and overall post-operative complications (P = 0.480). Operating costs were significantly cheaper in the no sealant group (P = 0.010). There was no difference seen in median post-operative stay between fibrin sealant versus no treatment (8 versus 9 days, P = 0.327), median total bed cost (£3900 versus £4300, P = 0.400), mean transfusion cost per patient (P = 0.201) and overall cost (£6706.15 versus £6555.80, P = 0.792). Fibrin sealant application to cut surface during liver surgery confers no cost benefit and their routine use may not be recommended. © 2014 Royal Australasian College of Surgeons.

Implications of Using Computer-Based Training with the AN/SQQ-89(v) Sonar System: Operating and Support Costs

DTIC Science & Technology

2012-06-01

Visibility and Management of Operating and Support Costs (VAMOSC...VAMOSC Visibility and Management of Operating and Support Costs VMA Variant Manning Average WAP Weapons Alternate Processor WCS Work Center...Visibility and Management of Operating and Support Costs (VAMOSC), under Unit Level Consumption and Manhours—Organizational Corrective Maintenance. C

25 CFR 39.201 - Does ISEF reflect the actual cost of school operations?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Does ISEF reflect the actual cost of school operations... Does ISEF reflect the actual cost of school operations? ISEF does not attempt to assess the actual cost of school operations either at the local school level or in the aggregate nationally. ISEF is a...

25 CFR 39.101 - Does ISEF assess the actual cost of school operations?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Does ISEF assess the actual cost of school operations? 39... SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula § 39.101 Does ISEF assess the actual cost of school operations? No. ISEF does not attempt to assess the actual cost of school operations either...

Adoption of robotics in a general surgery residency program: at what cost?

PubMed

Mehaffey, J Hunter; Michaels, Alex D; Mullen, Matthew G; Yount, Kenan W; Meneveau, Max O; Smith, Philip W; Friel, Charles M; Schirmer, Bruce D

2017-06-01

Robotic technology is increasingly being utilized by general surgeons. However, the impact of introducing robotics to surgical residency has not been examined. This study aims to assess the financial costs and training impact of introducing robotics at an academic general surgery residency program. All patients who underwent laparoscopic or robotic cholecystectomy, ventral hernia repair (VHR), and inguinal hernia repair (IHR) at our institution from 2011-2015 were identified. The effect of robotic surgery on laparoscopic case volume was assessed with linear regression analysis. Resident participation, operative time, hospital costs, and patient charges were also evaluated. We identified 2260 laparoscopic and 139 robotic operations. As the volume of robotic cases increased, the number of laparoscopic cases steadily decreased. Residents participated in all laparoscopic cases and 70% of robotic cases but operated from the robot console in only 21% of cases. Mean operative time was increased for robotic cholecystectomy (+22%), IHR (+55%), and VHR (+61%). Financial analysis revealed higher median hospital costs per case for robotic cholecystectomy (+$411), IHR (+$887), and VHR (+$1124) as well as substantial associated fixed costs. Introduction of robotic surgery had considerable negative impact on laparoscopic case volume and significantly decreased resident participation. Increased operative time and hospital costs are substantial. An institution must be cognizant of these effects when considering implementing robotics in departments with a general surgery residency program. Copyright © 2017 Elsevier Inc. All rights reserved.

Cost and effectiveness analysis on unmanned aerial vehicle (UAV) use at border security

NASA Astrophysics Data System (ADS)

Yilmaz, Bahadır.

2013-06-01

Drones and Remotely Piloted Vehicles are types of Unmanned Aerial Vehicles. UAVs began to be used with the war of Vietnam, they had a great interest when Israel used them in Bekaa Valley Operations of 1982. UAVs have been used by different countries with different aims with the help of emerging technology and investments. In this article, in the context of areas of UAV usage in national security, benefits and disadvantages of UAVs are put forward. Particularly, it has been evaluated on the basis of cost-effectiveness by focusing the use of UAV in the border security. UAVs have been studied by taking cost analysis, procurement and operational costs into consideration. Analysis of effectiveness has been done with illegal passages of people and drugs from flight times of UAVs. Although the procurement cost of the medium-level UAVs is low, its operational costs are high. For this reason, the idea of less costly alternative systems have been revealed for the border security. As the costs are reduced to acceptable level involving national security and border security in future with high-technology products in their structure, it will continue to be used in an increasing proportion.

Lost opportunity cost of surgical training in the Australian private sector.

PubMed

Aitken, R James

2012-03-01

To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Computer-Aided Surgical Simulation in Head and Neck Reconstruction: A Cost Comparison among Traditional, In-House, and Commercial Options.

PubMed

Li, Sean S; Copeland-Halperin, Libby R; Kaminsky, Alexander J; Li, Jihui; Lodhi, Fahad K; Miraliakbari, Reza

2018-06-01

 Computer-aided surgical simulation (CASS) has redefined surgery, improved precision and reduced the reliance on intraoperative trial-and-error manipulations. CASS is provided by third-party services; however, it may be cost-effective for some hospitals to develop in-house programs. This study provides the first cost analysis comparison among traditional (no CASS), commercial CASS, and in-house CASS for head and neck reconstruction.  The costs of three-dimensional (3D) pre-operative planning for mandibular and maxillary reconstructions were obtained from an in-house CASS program at our large tertiary care hospital in Northern Virginia, as well as a commercial provider (Synthes, Paoli, PA). A cost comparison was performed among these modalities and extrapolated in-house CASS costs were derived. The calculations were based on estimated CASS use with cost structures similar to our institution and sunk costs were amortized over 10 years.  Average operating room time was estimated at 10 hours, with an average of 2 hours saved with CASS. The hourly cost to the hospital for the operating room (including anesthesia and other ancillary costs) was estimated at $4,614/hour. Per case, traditional cases were $46,140, commercial CASS cases were $40,951, and in-house CASS cases were $38,212. Annual in-house CASS costs were $39,590.  CASS reduced operating room time, likely due to improved efficiency and accuracy. Our data demonstrate that hospitals with similar cost structure as ours, performing greater than 27 cases of 3D head and neck reconstructions per year can see a financial benefit from developing an in-house CASS program. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pneumatic versus laser ureteroscopic lithotripsy: a comparison of initial outcomes and cost.

PubMed

Demir, Aslan; Karadağ, Mert Ali; Ceçen, Kurşat; Uslu, Mehmet; Arslan, Omer Erkam

2014-11-01

To audit the cost of laser versus pneumatic semirigid ureteroscopic lithotripsy and to analyze their relative initial outcomes and cost. Hundred and eighty-seven patients who underwent semirigid ureteroscopic lithotripsy were analyzed retrospectively in terms of age and sex of the patients; location and size of the stones; the type of probe and ancillary equipment such as guide wire, basket catheter, JJ stent requirements; irrigation amount; operation time; the cost of the anesthesia and further treatments such as a JJ stent removal operation and shock wave lithotripsy requirements and their costs. Two groups were formed based on this type of lithotripters, pneumatic and laser lithotripsy. Operation times (min.) in terms of the stone size, for stones <100 and >100 mm(2) were 20.75 ± 10.78 and 25.82 ± 14.23, respectively (p = 0.007). Operation times for the pneumatic and laser groups were 33.05 ± 11.36 and 15.25 ± 6.14, respectively (p < 0.05).The stone-free rates for pneumatic and laser groups were 89.6 % (n = 69) and 98.2 % (n = 108), respectively (p = 0.01). The mean cost of the operations for each of the study groups was 261.5 ± 66.13 and 311.7 ± 51.97 US$, respectively (p = 0.001). The mean cost in terms of the stone size, for stones <100 and >100 mm(2), was 272.86 ± 53.05 and 323.71 ± 66.88 US$, respectively (p = 0.01). It seems that usage of laser lithotripsy (LL) in patients with ureteral stones is more effective than pneumatic lithotripsy (PL) in terms of operation time and SF rate. On the other hand, the mean cost of LL seems to be more expensive than PL. Urologists should think these parameters before the choice of these two treatment modalities. The higher the effectiveness, the greater the cost.

Minimally invasive mitral valve surgery is associated with equivalent cost and shorter hospital stay when compared with traditional sternotomy.

PubMed

Atluri, Pavan; Stetson, Robert L; Hung, George; Gaffey, Ann C; Szeto, Wilson Y; Acker, Michael A; Hargrove, W Clark

2016-02-01

Mitral valve surgery is increasingly performed through minimally invasive approaches. There are limited data regarding the cost of minimally invasive mitral valve surgery. Moreover, there are no data on the specific costs associated with mitral valve surgery. We undertook this study to compare the costs (total and subcomponent) of minimally invasive mitral valve surgery relative to traditional sternotomy. All isolated mitral valve repairs performed in our health system from March 2012 through September 2013 were analyzed. To ensure like sets of patients, only those patients who underwent isolated mitral valve repairs with preoperative Society of Thoracic Surgeons scores of less than 4 were included in this study. A total of 159 patients were identified (sternotomy, 68; mini, 91). Total incurred direct cost was obtained from hospital financial records. Analysis demonstrated no difference in total cost (operative and postoperative) of mitral valve repair between mini and sternotomy ($25,515 ± $7598 vs $26,049 ± $11,737; P = .74). Operative costs were higher for the mini cohort, whereas postoperative costs were significantly lower. Postoperative intensive care unit and total hospital stays were both significantly shorter for the mini cohort. There were no differences in postoperative complications or survival between groups. Minimally invasive mitral valve surgery can be performed with overall equivalent cost and shorter hospital stay relative to traditional sternotomy. There is greater operative cost associated with minimally invasive mitral valve surgery that is offset by shorter intensive care unit and hospital stays. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Estimating Airline Operating Costs

NASA Technical Reports Server (NTRS)

Maddalon, D. V.

1978-01-01

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

The High Cost of Leaving: An Analysis of the Cost of Teacher Turnover

ERIC Educational Resources Information Center

Watlington, Eliah; Shockley, Robert; Guglielmino, Paul; Felsher, Rivka

2010-01-01

The cost of teacher turnover to schools and school districts has only recently been studied. This research reveals that when high-quality teachers leave the classroom, the effect on both student performance and school and district fiscal operations is significant and deleterious. The implications for study in this area include the planning of…

Characteristics of future air cargo demand and impact on aircraft development: A report on the Cargo/Logistic Airlift Systems Study (CLASS) project

NASA Technical Reports Server (NTRS)

Whitehead, A. H., Jr.

1978-01-01

Current domestic and international air cargo operations are studied and the characteristics of 1990 air cargo demand are postulated from surveys conducted at airports and with shippers, consignees, and freight forwarders as well as air, land, and ocean carriers. Simulation and route optimization programs are exercised to evaluate advanced aircraft concepts. The results show that proposed changes in the infrastructure and improved cargo loading efficiencies are as important enhancing the prospects of air cargo growth as is the advent of advanced freighter aircraft. Potential reductions in aircraft direct operating costs are estimated and related to future total revenue. Service and cost elasticities are established and utilized to estimate future potential tariff reductions that may be realized through direct and indirect operating cost reductions and economies of scale.

Hybrid Airships: Intratheater Operations Cost-Benefit Analysis

DTIC Science & Technology

2011-06-01

airships (HA) in an intratheater humanitarian assistance scenario. A linear programming model was used to study various mixes of hybrid airships...i.e. 200 tons) must be moved as quickly as possible (or during sealift transit), then HA operating costs of $3,000 per hour or less also make them a ...for Future Research ................................................................................ 52 Appendix A : Examples of HA Concepts/Prototypes

Solar power satellite. System definition study. Part 1, volume 3: Construction, transportation and cost analyses

NASA Technical Reports Server (NTRS)

1977-01-01

Concepts developed for both LEO and GEO construction of photovoltaic and thermal engine satellites are analyzed. Topics discussed include: satellite construction; crew scheduling; crew jobs and organizations; operator productivity rating; constructability rating; transportation systems for cargo launch, refueling operations, personnel transport, and orbit transfer; collision analysis, cost analysis, and radiation evironment and effects.

On the Economics of Library Operation. Final Report Submitted to National Advisory Commission on Libraries.

ERIC Educational Resources Information Center

National Advisory Commission on Libraries, Washington, DC.

Both an analysis of the sources of cost trends in libraries and the relationship of the prospective role of automation in library operations to the causes of cost trends and the predicted shortage of trained librarians are examined in the study of the economic structure of the library. Issues investigated are those particularly relating to current…

Cost-effectiveness of the stream-gaging program in New Jersey

USGS Publications Warehouse

Schopp, R.D.; Ulery, R.L.

1984-01-01

The results of a study of the cost-effectiveness of the stream-gaging program in New Jersey are documented. This study is part of a 5-year nationwide analysis undertaken by the U.S. Geological Survey to define and document the most cost-effective means of furnishing streamflow information. This report identifies the principal uses of the data and relates those uses to funding sources, applies, at selected stations, alternative less costly methods (that is flow routing, regression analysis) for furnishing the data, and defines a strategy for operating the program which minimizes uncertainty in the streamflow data for specific operating budgets. Uncertainty in streamflow data is primarily a function of the percentage of missing record and the frequency of discharge measurements. In this report, 101 continuous stream gages and 73 crest-stage or stage-only gages are analyzed. A minimum budget of $548,000 is required to operate the present stream-gaging program in New Jersey with an average standard error of 27.6 percent. The maximum budget analyzed was $650,000, which resulted in an average standard error of 17.8 percent. The 1983 budget of $569,000 resulted in a standard error of 24.9 percent under present operating policy. (USGS)

Renewable Electricity Futures. Operational Analysis of the Western Interconnection at Very High Renewable Penetrations

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

Brinkman, Gregory

2015-09-01

The Renewable Electricity Futures Study (RE Futures)--an analysis of the costs and grid impacts of integrating large amounts of renewable electricity generation into the U.S. power system--examined renewable energy resources, technical issues regarding the integration of these resources into the grid, and the costs associated with high renewable penetration scenarios. These scenarios included up to 90% of annual generation from renewable sources, although most of the analysis was focused on 80% penetration scenarios. Hourly production cost modeling was performed to understand the operational impacts of high penetrations. One of the conclusions of RE Futures was that further work was necessarymore » to understand whether the operation of the system was possible at sub-hourly time scales and during transient events. This study aimed to address part of this by modeling the operation of the power system at sub-hourly time scales using newer methodologies and updated data sets for transmission and generation infrastructure. The goal of this work was to perform a detailed, sub-hourly analysis of very high penetration scenarios for a single interconnection (the Western Interconnection). It focused on operational impacts, and it helps verify that the operational results from the capacity expansion models are useful. The primary conclusion of this study is that sub-hourly operation of the grid is possible with renewable generation levels between 80% and 90%.« less

Cost/benefit tradeoffs for reducing the energy consumption of the commercial air transportation system. Volume 1: Technical analysis

NASA Technical Reports Server (NTRS)

Kraus, E. F.

1976-01-01

The effectiveness and associated costs of operational and technical options for reduced fuel consumption by Douglas aircraft in the domestic airline fleet are assessed. Areas explored include alternative procedures for airline and flight operations, advanced and state of the art technology, modification and derivative configurations, new near-term aircraft, turboprop configuration studies, and optimum aircraft geometry. Data for each aircraft studied is presented in tables and graphs.

Systematic Approach to Better Understanding Integration Costs: Preprint

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

Stark, Gregory B.

2015-09-28

When someone mentions integration costs, thoughts of the costs of integrating renewable generation into an existing system come to mind. We think about how variability and uncertainty can increase power system cycling costs as increasing amounts of wind or solar generation are incorporated into the generation mix. However, seldom do we think about what happens to system costs when new baseload generation is added to an existing system or when generation self-schedules. What happens when a highly flexible combined-cycle plant is added? Do system costs go up, or do they go down? Are other, non-cycling, maintenance costs impacted? In thismore » paper we investigate six technologies and operating practices--including VG, baseload generation, generation mix, gas prices, self-scheduling, and fast-start generation--and how changes in these areas can impact a system's operating costs. This paper provides a working definition of integration costs and four components of variable costs. It describes the study approach and how a production cost modeling-based method was used to determine the cost effects, and, as a part of the study approach section, it describes the test system and data used for the comparisons. Finally, it presents the research findings, and, in closing, suggests three areas for future work.« less

76 FR 30925 - Information Collection; Submission for OMB Review, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-27

.../startup): None. Total Burden Cost (operating/maintenance): None. Instrument: Application and Budget.../startup): None. Total Burden Cost (operating/maintenance): None. AmeriCorps\\*\\VISTA Project Progress...,800 hours. Total Burden Cost (capital/startup): None. Total Burden Cost (operating/maintenance): None...

49 CFR 1139.3 - Cost study.

Code of Federal Regulations, 2014 CFR

2014-10-01

... service units as developed from its traffic study. Operating ratios shall be determined for the issue... anticipated on the effective date of the proposed rates, with a separation indicating projected operating ratios on two bases, namely, “based on current revenues,” and “based on proposed revenues”. Operating...

49 CFR 1139.3 - Cost study.

Code of Federal Regulations, 2013 CFR

2013-10-01

... service units as developed from its traffic study. Operating ratios shall be determined for the issue... anticipated on the effective date of the proposed rates, with a separation indicating projected operating ratios on two bases, namely, “based on current revenues,” and “based on proposed revenues”. Operating...

49 CFR 1139.3 - Cost study.

Code of Federal Regulations, 2012 CFR

2012-10-01

... service units as developed from its traffic study. Operating ratios shall be determined for the issue... anticipated on the effective date of the proposed rates, with a separation indicating projected operating ratios on two bases, namely, “based on current revenues,” and “based on proposed revenues”. Operating...

Optimal Design and Operation of Permanent Irrigation Systems

NASA Astrophysics Data System (ADS)

Oron, Gideon; Walker, Wynn R.

1981-01-01

Solid-set pressurized irrigation system design and operation are studied with optimization techniques to determine the minimum cost distribution system. The principle of the analysis is to divide the irrigation system into subunits in such a manner that the trade-offs among energy, piping, and equipment costs are selected at the minimum cost point. The optimization procedure involves a nonlinear, mixed integer approach capable of achieving a variety of optimal solutions leading to significant conclusions with regard to the design and operation of the system. Factors investigated include field geometry, the effect of the pressure head, consumptive use rates, a smaller flow rate in the pipe system, and outlet (sprinkler or emitter) discharge.

Hand-assisted laparoscopic versus robot-assisted laparoscopic partial nephrectomy: comparison of short-term outcomes and cost.

PubMed

Elsamra, Sammy E; Leone, Andrew R; Lasser, Michael S; Thavaseelan, Simone; Golijanin, Dragan; Haleblian, George E; Pareek, Gyan

2013-02-01

Robot-assisted laparoscopic partial nephrectomy (RALPN) and laparoscopic partial nephrectomy (LPN) have become standard for the surgical management of small renal masses (SRMs). However, no studies have evaluated the short-term outcomes or cost of RALPN as compared with hand-assisted laparoscopic partial nephrectomy (HALPN) in a standardized fashion. A retrospective review of all patients who underwent HALPN or RALPN from 2006 to 2010 were assessed for patient age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, radiographic tumor size, nephrometry (radius, endo/exophytic, nearness to collecting system, anterior/posterior, lines of polarity [RENAL]) scores, operative and room times, hospital length of stay (LOS), estimated blood loss (EBL), requirement of hilar vessel clamping, warm ischemia time (WIT), pre- and postprocedural creatinine and hemoglobin levels, and complications. Total costs of the procedures were estimated based on operating room component (operative staff time, anesthesia, and supply) and hospital stay cost (room and board, pharmacy). A robotic premium cost, estimated based on the yearly overall cost of the da Vinci S surgical system divided by the annual number of cases, was included in the RALPN cost. Cost figures were obtained from hospital administration and applied to the mean HALPN and RALPN patient. Forty-seven patients underwent HALPN since 2006 and 21 patients underwent RALPN since 2008. ASA, BMI, EBL, tumor size, nephrometry score, positive margin rate, change in creatinine, change in hemoglobin, morphine equivalents used, and complication rate were all similar in both groups (p>0.05). Room time and operative time were significantly shorter for the HALPN cohort (p=0.001) whereas LOS was significantly shorter in the RALPN cohort (p=0.019). Despite the shorter LOS, RALPN was associated with a $1165 increased cost, mainly due to increased operating room time and premium cost of the robot. While early in our experience, RALPN offered no significant advantage in short-term outcomes over HALPN and was associated with an increased cost of over $1150.

Cost effectiveness of the stream-gaging program in Pennsylvania

USGS Publications Warehouse

Flippo, H.N.; Behrendt, T.E.

1985-01-01

This report documents a cost-effectiveness study of the stream-gaging program in Pennsylvania. Data uses and funding were identified for 223 continuous-record stream gages operated in 1983; four are planned for discontinuance at the close of water-year 1985; two are suggested for conversion, at the beginning of the 1985 water year, for the collection of only continuous stage records. Two of 11 special-purpose short-term gages are recommended for continuation when the supporting project ends; eight of these gages are to be discontinued and the other will be converted to a partial-record type. Current operation costs for the 212 stations recommended for continued operation is $1,199,000 per year in 1983. The average standard error of estimation for instantaneous streamflow is 15.2%. An overall average standard error of 9.8% could be attained on a budget of $1,271,000, which is 6% greater than the 1983 budget, by adopted cost-effective stream-gaging operations. (USGS)

Outcome and cost analysis of bilateral sequential same-day cartilage tympanoplasty compared with bilateral staged tympanoplasty.

PubMed

Olusesi, A D; Oyeniran, O

2017-05-01

Few studies have compared bilateral same-day with staged tympanoplasty using cartilage graft materials. A prospective randomised observational study was performed of 38 chronic suppurative otitis media patients (76 ears) who were assigned to undergo bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential tympanoplasty performed 3 months apart (20 patients, 40 ears). Disease duration, intra-operative findings, combined duration of surgery, post-operative graft appearance at 6 weeks, post-operative complications, re-do rate and relative cost of surgery were recorded. Tympanic membrane perforations were predominantly subtotal (p = 0.36, odds ratio = 0.75). Most grafts were harvested from the conchal cartilage and fewer from the tragus (p = 0.59, odds ratio = 1.016). Types of complication, post-operative hearing gain and revision rates were similar in both patient groups. Surgical outcomes are not significantly different for same-day and bilateral cartilage tympanoplasty, but same-day surgery has the added benefit of a lower cost.

[Economic impact of strategies using ephedrine prefilled syringes].

PubMed

Crégut-Corbaton, J; Malbranche, C; Guignard, M-H; Fagnoni, P

2013-11-01

Ephedrine is an emergency drug available in ampules and syringes need to be prepared in advance according to one of two strategies in our establishment: strategy 1 (S1: 1 ampule per patient) and strategy 2 (S2: 1 ampule per operating room). There are also prefilled syringes. Because of their high cost and conflicting results in the literature, we assessed the economic interest of using prefilled syringes compared with strategies S1 and S2. This was a prospective observational study. The consumption of ephedrine was recorded over two periods of 14 days: P1 with syringes prepared in advance according to S1 or S2 and P2 with the on-demand use of prefilled syringes. The cost of a syringe of ephedrine prepared in advance (nurse time preparation included) was evaluated at €1.65 vs. €3.57 for a prefilled syringe. In operating rooms using S1, the use of prefilled syringes reduced overall the cost per patient about €1.22 and global annual costs by 72% (€2830), while the decrease was about €0.32 for the cost per patient and about 47% (€2760) for global annual costs for operating rooms using S2. The interest of our study is that we investigated different supply strategies for ephedrine within a large number of operating rooms. In our establishment, it was decided to use prefilled syringes in operating rooms that used S1. As well as the economic interest, prefilled syringes contributed to improved safety and saved nursing time. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Operational feasibility of using whole blood in the rapid HIV testing algorithm of a resource-limited settings like Bangladesh.

PubMed

Munshi, Saif U; Oyewale, Tajudeen O; Begum, Shahnaz; Uddin, Ziya; Tabassum, Shahina

2016-03-01

Serum-based rapid HIV testing algorithm in Bangladesh constitutes operational challenge to scaleup HIV testing and counselling (HTC) in the country. This study explored the operational feasibility of using whole blood as alternative to serum for rapid HIV testing in Bangladesh. Whole blood specimens were collected from two study groups. The groups included HIV-positive patients (n = 200) and HIV-negative individuals (n = 200) presenting at the reference laboratory in Dhaka, Bangladesh. The specimens were subjected to rapid HIV tests using the national algorithm with A1 = Alere Determine (United States), A2 = Uni-Gold (Ireland), and A3 = First Response (India). The sensitivity and specificity of the test results, and the operational cost were compared with current serum-based testing. The sensitivities [95% of confidence interval (CI)] for A1, A2, and A3 tests using whole blood were 100% (CI: 99.1-100%), 100% (CI: 99.1-100%), and 97% (CI: 96.4-98.2%), respectively, and specificities of all test kits were 100% (CI: 99.1-100%). Significant (P < 0.05) reduction in the cost of establishing HTC centre and consumables by 94 and 61%, respectively, were observed. The cost of administration and external quality assurance reduced by 39 and 43%, respectively. Overall, there was a 36% cost reduction in total operational cost of rapid HIV testing with blood when compared with serum. Considering the similar sensitivity and specificity of the two specimens, and significant cost reduction, rapid HIV testing with whole blood is feasible. A review of the national HIV rapid testing algorithm with whole blood will contribute toward improving HTC coverage in Bangladesh.

Study of a dry room in a battery manufacturing plant using a process model

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

Ahmed, Shabbir; Nelson, Paul A.; Dees, Dennis W.

The manufacture of lithium ion batteries requires some processing steps to be carried out in a dry room, where the moisture content should remain below 100 parts per million. The design and operation of such a dry room adds to the cost of the battery. This paper studies the humidity management of the air to and from the dry room to understand the impact of design and operating parameters on the energy demand and the cost contribution towards the battery manufacturing cost. The study is conducted with the help of a process model for a dry room with a volumemore » of 16000 cubic meters. For a defined base case scenario it is found that the dry room operation has an energy demand of approximately 400 kW. The paper explores some tradeoffs in design and operating parameters by looking at the humidity reduction by quenching the make-up air vs. at the desiccant wheel, and the impact of the heat recovery from the desiccant regeneration cycle.« less

Overseas Contingency Operations: OMB and DOD Should Revise the Criteria for Determining Eligible Costs and Identify the Costs Likely to Endure Long Term

DTIC Science & Technology

2017-01-01

OVERSEAS CONTINGENCY OPERATIONS OMB and DOD Should Revise the Criteria for Determining Eligible Costs and Identify the... CONTINGENCY OPERATIONS OMB and DOD Should Revise the Criteria for Determining Eligible Costs and Identify the Costs Likely to Endure Long Term Why GAO...billion in funding for OCO. While DOD’s OCO budget request has included amounts for contingency operations primarily in Iraq and Afghanistan, more

Analysis of Anterior Cervical Discectomy and Fusion Healthcare Costs via the Value-Driven Outcomes Tool.

PubMed

Reese, Jared C; Karsy, Michael; Twitchell, Spencer; Bisson, Erica F

2018-04-11

Examining the costs of single- and multilevel anterior cervical discectomy and fusion (ACDF) is important for the identification of cost drivers and potentially reducing patient costs. A novel tool at our institution provides direct costs for the identification of potential drivers. To assess perioperative healthcare costs for patients undergoing an ACDF. Patients who underwent an elective ACDF between July 2011 and January 2017 were identified retrospectively. Factors adding to total cost were placed into subcategories to identify the most significant contributors, and potential drivers of total cost were evaluated using a multivariable linear regression model. A total of 465 patients (mean, age 53 ± 12 yr, 54% male) met the inclusion criteria for this study. The distribution of total cost was broken down into supplies/implants (39%), facility utilization (37%), physician fees (14%), pharmacy (7%), imaging (2%), and laboratory studies (1%). A multivariable linear regression analysis showed that total cost was significantly affected by the number of levels operated on, operating room time, and length of stay. Costs also showed a narrow distribution with few outliers and did not vary significantly over time. These results suggest that facility utilization and supplies/implants are the predominant cost contributors, accounting for 76% of the total cost of ACDF procedures. Efforts at lowering costs within these categories should make the most impact on providing more cost-effective care.

Vehicle operating costs, fuel consumption, and pavement type condition factors

DOT National Transportation Integrated Search

1982-06-01

This report presents updated vehicle operating cost tables which may be used by a highway agency for estimation of vehicle operating costs as a function of operational and roadway variables. These results, partially based on fuel consumption tests on...

19 CFR 10.197 - Direct costs of processing operations performed in a beneficiary country or countries.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Direct costs of processing operations performed in... TO A REDUCED RATE, ETC. Caribbean Basin Initiative § 10.197 Direct costs of processing operations... operations. As used in § 10.195 and § 10.198, the words “direct costs of processing operations” mean those...

43 CFR 404.40 - What is the non-Federal share of operation, maintenance, and replacement costs?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Cost-Sharing § 404.40 What is the non-Federal share of operation, maintenance, and replacement costs? You are required to pay 100 percent of the operation, maintenance, and replacement costs of any rural... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What is the non-Federal share of operation...

Engine Seal Technology Requirements to Meet NASA's Advanced Subsonic Technology Program Goals

NASA Technical Reports Server (NTRS)

Steinetz, Bruce M.; Hendricks, Robert C.

1994-01-01

Cycle studies have shown the benefits of increasing engine pressure ratios and cycle temperatures to decrease engine weight and improve performance of commercial turbine engines. NASA is working with industry to define technology requirements of advanced engines and engine technology to meet the goals of NASA's Advanced Subsonic Technology Initiative. As engine operating conditions become more severe and customers demand lower operating costs, NASA and engine manufacturers are investigating methods of improving engine efficiency and reducing operating costs. A number of new technologies are being examined that will allow next generation engines to operate at higher pressures and temperatures. Improving seal performance - reducing leakage and increasing service life while operating under more demanding conditions - will play an important role in meeting overall program goals of reducing specific fuel consumption and ultimately reducing direct operating costs. This paper provides an overview of the Advanced Subsonic Technology program goals, discusses the motivation for advanced seal development, and highlights seal technology requirements to meet future engine performance goals.

An economic study of an advanced technology supersonic cruise vehicle

NASA Technical Reports Server (NTRS)

Smith, C. L.; Williams, L. J.

1975-01-01

A description is given of the methods used and the results of an economic study of an advanced technology supersonic cruise vehicle. This vehicle was designed for a maximum range of 4000 n.mi. at a cruise speed of Mach 2.7 and carrying 292 passengers. The economic study includes the estimation of aircraft unit cost, operating cost, and idealized cash flow and discounted cash flow return on investment. In addition, it includes a sensitivity study on the effects of unit cost, manufacturing cost, production quantity, average trip length, fuel cost, load factor, and fare on the aircraft's economic feasibility.

Impact of Capital and Current Costs Changes of the Incineration Process of the Medical Waste on System Management Cost

NASA Astrophysics Data System (ADS)

Jolanta Walery, Maria

2017-12-01

The article describes optimization studies aimed at analysing the impact of capital and current costs changes of medical waste incineration on the cost of the system management and its structure. The study was conducted on the example of an analysis of the system of medical waste management in the Podlaskie Province, in north-eastern Poland. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. capital and current costs of medical waste incineration on economic efficiency index (E) and the spatial structure of the system was determined. Optimization studies were conducted for the following cases: with a 25% increase in capital and current costs of incineration process, followed by 50%, 75% and 100% increase. As a result of the calculations, the highest cost of system operation was achieved at the level of 3143.70 PLN/t with the assumption of 100% increase in capital and current costs of incineration process. There was an increase in the economic efficiency index (E) by about 97% in relation to run 1.

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.

Cost-effectiveness of Crohn’s disease post-operative care

PubMed Central

Wright, Emily K; Kamm, Michael A; Dr Cruz, Peter; Hamilton, Amy L; Ritchie, Kathryn J; Bell, Sally J; Brown, Steven J; Connell, William R; Desmond, Paul V; Liew, Danny

2016-01-01

AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection. METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo. RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented. CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated. PMID:27076772

Cost-of-illness studies of atrial fibrillation: methodological considerations.

PubMed

Becker, Christian

2014-10-01

Atrial fibrillation (AF) is the most common heart rhythm arrhythmia, which has considerable economic consequences. This study aims to identify the current cost-of-illness estimates of AF; a focus was put on describing the studies' methodology. A literature review was conducted. Twenty-eight cost-of-illness studies were identified. Cost-of-illness estimates exist for health insurance members, hospital and primary care populations. In addition, the cost of stroke in AF patients and the costs of post-operative AF were calculated. The methods used were heterogeneous, mostly studies calculated excess costs. The identified annual excess costs varied, even among studies from the USA (∼US$1900 to ∼US$19,000). While pointing toward considerable costs, the cost-of-illness studies' relevance could be improved by focusing on subpopulations and treatment mixes. As possible starting points for subsequent economic studies, the methodology of cost-of-illness studies should be taken into account using methods, allowing stakeholders to find suitable studies and validate estimates.

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

PubMed

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

Influence of design on cost of operating airplanes

NASA Technical Reports Server (NTRS)

Black, Archibald

1922-01-01

The author discusses cost of operating commercial airplanes and endeavors to clear up prevalent misunderstandings. Curves of operating cost for varying duration, speed, reserve horsepower, etc. are developed.

Migration towards fibre to the home: key cost factors

NASA Astrophysics Data System (ADS)

Zhou, L. W.; Mas Machuca, C.; Zhao, R.; Grunert, K.

2010-12-01

This paper presents a comprehensive cost model for migration towards FTTH, some case study results from different network area scenarios, as well as the identification of the most important cost factors to be considered by operators aiming at increasing the profitability of their networks.

Conceptual design study of advanced acoustic composite nacelle. [for achieving reductions in community noise and operating expense

NASA Technical Reports Server (NTRS)

Goodall, R. G.; Painter, G. W.

1975-01-01

Conceptual nacelle designs for wide-bodied and for advanced-technology transports were studied with the objective of achieving significant reductions in community noise with minimum penalties in airplane weight, cost, and in operating expense by the application of advanced composite materials to nacelle structure and sound suppression elements. Nacelle concepts using advanced liners, annular splitters, radial splitters, translating centerbody inlets, and mixed-flow nozzles were evaluated and a preferred concept selected. A preliminary design study of the selected concept, a mixed flow nacelle with extended inlet and no splitters, was conducted and the effects on noise, direct operating cost, and return on investment determined.

Does the cost of robotic cholecystectomy translate to a financial burden?

PubMed

Rosemurgy, Alexander; Ryan, Carrie; Klein, Richard; Sukharamwala, Prashant; Wood, Thomas; Ross, Sharona

2015-08-01

Robotic application to cholecystectomy has dramatically increased, though its impact on cost of care and reimbursement has not been elucidated. We undertook this study to evaluate and compare cost of care and reimbursement with robotic versus laparoscopic cholecystectomy. The charges and reimbursement of all robotic and laparoscopic cholecystectomies at one hospital undertaken from June 2012 to June 2013 were determined. Operative duration is defined as time into and time out of the operating room. Data are presented as median data. Comparisons were undertaken using the Mann-Whitney U-test with significance accepted at p ≤ 0.05. Robotic cholecystectomy took longer (47 min longer) and had greater charges ($8,182.57 greater) than laparoscopic cholecystectomy (p < 0.05 for each). However, revenue, earnings before depreciation, interest, and taxes (EBDIT), and Net Income were not impacted by approach. Relative to laparoscopic cholecystectomy, robotic cholecystectomy takes longer and has greater charges. Revenue, EBDIT, and Net Income are similar after either approach; this indicates that costs with either approach are similar. Notably, this is possible because much of hospital-based costs are determined by cost allocation and not cost accounting. Thus, the cost of longer operations and costs inherent to the robotic approach for cholecystectomy do not translate to a perceived financial burden.

Air Force Reusable Booster System A Quick-look, Design Focused Modeling and Cost Analysis Study

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2011-01-01

Presents work supporting the Air force Reusable Booster System (RBS) - A Cost Study with Goals as follows: Support US launch systems decision makers, esp. in regards to the research, technology and demonstration investments required for reusable systems to succeed. Encourage operable directions in Reusable Booster / Launch Vehicle Systems technology choices, system design and product and process developments. Perform a quick-look cost study, while developing a cost model for more refined future analysis.

A Cost Model for Air Force Institute of Technology Programs.

DTIC Science & Technology

1979-09-01

Patterson AFB OH, September 1977. ADA 047662. 16. Horngren , Charles T. Cost Accounting , A Managerial Emphasis. Englewood Cliffs NJ: Prentice Hall, Inc...25 S . Categorical Breakdown of AFIT Cost Matrix ....... .................. . 26 6. Elemental Breakdown of AFIT Direct Cost Category...maximum use of existing data sources such as the Air Force Accounting System for Operations. Justification for Research In past years, cost studies

Model for Assembly Line Re-Balancing Considering Additional Capacity and Outsourcing to Face Demand Fluctuations

NASA Astrophysics Data System (ADS)

Samadhi, TMAA; Sumihartati, Atin

2016-02-01

The most critical stage in a garment industry is sewing process, because generally, it consists of a number of operations and a large number of sewing machines for each operation. Therefore, it requires a balancing method that can assign task to work station with balance workloads. Many studies on assembly line balancing assume a new assembly line, but in reality, due to demand fluctuation and demand increased a re-balancing is needed. To cope with those fluctuating demand changes, additional capacity can be carried out by investing in spare sewing machine and paying for sewing service through outsourcing. This study develops an assembly line balancing (ALB) model on existing line to cope with fluctuating demand change. Capacity redesign is decided if the fluctuation demand exceeds the available capacity through a combination of making investment on new machines and outsourcing while considering for minimizing the cost of idle capacity in the future. The objective of the model is to minimize the total cost of the line assembly that consists of operating costs, machine cost, adding capacity cost, losses cost due to idle capacity and outsourcing costs. The model develop is based on an integer programming model. The model is tested for a set of data of one year demand with the existing number of sewing machines of 41 units. The result shows that additional maximum capacity up to 76 units of machine required when there is an increase of 60% of the average demand, at the equal cost parameters..

Cost Study of Educational Media Systems and Their Equipment Components. Volume II, Technical Report. Final Report.

ERIC Educational Resources Information Center

General Learning Corp., Washington, DC.

A common instructional task and a set of educational environments are hypothesized for analysis of media cost data. The analytic structure may be conceptulized as a three-dimensional matrix: the first vector separates costs into production, distribution, and reception; the second vector delineates capital (initial) and operating (annual) costs;…

Cost Study of Educational Media Systems and Their Equipment Components. Volume I, Guidelines for Determining Costs of Media Systems. Final Report.

ERIC Educational Resources Information Center

General Learning Corp., Washington, DC.

Objective cost estimates for planning and operating systems should be made after an assessment of administrative factors (school environment) and instructional factors (learning objectives, type of presentation). Specification of appropriate sensory stimuli and the design of alternative systems also precede cost estimations for production,…

Anatomy of backcountry management costs

Treesearch

Herbert E Echelberger; Harriet J. Plumley; Harriet J. Plumley

1986-01-01

Operation and management costs for several dispersed overnight site locations and backcountry trails in the White Mountain National Forest were studied. Average annual costs ranged from $200 to $1,500 per mile for trails and from $0.35 to $4.29 per visitor for overnight sites. Average annual costs for trails and overnight sites increased with elevation and use levels,...

Users guide for FRCS: fuel reduction cost simulator software.

Treesearch

Roger D. Fight; Bruce R. Hartsough; Peter Noordijk

2006-01-01

The Fuel Reduction Cost Simulator (FRCS) spreadsheet application is public domain software used to estimate costs for fuel reduction treatments involving removal of trees of mixed sizes in the form of whole trees, logs, or chips from a forest. Equipment production rates were developed from existing studies. Equipment operating cost rates are from December 2002 prices...

Development of termination and utilization concepts for flat conductor cables. Volume 3: Cost study comparison, flat versus round conductor cable

NASA Technical Reports Server (NTRS)

1972-01-01

A cost study comparing flat conductor cable (FCC) with small-gage wire (SGW) and conventional round conductor cable (RCC) is presented. This study was based on a vehicle wiring system consisting of 110,000 ft of conventional RCC equally divided between AWG sizes 20,22, and 24 using MIL-W-81044-type wire and MIL-C-26500 circular connectors. Basic cost data were developed on a similar-sized commercial jet airplane wiring system on a previous company R&D program in which advanced wiring techniques were carried through equivalent installations on an airplane mockup; and on data developed on typical average bundles during this program. Various cost elements included were engineering labor, operations (manufacturing) labor, material costs, and cost impact on payload. Engineering labor includes design, wiring system integration, wiring diagrams and cable assembly drawings, wire installations, and other related supporting functions such as the electronic data processing for the wiring. Operations labor includes mockup, tooling and production planning, fabrication, assembly, installation, and quality control cost impact on payload is the conversion of wiring system weight variations through use of different wiring concepts to program payload benefits in terms of dollars.

Capital and operating costs of full-scale fecal sludge management and wastewater treatment systems in Dakar, Senegal.

PubMed

Dodane, Pierre-Henri; Mbéguéré, Mbaye; Sow, Ousmane; Strande, Linda

2012-04-03

A financial comparison of a parallel sewer based (SB) system with activated sludge, and a fecal sludge management (FSM) system with onsite septic tanks, collection and transport (C&T) trucks, and drying beds was conducted. The annualized capital for the SB ($42.66 capita(-1) year(-1)) was ten times higher than the FSM ($4.05 capita(-1) year(-1)), the annual operating cost for the SB ($11.98 capita(-1) year(-1)) was 1.5 times higher than the FSM ($7.58 capita(-1) year(-1)), and the combined capital and operating for the SB ($54.64 capita(-1) year(-1)) was five times higher than FSM ($11.63 capita(-1) year(-1)). In Dakar, costs for SB are almost entirely borne by the sanitation utility, with only 6% of the annualized cost borne by users of the system. In addition to costing less overall, FSM operates with a different business model, with costs spread among households, private companies, and the utility. Hence, SB was 40 times more expensive to implement for the utility than FSM. However, the majority of FSM costs are borne at the household level and are inequitable. The results of the study illustrate that in low-income countries, vast improvements in sanitation can be affordable when employing FSM, whereas SB systems are prohibitively expensive.

Capital and Operating Costs of Full-Scale Fecal Sludge Management and Wastewater Treatment Systems in Dakar, Senegal

PubMed Central

2012-01-01

A financial comparison of a parallel sewer based (SB) system with activated sludge, and a fecal sludge management (FSM) system with onsite septic tanks, collection and transport (C&T) trucks, and drying beds was conducted. The annualized capital for the SB ($42.66 capita–1 year–1) was ten times higher than the FSM ($4.05 capita–1 year–1), the annual operating cost for the SB ($11.98 capita–1 year–1) was 1.5 times higher than the FSM ($7.58 capita–1 year–1), and the combined capital and operating for the SB ($54.64 capita–1 year–1) was five times higher than FSM ($11.63 capita–1 year–1). In Dakar, costs for SB are almost entirely borne by the sanitation utility, with only 6% of the annualized cost borne by users of the system. In addition to costing less overall, FSM operates with a different business model, with costs spread among households, private companies, and the utility. Hence, SB was 40 times more expensive to implement for the utility than FSM. However, the majority of FSM costs are borne at the household level and are inequitable. The results of the study illustrate that in low-income countries, vast improvements in sanitation can be affordable when employing FSM, whereas SB systems are prohibitively expensive. PMID:22413875

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.

Single visit surgery for pediatric ambulatory surgical procedures: a satisfaction and cost analysis.

PubMed

Olson, Jacob K; Deming, Lisa A; King, Denis R; Rager, Terrence M; Gartner, Sarah; Huibregtse, Natalie; Moss, R Lawrence; Besner, Gail E

2017-10-10

Single visit surgery (SVS) consists of same-day pre-operative assessment and operation with telephone post-operative follow-up. This reduces family time commitment to 1 hospital trip rather than 2-3. We began SVS for ambulatory patients with clear surgical indications in 2013. We sought to determine family satisfaction, cost savings to families, and institutional financial feasibility of SVS. SVS patients were compared to age/case matched conventional surgery (CS) patients. Satisfaction was assessed by post-operative telephone survey. Family costs were calculated as the sum of lost revenue (based on median income) and transportation costs ($0.50/mile). Satisfaction was high in both groups (98% for SVS vs. 93% for CS; p=0.27). 40% of CS families indicated that they would have preferred SVS, whereas no SVS families indicated preference for the CS option (p<0.001). Distance from the hospital did not correlate with satisfaction. Estimated cost savings for an SVS family was $188. Reimbursement, hospital and physician charges, and day-of-surgery cancellation rates were similar. SVS provides substantial cost savings to families while maintaining patient satisfaction and equivalent institutional reimbursement. SVS is an effective approach to low-risk ambulatory surgical procedures that is less disruptive to families, facilitates access to pediatric surgical care, and reduces resource utilization. Cost Effectiveness Study. Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

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

NASA Technical Reports Server (NTRS)

1975-01-01

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

20 CFR 662.270 - How are the costs of providing services through the One-Stop delivery system and the operating...

Code of Federal Regulations, 2014 CFR

2014-04-01

... through the One-Stop delivery system and the operating costs of the system to be funded? 662.270 Section... and the operating costs of the system to be funded? The MOU must describe the particular funding arrangements for services and operating costs of the One-Stop delivery system. Each partner must contribute a...

20 CFR 662.270 - How are the costs of providing services through the One-Stop delivery system and the operating...

Code of Federal Regulations, 2013 CFR

2013-04-01

... through the One-Stop delivery system and the operating costs of the system to be funded? 662.270 Section... and the operating costs of the system to be funded? The MOU must describe the particular funding arrangements for services and operating costs of the One-Stop delivery system. Each partner must contribute a...

20 CFR 662.270 - How are the costs of providing services through the One-Stop delivery system and the operating...

Code of Federal Regulations, 2011 CFR

2011-04-01

... through the One-Stop delivery system and the operating costs of the system to be funded? 662.270 Section... and the operating costs of the system to be funded? The MOU must describe the particular funding arrangements for services and operating costs of the One-Stop delivery system. Each partner must contribute a...

20 CFR 662.270 - How are the costs of providing services through the One-Stop delivery system and the operating...

Code of Federal Regulations, 2010 CFR

2010-04-01

... through the One-Stop delivery system and the operating costs of the system to be funded? 662.270 Section... and the operating costs of the system to be funded? The MOU must describe the particular funding arrangements for services and operating costs of the One-Stop delivery system. Each partner must contribute a...

20 CFR 662.270 - How are the costs of providing services through the One-Stop delivery system and the operating...

Code of Federal Regulations, 2012 CFR

2012-04-01

... through the One-Stop delivery system and the operating costs of the system to be funded? 662.270 Section... and the operating costs of the system to be funded? The MOU must describe the particular funding arrangements for services and operating costs of the One-Stop delivery system. Each partner must contribute a...

Greening the Grid: Advances in Production Cost Modeling for India Renewable Energy Grid Integration Study

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

Cochran, Jaquelin; Palchak, David

The Greening the Grid: Pathways to Integrate 175 Gigawatts of Renewable Energy into India's Electric Grid study uses advanced weather and power system modeling to explore the operational impacts of meeting India's 2022 renewable energy targets and identify actions that may be favorable for integrating high levels of renewable energy into the Indian grid. The study relies primarily on a production cost model that simulates optimal scheduling and dispatch of available generation in a future year (2022) by minimizing total production costs subject to physical, operational, and market constraints. This fact sheet provides a detailed look at each of thesemore » models, including their common assumptions and the insights provided by each.« less

Integrating black liquor gasification with pulping - Process simulation, economics and potential benefits

NASA Astrophysics Data System (ADS)

Lindstrom, Erik Vilhelm Mathias

Gasification of black liquor could drastically increase the flexibility and improve the profit potential of a mature industry. The completed work was focused on research around the economics and benefits of its implementation, utilizing laboratory pulping experiments and process simulation. The separation of sodium and sulfur achieved through gasification of recovered black liquor, can be utilized in processes like modified continuous cooking, split sulfidity and green liquor pretreatment pulping, and polysulfide-anthraquinone pulping, to improve pulp yield and properties. Laboratory pulping protocols have been developed for these modified pulping technologies and different process options evaluated. The process simulation work around BLG has led to the development of a WinGEMS module for the low temperature MTCI steam reforming process, and case studies comparing a simulated conventional kraft process to different process options built around the implementation of a BLG unit operation into the kraft recovery cycle. Pulp yield increases of 1-3% points with improved product quality, and the potential for capital and operating cost savings relative to the conventional kraft process have been demonstrated. Process simulation work has shown that the net variable operating cost for a pulping process using BLGCC is highly dependent on the cost of lime kiln fuel and the selling price of green power to the grid. Under the assumptions taken in the performed case study, the BLGCC process combined with split sulfidity or PSAQ pulping operations had net variable operating cost 2-4% greater than the kraft reference. The influence of the sales price of power to the grid is the most significant cost factor. If a sales price increase to 6 ¢/KWh for green power could be achieved, cost savings of about $40/ODtP could be realized in all investigated BLG processes. Other alternatives to improve the process economics around BLG would be to modify or eliminate the lime kiln unit operations, utilizing high sulfidity green liquor pretreatment, PSAQ with auto-causticization, or converting the process to mini-sulfide sulfite-AQ.

Preoperative predictors of increased hospital costs in elective anterior cervical fusions: a single-institution analysis of 1,082 patients.

PubMed

Minhas, Shobhit V; Chow, Ian; Jenkins, Tyler J; Dhingra, Brian; Patel, Alpesh A

2015-05-01

The frequency of anterior cervical fusion (ACF) surgery and total hospital costs in spine surgery have substantially increased in the last several years. To determine which patient comorbidities are associated with increased total hospital costs after elective one- or two-level ACFs. Retrospective cohort analysis. Individuals who have undergone elective one- or two-level ACFs at our single institution. The total number of patients amounted to 1,082. Total hospital costs during single admission. Multivariate linear regression models were used to analyze independent effects of preoperative patient characteristics on total hospital costs. Univariate analysis was used to examine association of these characteristics on operative time, length of hospital stay (LOS), and complications. Age, obesity, and diabetes were independently associated with increased average hospital costs of $1,404 (95% confidence interval [CI], $857-$1,951; p<.001), $681 (95% CI, $285-$1,076; p=.001), and $1,877 (95% CI, $726-$3,072; p=.001), respectively. Age was associated with increased LOS (p<.001) and complications (p<.001) but not operative time (p=.431). Diabetes was associated with increased LOS (p<.001) and complications (p=.042) but not operative time (p=.234). Obesity was not associated with increased LOS (p=.164), complications (p=.890), or operative time (p=.067). This study highlights the patient comorbidities associated with increased hospital costs after one- or two-level ACFs and the potential drivers of these costs. Copyright © 2015 Elsevier Inc. All rights reserved.

Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study.

PubMed

Luckraz, Heyman; Manga, Na'ngono; Senanayake, Eshan L; Abdelaziz, Mahmoud; Gopal, Shameer; Charman, Susan C; Giri, Ramesh; Oppong, Raymond; Andronis, Lazaros

2018-05-01

Ventilator-associated pneumonia is associated with significant morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416). Patients who were diagnosed as developing ventilator-associated pneumonia, as per the surveillance definition for ventilator-associated pneumonia (n = 338), were propensity score matched with those who did not (n = 338). Costs of treating post-op cardiac surgery patients in intensive care and cost difference if ventilator-associated pneumonia occurred based on Healthcare Resource Group categories were assessed. Secondary outcomes included differences in morbidity, mortality and cardiac intensive care unit and in-hospital length of stay. There were no significant differences in the pre-operative characteristics or procedures between the groups. Ventilator-associated pneumonia developed in 10% of post-cardiac surgery patients. Post-operatively, the ventilator-associated pneumonia group required longer ventilation (p < 0.01), more respiratory support, longer cardiac intensive care unit (8 vs 3, p < 0.001) and in-hospital stay (16 vs 9) days. The overall cost for post-operative recovery after cardiac surgery for ventilator-associated pneumonia patients was £15,124 compared to £6295 for non-ventilator-associated pneumonia (p < 0.01). The additional cost of treating patients with ventilator-associated pneumonia was £8829. Ventilator-associated pneumonia was associated with significant morbidity to the patients, generating significant costs. This cost was nearer to the lower end for the cost for general intensive care unit patients in privately reimbursed systems.

Anaerobic co-digestion of dairy manure and potato waste

NASA Astrophysics Data System (ADS)

Yadanaparthi, Sai Krishna Reddy

Dairy and potato are two important agricultural commodities in Idaho. Both the dairy and potato processing industries produce a huge amount of waste which could cause environmental pollution. To minimize the impact of potential pollution associated with dairy manure (DM) and potato waste (PW), anaerobic co-digestion has been considered as one of the best treatment process. The purpose of this research is to evaluate the anaerobic co-digestion of dairy manure and potato waste in terms of process stability, biogas generation, construction and operating costs, and potential revenue. For this purpose, I conducted 1) a literature review, 2) a lab study on anaerobic co-digestion of dairy manure and potato waste at three different temperature ranges (ambient (20-25°C), mesophilic (35-37°C) and thermophilic (55-57°C) with five mixing ratios (DM:PW-100:0, 90:10, 80:20, 60:40, 40:60), and 3) a financial analysis for anaerobic digesters based on assumed different capital costs and the results from the lab co-digestion study. The literature review indicates that several types of organic waste were co-digested with DM. Dairy manure is a suitable base matter for the co-digestion process in terms of digestion process stability and methane (CH4) production (Chapter 2). The lab tests showed that co-digestion of DM with PW was better than digestion of DM alone in terms of biogas and CH4 productions (Chapter 3). The financial analysis reveals DM and PW can be used as substrate for full size anaerobic digesters to generate positive cash flow within a ten year time period. Based on this research, the following conclusions and recommendations were made: ▸ The ratio of DM:PW-80:20 is recommended at thermophilic temperatures and the ratio of DM:PW-90:10 was recommended at mesophilic temperatures for optimum biogas and CH4 productions. ▸ In cases of anaerobic digesters operated with electricity generation equipment (generators), low cost plug flow digesters (capital cost of 600/cow) operating at thermophilic temperatures are recommended. • The ratio of DM:PW-90:10 or 80:20 is recommended while operating low cost plug flow digesters at thermophilic temperatures. ▸ In cases of anaerobic digesters operated without electricity generation equipment (generators), completely mixed or high or low cost plug flow digesters can be used. • The ratio of DM:PW-80:20 is recommended for completely mixed digesters operated at thermophilic temperatures; • The ratio of DM:PW-90:10 or 80:20 is recommended for high cost plug flow digesters (capital cost of 1,000/cow) operated at thermophilic temperatures; • All of the four co-digested mixing ratios (i.e. DM:PW-90:10 or 80:20 or 60:40 or 40:60) are good for low cost plug flow digesters (capital cost of $600/cow) operated at thermophilic temperatures. The ratio of DM:PW-90:10 is recommended for positive cash flow within the ten year period if the low cost plug flow digesters are operated at mesophilic temperatures.

Trade study: Liquid hydrogen transportation - Kennedy Space Center. [cost and operational effectivenss of shipping methods.

NASA Technical Reports Server (NTRS)

Gray, D. J.

1978-01-01

Cryogenic transportation methods for providing liquid hydrogen requirements are examined in support of shuttle transportation system launch operations at Kennedy Space Center, Florida, during the time frames 1982-1991 in terms of cost and operational effectiveness. Transportation methods considered included sixteen different options employing mobile semi-trailer tankers, railcars, barges and combinations of each method. The study concludes that the most effective method of delivering liquid hydrogen from the vendor production facility in New Orleans to Kennedy Space Center includes maximum utilization of existing mobile tankers and railcars supplemented by maximum capacity mobile tankers procured incrementally in accordance with shuttle launch rates actually achieved.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 4: OEPSS design concepts

NASA Technical Reports Server (NTRS)

Wong, George S.; Ziese, James M.; Farhangi, Shahram

1990-01-01

This study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advanced Launch System (ALS) program, the results of the OEPSS study have been organized into a series of OEPSS Data Books. This volume describes three propulsion concepts that will simplify the propulsion system design and significantly reduce operational requirements. The concepts include: (1) a fully integrated, booster propulsion module concept for the ALS that avoids the complex system created by using autonomous engines with numerous artificial interfaces; (2) an LOX tank aft concept which avoids potentially dangerous geysering in long LOX propellant lines; and (3) an air augmented, rocket engine nozzle afterburning propulsion concept that will significantly reduce LOX propellant requirements, reduce vehicle size and simplify ground operations and ground support equipment and facilities.

The space elevator: a new tool for space studies.

PubMed

Edwards, Bradley C

2003-06-01

The objective has been to develop a viable scenario for the construction, deployment and operation of a space elevator using current or near future technology. This effort has been primarily a paper study with several experimental tests of specific systems. Computer simulations, engineering designs, literature studies and inclusion of existing programs have been utilized to produce a design for the first space elevator. The results from this effort illustrate a viable design using current and near-term technology for the construction of the first space elevator. The timeline for possible construction is within the coming decades and estimated costs are less than $10 B. The initial elevator would have a 5 ton/day capacity and operating costs near $100/lb for payloads going to any Earth orbit or traveling to the Moon, Mars, Venus or the asteroids. An operational space elevator would allow for larger and much longer-term biological space studies at selectable gravity levels. The high-capacity and low operational cost of this system would also allow for inexpensive searches for life throughout our solar system and the first tests of environmental engineering. This work is supported by a grant from the NASA Institute for Advanced Concepts (NIAC).

Direct cost comparison of totally endoscopic versus open ear surgery.

PubMed

Patel, N; Mohammadi, A; Jufas, N

2018-02-01

Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting. A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy. Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

Mining hidden value through strategic real estate plans.

PubMed

Hayes, D

1998-11-01

Healthcare providers can get the most from their real estate investments if they manage them strategically rather than view them as a cost of doing business. Organizations that develop strategic real estate plans can optimize the cost-effectiveness of their assets, reduce operating costs, and create cash through disposition strategies. The cost-effectiveness of assets can be optimized by using off-balance-sheet financing structures, such as outright sale, sale-lease-back arrangements, synthetic leases, and beneficial occupancy agreements. Opportunities for cost reduction can be found by conducting operations, administrative, and maintenance reviews and cost-segregation studies. Cost-reduction efforts also should focus on ensuring space is used in the most productive manner possible and that the organization pays no more than the minimum required property tax. Disposition strategies should begin with inventorying real estate assets to identify surplus assets. Such assets then can be moved off the balance sheet or converted into commercial or public uses.

Conceptual design study of 1985 commercial VTOL transports that utilize rotors

NASA Technical Reports Server (NTRS)

Kefford, N. F. K.; Munch, C. L.

1975-01-01

Conceptual design studies of pure and compound helicopter commercial short-haul transport aircraft for initial fabrication in 1980 were performed to determine their technical and economic feasibility. One-hundred-passenger configurations were optimized for minimum direct operating cost consistent with producibility and marketability, with emphasis on proper account of mass properties, performance and handling qualities adequacy, and suppression of internal and external noise. The effect of external noise constraints was assessed, in terms of gross weight and direct operating cost, for each aircraft.

Robotic longitudinal pancreaticojejunostomy for chronic pancreatitis: Comparison of clinical outcomes and cost to the open approach.

PubMed

Kirks, Russell C; Lorimer, Patrick D; Fruscione, Michael; Cochran, Allyson; Baker, Erin H; Iannitti, David A; Vrochides, Dionisios; Martinie, John B

2017-09-01

This study compares clinical and cost outcomes of robot-assisted laparoscopic (RAL) and open longitudinal pancreaticojejunostomy (LPJ) for chronic pancreatitis. Clinical and cost data were retrospectively compared between open and RAL LPJ performed at a single center from 2008-2015. Twenty-six patients underwent LPJ: 19 open and 7 RAL. Two robot-assisted cases converted to open were included in the open group for analysis. Patients undergoing RAL LPJ had less intraoperative blood loss, a shorter surgical length of stay, and lower medication costs. Operation supply cost was higher in the RAL group. No difference in hospitalization cost was found. Versus the open approach, RAL LPJ performed for chronic pancreatitis shortens hospitalization and reduces medication costs; hospitalization costs are equivalent. A higher operative cost for RAL LPJ is mitigated by a shorter hospitalization. Decreased morbidity and healthcare resource economy support use of the robotic approach for LPJ when appropriate. Copyright © 2017 John Wiley & Sons, Ltd.

Cost-effectiveness of laparoscopy in rectal cancer.

PubMed

Keller, Deborah S; Champagne, Bradley J; Reynolds, Harry L; Stein, Sharon L; Delaney, Conor P

2014-05-01

There is an increasing trend to use laparoscopy for rectal cancer surgery. Although laparoscopic and open rectal resections appear oncologically equivalent, there is little information on the cost of different surgical approaches. With the current health care crisis and the importance of optimizing health care resources and patient outcomes, the cost of care is an important factor. The aim of this study was to evaluate the cost-effectiveness of laparoscopy in rectal cancer. This was a case-matched study. This study was conducted at a tertiary referral center. Patients undergoing elective rectal cancer resection between 2007 and 2012 were selected. A review of a prospective database for elective laparoscopic rectal cancer resections was performed. Laparoscopic cases were matched to open cases based on age, BMI, operative procedure, and diagnostic-related group. The primary outcomes measured were the cost of care, hospital length of stay, discharge disposition, readmission, postoperative complications, and mortality rates. Two hundred fifty-four matched cases were included in the analysis: 125 laparoscopic (49%) and 129 open (51%). The cTNM stage (p = 0.39), tumor distance from the anal verge (p = 0.07), and rate of neoadjuvant therapy received between the laparoscopic and open groups were similar (p = 0.12). Operating time (p< 0.01) and cost per operating room minute (p = 0.04) were significantly higher in the open group. The groups were oncologically equivalent, based on circumferential resection margin (p = 0.15). The laparoscopic group had a significantly shorter length of stay (p < 0.01) and lower total hospital cost (p < 0.01). Postoperative complications, 30-day readmission, reoperation, and mortality rates were similar. However, significantly more patients undergoing open resection required intensive care unit care (p = 0.03), skilled nursing (p = 0.03), or home care services (p < 0.01) at discharge. This investigation was conducted at a single institution and it is a retrospective study with potential bias. Laparoscopy is cost-effective for rectal cancer surgery, improving both health care expenditures and patient outcomes. For selected patients, laparoscopic rectal cancer resection can reduce length of stay, operating time, and resource utilization.

Re-Assessing Green Building Performance: A Post Occupancy Evaluation of 22 GSA Buildings

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

Fowler, Kimberly M.; Rauch, Emily M.; Henderson, Jordan W.

2010-06-01

2nd report on the performance of GSA's sustainably designed buildings. The purpose of this study was to provide an overview of measured whole building performance as it compares to GSA and industry baselines. The PNNL research team found the data analysis illuminated strengths and weaknesses of individual buildings as well as the portfolio of buildings. This section includes summary data, observations that cross multiple performance metrics, discussion of lessons learned from this research, and opportunities for future research. The summary of annual data for each of the performance metrics is provided in Table 25. The data represent 1 year ofmore » measurements and are not associated with any specific design features or strategies. Where available, multiple years of data were examined and there were minimal significant differences between the years. Individually focused post occupancy evaluation (POEs) would allow for more detailed analysis of the buildings. Examining building performance over multiple years could potentially offer a useful diagnostic tool for identifying building operations that are in need of operational changes. Investigating what the connection is between the building performance and the design intent would offer potential design guidance and possible insight into building operation strategies. The 'aggregate operating cost' metric used in this study represents the costs that were available for developing a comparative industry baseline for office buildings. The costs include water utilities, energy utilities, general maintenance, grounds maintenance, waste and recycling, and janitorial costs. Three of the buildings that cost more than the baseline in Figure 45 have higher maintenance costs than the baseline, and one has higher energy costs. Given the volume of data collected and analyzed for this study, the inevitable request is for a simple answer with respect to sustainably designed building performance. As previously stated, compiling the individual building values into single metrics is not statistically valid given the small number of buildings, but it has been done to provide a cursory view of this portfolio of sustainably designed buildings. For all metrics except recycling cost per rentable square foot and CBE survey response rate, the averaged building performance was better than the baseline for the GSA buildings in this study.« less

Special Education Costs and the Impact on Illinois School District Financial Operations. MacArthur/Spencer Series Number 10.

ERIC Educational Resources Information Center

Arnold, Robert; And Others

This study began as a cost study of special education programs in Illinois public education. An attempt was made to determine if the burden of extraordinary, nonreimbursed costs for special education programs was divided equally or unequally among school districts in Illinois. However, two problems with the data source were discovered. Illinois…

75 FR 37883 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... Planning and Cost Allocation by Transmission Owning and Operating Public Utilities; Proposed Rule #0;#0...] Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities Issued June 17... Transmission Services by Public Utilities; Recovery of Stranded Costs by Public Utilities and Transmitting...

Analyzing costs of space debris mitigation methods

NASA Astrophysics Data System (ADS)

Wiedemann, C.; Krag, H.; Bendisch, J.; Sdunnus, H.

The steadily increasing number of space objects poses a considerable hazard to all kinds of spacecraft. To reduce the risks to future space missions different debris mitigation measures and spacecraft protection techniques have been investigated during the last years. However, the economic efficiency has not been considered yet in this context. This economical background is not always clear to satellite operators and the space industry. Current studies have the objective to evaluate the mission costs due to space debris in a business as usual (no mitigation) scenario compared to the missions costs considering debris mitigation. The aim i an estimation of thes time until the investment in debris mitigation will lead to an effective reduction of mission costs. This paper presents the results of investigations on the key problems of cost estimation for spacecraft and the influence of debris mitigation and shielding on cost. The shielding of a satellite can be an effective method to protect the spacecraft against debris impact. Mitigation strategies like the reduction of orbital lifetime and de- or re-orbit of non-operational satellites are methods to control the space debris environment. These methods result in an increase of costs. In a first step the overall costs of different types of unmanned satellites are analyzed. The key problem is, that it is not possible to provide a simple cost model that can be applied to all types of satellites. Unmanned spacecraft differ very much in mission, complexity of design, payload and operational lifetime. It is important to classify relevant cost parameters and investigate their influence on the respective mission. The theory of empirical cost estimation and existing cost models are discussed. A selected cost model is simplified and generalized for an application on all operational satellites. In a next step the influence of space debris on cost is treated, if the implementation of mitigation strategies is considered.

The Launch Systems Operations Cost Model

NASA Technical Reports Server (NTRS)

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

2001-01-01

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

Operating room waste: disposable supply utilization in neurointerventional procedures.

PubMed

Rigante, Luigi; Moudrous, Walid; de Vries, Joost; Grotenhuis, André J; Boogaarts, Hieronymus D

2017-12-01

Operating rooms account for 70% of hospital waste, increasing healthcare costs and creating environmental hazards. Endovascular treatment of cerebrovascular pathologies has become prominent, and associated products highly impact the total cost of care. We investigated the costs of endovascular surgical waste at our institution. Data from 53 consecutive endovascular procedures at the Radboud UMC Nijmegen from May to December 2016 were collected. "Unused disposable supply" was defined as one-time use items opened but not used during the procedure. Two observers cataloged the unused disposable supply for each case. The cost of each item was determined from the center supply catalog, and these costs were summed to determine the total cost of unused supply per case. Thirteen diagnostic cerebral digital subtraction angiographies (DSA) (24.5%) and 40 endovascular procedures (75.5%) were analyzed. Total interventional waste was 27,299.53 € (mean 515.09 € per procedure). While total costs of unused disposable supply were almost irrelevant for DSAs, they were consistent for interventional procedures (mean 676.49 € per case). Aneurysm standard coiling had the highest impact on total interventional waste (mean 1061.55 €). Disposable interventional products had a very high impact on the surgical waste costs in the series of the neurointerventional procedures (95% of total waste). This study shows the impact of neurointerventional waste on the total care costs for cerebrovascular patients. This might reflect the tendency to anticipate needs and emergencies in neurointervention. Responsible use of disposable material can be achieved by educating operators and nurses and creating operator preference cards.

A simplified economic filter for open-pit mining and heap-leach recovery of copper in the United States

USGS Publications Warehouse

Long, Keith R.; Singer, Donald A.

2001-01-01

Determining the economic viability of mineral deposits of various sizes and grades is a critical task in all phases of mineral supply, from land-use management to mine development. This study evaluates two simple tools for estimating the economic viability of porphyry copper deposits mined by open-pit, heap-leach methods when only limited information on these deposits is available. These two methods are useful for evaluating deposits that either (1) are undiscovered deposits predicted by a mineral resource assessment, or (2) have been discovered but for which little data has been collected or released. The first tool uses ordinary least-squared regression analysis of cost and operating data from selected deposits to estimate a predictive relationship between mining rate, itself estimated from deposit size, and capital and operating costs. The second method uses cost models developed by the U.S. Bureau of Mines (Camm, 1991) updated using appropriate cost indices. We find that the cost model method works best for estimating capital costs and the empirical model works best for estimating operating costs for mines to be developed in the United States.

Laparoscopic versus open incisional hernia repair: a retrospective cohort study with costs analysis on 269 patients.

PubMed

Soliani, G; De Troia, A; Portinari, M; Targa, S; Carcoforo, P; Vasquez, G; Fisichella, P M; Feo, C V

2017-08-01

To compare clinical outcomes and institutional costs of elective laparoscopic and open incisional hernia mesh repairs and to identify independent predictors of prolonged operative time and hospital length of stay (LOS). Retrospective observational cohort study on 269 consecutive patients who underwent elective incisional hernia mesh repair, laparoscopic group (N = 94) and open group (N = 175), between May 2004 and July 2014. Operative time was shorter in the laparoscopic versus open group (p < 0.0001). Perioperative morbidity and mortality were similar in the two groups. Patients in the laparoscopic group were discharged a median of 2 days earlier (p < 0.0001). At a median follow-up over 50 months, no difference in hernia recurrence was detected between the groups. In laparoscopic group total institutional costs were lower (p = 0.02). At Cox regression analysis adjusted for potential confounders, large wall defect (W3) and higher operative risk (ASA score 3-4) were associated with prolonged operative time, while midline hernia site was associated with increased hospital LOS. Open surgical approach was associated with prolongation of both operative time and LOS. Laparoscopic approach may be considered safely to all patients for incisional hernia repair, regardless of patients' characteristics (age, gender, BMI, ASA score, comorbidities) and size of the wall defect (W2-3), with the advantage of shorter operating time and hospital LOS that yields reduced total institutional costs. Patients with higher ASA score and large hernia defects are at risk of prolonged operative time, while an open approach is associated with longer duration of surgical operation and hospital LOS.

Robotics in general surgery: A systematic cost assessment

PubMed Central

Gkegkes, Ioannis D.; Mamais, Ioannis A.; Iavazzo, Christos

2017-01-01

The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from 2539 to 57,002, 7888 to 16,851 and 1799 to 50,408 Euros, respectively. The mean operative charges ranged from 273.74 to 13,670 Euros. More specifically, for the robotic and laparoscopic gastric fundoplication, the cost ranged from 1534 to 2257 and 657 to 763 Euros, respectively. For the robotic and laparoscopic colectomy, it ranged from 3739 to 17,080 and 3109 to 33,865 Euros, respectively. For the robotic and laparoscopic cholecystectomy, ranged from 1163.75 to 1291 and from 273.74 to 1223 Euros, respectively. The mean non-operative costs ranged from 900 to 48,796 from 8347 to 8800 and from 870 to 42,055 Euros, for robotic, open and laparoscopic technique, respectively. Conversions to laparotomy were present in 34/18,620 (0.18%) cases of laparoscopic and in 22/1488 (1.5%) cases of robotic technique. Duration of surgery robotic, open and laparoscopic ranged from 54.6 to 328.7, 129 to 234, and from 50.2 to 260 min, respectively. The present evidence reveals that robotic surgery, under specific conditions, has the potential to become cost-effective. Large number of cases, presence of industry competition and multidisciplinary team utilisation are some of the factors that could make more reasonable and cost-effective the robotic-assisted technique. PMID:28000648

Robotics in general surgery: A systematic cost assessment.

PubMed

Gkegkes, Ioannis D; Mamais, Ioannis A; Iavazzo, Christos

2017-01-01

The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from 2539 to 57,002, 7888 to 16,851 and 1799 to 50,408 Euros, respectively. The mean operative charges ranged from 273.74 to 13,670 Euros. More specifically, for the robotic and laparoscopic gastric fundoplication, the cost ranged from 1534 to 2257 and 657 to 763 Euros, respectively. For the robotic and laparoscopic colectomy, it ranged from 3739 to 17,080 and 3109 to 33,865 Euros, respectively. For the robotic and laparoscopic cholecystectomy, ranged from 1163.75 to 1291 and from 273.74 to 1223 Euros, respectively. The mean non-operative costs ranged from 900 to 48,796 from 8347 to 8800 and from 870 to 42,055 Euros, for robotic, open and laparoscopic technique, respectively. Conversions to laparotomy were present in 34/18,620 (0.18%) cases of laparoscopic and in 22/1488 (1.5%) cases of robotic technique. Duration of surgery robotic, open and laparoscopic ranged from 54.6 to 328.7, 129 to 234, and from 50.2 to 260 min, respectively. The present evidence reveals that robotic surgery, under specific conditions, has the potential to become cost-effective. Large number of cases, presence of industry competition and multidisciplinary team utilisation are some of the factors that could make more reasonable and cost-effective the robotic-assisted technique.

Implementation of Hospital Computerized Physician Order Entry Systems in a Rural State: Feasibility and Financial Impact

PubMed Central

Ohsfeldt, Robert L.; Ward, Marcia M.; Schneider, John E.; Jaana, Mirou; Miller, Thomas R.; Lei, Yang; Wakefield, Douglas S.

2005-01-01

Objective The aim of this study was to estimate the costs of implementing computerized physician order entry (CPOE) systems in hospitals in a rural state and to evaluate the financial implications of statewide CPOE implementation. Methods A simulation model was constructed using estimates of initial and ongoing CPOE costs mapped onto all general hospitals in Iowa by bed quantity and current clinical information system (CIS) status. CPOE cost estimates were obtained from a leading CPOE vendor. Current CIS status was determined through mail survey of Iowa hospitals. Patient care revenue and operating cost data published by the Iowa Hospital Association were used to simulate the financial impact of CPOE adoption on hospitals. Results CPOE implementation would dramatically increase operating costs for rural and critical access hospitals in the absence of substantial costs savings associated with improved efficiency or improved patient safety. For urban and rural referral hospitals, the cost impact is less dramatic but still substantial. However, relatively modest benefits in the form of patient care cost savings or revenue enhancement would be sufficient to offset CPOE costs for these larger hospitals. Conclusion Implementation of CPOE in rural or critical access hospitals may depend on net increase in operating costs. Adoption of CPOE may be financially infeasible for these small hospitals in the absence of increases in hospital payments or ongoing subsidies from third parties. PMID:15492033

Cost Experience of Automated Guideway Transit Systems. (Supplement V) Costs and Trends for the Period 1976-1982.

DOT National Transportation Integrated Search

1984-04-01

This report summarizes the cost experiences and trends of sixteen domestic AGT systems. Capital costs, operation and maintenance costs, system characteristics, operational statistics, and unit cost measures are presented to provide useful information...

Scale Matters: A Cost-Outcome Analysis of an m-Health Intervention in Malawi.

PubMed

Larsen-Cooper, Erin; Bancroft, Emily; Rajagopal, Sharanya; O'Toole, Maggie; Levin, Ann

2016-04-01

The primary objectives of this study are to determine cost per user and cost per contact with users of a mobile health (m-health) intervention. The secondary objectives are to map costs to changes in maternal, newborn, and child health (MNCH) and to estimate costs of alternate implementation and usage scenarios. A base cost model, constructed from recurrent costs and selected capital costs, was used to estimate average cost per user and per contact of an m-health intervention. This model was mapped to statistically significant changes in MNCH intermediate outcomes to determine the cost of improvements in MNCH indicators. Sensitivity analyses were conducted to estimate costs in alternate scenarios. The m-health intervention cost $29.33 per user and $4.33 per successful contact. The average cost for each user experiencing a change in an MNCH indicator ranged from $67 to $355. The sensitivity analyses showed that cost per user could be reduced by 48% if the service were to operate at full capacity. We believe that the intervention, operating at scale, has potential to be a cost-effective method for improving maternal and child health indicators.

Scale Matters: A Cost-Outcome Analysis of an m-Health Intervention in Malawi

PubMed Central

Bancroft, Emily; Rajagopal, Sharanya; O'Toole, Maggie; Levin, Ann

2016-01-01

Abstract Background: The primary objectives of this study are to determine cost per user and cost per contact with users of a mobile health (m-health) intervention. The secondary objectives are to map costs to changes in maternal, newborn, and child health (MNCH) and to estimate costs of alternate implementation and usage scenarios. Materials and Methods: A base cost model, constructed from recurrent costs and selected capital costs, was used to estimate average cost per user and per contact of an m-health intervention. This model was mapped to statistically significant changes in MNCH intermediate outcomes to determine the cost of improvements in MNCH indicators. Sensitivity analyses were conducted to estimate costs in alternate scenarios. Results: The m-health intervention cost $29.33 per user and $4.33 per successful contact. The average cost for each user experiencing a change in an MNCH indicator ranged from $67 to $355. The sensitivity analyses showed that cost per user could be reduced by 48% if the service were to operate at full capacity. Conclusions: We believe that the intervention, operating at scale, has potential to be a cost-effective method for improving maternal and child health indicators. PMID:26348994

Cost of post-operative intravenous iron therapy in total lower limb arthroplasty: a retrospective, matched cohort study

PubMed Central

Muñoz, Manuel; Gómez-Ramírez, Susana; Martín-Montañez, Elisa; Naveira, Enrique; Seara, Javier; Pavía, José

2014-01-01

Background Requirements for allogeneic red cell transfusion after total lower limb arthroplasty are still high (20–50%), and post-operative intravenous iron has been shown to reduce transfusion requirements for this surgery. We performed a cost analysis to ascertain whether this alternative is also likely to be cost-effective. Materials and methods Data from 182 matched-pairs of total lower limb arthroplasty patients, managed with a restrictive transfusion protocol and without (control group) or with post-operative intravenous iron (iron group), were retrospectively reviewed. Acquisition and administration costs of iron (iron sucrose or ferric carboxymaltose) and allogeneic red cell concentrates, haemoglobin measurements, and prolonged stay in hospital were used for blood management cost analysis. Results Patients in the iron group received 600 mg intravenous iron, without clinically relevant incidents, and had a lower allogeneic transfusion rate (11.5% vs 26.4% for the iron and control groups, respectively; p=0.001). The reduction in transfusion rate was more pronounced in anaemic patients (17% vs 40%; p=0.015) than in non-anaemic ones (9.6% vs 21.2%; p=0.011). There were no differences with respect to post-operative infection rate. Patients receiving allogeneic transfusion stayed in hospital longer (+1.9 days [95% CI: 1.2–2.6]). As intravenous iron reduces the allogeneic transfusion rate, both iron formulations were cost-neutral in the different cost scenarios (−25.5 to 62.1 €/patient for iron sucrose, and −51.1 to 64.4 €/patient for ferric carboxymaltose). Discussion In patients presenting with or without pre-operative anaemia, post-operative intravenous iron after total lower limb arthroplasty seems to be safe and is associated with reduced transfusion rates, without incremental costs. For anaemic patients, its efficacy could be increased by associating some other blood-saving method. PMID:24120595

Water Distribution System Operation and Maintenance. A Field Study Training Program. Second Edition.

ERIC Educational Resources Information Center

Kerri, Kenneth D.; And Others

Proper installation, inspection, operation, maintenance, repair and management of water distribution systems have a significant impact on the operation and maintenance cost and effectiveness of the systems. The objective of this manual is to provide water distribution system operators with the knowledge and skills required to operate and maintain…

Use of National Burden to Define Operative Emergency General Surgery.

PubMed

Scott, John W; Olufajo, Olubode A; Brat, Gabriel A; Rose, John A; Zogg, Cheryl K; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2016-06-15

Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. To define a set of procedures accounting for at least 80% of the national burden of operative EGS. A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample. Adults (age, ≥18 years) with primary EGS diagnoses consistent with the American Association for the Surgery of Trauma definition, admitted urgently or emergently, who underwent an operative procedure within 2 days of admission were included in the analyses. Procedures were ranked to account for national mortality and complication burden. Among ranked procedures, contributions to total EGS frequency, mortality, and hospital costs were assessed. The data query and analysis were performed between November 15, 2015, and February 16, 2016. Overall procedure frequency, in-hospital mortality, major complications, and inpatient costs calculated per 3-digit International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. The study identified 421 476 patient encounters associated with operative EGS, weighted to represent 2.1 million nationally over the 4-year study period. The overall mortality rate was 1.23% (95% CI, 1.18%-1.28%), the complication rate was 15.0% (95% CI, 14.6%-15.3%), and mean cost per admission was $13 241 (95% CI, $12 957-$13 525). After ranking the 35 procedure groups by contribution to EGS mortality and morbidity burden, a final set of 7 operative EGS procedures were identified, which collectively accounted for 80.0% of procedures, 80.3% of deaths, 78.9% of complications, and 80.2% of inpatient costs nationwide. These 7 procedures included partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. Only 7 procedures account for most admissions, deaths, complications, and inpatient costs attributable to the 512 079 EGS procedures performed in the United States each year. National quality benchmarks and cost reduction efforts should focus on these common, complicated, and costly EGS procedures.

Clinical governance and operations management methodologies.

PubMed

Davies, C; Walley, P

2000-01-01

The clinical governance mechanism, introduced since 1998 in the UK National Health Service (NHS), aims to deliver high quality care with efficient, effective and cost-effective patient services. Scally and Donaldson recognised that new approaches are needed, and operations management techniques comprise potentially powerful methodologies in understanding the process of care, which can be applied both within and across professional boundaries. This paper summarises four studies in hospital Trusts which took approaches to improving process that were different from and less structured than business process re-engineering (BPR). The problems were then amenable to change at a relatively low cost and short timescale, producing significant improvement to patient care. This less structured approach to operations management avoided incurring overhead costs of large scale and costly change such as new information technology (IT) systems. The most successful changes were brought about by formal tools to control quantity, content and timing of changes.

A Field Investigation and Facility Review of Eight Modular Starved-Air Heat Recovery Incinerator Systems.

DTIC Science & Technology

1984-10-01

are shared with the production facility. I Capital Costs: $260,000 (1976) plus $45,000 for the building. Operating and Maintenance Costs: O&M costs are...agricultural product processing plant. Operation: Three shifts, 5.5 days/week, 52 weeks/year. Capital Costs: Total capital cost S1,400,000 (1981...which makes their operating and maintenance costs, waste tonnages, ; and steam production readily available. Sample Data (All Numbers Rounded) 1st

Experiences of operational costs of HPV vaccine delivery strategies in Gavi-supported demonstration projects

PubMed Central

Holroyd, Taylor; Nanda, Shreya; Bloem, Paul; Griffiths, Ulla K.; Sidibe, Anissa; Hutubessy, Raymond C. W.

2017-01-01

From 2012 to 2016, Gavi, the Vaccine Alliance, provided support for countries to conduct small-scale demonstration projects for the introduction of the human papillomavirus vaccine, with the aim of determining which human papillomavirus vaccine delivery strategies might be effective and sustainable upon national scale-up. This study reports on the operational costs and cost determinants of different vaccination delivery strategies within these projects across twelve countries using a standardized micro-costing tool. The World Health Organization Cervical Cancer Prevention and Control Costing Tool was used to collect costing data, which were then aggregated and analyzed to assess the costs and cost determinants of vaccination. Across the one-year demonstration projects, the average economic and financial costs per dose amounted to US$19.98 (standard deviation ±12.5) and US$8.74 (standard deviation ±5.8), respectively. The greatest activities representing the greatest share of financial costs were social mobilization at approximately 30% (range, 6–67%) and service delivery at about 25% (range, 3–46%). Districts implemented varying combinations of school-based, facility-based, or outreach delivery strategies and experienced wide variation in vaccine coverage, drop-out rates, and service delivery costs, including transportation costs and per diems. Size of target population, number of students per school, and average length of time to reach an outreach post influenced cost per dose. Although the operational costs from demonstration projects are much higher than those of other routine vaccine immunization programs, findings from our analysis suggest that HPV vaccination operational costs will decrease substantially for national introduction. Vaccination costs may be decreased further by annual vaccination, high initial investment in social mobilization, or introducing/strengthening school health programs. Our analysis shows that drivers of cost are dependent on country and district characteristics. We therefore recommend that countries carry out detailed planning at the national and district levels to define a sustainable strategy for national HPV vaccine roll-out, in order to achieve the optimal balance between coverage and cost. PMID:29016596

Cost analysis of the surgical treatment of fractures of the proximal humerus: an evaluation of the determinants of cost and comparison of the institutional cost of treatment with the national tariff.

PubMed

Sabharwal, S; Carter, A W; Rashid, A; Darzi, A; Reilly, P; Gupte, C M

2016-02-01

The aims of this study were to estimate the cost of surgical treatment of fractures of the proximal humerus using a micro-costing methodology, contrast this cost with the national reimbursement tariff and establish the major determinants of cost. A detailed inpatient treatment pathway was constructed using semi-structured interviews with 32 members of hospital staff. Its content validity was established through a Delphi panel evaluation. Costs were calculated using time-driven activity-based costing (TDABC) and sensitivity analysis was performed to evaluate the determinants of cost The mean cost of the different surgical treatments was estimated to be £3282. Although this represented a profit of £1138 against the national tariff, hemiarthroplasty as a treatment choice resulted in a net loss of £952. Choice of implant and theatre staffing were the largest cost drivers. Operating theatre delays of more than one hour resulted in a loss of income Our findings indicate that the national tariff does not accurately represent the cost of treatment for this condition. Effective use of the operating theatre and implant discounting are likely to be more effective cost containment approaches than control of bed-day costs. This cost analysis of fractures of the proximal humerus reinforces the limitations of the national tariff within the English National Health Service, and underlines the importance of effective use of the operating theatre, as well as appropriate implant procurement where controlling costs of treatment is concerned. ©2016 The British Editorial Society of Bone & Joint Surgery.

Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating.

PubMed

Francis, Tittu; Washington, Travis; Srivastava, Karan; Moutzouros, Vasilios; Makhni, Eric C; Hakeos, William

2017-11-01

Tension band wiring (TBW) and locked plating are common treatment options for Mayo IIA olecranon fractures. Clinical trials have shown excellent functional outcomes with both techniques. Although TBW implants are significantly less expensive than a locked olecranon plate, TBW often requires an additional operation for implant removal. To choose the most cost-effective treatment strategy, surgeons must understand how implant costs and return to the operating room influence the most cost-effective strategy. This cost-effective analysis study explored the optimal treatment strategies by using decision analysis tools. An expected-value decision tree was constructed to estimate costs based on the 2 implant choices. Values for critical variables, such as implant removal rate, were obtained from the literature. A Monte Carlo simulation consisting of 100,000 trials was used to incorporate variability in medical costs and implant removal rates. Sensitivity analysis and strategy tables were used to show how different variables influence the most cost-effective strategy. TBW was the most cost-effective strategy, with a cost savings of approximately $1300. TBW was also the dominant strategy by being the most cost-effective solution in 63% of the Monte Carlo trials. Sensitivity analysis identified implant costs for plate fixation and surgical costs for implant removal as the most sensitive parameters influencing the cost-effective strategy. Strategy tables showed the most cost-effective solution as 2 parameters vary simultaneously. TBW is the most cost-effective strategy in treating Mayo IIA olecranon fractures despite a higher rate of return to the operating room. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Autonomy versus Affirmative Action: What Price Social Justice?

ERIC Educational Resources Information Center

Cavalier, Anne; Slaughter, Sheila

1982-01-01

A study measured costs of an affirmative action/equal employment opportunity program at one institution through cost analysis of personnel, operating expenses, and capital replacement value. Costs incurred in one budget cycle were 0.4 percent of the total institutional budget, most spent indirectly through faculty time, and were found…

Audio Teleconferencing: Low Cost Technology for External Studies Networking.

ERIC Educational Resources Information Center

Robertson, Bill

1987-01-01

This discussion of the benefits of audio teleconferencing for distance education programs and for business and government applications focuses on the recent experience of Canadian educational users. Four successful operating models and their costs are reviewed, and it is concluded that audio teleconferencing is cost efficient and educationally…

Library Labor Cost Accounting System.

ERIC Educational Resources Information Center

Du Bois, Dan

The Library Labor Cost Accounting System will provide visibility on current costs of manually processing library materials, at each campus as well as system-wide. The scope of the study includes the following: (1) 100 individual activities, grouped into 14 functional areas, e.g., Ordering, Receiving; and into 3 major operations: Acquisitions,…

The Cost of Deploying a Role 2 Medical Asset to Afghanistan.

PubMed

Childers, Richard; Parker, Paul

2015-11-01

The costs of military assets, including medical resources, are necessary for military planners when determining their force make up. The monetary cost of operating a Role 3 unit, the most comprehensive medical asset in the combat theater, has been determined. The cost of operating a Role 2 (R2) facility-the less comprehensive but more common asset-has not been assessed. Here we estimate the cost of operating an R2 medical asset in Afghanistan. Personnel costs were assessed by combining the U.S. Department of Defense estimate for personnel cost with the replacement costs for deployed staff. Manning was for a U.S. Marine Corps Shock Trauma Platoon and Forward Resuscitative Surgical System. It costs $2,956,873 a month to operate an R2 medical facility in Afghanistan. It also takes the place of a rifle platoon and disrupts the domestic military health care mission. The costs of operating an R2 medical facility are significant and should be considered when the medical benefits of an R2 are unclear. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Operations Analysis of the 2nd Generation Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

Noneman, Steven R.; Smith, C. A. (Technical Monitor)

2002-01-01

The Space Launch Initiative (SLI) program is developing a second-generation reusable launch vehicle. The program goals include lowering the risk of loss of crew to 1 in 10,000 and reducing annual operations cost to one third of the cost of the Space Shuttle. The SLI missions include NASA, military and commercial satellite launches and crew and cargo launches to the space station. The SLI operations analyses provide an assessment of the operational support and infrastructure needed to operate candidate system architectures. Measures of the operability are estimated (i.e. system dependability, responsiveness, and efficiency). Operations analysis is used to determine the impact of specific technologies on operations. A conceptual path to reducing annual operations costs by two thirds is based on key design characteristics, such as reusability, and improved processes lowering labor costs. New operations risks can be expected to emerge. They can be mitigated with effective risk management with careful identification, assignment, tracking, and closure. SLI design characteristics such as nearly full reusability, high reliability, advanced automation, and lowered maintenance and servicing coupled with improved processes are contributors to operability and large operating cost reductions.

Rail Transit System Cost Study

DOT National Transportation Integrated Search

1977-01-01

The Transportation Systems Center serves as Systems Manager for the Rail Supporting Technology Program of the Urban Mass Transportation Administration. One task under this program has been to assess the cost of constructing, operating and maintaining...

Unit Cost of Medical Services at Different Hospitals in India

PubMed Central

Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

2013-01-01

Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates under government-sponsored insurance schemes. PMID:23936088

The 1988 Inland Waterway Review

DTIC Science & Technology

1988-11-01

Maintenance Costs ............. 91 Table 4.3 Major Rehabilitation Projects: ............................... 92 Table 4.4 Scheduled Constructed Projects in the...Maintenance Costs .......................... 100 Figure 4.7 Operations and Maintenance Costs Per Ton Mile in 1986 For Inland Waterways Suspect to Fuel Tax...application of study and construction cost -sharing. It also increased waterway fuel taxes and created the Inland Waterways Users Board. In effect, the Act

Analyzing the cost of screening selectee and non-selectee baggage.

PubMed

Virta, Julie L; Jacobson, Sheldon H; Kobza, John E

2003-10-01

Determining how to effectively operate security devices is as important to overall system performance as developing more sensitive security devices. In light of recent federal mandates for 100% screening of all checked baggage, this research studies the trade-offs between screening only selectee checked baggage and screening both selectee and non-selectee checked baggage for a single baggage screening security device deployed at an airport. This trade-off is represented using a cost model that incorporates the cost of the baggage screening security device, the volume of checked baggage processed through the device, and the outcomes that occur when the device is used. The cost model captures the cost of deploying, maintaining, and operating a single baggage screening security device over a one-year period. The study concludes that as excess baggage screening capacity is used to screen non-selectee checked bags, the expected annual cost increases, the expected annual cost per checked bag screened decreases, and the expected annual cost per expected number of threats detected in the checked bags screened increases. These results indicate that the marginal increase in security per dollar spent is significantly lower when non-selectee checked bags are screened than when only selectee checked bags are screened.

[Microeconomics of introduction of a PET system based on the revised Japanese National Insurance reimbursement system].

PubMed

Abe, Katsumi; Kosuda, Shigeru; Kusano, Shoichi; Nagata, Masayoshi

2003-11-01

It is crucial to evaluate an annual balance before-hand when an institution installs a PET system because the revised Japanese national insurance reimbursement system set the cost of a FDG PET study as 75,000 yen. A break-even point was calculated in an 8-hour or a 24-hour operation of a PET system, based on the total costs reported. The break-even points were as follows: 13.4, 17.7, 22.1 studies per day for the 1 cyclotron-1 PET camera, 1 cyclotron-2 PET cameras, 1 cyclotron-3 PET cameras system, respectively, in an ordinary PET system operation of 8 hours. The break-even points were 19.9, 25.5, 31.2 studies per day for the 1 cyclotron-1 PET camera, 1 cyclotron-2 PET cameras, 1 cyclotron-3 PET cameras system, respectively, in a full PET system operation of 24 hours. The results indicate no profit would accrue in an ordinary PET system operation of 8 hours. The annual profit and break-even point for the total cost including the initial investment would be respectively 530 million yen and 2.8 years in a 24-hour operation with 1 cyclotron-3 PET cameras system.

Data analytics and optimization of an ice-based energy storage system for commercial buildings

DOE PAGES

Luo, Na; Hong, Tianzhen; Li, Hui; ...

2017-07-25

Ice-based thermal energy storage (TES) systems can shift peak cooling demand and reduce operational energy costs (with time-of-use rates) in commercial buildings. The accurate prediction of the cooling load, and the optimal control strategy for managing the charging and discharging of a TES system, are two critical elements to improving system performance and achieving energy cost savings. This study utilizes data-driven analytics and modeling to holistically understand the operation of an ice–based TES system in a shopping mall, calculating the system’s performance using actual measured data from installed meters and sensors. Results show that there is significant savings potential whenmore » the current operating strategy is improved by appropriately scheduling the operation of each piece of equipment of the TES system, as well as by determining the amount of charging and discharging for each day. A novel optimal control strategy, determined by an optimization algorithm of Sequential Quadratic Programming, was developed to minimize the TES system’s operating costs. Three heuristic strategies were also investigated for comparison with our proposed strategy, and the results demonstrate the superiority of our method to the heuristic strategies in terms of total energy cost savings. Specifically, the optimal strategy yields energy costs of up to 11.3% per day and 9.3% per month compared with current operational strategies. A one-day-ahead hourly load prediction was also developed using machine learning algorithms, which facilitates the adoption of the developed data analytics and optimization of the control strategy in a real TES system operation.« less

Data analytics and optimization of an ice-based energy storage system for commercial buildings

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

Luo, Na; Hong, Tianzhen; Li, Hui

Ice-based thermal energy storage (TES) systems can shift peak cooling demand and reduce operational energy costs (with time-of-use rates) in commercial buildings. The accurate prediction of the cooling load, and the optimal control strategy for managing the charging and discharging of a TES system, are two critical elements to improving system performance and achieving energy cost savings. This study utilizes data-driven analytics and modeling to holistically understand the operation of an ice–based TES system in a shopping mall, calculating the system’s performance using actual measured data from installed meters and sensors. Results show that there is significant savings potential whenmore » the current operating strategy is improved by appropriately scheduling the operation of each piece of equipment of the TES system, as well as by determining the amount of charging and discharging for each day. A novel optimal control strategy, determined by an optimization algorithm of Sequential Quadratic Programming, was developed to minimize the TES system’s operating costs. Three heuristic strategies were also investigated for comparison with our proposed strategy, and the results demonstrate the superiority of our method to the heuristic strategies in terms of total energy cost savings. Specifically, the optimal strategy yields energy costs of up to 11.3% per day and 9.3% per month compared with current operational strategies. A one-day-ahead hourly load prediction was also developed using machine learning algorithms, which facilitates the adoption of the developed data analytics and optimization of the control strategy in a real TES system operation.« less

Applying activity-based costing to the nuclear medicine unit.

PubMed

Suthummanon, Sakesun; Omachonu, Vincent K; Akcin, Mehmet

2005-08-01

Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. The finding indicates that the current cost averages 236.11 US dollars for all procedures, which is quite different from the costs computed by using ABC. The difference is most significant with positron emission tomography scan, 463 US dollars (an increase of 96%), as well as bone scan and thyroid scan, 114 US dollars (a decrease of 52%). The result of ABC analysis demonstrates that the operational time (machine time and direct labour time) and the cost of drugs have the most influence on cost per procedure. Clearly, to reduce the cost per procedure for the NMU, the reduction in operational time and cost of drugs should be analysed. The result also indicates that ABC can be used to improve resource allocation and management. It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better.

The cost of trauma operating theatre inefficiency

PubMed Central

Ang, W.W.; Sabharwal, S.; Johannsson, H.; Bhattacharya, R.; Gupte, C.M.

2016-01-01

The National Health Service (NHS) is currently facing a financial crisis with a projected deficit of £2billion by the end of financial year 2015/16. As operating rooms (OR) are one of the costliest components in secondary care, improving theatre efficiency should be at the forefront of efforts to improve health service efficiency. The objectives of this study were to characterize the causes of trauma OR delays and to estimate the cost of this inefficiency. A 1-month prospective single-centre study in St. Mary's Hospital. Turnaround time (TT) was used as the surrogate parameter to measure theatre efficiency. Factors including patient age, ASA score and presence of surgical and anaesthetic consultant were evaluated to identify positive or negative associations with theatre delays. Inefficiency cost was calculated by multiplying the time wasted with staff capacity costs and opportunity costs, found to be £24.77/minute. The commonest causes for increased TT were delays in sending for patients (50%) and problems with patient transport to the OR (31%). 461 min of delay was observed in 12 days, equivalent to loss of £951.58/theatre/day. Non-statistically significant trends were seen between length of delays and advancing patient age, ASA score and absence of either a senior clinician or an anaesthetic consultant. Interestingly, the trend was not as strong for absence of an anaesthetic consultant. This study found delays in operating TT to represent a sizable cost, with potential efficiency savings based on TT of £347,327/theatre/year. Further study of a larger sample is warranted to better evaluate the identified trends. PMID:27047660

The cost of trauma operating theatre inefficiency.

PubMed

Ang, W W; Sabharwal, S; Johannsson, H; Bhattacharya, R; Gupte, C M

2016-05-01

The National Health Service (NHS) is currently facing a financial crisis with a projected deficit of £2billion by the end of financial year 2015/16. As operating rooms (OR) are one of the costliest components in secondary care, improving theatre efficiency should be at the forefront of efforts to improve health service efficiency. The objectives of this study were to characterize the causes of trauma OR delays and to estimate the cost of this inefficiency. A 1-month prospective single-centre study in St. Mary's Hospital. Turnaround time (TT) was used as the surrogate parameter to measure theatre efficiency. Factors including patient age, ASA score and presence of surgical and anaesthetic consultant were evaluated to identify positive or negative associations with theatre delays. Inefficiency cost was calculated by multiplying the time wasted with staff capacity costs and opportunity costs, found to be £24.77/minute. The commonest causes for increased TT were delays in sending for patients (50%) and problems with patient transport to the OR (31%). 461 min of delay was observed in 12 days, equivalent to loss of £951.58/theatre/day. Non-statistically significant trends were seen between length of delays and advancing patient age, ASA score and absence of either a senior clinician or an anaesthetic consultant. Interestingly, the trend was not as strong for absence of an anaesthetic consultant. This study found delays in operating TT to represent a sizable cost, with potential efficiency savings based on TT of £347,327/theatre/year. Further study of a larger sample is warranted to better evaluate the identified trends.

75 FR 7411 - Schedule of Water Charges

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

... sale revenues, while the costs of reservoir maintenance and operations, contractual services and..., ``including debt service, operation, maintenance, replacement, reserves, and associated administrative costs... holds funds dedicated to pay the costs of project construction, operation, maintenance, and replacement...

PREMChlor: Probabilistic Remediation Evaluation Model for Chlorinated Solvents

DTIC Science & Technology

2010-03-01

Council O&M Operation & Management PAT pump-and-treat PCE tetrachloroethylene PDFs Probability density functions PRBs Permeable reactive barriers...includes a one-time capital cost and a total operation & management (O&M) cost in present net value (NPV) for a certain remediation period. The...Generally, the costs of plume treatment include the capital cost (treatment volume multiply by the unit cost) and the annual operation & Management (O&M

Economic analysis of electronic waste recycling: modeling the cost and revenue of a materials recovery facility in California.

PubMed

Kang, Hai-Yong; Schoenung, Julie M

2006-03-01

The objectives of this study are to identify the various techniques used for treating electronic waste (e-waste) at material recovery facilities (MRFs) in the state of California and to investigate the costs and revenue drivers for these techniques. The economics of a representative e-waste MRF are evaluated by using technical cost modeling (TCM). MRFs are a critical element in the infrastructure being developed within the e-waste recycling industry. At an MRF, collected e-waste can become marketable output products including resalable systems/components and recyclable materials such as plastics, metals, and glass. TCM has two main constituents, inputs and outputs. Inputs are process-related and economic variables, which are directly specified in each model. Inputs can be divided into two parts: inputs for cost estimation and for revenue estimation. Outputs are the results of modeling and consist of costs and revenues, distributed by unit operation, cost element, and revenue source. The results of the present analysis indicate that the largest cost driver for the operation of the defined California e-waste MRF is the materials cost (37% of total cost), which includes the cost to outsource the recycling of the cathode ray tubes (CRTs) (dollar 0.33/kg); the second largest cost driver is labor cost (28% of total cost without accounting for overhead). The other cost drivers are transportation, building, and equipment costs. The most costly unit operation is cathode ray tube glass recycling, and the next are sorting, collecting, and dismantling. The largest revenue source is the fee charged to the customer; metal recovery is the second largest revenue source.

A Collection of JPME Operational Contract Support Case Studies and Vignettes

DTIC Science & Technology

2016-12-01

Contracting for goods and services in the contingency operational environment is a mission-enabling necessity; however, analyzing the strategic effects...choosing to contract for goods or services are largely ignored. This project explores the use of OCS in contingency environments, and the positive and...think of the costs literally, as tax dollars spent to enhance mission effectiveness. However, the less literal costs and the associated effects of

Efficiency assessment of wastewater treatment plants: A data envelopment analysis approach integrating technical, economic, and environmental issues.

PubMed

Castellet, Lledó; Molinos-Senante, María

2016-02-01

The assessment of the efficiency of wastewater treatment plants (WWTPs) is essential to compare their performance and consequently to identify the best operational practices that can contribute to the reduction of operational costs. Previous studies have evaluated the efficiency of WWTPs using conventional data envelopment analysis (DEA) models. Most of these studies have considered the operational costs of the WWTPs as inputs, while the pollutants removed from wastewater are treated as outputs. However, they have ignored the fact that each pollutant removed by a WWTP involves a different environmental impact. To overcome this limitation, this paper evaluates for the first time the efficiency of a sample of WWTPs by applying the weighted slacks-based measure model. It is a non-radial DEA model which allows assigning weights to the inputs and outputs according their importance. Thus, the assessment carried out integrates environmental issues with the traditional "techno-economic" efficiency assessment of WWTPs. Moreover, the potential economic savings for each cost item have been quantified at a plant level. It is illustrated that the WWTPs analyzed have significant room to save staff and energy costs. Several managerial implications to help WWTPs' operators make informed decisions were drawn from the methodology and empirical application carried out. Copyright © 2015 Elsevier Ltd. All rights reserved.

In-office vs. operating room procedures for recurrent respiratory papillomatosis.

PubMed

Miller, Anya J; Gardner, Glendon M

2017-01-01

We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13.5, and the mean interval between procedures was 14.3 months. An equal number of patients reported complications or adverse events with the two types of procedures-5 each. The difference in cost between the office procedure (mean: $3,413.00) and the operating room procedure (mean: $12,382.59) was almost $9,000, but these savings were offset by the fact that the office procedures needed to be performed three times as often. Patients reported slightly more anxiety and discomfort during the office procedures and, overall, they appeared to prefer the operating room procedure. We conclude that office procedures are significantly more cost-effective than operating room procedures, but their use may be limited by patient tolerance and the increased frequency of the procedure.

A market, operation, and mission assessment of large rural for-profit hospitals with positive cash flow.

PubMed

McCue, Michael J

2007-01-01

National benchmark data for 2002 indicate that large rural for-profit hospitals have a median cash flow margin of 19.5% compared to 9.2% for their nonprofit counterparts. This study aims to gain insight regarding the driving factors behind the high cash flow performance of large rural for-profit hospitals. Using 3 annual periods of Centers for Medicare and Medicaid cost report data with the last fiscal year ending between September 30, 2002, and August 30, 2003, the study found a cash flow margin of 21.5% for the large rural for-profit hospitals. All these facilities were owned by hospital management companies. To assess their underlying market, operational, and mission factors, these hospitals were compared to a similar comparison group of large rural nonprofit hospitals that are system owned and have positive cash flows. Using logistic regression analysis, the study found lower operating expense per adjusted discharge and salary expense as a percentage of total operating expense among large rural for-profit, system-owned hospitals with positive cash flows relative to nonprofits with similar traits. Overall, the findings of this study reflect how these for-profit hospitals, which are owned by hospital management companies, focus on controlling their labor costs as well as operating costs per discharge in order to achieve a greater positive cash flow position.

Evaluation of Needle Gun and Abrasive Blasting Technologies in Bridge Paint Removal Practices.

PubMed

Randall, Paul M; Kranz, Paul B; Sonntag, Mary L; Stadelmaier, James E

1998-03-01

This paper reviews the results of a U.S. Environmental Protection Agency (EPA) study that assessed needle gun technology as an alternative to conventional abrasive blasting technology to remove lead-based paint from steel bridges in western New York State. The study analyzed the operational and logistical aspects as they relate to worker health and safety, environmental protection, hazardous waste generation, and costs as compared to those arising from conventional abrasive blasting. In this 1992 EPA study, the costs and the product quality aspects favored conventional abrasive blasting over the needle gun technology for removing lead paint. However, abrasive blasting exposed workers to airborne lead levels that exceeded Permissible Exposure Limits (PELs) as established by the Occupational Safety and Health Administration (OSHA), as well as emitting high levels of lead-contaminated dusts and debris into the environment. It was estimated that more than 500 lbs of lead-contaminated spent abrasives and paint waste were released into the environment during paint removal operations. The needle gun system reduced (up to 97.5%) the generation of hazardous waste and the airborne concentrations (up to 99%) of respirable dusts and lead-containing particulates generated during paint removal operations. However, labor costs for the needle gun were three times higher than those for abrasive blasting primarily because of slower production rates that necessitated more operating personnel. The higher labor costs of the needle gun are partially offset by the increased costs associated with the expendable abrasive blast media and hazardous waste disposal. In the EPA study, the productivity of the needle gun system was 12.2 ft 2 /hr vs. 147.5 ft 2 /hr for abrasive blasting. A post blast was needed for the needle gun system to meet surface preparation specifications. When factoring in the costs of full containment structures to meet OSHA's 1993 Lead Exposure in Construction regulation, the needle gun system has the potential to be economically competitive with conventional abrasive blasting.

Eastern Renewable Generation Integration Study

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

Bloom, Aaron; Townsend, Aaron; Palchak, David

2016-08-01

The Eastern Interconnection (EI) is one of the largest power systems in the world, and its size and complexity have historically made it difficult to study in high levels of detail in a modeling environment. In order to understand how this system might be impacted by high penetrations (30% of total annual generation) of wind and solar photovoltaic (PV) during steady state operations, the National Renewable Energy Laboratory (NREL) and the U.S. Department of Energy (DOE) conducted the Eastern Renewable Generation Integration Study (ERGIS). This study investigates certain aspects of the reliability and economic efficiency problem faced by power systemmore » operators and planners. Specifically, the study models the ability to meet electricity demand at a 5-minute time interval by scheduling resources for known ramping events, while maintaining adequate reserves to meet random variation in supply and demand, and contingency events. To measure the ability to meet these requirements, a unit commitment and economic dispatch (UC&ED) model is employed to simulate power system operations. The economic costs of managing this system are presented using production costs, a traditional UC&ED metric that does not include any consideration of long-term fixed costs. ERGIS simulated one year of power system operations to understand regional and sub-hourly impacts of wind and PV by developing a comprehensive UC&ED model of the EI. In the analysis, it is shown that, under the study assumptions, generation from approximately 400 GW of combined wind and PV capacity can be balanced on the transmission system at a 5-minute level. In order to address the significant computational burdens associated with a model of this detail we apply novel computing techniques to dramatically reduce simulation solve time while simultaneously increasing the resolution and fidelity of the analysis. Our results also indicate that high penetrations of wind and PV (collectively variable generation (VG)), significantly impact the operation of traditional generating resources and cause these resources to be used less frequently and operate across a broader output range because wind and PV have lower operating costs and variable output levels.« less

Community Microgrid Scheduling Considering Network Operational Constraints and Building Thermal Dynamics

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

Liu, Guodong; Ollis, Thomas B.; Xiao, Bailu

Here, this paper proposes a Mixed Integer Conic Programming (MICP) model for community microgrids considering the network operational constraints and building thermal dynamics. The proposed optimization model optimizes not only the operating cost, including fuel cost, purchasing cost, battery degradation cost, voluntary load shedding cost and the cost associated with customer discomfort due to room temperature deviation from the set point, but also several performance indices, including voltage deviation, network power loss and power factor at the Point of Common Coupling (PCC). In particular, the detailed thermal dynamic model of buildings is integrated into the distribution optimal power flow (D-OPF)more » model for the optimal operation of community microgrids. The heating, ventilation and air-conditioning (HVAC) systems can be scheduled intelligently to reduce the electricity cost while maintaining the indoor temperature in the comfort range set by customers. Numerical simulation results show the effectiveness of the proposed model and significant saving in electricity cost could be achieved with network operational constraints satisfied.« less

Community Microgrid Scheduling Considering Network Operational Constraints and Building Thermal Dynamics

DOE PAGES

Liu, Guodong; Ollis, Thomas B.; Xiao, Bailu; ...

2017-10-10

Here, this paper proposes a Mixed Integer Conic Programming (MICP) model for community microgrids considering the network operational constraints and building thermal dynamics. The proposed optimization model optimizes not only the operating cost, including fuel cost, purchasing cost, battery degradation cost, voluntary load shedding cost and the cost associated with customer discomfort due to room temperature deviation from the set point, but also several performance indices, including voltage deviation, network power loss and power factor at the Point of Common Coupling (PCC). In particular, the detailed thermal dynamic model of buildings is integrated into the distribution optimal power flow (D-OPF)more » model for the optimal operation of community microgrids. The heating, ventilation and air-conditioning (HVAC) systems can be scheduled intelligently to reduce the electricity cost while maintaining the indoor temperature in the comfort range set by customers. Numerical simulation results show the effectiveness of the proposed model and significant saving in electricity cost could be achieved with network operational constraints satisfied.« less

42 CFR 412.71 - Determination of base-year inpatient operating costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of base-year inpatient operating... Costs § 412.71 Determination of base-year inpatient operating costs. (a) Base-year costs. (1) For each... before September 30, 1983 is for less than 12 months, the base period will be the hospital's most recent...

42 CFR 412.71 - Determination of base-year inpatient operating costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of base-year inpatient operating... Costs § 412.71 Determination of base-year inpatient operating costs. (a) Base-year costs. (1) For each... before September 30, 1983 is for less than 12 months, the base period will be the hospital's most recent...

42 CFR 412.71 - Determination of base-year inpatient operating costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Determination of base-year inpatient operating... Costs § 412.71 Determination of base-year inpatient operating costs. (a) Base-year costs. (1) For each... before September 30, 1983 is for less than 12 months, the base period will be the hospital's most recent...

Loop ileostomy closure: comparison of cost effectiveness between suture and stapler.

PubMed

Horisberger, Karoline; Beldi, Guido; Candinas, Daniel

2010-12-01

Closure of loop ileostomy can be safely performed using sutures or staplers. The aim of the present study was to compare the cost effectiveness of three different techniques. A total of 128 consecutive patients who underwent closure of loop ileostomy between January 2002 and December 2008 were analyzed retrospectively. The primary outcome parameter was operative cost. Closure of ileostomy was performed in 66 patients with hand-sewn anastomosis, in 25 patients with stapler only, and in 37 patients with a combination of stapler and suture. There were no differences in terms of early and late postoperative complications. Operative time was significantly longer for "suture only" (101.4 ± 26 min) than for "stapler/suture" (-4.9 min) and "stapler only" (-17.8 min); the difference between the three groups is significant (p = 0.05). Duration of hospital stay was not different among the three groups. Operative costs with "stapler/suture" (1,755.9 ± 355.6 EUR) were significantly higher than with "suture only" (-254 EUR; p = 0.001) and "stapler only" (-236 EUR; p = 0.005). Operative time using the stapler only is significantly shorter than with hand-sewn anastomosis or combinations of stapler and suture. Operative costs are significantly higher for a procedure that includes suture and stapler.

Small Water System Operations and Maintenance. A Field Study Training Program. Second Edition.

ERIC Educational Resources Information Center

Kerri, Kenneth D.; And Others

Proper installation, inspection, operation, maintenance, repair and management of small water systems have a significant impact on the operation and maintenance cost and effectiveness of the systems. The objective of this manual is to provide small water system operators with the knowledge and skills required to operate and maintain these systems…

Design optimization for cost and quality: The robust design approach

NASA Technical Reports Server (NTRS)

Unal, Resit

1990-01-01

Designing reliable, low cost, and operable space systems has become the key to future space operations. Designing high quality space systems at low cost is an economic and technological challenge to the designer. A systematic and efficient way to meet this challenge is a new method of design optimization for performance, quality, and cost, called Robust Design. Robust Design is an approach for design optimization. It consists of: making system performance insensitive to material and subsystem variation, thus allowing the use of less costly materials and components; making designs less sensitive to the variations in the operating environment, thus improving reliability and reducing operating costs; and using a new structured development process so that engineering time is used most productively. The objective in Robust Design is to select the best combination of controllable design parameters so that the system is most robust to uncontrollable noise factors. The robust design methodology uses a mathematical tool called an orthogonal array, from design of experiments theory, to study a large number of decision variables with a significantly small number of experiments. Robust design also uses a statistical measure of performance, called a signal-to-noise ratio, from electrical control theory, to evaluate the level of performance and the effect of noise factors. The purpose is to investigate the Robust Design methodology for improving quality and cost, demonstrate its application by the use of an example, and suggest its use as an integral part of space system design process.

Cost and risk assessment for spacecraft operation decisions caused by the space debris environment

NASA Astrophysics Data System (ADS)

Schaub, Hanspeter; Jasper, Lee E. Z.; Anderson, Paul V.; McKnight, Darren S.

2015-08-01

Space debris is a topic of concern among many in the space community. Most forecasting analyses look centuries into the future to attempt to predict how severe debris densities and fluxes will become in orbit regimes of interest. Conversely, space operators currently do not treat space debris as a major mission hazard. This survey paper outlines the range of cost and risk evaluations a space operator must consider when determining a debris-related response. Beyond the typical direct costs of performing an avoidance maneuver, the total cost including indirect costs, political costs and space environmental costs are discussed. The weights on these costs can vary drastically across mission types and orbit regimes flown. The operator response options during a mission are grouped into four categories: no action, perform debris dodging, follow stricter mitigation, and employ ADR. Current space operations are only considering the no action and debris dodging options, but increasing debris risk will eventually force the stricter mitigation and ADR options. Debris response equilibria where debris-related risks and costs settle on a steady-state solution are hypothesized.

Integrated orbital servicing study for low-cost payload programs. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Derocher, W. L., Jr.

1975-01-01

Various operating methodologies to achieve low-cost space operations were investigated as part of the Space Transportation System (STS) planning. The emphasis was to show that the development investment, initial fleet costs, and supporting facilities for the STS could be effectively offset by exploiting the capabilities of the STS to satisfy mission requirements and reduce the cost of payload programs. The following major conclusions were reached: (1) the development of an on-orbit servicer maintenance system is compatible with many spacecraft programs and is recommended as the most cost-effective system, (2) spacecraft can be designed to be serviceable with acceptable design, weight, volume, and cost effects, (3) use of on-orbit servicing over a 12 year period results in savings ranging between four and nine billion dollars, (4) the pivoting arm on-orbit servicer was selected and a preliminary design was prepared, (5) orbital maintenance has no significant impact on the STS.

Photocatalytic treatment of an industrial effluent using artificial and solar UV radiation: an operational cost study on a pilot plant scale.

PubMed

Durán, A; Monteagudo, J M; San Martín, I

2012-05-15

The aim of this work was to study the operation costs of treating a real effluent from an integrated gasification combined cycle (IGCC) power station located in Spain. The study compares different homogeneous photocatalytic processes on a pilot plant scale using different types of radiation (artificial UV or solar UV with a compound parabolic collector). The efficiency of the processes was evaluated by an analysis of the total organic carbon (TOC) removed. The following processes were considered in the study: (i) a photo-Fenton process at an artificial UV pilot plant (with the initial addition of H(2)O(2)), (ii) a modified photo-Fenton process with continuous addition of H(2)O(2) and O(2) to the system and (iii) a ferrioxalate-assisted solar photo-Fenton process at a compound parabolic collector (CPC) pilot plant. The efficiency of these processes in degrading pollutants has been studied previously, and the results obtained in each of those studies have been published elsewhere. The operational costs due to the consumption of electrical energy, reagents and catalysts were calculated from the optimal conditions of each process. The results showed that the solar photo-Fenton system was economically feasible, being able to achieve up to 75% mineralization with a total cost of 6 €/m(3), which can be reduced to 3.6 €/m(3) by subtracting the electrical costs because the IGCC plant is self-sufficient in terms of energy. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis.

PubMed

Walcott, Brian P; Khanna, Arjun; Yanamadala, Vijay; Coumans, Jean-Valery; Peterfreund, Robert A

2015-03-01

Lumbar spine surgery is typically performed under general anesthesia, although spinal anesthesia can also be used. Given the prevalence of lumbar spine surgery, small differences in cost between the two anesthetic techniques have the potential to make a large impact on overall healthcare costs. We sought to perform a cost comparison analysis of spinal versus general anesthesia for lumbar spine operations. Following Institutional Review Board approval, a retrospective cohort study was performed from 2009-2012 on consecutive patients undergoing non-instrumented, elective lumbar spine surgery for spondylosis by a single surgeon. Each patient was evaluated for both types of anesthesia, with the decision for anesthetic method being made based on a combination of physical status, anatomical considerations, and ultimately a consensus agreement between patient, surgeon, and anesthesiologist. Patient demographics and clinical characteristics were compared between the two groups. Operating room costs were calculated whilst blinded to clinical outcomes and reported in percentage difference. General anesthesia (n=319) and spinal anesthesia (n=81) patients had significantly different median operative times of 175 ± 39.08 and 158 ± 32.75 minutes, respectively (p<0.001, Mann-Whitney U test). Operating room costs were 10.33% higher for general anesthesia compared to spinal anesthesia (p=0.003, Mann-Whitney U test). Complications of spinal anesthesia included excessive movement (n=1), failed spinal attempt (n=3), intraoperative conversion to general anesthesia (n=2), and a high spinal level (n=1). In conclusion, spinal anesthesia can be performed safely in patients undergoing lumbar spine surgery. It has the potential to reduce operative times, costs, and possibly, complications. Further prospective evaluation will help to validate these findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Water and Climate Impacts on Power System Operations: The Importance of Cooling Systems and Demand Response Measures

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

Macknick, Jordan; Zhou, Ella; O'Connell, Matthew

The U.S. electricity sector is highly dependent upon water resources; changes in water temperatures and water availability can affect operational costs and the reliability of power systems. Despite the importance of water for power system operations, the effects of changes in water characteristics on multiple generators in a system are generally not modeled. Moreover, demand response measures, which can change the magnitude and timing of loads and can have beneficial impacts on power system operations, have not yet been evaluated in the context of water-related power vulnerabilities. This effort provides a first comprehensive vulnerability and cost analysis of water-related impactsmore » on a modeled power system and the potential for demand response measures to address vulnerability and cost concerns. This study uniquely combines outputs and inputs of a water and power plant system model, production cost, model, and relative capacity value model to look at variations in cooling systems, policy-related thermal curtailments, and demand response measures to characterize costs and vulnerability for a test system. Twenty-five scenarios over the course of one year are considered: a baseline scenario as well as a suite of scenarios to evaluate six cooling system combinations, the inclusion or exclusion of policy-related thermal curtailments, and the inclusion or exclusion of demand response measures. A water and power plant system model is utilized to identify changes in power plant efficiencies resulting from ambient conditions, a production cost model operating at an hourly scale is used to calculate generation technology dispatch and costs, and a relative capacity value model is used to evaluate expected loss of carrying capacity for the test system.« less

Cost of phosphate removal in municipal wastewater treatment plants

NASA Technical Reports Server (NTRS)

Schuessler, H.

1983-01-01

Construction and operating costs of advanced wastewater treatment for phosphate removal at municipal wastewater treatment plants have been investigated on orders from the Federal Environmental Bureau in Berlin. Particular attention has been paid to applicable kinds of precipitants for pre-, simultaneous and post-precipitation as well as to different phosphate influent and effluent concentrations. The article offers detailed comments on determination of technical data, investments, capital costs, operating costs and annual costs as well as potential cost reductions resulting from precipitation. Selected results of the cost investigation are shown in graphical form as specific investments, operating and annual costs depending on wastewater flow.

Case study project: The use of low-VOC/HAP coatings at wood furniture manufacturing facilities. Report for March 1995--March 1999

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

Marshall, A.M.; Jones, J.W.; Fields, J.L.

1999-07-01

The paper discusses a study of pollution prevention and the use of low-VOC/HAP (volatile organic compound/hazardous air pollutant) coatings at wood furniture manufacturing facilities. The study is to identify wood furniture and cabinet manufacturing facilities that have converted to low-VOC/HAP coatings and to develop case studies for those facilities. The case studies include a discussion of the types of products each facility manufactures; the types of low-VOC/HAP coatings each facility is using; problems encountered in converting to low-VOC/HAP coatings; equipment changes that were required; costs associated with the conversion process, including capital costs associated with equipment purchases, research and developmentmore » costs, and operating costs such as operator training in new application techniques;advantages/ disadvantages of the low-VOC/HAP coatings; and customer feedback on products finished with the low-VOC/HAP coatings. The paper discusses the progress of the study and pollution prevention options at wood furniture manufacturing facilities.« less

Turboprop cargo aircraft systems study

NASA Technical Reports Server (NTRS)

Muehlbauer, J. C.; Hewell, J. G., Jr.; Lindenbaum, S. P.; Randall, C. C.; Searle, N.; Stone, R. G., Jr.

1981-01-01

The effects of using advanced turboprop propulsion systems to reduce the fuel consumption and direct operating costs of cargo aircraft were studied, and the impact of these systems on aircraft noise and noise prints around a terminal area was determined. Parametric variations of aircraft and propeller characteristics were investigated to determine their effects on noiseprint areas, fuel consumption, and direct operating costs. From these results, three aircraft designs were selected and subjected to design refinements and sensitivity analyses. Three competitive turbofan aircraft were also defined from parametric studies to provide a basis for comparing the two types of propulsion.

Cost of Information Handling in Hospitals

PubMed Central

Jydstrup, Ronald A.; Gross, Malvern J.

1966-01-01

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

Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India.

PubMed

Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

2013-12-01

Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. The cost of referral transport per year varied from [symbol: see text] 5.2 million in Narnaul to [symbol: see text] 9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average [symbol: see text] 15.5 per km to [symbol: see text] 9.57 per km. Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.

Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India

PubMed Central

Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

2013-01-01

Background & objectives: Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Methods: Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. Results: The cost of referral transport per year varied from ₹5.2 million in Narnaul to ₹9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average ₹ 15.5 per km to ₹ 9.57 per km. Interpretation & conclusions: Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances. PMID:24521648

The Cost of Prior Restraint: "U. S. v. The Progressive."

ERIC Educational Resources Information Center

Soloski, John; Dyer, Carolyn Stewart

Increased litigation and rising litigation costs threaten the future of newspapers and magazines. A case study was conducted to determine the costs and effects of "United States v. 'The Progressive,'" a prior restraint case over the publication in 1979 of an article on the hydrogen bomb. "The Progressive," which operates at a…

Real Options as a Strategic Management Framework: A Case Study of the Operationally Responsive Space Initiative

DTIC Science & Technology

2007-03-01

of the project, and the Weighted Average Cost of Capital ( WACC ). WACC is defined as the after-tax marginal cost of capital (Copeland & Antikarov...Initial Investment t = Life Expectancy of Project (Start =1, to Finish=N) E(FCF) = Expected Free-Cash Flow WACC = Weighted Average Cost of

Dental School Accreditation Costs: The Impact of Accreditation on Dental Education at the University of Maryland Dental School, 1981.

ERIC Educational Resources Information Center

Moreland, Ernest F.; Linthicum, Dorothy S.

The Baltimore College of Dental Surgery (University of Maryland) measured direct and indirect costs of the school's 1981 accreditation visit. The four objectives of the cost study were these: (1) to determine the direct (wages and operating expenditures) and indirect (effect on school goals and morale) cost of accreditation to the Dental School;…

The Use of Satellite Delivery Systems in Education in Canada: The Costing of Two Networks and a Preliminary Needs Survey. Volume 1: The Costing of Two Networks.

ERIC Educational Resources Information Center

Daniel, John S.; And Others

This study examines the methodologies and costs of establishing educational delivery systems using satellites currently in orbit or planned. It identifies two operational system scenarios and their predicted costs. One system, the Canadian Universities Satellite System (CUSS), is hypothesized to provide the means of transmitting audio and video…

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

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

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

2011-03-15

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

47 CFR 54.305 - Sale or transfer of exchanges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... following the transfer of exchanges. For the first year of operation, a loop cost expense adjustment, using... operation shall be determined using cost data for the first year of operation of the transferred exchanges. Such cost data for the first year of operation shall be calculated in accordance with §§ 36.611, 36.612...

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

PubMed

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

2017-05-01

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

Cargo Logistics Airlift Systems Study (CLASS). Volume 3: Cross impact between the 1990 market and the air physical distribution systems, book 2

NASA Technical Reports Server (NTRS)

Burby, R. J.; Kuhlman, W. H.

1978-01-01

Book 2 of this volume is divided into the following sections: (1) commodities and system networks; (2) future mode choice decisions and commodity air eligibility; (3) comparative cargo transportation costs - air, truck, rail and water; (4) elasticities of demand; (5) operating cost; (6) operating profit, rate making, and returns; (7) importance of rate and service on future aircraft; (8) potential market demand for new aircraft; (9) scenario of events affecting system/market growth; and (10) future study and technology requirements.

Life Cycle Costing.

ERIC Educational Resources Information Center

McCraley, Thomas L.

1985-01-01

Life cycle costing establishes a realistic comparison of the cost of owning and operating products. The formula of initial cost plus maintenance plus operation divided by useful life identifies the best price over the lifetime of the product purchased. (MLF)

43 CFR 426.23 - Recovery of operation and maintenance (O&M) costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Recovery of operation and maintenance (O&M... operation and maintenance (O&M) costs. (a) General. All new, amended, and renewed contracts shall provide for payment of O&M costs as specified in this section. (b) Amount of O&M costs a district must pay if...

Space Costing: Who Should Pay for the Use of College Space? A Report.

ERIC Educational Resources Information Center

Zacher, Sy

The costs of owning and operating physical facilities are consuming an increasing share of the budgets of colleges and universities. In the past, academic and operating units of colleges have viewed their space as a free commodity and often used it extravagantly. Space costing is a method of cost accounting the space and operating and maintenance…

41 CFR 102-33.190 - What are the aircraft operations and ownership costs for which we must account?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Parts Accounting for the Cost of Government Aircraft § 102-33.190 What are the aircraft operations and... Government aircraft as described in the “Government Aircraft Cost Accounting Guide” (CAG), which follows OMB... operations and ownership costs for which we must account? 102-33.190 Section 102-33.190 Public Contracts and...

25 CFR 39.1200 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... School Operation and Maintenance Fund § 39.1200 Definitions. Contract school operation and maintenance costs for fiscal year 1979 means the sum of costs for custodial salaries and fringe benefits, related supplies and equipment and equipment repair, insurance, and school operation utilities costs, where such...

The cost benefit and efficiency of waste water treatment using domestic ponds—the ultimate solution in Southern Africa

NASA Astrophysics Data System (ADS)

Ntengwe, F. W.

Wastewater treatment has become a challenge to most countries in Southern Africa because of the fluctuating economies that have been hit by high levels of debts. The treatment of domestic wastewater using ponds, if carefully utilized, as has been observed in most countries in the world, is the most cost effective means of handling wastewaters. When compared to the conventional use of treatment plants, the ponds have been observed to be the ultimate solution for the countries in Southern Africa especially those that are classified as Highly Indebted Poor Countries (HIPC) because of little or no operating costs associated with the treatment. The study conducted on Kitwe Waste Water Treatment Ponds to evaluate the cost benefit and efficiencies has revealed low levels of operating cost and high removal efficiencies of oxygen demanding wastes (BOD removal of 86% and TSS removal of 75%), pH values ranged from 7 to 8 indicating an increasing alkalinity from facultative to maturation ponds while other parameters such as nitrates, phosphates and temperature were found to be within acceptable levels thereby releasing effluent that makes the environment sustainable. The overall social benefit was found to be much higher than the operating costs.

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

PubMed

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

2014-05-01

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

RESIDENTIAL VENTILATION STUDY

EPA Science Inventory

This project evaluated the effectiveness, first costs and operational costs of various types of residential ventilation systems in three different climates in the U.S. The Agency, through its Energy Star Program, recommends that builders construct homes that are energy efficient ...

Economics

NASA Technical Reports Server (NTRS)

1975-01-01

Tables covering the selling price of hydrogen as a function of each process temperature studied are presented. Estimated selling price, based on capital costs and operating and maintenance costs, is included. In all cases, no credit was given for the methane component of hydrogen.

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

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

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

2011-01-01

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

The Application of Architecture Frameworks to Modelling Exploration Operations Costs

NASA Technical Reports Server (NTRS)

Shishko, Robert

2006-01-01

Developments in architectural frameworks and system-of-systems thinking have provided useful constructs for systems engineering. DoDAF concepts, language, and formalisms, in particular, provide a natural way of conceptualizing an operations cost model applicable to NASA's space exploration vision. Not all DoDAF products have meaning or apply to a DoDAF inspired operations cost model, but this paper describes how such DoDAF concepts as nodes, systems, and operational activities relate to the development of a model to estimate exploration operations costs. The paper discusses the specific implementation to the Mission Operations Directorate (MOD) operational functions/activities currently being developed and presents an overview of how this powerful representation can apply to robotic space missions as well.

A Measure of Maintenance Training/Qualification Readiness and Its Impact on Billet Life Cycle Coast.

DTIC Science & Technology

1983-09-01

MAINTENANCE READINESS ESTIMATION---------------- 24 A. AVIATION TRAINING SUPPORT SYSTEM ---- 25 B. MAINTENANCE MATRIX UTILIZATION-------------- 27 C...nonexistent follow-on training programs. CRef. 13 The operation and maintenance o systems account for a major portion of system life cycle cost. Studies of... systems annual support costs show that manpower consistently consuwme over half of the funds appropriated for operation and maintenance of the system £Ref

Multiple and variable speed electrical generator systems for large wind turbines

NASA Technical Reports Server (NTRS)

Andersen, T. S.; Hughes, P. S.; Kirschbaum, H. S.; Mutone, G. A.

1982-01-01

A cost effective method to achieve increased wind turbine generator energy conversion and other operational benefits through variable speed operation is presented. Earlier studies of multiple and variable speed generators in wind turbines were extended for evaluation in the context of a specific large sized conceptual design. System design and simulation have defined the costs and performance benefits which can be expected from both two speed and variable speed configurations.

A Qualitative Study of Affordability: Virginia and San Antonio Class Programs

DTIC Science & Technology

2014-06-01

that actual costs and operational tempos resemble original assumptions is the most uncertain aspect of sustainment costs. Operators must respond to a...SSN 774 through SSN 787; this represents 47% of the total inventory, a typical variation for ships from the acquisition standard of 10%. Even... Goldberg , M., … MacKinnon, M. (1994). The U.S. submarine production base (MR-456-OSD). Santa Monica, CA: RAND. Blickstein, I. United States. Department

Contrast in low-cost operational concepts for orbiting satellites

NASA Astrophysics Data System (ADS)

Walyus, Keith D.; Reis, James; Bradley, Arthur J.

2002-12-01

Older spacecraft missions, especially those in low Earth orbit with telemetry intensive requirements, required round-the-clock control center staffing. The state of technology relied on control center personnel to continually examine data, make decisions, resolve anomalies, and file reports. Hubble Space Telescope (HST) is a prime example of this description. Technological advancements in hardware and software over the last decade have yielded increases in productivity and operational efficiency, which result in lower cost. The re-engineering effort of HST, which has recently concluded, utilized emerging technology to reduce cost and increase productivity. New missions, of which NASA's Transition Region and Coronal Explorer Satellite (TRACE) is an example, have benefited from recent technological advancements and are more cost-effective than when HST was first launched. During its launch (1998) and early orbit phase, the TRACE Flight Operations Team (FOT) employed continually staffed operations. Yet once the mission entered its nominal phase, the FOT reduced their staffing to standard weekday business hours. Operations were still conducted at night and during the weekends, but these operations occurred autonomously without compromising their high standards for data collections. For the HST, which launched in 1990, reduced cost operations will employ a different operational concept, when the spacecraft enters its low-cost phase after its final servicing mission in 2004. Primarily due to the spacecraft"s design, the HST Project has determined that single-shift operations will introduce unacceptable risks for the amount of dollars saved. More importantly, significant cost-savings can still be achieved by changing the operational concept for the FOT, while still maintaining round-the-clock staffing. It"s important to note that the low-cost solutions obtained for one satellite may not be applicable for other satellites. This paper will contrast the differences between low-cost operational concepts for a satellite launched in 1998 versus a satellite launched in 1990.

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

NASA Technical Reports Server (NTRS)

Sundaram, Meenakshi

2005-01-01

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

Operative costs, reasons for operative waste, and vendor credit replacement in spinal surgery.

PubMed

Epstein, Nancy E; Roberts, Rita; Collins, John

2015-01-01

In 2012, Epstein et al. documented that educating spinal surgeons reduced the cost of operative waste (explanted devices: placed but removed prior to closure) occurring during anterior cervical diskectomy/fusion from 20% to 5.8%.[5] This prompted the development of a two-pronged spine surgeon-education program (2012-2014) aimed at decreasing operative costs for waste, and reducing the nine reasons for operative waste. The spine surgeon-education program involved posting the data for operative costs of waste and the nine reasons for operative waste over the neurosurgery/orthopedic scrub sinks every quarter. These data were compared for 2012 (latter 10 months), 2013 (12 months), and 2014 (first 9 months) (e.g. data were normalized). Savings from a 2013 Vendor Credit Replacement program were also calculated. From 2012 to 2013 and 2014, spinal operative costs for waste were, respectively reduced by 64.7% and 61% for orthopedics, and 49.4% and 45.2% for neurosurgery. Although reduced by the program, the major reason for operative waste for all 3 years remained surgeon-related factors (e.g. 159.6, to 67, and 96, respectively). Alternatively, the eight other reasons for operative waste were reduced from 68.4 (2012) to 12 (2013) and finally to zero by 2014. Additionally, the Vendor Replacement program for 2013 netted $78,564. The spine surgeon-education program reduced the costs/reasons for operative waste for 2012 to lower levels by 2013 and 2014. Although the major cost/reasons for operative waste were attributed to surgeon-related factors, these declined while the other eight reasons for operative waste were reduced to zero by 2014.

Process analysis and economics of drinking water production from coastal aquifers containing chromophoric dissolved organic matter and bromide using nanofiltration and ozonation.

PubMed

Sobhani, R; McVicker, R; Spangenberg, C; Rosso, D

2012-01-01

In regions characterized by water scarcity, such as coastal Southern California, groundwater containing chromophoric dissolved organic matter is a viable source of water supply. In the coastal aquifer of Orange County in California, seawater intrusion driven by coastal groundwater pumping increased the concentration of bromide in extracted groundwater from 0.4 mg l⁻¹ in 2000 to over 0.8 mg l⁻¹ in 2004. Bromide, a precursor to bromate formation is regulated by USEPA and the California Department of Health as a potential carcinogen and therefore must be reduced to a level below 10 μg l⁻¹. This paper compares two processes for treatment of highly coloured groundwater: nanofiltration and ozone injection coupled with biologically activated carbon. The requirement for bromate removal decreased the water production in the ozonation process to compensate for increased maintenance requirements, and required the adoption of catalytic carbon with associated increase in capital and operating costs per unit volume. However, due to the absence of oxidant addition in nanofiltration processes, this process is not affected by bromide. We performed a process analysis and a comparative economic analysis of capital and operating costs for both technologies. Our results show that for the case studied in coastal Southern California, nanofiltration has higher throughput and lower specific capital and operating cost, when compared to ozone injection with biologically activate carbon. Ozone injection with biologically activated carbon, compared to nanofiltration, has 14% higher capital cost and 12% higher operating costs per unit water produced while operating at the initial throughput. Due to reduced ozone concentration required to accommodate for bromate reduction, the ozonation process throughput is reduced and the actual cost increase (per unit water produced) is 68% higher for capital cost and 30% higher for operations. Copyright © 2011 Elsevier Ltd. All rights reserved.

Financial analysis of experimental releases conducted at Glen Canyon Dam during water years 1997 through 2005.

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

Veselka, T. D.; Poch, L. A.; Palmer, C. S.

2010-04-21

Because of concerns about the impact that Glen Canyon Dam (GCD) operations were having on downstream ecosystems and endangered species, the Bureau of Reclamation (Reclamation) conducted an Environmental Impact Statement (EIS) on dam operations (DOE 1996). New operating rules and management goals for GCD that had been specified in the Record of Decision (ROD) (Reclamation 1996) were adopted in February 1997. In addition to issuing new operating criteria, the ROD mandated experimental releases for the purpose of conducting scientific studies. This paper examines the financial implications of the experimental flows that were conducted at the GCD from 1997 to 2005.more » An experimental release may have either a positive or negative impact on the financial value of energy production. This study estimates the financial costs of experimental releases, identifies the main factors that contribute to these costs, and compares the interdependencies among these factors. An integrated set of tools was used to compute the financial impacts of the experimental releases by simulating the operation of the GCD under two scenarios, namely, (1) a baseline scenario that assumes operations comply with the ROD operating criteria and experimental releases that actually took place during the study period, and (2) a ''without experiments'' scenario that is identical to the baseline scenario of operations that comply with the GCD ROD, except it assumes that experimental releases did not occur. The Generation and Transmission Maximization (GTMax) model was the main simulation tool used to dispatch GCD and other hydropower plants that comprise the Salt Lake City Area Integrated Projects (SLCA/IP). Extensive data sets and historical information on SLCA/IP power plant characteristics, hydrologic conditions, and Western Area Power Administration's (Western's) power purchase prices were used for the simulation. In addition to estimating the financial impact of experimental releases, the GTMax model was also used to gain insights into the interplay among ROD operating criteria, exceptions that were made to criteria to accommodate the experimental releases, and Western operating practices. Experimental releases in some water years resulted in financial benefits to Western while others resulted in financial costs. During the study period, the total financial costs of all experimental releases were $11.9 million.« less

Revised financial analysis of experimental releases conducted at Glen Canyon Dam during water years 1997 through 2005.

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

Veselka, T. D.; Poch, L. A.; Palmer, C. S.

2011-01-11

Because of concerns about the impact that Glen Canyon Dam (GCD) operations were having on downstream ecosystems and endangered species, the Bureau of Reclamation (Reclamation) conducted an Environmental Impact Statement (EIS) on dam operations (DOE 1996). New operating rules and management goals for GCD that had been specified in the Record of Decision (ROD) (Reclamation 1996) were adopted in February 1997. In addition to issuing new operating criteria, the ROD mandated experimental releases for the purpose of conducting scientific studies. This paper examines the financial implications of the experimental flows that were conducted at the GCD from 1997 to 2005.more » An experimental release may have either a positive or negative impact on the financial value of energy production. This study estimates the financial costs of experimental releases, identifies the main factors that contribute to these costs, and compares the interdependencies among these factors. An integrated set of tools was used to compute the financial impacts of the experimental releases by simulating the operation of the GCD under two scenarios, namely, (1) a baseline scenario that assumes operations comply with the ROD operating criteria and experimental releases that actually took place during the study period, and (2) a 'without experiments' scenario that is identical to the baseline scenario of operations that comply with the GCD ROD, except it assumes that experimental releases did not occur. The Generation and Transmission Maximization (GTMax) model was the main simulation tool used to dispatch GCD and other hydropower plants that comprise the Salt Lake City Area Integrated Projects (SLCA/IP). Extensive data sets and historical information on SLCA/IP power plant characteristics, hydrologic conditions, and Western Area Power Administration's (Western's) power purchase prices were used for the simulation. In addition to estimating the financial impact of experimental releases, the GTMax model was also used to gain insights into the interplay among ROD operating criteria, exceptions that were made to criteria to accommodate the experimental releases, and Western operating practices. Experimental releases in some water years resulted in financial benefits to Western whileothers resulted in financial costs. During the study period, the total financial costs of all experimental releases were more than $23 million.« less

New generation cut-and-seal devices in oral and oropharyngeal cancer resection: clinical and cost-effectiveness study.

PubMed

Tirelli, G; Del Piero, G C; Valentinuz, G; Monte, A; Gatto, A; Rebelli, A; Quatela, E

2018-04-01

To evaluate the clinical efficacy and cost-effectiveness of ultrasonic shears and the electrothermal bipolar vessel sealing system, in comparison to the traditional cold knife and bipolar forceps, in oral and oropharyngeal cancer surgery. Patients who underwent oral or oropharyngeal cancer resection and neck dissection with either ultrasonic shears (n = 36) or electrothermal bipolar vessel sealing (n = 32) were enrolled. Surgical time, intra-operative bleeding, blood drainage, post-operative pain, neck oedema, complications and hospitalisation duration were compared to those of an historical cohort of 36 patients treated using a cold knife and bipolar forceps. Additionally, a cost-effectiveness evaluation was performed. Ultrasonic shears and, in particular, electrothermal bipolar vessel sealing, were advantageous compared to the traditional techniques. The cost of ultrasonic shears and electrothermal bipolar vessel sealing was completely offset by declining time-driven costs for the surgical team and operating theatre. Ultrasonic shears and, in particular, electrothermal bipolar vessel sealing, are more advantageous compared to the traditional techniques, from both a clinical and economic point of view.

Upgrade of Compressed Air Control System Reduces Energy Costs at Michelin Tire Plant. Office of Industrial Technologies (OIT) BestPractices Project Case Study

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

Not Available

2002-01-01

This case study highlights the upgraded compressed air system at a Michelin tire manufacturing plant in Spartanburg, South Carolina. The controls upgrade project enabled multiple compressor operation without blow-off, and significantly reduced energy costs.

Operant Conditioning and Education.

ERIC Educational Resources Information Center

de Noronha, Mario

A case study of a learning disabled 8-year-old with behavior disturbancs is presented to highlight the use of operant conditioning in cutting down educational costs and easing the teacher's class management problems. (CL)

Space processing economics

NASA Technical Reports Server (NTRS)

Bredt, J. H.

1974-01-01

Two types of space processing operations may be considered economically justified; they are manufacturing operations that make profits and experiment operations that provide needed applied research results at lower costs than those of alternative methods. Some examples from the Skylab experiments suggest that applied research should become cost effective soon after the space shuttle and Spacelab become operational. In space manufacturing, the total cost of space operations required to process materials must be repaid by the value added to the materials by the processing. Accurate estimates of profitability are not yet possible because shuttle operational costs are not firmly established and the markets for future products are difficult to estimate. However, approximate calculations show that semiconductor products and biological preparations may be processed on a scale consistent with market requirements and at costs that are at least compatible with profitability using the Shuttle/Spacelab system.

Autologous blood transfusion during emergency trauma operations.

PubMed

Brown, Carlos V R; Foulkrod, Kelli H; Sadler, Holli T; Richards, E Kalem; Biggan, Dennis P; Czysz, Clea; Manuel, Tony

2010-07-01

Intraoperative cell salvage (CS) of shed blood during emergency surgical procedures provides an effective and cost-efficient resuscitation alternative to allogeneic blood transfusion, which is associated with increased morbidity and mortality in trauma patients. Retrospective matched cohort study. Level I trauma center. All adult trauma patients who underwent an emergency operation and received CS as part of their intraoperative resuscitation. The CS group was matched to a no-CS group for age, sex, Injury Severity Score, mechanism of injury, and operation performed. Amount and cost of allogeneic transfusion of packed red blood cells and plasma. The 47 patients in the CS group were similar to the 47 in the no-CS group for all matched variables. Patients in the CS group received an average of 819 mL of autologous CS blood. The CS group received fewer intraoperative (2 vs 4 U; P = .002) and total (4 vs 8 U; P < .001) units of allogeneic packed red blood cells. The CS group also received fewer total units of plasma (3 vs 5 U; P = .03). The cost of blood product transfusion (including the total cost of CS) was less in the CS group ($1616 vs $2584 per patient; P = .004). Intraoperative CS provides an effective and cost-efficient resuscitation strategy as an alternative to allogeneic blood transfusion in trauma patients undergoing emergency operative procedures.

Costs of genetic testing: Supporting Brazilian Public Policies for the incorporating of molecular diagnostic technologies

PubMed Central

Schlatter, Rosane Paixão; Matte, Ursula; Polanczyk, Carisi Anne; Koehler-Santos, Patrícia; Ashton-Prolla, Patricia

2015-01-01

This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%), microsatellite instability analysis (181%), gene rearrangement analysis by multiplex ligation probe amplification (412%), non-labeled sequencing (173%), and quantitation of nucleic acids (169%). These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System. PMID:26500437

Thermodynamic Performance and Cost Optimization of a Novel Hybrid Thermal-Compressed Air Energy Storage System Design

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

Houssainy, Sammy; Janbozorgi, Mohammad; Kavehpour, Pirouz

Compressed Air Energy Storage (CAES) can potentially allow renewable energy sources to meet electricity demands as reliably as coal-fired power plants. However, conventional CAES systems rely on the combustion of natural gas, require large storage volumes, and operate at high pressures, which possess inherent problems such as high costs, strict geological locations, and the production of greenhouse gas emissions. A novel and patented hybrid thermal-compressed air energy storage (HT-CAES) design is presented which allows a portion of the available energy, from the grid or renewable sources, to operate a compressor and the remainder to be converted and stored in themore » form of heat, through joule heating in a sensible thermal storage medium. The HT-CAES design incudes a turbocharger unit that provides supplementary mass flow rate alongside the air storage. The hybrid design and the addition of a turbocharger have the beneficial effect of mitigating the shortcomings of conventional CAES systems and its derivatives by eliminating combustion emissions and reducing storage volumes, operating pressures, and costs. Storage efficiency and cost are the two key factors, which upon integration with renewable energies would allow the sources to operate as independent forms of sustainable energy. The potential of the HT-CAES design is illustrated through a thermodynamic optimization study, which outlines key variables that have a major impact on the performance and economics of the storage system. The optimization analysis quantifies the required distribution of energy between thermal and compressed air energy storage, for maximum efficiency, and for minimum cost. This study provides a roundtrip energy and exergy efficiency map of the storage system and illustrates a trade off that exists between its capital cost and performance.« less

Development of the Architectural Simulation Model for Future Launch Systems and its Application to an Existing Launch Fleet

NASA Technical Reports Server (NTRS)

Rabadi, Ghaith

2005-01-01

A significant portion of lifecycle costs for launch vehicles are generated during the operations phase. Research indicates that operations costs can account for a large percentage of the total life-cycle costs of reusable space transportation systems. These costs are largely determined by decisions made early during conceptual design. Therefore, operational considerations are an important part of vehicle design and concept analysis process that needs to be modeled and studied early in the design phase. However, this is a difficult and challenging task due to uncertainties of operations definitions, the dynamic and combinatorial nature of the processes, and lack of analytical models and the scarcity of historical data during the conceptual design phase. Ultimately, NASA would like to know the best mix of launch vehicle concepts that would meet the missions launch dates at the minimum cost. To answer this question, we first need to develop a model to estimate the total cost, including the operational cost, to accomplish this set of missions. In this project, we have developed and implemented a discrete-event simulation model using ARENA (a simulation modeling environment) to determine this cost assessment. Discrete-event simulation is widely used in modeling complex systems, including transportation systems, due to its flexibility, and ability to capture the dynamics of the system. The simulation model accepts manifest inputs including the set of missions that need to be accomplished over a period of time, the clients (e.g., NASA or DoD) who wish to transport the payload to space, the payload weights, and their destinations (e.g., International Space Station, LEO, or GEO). A user of the simulation model can define an architecture of reusable or expendable launch vehicles to achieve these missions. Launch vehicles may belong to different families where each family may have it own set of resources, processing times, and cost factors. The goal is to capture the required resource levels of the major launch elements and their required facilities. The model s output can show whether or not a certain architecture of vehicles can meet the launch dates, and if not, how much the delay cost would be. It will also produce aggregate figures of missions cost based on element procurement cost, processing cost, cargo integration cost, delay cost, and mission support cost. One of the most useful features of this model is that it is stochastic where it accepts statistical distributions to represent the processing times mimicking the stochastic nature of real systems.

A cost comparison of laparoscopic and open colon surgery in a publicly funded academic institution.

PubMed

Hardy, Krista M; Kwong, Josephine; Pitzul, Kristen B; Vergis, Ashley S; Jackson, Timothy D; Urbach, David R; Okrainec, Allan

2014-04-01

The objective of this study was to compare the total hospital cost of laparoscopic (lap) and open colon surgery at a publicly funded academic institution. Patients undergoing elective laparoscopic or open colon surgery for all indications at the University Health Network, Toronto, Canada, from April 2004 to March 2009 were included. Patient demographic, operative, and outcome data were reviewed retrospectively. Hospital costs were determined from the Ontario Case Costing Initiative, adjusted for inflation, and compared using the Mann-Whitney U test. Linear regression was used to analyze the relationship between length of stay and total hospital cost. There were 391 elective colon resections (223 lap/168 open, 15.4 % conversion). There was no difference in median age, gender, or Charlson score. Body mass index was slightly higher for laparoscopic surgery (27.5/25.9 lap/open; p = 0.008), while the American Society of Anesthesiologists score was slightly higher for open surgery. Median operative time was greater for laparoscopic surgery (224/196 min, lap/open; p = 0.001). There was no difference in complication rates (21.6/22.5 % lap/open; p = 0.900), reoperations (5.8/6.5 % lap/open; p = 0.833) or 30-day readmissions (7.6/12.5 % lap/open; p = 0.122). Number of emergency room visits was greater with open surgery (12.6/20.8 % lap/open; p = 0.037). Operative cost was higher for laparoscopic surgery ($4,171.37/3,489.29 lap/open; p = 0.001), while total hospital cost was significantly reduced ($9,600.22/12,721.41 lap/open; p = 0.001). Median length of stay was shorter for laparoscopic surgery (5/7 days lap/open; p = 0.000), and this correlated directly with hospital cost. Laparoscopic colon surgery is associated with increased operative costs but significantly lower total hospital costs. The cost savings is related, in part, to reduced length of stay with laparoscopic surgery.

Advanced Manned Launch System (AMLS) study

NASA Technical Reports Server (NTRS)

Ehrlich, Carl F., Jr.; Potts, Jack; Brown, Jerry; Schell, Ken; Manley, Mary; Chen, Irving; Earhart, Richard; Urrutia, Chuck; Randolph, Ray; Morris, Jim

1992-01-01

To assure national leadership in space operations and exploration in the future, NASA must be able to provide cost effective and operationally efficient space transportation. Several NASA studies and the joint NASA/DoD Space Transportation Architecture Studies (STAS) have shown the need for a multi-vehicle space transportation system with designs driven by enhanced operations and low costs. NASA is currently studying an advanced manned launch system (AMLS) approach to transport crew and cargo to the Space Station Freedom. Several single and multiple stage systems from air-breathing to all-rocket concepts are being examined in a series of studies potential replacements for the Space Shuttle launch system in the 2000-2010 time frame. Rockwell International Corporation, under contract to the NASA Langley Research Center, has analyzed a two-stage all-rocket concept to determine whether this class of vehicles is appropriate for the AMLS function. The results of the pre-phase A study are discussed.

Study of solid rocket motors for a space shuttle booster. Volume 2, book 3, addendum 1: Cost estimating data

NASA Technical Reports Server (NTRS)

Vonderesch, A. H.

1972-01-01

A second iteration of the program baseline configuration and cost for the solid propellant rocket engines used with the space shuttle booster system is presented. The purpose of the study was to ensure that total program costs were complete and to review areas where costs might be overly conservative and could be reduced. Labor and material were analyzed in more depth, more definition was prepared to separate recurring from nonrecurring costs, and the operations portions of the engine and stage were separated into more identifiable activities.

The impact of complications on costs of major surgical procedures: a cost analysis of 1200 patients.

PubMed

Vonlanthen, René; Slankamenac, Ksenija; Breitenstein, Stefan; Puhan, Milo A; Muller, Markus K; Hahnloser, Dieter; Hauri, Dimitri; Graf, Rolf; Clavien, Pierre-Alain

2011-12-01

To assess the impact of postoperative complications on full in-hospital costs per case. Rising expenses for complex medical procedures combined with constrained resources represent a major challenge. The severity of postoperative complications reflects surgical outcomes. The magnitude of the cost created by negative outcomes is unclear. Morbidity of 1200 consecutive patients undergoing major surgery from 2005 to 2008 in a tertiary, high-volume center was assessed by a validated, complication score system. Full in-hospital costs were collected for each patient. Statistical analysis was performed using a multivariate linear regression model adjusted for potential confounders. This study population included 393 complex liver/bile duct surgeries, 110 major pancreas operations, 389 colon resections, and 308 Roux-en-Y gastric bypasses. The overall 30-day mortality rate was 1.8%, whereas morbidity was 53.8%. Patients with an uneventful course had mean costs per case of US$ 27,946 (SD US$ 15,106). Costs increased dramatically with the severity of postoperative complications and reached the mean costs of US$ 159,345 (SD US$ 151,191) for grade IV complications. This increase in costs, up to 5 times the cost of a similar operation without complications, was observed for all types of investigated procedures, although the magnitude of the increase varied, with the highest costs in patients undergoing pancreas surgery. This study demonstrates the dramatic impact of postoperative complications on full in-hospital costs per case and that complications are the strongest indicator of costs. Furthermore, the study highlights a relevant savings capacity for major surgical procedures, and supports all efforts to lower negative events in the postoperative course.

Reducing air pollutant emissions at airports by controlling aircraft ground operations

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

Gelinas, C.G.; Fan, H.S.L.

1979-02-01

Potential reductions in air pollutant emissions were determined for four stategies to control aircraft ground operations at two case study airports, Los Angeles and San Francisco International Airports. Safety, cost, and fuel savings associated with strategy implementation were examined. Two strategies, aircraft towing and shutdown of one engine during taxi operations, provided significant emission reductions. However, there are a number of safety problems associated with aircraft towing. The shutdown of one engine while taxiing was found to be the most viable strategy because of substantial emission reductions, cost benefits resulting from fuel savings, and no apparent safety problems.

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

Easton, C. R.

The objectives of this program are to establish a heliostat design with the associated manufacturing, assembly, installation and maintenance approaches that will: (1) yield a significant reduction of capital and operating costs; (2) meet performance specifications for large collector subsystems; and (3) can be produced and deployed throughout the southwestern United States. In addition, cost plans and schedules to develop, fabricate, and operate the heliostat are to be developed. This volume presents the collector design, including trade study and test results, and the manufacturing, installation and checkout, and operations and maintenance concepts. Also, a discussion of specification verification and optimizationmore » is included. (WHK)« less

Better Redd than Dead: Optimizing Reservoir Operations for Wild Fish Survival During Drought

NASA Astrophysics Data System (ADS)

Adams, L. E.; Lund, J. R.; Quiñones, R.

2014-12-01

Extreme droughts are difficult to predict and may incur large economic and ecological costs. Dam operations in drought usually consider minimizing economic costs. However, dam operations also offer an opportunity to increase wild fish survival under difficult conditions. Here, we develop a probabilistic optimization approach to developing reservoir release schedules to maximize fish survival in regulated rivers. A case study applies the approach to wild Fall-run Chinook Salmon below Folsom Dam on California's American River. Our results indicate that releasing more water early in the drought will, on average, save more wild fish over the long term.

The cost of noise reduction for departure and arrival operations of commercial tilt rotor aircraft

NASA Technical Reports Server (NTRS)

Faulkner, H. B.; Swan, W. M.

1976-01-01

The relationship between direct operating cost (DOC) and noise annoyance due to a departure and an arrival operation was developed for commercial tilt rotor aircraft. This was accomplished by generating a series of tilt rotor aircraft designs to meet various noise goals at minimum DOC. These vehicles ranged across the spectrum of possible noise levels from completely unconstrained to the quietest vehicles that could be designed within the study ground rules. Optimization parameters were varied to find the minimum DOC. This basic variation was then extended to different aircraft sizes and technology time frames.

A cost evaluation methodology for surgical technologies.

PubMed

Ismail, Imad; Wolff, Sandrine; Gronfier, Agnes; Mutter, Didier; Swanström, Lee L; Swantröm, Lee L

2015-08-01

To create and validate a micro-costing methodology that surgeons and hospital administrators can use to evaluate the cost of implementing innovative surgical technologies. Our analysis is broken down into several elements of fixed and variable costs which are used to effectively and easily calculate the cost of surgical operations. As an example of application, we use data from 86 robot assisted gastric bypass operations made in our hospital. To validate our methodology, we discuss the cost reporting approaches used in 16 surgical publications with respect to 7 predefined criteria. Four formulas are created which allow users to import data from their health system or particular situation and derive the total cost. We have established that the robotic surgical system represents 97.53 % of our operating room's medical device costs which amounts to $4320.11. With a mean surgery time of 303 min, personnel cost per operation amounts to $1244.73, whereas reusable instruments and disposable costs are, respectively, $1539.69 and $3629.55 per case. The literature survey demonstrates that the cost of surgery is rarely reported or emphasized, and authors who do cover this concept do so with variable methodologies which make their findings difficult to interpret. Using a micro-costing methodology, it is possible to identify the cost of any new surgical procedure/technology using formulas that can be adapted to a variety of operations and healthcare systems. We hope that this paper will provide guidance for decision makers and a means for surgeons to harmonise cost reporting in the literature.

Cost-evaluation model for clinical trials in a hospital pharmacy service.

PubMed

Idoate, A; Ortega, A; Carrera, F J; Aldaz, A; Giráldez, J

1995-09-22

A cost-evaluation model was applied to clinical trial protocols to estimate their cost for the hospital pharmacy service. The steps taken in the drug management of clinical research were identified. Fixed costs (common to all clinical trials) and variable costs (peculiar to each clinical trial) were determined for each step. The number of patients, the number of operations, the planned services (receptions, storage, drug dispensing), the timing and difficulty of the study (randomization) were included in the variable costs. The economic assessment of these items was based on the costs of the materials and means used, the cost of staff time and finally the cost of drug storage during the clinical trial. This model was applied to 24 clinical trials carried out in the University Clinic of Navarra. 83% of all pharmacy costs of a clinical trial were variable. Drug dispensing, stock management and return drugs account for 94% of the time expended. The approximate cost of the pharmacy providing investigational services was $1,766 per trial or $174 per patient. Drug storage costs were not an important source of expenditure among the variable costs (7.4%). The best way to determine the cost of a trial is to calculate the number of operations.

Effect of present technology on airship capabilities

NASA Technical Reports Server (NTRS)

Madden, R. T.

1975-01-01

The effect is presented of updating past airship designs using current materials and propulsion systems to determine new airship performance and productivity capabilities. New materials and power plants permit reductions in the empty weights and increases in the useful load capabilities of past airship designs. The increased useful load capability results in increased productivity for a given range, i.e., either increased payload at the same operating speed or increased operating speed for the same payload weight or combinations of both. Estimated investment costs and operating costs are presented to indicate the significant cost parameters in estimating transportation costs of payloads in cents per ton mile. Investment costs are presented considering production lots of 1, 10 and 100 units. Operating costs are presented considering flight speeds and ranges.

Sensitivity study of Space Station Freedom operations cost and selected user resources

NASA Technical Reports Server (NTRS)

Accola, Anne; Fincannon, H. J.; Williams, Gregory J.; Meier, R. Timothy

1990-01-01

The results of sensitivity studies performed to estimate probable ranges for four key Space Station parameters using the Space Station Freedom's Model for Estimating Space Station Operations Cost (MESSOC) are discussed. The variables examined are grouped into five main categories: logistics, crew, design, space transportation system, and training. The modification of these variables implies programmatic decisions in areas such as orbital replacement unit (ORU) design, investment in repair capabilities, and crew operations policies. The model utilizes a wide range of algorithms and an extensive trial logistics data base to represent Space Station operations. The trial logistics data base consists largely of a collection of the ORUs that comprise the mature station, and their characteristics based on current engineering understanding of the Space Station. A nondimensional approach is used to examine the relative importance of variables on parameters.

A Study of the Economic Benefit Potential of Intermodal Transports

NASA Technical Reports Server (NTRS)

Nelson, J. M.; Kawai, R. T.; Gregg, R. D.; McKinley, Robert E., Jr. (Technical Monitor)

2001-01-01

A conceptual study was conducted to determine the benefit potential of an Intermodal Transport in which quick change payload modules are used to reduce the cost of air travel by increasing daily utilization. Three basic concepts varying the degree of modularity were investigated for a 122,000 pounds payload 3,000 NM range regional wide body transport. The profit potential for operating as a passenger transport during the day and as a freighter at night was assessed. Assuming current levels of profitability, Intermodal operations could offer an operating cost reduction potential up to 20%. Enabling technology needs are identified as very quiet aircraft for expanded night operations, distributed load carrying quick disconnect latching, and configuration dependent safety issues. Recommendations are made to explore if additional benefits are possible from alternative mission and usage modules.

Earlier surgical intervention in congenital heart disease results in better outcome and resource utilization.

PubMed

Panni, Roheena Z; Ashfaq, Awais; Amanullah, Muhammad M

2011-12-29

Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively; among patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan. A prevalence based cost of illness study design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children ≤ 5 years of age from June 2006 to June 2009. A total of 120 patients were enrolled after obtaining an informed consent and the data was collected using a pre-tested questionnaire. The mean age at the time of surgery in group A (1-12 mo age) was 6.08 ± 2.80 months and in group B (1-5 yrs) was 37.10 ± 19.94 months. The cost of surgical admission was found to be significantly higher in the older group, p = 0.001. The total number and cost of post-operative outpatient visits was also higher in group B, p = 0.003. Pre and post operative hospital admissions were not found to be significantly different among the two groups, p = 0.166 and 0.627, respectively. The number of complications were found to be different between the two groups (p = 0.019). Majority of these were contributed by hemorrhage and post-operative seizures. This study concluded that significant expenditure is incurred by people with CHD; with the implication that resources could be saved by earlier detection and awareness campaigns.

Cellular Manufacturing System with Dynamic Lot Size Material Handling

NASA Astrophysics Data System (ADS)

Khannan, M. S. A.; Maruf, A.; Wangsaputra, R.; Sutrisno, S.; Wibawa, T.

2016-02-01

Material Handling take as important role in Cellular Manufacturing System (CMS) design. In several study at CMS design material handling was assumed per pieces or with constant lot size. In real industrial practice, lot size may change during rolling period to cope with demand changes. This study develops CMS Model with Dynamic Lot Size Material Handling. Integer Linear Programming is used to solve the problem. Objective function of this model is minimizing total expected cost consisting machinery depreciation cost, operating costs, inter-cell material handling cost, intra-cell material handling cost, machine relocation costs, setup costs, and production planning cost. This model determines optimum cell formation and optimum lot size. Numerical examples are elaborated in the paper to ilustrate the characterictic of the model.

Reducing Operating Room Costs Through Real-Time Cost Information Feedback: A Pilot Study.

PubMed

Tabib, Christian H; Bahler, Clinton D; Hardacker, Thomas J; Ball, Kevin M; Sundaram, Chandru P

2015-08-01

To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care. All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor nephrectomy. Before the beginning of this project, costs pertaining to the 20 most recent cases were analyzed. Items were identified from previous cases as modifiable for replacement or omission. Timely feedback of total OR costs and cost of each item used was provided to the surgeon after each case, and costs were analyzed. A cost analysis of the robot-assisted partial nephrectomy before the washout period indicates expenditures of $5243.04 per case. Ten recommended modifiable items were found to have an average per case cost of $1229.33 representing 23.4% of the total cost. A postwashout period cost analysis found the total OR cost decreased by $899.67 (17.2%) because of changes directly related to the modifiable items. Therefore, 73.2% of the possible identified savings was realized. The same stepwise approach was applied to laparoscopic donor nephrectomies. The average total cost per case before the washout period was $3530.05 with $457.54 attributed to modifiable items. After the washout period, modifiable items costs were reduced by $289.73 (8.0%). No complications occurred in the donor nephrectomy cases while one postoperative complication occurred in the partial nephrectomy group. Providing surgeons with feedback related to OR costs may lead to a change in surgeon behavior and decreased overall costs. Further studies are needed to show equivalence in patient outcomes.

Unit costs for house spraying and bednet impregnation with residual insecticides in Colombia: a management tool for the control of vector-borne disease.

PubMed

Kroeger, A; Ayala, C; Medina Lara, A

2002-06-01

A study of unit costs and cost components of two malaria-control strategies (house spraying and bednet impregnation with residual insecticides) was undertaken in 11 malaria-endemic states (departamentos) of Colombia, using data provided by control staff on self-administered questionnaires. The accuracy of the data was verified by personal visits, telephone conversations and complementary information from 10 other states. Allthe financial-cost components of the malaria-control operations carried out in the previous 6 months and the results of the control operations themselves (including the numbers of houses sprayed and numbers of bednets impregnated/day) were recorded. The information was stratified according to whether the target communities were 'near' or 'far away' from an operational base, the far-away communities being those that needed overnight stays by the control staff. The main variables analysed were unit costs/house treated, and annual cost/person protected. The results show that house spraying was generally more expensive for the health services than bednet impregnation. This is particularly the case in 'nearby' communities, where most of those at-risk live. In such communities, spraying one house was 7.2 times more expensive than impregnating one bednet. Even if only those sleeping under an impregnated net were assumed to be protected, the unit costs/person protected in a 'nearby' community were twice as high for house spraying than for bednet impregnation. In 'nearby' communities, where technicians could return to the operational base each evening, insecticides made up 80% of the total spraying costs and 42% of the costs of bednet impregnation. In 'far-away' communities, however, salaries and 'per diems' were the most important cost components, representing, respectively, 23% and 22% of the costs of spraying, and 34% plus 27% of the costs of impregnation. Insecticide wastage and non-use of discounts on insecticide prices (available through the national Ministry of Health) increased the overall costs considerably. The multiple uses of these cost calculations for district health managers are presented.

Autonomous Flight Rules Concept: User Implementation Costs and Strategies

NASA Technical Reports Server (NTRS)

Cotton, William B.; Hilb, Robert

2014-01-01

The costs to implement Autonomous Flight Rules (AFR) were examined for estimates in acquisition, installation, training and operations. The user categories were airlines, fractional operators, general aviation and unmanned aircraft systems. Transition strategies to minimize costs while maximizing operational benefits were also analyzed. The primary cost category was found to be the avionics acquisition. Cost ranges for AFR equipment were given to reflect the uncertainty of the certification level for the equipment and the extent of existing compatible avionics in the aircraft to be modified.

DCJ-indel and DCJ-substitution distances with distinct operation costs

PubMed Central

2013-01-01

Background Classical approaches to compute the genomic distance are usually limited to genomes with the same content and take into consideration only rearrangements that change the organization of the genome (i.e. positions and orientation of pieces of DNA, number and type of chromosomes, etc.), such as inversions, translocations, fusions and fissions. These operations are generically represented by the double-cut and join (DCJ) operation. The distance between two genomes, in terms of number of DCJ operations, can be computed in linear time. In order to handle genomes with distinct contents, also insertions and deletions of fragments of DNA – named indels – must be allowed. More powerful than an indel is a substitution of a fragment of DNA by another fragment of DNA. Indels and substitutions are called content-modifying operations. It has been shown that both the DCJ-indel and the DCJ-substitution distances can also be computed in linear time, assuming that the same cost is assigned to any DCJ or content-modifying operation. Results In the present study we extend the DCJ-indel and the DCJ-substitution models, considering that the content-modifying cost is distinct from and upper bounded by the DCJ cost, and show that the distance in both models can still be computed in linear time. Although the triangular inequality can be disrupted in both models, we also show how to efficiently fix this problem a posteriori. PMID:23879938

CleanFleet final report. Volume 8, fleet economics

DOT National Transportation Integrated Search

1995-12-01

The costs that face a fleet operator in implementing alternative motor fuels : into fleet operations are examined. The cost assessment is built upon a list of thirteen cost factors grouped into the three catagories: infrastructure costs, vehicle owni...

Development and application of a model for the analysis of trades between space launch system operations and acquisition costs

NASA Astrophysics Data System (ADS)

Nix, Michael B.

2005-12-01

Early design decisions in the development of space launch systems determine the costs to acquire and operate launch systems. Some sources indicate that as much as 90% of life cycle costs are fixed by the end of the critical design review phase. System characteristics determined by these early decisions are major factors in the acquisition cost of flight hardware elements and facilities and influence operations costs through the amount of maintenance and support labor required to sustain system function. Operations costs are also dependent on post-development management decisions regarding how much labor will be deployed to meet requirements of market demand and ownership profit. The ability to perform early trade-offs between these costs is vital to the development of systems that have the necessary capacity to provide service and are profitable to operate. An Excel-based prototype model was developed for making early analyses of trade-offs between the costs to operate a space launch system and to acquire the necessary assets to meet a given set of operational requirements. The model, integrating input from existing models and adding missing capability, allows the user to make such trade-offs across a range of operations concepts (required flight rates, staffing levels, shifts per workday, workdays per week and per year, unreliability, wearout and depot maintenance) and the number, type and capability of assets (flight hardware elements, processing and supporting facilities and infrastructure). The costs and capabilities of hypothetical launch systems can be modeled as a function of interrelated turnaround times and labor resource levels, and asset loss and retirement. The number of flight components and facilities required can be calculated and the operations and acquisition costs compared for a specified scenario. Findings, based on the analysis of a hypothetical two stage to orbit, reusable, unmanned launch system, indicate that the model is suitable for the trade-off analyses desired. The minimum turnaround time/maximum labor allocation for specific hardware configurations and characteristics and corresponding asset requirements can be estimated. Either turnaround time or resources can be varied and the resulting operations and acquisition costs can be compared. Asset reliability, wearout and depot maintenance intervals and durations can be varied as well to analyze the effects on costs. Likewise, the effects on operations and acquisitions costs of the introduction of alternative technologies that affect reliability, maintainability and supportability in various hardware configurations can be evaluated.

19 CFR 10.206 - Value content requirement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... countries, plus the direct costs of processing operations performed in a beneficiary country or countries...)(1) of this part. Any cost or value of materials or direct costs of processing operations...) combining or packaging operations, or mere dilution with water or mere dilution with another substance that...

40 CFR 610.23 - Operator interaction effects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of sensitivity of device effectiveness to variances in installation, operation and maintenance; (b..., operation and maintenance; (c) The extent to which device installation or use, or the effects of such... between total cost of ownership of the device (purchase price plus maintenance costs) and the cost savings...

Development challenges of secondary and small airports in California.

DOT National Transportation Integrated Search

2012-06-01

This study investigates the development of secondary and smaller airports in California. Low-Cost Carrier (LCC) business is growing at these airports because they offer reduced operating costs, and they have adequate capacity to help LCCs avoid battl...

Maintenance, repair, and rehabilitation unit costs for PONTIS.

DOT National Transportation Integrated Search

1995-01-01

In the summer of 1993, the Bridge Management Task Force chairman requested that the Virginia Transportation Research Council begin a study of the maintenance, repair, and rehabilitation unit costs needed for the operation of the Pontis system. Becaus...

A Cost-Effectiveness Analysis of Blended Versus Face-to-Face Delivery of Evidence-Based Medicine to Medical Students.

PubMed

Maloney, Stephen; Nicklen, Peter; Rivers, George; Foo, Jonathan; Ooi, Ying Ying; Reeves, Scott; Walsh, Kieran; Ilic, Dragan

2015-07-21

Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear. This study aimed to determine the cost-effectiveness of a face-to-face learning and blended learning approach for evidence-based medicine training within a medical program. The economic evaluation was conducted as part of a randomized controlled trial (RCT) comparing the evidence-based medicine (EBM) competency of medical students who participated in two different modes of education delivery. In the traditional face-to-face method, students received ten 2-hour classes. In the blended learning approach, students received the same total face-to-face hours but with different activities and additional online and mobile learning. Online activities utilized YouTube and a library guide indexing electronic databases, guides, and books. Mobile learning involved self-directed interactions with patients in their regular clinical placements. The attribution and differentiation of costs between the interventions within the RCT was measured in conjunction with measured outcomes of effectiveness. An incremental cost-effectiveness ratio was calculated comparing the ongoing operation costs of each method with the level of EBM proficiency achieved. Present value analysis was used to calculate the break-even point considering the transition cost and the difference in ongoing operation cost. The incremental cost-effectiveness ratio indicated that it costs 24% less to educate a student to the same level of EBM competency via the blended learning approach used in the study, when excluding transition costs. The sunk cost of approximately AUD $40,000 to transition to the blended model exceeds any savings from using the approach within the first year of its implementation; however, a break-even point is achieved within its third iteration and relative savings in the subsequent years. The sensitivity analysis indicates that approaches with higher transition costs, or staffing requirements over that of a traditional method, are likely to result in negative value propositions. Under the study conditions, a blended learning approach was more cost-effective to operate and resulted in improved value for the institution after the third year iteration, when compared to the traditional face-to-face model. The wider applicability of the findings are dependent on the type of blended learning utilized, staffing expertise, and educational context.

Optimization of wastewater treatment plant operation for greenhouse gas mitigation.

PubMed

Kim, Dongwook; Bowen, James D; Ozelkan, Ertunga C

2015-11-01

This study deals with the determination of optimal operation of a wastewater treatment system for minimizing greenhouse gas emissions, operating costs, and pollution loads in the effluent. To do this, an integrated performance index that includes three objectives was established to assess system performance. The ASMN_G model was used to perform system optimization aimed at determining a set of operational parameters that can satisfy three different objectives. The complex nonlinear optimization problem was simulated using the Nelder-Mead Simplex optimization algorithm. A sensitivity analysis was performed to identify influential operational parameters on system performance. The results obtained from the optimization simulations for six scenarios demonstrated that there are apparent trade-offs among the three conflicting objectives. The best optimized system simultaneously reduced greenhouse gas emissions by 31%, reduced operating cost by 11%, and improved effluent quality by 2% compared to the base case operation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Activity-based costing evaluation of a [(18)F]-fludeoxyglucose positron emission tomography study.

PubMed

Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Borght, Thierry Vander

2009-10-01

The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes. The cost data were obtained from the hospital administration, personnel and vendor interviews as well as from structured questionnaires. A process map separates the process in 16 patient- and non-patient-related activities, to which the detailed cost data are related. One-way sensitivity analyses shows to which degree of uncertainty the different parameters affect the individual cost and evaluate the impact of possible resource or practice changes like the acquisition of a hybrid PET/CT device, the patient throughput or the sales price of a 370MBq (18)F-FDG patient dose. The PET centre spends 73% of time in clinical activities and the resting time after injection of the tracer (42%) is the single largest departmental cost element. The tracer cost and the operational time have the most influence on cost per procedure. The analysis shows a total cost per FDG-PET ranging from 859 Euro for a BGO PET camera to 1142 Euro for a 16 slices PET-CT system, with a distribution of the resource costs in decreasing order: materials (44%), equipment (24%), wage (16%), space (6%) and hospital overhead (10%). The cost of FDG-PET is mainly influenced by the cost of the radiopharmaceutical. Therefore, the latter rather than the operational time should be reduced in order to improve its cost-effectiveness.

Costs of inguinal hernia repair associated with using different medical devices in the Czech Republic.

PubMed

Marešová, Petra; Peteja, Matus; Lerch, Milan; Zonca, Pavel; Kuca, Kamil

2016-01-01

Inguinal hernia repair is one of the most frequently carried out operations worldwide. The purpose of this article is to analyze the costs of hernia repair and to specify the loss or profit made under the conditions in the Czech Republic with respect to the currently used medical devices and approaches. This article is based on the Drummond and O'Brien methodology, which specifically determines the content of direct and indirect costs in health services. The costs of operations during the period 2010-2014 were specified for a total of 746 patients. The cost details are described for four patients who represent the use of different types of medical devices. The procedure was a laparoscopic surgery in all cases. The total costs of inguinal hernia repairs (as per 2015 currency conversion rate) are €1,248,579; only part is covered from public funds, resulting in a loss of €218,359 for the hospital. The obtained data indicate that this operation is unprofitable for hospitals under the present conditions. The loss in the subject facility amounts to 17% of the total cost, which is the cost incurred by the hospital in the Czech Republic. The study conducted in the Czech Republic refers to different economic results when using various medical device types. So the medical device selection depends on advantages or disadvantages for the patients, as well as on the cost effectiveness for the hospital.

Using RFID Tagging in a Mining Industry Maintenance, Repair, and Operating (MRO) Supply Warehouse: A Case Study

ERIC Educational Resources Information Center

Smith, George D.

2008-01-01

The use of Radio Frequency Identification (RFID) technology has been shown to be successful by reducing operating costs in the retail and manufacturing industries, but has never been considered in the literature for a mining industry maintenance, repair, and operating (MRO) supply chain. This field study was conducted to determine whether or not…

Economic Impact of Revision Surgery for Proximal Junctional Failure After Adult Spinal Deformity Surgery: A Cost Analysis of 57 Operations in a 10-year Experience at a Major Deformity Center.

PubMed

Theologis, Alexander A; Miller, Liane; Callahan, Matt; Lau, Darryl; Zygourakis, Corinna; Scheer, Justin K; Burch, Shane; Pekmezci, Murat; Chou, Dean; Tay, Bobby; Mummaneni, Praveen; Berven, Sigurd; Deviren, Vedat; Ames, Christopher P

2016-08-15

Retrospective cohort analysis. To evaluate the economic impact of revision surgery for proximal junctional failures (PJF) after thoracolumbar fusions for adult spinal deformity (ASD). PJF after fusions for ASD is a major cause of disability. Although clinical sequelae are described, PJF-revision operation costs are incompletely defined. Consecutive adults who underwent thoracolumbar fusions for ASD (August, 2003 to January, 2013) were evaluated. Inclusion criteria include construct from pelvis to L2 or above and minimum 6 months follow-up after the index ASD operation. Direct costs (surgical supplies/implants, room/care, pharmacy, services) were identified from medical billing data and calculated for index ASD operations and subsequent surgeries for PJF. Not included in direct cost data were indirect costs, charges, surgeon fees, or revision operations for indications other than PJF (i.e., pseudarthrosis). Patients were compared based on the construct's upper-instrumented vertebra: upper thoracic (UT: T1-6) versus thoracolumbar junction (TLjxn: T9-L2). Of 501 patients, 382 met inclusion criteria. Fifty-one patients [UT:14; TLjxn: 40 at index; average follow-up 32.6 months (6-92 months)] had revisions for PJF, which summed to $3.2 million total direct cost. Average direct cost of index operations for the cohort ($68,294) was significantly greater than PJF-revisions ($55,547). Compared with TLjxn, UT had a significantly higher average cost for index operations ($79,860 vs. $65,868). However, PJF-revision cases were similar in average cost (UT:$60,103; TLjxn:$53,920; P = 0.09). Costs of PJF amounted to an additional 12.1% of the total index surgical cost in 382 patients. Revision operations for PJF after long thoracolumbar fusions for ASD are associated with an average direct cost of $55,547 per case. Revision costs for PJF are similar based on the index procedure's upper-instrumented vertebra level. At a major tertiary center over a 10-year period, PJF came at a very significant economic expense amounting to $3.2 million for 57 cases. 3.

Sludge digestion instead of aerobic stabilisation - a cost benefit analysis based on experiences in Germany.

PubMed

Gretzschel, Oliver; Schmitt, Theo G; Hansen, Joachim; Siekmann, Klaus; Jakob, Jürgen

2014-01-01

As a consequence of a worldwide increase of energy costs, the efficient use of sewage sludge as a renewable energy resource must be considered, even for smaller wastewater treatment plants (WWTPs) with design capacities between 10,000 and 50,000 population equivalent (PE). To find the lower limit for an economical conversion of an aerobic stabilisation plant into an anaerobic stabilisation plant, we derived cost functions for specific capital costs and operating cost savings. With these tools, it is possible to evaluate if it would be promising to further investigate refitting aerobic plants into plants that produce biogas. By comparing capital costs with operation cost savings, a break-even point for process conversion could be determined. The break-even point varies depending on project specific constraints and assumptions related to future energy and operation costs and variable interest rates. A 5% increase of energy and operation costs leads to a cost efficient conversion for plants above 7,500 PE. A conversion of WWTPs results in different positive effects on energy generation and plant operations: increased efficiency, energy savings, and on-site renewable power generation by digester gas which can be used in the plant. Also, the optimisation of energy efficiency results in a reduction of primary energy consumption.

Syringe Port: A Convenient, Safe, and Cost-Effective Tubular Retractor for Transportal Removal of Deep-Seated Lesions of the Brain.

PubMed

Singh, Harnarayan; Patir, Rana; Vaishya, Sandeep; Miglani, Rahul; Kaur, Amandeep

2018-06-01

Minimally invasive transportal resection of deep intracranial lesions has become a widely accepted surgical technique. Many disposable, mountable port systems are available in the market for this purpose, like the ViewSite Brain Access System. The objective of this study was to find a cost-effective substitute for these systems. Deep-seated brain lesions were treated with a port system made from disposable syringes. The syringe port could be inserted through minicraniotomies placed and planned with navigation. All deep-seated lesions like ventricular tumours, colloid cysts, deep-seated gliomas, and basal ganglia hemorrhages were treated with this syringe port system and evaluated for safety, operative site hematomas, and blood loss. 62 patients were operated on during the study period from January 2015 to July 2017, using this innovative syringe port system for deep-seated lesions of the brain. No operative site hematoma or contusions were seen along the port entry site and tract. Syringe port is a cost-effective and safe alternative to the costly disposable brain port systems, especially for neurosurgical setups in developing countries for minimally invasive transportal resection of deep brain lesions. Copyright © 2018 Elsevier Inc. All rights reserved.

Earth Observatory Satellite system definition study. Report no. 3: Design/cost tradeoff studies

NASA Technical Reports Server (NTRS)

1974-01-01

The key issues in the Earth Observatory Satellite (EOS) program which are subject to configuration study and tradeoff are identified. The issue of a combined operational and research and development program is considered. It is stated that cost and spacecraft weight are the key design variables and design options are proposed in terms of these parameters. A cost analysis of the EOS program is provided. Diagrams of the satellite configuration and subsystem components are included.

Conceptual design of an orbital propellant transfer experiment. Volume 2: Study results

NASA Technical Reports Server (NTRS)

Drake, G. L.; Bassett, C. E.; Merino, F.; Siden, L. E.; Bradley, R. E.; Carr, E. J.; Parker, R. E.

1980-01-01

The OTV configurations, operations and requirements planned for the period from the 1980's to the 1990's were reviewed and a propellant transfer experiment was designed that would support the needs of these advanced OTV operational concepts. An overall integrated propellant management technology plan for all NASA centers was developed. The preliminary cost estimate (for planning purposes only) is $56.7 M, of which approximately $31.8 M is for shuttle user costs.

Microwave power transmission system studies. Volume 3, section 8: Mechanical systems and flight operations

NASA Technical Reports Server (NTRS)

Maynard, O. E.; Brown, W. C.; Edwards, A.; Haley, J. T.; Meltz, G.; Howell, J. M.; Nathan, A.

1975-01-01

The efforts and recommendations associated with preliminary design and concept definition for mechanical systems and flight operations are presented. Technical discussion in the areas of mission analysis, antenna structural concept, configuration analysis, assembly and packaging with associated costs are presented. Technology issues for the control system, structural system, thermal system and assembly including cost and man's role in assembly and maintenance are identified. Background and desired outputs for future efforts are discussed.

Study of the modifications needed for effective operation NASTRAN on IBM virtual storage computers

NASA Technical Reports Server (NTRS)

Mccormick, C. W.; Render, K. H.

1975-01-01

The necessary modifications were determined to make NASTRAN operational under virtual storage operating systems (VS1 and VS2). Suggested changes are presented which will make NASTRAN operate more efficiently under these systems. Estimates of the cost and time involved in design, coding, and implementation of all suggested modifications are included.

Reduced length of stay in hospital for burn patients following a change in practice guidelines: financial implications.

PubMed

Jansen, Leigh A; Hynes, Sally L; Macadam, Sheina A; Papp, Anthony

2012-01-01

The objective of this study was to analyze the financial implications of the implementation of new institutional practice guidelines including greater outpatient care and earlier operative intervention in a provincial burn center. A retrospective review was performed including all patients admitted to the Burn Unit with burns up to 20% TBSA between August 2005 and July 2009, including 2 years before and after the new guidelines were introduced. Daily costs for the burn unit were used to calculate this portion of cost. Length of stay (LOS) was based on actual data and representative clinical scenarios. Two hundred sixty-four patients were included. Mean LOS decreased from 10.3 to 3.9 (P < .01) and 21.0 to 13.3 (P > .05) for nonoperative burns 0 to 10% and 10 to 20% TBSA, respectively. Mean LOS for operative burns decreased from 16.6 to 12.9 and 32.3 to 29.8 days for 0 to 10% and 10 to 20% TBSA, respectively (P > .05). Burn patient management requires significant financial resources, and LOS has a large impact on cost. Given per diem rates of Can$1,663, scenario analysis shows potential cost savings of Can$19,956 per patient for operative and nonoperative burns <20% TBSA. With an average of 66 such patients treated each year, potential annual cost savings are Can$1.3 million. If outcomes are not compromised, earlier operative management and greater outpatient care can translate into significant cost savings. A prospective analysis capturing all costs and patient quality of life is required for further assessment.

The small community solar thermal power experiment. Parabolic dish technology for industrial process heat application

NASA Technical Reports Server (NTRS)

Polzien, R. E.; Rodriguez, D.

1981-01-01

Aspects of incorporating a thermal energy transport system (ETS) into a field of parabolic dish collectors for industrial process heat (IPH) applications were investigated. Specific objectives are to: (1) verify the mathematical optimization of pipe diameters and insulation thicknesses calculated by a computer code; (2) verify the cost model for pipe network costs using conventional pipe network construction; (3) develop a design and the associated production costs for incorporating risers and downcomers on a low cost concentrator (LCC); (4) investigate the cost reduction of using unconventional pipe construction technology. The pipe network design and costs for a particular IPH application, specifically solar thermally enhanced oil recovery (STEOR) are analyzed. The application involves the hybrid operation of a solar powered steam generator in conjunction with a steam generator using fossil fuels to generate STEOR steam for wells. It is concluded that the STEOR application provides a baseline pipe network geometry used for optimization studies of pipe diameter and insulation thickness, and for development of comparative cost data, and operating parameters for the design of riser/downcomer modifications to the low cost concentrator.

The Economics of Air Cargo

NASA Technical Reports Server (NTRS)

Kersey, J. W.

1972-01-01

The economic factors involved in air cargo operations and air cargo marketing development are discussed. Specific steps which are followed by various airports to reduce operating costs are described. The economics of cargo handling within an airline are analyzed with respect to: (1) paperwork costs, (2) terminal costs, (3) line haul costs, and (4) claims costs.

Enhanced education and physiotherapy before knee replacement; is it worth it? A systematic review.

PubMed

Jordan, R W; Smith, N A; Chahal, G S; Casson, C; Reed, M R; Sprowson, A P

2014-12-01

Around 20% of knee replacement have an unsatisfactory outcome. Pre-operative physiotherapy and education have been proposed to improve post-operative outcomes. This systematic review evaluated whether these factors improved length of stay and patient reported outcomes after knee replacement surgery. Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO and PEDro were searched on the 1st January 2013. Randomised or quasi-randomised studies assessing either pre-operative education or physiotherapy on patients undergoing a planned total or partial knee replacement were included in the review. Only studies with a control group receiving a defined standard of pre-operative care were included. Eleven studies met the inclusion criteria set. Two studies analysed the effect of pre-operative education, seven pre-operative treatment by a physiotherapist and two studies used both factors. No study found significant differences in validated joint specific patient reported outcome measures. The education studies found a decrease in pre-operative expectation and an improvement in knowledge, flexion and regularity of exercise. Two studies found an improvement in muscle strength in the group treated by a physiotherapist at three months. The combination of education and physiotherapy was shown to reduce patient length of stay and cost in one study. The evidence reviewed is insufficient to support the implementation of either pre-operative education or physiotherapy programmes. The combination of pre-operative education and treatment by a physiotherapist may reduce the medical costs associated with surgery. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Association Between Surgeon Scorecard Use and Operating Room Costs.

PubMed

Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

2017-03-01

Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases) in 2014 to $765 (IQR, $233-$1719) (17 227 cases) in 2015. This decrease represents a total savings of $836 147 in the intervention group during the 1-year study. After controlling for surgeon, department, patient demographics, and clinical indicators in a mixed-effects model, there was a 9.95% (95% CI, 3.55%-15.93%; P = .003) surgical supply cost decrease in the intervention group over 1 year. Patient outcomes were equivalent or improved after the intervention, and surgeons who received scorecards reported higher levels of cost awareness on the health care value survey compared with controls. Cost feedback to surgeons, combined with a small departmental financial incentive, was associated with significantly reduced surgical supply costs, without negatively affecting patient outcomes.

Open versus robot-assisted radical cystectomy: 30-day perioperative comparison and predictors for cost-to-patient, complication, and readmission.

PubMed

Flamiatos, Jason F; Chen, Yiyi; Lambert, William E; Martinez Acevedo, Ann; Becker, Thomas M; Bash, Jasper C; Amling, Christopher L

2018-06-08

The objectives of this study are to evaluate if robotic cystectomy demonstrates reduced complications, readmissions, and cost-to-patient compared to open approach 30-day post-operatively, and to identify predictors of complication, readmission, and cost-to-patient. This retrospective cohort study analyzed 249 patients who underwent open (n = 149) or robotic (n = 100) cystectomy from 2009 to 2015 at our institution. Outcomes included 30-day post-operative complication, readmission, and cost-to-patient charges. We used modified Clavien-Dindo/MSKCC classifications. Multivariable logistic and linear regression models were used to evaluate associations to outcomes and to build predictive models. Patient, clinical, and surgical characteristics differed by open and robotic groups, respectively, only for estimated blood loss (median: 600 versus 150 cc, p < 0.01), operative time (mean: 6.19 versus 6.85 h, p < 0.01), and length of stay (median: 7 versus 5 days, p < 0.01). Complication: frequency of patients with at least one 30-day complication was 85% compared to 66% (p < 0.01). Minor gastrointestinal and bleeding complications were increased in the open group (50% versus 41%, p = 0.01; 52% versus 11%, p < 0.01, respectively). Fifty percent of patients required blood transfusion in open compared to 11% (p < 0.01). Patients in the open group experienced more major complications (19% versus 10%, p = 0.04). Robotic approach was a predictor for fewer complications (OR 0.44, 95% CI 0.20-0.99, p = 0.049). Readmission: no significant difference in number of patients readmitted was found. Cost-to-patient: Robotic approach predicted an 18% reduction in total cost-to-patient compared to open approach (p < 0.01). Robotic cystectomy demonstrated reduced total cost-to-patient when taking into account all 30-day post-operative services with fewer complications compared to open cystectomy.

A mixed integer linear programming model for operational planning of a biodiesel supply chain network from used cooking oil

NASA Astrophysics Data System (ADS)

Jonrinaldi, Hadiguna, Rika Ampuh; Salastino, Rades

2017-11-01

Environmental consciousness has paid many attention nowadays. It is not only about how to recycle, remanufacture or reuse used end products but it is also how to optimize the operations of the reverse system. A previous research has proposed a design of reverse supply chain of biodiesel network from used cooking oil. However, the research focused on the design of the supply chain strategy not the operations of the supply chain. It only decided how to design the structure of the supply chain in the next few years, and the process of each stage will be conducted in the supply chain system in general. The supply chain system has not considered operational policies to be conducted by the companies in the supply chain. Companies need a policy for each stage of the supply chain operations to be conducted so as to produce the optimal supply chain system, including how to use all the resources that have been designed in order to achieve the objectives of the supply chain system. Therefore, this paper proposes a model to optimize the operational planning of a biodiesel supply chain network from used cooking oil. A mixed integer linear programming is developed to model the operational planning of biodiesel supply chain in order to minimize the total operational cost of the supply chain. Based on the implementation of the model developed, the total operational cost of the biodiesel supply chain incurred by the system is less than the total operational cost of supply chain based on the previous research during seven days of operational planning about amount of 2,743,470.00 or 0.186%. Production costs contributed to 74.6 % of total operational cost and the cost of purchasing the used cooking oil contributed to 24.1 % of total operational cost. So, the system should pay more attention to these two aspects as changes in the value of these aspects will cause significant effects to the change in the total operational cost of the supply chain.

Upgrade of Compressed Air Control System Reduces Energy Costs at Michelin Tire Plant

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

None

2002-01-01

This case study highlights the upgraded compressed air system at a Michelin tire manufacturing plant in Spartanburg, South Carolina. The controls upgrade project enabled multiple compressor operation without blow-off, and significantly reduced energy costs.

Costs of harvesting beetle-killed lodgepole pine in Eastern Oregon.

Treesearch

Peter J. Ince; John W. Henley; John B. Grantham; Douglas L. Hunt

1984-01-01

The cost of harvesting and recovering round wood logs and whole-tree chips from small diameter lodgepole pine (Pinus contorta) infested by mountain pine beetle (Dendroctonus sp.) was studied in the Blue Mountains of eastern Oregon in 1979. Mechanized harvest operations were conducted on six study sites totaling 134 acres. The...

Responding to Recession: IT Funding and Cost Management in Higher Education. Key Findings

ERIC Educational Resources Information Center

Goldstein, Philip J.

2010-01-01

This document presents the key findings from "Responding to Recession: IT Funding and Cost Management in Higher Education", the 2010 ECAR (EDUCAUSE Center for Applied Research) study of how the economic recession is impacting information technology (IT) organizations and operations in higher education. The study was designed to address the…

Television-Centered, Instructional Delivery Systems: Costs and Case Studies. A Review of Research.

ERIC Educational Resources Information Center

Maher, Thomas G.

This paper reviews the post-1975 research on the capacities, logistics, and costs of the various delivery technologies used in educational television, and details case studies of television-centered operations, particularly in relationship to adult learners. The paper begins with a section on general definitions and the capacities of various…

The relationships between OHS prevention costs, safety performance, employee satisfaction and accident costs.

PubMed

Bayram, Metin; Ünğan, Mustafa C; Ardıç, Kadir

2017-06-01

Little is known about the costs of safety. A literature review conducted for this study indicates there is a lack of survey-based research dealing with the effects of occupational health and safety (OHS) prevention costs. To close this gap in the literature, this study investigates the interwoven relationships between OHS prevention costs, employee satisfaction, OHS performance and accident costs. Data were collected from 159 OHS management system 18001-certified firms operating in Turkey and analyzed through structural equation modeling. The findings indicate that OHS prevention costs have a significant positive effect on safety performance, employee satisfaction and accident costs savings; employee satisfaction has a significant positive effect on accident costs savings; and occupational safety performance has a significant positive effect on employee satisfaction and accident costs savings. Also, the results indicate that safety performance and employee satisfaction leverage the relationship between prevention costs and accident costs.

Manned Systems Utilization Analysis. Study 2.1: Space Servicing Pilot Program Study. [for automated payloads

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1975-01-01

Space servicing automated payloads was studied for potential cost benefits for future payload operations. Background information is provided on space servicing in general, and on a pilot flight test program in particular. An fight test is recommended to demonstrate space servicing. An overall program plan is provided which builds upon the pilot program through an interim servicing capability. A multipayload servicing concept for the time when the full capability tug becomes operational is presented. The space test program is specifically designed to provide low-cost booster vehicles and a flight test platform for several experiments on a single flight.

Private equity ownership and nursing home financial performance.

PubMed

Pradhan, Rohit; Weech-Maldonado, Robert; Harman, Jeffrey S; Laberge, Alex; Hyer, Kathryn

2013-01-01

Private equity has acquired multiple large nursing home chains within the last few years; by 2009, it owned nearly 1,900 nursing homes. Private equity is said to improve the financial performance of acquired facilities. However, no study has yet examined the financial performance of private equity nursing homes, ergo this study. The primary purpose of this study is to understand the financial performance of private equity nursing homes and how it compares with other investor-owned facilities. It also seeks to understand the approach favored by private equity to improve financial performance-for instance, whether they prefer to cut costs or maximize revenues or follow a mixed approach. Secondary data from Medicare cost reports, the Online Survey, Certification and Reporting, Area Resource File, and Brown University's Long-term Care Focus data set are combined to construct a longitudinal data set for the study period 2000-2007. The final sample is 2,822 observations after eliminating all not-for-profit, independent, and hospital-based facilities. Dependent financial variables consist of operating revenues and costs, operating and total margins, payer mix (census Medicare, census Medicaid, census other), and acuity index. Independent variables primarily reflect private equity ownership. The study was analyzed using ordinary least squares, gamma distribution with log link, logit with binomial family link, and logistic regression. Private equity nursing homes have higher operating margin as well as total margin; they also report higher operating revenues and costs. No significant differences in payer mix are noted. Results suggest that private equity delivers superior financial performance compared with other investor-owned nursing homes. However, causes for concern remain particularly with the long-term financial sustainability of these facilities.

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

Miller, Benjamin, E-mail: BenjaminMiller@nyc.rr.com; Spertus, Juliette, E-mail: Juliette.Spertus@gmail.com; Kamga, Camille, E-mail: CKamga@UTRC2.org

Highlights: • Pneumatic and truck collection were compared in three New York City locations. • Relative costs, energy use, and greenhouse gas emissions varied significantly. • Variations were due to location-specific factors (e.g., route density, truck type). • Under appropriate conditions, pneumatic collection reduces TMT, BTU, and GHG. • Pneumatic capex may be offset by operating savings and externality benefits. - Abstract: Truck-based collection of municipal solid waste imposes significant negative externalities on cities and constrains the efficiency of separate collection of recyclables and organics and of unit-price-based waste-reduction systems. In recent decades, hundreds of municipal-scale pneumatic collection systems havemore » been installed in Europe and Asia. Relatively few prior studies have compared the economic or environmental impacts of these systems to those of truck collection. A critical factor to consider when making this comparison is the extent to which the findings reflect the specific geographic, demographic, and operational characteristics of the systems considered. This paper is based on three case studies that consider the specific characteristics of three locations, comparing pneumatic systems with conventional collection on the basis of actual waste tonnages, composition, sources, collection routes, truck trips, and facility locations. In one case, alternative upgrades to an existing pneumatic system are compared to a potential truck-collection operation. In the other cases, existing truck operations are compared to proposed pneumatic systems which, to reduce capital costs, would be installed without new trenching or tunneling through the use of existing linear infrastructure. For the two proposed retrofit pneumatic systems, up to 48,000 truck kilometers travelled would be avoided and energy use would be reduced by up to 60% at an incremental cost of up to $400,000 USD per year over the total operating-plus-capital cost of conventional collection. In the location where a greenfield pneumatic system is already in operation, truck collection would be both less expensive and more energy-efficient than pneumatic collection. The results demonstrate that local geographic, demographic, and operational conditions play a decisive role in determining whether pneumatic collection will reduce energy requirements, produce more or fewer greenhouse gas emissions, and cost more or less over the long-term. These findings point to the local factors that will determine the relative economic and environmental costs and benefits in specific situations.« less

Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

NASA Astrophysics Data System (ADS)

Hals, F. A.

1981-03-01

The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

Developing a cost effective environmental solution for produced water and creating a ''new'' water resource

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

Doran, Glenn; Leong, Lawrence Y.C.

2000-05-01

The project goal is to convert a currently usable by-product of oil production, produced water, into a valuable drinking water resource. The project was located at the Placate Oil Field in Santa Clarita, California, approximately 25 miles north of Los Angeles. The project included a literature review of treatment technologies; preliminary bench-scale studies to refine a planning level cost estimate; and a 10-100 gpm pilot study to develop the conceptual design and cost estimate for a 44,000 bpd treatment facility. A reverse osmosis system was constructed, pilot tested, and the data used to develop a conceptual design and operation ofmore » four operational scenarios, two industrial waters levels and two irrigation/potable water.« less

Conceptual design study of potential early commercial MHD powerplant. Report of task 2 results

NASA Technical Reports Server (NTRS)

Hals, F. A.

1981-01-01

The conceptual design of one of the potential early commercial MHD power plants was studied. The plant employs oxygen enrichment of the combustion air and preheating of this oxygen enriched air to an intermediate temperature of 1200 F attainable with a tubular type recuperative heat exchanger. Conceptual designs of plant componets and equipment with performance, operational characteristics, and costs are reported. Plant economics and overall performance including full and part load operation are reviewed. The projected performance and estimated cost of this early MHD plant are compared to conventional power plants, although it does not offer the same high efficiency and low costs as the mature MHD power plant. Environmental aspects and the methods incorporated in plant design for emission control of sulfur and nitrogen are reviewed.

Financial impact of hand surgery programs on academic medical centers.

PubMed

Hasan, Jafar S; Chung, Kevin C; Storey, Amy F; Bolg, Mary L; Taheri, Paul A

2007-02-01

This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. Fiscal year 2004 billing records for all patients (n = 671) who underwent hand surgery procedures were examined. The financial data were separated into professional revenues and costs (relating to the hand surgery program in the Section of Plastic Surgery) and into facility revenues and costs (relating to the overall University of Michigan Health System). Professional net revenue was calculated by applying historical collection rates to procedural and clinic charges. Facility revenue was calculated by applying historical collection rates to the following charge categories: inpatient/operating room, clinic facility, neurology/electromyography, radiology facilities, and occupational therapy. Total professional costs were calculated by adding direct costs and allocated overhead costs. Facility costs were obtained from the hospital's cost accounting system. Professional and facility incomes were calculated by subtracting costs from revenues. The net professional revenue and total costs were 1,069,836 and 1,027,421 dollars, respectively. Professional operating income was 42,415 dollars, or 3.96 percent of net professional revenue. Net facility revenue and total costs were 5,500,606 and 4,592,534 dollars, respectively. Facility operating income was 908,071 dollars, or 16.51 percent of net facility revenues. While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.

Identification of Flights for Cost-Efficient Climate Impact Reduction

NASA Technical Reports Server (NTRS)

Chen, Neil Y.; Kirschen, Philippe G.; Sridhar, Banavar; Ng, Hok K.

2014-01-01

The aircraft-induced climate impact has drawn attention in recent years. Aviation operations affect the environment mainly through the release of carbon-dioxide, nitrogen-oxides, and by the formation of contrails. Recent research has shown that altering trajectories can reduce aviation environmental cost by reducing Absolute Global Temperature Change Potential, a climate assessment metric that adapts a linear system for modeling the global temperature response to aviation emissions and contrails. However, these methods will increase fuel consumption that leads to higher fuel costs imposed on airlines. The goal of this work is to identify ights for which the environmental cost of climate impact reduction outweighs the increase in operational cost on an individual aircraft basis. Environmental cost is quanti ed using the monetary social cost of carbon. The increase in operational cost is considering cost of additional fuel usage only. For this paper, an algorithm has been developed that modi es the trajectories of ights to evaluate the e ect of environ- mental cost and operational cost of ights in the United States National Airspace System. The algorithm identi es ights for which the environmental cost of climate impact can be reduced and modi es their trajectories to achieve maximum environmental net bene t, which is the di erence between reduction in environmental cost and additional operational cost. The result shows on a selected day, 16% of the ights among eight major airlines, or 2,043 ights, can achieve environmental net bene t using weather forecast data, resulting in net bene t of around $500,000. The result also suggests that the long-haul ights would be better candidates for cost-ecient climate impact reduction than the short haul ights. The algorithm will help to identify the characteristics of ights that are capable of applying cost-ecient climate impact reduction strategy.

Effects of housing system on the costs of commercial egg production1

PubMed Central

Matthews, W. A.; Sumner, D. A.

2014-01-01

This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. PMID:25480736

Effects of housing system on the costs of commercial egg production.

PubMed

Matthews, W A; Sumner, D A

2015-03-01

This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

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...

Economical and technical efficiencies evaluation of full scale piggery wastewater treatment BNR plants.

PubMed

Oa, S W; Choi, E; Kim, S W; Kwon, K H; Min, K S

2009-01-01

A method evaluating the economic efficiency of piggery waste treatment plant based on kinetics for nitrogen removal performances is executed in this study and five full scale plants were evaluated, monitored intensively during one year under steady-state conditions. The performance data from those surveyed plants were recalculated by first-order kinetic equation instead of the Monod's equation, and the nitrogen removal kinetics related with COD/TKN ratios. Two plants adapting two extreme strategies for pre treatment, 'excess phase separation', and 'minimum phase separation', were evaluated by the assessment of life cycle cost (LCC). Although the compared two plants use an opposite strategy to each other, similar evaluation results are deduced by nitrogen removal efficiencies and operational and construction costs. But the proportions of constituent elements are as different as two opposite strategies, so electrical and construction costs are inversely proportional to chemical costs and operational costs respectively.

Economics of hydrogen production and liquefaction updated to 1980

NASA Technical Reports Server (NTRS)

Baker, C. R.

1979-01-01

Revised costs for generating and liquefying hydrogen in mid-1980 are presented. Plant investments were treated as straight-forward escalations resulting from inflation. Operating costs, however, were derived in terms of the unit cost of coal, fuel gas and electrical energy to permit the determination of the influence of these parameters on the cost of liquid hydrogen. Inflationary influence was recognized by requiring a 15% discounted rate of return on investment for Discounted Cash Flow financing analysis, up from 12% previously. Utility financing was revised to require an 11% interest rate on debt. The scope of operation of the hydrogen plant was revised from previous studies to include only the hydrogen generation and liquefaction facilities. On-site fuel gas and power generation, originally a part of the plant complex, was eliminated. Fuel gas and power are now treated as purchased utilities. Costs for on-site generation of fuel gas however, are included.

The cost of implementing inpatient bar code medication administration.

PubMed

Sakowski, Julie Ann; Ketchel, Alan

2013-02-01

To calculate the costs associated with implementing and operating an inpatient bar-code medication administration (BCMA) system in the community hospital setting and to estimate the cost per harmful error prevented. This is a retrospective, observational study. Costs were calculated from the hospital perspective and a cost-consequence analysis was performed to estimate the cost per preventable adverse drug event averted. Costs were collected from financial records and key informant interviews at 4 not-for profit community hospitals. Costs included direct expenditures on capital, infrastructure, additional personnel, and the opportunity costs of time for existing personnel working on the project. The number of adverse drug events prevented using BCMA was estimated by multiplying the number of doses administered using BCMA by the rate of harmful errors prevented by interventions in response to system warnings. Our previous work found that BCMA identified and intercepted medication errors in 1.1% of doses administered, 9% of which potentially could have resulted in lasting harm. The cost of implementing and operating BCMA including electronic pharmacy management and drug repackaging over 5 years is $40,000 (range: $35,600 to $54,600) per BCMA-enabled bed and $2000 (range: $1800 to $2600) per harmful error prevented. BCMA can be an effective and potentially cost-saving tool for preventing the harm and costs associated with medication errors.

The B-747 flight control system maintenance and reliability data base for cost effectiveness tradeoff studies

NASA Technical Reports Server (NTRS)

1982-01-01

Primary and automatic flight controls are combined for a total flight control reliability and maintenance cost data base using information from two previous reports and additional cost data gathered from a major airline. A comparison of the current B-747 flight control system effects on reliability and operating cost with that of a B-747 designed for an active control wing load alleviation system is provided.

Determination of the flight equipment maintenance costs of commuter airlines

NASA Technical Reports Server (NTRS)

1977-01-01

Labor and materials costs associated with maintaining and operating 12 commuter airlines carrying an average of from 42 to 1,100 passengers daily in a variety of aircraft types were studied to determine the total direct maintenance cost per flight hour for the airframe, engine, and avionics and other instruments. The distribution of maintenance costs are analyzed for two carriers, one using turboprop aircraft and the other using piston engine aircraft.

A flowsheet model of a well-mixed fluidized bed dryer: Applications in controllability assessment and optimization

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

Langrish, T.A.G.; Harvey, A.C.

2000-01-01

A model of a well-mixed fluidized-bed dryer within a process flowsheeting package (SPEEDUP{trademark}) has been developed and applied to a parameter sensitivity study, a steady-state controllability analysis and an optimization study. This approach is more general and would be more easily applied to a complex flowsheet than one which relied on stand-alone dryer modeling packages. The simulation has shown that industrial data may be fitted to the model outputs with sensible values of unknown parameters. For this case study, the parameter sensitivity study has found that the heat loss from the dryer and the critical moisture content of the materialmore » have the greatest impact on the dryer operation at the current operating point. An optimization study has demonstrated the dominant effect of the heat loss from the dryer on the current operating cost and the current operating conditions, and substantial cost savings (around 50%) could be achieved with a well-insulated and airtight dryer, for the specific case studied here.« less

Technology Solutions Case Study: Balancing Hydronic Systems in Multifamily Buildings, Chicago, Illinois

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

None

2014-09-01

In multifamily building hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. In this case study , Partnership for Advanced Residential Retrofit and Elevate Energy. explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs.

Experiments in a Combustion-Driven Shock Tube with an Area Change

NASA Astrophysics Data System (ADS)

Schmidt, B. E.; Bobbitt, B.; Parziale, N. J.; Shepherd, J. E.

Shock tubes are versatile and useful tools for studying high temperature gas dynamics and the production of hypervelocity flows. High shock speeds are desirable for creating higher enthalpy, pressure, and temperature in the test gas which makes the study of thermo-chemical effects on fluid dynamics possible. Independent of construction and operational cost, free-piston drivers, such as the one used in the T5 facility at Caltech, give the best performance [3]. The high operational cost and long turnaround time of such a facility make a more economical option desirable for smaller-scale testing.

41 CFR 102-33.200 - Must we periodically justify owning and operating Federal aircraft?

Code of Federal Regulations, 2010 CFR

2010-07-01

... aircraft, as required in OMB Circular A-76. You must also establish the cost-effectiveness of all your aircraft operations following OMB-approved cost justification methodologies, which are described in OMB... for the Cost of Government Aircraft § 102-33.200 Must we periodically justify owning and operating...

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

43 CFR 426.23 - Recovery of operation and maintenance (O&M) costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... operation and maintenance (O&M) costs. (a) General. All new, amended, and renewed contracts shall provide... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Recovery of operation and maintenance (O&M) costs. 426.23 Section 426.23 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF...

Techno Economical Study of PV-Diesel Power System for a Remote Island in Indonesia : A Case Study of Miangas Island

NASA Astrophysics Data System (ADS)

Rumbayan, M.; Nagasaka, K.

2018-05-01

The purpose of this study is to conduct the techno economical study of PC-Diesel power system based on renewable energy available locally in a remote island. This research is a case study for Miangas island which is the border island between Indonesia and Philipines. It is located in Talaud Island regency of North Sulawesi province of Indonesia. The monthly average daily radiation in Miangas island is 5.52 kWh/m2.The research methods used are data collection and data analysis using software HOMER. Based on the simulation result, the techno economic study of PV-Diesel power plant system based on energy demand in Miangas island can be obtained. The Cost of Energy (COE), Net Present Cost (NPC) and operating cost for proposed hybrid PV-Diesel power generation can be assessed for the design power systems uses Canadian solar Max Power C56x-325P of 150 KW PV, 18 string of Surette 6CS25P, Diesel Generator 50 kW and converter Magnum MS4448PAE 25 kW. The annual electricity production from the PV Diesel system for Miangas island is 309.589 kWh in which 80.7% electricity comes from PV, 19.3% electricity comes from diesel with the 109.063 kWh excess electricity. The cost of generating electrical energy in the term of cost of energy (COE), Net Present Cost (NPC) and operating cost are 0.318 US/kWh, 719.673 US and 36.857 US respectively.

Western Wind and Solar Integration Study Phase 2 (Presentation)

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

Lew, D.; Brinkman, G.; Ibanez, E.

This presentation accompanies Phase 2 of the Western Wind and Solar Integration Study, a follow-on to Phase 1, which examined the operational impacts of high penetrations of variable renewable generation on the electric power system in the West and was one of the largest variable generation studies to date. High penetrations of variable generation can induce cycling of fossil-fueled generators. Cycling leads to wear-and-tear costs and changes in emissions. Phase 2 calculated these costs and emissions, and simulated grid operations for a year to investigate the detailed impact of variable generation on the fossil-fueled fleet. The presentation highlights the scopemore » of the study and results.« less

Integrated operations payloads/fleet analysis study extension report

NASA Technical Reports Server (NTRS)

1971-01-01

An analysis of the factors affecting the cost effectiveness of space shuttle operations is presented. The subjects discussed are: (1)payload data bank, (2) program risk analysis, (3)navigation satellite program, and (4) reusable launch systems.

Beyond Control Centers

NASA Technical Reports Server (NTRS)

Trimble, Jay

2017-01-01

For NASA's Resource Prospector (RP) Lunar Rover Mission, we are moving away from a control center concept, to a fully distributed operation utilizing control nodes, with decision support from anywhere via mobile devices. This operations concept will utilize distributed information systems, notifications, mobile data access, and optimized mobile data display for off-console decision support. We see this concept of operations as a step in the evolution of mission operations from a central control center concept to a mission operations anywhere concept. The RP example is part of a trend, in which mission expertise for design, development and operations is distributed across countries and across the globe. Future spacecraft operations will be most cost efficient and flexible by following this distributed expertise, enabling operations from anywhere. For the RP mission we arrived at the decision to utilize a fully distributed operations team, where everyone operates from their home institution, based on evaluating the following factors: the requirement for physical proximity for near-real time command and control decisions; the cost of distributed control nodes vs. a centralized control center; the impact on training and mission preparation of flying the team to a central location. Physical proximity for operational decisions is seldom required, though certain categories of decisions, such as launch abort, or close coordination for mission or safety-critical near-real-time command and control decisions may benefit from co-location. The cost of facilities and operational infrastructure has not been found to be a driving factor for location in our studies. Mission training and preparation benefit from having all operators train and operate from home institutions.

[Case control study of fractures-dislocations of ankle joint with conservative and operative treatment].

PubMed

Zhang, Song-Tu; Lin, Yi-Rong; Chen, Lian-Yuan

2010-10-01

To compare the clinical efficacy of grade III, IV supination-eversion fractures-dislocations of ankle joint between manipulative treatment and operative treatment. From September 2007 to December 2008, the clinical data of 60 patients with grade III, IV supination-eversion fractures-dislocations of ankle joint were retrospectively analyzed. There were 32 males and 28 females, ranging in age from 18 to 70 years with an average age of 38.17 years. All patients were respectively treated with manipulative treatment (conservative group, 30 cases) and operative treatment (operative group, 30 cases). The joint function was compared with Mazur standard; the reduction and shifting of fractures were observed with X-ray; the hospitalization day and the therapeutic cost were compared between two groups. All patients were followed up with an average of 15.27 months (ranged, 6 to 25 months). In conservative group, 16 cases got excellent result in joint function, 10 good, 3 fair, 1 poor; in operative group, 20 cases got excellent result, 8 good, 2 fair, 0 poor. In conservative group in the X-ray showed 25 cases obtained excellent and good reduction, 4 fair, 1 poor; and in operative group in the X-ray showed 28 cases obtained excellent and good reduction, 2 fair, 0 poor. There was no significant difference at the joint function and X-ray film after treatment between two groups (P > 0.05). The hospital day was respectively (7.87 +/- 3.34), (17.37 +/- 4.64) d in conservative group and operative group; and the therapeutic cost was respectively (2 506.67 +/- 649.10), (11 473.33 +/- 1 564.90) yuan. There was significant difference at hospital day and therapeutic cost between two groups (P < 0.05). Conservative treatment and operative treatment can both reach a very good result in treating grade III, IV supination-eversion fractures and dislocations of ankle joint. However, conservative treatment has advantage of high safety factor, low therapeutic cost, can reduce medical costs for patients.

19 CFR 10.197 - Direct costs of processing operations performed in a beneficiary country or countries.

Code of Federal Regulations, 2013 CFR

2013-04-01

... specific merchandise, including fringe benefits, on-the-job training, and the cost of engineering..., engineering, and blueprint costs insofar as they are allocable to the specific merchandise and; (4) Costs of... 19 Customs Duties 1 2013-04-01 2013-04-01 false Direct costs of processing operations performed in...

19 CFR 10.197 - Direct costs of processing operations performed in a beneficiary country or countries.

Code of Federal Regulations, 2014 CFR

2014-04-01

... specific merchandise, including fringe benefits, on-the-job training, and the cost of engineering..., engineering, and blueprint costs insofar as they are allocable to the specific merchandise and; (4) Costs of... 19 Customs Duties 1 2014-04-01 2014-04-01 false Direct costs of processing operations performed in...

Satellite Power Systems (SPS) concept definition study (Exhibit D). Volume 6, part 1: Cost and Programmatics

NASA Technical Reports Server (NTRS)

Hanley, G. M.

1981-01-01

A summary of the cost data reviewed as well as conclusions and recommendations are presented. Cost and programmatic aspects of Rockwell's SPS CR-2 reference configuration were based on the results of several contracts with NASA and independent company-sponsored activities by the Space Operations and Satellite Systems Division of Rockwell International.

Productivity and cost estimators for conventional ground-based skidding on steep terrain using preplanned skid roads

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1991-01-01

Continuous time and motion study techniques were used to develop productivity and cost estimators for the skidding component of ground-based logging systems, operating on steep terrain using preplanned skid roads. Comparisons of productivity and costs were analyzed for an overland random access skidding method, verses a skidding method utilizing a network of preplanned...

Production rates and costs of cable yarding wood residue from clearcut units

Treesearch

Chris B. LeDoux

1984-01-01

Wood residue is a little used source of fiber, chips, and fuel because harvest costs are largely unknown. This study calculates incremental production rates and costs for yarding and loading logging residue in clearcut old-growth Douglas-fir/western hemlock forests. Harvest operations were observed for two timber sales in western Oregon. Three different cable yarding...

Users guide for STHARVEST: software to estimate the cost of harvesting small timber.

Treesearch

Roger D. Fight; Xiaoshan Zhang; Bruce R. Hartsough

2003-01-01

The STHARVEST computer application is Windows-based, public-domain software used to estimate costs for harvesting small-diameter stands or the small-diameter component of a mixed-sized stand. The equipment production rates were developed from existing studies. Equipment operating cost rates were based on November 1998 prices for new equipment and wage rates for the...

Chipping whole trees for fuel chips: a production study

Treesearch

Dana Mitchell; Tom Gallagher

2007-01-01

A time and motion study was conducted to determine the productivity and cost of an in-woods chipping operation when processing whole mall-diameter trees for biomass. The study removed biomass from two overstocked stands and compared the cost of this treatment to existing alternatives. The treatment stands consisted of a 30-year-old longleaf pine stand and a 37-year-old...

HUMeral shaft fractures: measuring recovery after operative versus non-operative treatment (HUMMER): a multicenter comparative observational study.

PubMed

Mahabier, Kiran C; Van Lieshout, Esther M M; Bolhuis, Hugo W; Bos, P Koen; Bronkhorst, Maarten Wga; Bruijninckx, Milko M M; De Haan, Jeroen; Deenik, Axel R; Dwars, Boudewijn J; Eversdijk, Martin G; Goslings, J Carel; Haverlag, Robert; Heetveld, Martin J; Kerver, Albert J H; Kolkman, Karel A; Leenhouts, Peter A; Meylaerts, Sven A G; Onstenk, Ron; Poeze, Martijn; Poolman, Rudolf W; Punt, Bas J; Roerdink, W Herbert; Roukema, Gert R; Sintenie, Jan Bernard; Soesman, Nicolaj M R; Tanka, Andras K F; Ten Holder, Edgar J T; Van der Elst, Maarten; Van der Heijden, Frank H W M; Van der Linden, Frits M; Van der Zwaal, Peer; Van Dijk, Jan P; Van Jonbergen, Hans-Peter W; Verleisdonk, Egbert J M M; Vroemen, Jos P A M; Waleboer, Marco; Wittich, Philippe; Zuidema, Wietse P; Polinder, Suzanne; Verhofstad, Michael H J; Den Hartog, Dennis

2014-02-11

Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery. The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be analyzed using univariate and multivariable analyses (including mixed effects regression analysis). The cost-effectiveness analysis will be performed from a societal perspective. Successful completion of this trial will provide evidence on the effectiveness of operative versus non-operative treatment of patients with a humeral shaft fracture. The trial is registered at the Netherlands Trial Register (NTR3617).

A deterministic aggregate production planning model considering quality of products

NASA Astrophysics Data System (ADS)

Madadi, Najmeh; Yew Wong, Kuan

2013-06-01

Aggregate Production Planning (APP) is a medium-term planning which is concerned with the lowest-cost method of production planning to meet customers' requirements and to satisfy fluctuating demand over a planning time horizon. APP problem has been studied widely since it was introduced and formulated in 1950s. However, in several conducted studies in the APP area, most of the researchers have concentrated on some common objectives such as minimization of cost, fluctuation in the number of workers, and inventory level. Specifically, maintaining quality at the desirable level as an objective while minimizing cost has not been considered in previous studies. In this study, an attempt has been made to develop a multi-objective mixed integer linear programming model that serves those companies aiming to incur the minimum level of operational cost while maintaining quality at an acceptable level. In order to obtain the solution to the multi-objective model, the Fuzzy Goal Programming approach and max-min operator of Bellman-Zadeh were applied to the model. At the final step, IBM ILOG CPLEX Optimization Studio software was used to obtain the experimental results based on the data collected from an automotive parts manufacturing company. The results show that incorporating quality in the model imposes some costs, however a trade-off should be done between the cost resulting from producing products with higher quality and the cost that the firm may incur due to customer dissatisfaction and sale losses.

Design study of wind turbines 50 kW to 3000 kW for electric utility applications. Volume 2: Analysis and design

NASA Technical Reports Server (NTRS)

1976-01-01

All possible overall system configurations, operating modes, and subsystem concepts for a wind turbine configuration for cost effective generation of electrical power were evaluated for both technical feasibility and compatibility with utility networks, as well as for economic attractiveness. A design optimization computer code was developed to determine the cost sensitivity of the various design features, and thus establish the configuration and design conditions that would minimize the generated energy costs. The preliminary designs of both a 500 kW unit and a 1500 kW unit operating in a 12 mph and 18 mph median wind speed respectively, were developed. The various design features and components evaluated are described, and the rationale employed to select the final design configuration is given. All pertinent technical performance data and component cost data is included. The costs of all major subassemblies are estimated and the resultant energy costs for both the 500 kW and 1500 kW units are calculated.

A simplified economic filter for open-pit gold-silver mining in the United States

USGS Publications Warehouse

Singer, Donald A.; Menzie, W. David; Long, Keith R.

1998-01-01

In resource assessments of undiscovered mineral deposits and in the early stages of exploration, including planning, a need for prefeasibility cost models exists. In exploration, these models to filter economic from uneconomic deposits help to focus on targets that can really benefit the exploration enterprise. In resource assessment, these models can be used to eliminate deposits that would probably be uneconomic even if discovered. The U. S. Bureau of Mines (USBM) previously developed simplified cost models for such problems (Camm, 1991). These cost models estimate operating and capital expenditures for a mineral deposit given its tonnage, grade, and depth. These cost models were also incorporated in USBM prefeasibility software (Smith, 1991). Because the cost data used to estimate operating and capital costs in these models are now over ten years old, we decided that it was necessary to test these equations with more current data. We limited this study to open-pit gold-silver mines located in the United States.

An Application of Six Sigma to Reduce Supplier Quality Cost

NASA Astrophysics Data System (ADS)

Gaikwad, Lokpriya Mohanrao; Teli, Shivagond Nagappa; Majali, Vijay Shashikant; Bhushi, Umesh Mahadevappa

2016-01-01

This article presents an application of Six Sigma to reduce supplier quality cost in manufacturing industry. Although there is a wider acceptance of Six Sigma in many organizations today, there is still a lack of in-depth case study of Six Sigma. For the present research the case study methodology was used. The company decided to reduce quality cost and improve selected processes using Six Sigma methodologies. Regarding the fact that there is a lack of case studies dealing with Six Sigma especially in individual manufacturing organization this article could be of great importance also for the practitioners. This paper discusses the quality and productivity improvement in a supplier enterprise through a case study. The paper deals with an application of Six Sigma define-measure-analyze-improve-control methodology in an industry which provides a framework to identify, quantify and eliminate sources of variation in an operational process in question, to optimize the operation variables, improve and sustain performance viz. process yield with well-executed control plans. Six Sigma improves the process performance (process yield) of the critical operational process, leading to better utilization of resources, decreases variations and maintains consistent quality of the process output.

Contingency Power Study for Short Haul Civil Tiltrotor

NASA Technical Reports Server (NTRS)

D'Angelo, Marin M.

2004-01-01

NASA has concluded from previous studies that the twin engine tiltrotor is the most economical and technologically viable rotorcraft for near-term civil applications. Twin engine civil rotorcraft must be able to hover safely on one engine in an emergency. This emergency power requirement generally results in engines 20 to 50 percent larger than needed for normal engine operation, negatively impacting aircraft economics. This study identifies several contingency power enhancement concepts, and quantifies their potential to reduce aircraft operating costs. Many unique concepts were examined, and the selected concepts are simple, reliable, and have a high potential for near term realization. These engine concepts allow extremely high turbine temperatures during emergency operation by providing cooling to the power turbine and augmenting cooling of both turbines and structural hardware. Direct operating cost are reduced 3 to percent, which could yield a 30 to 80 percent increase in operating profits. The study consists of the definition of an aircraft economics model and a baseline engine, and an engine concept screening study, and a preliminary definition of the selected concepts. The selected concepts are evaluated against the baseline engine, and the critical technologies and development needs are identified, along with applications for this technology.

Cost optimisation and minimisation of the environmental impact through life cycle analysis of the waste water treatment plant of Bree (Belgium).

PubMed

De Gussem, K; Wambecq, T; Roels, J; Fenu, A; De Gueldre, G; Van De Steene, B

2011-01-01

An ASM2da model of the full-scale waste water plant of Bree (Belgium) has been made. It showed very good correlation with reference operational data. This basic model has been extended to include an accurate calculation of environmental footprint and operational costs (energy consumption, dosing of chemicals and sludge treatment). Two optimisation strategies were compared: lowest cost meeting the effluent consent versus lowest environmental footprint. Six optimisation scenarios have been studied, namely (i) implementation of an online control system based on ammonium and nitrate sensors, (ii) implementation of a control on MLSS concentration, (iii) evaluation of internal recirculation flow, (iv) oxygen set point, (v) installation of mixing in the aeration tank, and (vi) evaluation of nitrate setpoint for post denitrification. Both an environmental impact or Life Cycle Assessment (LCA) based approach for optimisation are able to significantly lower the cost and environmental footprint. However, the LCA approach has some advantages over cost minimisation of an existing full-scale plant. LCA tends to chose control settings that are more logic: it results in a safer operation of the plant with less risks regarding the consents. It results in a better effluent at a slightly increased cost.

Comparative analysis of heat pump and biomass boiler for small detached house heating

NASA Astrophysics Data System (ADS)

Olkowski, Tomasz; Lipiński, Seweryn; Olędzka, Aneta

2017-10-01

The purpose of the work is to answer the question - which of the two selected heat sources is more economically beneficial for small detached house: heat pump or biomass boiler fuelled with wood-pellets? The comparative analysis of these sources was carried out to discuss the issue. First, cost of both, equipment and operation of selected heat systems were analysed. Additionally, CO2 emission levels associated with these heat systems were determined. The comparative analysis of the costs of both considered heat systems showed that equipment cost of heat pump system is considerably bigger than the cost of biomass boiler system. The comparison of annual operation costs showed that heat pump operation cost is slightly lower than operation cost of biomass boiler. The analysis of above results shows that lower operation cost of heat pump in comparison with biomass boiler cost lets qualify heat pump as more economically justified only after 38 years of work. For both analysed devices, CO2 emission levels were determined. The considerations take into account the fact that heat pump consumes electricity. It is mostly generated through combustion of coal in Poland. The results show that in Poland biomass boiler can be described as not only more economically justified system but also as considerably more ecological.

Working Group 3: Operations Analysis for Systems of System within a Networked C2 Context: Introduction, Purpose, and Approach

DTIC Science & Technology

2012-01-01

1200 Session 3 – C2 Framework, OR Methods MOOs, MOEs, MOPs Development Case Study – 1300-1630 Session 4 – Findings...Objective 1: Understand the impact of the application of traditional operational research techniques to networked C2 systems. • Objective 2: Develop ...for the network. 3. Cost measures including cost and time to implement the solution (for example, a basic rule-of-thumb I use for development

Spaceborne construction and operations planning - Decision rules for selecting EVA, telerobot, and combined work-systems

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.

1992-01-01

An approach is presented for selecting an appropriate work-system for performing construction and operations tasks by humans and telerobots. The decision to use extravehicular activity (EVA) performed by astronauts, extravehicular robotics (EVR), or a combination of EVA and EVR is determined by the ratio of the marginal costs of EVA, EVR, and IVA. The approach proposed here is useful for examining cost trade-offs between tasks and performing trade studies of task improvement techniques (human or telerobotic).

Long life reaction control system design

NASA Astrophysics Data System (ADS)

Fanciullo, Thomas J.; Judd, Craig

1993-02-01

Future single stage to orbit systems will utilize oxygen/hydrogen propellants in their main propulsion means due to the propellant's high energy content and environmental acceptability. Operational effectiveness studies and life cycle cost studies have indicated that minimizing the number of different commodities on a given vehicle not only reduces cost, but reduces the ground span times in both the pre- and postflight operations. Therefore, oxygen and hydrogen should be used for the reaction controls systems, eliminating the need to deal with toxic or corrosive fluids. When the hydrogen scramjet powered NASP design development began in 1985, new system design studies considered overall integration of subsystems; in the context of that approach, O2/H2 reaction controls system were more than competitive with storable propellant systems and had the additional benefits of lower life cycle cost, rapid turnaround times, and O2 and H2 commodities for use throughout the vehicle. Similar benefits were derived in rocket-powered SSTO vehicles.