Sample records for partial cost-benefit analysis

  1. Defense Commissaries: DOD Needs to Improve Business Processes to Ensure Patron Benefits and Achieve Operational Efficiencies

    DTIC Science & Technology

    2017-03-01

    sales, leverage efficiencies, and achieve savings in commissary operations. Second, DeCA has not conducted cost - benefit analyses for costs ...conduct comprehensive cost - benefit analyses for service contracts and distribution options. DOD concurred with GAO’s first two recommendations and...partially concurred with the third recommendation. GAO continues to believe the cost - benefit analysis recommendation is valid

  2. A comparative cost analysis of robot-assisted versus traditional laparoscopic partial nephrectomy.

    PubMed

    Hyams, Elias; Pierorazio, Philip; Mullins, Jeffrey K; Ward, Maryann; Allaf, Mohamad

    2012-07-01

    Robot-assisted laparoscopic partial nephrectomy (RALPN) is supplanting traditional laparoscopic partial nephrectomy (LPN) as the technique of choice for minimally invasive nephron-sparing surgery. This evolution has resulted from potential clinical benefits, as well as proliferation of robotic systems and patient demand for robot-assisted surgery. We sought to quantify the costs associated with the use of robotics for minimally invasive partial nephrectomy. A cost analysis was performed for 20 consecutive robot-assisted partial nephrectomy (RPN) and LPN patients at our institution from 2009 to 2010. Data included actual perioperative and hospitalization costs as well as professional fees. Capital costs were estimated using purchase costs and amortization of two robotic systems from 2001 to 2009, as well as maintenance contract costs. The estimated cost/case was obtained using total robotic surgical volume during this period. Total estimated costs were compared between groups. A separate analysis was performed assuming "ideal" robotic utilization during a comparable period. RALPN had a cost premium of +$1066/case compared with LPN, assuming actual robot utilization from 2001 to 2009. Assuming "ideal" utilization during a comparable period, this premium decreased to +$334; capital costs per case decreased from $1907 to $1175. Tumor size, operative time, and length of stay were comparable between groups. RALPN is associated with a small to moderate cost premium depending on assumptions regarding robotic surgical volume. Saturated utilization of robotic systems decreases attributable capital costs and makes comparison with laparoscopy more favorable. Purported clinical benefits of RPN (eg, decreased warm ischemia time, increased utilization of nephron-sparing surgery) need further study, because these may have cost implications.

  3. Childhood lead exposure in France: benefit estimation and partial cost-benefit analysis of lead hazard control

    PubMed Central

    2011-01-01

    Background Lead exposure remains a public health concern due to its serious adverse effects, such as cognitive and behavioral impairment: children younger than six years of age being the most vulnerable population. In Europe, the lead-related economic impacts have not been examined in detail. We estimate the annual costs in France due to childhood exposure and, through a cost benefit analysis (CBA), aim to assess the expected social and economic benefits of exposure abatement. Methods Monetary benefits were assessed in terms of avoided national costs. We used results from a 2008 survey on blood-lead (B-Pb) concentrations in French children aged one to six years old. Given the absence of a threshold concentration being established, we performed a sensitivity analysis assuming different hypothetical threshold values for toxicity above 15 μg/L, 24 μg/L and 100 μg/L. Adverse health outcomes of lead exposure were translated into social burden and economic costs based on literature data from literature. Direct health benefits, social benefits and intangible avoided costs were included. Costs of pollutant exposure control were partially estimated in regard to homes lead-based paint decontamination, investments aiming at reducing industrial lead emissions and removal of all lead drinking water pipes. Results The following overall annual benefits for the three hypothetical thresholds values in 2008 are: €22.72 billion, €10.72 billion and €0.44 billion, respectively. Costs from abatement ranged from €0.9 billion to 2.95 billion/year. Finally, from a partial CBA of lead control in soils and dust the estimates of total net benefits were € 3.78 billion, € 1.88 billion and €0.25 billion respectively for the three hypothesized B-Pb effect values. Conclusions Prevention of childhood lead exposure has a high social benefit, due to reduction of B-Pb concentrations to levels below 15 μg/L or 24 μg/L, respectively. Reducing only exposures above 100 μg/L B-Pb has little economic impact due to the small number of children who now exhibit such high exposure levels. Prudent public policies would help avoiding future medical interventions, limit the need for special education and increase future productivity, and hence lifetime income for children exposed to lead. PMID:21599937

  4. Partially wrong? Partial equilibrium and the economic analysis of public health emergencies of international concern.

    PubMed

    Beutels, P; Edmunds, W J; Smith, R D

    2008-11-01

    We argue that traditional health economic analysis is ill-equipped to estimate the cost effectiveness and cost benefit of interventions that aim at controlling and/or preventing public health emergencies of international concern (such as pandemic influenza or severe acute respiratory syndrome). The implicit assumption of partial equilibrium within both the health sector itself and--if a wider perspective is adopted--the economy as a whole would be violated by such emergencies. We propose an alternative, with the specific aim of accounting for the behavioural changes and capacity problems that are expected to occur when such an outbreak strikes. Copyright (c) 2008 John Wiley & Sons, Ltd.

  5. Costs and Benefits of Bilingual Education in Guatemala: A Partial Analysis

    ERIC Educational Resources Information Center

    Patrinos, Harry Anthony; Velez, Eduardo

    2009-01-01

    The benefits of bilingual education for a disadvantaged indigenous population as an investment in human capital are significant. Students of bilingual schools in Guatemala have higher attendance and promotion rates, and lower repetition and dropout rates. Bilingual students receive higher scores on all subject matters, including mastery of…

  6. A cost-benefit model comparing the California Milk Cell Test and Milk Electrical Resistance Test.

    PubMed

    Petzer, Inge-Marie; Karzis, Joanne; Meyer, Isabel A; van der Schans, Theodorus J

    2013-04-24

    The indirect effects of mastitis treatment are often overlooked in cost-benefit analyses, but it may be beneficial for the dairy industry to consider them. The cost of mastitis treatment may increase when the duration of intra-mammary infections are prolonged due to misdiagnosis of host-adapted mastitis. Laboratory diagnosis of mastitis can be costly and time consuming, therefore cow-side tests such as the California Milk Cell Test (CMCT) and Milk Electrical Resistance (MER) need to be utilised to their full potential. The aim of this study was to determine the relative benefit of using these two tests separately and in parallel. This was done using a partial-budget analysis and a cost-benefit model to estimate the benefits and costs of each respective test and the parallel combination thereof. Quarter milk samples (n= 1860) were taken from eight different dairy herds in South Africa. Milk samples were evaluated by means of the CMCT, hand-held MER meter and cyto-microbiological laboratory analysis. After determining the most appropriate cut-off points for the two cow-side tests, the sensitivity and specificity of the CMCT (Se= 1.00, Sp= 0.66), MER (Se= 0.92, Sp= 0.62) and the tests done in parallel (Se= 1.00, Sp= 0.87) were calculated. The input data that were used for partial-budget analysis and in the cost-benefit model were based on South African figures at the time of the study, and on literature. The total estimated financial benefit of correct diagnosis of host-adapted mastitis per cow for the CMCT, MER and the tests done in parallel was R898.73, R518.70 and R1064.67 respectively. This involved taking the expected benefit of a correct test result per cow, the expected cost of an error per cow and the cost of the test into account. The CMCT was shown to be 11%more beneficial than the MER test, whilst using the tests in parallel was shown to be the most beneficial method for evaluating the mastitis-control programme. Therefore, it is recommended that the combined tests should be used strategically in practice to monitor udder health and promote a pro-active udder health approach when dealing with host-adapted pathogens.

  7. Screening blood donors for human immunodeficiency virus antibody: cost-benefit analysis.

    PubMed Central

    Eisenstaedt, R S; Getzen, T E

    1988-01-01

    The costs and benefits of screening blood donors for antibody to human immunodeficiency virus (HIV) are assessed. Total costs, including testing, discarding processed blood, marginal donor recruiting, notifying and evaluating positive donors, are $36,234,000 annually for 10 million donors in 1986. Screening these donors will prevent 292 cases of transfusion-transmitted acquired immune deficiency syndrome (TT-AIDS), saving the costs of therapy and loss of earnings for total benefits of $43,490,480, a benefit:cost ratio of 1.2:1. Net economic benefits of $0.73 per donor will arise from the program. Calculated benefits will rise as increased numbers of infected recipients are diagnosed with longer follow-up or as partially effective therapy increases the cost of caring for patients with AIDS. Changes in test sensitivity, follow-up procedures, estimated value of life, and testing costs will also alter these projections, but none as dramatically as a change in the overall specificity of the screening process. The cost per case of TT-AIDS prevented, $124,089, and cost per year of life extended, $10,885, are comparable to costs of other screening programs. PMID:3126676

  8. Partially Turboelectric Aircraft Drive Key Performance Parameters

    NASA Technical Reports Server (NTRS)

    Jansen, Ralph H.; Duffy, Kirsten P.; Brown, Gerald V.

    2017-01-01

    The purpose of this paper is to propose electric drive specific power, electric drive efficiency, and electrical propulsion fraction as the key performance parameters for a partially turboelectric aircraft power system and to investigate their impact on the overall aircraft performance. Breguet range equations for a base conventional turbofan aircraft and a partially turboelectric aircraft are found. The benefits and costs that may result from the partially turboelectric system are enumerated. A break even analysis is conducted to find the minimum allowable electric drive specific power and efficiency, for a given electrical propulsion fraction, that can preserve the range, fuel weight, operating empty weight, and payload weight of the conventional aircraft. Current and future power system performance is compared to the required performance to determine the potential benefit.

  9. How the Military Health System Can Fulfill the Promise. An Analysis of the Federal Employees Health Benefit Program for the DOD

    DTIC Science & Technology

    2007-04-01

    over the other. If DoD utilized FEHBP, advantages of size, shifting financial risk to insurers, keeping the health benefit up to date, and improved... advantages in size, reduction of administrative costs, unifying the benefit , shifting financial risk to insurers, keeping the benefit up to date...FEDERAL EMPLOYEES HEALTH BENEFIT PROGRAM FOR THE DOD by Daniel E. Lee, Major, USAF A Research Report Submitted to the Faculty In Partial

  10. Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia.

    PubMed

    Sanghera, Sabina; Frew, Emma; Gupta, Janesh Kumar; Kai, Joe; Roberts, Tracy Elizabeth

    2015-09-01

    The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition's periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia. A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected. Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia.

  11. A cost-benefit analysis of the outpatient smoking cessation services in Taiwan from a societal viewpoint.

    PubMed

    Chen, Pei-Ching; Lee, Yue-Chune; Tsai, Shih-Tzu; Lai, Chih-Kuan

    2012-05-01

    This study applied a cost-benefit analysis from a societal viewpoint to evaluate the Outpatient Smoking Cessation Services (OSCS) program. The costs measured in this study include the cost to the health sector, non-health sectors, the patients and their family, as well as the loss of productivity as a result of smoking. The benefits measured the medical costs savings and the earnings due to the increased life expectancy of a person that has stopped smoking for 15 years. Data were obtained from the primary data of a telephone survey, the literatures and reports from the Outpatient Smoking Cessation Management Center and government. Sensitivity analyses were conducted to verify the robustness of the results. There were 169,761 cases that participated in the outpatient smoking cessation program in the years 2007 and 2008, of those cases, 8,282 successfully stopped smoking. The total cost of the OSCS program was 18 million USD. The total benefits of the program were 215 million USD with a 3% discount rate; the net benefit to society was 196 million USD. After conducting sensitivity analyses on the different abstinence, relapse, and discount rates, from a societal perspective, the benefits still far exceeded the costs, while from a health care perspective, there was only a net benefit when the respondent's abstinence rate was used. From a societal perspective, the OSCS program in Taiwan is cost-beneficial. This study provides partial support for the policy makers to increase the budget and expand the OSCS program.

  12. Management Costs of DoD Military Construction Projects.

    DTIC Science & Technology

    1983-04-01

    by 13 percent to include full costs of civilian retirement and other benefits which are only partially included in organizational budget and...capitalization of costs of owned facilities and equipment as well as the total costs paid for personnel benefits (including all payments to...of these is civilian personnel benefits , the cost of which is 20.4 percent of base pay for retirement and 5.6 for insurance and other items, for a

  13. Supported employment: cost-effectiveness across six European sites

    PubMed Central

    Knapp, Martin; Patel, Anita; Curran, Claire; Latimer, Eric; Catty, Jocelyn; Becker, Thomas; Drake, Robert E; Fioritti, Angelo; Kilian, Reinhold; Lauber, Christoph; Rössler, Wulf; Tomov, Toma; van Busschbach, Jooske; Comas-Herrera, Adelina; White, Sarah; Wiersma, Durk; Burns, Tom

    2013-01-01

    A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n=312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost-effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost-benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost-effective than standard vocational services. Further analysis demonstrated cost-benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost-saving and almost certainly more cost-effective as a way to help people with severe mental health problems into competitive employment. PMID:23471803

  14. Incorporating Non-energy Benefits into Energy Savings Performance Contracts

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

    Larsen, Peter; Goldman, Charles; Gilligan, Donald

    2012-06-01

    This paper evaluates the issue of non-energy benefits within the context of the U.S. energy services company (ESCO) industry?a growing industry comprised of companies that provide energy savings and other benefits to customers through the use of performance-based contracting. Recent analysis has found that ESCO projects in the public/institutional sector, especially at K-12 schools, are using performance-based contracting, at the behest of the customers, to partially -- but not fully -- offset substantial accumulated deferred maintenance needs (e.g., asbestos removal, wiring) and measures that have very long paybacks (roof replacement). This trend is affecting the traditional economic measures policymakers usemore » to evaluate success on a benefit to cost basis. Moreover, the value of non-energy benefits which can offset some or all of the cost of the non-energy measures -- including operations and maintenance (O&M) savings, avoided capital costs, and tradable pollution emissions allowances-- are not always incorporated into a formal cost-effectiveness analysis of ESCO projects. Nonenergy benefits are clearly important to customers, but state and federal laws that govern the acceptance of these types of benefits for ESCO projects vary widely (i.e., 0-100percent of allowable savings can come from one or more non-energy categories). Clear and consistent guidance on what types of savings are recognized in Energy Savings agreements under performance contracts is necessary, particularly where customers are searching for deep energy efficiency gains in the building sector.« less

  15. Value of Robotically Assisted Surgery for Mitral Valve Disease

    PubMed Central

    Mihaljevic, Tomislav; Koprivanac, Marijan; Kelava, Marta; Goodman, Avi; Jarrett, Craig; Williams, Sarah J.; Gillinov, A. Marc; Bajwa, Gurjyot; Mick, Stephanie L.; Bonatti, Johannes; Blackstone, Eugene H.

    2014-01-01

    Importance The value of robotically assisted surgery for mitral valve disease is questioned because the high cost of care associated with robotic technology may outweigh its clinical benefits. Objective To investigate conditions under which benefits of robotic surgery mitigate high technology costs. Design Clinical cohort study comparing costs of robotic vs. three contemporaneous conventional surgical approaches for degenerative mitral disease. Surgery was performed from 2006–2011, and comparisons were based on intent-to-treat, with propensity-matching used to reduce selection bias. Setting Large multi-specialty academic medical center. Participants 1,290 patients aged 57±11 years, 27% women, underwent mitral repair for regurgitation from posterior leaflet prolapse. Robotic surgery was used in 473, complete sternotomy in 227, partial sternotomy in 349, and anterolateral thoracotomy in 241. Three propensity-matched groups were formed based on demographics, symptoms, cardiac and noncardiac comorbidities, valve pathophysiology, and echocardiographic measurements: robotic vs. sternotomy (n=198 pairs) vs. partial sternotomy (n=293 pairs) vs. thoracotomy (n=224 pairs). Interventions Mitral valve repair. Main Outcome Measures Cost of care, expressed as robotic capital investment, maintenance, and direct technical hospital cost, and benefit of care, based on differences in recovery time. Results Median cost of care for robotically assisted surgery exceeded the cost of alternative approaches by 27% (−5%, 68%), 32% (−6%, 70%), and 21% (−2%, 54%) (median [15th, 85th percentiles]) for complete sternotomy, partial sternotomy, and anterolateral thoracotomy, respectively. Higher operative costs were partially offset by lower postoperative costs and earlier return to work: median 35 days for robotic surgery, 49 for complete sternotomy, 56 for partial sternotomy, and 42 for anterolateral thoracotomy. Resulting net differences in cost of robotic surgery vs. the three alternatives were 16% (−15%, 55%), 16% (−19%, 51%), and 15% (−7%, 49%), respectively. Beyond a volume threshold of 55–100 robotic cases per year, confidence limits for the cost of robotic surgery broadly overlapped those of conventional approaches. Conclusions In exchange for higher procedural costs, robotically assisted mitral valve surgery offers the clinical benefit of least invasive surgery, lowest postoperative cost, and fastest return to work. The value of robotically assisted surgery comparable to conventional approaches can only be realized in high-volume centers. PMID:24848944

  16. Costs and benefits of urban erosion and sediment control: The North Carolina experience

    NASA Astrophysics Data System (ADS)

    Paterson, Robert G.; Luger, Michael I.; Burby, Raymond J.; Kaiser, Edward J.; Malcom, H. Rooney; Beard, Alicia C.

    1993-03-01

    The EPA’s new nonpoint source pollution control requirements will soon institutionalize urban erosion and sediment pollution control practices nationwide. The public and private sector costs and social benefits associated with North Carolina’s program (one of the strongest programs in the country in terms of implementation authority, staffing levels, and comprehensiveness of coverage) are examined to provide general policy guidance on questions relating to the likely burden the new best management practices will have on the development industry, the likely costs and benefits of such a program, and the feasibility of running a program on a cost recovery basis. We found that urban erosion and sediment control requirements were not particularly burdensome to the development industry (adding about 4% on average to development costs). Public-sector program costs ranged between 2.4 and 4.8 million in fiscal year 1989. Our contingent valuation survey suggests that urban households in North Carolina are willing to pay somewhere between 7.1 and 14.2 million a year to maintain current levels of sediment pollution control. Our benefit-cost analysis suggests that the overall ratio is likely to be positive, although a definitive figure is elusive. Lastly, we found that several North Carolina localities have cost recovery fee systems that are at least partially self-financing.

  17. 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.

  18. Electromagnetic Aircraft Launching System: Do the Benefits Outweigh the Costs?

    DTIC Science & Technology

    2010-03-29

    Launching System: N/A Do the Benefits Outweigh the Costs? 5b. GRANT NUMBER N/A 5c. PROGRAM ELEMENT NUMBER ’ N/A 6. AUTHOR(S) 5d. PROJECT NUMBER Hartman...levitation (MAGLEV) trains. State-of-the-art systems make up the components of the system. There are several benefits the EIV1ALS has over the current...Do the Benefits Outweigh the Costs? SUBMITTED IN PARTIAL I:tJLFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF MILITARY STUDIES Author

  19. Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries.

    PubMed

    Massad, Eduardo; Behrens, Ben C; Coutinho, Francisco A B; Behrens, Ronald H

    2011-05-17

    In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used. Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions) and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.

  20. Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo.

    PubMed

    Chang, Wei-Lun; Andersen, Carit Jacques; Berisha, Besa Shatri; Estrup, Olena; Wang, Shr-Jie

    2018-05-08

    Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective. Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial. Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013. Participants were randomly assigned to an "intervention" and a "waiting-list" group. Changes in mental, emotional and physical health and functional impairment were assessed before and after treatment, along with increase in labour income as a proxy for productivity gain. The cost of an extra unit of effectiveness and an additional quality-adjusted life year were calculated. The total cost per participant was €1,322 including, or €1,019 excluding, research costs. Wide variations in costs of changes in mental, emotional and physical effectiveness were demonstrated. Multidisciplinary intervention resulted in functional improvement at a cost of €10,508 per quality-adjusted life year gained. With a mean monthly income increase to €133 (18%) after intervention, the intervention cost per participant would be equal to the total increase in monthly income after 4-5 years, assuming the increased level is maintained. Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.

  1. PubMed Central

    Turchetti, G.; Bellelli, S.; Palla, I.; Forli, F.

    2011-01-01

    SUMMARY The aim of the study consists in a systematic review concerning the economic evaluation of cochlear implant (CI) in children by searching the main international clinical and economic electronic databases. All primary studies published in English from January 2000 to May 2010 were included. The types of studies selected concerned partial economic evaluation, including direct and indirect costs of cochlear implantation; complete economic evaluation, including minimization of costs, cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and cost-benefit analysis (CBA) performed through observational and experimental studies. A total of 68 articles were obtained from the database research. Of these, 54 did not meet the inclusion criteria and were eliminated. After reading the abstracts of the 14 articles selected, 11 were considered eligible. The articles were then read in full text. Furthermore, 5 articles identified by bibliography research were added manually. After reading 16 of the selected articles, 9 were included in the review. With regard to the studies included, countries examined, objectives, study design, methodology, prospect of analysis adopted, temporal horizon, the cost categories analyzed strongly differ from one study to another. Cost analysis, cost-effectiveness analysis and an analysis of educational costs associated with cochlear implants were performed. Regarding the cost analysis, only two articles reported both direct cost and indirect costs. The direct cost ranged between € 39,507 and € 68,235 (2011 values). The studies related to cost-effectiveness analysis were not easily comparable: one study reported a cost per QALY ranging between $ 5197 and $ 9209; another referred a cost of $ 2154 for QALY if benefits were not discounted, and $ 16,546 if discounted. Educational costs are significant, and increase with the level of hearing loss and type of school attended. This systematic review shows that the healthcare costs are high, but savings in terms of indirect and quality of life costs are also significant. Cochlear implantation in a paediatric age is cost-effective. The exiguity and heterogeneity of studies did not allow detailed comparative analysis of the studies included in the review. PMID:22287822

  2. Policing in nonhuman primates: partial interventions serve a prosocial conflict management function in rhesus macaques.

    PubMed

    Beisner, Brianne A; McCowan, Brenda

    2013-01-01

    Studies of prosocial policing in nonhuman societies traditionally focus on impartial interventions because of an underlying assumption that partial support implies a direct benefit to the intervener, thereby negating the potential for being prosocial in maintaining social stability for the benefit of the group. However, certain types of partial interventions have significant potential to be prosocial in controlling conflict, e.g. support of non-kin subordinates. Here, we propose a policing support hypothesis that some types of agonistic support serve a prosocial policing function that maintains group stability. Using seven large captive groups of rhesus macaques, we investigated the relationship between intervention type and group-level costs and benefits (rates of trauma, severe aggression, social relocation) and individual level costs and benefits (preferential sex-dyad targeting, dominance ambiguity reduction, access to mates, and return aggression). Our results show that impartial interventions and support of subordinate non-kin represent prosocial policing as both (1) were negatively associated with group-level rates of trauma and severe aggression, respectively, (2) showed no potential to confer individual dominance benefits, (3) when performed outside the mating season, they did not increase chances of mating with the beneficiary, and (4) were low-cost for the highest-ranking interveners. We recommend expanding the definition of 'policing' in nonhumans to include these 'policing support interventions'.

  3. Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand.

    PubMed

    Hayman, D T S; Marshall, J C; French, N P; Carpenter, T E; Roberts, M G; Kiedrzynski, T

    2017-09-05

    As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (R v , the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles R v often includes or exceeds one (0.18-3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. 40 CFR 1502.23 - Cost-benefit analysis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Cost-benefit analysis. 1502.23 Section... § 1502.23 Cost-benefit analysis. If a cost-benefit analysis relevant to the choice among environmentally... compliance with section 102(2)(B) of the Act the statement shall, when a cost-benefit analysis is prepared...

  5. 40 CFR 1502.23 - Cost-benefit analysis.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Cost-benefit analysis. 1502.23 Section... § 1502.23 Cost-benefit analysis. If a cost-benefit analysis relevant to the choice among environmentally... compliance with section 102(2)(B) of the Act the statement shall, when a cost-benefit analysis is prepared...

  6. Investigating the financial impact of porcine reproductive and respiratory syndrome on smallholder pig farmers in Cambodia.

    PubMed

    Zhang, A; Young, J R; Suon, S; Ashley, K; Windsor, P A; Bush, R D

    2017-04-01

    Porcine reproductive and respiratory syndrome (PRRS) was first identified in Cambodia in 2010, causing serious problems on affected farms, although the costs of the disease have not been well defined. The household financial impact of a PRRS outbreak in Cambodia was investigated using partial budget analysis, examining the economic benefit of three proposed interventions: (i) quarterly PRRS vaccine use, (ii) biosecurity implementation, and (iii) implementation of vaccination and biosecurity. The analyses were applied to three farm models: (i) a two-sow breeder; (ii) a five-pig fattener; and (iii) a single-sow, three-pig farrow-to-finish/breeder. Data was derived from a knowledge, attitude, and practice survey of 240 smallholder farmers (61 with pigs) from 16 villages across 5 provinces, plus case studies of 12 farmers selected for more detailed financial analysis. The study indicated that financial losses associated with PRRS were severe, with a 25% mean loss to the annual household income of 61 interviewed farmers. Partial budget analysis identified a strongly positive incentive for vaccination and biosecurity to be implemented in combination, with the highest annual net benefit of USD 357.10 realised by the breeder system. However, due to current scarcity of the PRRS vaccine and its high cost to smallholders, biosecurity interventions may be more cost-effective, especially for low PRRS incidence regions. It was concluded that PRRS critically constrains the profitability of smallholder pig farms and that these findings will assist development of village-level livestock disease risk management programmes that encourage adoption of vaccination and biosecurity practices to enhance farmer livelihoods in Cambodia.

  7. The capitalized value of rainwater tanks in the property market of Perth, Australia

    NASA Astrophysics Data System (ADS)

    Zhang, Fan; Polyakov, Maksym; Fogarty, James; Pannell, David J.

    2015-03-01

    In response to frequent water shortages, governments in Australia have encouraged home owners to install rainwater tanks, often by provision of partial funding for their installation. A simple investment analysis suggests that the net private benefits of rainwater tanks are negative, potentially providing justification for funding support for tank installation if it results in sufficiently large public benefits. However, using a hedonic price analysis we estimate that there is a premium of up to AU18,000 built into the sale prices of houses with tanks installed. The premium is likely to be greater than the costs of installation, even allowing for the cost of time that home owners must devote to research, purchase and installation. The premium is likely to reflect non-financial as well as financial benefits from installation. The robustness of our estimated premium is investigated using both bounded regression analysis and simulation methods and the result is found to be highly robust. The policy implication is that governments should not rely on payments to encourage installation of rainwater tanks, but instead should use information provision as their main mechanism for promoting uptake. Several explanations for the observation that many home owners are apparently leaving benefits on the table are canvased, but no fully satisfactory explanation is identified.

  8. International investigation into the relationship between social expenditure for family and total fertility rate.

    PubMed

    Motoki, Airi; Shinohara, Ryoji; Yamagata, Zentaro

    2016-01-01

    Purpose Declining birth rates are an important social issue worldwide, and allocating resources to benefits for child-rearing households is a necessary countermeasure. In this study, we investigate and compare the relationship between child-related social security costs and total fertility rate internationally.Method In 2011, the ratios of family- and elderly-related social spending to gross domestic product (GDP) were recorded in 34 Organisation for Economic Co-operation and Development (OECD) member countries. The former was designated as the percentage allocated to members of the population between the ages of 0 and 14 (young population ratio), and the latter was designated as the percentage allocated to members of the population over the age of 65 (elderly population ratio). We compared these two factors for every country and performed correlation and partial correlation analyses of total fertility rates and family-related social spending to GDP adjusted by population proportion to examine the relationship between the two.Results The comparison of the youth and elderly populations' spending ratios in the total social spending to GDP ratio revealed that OECD countries had an average family-related social spending ratio of 0.13 and an average elderly-related social spending ratio of 0.47. Comparatively, Japan has a family-related social spending ratio of 0.10 and an elderly-related social spending ratio of 0.45. In the correlation analysis for total fertility rates and family-related social spending to GDP ratio, the benefits-in-kind to GDP ratio and total fertility rates indicated a trend toward correlation (r=0.32, P=0.06). In addition, the results for the partial correlation between family-related social spending to GDP ratio and total fertility rates showed a significant correlation between the two. When divided into cash benefits and benefits-in-kind, the partial correlation analysis of the GDP ratios and total fertility rates revealed a significant correlation (r=0.51, P<0.01). Benefits-in-kind (r=0.45, P<0.01) had a stronger correlation than did cash benefits (r=0.39, P=0.03).Conclusion In an international comparison accounting for economic standards, the social security cost of children and child-rearing families in Japan was low. Further, in terms of social security spending, increasing benefits-in-kind, such as improving childcare services or preschool education, is one factor that improves the total fertility rate.

  9. Comparison Of Intake Gate Closure Methods At Lower Granite, Little Goose, Lower Monumental, And Mcnary Dams Using Risk-Based Analysis

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

    Gore, Bryan F.; Blackburn, Tyrone R.; Heasler, Patrick G.

    2001-01-19

    The objective of this report is to compare the benefits and costs of modifications proposed for intake gate closure systems at four hydroelectric stations on the Lower Snake and Upper Columbia Rivers in the Walla Walla District that are unable to meet the COE 10-minute closure rule due to the installation of fish screens. The primary benefit of the proposed modifications is to reduce the risk of damage to the station and environs when emergency intake gate closure is required. Consequently, this report presents the results and methodology of an extensive risk analysis performed to assess the reliability of powerhousemore » systems and the costs and timing of potential damages resulting from events requiring emergency intake gate closure. As part of this analysis, the level of protection provided by the nitrogen emergency closure system was also evaluated. The nitrogen system was the basis for the original recommendation to partially disable the intake gate systems. The risk analysis quantifies this protection level.« less

  10. Improvement of the cost-benefit analysis algorithm for high-rise construction projects

    NASA Astrophysics Data System (ADS)

    Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

    2018-03-01

    The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

  11. 48 CFR 570.402-6 - Cost-benefit analysis.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Cost-benefit analysis. 570.402-6 Section 570.402-6 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION SPECIAL... Continued Space Requirements 570.402-6 Cost-benefit analysis. (a) The cost-benefit analysis must consider...

  12. 48 CFR 570.402-6 - Cost-benefit analysis.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Cost-benefit analysis. 570.402-6 Section 570.402-6 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION SPECIAL... Continued Space Requirements 570.402-6 Cost-benefit analysis. (a) The cost-benefit analysis must consider...

  13. Perturbed Partial Cavity Drag Reduction at High Reynolds Numbers

    NASA Astrophysics Data System (ADS)

    Makiharju, Simo; Elbing, Brian; Wiggins, Andrew; Dowling, David; Perlin, Marc; Ceccio, Steven

    2010-11-01

    Ventilated partial cavities were investigated at Reynolds numbers to 80 million. These cavities could be suitable for friction drag reduction on ocean going vessels and thereby lead to environmental and economical benefits. The test model was a 3.05 m wide by 12.9 m long flat plate, with a 0.18 m backward-facing step and a cavity-terminating beach, which had an adjustable slope, tilt and height. The step and beach trapped a ventilated partial cavity over the longitudinal mid-section of the model. Large-scale flow perturbations, mimicking the effect of ambient ocean waves were investigated. For the conditions tested a cavity could be maintained under perturbed flow conditions when the gas flux supplied was greater than the minimum required to maintain a cavity under steady conditions, with larger perturbations requiring more excess gas flux to maintain the cavity. High-speed video was used to observe the unsteady three dimensional cavity closure, the overall cavity shape, and the cavity oscillations. Cavities with friction drag reduction exceeding 95% were attained at optimal conditions. A simplified energy cost-benefit analysis of partial cavity drag reduction was also performed. The results suggest that PCDR could potentially lead to energy savings.

  14. An Economic Analysis of a Safe Resident Handling Program in Nursing Homes

    PubMed Central

    Lahiri, Supriya; Latif, Saira; Punnett, Laura

    2018-01-01

    Background Occupational injuries, especially back problems related to resident handling, are common in nursing home employees and their prevention may require substantial up-front investment. This study evaluated the economics of a safe resident handling program (SRHP), in a large chain of skilled nursing facilities, from the corporation's perspective. Methods The company provided data on program costs, compensation claims, and turnover rates (2003-2009). Workers' compensation and turnover costs before and after the intervention were compared against investment costs using the “net-cost model”. Results Among 110 centers, the overall benefit-to-cost ratio was 1.7–3.09 and the payback period was 1.98–1.06 year (using alternative turnover cost estimates). The average annualized net savings per bed for the 110 centers (using company based turnover cost estimates) was $143, with a 95% confidence interval of $22–$264. This was very similar to the average annualized net savings per full time equivalent (FTE) staff member, which was $165 (95% confidence interval $22–$308). However, at 49 centers costs exceeded benefits. Conclusions Decreased costs of worker injury compensation claims and turnover appear at least partially attributable to the SRHP. Future research should examine center-specific factors that enhance program success, and improve measures of turnover costs and healthcare productivity. PMID:23203729

  15. An economic analysis of a safe resident handling program in nursing homes.

    PubMed

    Lahiri, Supriya; Latif, Saira; Punnett, Laura

    2013-04-01

    Occupational injuries, especially back problems related to resident handling, are common in nursing home employees and their prevention may require substantial up-front investment. This study evaluated the economics of a safe resident handling program (SRHP), in a large chain of skilled nursing facilities, from the corporation's perspective. The company provided data on program costs, compensation claims, and turnover rates (2003-2009). Workers' compensation and turnover costs before and after the intervention were compared against investment costs using the "net-cost model." Among 110 centers, the overall benefit-to-cost ratio was 1.7-3.09 and the payback period was 1.98-1.06 year (using alternative turnover cost estimates). The average annualized net savings per bed for the 110 centers (using company based turnover cost estimates) was $143, with a 95% confidence interval of $22-$264. This was very similar to the average annualized net savings per full time equivalent (FTE) staff member, which was $165 (95% confidence interval $22-$308). However, at 49 centers costs exceeded benefits. Decreased costs of worker injury compensation claims and turnover appear at least partially attributable to the SRHP. Future research should examine center-specific factors that enhance program success, and improve measures of turnover costs and healthcare productivity. Copyright © 2012 Wiley Periodicals, Inc.

  16. 24 CFR 965.402 - Benefit/cost analysis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Benefit/cost analysis. 965.402...-Owned Projects § 965.402 Benefit/cost analysis. (a) A benefit/cost analysis shall be made to determine... (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN...

  17. Evolution of cooperation with shared costs and benefits

    PubMed Central

    Brown, Joel S; Vincent, Thomas L

    2008-01-01

    The quest to determine how cooperation evolves can be based on evolutionary game theory, in spite of the fact that evolutionarily stable strategies (ESS) for most non-zero-sum games are not cooperative. We analyse the evolution of cooperation for a family of evolutionary games involving shared costs and benefits with a continuum of strategies from non-cooperation to total cooperation. This cost–benefit game allows the cooperator to share in the benefit of a cooperative act, and the recipient to be burdened with a share of the cooperator's cost. The cost–benefit game encompasses the Prisoner's Dilemma, Snowdrift game and Partial Altruism. The models produce ESS solutions of total cooperation, partial cooperation, non-cooperation and coexistence between cooperation and non-cooperation. Cooperation emerges from an interplay between the nonlinearities in the cost and benefit functions. If benefits increase at a decelerating rate and costs increase at an accelerating rate with the degree of cooperation, then the ESS has an intermediate level of cooperation. The game also exhibits non-ESS points such as unstable minima, convergent-stable minima and unstable maxima. The emergence of cooperative behaviour in this game represents enlightened self-interest, whereas non-cooperative solutions illustrate the Tragedy of the Commons. Games having either a stable maximum or a stable minimum have the property that small changes in the incentive structure (model parameter values) or culture (starting frequencies of strategies) result in correspondingly small changes in the degree of cooperation. Conversely, with unstable maxima or unstable minima, small changes in the incentive structure or culture can result in a switch from non-cooperation to total cooperation (and vice versa). These solutions identify when human or animal societies have the potential for cooperation and whether cooperation is robust or fragile. PMID:18495622

  18. Economic analysis of interventions to improve village chicken production in Myanmar.

    PubMed

    Henning, J; Morton, J; Pym, R; Hla, T; Sunn, K; Meers, J

    2013-07-01

    A cost-benefit analysis using deterministic and stochastic modelling was conducted to identify the net benefits for households that adopt (1) vaccination of individual birds against Newcastle disease (ND) or (2) improved management of chick rearing by providing coops for the protection of chicks from predation and chick starter feed inside a creep feeder to support chicks' nutrition in village chicken flocks in Myanmar. Partial budgeting was used to assess the additional costs and benefits associated with each of the two interventions tested relative to neither strategy. In the deterministic model, over the first 3 years after the introduction of the interventions, the cumulative sum of the net differences from neither strategy was 13,189Kyat for ND vaccination and 77,645Kyat for improved chick management (effective exchange rate in 2005: 1000Kyat=1$US). Both interventions were also profitable after discounting over a 10-year period; Net Present Values for ND vaccination and improved chick management were 30,791 and 167,825Kyat, respectively. The Benefit-Cost Ratio for ND vaccination was very high (28.8). This was lower for improved chick management, due to greater costs of the intervention, but still favourable at 4.7. Using both interventions concurrently yielded a Net Present Value of 470,543Kyat and a Benefit-Cost Ratio of 11.2 over the 10-year period in the deterministic model. Using the stochastic model, for the first 3 years following the introduction of the interventions, the mean cumulative sums of the net difference were similar to those values obtained from the deterministic model. Sensitivity analysis indicated that the cumulative net differences were strongly influenced by grower bird sale income, particularly under improved chick management. The effects of the strategies on odds of households selling and consuming birds after 7 months, and numbers of birds being sold or consumed after this period also influenced profitability. Cost variations for equipment used under improved chick management were not markedly associated with profitability. Net Present Values and Benefit-Cost Ratios discounted over a 10-year period were also similar to the deterministic model when mean values obtained through stochastic modelling were used. In summary, the study showed that ND vaccination and improved chick management can improve the viability and profitability of village chicken production in Myanmar. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Strategies for Efficient Computation of the Expected Value of Partial Perfect Information

    PubMed Central

    Madan, Jason; Ades, Anthony E.; Price, Malcolm; Maitland, Kathryn; Jemutai, Julie; Revill, Paul; Welton, Nicky J.

    2014-01-01

    Expected value of information methods evaluate the potential health benefits that can be obtained from conducting new research to reduce uncertainty in the parameters of a cost-effectiveness analysis model, hence reducing decision uncertainty. Expected value of partial perfect information (EVPPI) provides an upper limit to the health gains that can be obtained from conducting a new study on a subset of parameters in the cost-effectiveness analysis and can therefore be used as a sensitivity analysis to identify parameters that most contribute to decision uncertainty and to help guide decisions around which types of study are of most value to prioritize for funding. A common general approach is to use nested Monte Carlo simulation to obtain an estimate of EVPPI. This approach is computationally intensive, can lead to significant sampling bias if an inadequate number of inner samples are obtained, and incorrect results can be obtained if correlations between parameters are not dealt with appropriately. In this article, we set out a range of methods for estimating EVPPI that avoid the need for nested simulation: reparameterization of the net benefit function, Taylor series approximations, and restricted cubic spline estimation of conditional expectations. For each method, we set out the generalized functional form that net benefit must take for the method to be valid. By specifying this functional form, our methods are able to focus on components of the model in which approximation is required, avoiding the complexities involved in developing statistical approximations for the model as a whole. Our methods also allow for any correlations that might exist between model parameters. We illustrate the methods using an example of fluid resuscitation in African children with severe malaria. PMID:24449434

  20. General methodology: Costing, budgeting, and techniques for benefit-cost and cost-effectiveness analysis

    NASA Technical Reports Server (NTRS)

    Stretchberry, D. M.; Hein, G. F.

    1972-01-01

    The general concepts of costing, budgeting, and benefit-cost ratio and cost-effectiveness analysis are discussed. The three common methods of costing are presented. Budgeting distributions are discussed. The use of discounting procedures is outlined. The benefit-cost ratio and cost-effectiveness analysis is defined and their current application to NASA planning is pointed out. Specific practices and techniques are discussed, and actual costing and budgeting procedures are outlined. The recommended method of calculating benefit-cost ratios is described. A standardized method of cost-effectiveness analysis and long-range planning are also discussed.

  1. 24 CFR 965.406 - Benefit/cost analysis for similar projects.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Benefit/cost analysis for similar... Existing PHA-Owned Projects § 965.406 Benefit/cost analysis for similar projects. PHAs with more than one project of similar design and utilities service may prepare a benefit/cost analysis for a representative...

  2. Cost benefit analysis: applications and future opportunities.

    DOT National Transportation Integrated Search

    2016-06-01

    Cost Benefit Analysis (CBA or Benefit Cost Analysis BCA) is an evaluation tool that state transportation agencies can : use to compare infrastructure project options across transportation modes and gauge if the discounted value of benefits : exce...

  3. The irrationality of continued fire suppression: A partial analysis of the costs and benefits of restoration-based fuel reduction treatments vs. no treatment

    Treesearch

    G. B. Snider; P. J. Daugherty

    2008-01-01

    (Please note, this is an abstract only) In 1905, the Bureau of Forestry became the U.S. Forest Service and was given responsibility for protecting newly designated forest reserves. A critical part of its charge was the prevention and control of fires. In 1908 Congress set up a unique system, like an open checkbook, that assured payment for fire suppression as needed....

  4. Comparative study of various normal mode analysis techniques based on partial Hessians.

    PubMed

    Ghysels, An; Van Speybroeck, Veronique; Pauwels, Ewald; Catak, Saron; Brooks, Bernard R; Van Neck, Dimitri; Waroquier, Michel

    2010-04-15

    Standard normal mode analysis becomes problematic for complex molecular systems, as a result of both the high computational cost and the excessive amount of information when the full Hessian matrix is used. Several partial Hessian methods have been proposed in the literature, yielding approximate normal modes. These methods aim at reducing the computational load and/or calculating only the relevant normal modes of interest in a specific application. Each method has its own (dis)advantages and application field but guidelines for the most suitable choice are lacking. We have investigated several partial Hessian methods, including the Partial Hessian Vibrational Analysis (PHVA), the Mobile Block Hessian (MBH), and the Vibrational Subsystem Analysis (VSA). In this article, we focus on the benefits and drawbacks of these methods, in terms of the reproduction of localized modes, collective modes, and the performance in partially optimized structures. We find that the PHVA is suitable for describing localized modes, that the MBH not only reproduces localized and global modes but also serves as an analysis tool of the spectrum, and that the VSA is mostly useful for the reproduction of the low frequency spectrum. These guidelines are illustrated with the reproduction of the localized amine-stretch, the spectrum of quinine and a bis-cinchona derivative, and the low frequency modes of the LAO binding protein. 2009 Wiley Periodicals, Inc.

  5. Comparative Study of Various Normal Mode Analysis Techniques Based on Partial Hessians

    PubMed Central

    GHYSELS, AN; VAN SPEYBROECK, VERONIQUE; PAUWELS, EWALD; CATAK, SARON; BROOKS, BERNARD R.; VAN NECK, DIMITRI; WAROQUIER, MICHEL

    2014-01-01

    Standard normal mode analysis becomes problematic for complex molecular systems, as a result of both the high computational cost and the excessive amount of information when the full Hessian matrix is used. Several partial Hessian methods have been proposed in the literature, yielding approximate normal modes. These methods aim at reducing the computational load and/or calculating only the relevant normal modes of interest in a specific application. Each method has its own (dis)advantages and application field but guidelines for the most suitable choice are lacking. We have investigated several partial Hessian methods, including the Partial Hessian Vibrational Analysis (PHVA), the Mobile Block Hessian (MBH), and the Vibrational Subsystem Analysis (VSA). In this article, we focus on the benefits and drawbacks of these methods, in terms of the reproduction of localized modes, collective modes, and the performance in partially optimized structures. We find that the PHVA is suitable for describing localized modes, that the MBH not only reproduces localized and global modes but also serves as an analysis tool of the spectrum, and that the VSA is mostly useful for the reproduction of the low frequency spectrum. These guidelines are illustrated with the reproduction of the localized amine-stretch, the spectrum of quinine and a bis-cinchona derivative, and the low frequency modes of the LAO binding protein. PMID:19813181

  6. Nurse manager succession planning: A cost-benefit analysis.

    PubMed

    Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

    2018-03-01

    This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

  7. Feminine charm: an experimental analysis of its costs and benefits in negotiations.

    PubMed

    Kray, Laura J; Locke, Connson C; Van Zant, Alex B

    2012-10-01

    The authors examined feminine charm, an impression management technique available to women that combines friendliness with flirtation. They asked whether feminine charm resolves the impression management dilemma facing women who simultaneously pursue task (i.e., economic) and social goals in negotiations. They compared women's social and economic consequences after using feminine charm versus a neutral interaction style. They hypothesized that feminine charm would create positive impressions of its users, thus partially mitigating the social penalties women negotiators often incur. They also expected that the degree to which females were perceived as flirtatious (signaling a concern for self), rather than merely friendly (signaling a concern for other), would predict better economic deals for females. Hypotheses were supported across a correlational study and three experiments. Feminine charm has costs and benefits spanning economic and social measures. Theoretical and practical implications are discussed.

  8. Cost-Benefit Analysis: Applicability in Higher Education.

    ERIC Educational Resources Information Center

    Dunn, Briggs P.; Sullins, W. Robert

    1982-01-01

    Discusses problems in applying cost-benefit analysis to higher education, including selecting the correct productivity index, determining the discount rate for social consumption foregone, measuring individual and social costs and benefits, and defining the time horizon for educational investment returns. Contrasts cost-benefit and…

  9. Cost and benefit estimates of partially-automated vehicle collision avoidance technologies.

    PubMed

    Harper, Corey D; Hendrickson, Chris T; Samaras, Constantine

    2016-10-01

    Many light-duty vehicle crashes occur due to human error and distracted driving. Partially-automated crash avoidance features offer the potential to reduce the frequency and severity of vehicle crashes that occur due to distracted driving and/or human error by assisting in maintaining control of the vehicle or issuing alerts if a potentially dangerous situation is detected. This paper evaluates the benefits and costs of fleet-wide deployment of blind spot monitoring, lane departure warning, and forward collision warning crash avoidance systems within the US light-duty vehicle fleet. The three crash avoidance technologies could collectively prevent or reduce the severity of as many as 1.3 million U.S. crashes a year including 133,000 injury crashes and 10,100 fatal crashes. For this paper we made two estimates of potential benefits in the United States: (1) the upper bound fleet-wide technology diffusion benefits by assuming all relevant crashes are avoided and (2) the lower bound fleet-wide benefits of the three technologies based on observed insurance data. The latter represents a lower bound as technology is improved over time and cost reduced with scale economies and technology improvement. All three technologies could collectively provide a lower bound annual benefit of about $18 billion if equipped on all light-duty vehicles. With 2015 pricing of safety options, the total annual costs to equip all light-duty vehicles with the three technologies would be about $13 billion, resulting in an annual net benefit of about $4 billion or a $20 per vehicle net benefit. By assuming all relevant crashes are avoided, the total upper bound annual net benefit from all three technologies combined is about $202 billion or an $861 per vehicle net benefit, at current technology costs. The technologies we are exploring in this paper represent an early form of vehicle automation and a positive net benefit suggests the fleet-wide adoption of these technologies would be beneficial from an economic and social perspective. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Cost effectiveness of meniscal allograft for torn discoid lateral meniscus in young women.

    PubMed

    Ramme, Austin J; Strauss, Eric J; Jazrawi, Laith; Gold, Heather T

    2016-09-01

    A discoid meniscus is more prone to tears than a normal meniscus. Patients with a torn discoid lateral meniscus are at increased risk for early onset osteoarthritis requiring total knee arthroplasty (TKA). Optimal management for this condition is controversial given the up-front cost difference between the two treatment options: the more expensive meniscal allograft transplantation compared with standard partial meniscectomy. We hypothesize that meniscal allograft transplantation following excision of a torn discoid lateral meniscus is more cost-effective compared with partial meniscectomy alone because allografts will extend the time to TKA. A decision analytic Markov model was created to compare the cost effectiveness of two treatments for symptomatic, torn discoid lateral meniscus: meniscal allograft and partial meniscectomy. Probability estimates and event rates were derived from the scientific literature, and costs and benefits were discounted by 3%. One-way sensitivity analyses were performed to test model robustness. Over 25 years, the partial meniscectomy strategy cost $10,430, whereas meniscal allograft cost on average $4040 more, at $14,470. Partial meniscectomy postponed TKA an average of 12.5 years, compared with 17.30 years for meniscal allograft, an increase of 4.8 years. Allograft cost $842 per-year-gained in time to TKA. Meniscal allografts have been shown to reduce pain and improve function in patients with discoid lateral meniscus tears. Though more costly, meniscal allografts may be more effective than partial meniscectomy in delaying TKA in this model. Additional future long term clinical studies will provide more insight into optimal surgical options.

  11. 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

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

    PubMed Central

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

    2015-01-01

    Introduction Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA) is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses—where outcomes are considered separately, with their joint relationship under uncertainty ignored—lead to incorrect inference regarding preferred strategies. Objective The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison. Methods Multiple outcomes CEA of a home-based palliative care model (PEACH) relative to usual care is undertaken in cost disutility (CDU) space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL) planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL. Results Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home ( 1) exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home), with a 51.6% chance of PEACH being cost-effective. Conclusion Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding transparent and robust joint comparison of costs and multiple effects under uncertainty across potential threshold values for effect, better informing net benefit assessment and related reimbursement and research decisions. PMID:25751629

  13. 48 CFR 3046.792 - Cost benefit analysis (USCG).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Cost benefit analysis (USCG). 3046.792 Section 3046.792 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY... Cost benefit analysis (USCG). If a specific warranty is considered not to be cost beneficial by the...

  14. 48 CFR 3046.792 - Cost benefit analysis (USCG).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Cost benefit analysis (USCG). 3046.792 Section 3046.792 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY... Cost benefit analysis (USCG). If a specific warranty is considered not to be cost beneficial by the...

  15. 77 FR 16852 - Notice of Reclassification of Five Regional Offices to Investigative Field Offices: Seattle, WA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ..., it does not need to reorganize. This notice also includes a cost-benefit analysis supporting the...-benefit analysis of the effect of the plan on the office involved. The required cost-benefit analysis must... such offices, HUD/OIG nonetheless voluntarily publishes the following cost-benefit analysis of its plan...

  16. An Introduction to Benefit-Cost Analysis for Evaluating Public Expenditure Alternatives. Learning Packages in the Policy Sciences, PS-22.

    ERIC Educational Resources Information Center

    LaPlante, Josephine M.; Durham, Taylor R.

    A revised edition of PS-14, "An Introduction to Benefit-Cost Analysis for Evaluating Public Programs," presents concepts and techniques of benefit-cost analysis as tools that can be used to assist in deciding between alternatives. The goals of the new edition include teaching students to think about the possible benefits and costs of each…

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

    PubMed

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

    2002-04-01

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

  18. 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

  19. Contemporary health care economics: an overview.

    PubMed

    McLaughlin, Nancy; Ong, Michael K; Tabbush, Victor; Hagigi, Farhad; Martin, Neil A

    2014-11-01

    Economic evaluations provide a decision-making framework in which outcomes (benefits) and costs are assessed for various alternative options. Although the interest in complete and partial economic evaluations has increased over the past 2 decades, the quality of studies has been marginal due to methodological challenges or incomplete cost determination. This paper provides an overview of the main types of complete and partial economic evaluations, reviews key methodological elements to be considered for any economic evaluation, and reviews concepts of cost determination. The goal is to provide the clinician neurosurgeon with the knowledge and tools needed to appraise published economic evaluations and to direct high-quality health economic evaluations.

  20. The management of an endodontically abscessed tooth: patient health state utility, decision-tree and economic analysis

    PubMed Central

    Balevi, Ben; Shepperd, Sasha

    2007-01-01

    Background A frequent encounter in clinical practice is the middle-aged adult patient complaining of a toothache caused by the spread of a carious infection into the tooth's endodontic complex. Decisions about the range of treatment options (conventional crown with a post and core technique (CC), a single tooth implant (STI), a conventional dental bridge (CDB), and a partial removable denture (RPD)) have to balance the prognosis, utility and cost. Little is know about the utility patients attach to the different treatment options for an endontically abscessed mandibular molar and maxillary incisor. We measured patients' dental-health-state utilities and ranking preferences of the treatment options for these dental problems. Methods Forty school teachers ranked their preferences for conventional crown with a post and core technique, a single tooth implant, a conventional dental bridge, and a partial removable denture using a standard gamble and willingness to pay. Data previously reported on treatment prognosis and direct "out-of-pocket" costs were used in a decision-tree and economic analysis Results The Standard Gamble utilities for the restoration of a mandibular 1st molar with either the conventional crown (CC), single-tooth-implant (STI), conventional dental bridge (CDB) or removable-partial-denture (RPD) were 74.47 [± 6.91], 78.60 [± 5.19], 76.22 [± 5.78], 64.80 [± 8.1] respectively (p < 0.05). Their respective Willingness-to-Pay ($CDN) were 1,782.05 [± 361.42], 1,871.79 [± 349.44], 1,605.13 [± 348.10], 1,351.28 [± 368.62] (p < 0.05). The standard gamble utilities for the restoration of a maxillary central incisor with a CC, STI, CDB and RPD were 88.50 [± 6.12], 90.68 [± 3.41], 89.78 [± 3.81] and 91.10 [± 3.57] respectively (p > 0.05). Their respective willingness-to-pay ($CDN) were: 1,782.05 [± 361.42], 1,871.79 [± 349.44], 1,605.13 [± 348.10] and 1,351.28 [± 368.62]. A statistical difference was found between the utility of treating a maxillary central incisor and mandibular 1st-molar (p < 0.05). The expected-utility-value for a 5-year prosthetic survival was highest for the CDB and the STI treatment of an abscessed mandibular molar (74.75 and 71.47 respectively) and maxillary incisor (86.24 and 84.91 respectively). This held up to a sensitivity analysis when the success of root canal therapy and the risk of damage to the adjacent tooth were varied. The RPD for both the molar and incisor was the favored treatment based on a cost-utility (3.85 and 2.74 CND$ per year of tooth saved respectively) and cost-benefit analysis (0.92 to 0.60 CND$ of cost per $ of benefit, respectively) for a prosthetic clinical survival of 5-years. Conclusion The position of the abscessed tooth and the amount of insurance coverage influences the utility and rank assigned by patients to the different treatment options. STI and CDB have optimal EUVs for a 5-year survival outcome, and RPD has significantly lower cost providing the better cost:benefit ratio. PMID:18053267

  1. Who pays for the health benefits of exclusive breastfeeding? An analysis of maternal time costs.

    PubMed

    Smith, J P; Forrester, Robert

    2013-11-01

    The benefits of exclusive breastfeeding, including public health cost savings, are widely recognized, but breastfeeding requires maternal time investments. This study investigates the time taken to exclusively breastfeed at 6 months compared with not exclusively breastfeeding. Time use data were examined from an Australian survey of new mothers conducted during 2005-2006. Data from 139 mothers with infants age 6 months were analyzed using chi-square tests of independence to examine socioeconomic and demographic characteristics and 2-sided t tests to compare average weekly hours spent on milk feeding, feeding solids, preparing feeds, and the total of these. The comparison was of exclusively breastfeeding mothers with other mothers. We also compared exclusively breastfeeding with partially breastfeeding and formula feeding mothers using a 1-way between-groups analysis of variance (ANOVA). The exclusively breastfeeding (vs other) mothers spent 7 hours extra weekly on milk feeding their infants but 2 hours less feeding solids. These differences were statistically significant. ANOVA revealed significant differences between exclusively breastfeeding mothers, breastfeeding mothers who had introduced solids, and mothers who fed any formula, in time spent feeding milk, and solids, and preparing feeds. Exclusive breastfeeding is time intensive, which is economically costly to women. This may contribute to premature weaning for women who are time-stressed, lack household help from family, or cannot afford paid help. Gaining public health benefits of exclusive breastfeeding requires strategies to share maternal lactation costs more widely, such as additional help with housework or caring for children, enhanced leave, and workplace lactation breaks and suitable child care.

  2. 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.

  3. A Subject Reference: Benefit-Cost Analysis of Toxic Substances, Hazardous Materials and Solid Waste Control (1977)

    EPA Pesticide Factsheets

    Discussion of methodological issues for conducting benefit-cost analysis and provides guidance for selecting and applying the most appropriate and useful mechanisms in benefit-cost analysis of toxic substances, hazardous materials, and solid waste control

  4. A Preliminary Analysis of the Costs and Benefits of Older Age Accessions.

    DTIC Science & Technology

    1984-03-01

    8217AD-A143 160 A PRELIMINARY ANALYSIS OF THE COSTS AND BENEFITS OF I/ OLDER AGE ACCESSIONS(U) NAVAL POSTGRADUATE SCHOOL N A MONTEREY CA S D BARCLAY MAR...ELECTE JUL 1884d THESIS A PRELIMINARY ANALYSIS CF THE COSTS AND BENEFITS OF OLDER AGE ACCESSIONS CL by Susan D. Barclay March 1984 Thesis Advisor...for public release; distribution unlimited. A Preliminary Analysis of the Costs and Benefits of Older Age Accessions by Susan D. Barclay Lieutenant

  5. Principles of cost-benefit analysis for ERTS experiments, volumes 1 and 2

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The basic elements of a cost-benefit study are discussed along with special considerations for ERTS experiments. Elements required for a complete economic analysis of ERTS are considered to be: statement of objectives, specification of assumptions, enumeration of system alternatives, benefit analysis, cost analysis nonefficiency considerations, and final system selection. A hypothetical cost-benefit example is presented with the assumed objective of an increase in remote sensing surveys of grazing lands to better utilize available forage to lower meat prices.

  6. Information System for Societal Cost and Benefit Analysis of Vocational and Manpower Programs. Final Report.

    ERIC Educational Resources Information Center

    Arora, Mehar

    The study was directed toward developing a manual for establishing societal benefits and costs of vocational and manpower programs in Wisconsin. After first outlining the background of benefit-cost analysis, problems in establishing cost functions in education are presented along with some important cost concepts and uses of cost information in…

  7. Cost-Benefit Analysis of Implementing a Car-Sharing Model to the Navy’s Passenger Vehicle Fleet

    DTIC Science & Technology

    2016-12-01

    and Public Policy iv THIS PAGE INTENTIONALLY LEFT BLANK v COST - BENEFIT ANALYSIS OF IMPLEMENTING A CAR- SHARING MODEL TO THE NAVY’S PASSENGER...the public good. This CBA will be conducted using a federal government perspective and standing (whose costs and benefits will be counted) will be...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT COST - BENEFIT ANALYSIS OF IMPLEMENTING A CAR-SHARING

  8. Benefit-Cost Analysis of Drug Abuse Prevention Programs: A Macroscopic Approach.

    ERIC Educational Resources Information Center

    Kim, Sehwan; And Others

    1995-01-01

    Determines the overall strategy for initiating benefit-cost analysis (BCA) in relation to drug abuse prevention programs, followed by definitions of BCA and cost-effectiveness analysis. Determines the most likely population benefit-cost efficiency ratio of 15:1, indicating that there is a $15 savings on every dollar spent on drug abuse education.…

  9. A Prospective Analysis of the Costs, Benefits, and Impacts of U.S. Renewable Portfolio Standards

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

    Mai, Trieu; Wiser, Ryan; Barbose, Galen

    This report evaluates the future costs, benefits, and other impacts of renewable energy used to meet current state renewable portfolio standards (RPSs). It also examines a future scenario where RPSs are expanded. The analysis examines changes in electric system costs and retail electricity prices, which include all fixed and operating costs, including capital costs for all renewable, non-renewable, and supporting (e.g., transmission and storage) electric sector infrastructure; fossil fuel, uranium, and biomass fuel costs; and plant operations and maintenance expenditures. The analysis evaluates three specific benefits: air pollution, greenhouse gas emissions, and water use. It also analyzes two other impacts,more » renewable energy workforce and economic development, and natural gas price suppression. This analysis finds that the benefits or renewable energy used to meet RPS polices exceed the costs, even when considering the highest cost and lowest benefit outcomes.« less

  10. 7 CFR 2.71 - Director, Office of Risk Assessment and Cost-Benefit Analysis.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Analysis. 2.71 Section 2.71 Agriculture Office of the Secretary of Agriculture DELEGATIONS OF AUTHORITY BY... Chief Economist § 2.71 Director, Office of Risk Assessment and Cost-Benefit Analysis. (a) Delegations..., Office of Risk Assessment and Cost-Benefit Analysis: (1) Responsible for assessing the risks to human...

  11. 7 CFR 2.71 - Director, Office of Risk Assessment and Cost-Benefit Analysis.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Analysis. 2.71 Section 2.71 Agriculture Office of the Secretary of Agriculture DELEGATIONS OF AUTHORITY BY... Chief Economist § 2.71 Director, Office of Risk Assessment and Cost-Benefit Analysis. (a) Delegations..., Office of Risk Assessment and Cost-Benefit Analysis: (1) Responsible for assessing the risks to human...

  12. Design-to-cost

    NASA Technical Reports Server (NTRS)

    Bradley, F. E.

    1974-01-01

    Attempts made to design to costs equipment, vehicles and subsystems for various space projects are discussed. A systematic approach, based on mission requirement analysis, definition of a mission baseline design, benefit and cost analysis, and a benefit-cost analysis was proposed for implementing the cost control program.

  13. National surveillance and control costs for highly pathogenic avian influenza H5N1 in poultry: A benefit-cost assessment for a developing economy, Nigeria.

    PubMed

    Fasanmi, Olubunmi G; Kehinde, Olugbenga O; Laleye, Agnes T; Ekong, Bassey; Ahmed, Syed S U; Fasina, Folorunso O

    2018-06-13

    We conducted benefit-cost analysis of outbreak and surveillance costs for HPAI H5N1in poultry in Nigeria. Poultry's death directly cost US$ 939,734.0 due to outbreaks. The integrated disease surveillance and response originally created for comprehensive surveillance and laboratory investigation of human diseases was adapted for HPAI H5N1 in poultry. Input data were obtained from the field, government documents and repositories and peer-reviewed publications. Actual/forecasted bird numbers lost were integrated into a financial model and estimates of losses were calculated. Costs of surveillance as alternative intervention were determined based on previous outbreak control costs and outputs were generated in SurvCost® with sensitivity analyses for different scenarios. Uncontrolled outbreaks will lead to loss of over US$ 2.2 billion annually in Nigeria with 47.8% of the losses coming from eggs. The annual cost of all animal related health activities was

  14. Cost-Effectiveness and Cost-Benefit Analysis: Confronting the Problem of Choice.

    ERIC Educational Resources Information Center

    Clardy, Alan

    Cost-effectiveness analysis and cost-benefit analysis are two related yet distinct methods to help decision makers choose the best course of action from among competing alternatives. For both types of analysis, costs are computed similarly. Costs may be reduced to present value amounts for multi-year programs, and parameters may be altered to show…

  15. The benefits of integrating cost-benefit analysis and risk assessment

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

    Fisher, K.; Clarke-Whistler, K.

    1995-12-31

    It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements inmore » health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada`s concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health.« less

  16. Enhancing TSM&O strategies through life cycle benefit/cost analysis : life cycle benefit/cost analysis & life cycle assessment of adaptive traffic control systems and ramp metering systems.

    DOT National Transportation Integrated Search

    2015-05-01

    The research team developed a comprehensive Benefit/Cost (B/C) analysis framework to evaluate existing and anticipated : intelligent transportation system (ITS) strategies, particularly, adaptive traffic control systems and ramp metering systems, : i...

  17. The Application of Cost-Benefit Analysis in Manpower Area.

    ERIC Educational Resources Information Center

    Barsby, Steven L.

    The relative efficiency of various manpower programs as seen through cost-benefit analysis is assessed, and the contribution that cost-benefit analysis has made in evaluating manpower programs is discussed, taking into account a variety of methodologies presented in different studies. Vocational rehabilitation appears to yield the highest…

  18. Cost-Benefit Analysis of Possible U.S. Adherence to Two International Conventions on Liability and Compensation for Oil Pollution Damages.

    DTIC Science & Technology

    1983-06-30

    advantages and disadvantages of adher- ing to the conventions. This report presents the results of the cost- benefit analysis. The primary question...AD-A133 iii COST- BENEFIT ANALYSIS OF POSSIBLE US ADHERENCE TO TWO 114 INTERNATIONAL CONVE..(U) TEMPLE BARKER AND SLOANE INC LEXINGTON MA 30 JUN 83...Accession No. 3. Recipient’s Catalog No. CC-WER-83-1 4. Title and Subti e Cost- Benefit Analysis of possible U.S. S. Report Date Adherence to two

  19. Future Costs, Benefits, and Impacts of Renewables Used to Meet U.S. Renewable Portfolio Standards

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

    This brochure provides a brief overview of the report titled 'A Prospective Analysis of the Costs, Benefits, and Impacts of U.S. Renewable Portfolio Standards.' The report evaluates the future costs, benefits, and other impacts of renewable energy used to meet current state renewable portfolio standards (RPSs). It also examines a future scenario where RPSs are expanded. The analysis examines changes in electric system costs and retail electricity prices, which include all fixed and operating costs, including capital costs for all renewable, non-renewable, and supporting (e.g., transmission and storage) electric sector infrastructure; fossil fuel, uranium, and biomass fuel costs; and plantmore » operations and maintenance expenditures. The analysis evaluates three specific benefits: air pollution, greenhouse gas emissions, and water use. It also analyzes two other impacts, renewable energy workforce and economic development, and natural gas price suppression. The analysis finds that the benefits or renewable energy used to meet RPS polices exceed the costs, even when considering the highest cost and lowest benefit outcomes.« less

  20. Distribution Grid Integration Costs Under High PV Penetrations Workshop |

    Science.gov Websites

    grids. These distribution grid integration costs are one component of a complete cost-benefit analysis . Engaging stakeholders to coalesce around transparent and mutually acceptable frameworks for cost-benefit -voltage only). In particular, there was be a focus on methods most appropriate for cost-benefit analysis

  1. Consortium Purchases: Case Study for a Cost-Benefit Analysis.

    ERIC Educational Resources Information Center

    Scigliano, Marisa

    2002-01-01

    Discusses library cooperation and academic library consortia and presents a case study of a Canadian consortia that conducted a cost-benefit analysis for purchasing an electronic resource. Reports on member library subscription costs, external economic factors, value of patron time saved, costs and benefits for patrons, and net savings. (LRW)

  2. An Evaluation of the AirCare Program Based on Cost-Benefit and Cost-Effectiveness Analyses

    ERIC Educational Resources Information Center

    Bi, Hsiaotao T.; Wang, Dianle

    2006-01-01

    A cost-benefit analysis of the AirCare program in the province of British Columbia on the basis of emissions cost factors from the literature showed a benefit outweighing the cost. Furthermore, a cost-effectiveness analysis comparing the AirCare program with a hybrid-car rebate program revealed that the AirCare program is more effective in…

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

    PubMed

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

    2011-10-01

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

  4. Cost/benefit analysis of advanced materials technology candidates for the 1980's, part 2

    NASA Technical Reports Server (NTRS)

    Dennis, R. E.; Maertins, H. F.

    1980-01-01

    Cost/benefit analyses to evaluate advanced material technologies projects considered for general aviation and turboprop commuter aircraft through estimated life-cycle costs, direct operating costs, and development costs are discussed. Specifically addressed is the selection of technologies to be evaluated; development of property goals; assessment of candidate technologies on typical engines and aircraft; sensitivity analysis of the changes in property goals on performance and economics, cost, and risk analysis for each technology; and ranking of each technology by relative value. The cost/benefit analysis was applied to a domestic, nonrevenue producing, business-type jet aircraft configured with two TFE731-3 turbofan engines, and to a domestic, nonrevenue producing, business type turboprop aircraft configured with two TPE331-10 turboprop engines. In addition, a cost/benefit analysis was applied to a commercial turboprop aircraft configured with a growth version of the TPE331-10.

  5. [Cost-benefit analysis of a school-based smoking prevention program].

    PubMed

    Hormigo Amaro, Jordi; García-Altés, Anna; López, M José; Bartoll, Xavier; Nebot, Manel; Ariza, Carles

    2009-01-01

    To analyze the efficiency of a school-based smoking prevention program in Barcelona (PASE.bcn program). A cost-benefit analysis was performed. As costs we included those corresponding to the design and implementation of the program. As benefits we considered healthcare costs and the productivity losses avoided. This study was conducted from a societal perspective, and the estimations of costs and benefits related to 2005. Assuming an effectiveness of 1%, the PASE.bcn program would achieve a total benefit of 1,558,311.46euro. The healthcare benefits per prevented smoker were 1997.57euro, and the indirect benefits per prevented smoker were 21,260.80euro. Given the total cost of the school-based program (68,526.03euro), the cost-benefit ratio was 22.74. From a societal perspective, the benefits of school-based tobacco prevention programs, in terms of healthcare costs and productivity losses avoided, are far greater than the costs. These results support universal application of this type of intervention.

  6. 78 FR 64029 - Cost-Benefit Analysis for Radwaste Systems for Light-Water-Cooled Nuclear Power Reactors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... NUCLEAR REGULATORY COMMISSION [NRC-2013-0237] Cost-Benefit Analysis for Radwaste Systems for Light... (RG) 1.110, ``Cost-Benefit Analysis for Radwaste Systems for Light-Water-Cooled Nuclear Power Reactors... components for light water nuclear power reactors. ADDRESSES: Please refer to Docket ID NRC-2013-0237 when...

  7. The Socioemotional Costs and Benefits of Social-Evaluative Concerns: Do Girls Care Too Much?

    PubMed Central

    Rudolph, Karen D.; Conley, Colleen S.

    2011-01-01

    This research investigated the hypothesis that girls’ heightened concerns about social evaluation contribute to sex differences in depression and interpersonal competence during early adolescence. A short-term longitudinal study was conducted with 474 adolescents to examine the consequences of heightened social-evaluative concerns. Adolescents reported on their levels of social-evaluative concerns and depressive symptoms. Teachers provided ratings of adolescents’ competence with peers (displays of prosocial and aggressive behavior). As anticipated, girls demonstrated higher levels of social-evaluative concerns, depressive symptoms, and interpersonal competence than did boys. Moreover, path analysis confirmed that heightened social-evaluative concerns were associated both concurrently and over time with higher levels of depression, as well as with higher levels of interpersonal competence. Notably, social-evaluative concerns accounted fully for the sex difference in depression and partially for the sex difference in interpersonal competence. These findings highlight the need to consider both the socioemotional costs and benefits of sex-linked relational orientations. PMID:15660675

  8. Appropriate VTE prophylaxis is associated with lower direct medical costs.

    PubMed

    Amin, Alpesh; Hussein, Mohamed; Battleman, David; Lin, Jay; Stemkowski, Stephen; Merli, Geno J

    2010-11-01

    To calculate and compare the direct medical costs of guideline-recommended prophylaxis with prophylaxis that does not fully adhere with guideline recommendations in a large, real-world population. Discharge records were retrieved from the US Premier Perspective™ database (January 2003-December 2003) for patients aged≥40 years with a primary diagnosis of cancer, chronic heart failure, lung disease, or severe infectious disease who received some form of thromboprophylaxis. Univariate analysis and multivariate regression modeling were performed to compare direct medical costs between discharges who received appropriate prophylaxis (correct type, dose, and duration based on sixth edition American College of Chest Physicians [ACCP] recommendations) and partial prophylaxis (not in full accordance with ACCP recommendations). Market segmentation analysis was used to compare costs stratified by hospital and patient characteristics. Of the 683 005 discharges included, 148,171 (21.7%) received appropriate prophylaxis and 534,834 (78.3%) received partial prophylaxis. The total direct unadjusted costs were $15,439 in the appropriate prophylaxis group and $17,763 in the partial prophylaxis group. After adjustment, mean adjusted total costs per discharge were lower for those receiving appropriate prophylaxis ($11,713; 95% confidence interval [CI], $11,675-$11,753) compared with partial prophylaxis ($13,369; 95% CI, $13,332-$13 406; P<0.01). Appropriate prophylaxis appeared to be associated with numerically lower unadjusted costs than partial prophylaxis, regardless of hospital size, rural/urban location, teaching status, and patient age and gender. This large, real-world analysis suggests that appropriate prophylaxis, in adherence with ACCP guidelines, is potentially cost-saving compared with partial prophylaxis in at-risk medical patients.

  9. 78 FR 47336 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... provides an updated cost/benefit analysis providing an assessment of the benefits attained by HUD through... the scope of the existing computer matching program to now include the updated cost/ benefit analysis... change, and find a continued favorable examination of benefit/cost results; and (2) All parties certify...

  10. A Benefit Analysis of Using a Low-Cost Flight Simulator for the MH-60R

    DTIC Science & Technology

    2016-09-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. A BENEFIT ...2016 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE A BENEFIT ANALYSIS OF USING A LOW- COST FLIGHT SIMULATOR FOR THE MH... BENEFIT ANALYSIS OF USING A LOW- COST FLIGHT SIMULATOR FOR THE MH-60R J. Gregory Zilai Lieutenant, United States Navy B.S., United States Naval

  11. Benefit-cost analysis framework for evaluating inter-city transit investment.

    DOT National Transportation Integrated Search

    2008-10-01

    This report describes the development and application of a benefit/cost analysis (BCA) model to support the evaluation of investment decisions for intercity bus services. The model recognizes two principle types of intercity bus benefits: benefits th...

  12. Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members.

    PubMed

    Ackermann, Ronald T; Williams, Barbara; Nguyen, Huong Q; Berke, Ethan M; Maciejewski, Matthew L; LoGerfo, James P

    2008-08-01

    To determine whether participation in a physical activity benefit by Medicare managed care enrollees is associated with lower healthcare utilization and costs. Retrospective cohort study. Medicare managed care. A cohort of 1,188 older adult health maintenance organization enrollees who participated at least once in the EnhanceFitness (EF) physical activity benefit and a matched group of enrollees who never used the program. Healthcare costs and utilization were estimated. Ordinary least squares regression was used, adjusting for demographics, comorbidity, indicators of preventive service use, and baseline utilization or cost. Robustness of findings was tested in sensitivity analyses involving continuous propensity score adjustment and generalized linear models with nonconstant variance assumptions. EF participants had similar total healthcare costs during Year 1 of the program, but during Year 2, adjusted total costs were $1,186 lower (P=.005) than for non-EF users. Differences were partially attributable to lower inpatient costs (-$3,384; P=.02), which did not result from high-cost outliers. Enrollees who attended EF an average of one visit or more per week had lower adjusted total healthcare costs in Year 1 (-$1,929; P<.001) and Year 2 (-$1,784; P<.001) than nonusers. Health plan coverage of a preventive physical activity benefit for seniors is a promising strategy to avoid significant healthcare costs in the short term.

  13. Regulatory impact analysis: benefits and costs of proposed surface water treatment rule and total coliform rule

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

    Not Available

    1987-09-01

    This report contains an analysis of the costs and benefits of controlling microbial contaminants in drinking water through the promulgation of two regulations: (1) the Surface Water Treatment Rule (SWTR); and (2) the Total Coliform Rule. This regulatory impact analysis (RIA) was prepared in accordance with Executive Order 12291, which requires that the costs and benefits of all major rules be examined and compared. The major topical areas covered in the RIA are as follows: problem definition; market imperfections, the need for federal regulation, and consideration of regulatory alternatives; assessment of total costs; assessment of benefits; regulatory flexibility act andmore » Paperwork Reduction Act analyses; and a summary of costs and benefits.« less

  14. Is Job Sharing Worthwhile? A Cost-Benefit Analysis in UK Universities.

    ERIC Educational Resources Information Center

    Harris, Geoff

    1997-01-01

    Data from a survey of personnel directors in United Kingdom universities were used to conduct a cost-benefit analysis of job sharing from the institutions' perspective. Results show a 5% rise in productivity would raise the ratio of benefits to cost to 14.3 to 1. Retention of staff, reduction of stress, and reduced unemployment are also benefits.…

  15. Cost-Benefit Comparison: A Method for Evaluation Proposed Changes to Defense Acquisition Procedures

    DTIC Science & Technology

    1990-09-01

    Department of Civil Engineering, Florida University, Gainsville FL, Summer 1986 (AD-A170752). Horngren , Charles T. and George Foster. Cost Accounting : A...Acquisition Regulation (FAR) system, The Department of Labor (DOL) , the Cost Accounting Standards Board (CASB) , and the General Services...decision. In management and in managerial accounting , this type of study is known as cost - benefit analysis. A cost -benefit analysis is the most important

  16. A cost-utility analysis of sacral anterior root stimulation (SARS) compared with medical treatment in patients with complete spinal cord injury with a neurogenic bladder.

    PubMed

    Morlière, Camille; Verpillot, Elise; Donon, Laurence; Salmi, Louis-Rachid; Joseph, Pierre-Alain; Vignes, Jean-Rodolphe; Bénard, Antoine

    2015-12-01

    Sacral anterior root stimulation (SARS) and posterior sacral rhizotomy restores the ability to urinate on demand with low residual volumes, which is a key for preventing urinary complications that account for 10% of the causes of death in patients with spinal cord injury with a neurogenic bladder. Nevertheless, comparative cost-effectiveness results on a long time horizon are lacking to adequately inform decisions of reimbursement. This study aimed to estimate the long-term cost-utility of SARS using the Finetech-Brindley device compared with medical treatment (anticholinergics+catheterization). The following study design is used for the paper: Markov model elaborated with a 10-year time horizon; with four irreversible states: (1) initial treatment, (2) year 1 of surgery for urinary complication, (3) year >1 of surgery for urinary complication, and (4) death; and reversible states: urinary calculi; Finetech-Brindley device failures. The sample consisted of theoretical cohorts of patients with a complete spinal cord lesion since ≥1 year, and a neurogenic bladder. Effectiveness was expressed as quality adjusted life years (QALYs). Costs were valued in EUR 2013 in the perspective of the French health system. A systematic review and meta-analyses were performed to estimate transition probabilities and QALYs. Costs were estimated from the literature, and through simulations using the 2013 French prospective payment system classification. Probabilistic analyses were conducted to handle parameter uncertainty. In the base case analysis (2.5% discount rate), the cost-utility ratio was 12,710 EUR per QALY gained. At a threshold of 30,000 EUR per QALY the probability of SARS being cost-effective compared with medical treatment was 60%. If the French Healthcare System reimbursed SARS for 80 patients per year during 10 years (anticipated target population), the expected incremental net health benefit would be 174 QALYs, and the expected value of perfect information (EVPI) would be 4.735 million EUR. The highest partial EVPI is reached for utility values and costs (1.3-1.6 million EUR). Our model shows that SARS using Finetech-Brindley device offers the most important benefit and should be considered cost-effective at a cost-effectiveness threshold of 30,000 EUR per QALY. Despite a high uncertainty, EVPI and partial EVPI may indicate that further research would not be profitable to inform decision-making. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. A Benefit Cost Analysis of the Abecedarian Early Childhood Intervention.

    ERIC Educational Resources Information Center

    Masse, Leonard N.; Barnett, W. Steven

    Although the benefits to academic achievement and cognitive development experienced by children participating in the Carolina Abecedarian Project have been well documented, there is little information available on the cost effectiveness of programs based on the Abecedarian preschool model. This study involved a benefit-cost analysis of the…

  18. Cost/Benefit Analysis of Competing Patient Education Systems.

    DTIC Science & Technology

    1977-10-28

    The purpose of this study was to determine the best of three methods of administering patient education based on both cost and benefits. The two...objectives were to perform a cost/benefit analysis (CBA) on the various approaches to administering patient education , and to make a recommendation based

  19. Benefit-Cost Analysis of the Perry Preschool Program and Its Policy Implications.

    ERIC Educational Resources Information Center

    Barnett, W. Steven

    1985-01-01

    Benefit-cost analysis is applied to the Perry Preschool Program and its long-term follow-up in order to examine preschool education as a social investment. The net present value of benefits and costs is positive, indicating that the program was a profitable social investment. (Author/LMO)

  20. [A cost-benefit analysis of occupational disease reporting in China].

    PubMed

    Tang, X Z; Zeng, Q; Liu, D S

    2017-03-20

    Objective: To perform a cost-benefit analysis of the occupational disease reporting system in China, and to provide a basis for effective resource allocation. Methods: The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013, the estimated benefit data were collected from published articles in China and foreign countries, and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments. Adecision-making tree was used for the cost-benefit analysis. Results: The estimated cost of occupational disease reporting was about 102.47 million yuan/year, consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year, a management cost of 30.35 million yuan/year, a management cost in local public health institutions of 69.80 million yuan/year, a management cost in national public health institutions of 370 thousand yuan/year, and a cost of construction and maintenance of reporting system of 700 thousand yuan/year. The results of the decision tree analysis showed that when an occupational disease monitoring system was established, the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year, the output was 6.5 billion yuan/year, and the benefit of occupational disease reporting system was 4.4 billion yuan/year. Conclusion: The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures, and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.

  1. [Cost-effectiveness of two hospital care schemes for psychiatric disorders].

    PubMed

    Nevárez-Sida, Armando; Valencia-Huarte, Enrique; Escobedo-Islas, Octavio; Constantino-Casas, Patricia; Verduzco-Fragoso, Wázcar; León-González, Guillermo

    2013-01-01

    In Mexico, six of every twenty Mexicans suffer psychiatric disorders at some time in their lives. This disease ranks fifth in the country. The objective was to determine and compare the cost-effectiveness of two models for hospital care (partial and traditional) at a psychiatric hospital of Instituto Mexicano del Seguro Social (IMSS). a multicenter study with a prospective cohort of 374 patients was performed. We made a cost-effectiveness analysis from an institutional viewpoint with a six-month follow-up. Direct medical costs were analyzed, with quality of life gains as outcome measurement. A decision tree and a probabilistic sensitivity analysis were used. patient care in the partial model had a cost 50 % lower than the traditional one, with similar results in quality of life. The cost per successful unit in partial hospitalization was 3359 Mexican pesos while in the traditional it increased to 5470 Mexican pesos. treating patients in the partial hospitalization model is a cost-effective alternative compared with the traditional model. Therefore, the IMSS should promote the infrastructure that delivers the psychiatric services to the patient attending to who requires it.

  2. A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

    NASA Astrophysics Data System (ADS)

    Qi, Wei

    2017-11-01

    Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

  3. Estimating the monetary value of willingness to pay for E-book reader's attributes using partially confounded factorial conjoint choice experiment

    NASA Astrophysics Data System (ADS)

    Yong, Chin-Khian

    2013-09-01

    A partially confounded factorial conjoint choice experiments design was used to examine the monetary value of the willingness to pay for E-book Reader's attributes. Conjoint analysis is an efficient, cost-effective, and most widely used quantitative method in marketing research to understand consumer preferences and value trade-off. Value can be interpreted by customer or consumer as the received of multiple benefits from a price that was paid. The monetary value of willingness to pay for battery life, internal memory, external memory, screen size, text to Speech, touch screen, and converting handwriting to digital text of E-book reader were estimated in this study. Due to the significant interaction effect of the attributes with the price, the monetary values for the seven attributes were found to be different at different values of odds of purchasing versus not purchasing. The significant interactions effects were one of the main contribution of the partially confounded factorial conjoint choice experiment.

  4. Converting unused vacation days to retiree medical benefits: a proposed partial solution to an emerging national crisis.

    PubMed

    Saxon, Donald R

    2003-06-01

    Costs for retiree medical benefits are spiraling upward. One way to help fund this area of compensation, with little or no additional financial burden to either employers or employees, could be using an employee benefit plan whereby each year's unused vacation days and sick days are transferred into an employee's tax-free account in a voluntary employee benefit association (VEBA) trust. On retirement, the account is used to purchase a (pre-Medicare) retiree medical plan, prescription drug benefit, a Medicare supplemental policy and/or simply make Medicare premium payments.

  5. Migration confers winter survival benefits in a partially migratory songbird

    PubMed Central

    Zúñiga, Daniel; Gager, Yann; Kokko, Hanna; Fudickar, Adam Michael; Schmidt, Andreas; Naef-Daenzer, Beat; Wikelski, Martin

    2017-01-01

    To evolve and to be maintained, seasonal migration, despite its risks, has to yield fitness benefits compared with year-round residency. Empirical data supporting this prediction have remained elusive in the bird literature. To test fitness related benefits of migration, we studied a partial migratory population of European blackbirds (Turdus merula) over 7 years. Using a combination of capture-mark-recapture and radio telemetry, we compared survival probabilities between migrants and residents estimated by multi-event survival models, showing that migrant blackbirds had 16% higher probability to survive the winter compared to residents. A subsequent modelling exercise revealed that residents should have 61.25% higher breeding success than migrants, to outweigh the survival costs of residency. Our results support theoretical models that migration should confer survival benefits to evolve, and thus provide empirical evidence to understand the evolution and maintenance of migration. PMID:29157357

  6. Prospective Costs, Benefits, and Impacts of U.S. Renewable Portfolio Standards

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

    Heeter, Jenny S; Mai, Trieu T; Bird, Lori A

    These slides were presented at a webinar on January 9, 2017. The slides overview a report that evaluates the future costs, benefits, and other impacts of renewable energy used to meet current state renewable portfolio standards (RPSs). It also examines a future scenario where RPSs are expanded. The analysis examines changes in electric system costs and retail electricity prices, which include all fixed and operating costs, including capital costs for all renewable, non-renewable, and supporting (e.g., transmission and storage) electric sector infrastructure; fossil fuel, uranium, and biomass fuel costs; and plant operations and maintenance expenditures. The analysis evaluates three specificmore » benefits: air pollution, greenhouse gas emissions, and water use. It also analyzes two other impacts, renewable energy workforce and economic development, and natural gas price suppression. The analysis finds that the benefits or renewable energy used to meet RPS polices exceed the costs, even when considering the highest cost and lowest benefit outcomes.« less

  7. Cost-Benefit Analysis of Communities That Care Outcomes at Eighth Grade

    PubMed Central

    Kuklinski, Margaret R.; Briney, John S.; Hawkins, J. David; Catalano, Richard F.

    2011-01-01

    This paper presents a cost-benefit analysis of the Communities That Care (CTC) prevention system, a public health approach to reducing risk, enhancing protection, and reducing the prevalence of adolescent health and behavior problems community wide. The analysis is based on outcomes from a panel of students followed from Grade 5 through Grade 8 in a randomized controlled trial involving 24 communities in 7 states. Previous analyses have shown that CTC prevented the initiation of cigarette smoking, alcohol use, and delinquency by the end of 8th grade in CTC communities compared to controls. This paper estimates long-term monetary benefits associated with significant intervention effects on cigarette smoking and delinquency as compared to the cost of conducting the intervention. Under conservative cost assumptions, the net present benefit is $5,250 per youth, including $812 from the prevention of cigarette smoking and $4,438 from the prevention of delinquency. The benefit-cost ratio indicates a return of $5.30 per $1.00 invested. Under less conservative but still viable cost assumptions, the benefit-cost ratio due to prevention of cigarette smoking and delinquency increases to $10.23 per $1.00 invested. Benefits from CTC’s reduction in alcohol initiation as well as broader inclusion of quality-of-life gains would further increase CTC’s benefit-cost ratio. Results provide evidence that CTC is a cost-beneficial preventive intervention and a good investment of public dollars, even under very conservative cost and benefit assumptions. PMID:22108900

  8. Cost benefit analysis of two policy options for cannabis: status quo and legalisation.

    PubMed

    Shanahan, Marian; Ritter, Alison

    2014-01-01

    To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised-regulated option was conducted. A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised-regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised-regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case.

  9. Cost Benefit Analysis of Two Policy Options for Cannabis: Status Quo and Legalisation

    PubMed Central

    Shanahan, Marian; Ritter, Alison

    2014-01-01

    Aims To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised–regulated option was conducted. Method A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). Findings The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised–regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised–regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Conclusion Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case. PMID:24755942

  10. Market Assessment of Forward-Looking Turbulence Sensing Systems

    NASA Technical Reports Server (NTRS)

    Kauffmann, Paul

    2003-01-01

    This viewgraph presentation provides a cost benefit analysis of three next-generation forward-looking turbulence sensing systems: X band turbulence radar system for convective turbulence, LIDAR based turbulence systems to sense clear air turbulence and a combined hybrid system. Parameters for the cost benefit analysis were established using a business model which considered injury rates, cost of injuries, indirect costs, market penetration rate estimates and product success characteristics. Topics covered include: study approach, business case equations, data acquisition, benchmark analysis. Data interpretation from the cost benefit analysis is presented. The researchers conclude that the market potential for these products is based primarily on injury cost reduction and that X band radar systems have the greatest chance for commercial success.

  11. Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study.

    PubMed

    Bager, Line; Hansen, Kristian Schultz; Andersen, Carit Jacques; Wang, Shr-Jie

    2018-05-18

    The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective. The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA). The CUA incorporated data on Quality Adjusted Life Years (QALY) for 45 patients who were treated at the Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark, in 2001-2004 and followed for up to 2 years, to determine the incremental cost effectiveness ratio (ICER). For the CBA, data was collected for 44 patients who completed treatment between 2001 and 2004 and 44 matched controls on the waiting list, for the patients' primary health care utilisation, and personal and family labour income from 2001 to 2014. This was analysed to evaluate the Net Social Benefit (NSB) of the programme. The average cost of treatment was found to be about 32,000 USD per patient (2016 prices) with an average gain in QALY of 0.82. The treatment was cost effective according to the ICER threshold suggested by the National Institute of Health and Care Excellence (UK). At the individual level, the NSB remained negative throughout the study period. However, at the family income level the intervention proved to have been beneficial after 3 years. The implication of the study is, that providing rehabilitation to severely traumatised refugee families can be an economically viable strategy, considering the economic effects observed at the family level.

  12. Cost-benefit and effectiveness analysis of rapid testing for MRSA carriage in a hospital setting.

    PubMed

    Henson, Gay; Ghonim, Elham; Swiatlo, Andrea; King, Shelia; Moore, Kimberly S; King, S Travis; Sullivan, Donna

    2014-01-01

    A cost-effectiveness analysis was conducted comparing the polymerase chain reaction assay and traditional microbiological culture as screening tools for the identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to the pediatric and surgical intensive care units (PICU and SICU) at a 722 bed academic medical center. In addition, the cost benefits of identification of colonized MRSA patients were determined. The cost-effectiveness analysis employed actual hospital and laboratory costs, not patient costs. The actual cost of the PCR assay was higher than the microbiological culture identification of MRSA ($602.95 versus $364.30 per positive carrier identified). However, this did not include the decreased turn-around time of PCR assays compared to traditional culture techniques. Patient costs were determined indirectly in the cost-benefit analysis of clinical outcome. There was a reduction in MRSA hospital-acquired infection (3.5 MRSA HAI/month without screening versus 0.6/month with screening by PCR). A cost-benefit analysis based on differences in length of stay suggests an associated savings in hospitalization costs: MRSA HAI with 29.5 day median LOS at $63,810 versus MRSA identified on admission with 6 day median LOS at $14,561, a difference of $49,249 per hospitalization. Although this pilot study was small and it is not possible to directly relate the cost-effectiveness and cost-benefit analysis due to confounding factors such as patient underlying morbidity and mortality, a reduction of 2.9 MRSA HAI/month associated with PCR screening suggests potential savings in hospitalization costs of $142,822 per month.

  13. Improving air pollution control policy in China--A perspective based on cost-benefit analysis.

    PubMed

    Gao, Jinglei; Yuan, Zengwei; Liu, Xuewei; Xia, Xiaoming; Huang, Xianjin; Dong, Zhanfeng

    2016-02-01

    To mitigate serious air pollution, the State Council of China promulgated the Air Pollution Prevention and Control Action Plan in 2013. To verify the feasibility and validity of industrial energy-saving and emission-reduction policies in the action plan, we conducted a cost-benefit analysis of implementing these policies in 31 provinces for the period of 2013 to 2017. We also completed a scenario analysis in this study to assess the cost-effectiveness of different measures within the energy-saving and the emission-reduction policies individually. The data were derived from field surveys, statistical yearbooks, government documents, and published literatures. The results show that total cost and total benefit are 118.39 and 748.15 billion Yuan, respectively, and the estimated benefit-cost ratio is 6.32 in the S3 scenario. For all the scenarios, these policies are cost-effective and the eastern region has higher satisfactory values. Furthermore, the end-of-pipe scenario has greater emission reduction potential than energy-saving scenario. We also found that gross domestic product and population are significantly correlated with the benefit-cost ratio value through the regression analysis of selected possible influencing factors. The sensitivity analysis demonstrates that benefit-cost ratio value is more sensitive to unit emission-reduction cost, unit subsidy, growth rate of gross domestic product, and discount rate among all the parameters. Compared with other provinces, the benefit-cost ratios of Beijing and Tianjin are more sensitive to changes of unit subsidy than unit emission-reduction cost. These findings may have significant implications for improving China's air pollution prevention policy. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Valuing Non-CO2 GHG Emission Changes in Benefit-Cost ...

    EPA Pesticide Factsheets

    The climate impacts of greenhouse gas (GHG) emissions impose social costs on society. To date, EPA has not had an approach to estimate the economic benefits of reducing emissions of non-CO2 GHGs (or the costs of increasing them) that is consistent with the methodology underlying the U.S. Government’s current estimates of the social cost of carbon (SCC). A recently published paper presents estimates of the social cost of methane that are consistent with the SCC estimates. The Agency is seeking review of the potential application of these new benefit estimates to benefit cost analysis in relation to current practice in this area. The goal of this project is to improve upon the current treatment of non-CO2 GHG emission impacts in benefit-cost analysis.

  15. Cost Benefit and Alternatives Analysis of Distribution Systems with Energy Storage Systems: Preprint

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

    Harris, Tom; Nagarajan, Adarsh; Baggu, Murali

    This paper explores monetized and non-monetized benefits from storage interconnected to distribution system through use cases illustrating potential applications for energy storage in California's electric utility system. This work supports SDG&E in its efforts to quantify, summarize, and compare the cost and benefit streams related to implementation and operation of energy storage on its distribution feeders. This effort develops the cost benefit and alternatives analysis platform, integrated with QSTS feeder simulation capability, and analyzed use cases to explore the cost-benefit of implementation and operation of energy storage for feeder support and market participation.

  16. Smart roadside initiative macro benefit analysis : user’s guide for the benefit-cost analysis tool.

    DOT National Transportation Integrated Search

    2015-03-01

    Through the Smart Roadside Initiative (SRI), a Benefit-Cost Analysis (BCA) tool was developed for the evaluation of various new transportation technologies at a State level and to provide results that could support technology adoption by a State Depa...

  17. Cost-benefit analysis of targeted hearing directed early testing for congenital cytomegalovirus infection.

    PubMed

    Bergevin, Anna; Zick, Cathleen D; McVicar, Stephanie Browning; Park, Albert H

    2015-12-01

    In this study, we estimate an ex ante cost-benefit analysis of a Utah law directed at improving early cytomegalovirus (CMV) detection. We use a differential cost of treatment analysis for publicly insured CMV-infected infants detected by a statewide hearing-directed CMV screening program. Utah government administrative data and multi-hospital accounting data are used to estimate and compare costs and benefits for the Utah infant population. If antiviral treatment succeeds in mitigating hearing loss for one infant per year, the public savings will offset the public costs incurred by screening and treatment. If antiviral treatment is not successful, the program represents a net cost, but may still have non-monetary benefits such as accelerated achievement of diagnostic milestones. The CMV education and treatment program costs are modest and show potential for significant cost savings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. A Framework for Assessing the Economic Benefits and Costs of Workplace Literacy Training.

    ERIC Educational Resources Information Center

    Hollenbeck, Kevin

    The relative costs and benefits of workplace literacy training were analyzed. An analysis based on eight benefits/costs (training costs; higher productivity; high wages; nonwage compensation; less worker turnover; safer workplace; higher taxes; and improved self-esteem) established that workplace literacy training offers net benefits for workers,…

  19. Implementation of Flu (Influenza) Vaccination into Armenian Armed Forces Pre-Emptive Vaccination Plan

    DTIC Science & Technology

    2016-12-01

    Vinci, M., Zordan, M., & Serra, G. (2006). Cost - benefit analysis of influenza vaccination in a public healthcare unit. Therapeutics and Clinical...readiness, flu morbidity, flu vaccination, pre-emptive vaccination plan, cost - benefit analysis 15. NUMBER OF PAGES 83 16. PRICE CODE 17...expenditures pose a heavy burden on the government. A cost - benefit analysis of the flu vaccination would assess whether conducting flu vaccination is

  20. A Business Of Security: Applying An Economic Model To Human Trafficking In Oregon

    DTIC Science & Technology

    2016-12-01

    presents policy analysis under a qualitative cost - benefit lens to assess economic model variables applied to state level policies. The conclusion is...modern slavery, sex trafficking, labor trafficking, Oregon, supply and demand, cost - benefit analysis 15. NUMBER OF PAGES 129 16. PRICE CODE 17...analyzing weaknesses and gaps. The thesis presents policy analysis under a qualitative cost - benefit lens to assess economic model variables applied to

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

    DTIC Science & Technology

    1980-08-01

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

  2. Cost-benefit analysis of drug treatment services: review of the literature*

    PubMed

    Cartwright, William S.

    2000-03-01

    BACKGROUND: How valuable is public investment in treatment for drug abuse and dependency in the real world of everyday practice? Does drug abuse treatment provide benefits and how are they valued? What are the costs of obtaining outcomes and benefits? Cost-benefit analysis attempts to answer these questions in a standard analytic framework. AIMS: This paper reviews cost-benefit analyses with scientific merit so that analysts will have a current picture of the state of the research. It will also give public decision-makers information with regards to the available evidence for policy purposes. METHOD: Bibliographic searches were performed. Studies were obtained through the assistance of the Parklawn Health Library system, a component of the US Public Health Service. Selected studies were from the scientific literature with the exception of eight studies published as governmental reports. RESULTS: Cost-benefit studies have fallen into the following categories: (i) planning models for delivery systems in states and cities; (ii) short-term follow-up studies of individuals, (iii) single individual programs and (iv) state system's monitoring of outcomes. In 18 cost-benefit studies, a persistent finding is that benefits exceed costs, even when not all benefits are accounted for in the analysis. Much variation is found in the implementation of cost-benefit methods, and this is detailed across discussions of effectiveness, benefits and costs. Studies have emphasized the cost savings to society from the reduction in external costs created by the behavioral consequences of addiction and drug use. DISCUSSION: Economic analysis of drug treatment requires sophisticated conceptualization and measurement. Cost-benefit analysis of drug treatment has been a significant analytical exercise since the early 1970s when the public drug treatment system was founded in the United States. CONCLUSION: Drug abuse treatment services may be considered as contributing positive economic returns to society. However, considerable work needs to be done to standardize methods used in the studies. A striking area of omission is the absence of studies for adolescents and only one for women in treatment. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Finding a positive net social benefit should assist policy-makers with decisions related to drug abuse treatment expenditures. Additional work on allocation of budget dollars across various drug treatment services will be needed. IMPLICATIONS FOR HEALTH POLICY FORMULATION: Government agencies and other stakeholders in national health care systems must realize that cost-benefit studies are an important tool for decision-making. Rational strategies can only be addressed by examining alternatives for the efficient allocation and equitable distribution of scarce resources. IMPLICATIONS FOR FURTHER RESEARCH: Future research should focus on standardizing the methods used in the cost-benefit analysis. Extensions should examine methods related to the willingness-to-pay approach. Studies are needed for drug abuse treatment targeted to adolescents and women. More studies should be published in the scientific literature.

  3. Benefits of investing in ecosystem restoration.

    PubMed

    DE Groot, Rudolf S; Blignaut, James; VAN DER Ploeg, Sander; Aronson, James; Elmqvist, Thomas; Farley, Joshua

    2013-12-01

    Measures aimed at conservation or restoration of ecosystems are often seen as net-cost projects by governments and businesses because they are based on incomplete and often faulty cost-benefit analyses. After screening over 200 studies, we examined the costs (94 studies) and benefits (225 studies) of ecosystem restoration projects that had sufficient reliable data in 9 different biomes ranging from coral reefs to tropical forests. Costs included capital investment and maintenance of the restoration project, and benefits were based on the monetary value of the total bundle of ecosystem services provided by the restored ecosystem. Assuming restoration is always imperfect and benefits attain only 75% of the maximum value of the reference systems over 20 years, we calculated the net present value at the social discount rates of 2% and 8%. We also conducted 2 threshold cum sensitivity analyses. Benefit-cost ratios ranged from about 0.05:1 (coral reefs and coastal systems, worst-case scenario) to as much as 35:1 (grasslands, best-case scenario). Our results provide only partial estimates of benefits at one point in time and reflect the lower limit of the welfare benefits of ecosystem restoration because both scarcity of and demand for ecosystem services is increasing and new benefits of natural ecosystems and biological diversity are being discovered. Nonetheless, when accounting for even the incomplete range of known benefits through the use of static estimates that fail to capture rising values, the majority of the restoration projects we analyzed provided net benefits and should be considered not only as profitable but also as high-yielding investments. Beneficios de Invertir en la Restauración de Ecosistemas. © 2013 Society for Conservation Biology.

  4. The impact of including passive benefits in cost-effectiveness analysis: the case of automated external defibrillators on commercial aircraft.

    PubMed

    Cram, Peter; Vijan, Sandeep; Wolbrink, Alex; Fendrick, A Mark

    2003-01-01

    Traditional cost-utility analysis assumes that all benefits from health-related interventions are captured by the quality-adjusted life-years (QALYs) gained by the few individuals whose outcome is improved by the intervention. However, it is possible that many individuals who do not directly benefit from an intervention receive utility, and therefore QALYs, because of the passive benefit (aka sense of security) provided by the existence of the intervention. The objective of this study was to evaluate the impact that varying quantities of passive benefit have on the cost-effectiveness of airline defibrillator programs. A decision analytic model with Markov processes was constructed to evaluate the cost-effectiveness of defibrillator deployment on domestic commercial passenger aircraft over 1 year. Airline passengers were assigned small incremental utility gains (.001-.01) during an estimated 3-hour flight to evaluate the impact of passive benefit on overall cost-effectiveness. In the base case analysis with no allowance for passive benefit, the cost-effectiveness of airline automated external defibrillator deployment was US dollars 34000 per QALY gained. If 1% of all passengers received utility gain of.01, the cost-effectiveness declined to US dollars 30000. Cost-effectiveness was enhanced when the quantity of passive benefit was raised or the percentage of individuals receiving passive benefit increased. Automated external defibrillator deployment on passenger aircraft is likely to be cost-effective. If a small percentage of airline passengers receive incremental utility gains from passive benefit of automated external defibrillator availability, the impact on overall cost-effectiveness may be substantial. Further research should attempt to clarify the magnitude and percentage of patients who receive passive benefit.

  5. Costs and Benefits to Pregnant Male Pipefish Caring for Broods of Different Sizes

    PubMed Central

    Sagebakken, Gry; Ahnesjö, Ingrid; Kvarnemo, Charlotta

    2016-01-01

    Trade-offs between brood size and offspring size, offspring survival, parental condition or parental survival are classic assumptions in life history biology. A reduction in brood size may lessen these costs of care, but offspring mortality can also result in an energetic gain, if parents are able to utilize the nutrients from the demised young. Males of the broad-nosed pipefish (Syngnathus typhle) care for the offspring by brooding embryos in a brood pouch. Brooding males can absorb nutrients that emanate from embryos, and there is often a reduction in offspring number over the brooding period. In this study, using two experimentally determined brood sizes (partially and fully filled brood pouches), we found that full broods resulted in larger number of developing offspring, despite significantly higher absolute and relative embryo mortality, compared to partial broods. Male survival was also affected by brood size, with males caring for full broods having poorer survival, an effect that together with the reduced embryo survival was found to negate the benefit of large broods. We found that embryo mortality was lower when the brooding males were in good initial condition, that embryos in broods with low embryo mortality weighed more, and surprisingly, that males in higher initial condition had embryos of lower weight. Brood size, however, did not affect embryo weight. Male final condition, but not initial condition, correlated with higher male survival. Taken together, our results show costs and benefits of caring for large brood sizes, where the numerical benefits come with costs in terms of both embryo survival and survival of the brooding father, effects that are often mediated via male condition. PMID:27243937

  6. When Benefits Are Difficult to Measure.

    ERIC Educational Resources Information Center

    Birdsall, William C.

    1987-01-01

    It is difficult to apply benefit cost analysis to human service programs. This paper explains "threshold benefit analysis," the derivation of the minimum dollar value which the benefits must attain in order for their value to equal the intervention costs. The method is applied to a mobility training program. (BS)

  7. 75 FR 8338 - EPA Science Advisory Board Staff Office Notification of a Meeting of the Ecological Effects...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-24

    ... the Second Section 812 Benefit-Cost Analysis of the Clean Air Act. The assessment of ecological... Analysis of the benefits and costs of the Clean Air Act. DATES: The EES augmented with additional experts... ecological effects of modeled air quality scenarios developed to support the Second Section 812 Benefit-Cost...

  8. Development of a module for Cost-Benefit analysis of risk reduction measures for natural hazards for the CHANGES-SDSS platform

    NASA Astrophysics Data System (ADS)

    Berlin, Julian; Bogaard, Thom; Van Westen, Cees; Bakker, Wim; Mostert, Eric; Dopheide, Emile

    2014-05-01

    Cost benefit analysis (CBA) is a well know method used widely for the assessment of investments either in the private and public sector. In the context of risk mitigation and the evaluation of risk reduction alternatives for natural hazards its use is very important to evaluate the effectiveness of such efforts in terms of avoided monetary losses. However the current method has some disadvantages related to the spatial distribution of the costs and benefits, the geographical distribution of the avoided damage and losses, the variation in areas that are benefited in terms of invested money and avoided monetary risk. Decision-makers are often interested in how the costs and benefits are distributed among different administrative units of a large area or region, so they will be able to compare and analyse the cost and benefits per administrative unit as a result of the implementation of the risk reduction projects. In this work we first examined the Cost benefit procedure for natural hazards, how the costs are assessed for several structural and non-structural risk reduction alternatives, we also examined the current problems of the method such as the inclusion of cultural and social considerations that are complex to monetize , the problem of discounting future values using a defined interest rate and the spatial distribution of cost and benefits. We also examined the additional benefits and the indirect costs associated with the implementation of the risk reduction alternatives such as the cost of having a ugly landscape (also called negative benefits). In the last part we examined the current tools and software used in natural hazards assessment with support to conduct CBA and we propose design considerations for the implementation of the CBA module for the CHANGES-SDSS Platform an initiative of the ongoing 7th Framework Programme "CHANGES of the European commission. Keywords: Risk management, Economics of risk mitigation, EU Flood Directive, resilience, prevention, cost benefit analysis, spatial distribution of costs and benefits

  9. A cost-benefit analysis of physical activity using bike/pedestrian trails.

    PubMed

    Wang, Guijing; Macera, Caroline A; Scudder-Soucie, Barbara; Schmid, Tom; Pratt, Michael; Buchner, David

    2005-04-01

    From a public health perspective, a cost-benefit analysis of using bike/pedestrian trails in Lincoln, Nebraska, to reduce health care costs associated with inactivity was conducted. Data was obtained from the city's 1998 Recreational Trails Census Report and the literature. Per capita annual cost of using the trails was 209.28 U.S. dollars (59.28 U.S. dollars construction and maintenance, 150 U.S. dollars of equipment and travel). Per capita annual direct medical benefit of using the trails was 564.41 U.S. dollars. The cost-benefit ratio was 2.94, which means that every 1 U.S. dollar investment in trails for physical activity led to 2.94 U.S. dollars in direct medical benefit. The sensitivity analyses indicated the ratios ranged from 1.65 to 13.40. Therefore, building trails is cost beneficial from a public health perspective. The most sensitive parameter affecting the cost-benefit ratios were equipment and travel costs; however, even for the highest cost, every 1 U.S. dollar investment in trails resulted in a greater return in direct medical benefit.

  10. Air quality co-benefits of carbon pricing in China

    NASA Astrophysics Data System (ADS)

    Li, Mingwei; Zhang, Da; Li, Chiao-Ting; Mulvaney, Kathleen M.; Selin, Noelle E.; Karplus, Valerie J.

    2018-05-01

    Climate policies targeting energy-related CO2 emissions, which act on a global scale over long time horizons, can result in localized, near-term reductions in both air pollution and adverse human health impacts. Focusing on China, the largest energy-using and CO2-emitting nation, we develop a cross-scale modelling approach to quantify these air quality co-benefits, and compare them to the economic costs of climate policy. We simulate the effects of an illustrative climate policy, a price on CO2 emissions. In a policy scenario consistent with China's recent pledge to reach a peak in CO2 emissions by 2030, we project that national health co-benefits from improved air quality would partially or fully offset policy costs depending on chosen health valuation. Net health co-benefits are found to rise with increasing policy stringency.

  11. ECONOMIC ANALYSIS OF THE LONGTERM 2 ENHANCED ...

    EPA Pesticide Factsheets

    Presents an analysis of the projected costs and benefits of new drinking water regulation that will reduce exposure to disease-causing microorganisms in drinking water. Cost and benefit analysis LT2ESWTR

  12. Benefit-Cost Analysis of Integrated Paratransit Systems : Volume 6. Technical Appendices.

    DOT National Transportation Integrated Search

    1979-09-01

    This last volume, includes five technical appendices which document the methodologies used in the benefit-cost analysis. They are the following: Scenario analysis methodology; Impact estimation; Example of impact estimation; Sensitivity analysis; Agg...

  13. Performance and hemtochemical parameters of buck-kids fed concentrate partially replaced with tropical Piliostigma thonningii foliage.

    PubMed

    Olafadehan, Olurotimi A; Njidda, Ahmed A; Okunade, Sunday A; Salihu, Sarah O; Balogun, David O; Salem, Abdelfattah Z M

    2018-02-01

    Fifteen 5-month-old Red Sokoto buck-kids, (6.6 ± 0.71 kg body weight (BW)) randomly distributed into three groups of five animals per group, were used to study the effects of supplementary concentrate partially replaced with Piliostigma thonningii (PT) foliage on the growth performance, economic benefit and blood profile in a completely randomized design using analysis of variance. The goats in group 1 received 100% supplementary concentrates (PT0), groups 2 and 3 received 25% (PT25) and 50% (PT50), respectively, of concentrate replaced with an equal amount (dry matter basis) of Piliostigma foliage. The goats were fed a basal diet of threshed sorghum top (TST). Intake of concentrate, hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, total feeding cost and cost/kg BW were greater (P < 0.05) for PT0 than for PT25 and PT50. Consumption of P. thonningii foliage was greater (P < 0.05) for PT50 relative to PT25. Tannin consumption of the treatment diets were greater (P < 0.05) than that of the control concentrate diet. Serum urea N reduced (P < 0.05) with increasing level of concentrate replacement, while serum glucose was higher (P < 0.05) in PT0 than in PT50. However, means of all blood measurements were within normal ranges for goats. Net benefit showed this rank order: PT0 < PT50 < PT25 (all P < 0.05). Both differential and relative benefits were higher (P < 0.05) for PT25 than for PT50. P. thonningii foliage can replace 50% of supplemental concentrate without impairing feed intake, growth performance and health of buck-kids. © 2017 Japanese Society of Animal Science.

  14. Analysis of National Solid Waste Recycling Programs and Development of Solid Waste Recycling Cost Functions: A Summary of the Literature (1999)

    EPA Pesticide Factsheets

    Discussion of methodological issues for conducting benefit-cost analysis and provides guidance for selecting and applying the most appropriate and useful mechanisms in benefit-cost analysis of toxic substances, hazardous materials, and solid waste control

  15. A Method of Measuring the Costs and Benefits of Applied Research.

    ERIC Educational Resources Information Center

    Sprague, John W.

    The Bureau of Mines studied the application of the concepts and methods of cost-benefit analysis to the problem of ranking alternative applied research projects. Procedures for measuring the different classes of project costs and benefits, both private and public, are outlined, and cost-benefit calculations are presented, based on the criteria of…

  16. Cost-benefit analysis of electronic medical record system at a tertiary care hospital.

    PubMed

    Choi, Jong Soo; Lee, Woo Baik; Rhee, Poong-Lyul

    2013-09-01

    Although Electronic Medical Record (EMR) systems provide various benefits, there are both advantages and disadvantages regarding its cost-effectiveness. This study analyzed the economic effects of EMR systems using a cost-benefit analysis based on the differential costs of managerial accounting. Samsung Medical Center (SMC) is a general hospital in Korea that developed an EMR system for outpatients from 2006 to 2008. This study measured the total costs and benefits during an 8-year period after EMR adoption. The costs include the system costs of building the EMR and the costs incurred in smoothing its adoption. The benefits included cost reductions after its adoption and additional revenues from both remodeling of paper-chart storage areas and medical transcriptionists' contribution. The measured amounts were discounted by SMC's expected interest rate to calculate the net present value (NPV), benefit-cost ratio (BCR), and discounted payback period (DPP). During the analysis period, the cumulative NPV and the BCR were US$3,617 thousand and 1.23, respectively. The DPP was about 6.18 years. Although the adoption of an EMR resulted in overall growth in administrative costs, it is cost-effective since the cumulative NPV was positive. The positive NPV was attributed to both cost reductions and additional revenues. EMR adoption is not so attractive to management in that the DPP is longer than 5 years at 6.18 and the BCR is near 1 at 1.23. However, an EMR is a worthwhile investment, seeing that this study did not include any qualitative benefits and that the paper-chart system was cost-centric.

  17. Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach.

    PubMed

    Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H Gregory; Gray, Stacey T; Shrime, Mark G

    2015-10-01

    Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Cost-benefit analysis based on contingent valuation surveys. An otolaryngology-specific ER in a tertiary care academic medical center. Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  18. Biological and chemical removal of Cr(VI) from waste water: cost and benefit analysis.

    PubMed

    Demir, Aynur; Arisoy, Münevver

    2007-08-17

    The objective of the present study is cost and benefit analysis of biological and chemical removal of hexavalent chromium [Cr(VI)] ions. Cost and benefit analysis were done with refer to two separate studies on removal of Cr(VI), one of heavy metals with a crucial role concerning increase in environmental pollution and disturbance of ecological balance, through biological adsorption and chemical ion-exchange. Methods of biological and chemical removal were compared with regard to their cost and percentage in chrome removal. According to the result of the comparison, cost per unit in chemical removal was calculated 0.24 euros and the ratio of chrome removal was 99.68%, whereas those of biological removal were 0.14 and 59.3% euros. Therefore, it was seen that cost per unit in chemical removal and chrome removal ratio were higher than those of biological removal method. In the current study where chrome removal is seen as immeasurable benefit in terms of human health and the environment, percentages of chrome removal were taken as measurable benefit and cost per unit of the chemicals as measurable cost.

  19. 75 FR 48327 - Science Advisory Board Staff Office; Notification of a Public Meeting of the Advisory Council on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... Analysis of the benefits and costs of the Clean Air Act. DATES: The meeting will be held on Thursday... Second Section 812 Prospective Benefit-Cost Analysis of the Clean Air Act. The Council was established in... Clean Air Act Amendments (CAAA), EPA conducts periodic studies to assess benefits and costs of the EPA's...

  20. 75 FR 19969 - Science Advisory Board Staff Office; Notification of a Public Meeting of the Advisory Council on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... Office of Air and Radiation's Second Section 812 Prospective Analysis of the benefits and costs of the... review draft EPA documents prepared for the Second Section 812 Prospective Benefit-Cost Analysis of the... studies to assess benefits and costs of the EPA's regulatory actions under the Clean Air Act. The Council...

  1. 75 FR 4070 - Science Advisory Board Staff Office; Notification of a Public Meeting of the Air Quality Modeling...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... Prospective Analysis of the benefits and costs of the Clean Air Act. DATES: The meeting date is Friday... support the Second Prospective Section 812 Benefit-Cost Analysis of the Clean Air Act. The Council was... studies to assess benefits and costs of the EPA's regulatory actions under the Clean Air Act. The Council...

  2. Increasing social welfare by taxing pesticide externalities in the Indian cotton sector.

    PubMed

    Rasche, Livia; Dietl, Alexander; Shakhramanyan, Nikolinka; Pandey, Divya; Schneider, Uwe A

    2016-12-01

    Pesticide use in the Indian cotton industry has decreased with the introduction of Bt cotton, but rates are still high in comparison with other countries. The adoption of alternative strategies, such as integrated pest management, has been slow, even though benefits are potentially high, more so if the full costs of the external effects of the technologies are taken into account. In order to estimate true societal benefits of different strategies, we compare their external costs and economic performance under external cost taxation, using a state-of-the-art partial equilibrium model of the Indian agricultural sector. Pesticide externalities lower social welfare in the Indian cotton sector by $US 400-2200 million, depending on the technologies employed. A full internalisation reduces producer revenues by $US 100 ha -1 if only Bt cotton is used, and by $US 30 ha -1 if IPM is another option. Consumers do not start to lose surplus until 20-70% are internalised, and losses are smaller if all technologies are available. External pesticide costs can be internalised partially without substantially affecting consumer surplus while still increasing social welfare, but producers need to have access to and the knowledge to employ all available cotton production technologies to minimise losses. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  3. Comparative Cost-Benefit Analysis of Renewable Energy Resource Trade Offs for Military Installations

    DTIC Science & Technology

    2012-12-01

    OVERVIEW ......................................5  C.  CURRENT MEASUREMENTS USED IN DETERMINING COST- EFFECTIVE SAVINGS...Weather Effects ..................................................................................61  G.  COST-BENEFIT ANALYSIS OVERVIEW...Energy Production, Consumption , Imports and Exports 1949–2010 (From EIA, 2010

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

    PubMed

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

    2017-12-01

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

  5. Economic evaluation of a comprehensive teenage pregnancy prevention program: pilot program.

    PubMed

    Rosenthal, Marjorie S; Ross, Joseph S; Bilodeau, Roseanne; Richter, Rosemary S; Palley, Jane E; Bradley, Elizabeth H

    2009-12-01

    Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic support are effective in reducing births among enrolled teenagers. However, there have been limited data on the costs and cost effectiveness of such programs. The study used a community-based participatory research approach to develop estimates of the cost-benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents. Using data from 1997-2003, an in-time intervention analysis was conducted to determine program cost-benefit while teenagers were enrolled; an extrapolation analysis was then used to estimate accrued economic benefits and cost-benefit up to age 30 years. The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage girls, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 years on average, with social benefits outweighing total social costs by age 20.1 years. This comprehensive teenage pregnancy prevention program is estimated to provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost effectiveness of similarly comprehensive programs when they are implemented more widely in high-risk neighborhoods.

  6. Economic Evaluation of a Comprehensive Teenage Pregnancy Prevention Program: Pilot Program

    PubMed Central

    Rosenthal, Marjorie S.; Ross, Joseph S.; Bilodeau, RoseAnne; Richter, Rosemary S.; Palley, Jane E.; Bradley, Elizabeth H.

    2011-01-01

    Background Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic are effective in reducing births among enrolled teenagers. However, there have been limited data on costs and cost-effectiveness of such programs. Objectives To use a community-based participatory research approach, to develop estimates of the cost-benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents. Methods Using data from 1997-2003, we conducted an in-time intervention analysis to determine program cost-benefit while teenagers were enrolled and then used an extrapolation analysis to estimate accyrred economibc benefits and cost-benefit up to age 30. Results The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage females, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1,599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 on average, with social benefits outweighing total social costs by age 20.1. Conclusions We estimate that this comprehensive teenage pregnancy prevention program would provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost-effectiveness of similarly comprehensive programs when implemented more widely in high-risk neighborhoods. PMID:19896030

  7. Cost benefits of advanced software: A review of methodology used at Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Joglekar, Prafulla N.

    1993-01-01

    To assist rational investments in advanced software, a formal, explicit, and multi-perspective cost-benefit analysis methodology is proposed. The methodology can be implemented through a six-stage process which is described and explained. The current practice of cost-benefit analysis at KSC is reviewed in the light of this methodology. The review finds that there is a vicious circle operating. Unsound methods lead to unreliable cost-benefit estimates. Unreliable estimates convince management that cost-benefit studies should not be taken seriously. Then, given external demands for cost-benefit estimates, management encourages software enginees to somehow come up with the numbers for their projects. Lacking the expertise needed to do a proper study, courageous software engineers with vested interests use ad hoc and unsound methods to generate some estimates. In turn, these estimates are unreliable, and the cycle continues. The proposed methodology should help KSC to break out of this cycle.

  8. Costs and benefits of low-sulphur fuel standard for Baltic Sea shipping.

    PubMed

    Antturi, Jim; Hänninen, Otto; Jalkanen, Jukka-Pekka; Johansson, Lasse; Prank, Marje; Sofiev, Mikhail; Ollikainen, Markku

    2016-12-15

    The maximum allowable fuel sulphur content for shipping in the Baltic Sea dropped from 1%S to 0.1%S in 1 January 2015. We provide a cost-benefit analysis of the sulphur reduction policy in the Baltic Sea Sulphur Emission Control Area (SECA). We calculated the abatement costs based on shipowners' optimal decision-making in choosing between low-sulphur fuel and a sulphur scrubber, and the benefits were modelled through a high-resolution impact pathway analysis, which took into account the formation and dispersion of the emissions, and considered the positive health impacts resulting from lowered ambient PM 2.5 concentrations. Our basic result indicates that for the Baltic Sea only, the latest sulphur regulation is not cost-effective. The expected annual cost is roughly €465 M and benefit 2200 saved Disability Adjusted Life-Years (DALYs) or monetized €105 M. Based on our sensitivity analysis, the benefits yet have a potential to exceed the costs. The analysis neither takes into account the acidifying impact of sulphur nor the impact North Sea shipping has on the cost-benefit ratio. Lastly, a similar approach is found highly recommendable to study the implications of the upcoming Tier III NO x standard for shipping. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Cost-Benefit Analysis of Nanoparticle Albumin-Bound Paclitaxel versus Solvent-Based Paclitaxel for the Treatment of Metastatic Breast Cancer in the United States

    NASA Astrophysics Data System (ADS)

    Vichansavakul, Kittaya

    Breast cancer is the second leading cause of death among women in the US. Although early detection and treatment help to increase survival rates, some unfortunate patients develop metastatic breast cancer that has no cure. Palliative treatment is the main objective in this group of patients in order to prolong life and reduce toxicities from interventions. In the advancement of treatment for metastatic breast cancer, solvent-based paclitaxel has been widely used. However, solvent-based paclitaxel often causes adverse reactions. Therefore, researchers have developed a new chemotherapy based on nanotechnology. One of these drugs is the Nanoparticle albumin-bound Paclitaxel. This nanodrug aims to increase therapeutic index by reducing adverse reactions from solvents and to improve efficacy of conventional cytotoxic chemotherapy. Breast cancer is a disease with high epidemiological and economic burden. The treatment of metastatic breast cancer has not only high direct costs but also high indirect costs. Breast cancer affects mass populations, especially women younger than 50 years of age. It relates to high indirect costs due to lost productivity and premature death because the majority of these patients are in the workforce. Because of the high cost of breast cancer therapies and short survival rates, the question is raised whether the costs and benefits are worth paying or not. Due to the rising costs in healthcare and new financing policies that have been developed to address this issue, economic evaluation is an important aspect of the development and use of any new interventions. To guide policy makers on how to allocate limited healthcare resources in the most efficient and effective manner, many economic evaluation methods can be used to measure the costs, benefits, and impacts of healthcare innovations. Currently, economic evaluation and health outcomes studies have focused greatly on cost-effectiveness and cost-utility analysis. However, the previous studies had some limitations because they were conducted from a narrow perspective such as payer and provider point of views. The studies also considered only direct costs in their analysis. In fact, conducting economic evaluations from a narrow perspective and leaving out indirect costs might undermine the true benefit of the interventions for society. A cost-benefit analysis measures all costs and benefits in monetary units. It incorporates both health outcomes gained from individuals and the value gained to society in order to maximize the usage of resources effectively. This thesis conducted a cost-benefit analysis to compare nab-paclitaxel and generic paclitaxel in treating metastatic breast cancer from a societal perspective in the United States. The results showed that nab-paclitaxel is a cost-benefit strategy regardless of the different costs and benefits due to the extra 3 years of living it provides. In all models, when nab-paclitaxel was compared to generic paclitaxel, nab-paclitaxel showed cost-benefit to society. However, the results of generic paclitaxel were dependent on the total medical costs. Performing a cost-benefit analysis of nab-paclitaxel from a societal perspective is important to understand the true benefit of interventions. Furthermore, considering both direct and indirect costs, as well as benefits, of this drug is vital because the economic profile of nab-paclitaxel would be improved.

  10. Stochastic Simulation Using @ Risk for Dairy Business Investment Decisions

    USDA-ARS?s Scientific Manuscript database

    A dynamic, stochastic, mechanistic simulation model of a dairy business was developed to evaluate the cost and benefit streams coinciding with technology investments. The model was constructed to embody the biological and economical complexities of a dairy farm system within a partial budgeting fram...

  11. Cost-benefit analysis of space technology

    NASA Technical Reports Server (NTRS)

    Hein, G. F.; Stevenson, S. M.; Sivo, J. N.

    1976-01-01

    A discussion of the implications and problems associated with the use of cost-benefit techniques is presented. Knowledge of these problems is useful in the structure of a decision making process. A methodology of cost-benefit analysis is presented for the evaluation of space technology. The use of the methodology is demonstrated with an evaluation of ion thrusters for north-south stationkeeping aboard geosynchronous communication satellites. A critique of the concept of consumers surplus for measuring benefits is also presented.

  12. Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for dupuytren contracture.

    PubMed

    Chen, Neal C; Shauver, Melissa J; Chung, Kevin C

    2011-11-01

    We undertook a cost-utility analysis to compare traditional fasciectomy for Dupuytren with 2 new treatments, needle aponeurotomy and collagenase injection. We constructed an expected-value decision analysis model with an arm representing each treatment. A survey was administered to a cohort of 50 consecutive subjects to determine utilities of different interventions. We conducted multiple sensitivity analyses to assess the impact of varying the rate of disease recurrence in each arm of the analysis as well as the cost of the collagenase injection. The threshold for a cost-effective treatment is based on the traditional willingness-to-pay of $50,000 per quality-adjusted life years (QALY) gained. The cost of open partial fasciectomy was $820,114 per QALY gained over no treatment. The cost of needle aponeurotomy was $96,474 per QALY gained versus no treatment. When we performed a sensitivity analysis and set the success rate at 100%, the cost of needle aponeurotomy was $49,631. When needle aponeurotomy was performed without surgical center or anesthesia costs and with reduced hand therapy, the cost was $36,570. When a complete collagenase injection series was priced at $250, the cost was $31,856 per QALY gained. When the injection series was priced at $945, the cost was $49,995 per QALY gained. At the market price of $5,400 per injection, the cost was $166,268 per QALY gained. In the current model, open partial fasciectomy is not cost-effective. Needle aponeurotomy is cost-effective if the success rate is high. Collagenase injection is cost-effective when priced under $945. Economic and Decision Analysis II. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. Economic evaluation of environmental epidemiological projects in national industrial complexes.

    PubMed

    Shin, Youngchul

    2017-01-01

    In this economic evaluation of environmental epidemiological monitoring projects, we analyzed the economic feasibility of these projects by determining the social cost and benefit of these projects and conducting a cost/benefit analysis. Here, the social cost was evaluated by converting annual budgets for these research and survey projects into present values. Meanwhile, the societal benefit of these projects was evaluated by using the contingent valuation method to estimate the willingness-to-pay of residents living in or near industrial complexes. In addition, the extent to which these projects reduced negative health effects (i.e., excess disease and premature death) was evaluated through expert surveys, and the analysis was conducted to reflect the unit of economic value, based on the cost of illness and benefit transfer method. The results were then used to calculate the benefit of these projects in terms of the decrease in negative health effects. For residents living near industrial complexes, the benefit/cost ratio was 1.44 in the analysis based on resident surveys and 5.17 in the analysis based on expert surveys. Thus, whichever method was used for the economic analysis, the economic feasibility of these projects was confirmed.

  14. Benefits of flooding-induced aquatic adventitious roots depend on the duration of submergence: linking plant performance to root functioning.

    PubMed

    Zhang, Qian; Huber, Heidrun; Beljaars, Simone J M; Birnbaum, Diana; de Best, Sander; de Kroon, Hans; Visser, Eric J W

    2017-07-01

    Temporal flooding is a common environmental stress for terrestrial plants. Aquatic adventitious roots (aquatic roots) are commonly formed in flooding-tolerant plant species and are generally assumed to be beneficial for plant growth by supporting water and nutrient uptake during partial flooding. However, the actual contribution of these roots to plant performance under flooding has hardly been quantified. As the investment into aquatic root development in terms of carbohydrates may be costly, these costs may - depending on the specific environmental conditions - offset the beneficial effects of aquatic roots. This study tested the hypothesis that the balance between potential costs and benefits depends on the duration of flooding, as the benefits are expected to outweigh the costs in long-term but not in short-term flooding. The contribution of aquatic roots to plant performance was tested in Solanum dulcamara during 1-4 weeks of partial submergence and by experimentally manipulating root production. Nutrient uptake by aquatic roots, transpiration and photosynthesis were measured in plants differing in aquatic root development to assess the specific function of these roots. As predicted, flooded plants benefited from the presence of aquatic roots. The results showed that this was probably due to the contribution of roots to resource uptake. However, these beneficial effects were only present in long-term but not in short-term flooding. This relationship could be explained by the correlation between nutrient uptake and the flooding duration-dependent size of the aquatic root system. The results indicate that aquatic root formation is likely to be selected for in habitats characterized by long-term flooding. This study also revealed only limited costs associated with adventitious root formation, which may explain the maintenance of the ability to produce aquatic roots in habitats characterized by very rare or short flooding events. © The Author 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  15. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    PubMed

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  16. Total thyroidectomy versus hemithyroidectomy for patients with follicular neoplasm. A cost-utility analysis.

    PubMed

    Corso, C; Gomez, X; Sanabria, A; Vega, V; Dominguez, L C; Osorio, C

    2014-01-01

    Thyroid nodules are a common condition. Overall, 20% of the nodules assessed with FNAB correspond to the follicular pattern. A partial thyroidectomy is the minimal procedure that should be performed to determine the nature of these nodules. Some authors have suggested performing a total thyroidectomy based on the elimination of reoperation and ultrasound follow-up. The aim of this study was to evaluate the most cost-useful surgical strategy in a patient with an undetermined nodule, assessing complications, reoperation, recurrence and costs. A cost-utility study was designed to compare hemithyroidectomy and total thyroidectomy. The outcomes were complications (definitive RLN palsy, permanent hypoparathyroidism, reoperation for cancer, and recurrence of the disease), direct costs and utility. We used the payer perspective at 5 years. A deterministic and probabilistic sensitivity analysis was completed. In a deterministic analysis, the cost, utility and cost-utility ratio was COP $12.981.801, 44.5 and COP $291.310 for total thyroidectomy and COP $14.309.889, 42.0 and $340.044 for partial thyroidectomy, respectively. The incremental cost-utility ratio was -$535.302 favoring total thyroidectomy. Partial thyroidectomy was more cost-effective when the risks of RLN injury and definitive hypoparathyroidism were greater than 8% and 9% in total thyroidectomy, respectively. In total, 46.8% of the simulations for partial thyroidectomy were located in the quadrant of more costly and less effective. Under a common range of complications, and considering the patient's preference and costs, total thyroidectomy should be selected as the most cost-effective treatment for patients with thyroid nodules and follicular patterns. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Cost benefit of privatizing wall barrier.

    DOT National Transportation Integrated Search

    2007-08-01

    This project began as an attempt to perform a formal comparative cost benefit analysis of privatized wall barrier purchase/management and NMDOT wall barrier purchase/management in order to answer the question "What are the costs and benefits of priva...

  18. ESTCP Munitions Response Live Site Demonstrations Southwest Proving Ground, Arkansas Andersen Air Force Base, Guam Cost and Performance Report

    DTIC Science & Technology

    2017-09-01

    CANNOT BE ANALYZED ....... 17  7.0  COST BENEFIT ANALYSIS...20  7.3  COST BENEFIT ...sites and assess the performance and cost benefits of implementing AGC technologies. OBJECTIVES OF THE DEMONSTRATION The demonstrations were

  19. A method for the inclusion of physical activity-related health benefits in cost-benefit analysis of built environment initiatives.

    PubMed

    Zapata-Diomedi, Belen; Gunn, Lucy; Giles-Corti, Billie; Shiell, Alan; Lennert Veerman, J

    2018-01-01

    The built environment has a significant influence on population levels of physical activity (PA) and therefore health. However, PA-related health benefits are seldom considered in transport and urban planning (i.e. built environment interventions) cost-benefit analysis. Cost-benefit analysis implies that the benefits of any initiative are valued in monetary terms to make them commensurable with costs. This leads to the need for monetised values of the health benefits of PA. The aim of this study was to explore a method for the incorporation of monetised PA-related health benefits in cost-benefit analysis of built environment interventions. Firstly, we estimated the change in population level of PA attributable to a change in the built environment due to the intervention. Then, changes in population levels of PA were translated into monetary values. For the first step we used estimates from the literature for the association of built environment features with physical activity outcomes. For the second step we used the multi-cohort proportional multi-state life table model to predict changes in health-adjusted life years and health care costs as a function of changes in PA. Finally, we monetised health-adjusted life years using the value of a statistical life year. Future research could adapt these methods to assess the health and economic impacts of specific urban development scenarios by working in collaboration with urban planners. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses.

    PubMed

    Angevine, Peter D; Berven, Sigurd

    2014-10-15

    Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

  1. Cost-Benefit Analysis of Green Infrastructures on Community Stormwater Reduction and Utilization: A Case of Beijing, China.

    PubMed

    Liu, Wen; Chen, Weiping; Feng, Qi; Peng, Chi; Kang, Peng

    2016-12-01

    Cost-benefit analysis is demanded for guiding the plan, design and construction of green infrastructure practices in rapidly urbanized regions. We developed a framework to calculate the costs and benefits of different green infrastructures on stormwater reduction and utilization. A typical community of 54,783 m 2 in Beijing was selected for case study. For the four designed green infrastructure scenarios (green space depression, porous brick pavement, storage pond, and their combination), the average annual costs of green infrastructure facilities are ranged from 40.54 to 110.31 thousand yuan, and the average of the cost per m 3 stormwater reduction and utilization is 4.61 yuan. The total average annual benefits of stormwater reduction and utilization by green infrastructures of the community are ranged from 63.24 to 250.15 thousand yuan, and the benefit per m 3 stormwater reduction and utilization is ranged from 5.78 to 11.14 yuan. The average ratio of average annual benefit to cost of four green infrastructure facilities is 1.91. The integrated facilities had the highest economic feasibility with a benefit to cost ratio of 2.27, and followed by the storage pond construction with a benefit to cost ratio of 2.14. The results suggested that while the stormwater reduction and utilization by green infrastructures had higher construction and maintenance costs, their comprehensive benefits including source water replacements benefits, environmental benefits and avoided cost benefits are potentially interesting. The green infrastructure practices should be promoted for sustainable management of urban stormwater.

  2. Cost Benefit Analysis: Cost Benefit Analysis for Human Effectiveness Research: Bioacoustic Protection

    DTIC Science & Technology

    2001-07-21

    APPENDIX A. ACRONYMS ACCES Attenuating Custom Communication Earpiece System ACEIT Automated Cost estimating Integrated Tools AFSC Air Force...documented in the ACEIT cost estimating tool developed by Tecolote, Inc. The factor used was 14 percent of PMP. 1.3 System Engineering/ Program...The data source is the ASC Aeronautical Engineering Products Cost Factor Handbook which is documented in the ACEIT cost estimating tool developed

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

    NASA Technical Reports Server (NTRS)

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

    1978-01-01

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

  4. Status of risk-benefit analysis

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

    Van Horn, A.J.; Wilson, R.

    1976-12-01

    The benefits and deficiencies of cost benefit analysis are reviewed. It is pointed out that, if decision making involving risks and benefits is to improve, more attention must be paid to the clear presentation of the assumptions, values, and results. Reports need to present concise summaries which convey the uncertainties and limitations of the analysis in addition to the matrix of costs, risks, and benefits. As the field of risk-benefit analysis advances the estimation of risks and benefits will become more precise and implicit valuations will be made more explicit. Corresponding improvements must also be made to enhance communications betweenmore » the risk-benefit analyst and the accountable decision maker.« less

  5. Practical thoughts on cost-benefit analysis and health services.

    PubMed

    Burchell, A; Weeden, R

    1982-08-01

    Cost-benefit analysis is fast becoming--if it is not already--an essential tool in decision making. It is, however, a complex subject, and one in which few doctors have been trained. This paper offers practical thoughts on the art of cost-benefit analysis, and is written for clinicians and other medical specialists who, though inexpert in the techniques of accountancy, nevertheless wish to carry out their own simple analyses in a manner that will enable them, and others, to take effective decisions.

  6. The net return from animal activity in agro-ecosystems: trading off benefits from ecosystem services against costs from crop damage.

    PubMed

    Luck, Gary W

    2013-01-01

    Animals provide benefits to agriculture through the provision of ecosystem services, but also inflict costs such as damaging crops. These benefits and costs are mostly examined independently, rather than comparing the trade-offs of animal activity in the same system and quantifying the net return from beneficial minus detrimental activities. Here, I examine the net return associated with the activity of seed-eating birds in almond orchards by quantifying the economic costs and benefits of bird consumption of almonds. Pre-harvest, the consumption of harvestable almonds by birds cost growers AUD$57.50 ha (-1) when averaged across the entire plantation. Post-harvest, the same bird species provide an ecosystem service by removing mummified nuts from trees that growers otherwise need to remove to reduce threats from fungal infection or insect pest infestations. The value of this ecosystem service ranged from AUD$82.50 ha (-1)-$332.50 ha (-1) based on the replacement costs of mechanical or manual removal of mummified nuts, respectively. Hence, bird consumption of almonds yielded a positive net return of AUD$25-$275 ha (-1) averaged across the entire plantation. However, bird activity varied spatially resulting in positive net returns occurring primarily at the edges of crops where activity was higher, compared to negative net returns in crop interiors. Moreover, partial mummy nut removal by birds meant that bird activity may only reduce costs to growers rather than replace these costs completely. Similar cost-benefit trade-offs exist across nature, and quantifying net returns can better inform land management decisions such as when to control pests or promote ecosystem service provision.

  7. The net return from animal activity in agro-ecosystems: trading off benefits from ecosystem services against costs from crop damage

    PubMed Central

    Luck, Gary W

    2014-01-01

    Animals provide benefits to agriculture through the provision of ecosystem services, but also inflict costs such as damaging crops. These benefits and costs are mostly examined independently, rather than comparing the trade-offs of animal activity in the same system and quantifying the net return from beneficial minus detrimental activities. Here, I examine the net return associated with the activity of seed-eating birds in almond orchards by quantifying the economic costs and benefits of bird consumption of almonds. Pre-harvest, the consumption of harvestable almonds by birds cost growers AUD$57.50 ha -1 when averaged across the entire plantation. Post-harvest, the same bird species provide an ecosystem service by removing mummified nuts from trees that growers otherwise need to remove to reduce threats from fungal infection or insect pest infestations. The value of this ecosystem service ranged from AUD$82.50 ha -1–$332.50 ha -1 based on the replacement costs of mechanical or manual removal of mummified nuts, respectively. Hence, bird consumption of almonds yielded a positive net return of AUD$25–$275 ha -1 averaged across the entire plantation. However, bird activity varied spatially resulting in positive net returns occurring primarily at the edges of crops where activity was higher, compared to negative net returns in crop interiors. Moreover, partial mummy nut removal by birds meant that bird activity may only reduce costs to growers rather than replace these costs completely. Similar cost-benefit trade-offs exist across nature, and quantifying net returns can better inform land management decisions such as when to control pests or promote ecosystem service provision. PMID:25285202

  8. A cost-benefit analysis of Wisconsin's screening, brief intervention, and referral to treatment program: adding the employer's perspective.

    PubMed

    Quanbeck, Andrew; Lang, Katharine; Enami, Kohei; Brown, Richard L

    2010-02-01

    A previous cost-benefit analysis found Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be cost-beneficial from a societal perspective. This paper develops a cost-benefit model that includes the employer's perspective by considering the costs of absenteeism and impaired presenteeism due to problem drinking. We developed a Monte Carlo simulation model to estimate the costs and benefits of SBIRT implementation to an employer. We first presented the likely costs of problem drinking to a theoretical Wisconsin firm that does not currently provide SBIRT services. We then constructed a cost-benefit model in which the firm funds SBIRT for its employees. The net present value of SBIRT adoption was computed by comparing costs due to problem drinking both with and without the program. When absenteeism and impaired presenteeism costs were considered from the employer's perspective, the net present value of SBIRT adoption was $771 per employee. We concluded that implementing SBIRT is cost-beneficial from the employer's perspective and recommend that Wisconsin employers consider covering SBIRT services for their employees.

  9. A Cost-Effectiveness/Benefit Analysis Model for Postsecondary Vocational Programs. Technical Report.

    ERIC Educational Resources Information Center

    Kim, Jin Eun

    A cost-effectiveness/benefit analysis is defined as a technique for measuring the outputs of existing and new programs in relation to their specified program objectives, against the costs of those programs. In terms of its specific use, the technique is conceptualized as a systems analysis method, an evaluation method, and a planning tool for…

  10. Out-of-pocket drug costs and drug utilization patterns of postmenopausal Medicare beneficiaries with osteoporosis.

    PubMed

    Conwell, Leslie Jackson; Esposito, Dominick; Garavaglia, Susan; Meadows, Eric S; Colby, Margaret; Herrera, Vivian; Goldfarb, Seth; Ball, Daniel; Marciniak, Martin

    2011-08-01

    The Medicare Part D coverage gap has been associated with lower adherence and drug utilization and higher discontinuation. Because osteoporosis has a relatively high prevalence among Medicare-eligible postmenopausal women, we examined changes in utilization of osteoporosis medications during this coverage gap. The purpose of this study was to investigate changes in out-of-pocket (OOP) drug costs and utilization associated with the Medicare Part D coverage gap among postmenopausal beneficiaries with osteoporosis. This retrospective analysis of 2007 pharmacy claims focuses on postmenopausal female Medicare beneficiaries enrolled in full-, partial-, or no-gap exposure standard or Medicare Advantage prescription drug plans (PDPs), retiree drug subsidy (RDS) plans, or the low-income subsidy program. We compared beneficiaries with osteoporosis who were taking teriparatide (Eli Lilly and Company, Indianapolis, Indiana) (n = 5657) with matched samples of beneficiaries who were taking nonteriparatide osteoporosis medications (NTO; n = 16,971) or who had other chronic conditions (OCC; n = 16,971). We measured average monthly prescription drug fills and OOP costs, medication discontinuation, and skipping. More than half the sample reached the coverage gap; OOP costs then rose for teriparatide users enrolled in partial- or full-gap exposure plans (increase of 121% and 186%; $300 and $349) but fell for those in no-gap exposure PDPs or RDS plans (decrease of 49% and 30%; $131 and $40). OOP costs for beneficiaries in partial- or full-gap exposure PDPs increased >120% (increase of $144 and $176) in the NTO group and nearly doubled for the OCC group (increase of $124 and $151); these OOP costs were substantially lower than those for teriparatide users. Both teriparatide users and NTO group members discontinued or skipped medications more often than persons in the OCC group, regardless of plan or benefit design. Medication discontinuation and OOP costs among beneficiaries with osteoporosis were highest for those enrolled in Part D plans with a coverage gap. Providers should be aware of potential cost-related nonadherence among Medicare beneficiaries taking osteoporosis medications. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

  11. 75 FR 59323 - Early Scoping for the Alternatives Analysis of the North Corridor Transit Project in Metropolitan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... impacts and benefits to be considered, the capital and operating costs, the financial plans and other... evaluating the costs, benefits, and impacts of a range of transportation alternatives designed to address... maintenance costing, and environmental and land use analyses. Finally, costs, benefits, and impacts of each...

  12. Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces costs: a randomized, controlled clinical trial and health economic evaluation.

    PubMed

    Rosenfeld, Mark; Seferiadis, Aris; Gunnarsson, Ronny

    2006-07-15

    To examine and compare the costs and consequences in a partial economic evaluation of two competing interventions in patients exposed to whiplash trauma in automobile crashes. The interventions were an active involvement and intervention using early mobilization and a standard intervention of rest, recommended short-term immobilization in a cervical collar and a cautious, gradual self-exercise program according to a leaflet. The study was randomized and controlled. The aim of the study was to compare the costs of an active involvement and intervention versus a standard intervention and to relate them to the clinical benefits in patients exposed to whiplash trauma in automobile crashes to facilitate decision-making regarding intervention and resource allocation. There is very little known about the health economic aspects of various interventions in the target treatment group of patients. Based on a prospective, randomized, clinical trial, data on clinical effectiveness and resources used for the active involvement and intervention and standard intervention were collected for a comparative analysis of the costs related to physical therapy treatment and sick leave. A cost-consequence analysis consisting of a modified cost-effectiveness analysis was used. The costs were significantly lower after 6 and 36 months with an active involvement and intervention as compared with the standard intervention. The active involvement and intervention were significantly superior in reducing experienced pain and reducing sick leave. For patients exposed to whiplash trauma in a motor vehicle collision, an active involvement and intervention were both less costly and more effective than a standard intervention.

  13. Risk-benefit analysis and public policy: a bibliography

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

    Clark, E.M.; Van Horn, A.J.

    1976-11-01

    Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis,more » and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk.« less

  14. Implementing electronic identification for performance recording in sheep: II. Cost-benefit analysis in meat and dairy farms.

    PubMed

    Ait-Saidi, A; Caja, G; Salama, A A K; Milán, M J

    2014-12-01

    Costs and secondary benefits of implementing electronic identification (e-ID) for performance recording (i.e., lambing, body weight, inventory, and milk yield) in dairy and meat ewes were assessed by using the results from a previous study in which manual (M), semiautomatic (SA), and automatic (AU) data collection systems were compared. Ewes were identified with visual ear tags and electronic rumen boluses. The M system used visual identification, on-paper data recording, and manual data uploading to a computer. The SA system used e-ID with a handheld reader in which performances were typed and automatic uploaded to a computer. The use of a personal digital assistant (PDA) for recording and automatic data uploading, which transformed M in a SA system, was also considered. The AU system was only used for BW recording and consisted of e-ID, automatic data recording in an electronic scale, and uploading to a computer. The cost-benefit study was applied to 2 reference sheep farms of 700 meat ewes, under extensive or intensive production systems, and of 400 dairy ewes, practicing once- or twice-a-day machine milkings. Sensitivity analyses under voluntary and mandatory e-ID scenarios were also included. Benefits of using e-ID for SA or AU performance recording mainly depended on sheep farm purpose, number of test days per year, handheld reader and PDA prices, and flock size. Implementing e-ID for SA and AU performance recording saved approximately 50% of the time required by the M system, and increased the reliability of the data collected. Use of e-ID increased the cost of performance recording in a voluntary e-ID scenario, paying only partially the investment made (15 to 70%). For the mandatory e-ID scenario, in which the cost of e-ID devices was not included, savings paid 100% of the extra costs needed for using e-ID in all farm types and conditions. In both scenarios, the reader price was the most important extra cost (40 to 90%) for implementing e-ID in sheep farms. Calculated extra costs of using the PDA covered more than 100% of the implementation costs in all type of sheep farms, indicating that this device was cost-effective for sheep-performance recording. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. The benefits of transit in the United States : a review and analysis of benefit-cost studies.

    DOT National Transportation Integrated Search

    2015-07-01

    This white paper presents the findings from a review and analysis of the available literature on benefit-cost (b-c) estimates of : existing U.S. transit systems. Following an inventory of the literature, the b-c estimates from each study were organiz...

  16. Economic impact of a nationwide interoperable e-Health system using the PENG evaluation tool.

    PubMed

    Parv, L; Saluse, J; Aaviksoo, A; Tiik, M; Sepper, R; Ross, P

    2012-01-01

    The aim of this paper is to evaluate the costs and benefits of the Estonian interoperable health information exchange system. In addition, a framework will be built for follow-up monitoring and analysis of a nationwide HIE system. PENG evaluation tool was used to map and quantify the costs and benefits arising from type II diabetic patient management for patients, providers and the society. The analysis concludes with a quantification based on real costs and potential benefits identified by a panel of experts. Setting up a countrywide interoperable eHealth system incurs a large initial investment. However, if the system is working seamlessly, benefits will surpass costs within three years. The results show that while the society stands to benefit the most, the costs will be mainly borne by the healthcare providers. Therefore, new government policies should be devised to encourage providers to invest to ensure society wide benefits.

  17. Cost Benefit Analysis and Other Fun and Games.

    ERIC Educational Resources Information Center

    White, Herbert S.

    1985-01-01

    Discussion of application of cost benefit analysis (CBA) accounting techniques to libraries highlights user willingness to be charged for services provided, reasons why CBA will not work in library settings, libraries and budgets, cost distribution on basis of presumed or expected use, implementation of information-seeking behavior control, and…

  18. Wake Vortex Systems Cost/Benefits Analysis

    NASA Technical Reports Server (NTRS)

    Crisp, Vicki K.

    1997-01-01

    The goals of cost/benefit assessments are to provide quantitative and qualitative data to aid in the decision-making process. Benefits derived from increased throughput (or decreased delays) used to balance life-cycle costs. Packaging technologies together may provide greater gains (demonstrate higher return on investment).

  19. Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study.

    PubMed

    Kausto, Johanna; Virta, Lauri; Luukkonen, Ritva; Viikari-Juntura, Eira

    2010-06-23

    Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. This is the first follow up study of the newly adopted partial sickness benefit in Finland. The results show that compared to full sick leave, partial sick leave - when not followed by lasting return to work - is more typically followed by partial disability pension and less frequently by full disability pension. It is anticipated that the use of partial benefits in connection with part-time participation in work life will have favourable effects on future disability pension rates in Finland.

  20. Distinguishing between the partial-mapping preparation hypothesis and the failure-to-engage hypothesis of residual switch costs.

    PubMed

    Lindsen, Job P; de Jong, Ritske

    2010-10-01

    Lien, Ruthruff, Remington, & Johnston (2005) reported residual switch cost differences between stimulus-response (S-R) pairs and proposed the partial-mapping preparation (PMP) hypothesis, which states that advance preparation will typically be limited to a subset of S-R pairs because of structural capacity limitations, to account for these differences. Alternatively, the failure-to-engage (FTE) hypothesis does not allow for differences in probability of advance preparation between S-R pairs within a set; it accounts for residual switch cost differences by assuming that benefits of advance preparation may differ between S-R pairs. Three Experiments were designed to test between these hypotheses. No capacity limitations of the type assumed by the PMP hypothesis were found for many participants in Experiment 1. In Experiments 2 and 3, no evidence was found for the dependency of residual switch cost differences between S-R pairs on response-stimulus interval that is predicted by the PMP hypothesis. Mixture-model analysis of reaction times distributions in Experiment 3 provided strong support for the FTE hypothesis over the PMP hypothesis. Simulation studies with a computational implementation of the FTE hypothesis showed that it is able to account in great detail for the results of the present study. Together, these results provide strong evidence against the PMP hypothesis and support the FTE hypothesis that advance preparation probabilistically fails or succeeds at the level of the task set. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  1. Papercrete brick as an alternate building material to control Environmental Pollution

    NASA Astrophysics Data System (ADS)

    Sudarsan, J. S.; Ramesh, S.; Jothilingam, M.; Ramasamy, Vishalatchi; Rajan, Rajitha J.

    2017-07-01

    Utilization of concrete in the construction industry is increasing day by day. The increasing demand for concrete in the future is the major issue, for which an alternate option is to find out at a reduced or no additional cost and to reduce the environmental impact due to increase of cement industries that are important ingredient to economic development. It turns out urgent to find out alternate for the partial replacement of concrete and cement, as natural sources of aggregates are becoming exhausted. As large quantity of paper waste is generated from different countries all over the world which causes serious environmental problems, So in this present study abandoned paper waste was used as a partial replacement material in concrete,. Study indicates that 80% of the construction cost of a building was contributed by building material and still millions of people in developing countries like India are not able to afford the cost of construction of house. This study is based on potential use of light weight composite brick as a building material and potential use of paper waste for producing at low-cost. Experimental investigation was carried out to analyse optimization of mix for papercrete bricks depending upon the water absorption, compressive strength and unit weight. Papercrete bricks were prepared out of waste paper, and quarry dust with partial replacement of cement by another industrial by-product Fly Ash in varying proportions of 25%, 40% and 55%. The properties like mechanical strength, standard quality comparisons with the conventional bricks through standard tests like hardness, soundness, fire resistance and Cost-Benefit Analysis were performed and studied. The specimens of dimension 230mm x 110mm x 80mm were subjected to 7 Days and 28 days air curing and sun drying before tests were performed on them. Based on the study it was found that for non-load bearing walls papercrete bricks are best suited.

  2. Partial Discharge Monitoring in Power Transformers Using Low-Cost Piezoelectric Sensors

    PubMed Central

    Castro, Bruno; Clerice, Guilherme; Ramos, Caio; Andreoli, André; Baptista, Fabricio; Campos, Fernando; Ulson, José

    2016-01-01

    Power transformers are crucial in an electric power system. Failures in transformers can affect the quality and cause interruptions in the power supply. Partial discharges are a phenomenon that can cause failures in the transformers if not properly monitored. Typically, the monitoring requires high-cost corrective maintenance or even interruptions of the power system. Therefore, the development of online non-invasive monitoring systems to detect partial discharges in power transformers has great relevance since it can reduce significant maintenance costs. Although commercial acoustic emission sensors have been used to monitor partial discharges in power transformers, they still represent a significant cost. In order to overcome this drawback, this paper presents a study of the feasibility of low-cost piezoelectric sensors to identify partial discharges in mineral insulating oil of power transformers. The analysis of the feasibility of the proposed low-cost sensor is performed by its comparison with a commercial acoustic emission sensor commonly used to detect partial discharges. The comparison between the responses in the time and frequency domain of both sensors was carried out and the experimental results indicate that the proposed piezoelectric sensors have great potential in the detection of acoustic waves generated by partial discharges in insulation oil, contributing for the popularization of this noninvasive technique. PMID:27517931

  3. Partial Discharge Monitoring in Power Transformers Using Low-Cost Piezoelectric Sensors.

    PubMed

    Castro, Bruno; Clerice, Guilherme; Ramos, Caio; Andreoli, André; Baptista, Fabricio; Campos, Fernando; Ulson, José

    2016-08-10

    Power transformers are crucial in an electric power system. Failures in transformers can affect the quality and cause interruptions in the power supply. Partial discharges are a phenomenon that can cause failures in the transformers if not properly monitored. Typically, the monitoring requires high-cost corrective maintenance or even interruptions of the power system. Therefore, the development of online non-invasive monitoring systems to detect partial discharges in power transformers has great relevance since it can reduce significant maintenance costs. Although commercial acoustic emission sensors have been used to monitor partial discharges in power transformers, they still represent a significant cost. In order to overcome this drawback, this paper presents a study of the feasibility of low-cost piezoelectric sensors to identify partial discharges in mineral insulating oil of power transformers. The analysis of the feasibility of the proposed low-cost sensor is performed by its comparison with a commercial acoustic emission sensor commonly used to detect partial discharges. The comparison between the responses in the time and frequency domain of both sensors was carried out and the experimental results indicate that the proposed piezoelectric sensors have great potential in the detection of acoustic waves generated by partial discharges in insulation oil, contributing for the popularization of this noninvasive technique.

  4. Grid connected integrated community energy system. Phase II: final state 2 report. Cost benefit analysis, operating costs and computer simulation

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

    Not Available

    1978-03-22

    A grid-connected Integrated Community Energy System (ICES) with a coal-burning power plant located on the University of Minnesota campus is planned. The cost benefit analysis performed for this ICES, the cost accounting methods used, and a computer simulation of the operation of the power plant are described. (LCL)

  5. Benefit-Cost Analysis of Integrated Paratransit Systems : Volume 3. Scenario Analysis.

    DOT National Transportation Integrated Search

    1979-09-01

    This is the third volume of a six-volume report documenting the results of a study entitled "Benefit-Cost Analysis of Integrated Paratransit Systems." This volume provides detailed results of a series of scenario analyses designed to determine the im...

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

    PubMed Central

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

    2016-01-01

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

  7. Physiotherapy after arthroscopic partial meniscectomy surgery: an assessment of costs to the National Health Service, patients, and society.

    PubMed

    Goodwin, Peter Charles; Ratcliffe, Julie; Morrissey, Matthew Charles

    2005-01-01

    The purpose of this study was to determine and inform clinicians, managers, and budget allocators of the costs incurred to the British National Health Service (NHS), patient, and society when attending clinic-based physiotherapy compared with not attending clinic-based physiotherapy after arthroscopic partial meniscectomy surgery. The valuation principle used in this study was the economic concept of opportunity cost. Costs were referred to as direct medical (NHS), direct nonmedical (patient), and indirect (societal) costs. Due to the difficulties of their measurement and valuation, intangible costs, in the form of pain and anxiety related to the effect of receiving or not receiving treatment, have not been considered in this analysis. Providing clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is more costly to the NHS and patient, but no more costly to society than when not providing it and does not result in reduced contact with the NHS. Clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is costly and evidence is needed that its effectiveness is high enough to support its use.

  8. Abatement vs. treatment for efficient diffuse source water pollution management in terrestrial-marine systems.

    PubMed

    Roebeling, P C; Cunha, M C; Arroja, L; van Grieken, M E

    2015-01-01

    Marine ecosystems are affected by water pollution originating from coastal catchments. The delivery of water pollutants can be reduced through water pollution abatement as well as water pollution treatment. Hence, sustainable economic development of coastal regions requires balancing of the marginal costs from water pollution abatement and/or treatment and the associated marginal benefits from marine resource appreciation. Water pollution delivery reduction costs are, however, not equal across abatement and treatment options. In this paper, an optimal control approach is developed and applied to explore welfare maximizing rates of water pollution abatement and/or treatment for efficient diffuse source water pollution management in terrestrial-marine systems. For the case of diffuse source dissolved inorganic nitrogen water pollution in the Tully-Murray region, Queensland, Australia, (agricultural) water pollution abatement cost, (wetland) water pollution treatment cost and marine benefit functions are determined to explore welfare maximizing rates of water pollution abatement and/or treatment. Considering partial (wetland) treatment costs and positive water quality improvement benefits, results show that welfare gains can be obtained, primarily, through diffuse source water pollution abatement (improved agricultural management practices) and, to a minor extent, through diffuse source water pollution treatment (wetland restoration).

  9. Cost-Effectiveness of Insulin Degludec Versus Insulin Glargine U100 in Patients with Type 1 and Type 2 Diabetes Mellitus in Serbia.

    PubMed

    Lalić, Nebojša; Russel-Szymczyk, Monika; Culic, Marina; Tikkanen, Christian Klyver; Chubb, Barrie

    2018-04-26

    This study investigates the cost-effectiveness of insulin degludec versus insulin glargine U100 in patients with type 1 and type 2 diabetes mellitus in Serbia. A cost-utility analysis, implementing a simple short-term model, was used to compare treatment costs and outcomes with degludec versus glargine U100 in patients with type 1 (T1DM) and type 2 diabetes (T2DM). Cost-effectiveness was analysed in a 1-year setting, based on data from clinical trials. Costs were estimated from the healthcare payer perspective, the Serbian Health Insurance Fund (RFZO). The outcome measure was the incremental cost-effectiveness ratio (ICER) or cost per quality-adjusted life-year (QALY) gained. Degludec is highly cost-effective compared with glargine U100 for people with T1DM and T2DM in Serbia. The ICERs are estimated at 417,586 RSD/QALY gained in T1DM, 558,811 RSD/QALY gained in T2DM on basal oral therapy (T2DM BOT ) and 1,200,141 RSD/QALY gained in T2DM on basal-bolus therapy (T2DM B/B ). All ICERs fall below the commonly accepted thresholds for cost-effectiveness in Serbia (1,785,642 RSD/QALY gained). In all three patient groups, insulin costs are higher with degludec than with glargine U100, but these costs are partially offset by savings from a lower daily insulin dose in T1DM and T2DM BOT , a reduction in hypoglycaemic events in all three patient groups and reduced costs of SMBG testing in the T2DM groups with degludec versus glargine U100. Degludec is a cost-effective alternative to glargine U100 for patients with T1DM and T2DM in Serbia. Degludec may particularly benefit those suffering from hypoglycaemia or where the patient would benefit from the option of flexible dosing. Novo Nordisk.

  10. CERCLA-linked environmental impact and benefit analysis: Evaluating remedial alternatives for the Portland Harbor Superfund Site, Portland, Oregon, USA.

    PubMed

    McNally, Amanda D; Fitzpatrick, Anne G; Mirchandani, Sera; Salmon, Matthew; Edwards, Deborah A

    2018-01-01

    This analysis focused on evaluating the environmental consequences of remediation, providing indicators for the environmental quality pillar of 3 "pillars" of the Portland Harbor Sustainability Project (PHSP) framework (the other 2 pillars are economic viability and social equity). The project an environmental impact and benefit analysis (EIBA) and an EIBA-based cost-benefit analysis. Metrics developed in the EIBA were used to quantify and compare remedial alternatives' environmental benefits and impacts in the human and ecological domains, as a result of remedial actions (relative to no action). The cost-benefit results were used to evaluate whether remediation costs were proportionate or disproportionate to the environmental benefits. Alternatives B and D had the highest overall benefit scores, and Alternative F was disproportionately costly relative to its achieved benefits when compared to the other remedial alternatives. Indeed, the costlier alternatives with larger remedial footprints had lower overall EIBA benefit scores-because of substantially more air emissions, noise, and light impacts, and more disturbance to business, recreational access, and habitat during construction-compared to the less costly and smaller alternatives. Put another way, the adverse effects during construction tended to outweigh the long-term benefits, and the net environmental impacts of the larger remedial alternatives far outweighed their small incremental improvements in risk reduction. Results of this Comprehensive Environmental Response Compensation and Liability Act (CERCLA)-linked environmental analysis were integrated with indicators of economic and social impacts of remediation in a stakeholder values-based sustainability framework. These tools (EIBA, EIBA-based cost-benefit analysis, economic impact assessment, and the stakeholder values-based integration) provide transparent and quantitative evaluations of the benefits and impacts associated with remedial alternatives, and should be applied to complex remediation projects to aid environmental decision making. Integr Environ Assess Manag 2018;14:22-31. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  11. The Dollars and Cents of Investing Early: Cost-Benefit Analysis in Early Care and Education

    ERIC Educational Resources Information Center

    Heckman, James; Grunewald, Rob; Reynolds, Arthur

    2006-01-01

    Heckman et al. discuss how cost-benefit analysis of prekindergarten education programs demonstrates that the highest per child benefits stem from programs that focus on economically disadvantaged children. Indeed, studies have shown that these children make significant gains in cognition, social-emotional development, and educational performance…

  12. Cost-benefit analysis of screening for esophageal and gastric cardiac cancer.

    PubMed

    Wei, Wen-Qiang; Yang, Chun-Xia; Lu, Si-Han; Yang, Juan; Li, Bian-Yun; Lian, Shi-Yong; Qiao, You-Lin

    2011-03-01

    In 2005, a program named "Early Detection and Early Treatment of Esophageal and Cardiac Cancer" (EDETEC) was initiated in China. A total of 8279 residents aged 40-69 years old were recruited into the EDETEC program in Linzhou of Henan Province between 2005 and 2008. Howerer, the cost-benefit of the EDETEC program is not very clear yet. We conducted herein a cost-benefit analysis of screening for esophageal and cardiac cancer. The assessed costs of the EDETEC program included screening costs for each subject, as well as direct and indirect treatment costs for esophageal and cardiac severe dysplasia and cancer detected by screening. The assessed benefits of this program included the saved treatment costs, both direct and indirect, on esophageal and cardiac cancer, as well as the value of prolonged life due to screening, as determined by the human capital approach. The results showed the screening cost of finding esophageal and cardiac severe dysplasia or cancer ranged from RMB 2707 to RMB 4512, and the total cost on screening and treatment was RMB 13 115-14 920. The cost benefit was RMB 58 944-155 110 (the saved treatment cost, RMB 17 730, plus the value of prolonged life, RMB 41 214-137 380). The ratio of benefit-to-cost (BCR) was 3.95-11.83. Our results suggest that EDETEC has a high benefit-to-cost ratio in China and could be instituted into high risk areas of China.

  13. Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation.

    PubMed

    Wilby, J; Kainth, A; Hawkins, N; Epstein, D; McIntosh, H; McDaid, C; Mason, A; Golder, S; O'Meara, S; Sculpher, M; Drummond, M; Forbes, C

    2005-04-01

    To examine the clinical effectiveness, tolerability and cost-effectiveness of gabapentin (GBP), lamotrigine (LTG), levetiracetam (LEV), oxcarbazepine (OXC), tiagabine (TGB), topiramate (TPM) and vigabatrin (VGB) for epilepsy in adults. Electronic databases. Internet resources. Pharmaceutical company submissions. Selected studies were screened and quality assessed. Separate analyses assessed clinical effectiveness, serious, rare and long-term adverse events and cost-effectiveness. An integrated economic analysis incorporating information on costs and effects of newer and older antiepileptic drugs (AEDs) was performed to give direct comparisons of long-term costs and benefits. A total of 212 studies were included in the review. All included systematic reviews were Cochrane reviews and of good quality. The quality of randomised controlled trials (RCTs) was variable. Assessment was hampered by poor reporting of methods of randomisation, allocation concealment and blinding. Few of the non-randomised studies were of good quality. The main weakness of the economic evaluations was inappropriate use of the cost-minimisation design. The included systematic reviews reported that newer AEDs were effective as adjunctive therapy compared to placebo. For newer versus older drugs, data were available for all three monotherapy AEDs, although data for OXC and TPM were limited. There was limited, poor-quality evidence of a significant improvement in cognitive function with LTG and OXC compared with older AEDs. However, there were no consistent statistically significant differences in other clinical outcomes, including proportion of seizure-free patients. No studies assessed effectiveness of AEDs in people with intellectual disabilities or in pregnant women. There was very little evidence to assess the effectiveness of AEDs in the elderly; no significant differences were found between LTG and carbamazepine monotherapy. Sixty-seven RCTs compared adjunctive therapy with placebo, older AEDs or other newer AEDs. For newer AEDs versus placebo, a trend was observed in favour of newer drugs, and there was evidence of statistically significant differences in proportion of responders favouring newer drugs. However, it was not possible to assess long-term effectiveness. Most trials were conducted in patients with partial seizures. For newer AEDs versus older drugs, there was no evidence to assess the effectiveness of LEV, LTG or OXC, and evidence for other newer drugs was limited to single studies. Trials only included patients with partial seizures and follow-up was relatively short. There was no evidence to assess effectiveness of adjunctive LEV, OXC or TPM versus other newer drugs, and there were no time to event or cognitive data. No studies assessed the effectiveness of adjunctive AEDs in the elderly or pregnant women. There was some evidence from one study (GBP versus LTG) that both drugs have some beneficial effect on behaviour in people with learning disabilities. Eighty RCTs reported the incidence of adverse events. There was no consistent or convincing evidence to draw any conclusions concerning relative safety and tolerability of newer AEDs compared with each other, older AEDs or placebo. The integrated economic analysis for monotherapy for newly diagnosed patients with partial seizures showed that older AEDs were more likely to be cost-effective, although there was considerable uncertainty in these results. The integrated analysis suggested that newer AEDs used as adjunctive therapy for refractory patients with partial seizures were more effective and more costly than continuing with existing treatment alone. Combination therapy, involving new AEDs, may be cost-effective at a threshold willingness to pay per quality-adjusted life year (QALY) greater than 20,000 pounds, depending on patients' previous treatment history. There was, again, considerable uncertainty in these results. There were few data available to determine effectiveness of treatments for patients with generalised seizures. LTG and VPA showed similar health benefits when used as monotherapy. VPA was less costly and was likely to be cost-effective. The analysis indicated that TPM might be cost-effective when used as an adjunctive therapy, with an estimated incremental cost-effectiveness ratio of 34,500 pounds compared with continuing current treatment alone. There was little good-quality evidence from clinical trials to support the use of newer monotherapy or adjunctive therapy AEDs over older drugs, or to support the use of one newer AED in preference to another. In general, data relating to clinical effectiveness, safety and tolerability failed to demonstrate consistent and statistically significant differences between the drugs. The exception was comparisons between newer adjunctive AEDs and placebo, where significant differences favoured newer AEDs. However, trials often had relatively short-term treatment durations and often failed to limit recruitment to either partial or generalised onset seizures, thus limiting the applicability of the data. Newer AEDs, used as monotherapy, may be cost-effective for the treatment of patients who have experienced adverse events with older AEDs, who have failed to respond to the older drugs, or where such drugs are contraindicated. The integrated economic analysis also suggested that newer AEDs used as adjunctive therapy may be cost-effective compared with the continuing current treatment alone given a QALY of about 20,000 pounds. There is a need for more direct comparisons of the different AEDs within clinical trials, considering different treatment sequences within both monotherapy and adjunctive therapy. Length of follow-up also needs to be considered. Trials are needed that recruit patients with either partial or generalised seizures; that investigate effectiveness and cost-effectiveness in patients with generalised onset seizures and that investigate effectiveness in specific populations of epilepsy patients, as well as studies evaluating cognitive outcomes to use more stringent testing protocols and to adopt a more consistent approach in assessing outcomes. Further research is also required to assess the quality of life within trials of epilepsy therapy using preference-based measures of outcomes that generate cost-effectiveness data. Future RCTs should use CONSORT guidelines; and observational data to provide information on the use of AEDs in actual practice, including details of treatment sequences and doses.

  14. An Approach and Instrumentation for Management System Analysis

    DTIC Science & Technology

    1974-10-01

    Benefit Analysis Systems Analysis Manpower Planning Resource Planning Information Theory 20. ABSTRACT (Conlliwa on ravaraa alda It nacaaaary...participants the data necessary to trace both formal and informal information flows and make cost- benefit judgments about specific communications. The...network within a manage- ment structure and to provide a basis tor preliminary cost- benefit evaluations. This objective was in response to Phase I of the

  15. [Effects, safety and cost-benefit analysis of Down syndrome screening in first trimester].

    PubMed

    Shengmou, Lin; Min, Chen; Chenhong, Wang; Shengli, Li; Jiansheng, Xie; Hui, Yuan; Dinghao, Lin; Xiaoxia, Wu; Wei, Wang; Hongyun, Zhang; Haiyan, Tang

    2014-05-01

    To investigate the effects, safety and cost-benefit analysis of Down syndrome screening in first trimester. From January 2009 to December 2012, 43 729 pregnant women undergoing 3 methods of Down syndrome traditional screening strategies in Shenzhen Maternity and Child Healthcare Hospital were studied retrospectively, including in 17 502 cases in pregnancy associated plasma protein A (PAPP-A) and free β-hCG measured biochemistry screening, 14 080 cases in nuchal translucency (NT) screening and 12 147 cases in combined screening, meanwhile, 7 389 cases on non-invasive fetal trisomy test (NIFTY) were performed in Huada Gene Research Institute(BGI). The effects and safety of four screening strategies were assessed throughout a decision tree. The economical characters of each screening strategy were compared by cost-effectiveness analysis as well as cost-benefit analysis. (1) The effects of four strategies are: NIFTY > combined screening > NT screening > biochemistry screening. (2) The safety of four strategies are: NIFTY > combined screening > NT screening > biochemistry screening. (3) Cost-effectiveness analysis and cost-benefit analysis:the biochemistry screening has lowest cost-effectiveness ratio (CER) and highest cost-benefit ratio (CBR), which performed a better economical efficiency. The incremental CER of three traditional screening strategies are all less than the economical burden of Down syndrome.NIFTY has highest CER and negative net present value (NPV), NPV would be positive and CBR would be more than 1 if the price of NIFTY reduce to 1 434 Yuan. Combined screening possess best screening efficiency, while biochemistry screening was demonstrated more economical in traditional screening.NIFTY is the future of Down syndrome screening.

  16. Advantages of the net benefit regression framework for economic evaluations of interventions in the workplace: a case study of the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders.

    PubMed

    Hoch, Jeffrey S; Dewa, Carolyn S

    2014-04-01

    Economic evaluations commonly accompany trials of new treatments or interventions; however, regression methods and their corresponding advantages for the analysis of cost-effectiveness data are not well known. To illustrate regression-based economic evaluation, we present a case study investigating the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders. We implement net benefit regression to illustrate its strengths and limitations. Net benefit regression offers a simple option for cost-effectiveness analyses of person-level data. By placing economic evaluation in a regression framework, regression-based techniques can facilitate the analysis and provide simple solutions to commonly encountered challenges. Economic evaluations of person-level data (eg, from a clinical trial) should use net benefit regression to facilitate analysis and enhance results.

  17. Benefit-cost analysis of spruce budworm (Choristoneura fumiferana Clem.) control: incorporating market and non-market values.

    PubMed

    Chang, Wei-Yew; Lantz, Van A; Hennigar, Chris R; MacLean, David A

    2012-01-01

    This study employs a benefit-cost analysis framework to estimate market and non-market benefits and costs of controlling future spruce budworm (Choristoneura fumiferana) outbreaks on Crown forest lands in New Brunswick, Canada. We used: (i) an advanced timber supply model to project potential timber volume saved, timber value benefits, and costs of pest control efforts; and (ii) a recent contingent valuation method analysis that evaluated non-market benefits (i.e., changes in recreation opportunities and existence values) of controlling future spruce budworm outbreaks in the Province. A total of six alternative scenarios were evaluated, including two uncontrolled future budworm outbreak severities (moderate vs. severe) and, for each severity, three control program levels (protecting 10%, 20%, or 40% of the susceptible Crown land forest area). The economic criteria used to evaluate each scenario included benefit-cost ratios and net present values. Under severe outbreak conditions, results indicated that the highest benefit-cost ratio (4.04) occurred when protecting 10% (284,000 ha) of the susceptible area, and the highest net present value ($111 M) occurred when protecting 20% (568,000 ha) of the susceptible area. Under moderate outbreak conditions, the highest benefit-cost ratio (3.24) and net present value ($58.7 M) occurred when protecting 10% (284,000 ha) of the susceptible area. Inclusion of non-market values generally increased the benefit-cost ratios and net present values of the control programs, and in some cases, led to higher levels of control being supported. Results of this study highlight the importance of including non-market values into the decision making process of forest pest management. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Benefit, risk and cost of new oral anticoagulants and warfarin in atrial fibrillation; A multicriteria decision analysis.

    PubMed

    Mendoza-Sanchez, Jose; Silva, Federico; Rangel, Lady; Jaramillo, Linda; Mendoza, Leidy; Garzon, Jenny; Quiroga, Andrea

    2018-01-01

    Warfarin and new oral anticoagulants are effective in reducing stroke in atrial fibrillation; however, the benefits and risks rates in clinical trials show heterogeneity for each anticoagulant, and is unknown the cost influence on a model considering most of the treatment consequences. We designed a benefit-risk and cost assessment of oral anticoagulants. We followed the roadmap proposed by IMI-PROTECT and the considerations of emerged good practice to perform Multi-Criteria Decision Analysis (MCDA). The roadmap defines the following steps: (1) planning, (2) evidence gathering and data preparation, (3) analyses, (4) explorations, and (5) conclusions. We defined two reference points (0-100) to allocate numerical values for scores and weights, and used an analogue numeric scale to assess physicians' preferences. As benefits of the anticoagulant therapy, we included reductions in stroke and all-cause mortality; intracranial haemorrhage, gastrointestinal haemorrhage, minor bleeding and myocardial infarction were considered risks. We also made an estimation of the annual drug cost per person. The scores were: Apixaban 33, Dabigatrán 25, warfarin 18 and Rivaroxaban 14 this score reveals the most preferred up to the less preferred option, considering the benefit-risk ratio and drug costs altogether. The relative model weights were: 51.1% for risks, 40.4% for benefits and 8.5% for cost. The sensitivity analysis confirms the model robustness. From this analysis, apixaban should be considered as the preferred anticoagulant option -due to a better benefit-risk balance and a minor cost influence- followed by dabigatran, warfarin and rivaroxaban.

  19. Minnesota Computer Aided Library System (MCALS); University of Minnesota Subsystem Cost/Benefits Analysis.

    ERIC Educational Resources Information Center

    Lourey, Eugene D., Comp.

    The Minnesota Computer Aided Library System (MCALS) provides a basis of unification for library service program development in Minnesota for eventual linkage to the national information network. A prototype plan for communications functions is illustrated. A cost/benefits analysis was made to show the cost/effectiveness potential for MCALS. System…

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

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

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

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

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

    PubMed

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

    2015-01-01

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

  2. By Land, Sea, or Air A Comparative Analysis of Cartel Smuggling Strategies

    DTIC Science & Technology

    2017-06-01

    30  D.  SEEING LIKE A CARTEL: THE COSTS AND BENEFITS OF LAND SMUGGLING...52  D.  SEEING LIKE A CARTEL: THE COSTS AND BENEFITS OF MARITIME SMUGGLING...70  D.  SEEING LIKE A CARTEL: THE COSTS AND BENEFITS OF AIR SMUGGLING

  3. Analysis of Costs and Benefits in Rehabilitation. Final Report.

    ERIC Educational Resources Information Center

    Berkowitz, Monroe, Ed.; And Others

    This report suggests feasible alternatives to the present methods of calculating benefits and costs of the joint federal-state vocational rehabilitation program. "Summary and Guide to Reading This Report" (Monroe Berkowitz) appears first. Part I, Background, Theory and Models, includes "The Cost Benefit Tradition in Vocational Rehabilitation"…

  4. Benefit-Cost Analysis as a Teaching Tool.

    ERIC Educational Resources Information Center

    Dowd, Richard F.

    1980-01-01

    Demonstrates how benefit-cost and present-value analyses can be used to assess the potential social benefits of government projects and to illustrate how interest rates affect decision-making in government and business. (AYC)

  5. A fuzzy cost-benefit function to select economical products for processing in a closed-loop supply chain

    NASA Astrophysics Data System (ADS)

    Pochampally, Kishore K.; Gupta, Surendra M.; Cullinane, Thomas P.

    2004-02-01

    The cost-benefit analysis of data associated with re-processing of used products often involves the uncertainty feature of cash-flow modeling. The data is not objective because of uncertainties in supply, quality and disassembly times of used products. Hence, decision-makers must rely on "fuzzy" data for analysis. The same parties that are involved in the forward supply chain often carry out the collection and re-processing of used products. It is therefore important that the cost-benefit analysis takes the data of both new products and used products into account. In this paper, a fuzzy cost-benefit function is proposed that is used to perform a multi-criteria economic analysis to select the most economical products to process in a closed-loop supply chain. Application of the function is detailed through an illustrative example.

  6. Economic analysis of measles elimination program in the Republic of Korea, 2001: a cost benefit analysis study.

    PubMed

    Bae, Geun-Ryang; Choe, Young June; Go, Un Yeong; Kim, Yong-Ik; Lee, Jong-Koo

    2013-05-31

    In this study, we modeled the cost benefit analysis for three different measles vaccination strategies based upon three different measles-containing vaccines in Korea, 2001. We employed an economic analysis model using vaccination coverage data and population-based measles surveillance data, along with available estimates of the costs for the different strategies. In addition, we have included analysis on benefit of reduction of complication by mumps and rubella. We evaluated four different strategies: strategy 1, keep-up program with a second dose measles-mumps-rubella (MMR) vaccine at 4-6 years without catch-up campaign; strategy 2, additional catch-up campaign with measles (M) vaccine; strategy 3, catch-up campaign with measles-rubella (MR) vaccine; and strategy 4, catch-up campaign with MMR vaccine. The cost of vaccination included cost for vaccines, vaccination practices and other administrative expenses. The direct benefit of estimated using data from National Health Insurance Company, a government-operated system that reimburses all medical costs spent on designated illness in Korea. With the routine one-dose MMR vaccination program, we estimated a baseline of 178,560 measles cases over the 20 years; when the catch-up campaign with M, MR or MMR vaccines was conducted, we estimated the measles cases would decrease to 5936 cases. Among all strategies, the two-dose MMR keep-up program with MR catch-up campaign showed the highest benefit-cost ratio of 1.27 with a net benefit of 51.6 billion KRW. Across different vaccination strategies, our finding suggest that MR catch-up campaign in conjunction with two-dose MMR keep-up program was the most appropriate option in terms of economic costs and public health effects associated with measles elimination strategy in Korea. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Energy savings and cost-benefit analysis of the new commercial building standard in China

    DOE PAGES

    Zhao, Shanguo; Feng, Wei; Zhang, Shicong; ...

    2015-10-07

    In this study, a comprehensive comparison of the commercial building energy efficiency standard between the previous 2005 version and the new proposed version is conducted, including the energy efficiency analysis and cost-benefit analysis. To better understand the tech-economic performance of the new Chinese standard, energy models were set up based on a typical commercial office building in Chinese climate zones. The building energy standard in 2005 is used as the baseline for this analysis. Key building technologies measures are analyzed individually, including roof, wall, window, lighting and chiller and so on and finally whole building cost-benefit analysis was conducted. Resultsmore » show that the new commercial building energy standard demonstrates good cost-effective performance, with whole building payback period around 4 years.« less

  8. Energy savings and cost-benefit analysis of the new commercial building standard in China

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

    Zhao, Shanguo; Feng, Wei; Zhang, Shicong

    In this study, a comprehensive comparison of the commercial building energy efficiency standard between the previous 2005 version and the new proposed version is conducted, including the energy efficiency analysis and cost-benefit analysis. To better understand the tech-economic performance of the new Chinese standard, energy models were set up based on a typical commercial office building in Chinese climate zones. The building energy standard in 2005 is used as the baseline for this analysis. Key building technologies measures are analyzed individually, including roof, wall, window, lighting and chiller and so on and finally whole building cost-benefit analysis was conducted. Resultsmore » show that the new commercial building energy standard demonstrates good cost-effective performance, with whole building payback period around 4 years.« less

  9. A cost-benefit analysis of The National Map

    USGS Publications Warehouse

    Halsing, David L.; Theissen, Kevin; Bernknopf, Richard

    2003-01-01

    The Geography Discipline of the U.S. Geological Survey (USGS) has conducted this cost-benefit analysis (CBA) of The National Map. This analysis is an evaluation of the proposed Geography Discipline initiative to provide the Nation with a mechanism to access current and consistent digital geospatial data. This CBA is a supporting document to accompany the Exhibit 300 Capital Asset Plan and Business Case of The National Map Reengineering Program. The framework for estimating the benefits is based on expected improvements in processing information to perform any of the possible applications of spatial data. This analysis does not attempt to determine the benefits and costs of performing geospatial-data applications. Rather, it estimates the change in the differences between those benefits and costs with The National Map and the current situation without it. The estimates of total costs and benefits of The National Map were based on the projected implementation time, development and maintenance costs, rates of data inclusion and integration, expected usage levels over time, and a benefits estimation model. The National Map provides data that are current, integrated, consistent, complete, and more accessible in order to decrease the cost of implementing spatial-data applications and (or) improve the outcome of those applications. The efficiency gains in per-application improvements are greater than the cost to develop and maintain The National Map, meaning that the program would bring a positive net benefit to the Nation. The average improvement in the net benefit of performing a spatial data application was multiplied by a simulated number of application implementations across the country. The numbers of users, existing applications, and rates of application implementation increase over time as The National Map is developed and accessed by spatial data users around the country. Results from the 'most likely' estimates of model parameters and data inputs indicate that, over its 30-year projected lifespan, The National Map will bring a net present value (NPV) of benefits of $2.05 billion in 2001 dollars. The average time until the initial investments (the break-even period) are recovered is 14 years. Table ES-1 shows a running total of NPV in each year of the simulation model. In year 14, The National Map first shows a positive NPV, and so the table is highlighted in gray after that point. Figure ES-1 is a graph of the total benefit and total cost curves of a single model run over time. The curves cross in year 14, when the project breaks even. A sensitivity analysis of the input variables illustrated that these results of the NPV of The National Map are quite robust. Figure ES-2 plots the mean NPV results from 60 different scenarios, each consisting of fifty 30-year runs. The error bars represent a two-standard-deviation range around each mean. The analysis that follows contains the details of the cost-benefit analysis, the framework for evaluating economic benefits, a computational simulation tool, and a sensitivity analysis of model variables and values.

  10. Who wants feedback? An investigation of the variables influencing residents' feedback-seeking behavior in relation to night shifts.

    PubMed

    Teunissen, Pim W; Stapel, Diederik A; van der Vleuten, Cees; Scherpbier, Albert; Boor, Klarke; Scheele, Fedde

    2009-07-01

    The literature on feedback in clinical medical education has predominantly treated trainees as passive recipients. Past research has focused on how clinical supervisors can use feedback to improve a trainee's performance. On the basis of research in social and organizational psychology, the authors reconceptualized residents as active seekers of feedback. They investigated what individual and situational variables influence residents' feedback-seeking behavior on night shifts. Early in 2008, the authors sent obstetrics-gynecology residents in the Netherlands--both those in their first two years of graduate training and those gaining experience between undergraduate and graduate training--a questionnaire that assessed four predictor variables (learning and performance goal orientation, and instrumental and supportive leadership), two mediator variables (perceived feedback benefits and costs), and two outcome variables (frequency of feedback inquiry and monitoring). They used structural equation modeling software to test a hypothesized model of relationships between variables. The response rate was 76.5%. Results showed that residents who perceive more feedback benefits report a higher frequency of feedback inquiry and monitoring. More perceived feedback costs result mainly in more feedback monitoring. Residents with a higher learning goal orientation perceive more feedback benefits and fewer costs. Residents with a higher performance goal orientation perceive more feedback costs. Supportive physicians lead residents to perceive more feedback benefits and fewer costs. This study showed that some residents actively seek feedback. Residents' feedback-seeking behavior partially depends on attending physicians' supervisory style. Residents' goal orientations influence their perceptions of the benefits and costs of feedback-seeking.

  11. Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost-benefit analysis.

    PubMed

    An, R; Xue, H; Wang, L; Wang, Y

    2017-09-22

    This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. A decision model was constructed to simulate two events under Markov chain processes - placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved. Based on the decision model, the estimated incremental cost of the school-based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5. The New York school-based water access intervention, if adopted nationwide, may have a considerably favourable benefit-cost portfolio. © 2017 World Obesity Federation.

  12. Treatment planning: implant-supported partial overdentures.

    PubMed

    Chee, Winston W L

    2005-04-01

    When multiple anterior teeth are missing, many options of replacement are available. Traditionally, the choice was between a fixed or removable prostheses. Today, with the predictability of dental implants, the options of tooth replacement range from removable partial dentures to implant-supported fixed prostheses. The choice of which restoration that will best provide occlusion and esthetics depends on multiple factors including the number and location of missing teeth, the residual ridge form in relation to the replacement teeth, the relationship of the maxillary and mandibular anterior teeth, the condition of teeth adjacent to the edentulous span, the amount of bone available for implant placement, the patients "smile line" and display of teeth, lip support, and financial constraints. When there is minimal loss of the ridge contour, restorations that emerge from the ridge are the most functional and esthetic restorations, adhesive-type fixed partial dentures, conventional fixed partial dentures, and implant-supported restorations can be indicated with the choice of restoration dependent on a risk benefit and cost benefit analysis. When there is a loss of ridge contour due to residual ridge resorption or trauma, the decision becomes more complex as not only does the tooth structure need to be replaced, the ridge form also has to be replaced. (Figures 1 and 2). This can be assessed clinically as illustrated by Figures 1 and 2 where a dis crepancy in arch form and ridge form in relation to the adjacent teeth and/or opposing arch can be observed. Other considerations are lip support and display of the teeth when smiling. This article presents a case and rationale for implant-supported par tial overdentures. Many authors have written on the merits of com plete overdentures. The complete overdenture has proven to be an improvement over conventional complete prostheses with respect to chewing efficiency, patient comfort and satisfaction. In partial edentulism, the implant-supported overdenture has several advantages, some in common with a removable partial denture.

  13. Using the Kaldor-Hicks Tableau Format for Cost-Benefit Analysis and Policy Evaluation

    ERIC Educational Resources Information Center

    Krutilla, Kerry

    2005-01-01

    This note describes the Kaldor-Hicks (KH) tableau format as a framework for distributional accounting in cost-benefit analysis and policy evaluation. The KH tableau format can serve as a heuristic aid for teaching microeconomics-based policy analysis, and offer insight to policy analysts and decisionmakers beyond conventional efficiency analysis.

  14. Separating analysis from politics: Acid rain in Europe

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

    Patt, A.

    Over the last twenty years, policy-makers in Europe have attempted to solve the problem of acid rain using detailed analysis grounded in natural science and economics. The results are impressive, as Europeans have successfully implemented a number of international agreements to reduce pollution emissions, agreements that in theory achieve the greatest environmental benefit at the lowest aggregate cost across Europe. This article examines the analysis on which these policies were based. First, it finds a pattern of investigating the use of cost-benefit analysis, together with a lack of usefulness associated with the actual results of such analysis. Second, it findsmore » that the analytic framework that came to replace cost-benefit analysis--critical loads--contained many of the same uncertainties and political decisions that plagued cost-benefit analysis. Nevertheless, critical loads analysis was seen as less value-laden and more reliable, and contributed significantly to policy development. Desire for rapid action led policy-makers to ignore or overlook the politics and uncertainties inherent in efforts at scientific assessment and modeling.« less

  15. Cost-Benefit Analysis of a Support Program for Nursing Staff.

    PubMed

    Moran, Dane; Wu, Albert W; Connors, Cheryl; Chappidi, Meera R; Sreedhara, Sushama K; Selter, Jessica H; Padula, William V

    2017-04-27

    A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit. A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital. Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program. The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

  16. Optimizing Economic Indicators in the Case of Using Two Types of State-Subsidized Chemical Fertilizers for Agricultural Production

    NASA Astrophysics Data System (ADS)

    Boldea, M.; Sala, F.

    2010-09-01

    We admit that the mathematical relation between agricultural production f(x, y) and the two types of fertilizers x and y is given by function (1). The coefficients that appear are determined by using the least squares method by comparison with the experimental data. We took into consideration the following economic indicators: absolute benefit, relative benefit, profitableness and cost price. These are maximized or minimized, thus obtaining the optimal solutions by annulling the partial derivatives.

  17. Shifting the bell curve: the benefits and costs of raising student achievement.

    PubMed

    Yeh, Stuart S

    2009-02-01

    Benefit-cost analysis was conducted to estimate the increase in earnings, increased tax revenues, value of less crime, and reductions in welfare costs attributable to nationwide implementation of rapid assessment, a promising intervention for raising student achievement in math and reading. Results suggest that social benefits would exceed total social costs by a ratio of 28. Fiscal benefits to the federal government would exceed costs to the federal treasury by a ratio of 93. Social benefits would exceed costs to each state treasury by a ratio no lower than 286, and fiscal benefits would exceed costs to each state treasury by a ratio no lower than 5, for all but two state treasuries. Sensitivity analyses suggest that the findings are robust to a 5-fold change in the underlying parameters.

  18. A cost-benefit analysis of a deposit-refund program for beverage containers in Israel.

    PubMed

    Lavee, Doron

    2010-02-01

    The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program--storage, collection, and treatment costs of empty containers, and all potential benefits--savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearly economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.

  19. [Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

    PubMed

    Machado, Flávia Mori Sarti; Simões, Arlete Naresse

    2008-02-01

    To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

  20. Analysis of cost and assessment of computerized patient record systems in Japan based on questionnaire survey.

    PubMed

    Zhang, W P; Yamauchi, K; Mizuno, S; Zhang, R; Huang, D M

    2004-01-01

    The purpose of this study was to clarify the implementation and maintenance costs of a computerized patient record (CPR) system by means of a questionnaire survey. Moreover, the benefits of CPR systems were evaluated to determine their contribution to enhancing the quality of medical care and hospital management. Data were collected by a questionnaire survey mailed out to participants. The per-bed mean cost for implementation was 14,308 dollars (range: 3538-38,077 dollars). The mean annual maintenance cost for the CPR system was 457,615 dollars (range: 39,769-2,307,692 dollars). The multivariate analysis (Hayashi's Quantification Type I) revealed high partial correlation coefficients between implementation cost and the CPR system maker. In addition, the multiple correlation coefficient for four factors (CPR system maker, number of servers, institution type and implementation date) in predicting implementation cost was 0.798. Over 60% of respondents replied that their satisfaction with the CPR system was 'very high' or 'high.' Eighty-two percent of the hospitals responded positively that CPR systems improve the quality of medical care, and 70% felt that the systems help prevent medical errors. Our findings indicate that the maker of CPR system, number of servers, institution type and implementation date had a strong influence on per-bed implementation costs in that order. Finally, it was found that CPR systems were considered effective for hospital administration and medical examinations, based on the high assessments of the results of installing a CPR system.

  1. Cost-benefit analysis of a preventive intervention for divorced families: reduction in mental health and justice system service use costs 15 years later.

    PubMed

    Herman, Patricia M; Mahrer, Nicole E; Wolchik, Sharlene A; Porter, Michele M; Jones, Sarah; Sandler, Irwin N

    2015-05-01

    This cost-benefit analysis compared the costs of implementing the New Beginnings Program (NBP), a preventive intervention for divorced families to monetary benefits saved in mental healthcare service use and criminal justice system costs. NBP was delivered when the offspring were 9-12 years old. Benefits were assessed 15 years later when the offspring were young adults (ages 24-27). This study estimated the costs of delivering two versions of NBP, a single-component parenting-after-divorce program (Mother Program, MP) and a two-component parenting-after-divorce and child-coping program (Mother-Plus-Child Program, MPCP), to costs of a literature control (LC). Long-term monetary benefits were determined from actual expenditures from past-year mental healthcare service use for mothers and their young adult (YA) offspring and criminal justice system involvement for YAs. Data were gathered from 202 YAs and 194 mothers (75.4 % of families randomly assigned to condition). The benefits, as assessed in the 15th year after program completion, were $1630/family (discounted benefits $1077/family). These 1-year benefits, based on conservative assumptions, more than paid for the cost of MP and covered the majority of the cost of MPCP. Because the effects of MP versus MPCP on mental health and substance use problems have not been significantly different at short-term or long-term follow-up assessments, program managers would likely choose the lower-cost option. Given that this evaluation only calculated economic benefit at year 15 and not the previous 14 (nor future years), these findings suggest that, from a societal perspective, NBP more than pays for itself in future benefits.

  2. Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: Non-Government versus Government Supported Funding Models.

    PubMed

    Akiyama, Miki; Abraham, Chon

    2017-08-01

    Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non-labor) per user per year. The benefit of tele-homecare was measured by annual willingness to pay (WTP) for tele-homecare by a user and medical expenditures avoided. Both costs and benefits were inflated using the relevant Japanese consumer price index (CPI) and converted into 2015 US dollars with purchasing power parity (PPP) adjusted. Base case net benefits of Model 1 and Model 2 were $417.00 and $97.30, respectively. Base case BCR of Model 1 tele-homecare was 1.63, while Model 2 was 1.03. The probabilistic analysis estimated mean (95%CI) for BCRs of Model 1 and Model 2 was 1.84 (1.89, 1.88) and 1.46 (1.43, 1.49), respectively. Sensitivity analysis showed robustness of Model 1 in 7 parameters but Model 2 was sensitive in all key parameters such as initial system cost, device cost, number of users, and medical expenditure saved. Break-even analysis showed that the system cost of Model 2 had to be under $187,500. Our results for each model collectively showed that tele-homecare in Japan is cost-saving to some extent. However, the government-funded model (i.e., Model 2), which typically requires use of all startup funding to be spent within the first year on system costs, was inferior to the monthly fee model (i.e., Model 1) that did not use the government funding for installation or continued operations, but rather incorporated a monthly fee from users to support the receipt of services via tele-homecare. While the benefits of Model 1 outweighed the benefits of Model 2, the government-subsidized method employed in Model 2 could be more beneficial in general if some explicit prequalifying estimated metrics are instituted prior to funding. Thus, governments need to require applicants requesting funding to note, at a minimum, (a) estimated costs, (b) the expected number of tele-homecare users, and expected benefits such as (c) WTP by the user, or (d) medical expenditure saved by tele-homecare as a means of financing some of the operational costs. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Immunization against Haemophilus Influenzae Type b in Iran; Cost-utility and Cost-benefit Analyses

    PubMed Central

    Moradi-Lakeh, Maziar; Shakerian, Sareh; Esteghamati, Abdoulreza

    2012-01-01

    Background: Haemophilus Influenzae type b (Hib) is an important cause of morbidity and mortality in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to assess the cost-benefit and cost-utility of running an Hib vaccination program in Iran. Methods: Based on a previous systematic review and meta-analysis for vaccine efficacy, we estimated the averted DALYs (Disability adjusted life years) and cost-benefit of vaccination. Different acute invasive forms of Hib infection and the permanent sequels were considered for estimating the attributed DALYs. We used a societal perspective for economic evaluation and included both direct and indirect costs of alternative options about vaccination. An annual discount rate of 3% and standard age-weighting were used for estimation. To assess the robustness of the results, a sensitivity analysis was performed. Results: The incidence of Hib infection was estimated 43.0 per 100000, which can be reduced to 6.7 by vaccination. Total costs of vaccination were estimated at US$ 15,538,129. Routine vaccination of the 2008 birth cohort would prevent 4079 DALYs at a cost per averted-DALY of US$ 4535. If we consider parents’ loss of income and future productivity loss of children, it would save US$ 8,991,141, with a benefit-cost ratio of 2.14 in the base-case analysis. Sensitivity analysis showed a range of 0.78 to 3.14 for benefit-to-cost ratios. Conclusion: Considering costs per averted DALY, vaccination against Hib is a cost-effective health intervention in Iran, and allocating resources for routine vaccination against Hib seems logical. PMID:22708030

  4. A framework for a cost benefit analysis of the Fairfax County, Virginia Alcohol Safety Action Project.

    DOT National Transportation Integrated Search

    1973-01-01

    Cost-benefit analysis is sometimes a useful tool for evaluating the advantages and disadvantages of alternative courses of action. The first half of this study was an attempt to further the use of such analysis in the evaluation of a highway safety p...

  5. Naval Surface Forces Real-Time Reutilization Asset Management Warehouses: A Cost-Benefit Analysis

    DTIC Science & Technology

    2008-12-01

    shared their valuable insights. And finally, to our advisors Dr . Ken Euske and CDR Brett Wagner who kept us on track throughout the project. Nick could...of $206,368,657. SURFOR’s East and West Coast warehouses accounted for $146,975,108 of the list value. The team identified potential cost...obligating the funds. A relatively simple cost benefit analysis of the reprogramming costs versus the cost savings would justify the expense. In the

  6. Business Case Analysis of the Marine Corps Base Pendleton Virtual Smart Grid

    DTIC Science & Technology

    2017-06-01

    Metering Infrastructure on DOD installations. An examination of five case studies highlights the costs and benefits of the Virtual Smart Grid (VSG...studies highlights the costs and benefits of the Virtual Smart Grid (VSG) developed by Space and Naval Warfare Systems Command for use at Marine Corps...41 A. SMART GRID BENEFITS .....................................................................41 B. SUMMARY OF VSG ESTIMATED COSTS AND BENEFITS

  7. The High/Scope Perry Preschool Program: Cost-Benefit Analysis Using Data from the Age-40 Followup

    ERIC Educational Resources Information Center

    Belfield, Clive R.; Nores, Milagros; Barnett, Steve; Schweinhart, Lawrence

    2006-01-01

    This paper presents an updated cost-benefit analysis of the High/Scope Perry preschool Program, using data on individuals aged 40. Children were randomly assigned to a treatment or control group. Program costs are compared against treatment impacts on educational resources, earnings, criminal activity, and welfare receipt. Net present values are…

  8. Potential impacts of the Alberta fetal alcohol spectrum disorder service networks on secondary disabilities: a cost-benefit analysis.

    PubMed

    Thanh, Nguyen Xuan; Moffatt, Jessica; Jacobs, Philip; Chuck, Anderson W; Jonsson, Egon

    2013-01-01

    To estimate the break-even effectiveness of the Alberta Fetal Alcohol Spectrum Disorder (FASD) Service Networks in reducing occurrences of secondary disabilities associated with FASD. The secondary disabilities addressed within this study include crime, homelessness, mental health problems, and school disruption (for children) or unemployment (for adults). We used a cost-benefit analysis approach where benefits of the service networks were the cost difference between the two approaches: having the 12 service networks and having no service network in place, across Alberta. We used a threshold analysis to estimate the break-even effectiveness (i.e. the effectiveness level at which the service networks became cost-saving). If no network was in place throughout the province, the secondary disabilities would cost $22.85 million (including $8.62 million for adults and $14.24 million for children) per year. Given the cost of network was $6.12 million per year, the break-even effectiveness was estimated at 28% (range: 25% to 32%). Although not all benefits associated with the service networks are included, such as the exclusion of the primary benefit to those experiencing FASD, the benefits to FASD caregivers, and the preventative benefits, the economic and social burden associated with secondary disabilities will "pay-off" if the effectiveness of the program in reducing secondary disabilities is 28%.

  9. 14 CFR 161.205 - Required analysis of proposed restriction and alternatives.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of the anticipated or actual costs and benefits of the proposed noise or access restriction; (2) A... not involve aircraft restrictions, and a comparison of the costs and benefits of such alternative measures to costs and benefits of the proposed noise or access restriction. (b) In preparing the analyses...

  10. Shifting the Bell Curve: The Benefits and Costs of Raising Student Achievement

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2009-01-01

    Benefit-cost analysis was conducted to estimate the increase in earnings, increased tax revenues, value of less crime, and reductions in welfare costs attributable to nationwide implementation of rapid assessment, a promising intervention for raising student achievement in math and reading. Results suggest that social benefits would exceed total…

  11. Cost benefit analysis of remediation alternatives for controlling the flux of strontium-90 into the Columbia River

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

    Gustafson, F.W.; Todd, M.E.

    1993-09-01

    The release of large volumes of water to waste disposal cribs at the Hanford Site`s 100-N Area caused contaminants, principally strontium-90, to be carried toward the Columbia River through the groundwater. Since shutdown of the N Reactor, these releases have been discontinued, although small water flows continue to be discharged to the 1325-N crib. Most of the contamination which is now transported to the river is occurring as a result of the natural groundwater movement. The contaminated groundwater at N Springs flows into the river through seeps and springs along the river`s edge. An expedited response action (ERA) has beenmore » proposed to eliminate or restrict the flux of strontium-90 into the river. A cost benefit analysis of potential remedial alternatives was completed that recommends the alternative which best meets given selection criteria prescribed by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). The methodology used for evaluation, cost analysis, and alternative recommendation is the engineering evaluation/cost analysis (EE/CA). Complete remediation of the contaminated groundwater beneath 100-N Area was not a principal objective of the analysis. The objective of the cost benefit analysis was to identify a remedial alternative that optimizes the degree of benefit produced for the costs incurred.« less

  12. Minnesota urban partnership agreement national evaluation : cost benefit analysis test plan.

    DOT National Transportation Integrated Search

    2009-11-17

    This report presents the cost benefit analysis test plan for the Minnesota Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The Minnesota UPA projects focus on reducing congestion by emplo...

  13. Preliminary Limited Surveillance Radar (LSR) Cost/Benefit Analysis

    DOT National Transportation Integrated Search

    1977-10-01

    This report presents the findings of a cost/benefit analysis of the deployment of a new Limited Surveillance Radar (LSR). An LSR is an inexpensive, single channel, short-range (about 20 miles), primary radar for use at approach control facilities whi...

  14. EPA's Use of Benefit-Cost Analysis: 1981-1986 (1987)

    EPA Pesticide Factsheets

    This report describes the contributions that benefit-cost analysis has made to EPA's regulatory process, the various statutory provisions that affect EPA's use of these analyses in regulatory decision making, and how EPA is working to improve its analyses.

  15. Outline of cost-benefit analysis and a case study

    NASA Technical Reports Server (NTRS)

    Kellizy, A.

    1978-01-01

    The methodology of cost-benefit analysis is reviewed and a case study involving solar cell technology is presented. Emphasis is placed on simplifying the technique in order to permit a technical person not trained in economics to undertake a cost-benefit study comparing alternative approaches to a given problem. The role of economic analysis in management decision making is discussed. In simplifying the methodology it was necessary to restrict the scope and applicability of this report. Additional considerations and constraints are outlined. Examples are worked out to demonstrate the principles. A computer program which performs the computational aspects appears in the appendix.

  16. Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study

    PubMed Central

    2010-01-01

    Background Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Methods Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Results Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. Conclusions This is the first follow up study of the newly adopted partial sickness benefit in Finland. The results show that compared to full sick leave, partial sick leave - when not followed by lasting return to work - is more typically followed by partial disability pension and less frequently by full disability pension. It is anticipated that the use of partial benefits in connection with part-time participation in work life will have favourable effects on future disability pension rates in Finland. PMID:20573207

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

    PubMed

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

    2015-04-01

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

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

    PubMed Central

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

    2015-01-01

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

  19. Economic and Social Impact of Increasing Uptake of Cardiac Rehabilitation Services--A Cost Benefit Analysis.

    PubMed

    De Gruyter, Elaine; Ford, Greg; Stavreski, Bill

    2016-02-01

    Cardiac rehabilitation can reduce mortality, improve cardiac risk factor profile and reduce readmissions; yet uptake remains low at 30%. This research aims to investigate the social and economic impact of increasing the uptake of cardiac rehabilitation in Victoria, Australia using cost benefit analysis (CBA). Cost benefit analysis has been undertaken over a 10-year period to analyse three scenarios: (1) Base Case: 30% uptake; (2) Scenario 1: 50% uptake; and (3) Scenario 2: 65% uptake. Impacts considered include cardiac rehabilitation program costs, direct inpatient costs, other healthcare costs, burden of disease, productivity losses, informal care costs and net deadweight loss. There is a net financial saving of $46.7-$86.7 million under the scenarios. Compared to the Base Case, an additional net benefit of $138.9-$227.2 million is expected. This results in a Benefit Cost Ratio of 5.6 and 6.8 for Scenarios 1 and 2 respectively. Disability Adjusted Life Years were 21,117-37,565 years lower than the Base Case. Greater uptake of cardiac rehabilitation can reduce the burden of disease, directly translating to benefits for society and the economy. This research supports the need for greater promotion, routine referral to be made standard practice and implementation of reforms to boost uptake. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  20. [Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

    PubMed

    Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

    2009-08-01

    To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated control strategy focusing on infection source control brings about triplex benefits in schistosomiasis control, social development (and ecological protection) and economic efficacy, and shows better effects and benefits than the conventional control strategy.

  1. Educating Foreign Students in the U.S.A.: A Cost Benefit Analysis.

    ERIC Educational Resources Information Center

    Mehrabi, Shah M.

    The economic costs and benefits of educating foreign students in U.S. public and private colleges are estimated. U.S. costs of educating foreign students consist primarily of: (1) direct educational costs, (2) cost of the foreign students who receive their maintenance allowance from U.S. sources, (3) travel costs of those foreign students whose…

  2. Army Enlisted Personnel Competency Assessment Program: Phase 2 Report

    DTIC Science & Technology

    2006-01-01

    benefit analysis of a notional Army program will be conducted. v Findings: The prototype Army core assessment was successfully administered to over 600...about competency assessment. They will also be incorporated into a cost and benefit analysis to be conducted in Phase III. vi CONTENTS Page Chapter 1...Conduct a Cost- Benefit Analysis, and Make System Recommendations Phase I of PerformM21 resulted in program design recommendations that included such

  3. COST-RISK-BENEFIT ANALYSIS IN DIAGNOSTIC RADIOLOGY: A THEORETICAL AND ECONOMIC BASIS FOR RADIATION PROTECTION OF THE PATIENT.

    PubMed

    Moores, B Michael

    2016-06-01

    In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost-benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: [Formula: see text] This article presents a theoretical cost-risk-benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. © The Author 2015. Published by Oxford University Press.

  4. An effectiveness and cost-benefit analysis of a hospital-based discharge transition program for elderly Medicare recipients.

    PubMed

    Saleh, Shadi S; Freire, Chris; Morris-Dickinson, Gwendolyn; Shannon, Trip

    2012-06-01

    To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis. Randomized controlled trial. A general hospital in upstate New York State. Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months. The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow. Cost-benefit ratio of the PDCT program; self-management skills and abilities. The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities. Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  5. Relative importance of attributes of drug benefit plans: Thai civil servants' perspective.

    PubMed

    Ngorsuraches, Surachat; Wanishayakorn, Tanatape; Tanvejsilp, Pimwara; Udomaksorn, Siripa

    2013-01-01

    The drug benefit plan of Thailand's Civil Servant Medical Benefit Scheme (CSMBS) must be amended to control increasing costs; to that end, it is important to gather the views of beneficiaries before making changes to the benefit plan. To examine the relative importance of attributes of drug benefit plans from the perspective of CSMBS beneficiaries. Attributes and levels adopted from focus group discussions and a preliminary survey were used to develop a questionnaire concerning hypothetical drug benefit plans. A convenience sample of 650 CSMBS beneficiaries in Songkhla province was asked to rate the drug benefit plans. To determine the beneficiaries' decision models, judgment analysis was used. Policy-capturing analysis was used to examine the beneficiaries' preferences, and cluster analysis was conducted to explore the variability among judgment plans. Judgment policy insight was also examined. The results of the study showed that the beneficiaries weighed on cost-sharing as their most important attribute. The results remained unchanged, although only data from the beneficiaries who used the compensatory model were analyzed. The results of the cluster analysis showed that the largest cluster of beneficiaries weighed mostly on the cost-sharing attribute. The judgment policy insight results not only supported the finding that most beneficiaries focused on the cost-sharing attribute but also revealed that they might have the least understanding of how the formulary attribute affected beneficiaries' decision making. Cost-sharing was the most important attribute for the CSMBS beneficiaries. This study indicated that a possible preferred drug benefit plan should have no cost-sharing, permit access only to drugs listed in a closed formulary, allow beneficiaries to obtain 3 months of drugs, and allow them to obtain drugs from either a community pharmacy or a government hospital. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Cost-benefit analysis - noise barriers and quieter pavements

    DOT National Transportation Integrated Search

    2014-01-01

    This report presents the results of one TQA Follow-up event, a workshop titled Cost Benefit Analysis Noise Barriers and Quieter Pavements, which was organized by the DOT Volpe Center and hosted by the NAE at the National Academies Keck Center, Wa...

  7. 48 CFR 3046.792 - Cost benefit analysis (USCG).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost benefit analysis (USCG). 3046.792 Section 3046.792 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY ACQUISITION REGULATION (HSAR) CONTRACT MANAGEMENT QUALITY ASSURANCE Warranties 3046.792...

  8. 20 CFR 435.45 - Cost and price analysis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Cost and price analysis. 435.45 Section 435.45 Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND...

  9. Educational Cost-Benefit Analysis.

    ERIC Educational Resources Information Center

    Hough, J. R.

    1994-01-01

    Educational cost-benefit analysis, as practiced in both industrialized and developing nations, has been much criticized. Manpower planning, the principal alternative, has received even harsher criticism. The two approaches should be combined in empirically based projects that study recent graduates and chart their subsequent employment progress.…

  10. Cost-benefit analysis for sheltered employment service programs for people with disabilities in Taiwan - a preliminary study.

    PubMed

    Wang, Yun-Tung; Lin, Yi-Jiun; Shu, Ching-Hsien

    2012-01-01

    The aim of this study is to do a cost-benefit analysis with monetary and non-monetary benefits for sheltered employment service programs and try to provide more evidence-based information for policy makers and practitioners to understand the outcomes of sheltered employment services. This study analyzed 3 sheltered employment service programs for people with disabilities (2006-2007) implemented by Sunshine Social Welfare Foundation in Taiwan using cost-benefit analysis (including non-monetary benefits). Three groups were analyzed, including participants in the programs, taxpayers, and society (participants and taxpayers). This study found that the net social monetary benefit was $NT29,432.07 per participant per year and the benefit cost ratio was 1.43. (In 2006-2007, $US1 = $NT32.5 averagely around.) The net monetary benefit for the participants was between $NT7,890.86 and $NT91,890.86 per participant per year. On the non-monetary benefit side, the physical health (raised 7.49%), social relationship (raised 3.36%) domains, and general quality of life (raised 2.53%) improved. However, the psychological (decreased 1.51%) and working/environment (decreased 3.85%) domains backslided. In addition, the differences between pre-test and post-test average scores of all domains were not statistically significant. This study is the first to use monetary and non-monetary cost-benefit analysis methods to analyze sheltered employment service programs for people with disabilities in Taiwan. The findings indicated that sheltered employment service programs for people with disabilities could be efficient and beneficial for the whole society and sheltered employees/clients, and also helpful for raising their quality of lives.

  11. Revising a priority list based on cost-effectiveness: the role of the prominence effect and distorted utility judgments.

    PubMed

    Baron, J; Ubel, P A

    2001-01-01

    People sometimes object to the results of cost-effectiveness analysis when the analysis produces a ranking of options based on both cost and benefit. We suggest 2 new reasons for these objections: the prominence effect, in which people attend mostly to a more prominent attrbute (benefit as opposed to cost), and distortion of utility judgments. We simulated the production of a cost-effectiveness ranking list in 3 experiments using questionnaires on the World Wide Web. Subjects rated the utility of 16 health benefits using either rating scale or person trade-off elicitation methods. In some experiments, subjects were asked to rate the utility of the health benefits with attention also to the cost of achieving the benefits. In all experiments, at the end, subjects were shown a priority list based on their own utility judgments and were asked whether they wanted to move any of the health benefits up or down the list. In all experiments, subjects wanted to give higher priority to treatments with higher benefit, even when they also had higher cost. They thus wanted to give less weight to high cost (which would, by itself, lead to lower ranking) and more weight to benefit than the weight implied by their own prior judgments. The desire for revision was reduced when subjects made their utility judgments after indicating whether the utility was above or below the midpoint of the scale (a manipulation previously found to reduce distortion). The desire to change cost-effectiveness rankings is in part a preference reversal phenomenon that occurs because people attend mainly to the benefit of health interventions as opposed to cost, when they examine the ranking. People should be wary of tinkering with priority lists by examining the lists themselves.

  12. Axiomatic foundations for cost-effectiveness analysis.

    PubMed

    Canning, David

    2013-12-01

    We show that individual utilities can be measured in units of healthy life years. Social preferences over these life metric utilities are assumed to satisfy the Pareto principle, anonymity, and invariance to a change in origin. These axioms generate a utilitarian social welfare function implying the use of cost-effectiveness analysis in ordering health projects, based on maximizing the healthy years equivalents gained from a fixed health budget. For projects outside the health sector, our cost-effectiveness axioms imply a form of cost-benefit analysis where both costs and benefits are measured in equivalent healthy life years. Copyright © 2013 John Wiley & Sons, Ltd.

  13. Benefit-cost analysis of fishery rehabilitation projects: A Great Lakes case study. Spec. issue: Responses to marine resource change/social sciences perspective

    USGS Publications Warehouse

    Bishop, R.C.; Milliman, S.R.; Boyle, K.J.; Johnson, B.L.

    1990-01-01

    Tools of benefit-cost analysis are used to evaluate a project to rehabilitate the yellow perch (Perca flavescens ) fishery of Green Bay, Wisconsin. Both sport and commercial fishers harvest from this stock, which has been suffering from much reduced productivity since the early 1960s. The project is composed of commercial quotas and other regulations. Measures of benefits and costs were used that explicitly incorporate uncertainly about the potential level of success of the project. The analysis shows that commercial fish producers will more or less break even compared to where they would have been without the project, but that substantial recreational benefits can be expected.

  14. A cost-benefit analysis for materials management information systems.

    PubMed

    Slapak-Iacobelli, L; Wilde, A H

    1993-02-01

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

  15. Partial budget of the discounted annual benefit of mastitis control strategies.

    PubMed

    Allore, H G; Erb, H N

    1998-08-01

    The objective of this study was to rank the benefits associated with various mastitis control strategies in simulated herds with intramammary infections caused by Streptococcus agalactiae, Streptococcus spp. other than Strep. agalactiae, Staphylococcus aureus, coagulase-negative staphylococci, and Escherichia coli. The control strategies tested were prevention, vaccination for E. coli, lactation therapy, and dry cow antibiotic therapy. Partial budgets were based on changes caused by mastitis control strategies from the mean values for milk, fat, and protein yields of the control herd and the number of cows that were culled under a fixed mastitis culling criterion. Each annual benefit (dollars per cow per year) of a mastitis control strategy was compared with the revenue for the control herd and was calculated under two different milk pricing plans (3.5% milk fat and multiple-component pricing), three net replacement costs, and three prevalences of pathogen-specific intramammary infection. Twenty replicates of each control strategy were run with SIMMAST (a dynamic discrete event stochastic simulation model) for 5 simulated yr. Rankings of discounted annual benefits differed only slightly according to milk pricing plans within a pathogen group but differed among the pathogen groups. Differences in net replacement costs for cows culled because of mastitis did not change the ranking of control strategies within a pathogen group. Both prevention and dry cow therapy were important mastitis control strategies. For herds primarily infected with environmental pathogens, strategies that included vaccination for mastitis caused by E. coli dominated strategies that did not include vaccination against this microorganism.

  16. The principles of quality-associated costing: derivation from clinical transfusion practice.

    PubMed

    Trenchard, P M; Dixon, R

    1997-01-01

    As clinical transfusion practice works towards achieving cost-effectiveness, prescribers of blood and its derivatives must be certain that the prices of such products are based on real manufacturing costs and not market forces. Using clinical cost-benefit analysis as the context for the costing and pricing of blood products, this article identifies the following two principles: (1) the product price must equal the product cost (the "price = cost" rule) and (2) the product cost must equal the real cost of product manufacture. In addition, the article describes a new method of blood product costing, quality-associated costing (QAC), that will enable valid cost-benefit analysis of blood products.

  17. Reduction of Direct Health Costs Associated with Pertussis Vaccination with Acellular Vaccines in Children Aged 0-9 Years with Pertussis in Catalonia (Spain).

    PubMed

    Plans-Rubió, Pedro; Navas, Encarna; Godoy, Pere; Carmona, Gloria; Domínguez, Angela; Jané, Mireia; Muñoz-Almagro, Carmen; Brotons, Pedro

    2018-05-14

    The aim of this study was to assess direct health costs in children with pertussis aged 0-9 years who were vaccinated, partially vaccinated, and unvaccinated during childhood, and to assess the association between pertussis costs and pertussis vaccination in Catalonia (Spain) in 2012-2013. Direct healthcare costs included pertussis treatment, pertussis detection, and preventive chemotherapy of contacts. Pertussis patients were considered vaccinated when they had received 4-5 doses, and unvaccinated or partially vaccinated when they had received 0-3 doses of vaccine. The Chi square test and the odds ratios were used to compare percentages and the t test was used to compare mean pertussis costs in different groups, considering a p < 0.05 as statistically significant. The correlation between pertussis costs and study variables was assessed using the Spearman's ρ, with a p < 0.05 as statistically significant. Multiple linear regression analysis (IBM-SPSS program) was used to quantify the association of pertussis vaccination and other study variables with pertussis costs. Vaccinated children with pertussis aged 0-9 years had significantly lower odds ratios of hospitalizations (OR 0.02, p < 0.001), laboratory confirmation (OR 0.21, p < 0.001), and severe disease (OR 0.02, p < 0.001) than unvaccinated or partially vaccinated children with pertussis of the same age. Mean direct healthcare costs were significantly lower (p < 0.001) in vaccinated patients (€190.6) than in unvaccinated patients (€3550.8), partially vaccinated patients (€1116.9), and unvaccinated/partially vaccinated patients (€2330). Multivariable linear regression analysis showed that pertussis vaccination with 4-5 doses was associated with a non-significant reduction of pertussis costs of €107.9 per case after taking into account the effect of other study variables, and €200 per case after taking into account pertussis severity. Direct healthcare costs were lower in children with pertussis aged 0-9 years vaccinated with 4-5 doses of acellular vaccines than in unvaccinated or partially vaccinated children with pertussis of the same age.

  18. A cost-benefit analysis of three older adult fall prevention interventions.

    PubMed

    Carande-Kulis, Vilma; Stevens, Judy A; Florence, Curtis S; Beattie, Bonita L; Arias, Ileana

    2015-02-01

    One out of three persons aged 65 and older falls annually and 20% to 30% of falls result in injury. The purpose of this cost-benefit analysis was to identify community-based fall interventions that were feasible, effective, and provided a positive return on investment (ROI). A third-party payer perspective was used to determine the costs and benefits of three effective fall interventions. Intervention effectiveness was based on randomized controlled trial results. National data were used to estimate the average annual benefits from averting the direct medical costs of a fall. The net benefit and ROI were estimated for each of the interventions. For the Otago Exercise Program delivered to persons aged 65 and older, the net benefit was $121.85 per participant and the ROI was 36% for each dollar invested. For Otago delivered to persons aged 80 and older, the net benefit was $429.18 and the ROI was 127%. Tai chi: Moving for Better Balance had a net benefit of $529.86 and an ROI of 509% and Stepping On had a net benefit of $134.37 and an ROI of 64%. All three fall interventions provided positive net benefits. The ROIs showed that the benefits not only covered the implementation costs but also exceeded the expected direct program delivery costs. These results can help health care funders and other community organizations select appropriate and effective fall interventions that also can provide positive returns on investment. Published by Elsevier Ltd.

  19. A Simple Method for Causal Analysis of Return on IT Investment

    PubMed Central

    Alemi, Farrokh; Zargoush, Manaf; Oakes, James L.; Edrees, Hanan

    2011-01-01

    This paper proposes a method for examining the causal relationship among investment in information technology (IT) and the organization's productivity. In this method, first a strong relationship among (1) investment in IT, (2) use of IT and (3) organization's productivity is verified using correlations. Second, the assumption that IT investment preceded improved productivity is tested using partial correlation. Finally, the assumption of what may have happened in the absence of IT investment, the so called counterfactual, is tested through forecasting productivity at different levels of investment. The paper applies the proposed method to investment in the Veterans Health Information Systems and Technology Architecture (VISTA) system. Result show that the causal analysis can be done, even with limited data. Furthermore, because the procedure relies on overall organization's productivity, it might be more objective than when the analyst picks and chooses which costs and benefits should be included in the analysis. PMID:23019515

  20. Integrated corridor management initiative : demonstration phase evaluation – San Diego benefit-cost analysis test plan.

    DOT National Transportation Integrated Search

    2012-08-01

    This report presents the test plan for conducting the Benefit-Cost Analysis (BCA) for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM project...

  1. Where's the evidence? a systematic review of economic analyses of residential aged care infrastructure.

    PubMed

    Easton, Tiffany; Milte, Rachel; Crotty, Maria; Ratcliffe, Julie

    2017-03-21

    Residential care infrastructure, in terms of the characteristics of the organisation (such as proprietary status, size, and location) and the physical environment, have been found to directly influence resident outcomes. This review aimed to summarise the existing literature of economic evaluations of residential care infrastructure. A systematic review of English language articles using AgeLine, CINAHL, Econlit, Informit (databases in Health; Business and Law; Social Sciences), Medline, ProQuest, Scopus, and Web of Science with retrieval up to 14 December 2015. The search strategy combined terms relating to nursing homes, economics, and older people. Full economic evaluations, partial economic evaluations, and randomised trials reporting more limited economic information, such as estimates of resource use or costs of interventions were included. Data was extracted using predefined data fields and synthesized in a narrative summary to address the stated review objective. Fourteen studies containing an economic component were identified. None of the identified studies attempted to systematically link costs and outcomes in the form of a cost-benefit, cost-effectiveness, or cost-utility analysis. There was a wide variation in approaches taken for valuing the outcomes associated with differential residential care infrastructures: 8 studies utilized various clinical outcomes as proxies for the quality of care provided, and 2 focused on resident outcomes including agitation, quality of life, and the quality of care interactions. Only 2 studies included residents living with dementia. Robust economic evidence is needed to inform aged care facility design. Future research should focus on identifying appropriate and meaningful outcome measures that can be used at a service planning level, as well as the broader health benefits and cost-saving potential of different organisational and environmental characteristics in residential care. International Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42015015977 .

  2. Evidence-based economic analysis demonstrates that ecosystem service benefits of water hyacinth management greatly exceed research and control costs

    PubMed Central

    Harms, Nathan E.; Magen, Cedric; Liang, Dong; Nesslage, Genevieve M.; McMurray, Anna M.; Cofrancesco, Al F.

    2018-01-01

    Invasive species management can be a victim of its own success when decades of effective control cause memories of past harm to fade and raise questions of whether programs should continue. Economic analysis can be used to assess the efficiency of investing in invasive species control by comparing ecosystem service benefits to program costs, but only if appropriate data exist. We used a case study of water hyacinth (Eichhornia crassipes (Mart.) Solms), a nuisance floating aquatic plant, in Louisiana to demonstrate how comprehensive record-keeping supports economic analysis. Using long-term data sets, we developed empirical and spatio-temporal simulation models of intermediate complexity to project invasive species growth for control and no-control scenarios. For Louisiana, we estimated that peak plant cover would be 76% higher without the substantial growth rate suppression (84% reduction) that appeared due primarily to biological control agents. Our economic analysis revealed that combined biological and herbicide control programs, monitored over an unusually long time period (1975–2013), generated a benefit-cost ratio of about 34:1 derived from the relatively modest costs of $124 million ($2013) compared to the $4.2 billion ($2013) in benefits to anglers, waterfowl hunters, boating-dependent businesses, and water treatment facilities over the 38-year analysis period. This work adds to the literature by: (1) providing evidence of the effectiveness of water hyacinth biological control; (2) demonstrating use of parsimonious spatio-temporal models to estimate benefits of invasive species control; and (3) incorporating activity substitution into economic benefit transfer to avoid overstating benefits. Our study suggests that robust and cost-effective economic analysis is enabled by good record keeping and generalizable models that can demonstrate management effectiveness and promote social efficiency of invasive species control. PMID:29844976

  3. Evidence-based economic analysis demonstrates that ecosystem service benefits of water hyacinth management greatly exceed research and control costs.

    PubMed

    Wainger, Lisa A; Harms, Nathan E; Magen, Cedric; Liang, Dong; Nesslage, Genevieve M; McMurray, Anna M; Cofrancesco, Al F

    2018-01-01

    Invasive species management can be a victim of its own success when decades of effective control cause memories of past harm to fade and raise questions of whether programs should continue. Economic analysis can be used to assess the efficiency of investing in invasive species control by comparing ecosystem service benefits to program costs, but only if appropriate data exist. We used a case study of water hyacinth ( Eichhornia crassipes (Mart.) Solms), a nuisance floating aquatic plant, in Louisiana to demonstrate how comprehensive record-keeping supports economic analysis. Using long-term data sets, we developed empirical and spatio-temporal simulation models of intermediate complexity to project invasive species growth for control and no-control scenarios. For Louisiana, we estimated that peak plant cover would be 76% higher without the substantial growth rate suppression (84% reduction) that appeared due primarily to biological control agents. Our economic analysis revealed that combined biological and herbicide control programs, monitored over an unusually long time period (1975-2013), generated a benefit-cost ratio of about 34:1 derived from the relatively modest costs of $124 million ($2013) compared to the $4.2 billion ($2013) in benefits to anglers, waterfowl hunters, boating-dependent businesses, and water treatment facilities over the 38-year analysis period. This work adds to the literature by: (1) providing evidence of the effectiveness of water hyacinth biological control; (2) demonstrating use of parsimonious spatio-temporal models to estimate benefits of invasive species control; and (3) incorporating activity substitution into economic benefit transfer to avoid overstating benefits. Our study suggests that robust and cost-effective economic analysis is enabled by good record keeping and generalizable models that can demonstrate management effectiveness and promote social efficiency of invasive species control.

  4. Reassessing the human health benefits from cleaner air.

    PubMed

    Cox, Louis Anthony

    2012-05-01

    Recent proposals to further reduce permitted levels of air pollution emissions are supported by high projected values of resulting public health benefits. For example, the Environmental Protection Agency recently estimated that the 1990 Clean Air Act Amendment (CAAA) will produce human health benefits in 2020, from reduced mortality rates, valued at nearly $2 trillion per year, compared to compliance costs of $65 billion ($0.065 trillion). However, while compliance costs can be measured, health benefits are unproved: they depend on a series of uncertain assumptions. Among these are that additional life expectancy gained by a beneficiary (with median age of about 80 years) should be valued at about $80,000 per month; that there is a 100% probability that a positive, linear, no-threshold, causal relation exists between PM(2.5) concentration and mortality risk; and that progress in medicine and disease prevention will not greatly diminish this relationship. We present an alternative uncertainty analysis that assigns a positive probability of error to each assumption. This discrete uncertainty analysis suggests (with probability >90% under plausible alternative assumptions) that the costs of CAAA exceed its benefits. Thus, instead of suggesting to policymakers that CAAA benefits are almost certainly far larger than its costs, we believe that accuracy requires acknowledging that the costs purchase a relatively uncertain, possibly much smaller, benefit. The difference between these contrasting conclusions is driven by different approaches to uncertainty analysis, that is, excluding or including discrete uncertainties about the main assumptions required for nonzero health benefits to exist at all. © 2011 Society for Risk Analysis.

  5. Value-Based Medicine and Pharmacoeconomics.

    PubMed

    Brown, Gary C; Brown, Melissa M

    2016-01-01

    Pharmacoeconomics is assuming increasing importance in the pharmaceutical field since it is entering the public policy arena in many countries. Among the variants of pharmacoeconomic analysis are cost-minimization, cost-benefit, cost-effectiveness and cost-utility analyses. The latter is the most versatile and sophisticated in that it integrates the patient benefit (patient value) conferred by a drug in terms of improvement in length and/or quality of life. It also incorporates the costs expended for that benefit, as well as the dollars returned to patients and society from the use of a drug (financial value). Unfortunately, one cost-utility analysis in the literature is generally not comparable to another because of the lack of standardized formats and standardized input variables (costs, cost perspective, quality-of-life measurement instruments, quality-of-life respondents, discounting and so forth). Thus, millions of variants can be used. Value-based medicine® (VBM) cost-utility analysis standardizes these variants so that one VBM analysis is comparable to another. This system provides a highly rational methodology that allows providers and patients to quantify and compare the patient value and financial value gains associated with the use of pharmaceutical agents for example. © 2016 S. Karger AG, Basel.

  6. Networking K-12 Schools: Architecture Models and Evaluation of Costs and Benefits.

    ERIC Educational Resources Information Center

    Rothstein, Russell Isaac

    This thesis examines the cost and benefits of communication networks in K-12 schools using cost analysis of five technology models with increasing levels of connectivity. Data indicate that the cost of the network hardware is only a small fraction of the overall networking costs. PC purchases, initial training, and retrofitting are the largest…

  7. A cost-benefit analysis of a deposit-refund program for beverage containers in Israel

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

    Lavee, Doron, E-mail: doron@pareto.co.i

    2010-02-15

    The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program - storage, collection, and treatment costs of empty containers, and all potential benefits - savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearlymore » economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.« less

  8. MARINE CORPS ASIA PACIFIC REALIGNMENT: DOD Should Resolve Capability Deficiencies and Infrastructure Risks and Revise Cost Estimates

    DTIC Science & Technology

    2017-04-01

    environmental mitigation and the costs associated with it. In April 2015, the Navy released a draft environmental impact statement to the public that...economic analysis for decision making indicates that, as part of assessing the costs and benefits of alternatives, an economic analysis should include...Page 48 GAO-17-415 Marine Corps Asia-Pacific Realignment comprehensive estimates of the expected costs and benefits that are incident to achieving

  9. Smoke alarm giveaway and installation programs: an economic evaluation.

    PubMed

    Liu, Ying; Mack, Karin A; Diekman, Shane T

    2012-10-01

    The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Cost-effectiveness analysis (CEA) resulted in an average cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost-benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit-cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventions to reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. Published by Elsevier Inc.

  10. Meaningful Cost-Benefit Analysis for Service-Oriented Architecture Projects

    DTIC Science & Technology

    2010-05-01

    SOA to identify these activities and shows how those costs come to be commingled with other development and maintenance activities. The paper argues...affected by SOA . To be consistent with the separation suggested above, this paper suggests the following new activities: • Enterprise architecture...Government or Federal Rights License 14. ABSTRACT This paper argues that proper cost-benefit analysis of service-oriented architecture projects is not

  11. Cost Benefit Analysis. Community College of Vermont.

    ERIC Educational Resources Information Center

    Parker, Charles A.

    A cost benefit analysis of the Community College of Vermont revealed that (1) the proportions of State support of the total budgets for Vermont's institutions of higher education are 22.7% at UVM, 37.2% at the VSC, and 12.7% for the Community College; (2) tuition is budgeted for FY73 to generate 27% of total cost at UVM, 29.6% at the VSC, and…

  12. Assessing Corporate Culture and Infrastructure before Undertaking Cost-Benefit Analysis.

    ERIC Educational Resources Information Center

    Driscoll, Margaret

    1993-01-01

    One of the simplest definitions of cost-benefit analysis states "ultimately, it is nothing more than a logical attempt to weigh the pros and cons of a decision" (Gramlich 1981). This definition highlights two issues: practitioners should be clear about what decisions will be made as a result of this analysis, and they need to decide how…

  13. 75 FR 68787 - Science Advisory Board Staff Office; Notification of a Public Teleconference of the Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

    ... Radiation's Second Section 812 Prospective Analysis of the benefits and costs of the Clean Air Act. DATES... Study of the Benefits and Costs of the Clean Air Act. The Council was established in 1991 pursuant to...), EPA conducts periodic studies to assess benefits and costs of the EPA's regulatory actions under the...

  14. 75 FR 9410 - Science Advisory Board Staff Office Notification of a Public Teleconference of the Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... advisory report on EPA's air quality modeling work for the Second Section 812 Prospective Benefit-Cost... Section 812 Benefit-Cost Analysis of the Clean Air Act. The Council was established in 1991 pursuant to... assess benefits and costs of the EPA's regulatory actions under the Clean Air Act. The Council has...

  15. Benefit-Cost Analysis of TAT Phase I Worker Training. Training and Technology Project. Special Report.

    ERIC Educational Resources Information Center

    Kirby, Frederick C.; Castagna, Paul A.

    The purpose of this study is to estimate costs and benefits and to compute alternative benefit-cost ratios for both the individuals and the Federal Government as a result of investing time and resources in the Training and Technology (TAT) Project. TAT is a continuing experimental program in training skilled workers for private industry. The five…

  16. Cost-benefit analysis of second-generation antipsychotics and placebo in a randomized trial of the treatment of psychosis and aggression in Alzheimer disease.

    PubMed

    Rosenheck, Robert A; Leslie, Douglas L; Sindelar, Jody L; Miller, Edward A; Tariot, Peter N; Dagerman, Karen S; Davis, Sonia M; Lebowitz, Barry D; Rabins, Peter; Hsiao, John K; Lieberman, Jeffery A; Schneider, Lon S

    2007-11-01

    Second-generation antipsychotics (SGAs) are prescribed for psychosis, aggression, and agitation in Alzheimer disease (AD). To conduct a cost-benefit analysis of SGAs and placebo (taken to represent a "watchful waiting" treatment strategy) for psychosis and aggression in outpatients with AD. Randomized placebo-controlled trial of alternative SGA initiation strategies. Forty-two outpatient clinics. Outpatients with AD and psychosis, aggression, or agitation (N = 421). Intervention Participants were randomly assigned to treatment with olanzapine, quetiapine fumarate, risperidone, or placebo with the option of double-blind rerandomization to another antipsychotic or citalopram hydrobromide or open treatment over 9 months. Monthly interviews documented health service use and costs. The economic perspective addressed total health care and medication costs. Costs of study drugs were estimated from wholesale prices with adjustment for discounts and rebates. Quality-adjusted life-years (QALYs) were assessed with the Health Utilities Index Mark 3 and were supplemented with measures of functioning, activities of daily living, and quality of life. Primary analyses were conducted using all available data. Secondary analyses excluded observations after the first medication change (ie, phase 1 only). Cost-benefit analysis was conducted using the net health benefits approach in a sensitivity analysis in which QALYs were valued at $50,000 per year and $100,000 per year. Average total health costs, including medications, were significantly lower for placebo than for SGAs, by $50 to $100 per month. There were no differences between treatments in QALYs or other measures of function. Phase 1-only analyses were broadly similar. Net-benefit analysis showed greater net health benefits for placebo as compared with other treatments, with probabilities ranging from 50% to 90%. There were no differences in measures of effectiveness between initiation of active treatments or placebo (which represented watchful waiting) but the placebo group had significantly lower health care costs. clinicaltrials.gov Identifier: NCT00015548.

  17. Neutral location cues and cost/benefit analysis of visual attention shifts.

    PubMed

    Wright, R D; Richard, C M; McDonald, J J

    1995-12-01

    The effects of location cuing on target responses can be examined by comparing informative and neutral cuing conditions. In particular, the magnitudes of costs of invalid location cuing and of benefits of valid location cuing can be determined by comparing invalid and valid cue responses to location-nonspecific neutral cue responses. Cost/benefit analysis is based on the assumption that neutral baseline measures reflect a general warning effect about the impending target's onset but no other specific target information. The experiments we report were carried out to determine the appropriateness of two baseline measures for cost/benefit analyses of direct (nonsymbolic) location cuing effects. We found that a multiple-cue baseline attenuated the benefits of valid cuing, and that a background-flash baseline arbitrarily attenuated costs or benefits depending on flash intensity. It is proposed that a background flash is the more suitable neutral cue because it is target-location-nonspecific, but that its intensity should be adjusted to elicit a target-onset warning signal of the same magnitude as the location cues with which it will be compared.

  18. Do health benefits outweigh the costs of mass recreational programs? An economic analysis of four Ciclovía programs.

    PubMed

    Montes, Felipe; Sarmiento, Olga L; Zarama, Roberto; Pratt, Michael; Wang, Guijing; Jacoby, Enrique; Schmid, Thomas L; Ramos, Mauricio; Ruiz, Oscar; Vargas, Olga; Michel, Gabriel; Zieff, Susan G; Valdivia, Juan Alejandro; Cavill, Nick; Kahlmeier, Sonja

    2012-02-01

    One promising public health intervention for promoting physical activity is the Ciclovía program. The Ciclovía is a regular multisectorial community-based program in which streets are temporarily closed for motorized transport, allowing exclusive access to individuals for recreational activities and physical activity. The objective of this study was to conduct an analysis of the cost-benefit ratios of physical activity of the Ciclovía programs of Bogotá and Medellín in Colombia, Guadalajara in México, and San Francisco in the U.S.A. The data of the four programs were obtained from program directors and local surveys. The annual cost per capita of the programs was: U.S. $6.0 for Bogotá, U.S. $23.4 for Medellín, U.S. $6.5 for Guadalajara, and U.S. $70.5 for San Francisco. The cost-benefit ratio for health benefit from physical activity was 3.23-4.26 for Bogotá, 1.83 for Medellín, 1.02-1.23 for Guadalajara, and 2.32 for San Francisco. For the program of Bogotá, the cost-benefit ratio was more sensitive to the prevalence of physically active bicyclists; for Guadalajara, the cost-benefit ratio was more sensitive to user costs; and for the programs of Medellín and San Francisco, the cost-benefit ratios were more sensitive to operational costs. From a public health perspective for promoting physical activity, these Ciclovía programs are cost beneficial.

  19. 2016 reflections on the favorable cost-benefit of lung cancer screening

    PubMed Central

    Dieguez, Gabriela

    2016-01-01

    This article gives a basic background on the confusing and often politicized topic of cost-benefit analysis in healthcare, using lung cancer screening as a case study. The authors are actuaries who work with the insurance industry, where real-world data is used to produce audited financial figures; other disciplines which work with cost-benefit analysis include those academic disciplines where randomized controlled trials may be perceived as the gold standard of evidence. In recent years, the finance and academic sectors of healthcare have begun to converge, as academic disciplines have come to increasingly appreciate real-world data, and insurers increasingly appreciate classical evidence-based medicine. Nevertheless, the variation of results in cost-benefit analyses for particular treatments can be bewildering to medical experts unfamiliar with real-world healthcare financing. PMID:27195273

  20. Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services.

    PubMed

    Birch, Jennifer C; Newton, Adrian C; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

    2010-12-14

    Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost-benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape.

  1. Economic Evaluation of Hospital and Community Pharmacy Services.

    PubMed

    Gammie, Todd; Vogler, Sabine; Babar, Zaheer-Ud-Din

    2017-01-01

    To review the international body of literature from 2010 to 2015 concerning methods of economic evaluations used in hospital- and community-based studies of pharmacy services in publicly funded health systems worldwide, their clinical outcomes, and economic effectiveness. The literature search was undertaken between May 2, 2015, and September 4, 2015. Keywords included "health economics" and "evaluation" "assessment" or "appraisal," "methods," "hospital" or "community" or "residential care," "pharmacy" or "pharmacy services" and "cost minimisation analysis" or "cost utility analysis" or "cost effectiveness analysis" or "cost benefit analysis." The databases searched included MEDLINE, PubMed, Google Scholar, Science Direct, Springer Links, and Scopus, and journals searched included PLoS One, PLoS Medicine, Nature, Health Policy, Pharmacoeconomics, The European Journal of Health Economics, Expert Review of Pharmacoeconomics and Outcomes Research, and Journal of Health Economics. Studies were selected on the basis of study inclusion criteria. These criteria included full-text original research articles undertaking an economic evaluation of hospital- or community-based pharmacy services in peer-reviewed scientific journals and in English, in countries with a publicly funded health system published between 2010 and 2015. 14 articles were included in this review. Cost-utility analysis (CUA) was the most utilized measure. Cost-minimization analysis (CMA) was not used by any studies. The limited use of cost-benefit analyses (CBAs) is likely a result of technical challenges in quantifying the cost of clinical benefits, risks, and outcomes. Hospital pharmacy services provided clinical benefits including improvements in patient health outcomes and reductions in adverse medication use, and all studies were considered cost-effective due to meeting a cost-utility (per quality-adjusted life year) threshold or were cost saving. Community pharmacy services were considered cost-effective in 8 of 10 studies. Economic evaluations of hospital and community pharmacy services are becoming increasingly commonplace to enable an understanding of which health care services provide value for money and to inform policy makers as to which services will be cost-effective in light of limited health care resources.

  2. Managing health care costs: strategies available to small businesses.

    PubMed

    Higgins, C W; Finley, L; Kinard, J

    1990-07-01

    Although health care costs continue to rise at an alarming rate, small businesses can take steps to help moderate these costs. First, business firms must restructure benefits so that needless surgery is eliminated and inpatient hospital care is minimized. Next, small firms should investigate the feasibility of partial self-insurance options such as risk pooling and purchasing preferred premium plans. Finally, small firms should investigate the cost savings that can be realized through the use of alternative health care delivery systems such as HMOs and PPOs. Today, competition is reshaping the health care industry by creating more options and rewarding efficiency. The prospect of steadily rising prices and more choices makes it essential that small employers become prudent purchasers of employee health benefits. For American businesses, the issue is crucial. Unless firms can control health care costs, they will have to keep boosting the prices of their goods and services and thus become less competitive in the global marketplace. In that event, many workers will face a prospect even more grim than rising medical premiums: losing their jobs.

  3. [Cost-effectiveness and cost-benefit analysis on strategy for preventing mother-to-child transmission of hepatitis B virus].

    PubMed

    Cai, Y L; Zhang, S X; Yang, P C; Lin, Y

    2016-06-01

    Through cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and quantitative optimization analysis to understand the economic benefit and outcomes of strategy regarding preventing mother-to-child transmission (PMTCT) on hepatitis B virus. Based on the principle of Hepatitis B immunization decision analytic-Markov model, strategies on PMTCT and universal vaccination were compared. Related parameters of Shenzhen were introduced to the model, a birth cohort was set up as the study population in 2013. The net present value (NPV), benefit-cost ratio (BCR), incremental cost-effectiveness ratio (ICER) were calculated and the differences between CBA and CEA were compared. A decision tree was built as the decision analysis model for hepatitis B immunization. Three kinds of Markov models were used to simulate the outcomes after the implementation of vaccination program. The PMTCT strategy of Shenzhen showed a net-gain as 38 097.51 Yuan/per person in 2013, with BCR as 14.37. The universal vaccination strategy showed a net-gain as 37 083.03 Yuan/per person, with BCR as 12.07. Data showed that the PMTCT strategy was better than the universal vaccination one and would end with gaining more economic benefit. When comparing with the universal vaccination program, the PMTCT strategy would save 85 100.00 Yuan more on QALY gains for every person. The PMTCT strategy seemed more cost-effective compared with the one under universal vaccination program. In the CBA and CEA hepatitis B immunization programs, the immunization coverage rate and costs of hepatitis B related diseases were the most important influencing factors. Outcomes of joint-changes of all the parameters in CEA showed that PMTCT strategy was a more cost-effective. The PMTCT strategy gained more economic benefit and effects on health. However, the cost of PMTCT strategy was more than the universal vaccination program, thus it is important to pay attention to the process of PMTCT strategy and the universal vaccination program. CBA seemed suitable for strategy optimization while CEA was better for strategy evaluation. Hopefully, programs as combination of the above said two methods would facilitate the process of economic evaluation.

  4. Valuing vaccines using value of statistical life measures.

    PubMed

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

    2014-09-03

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

  5. Foregone benefits of important food crop improvements in Sub-Saharan Africa

    PubMed Central

    2017-01-01

    A number of new crops have been developed that address important traits of particular relevance for smallholder farmers in Africa. Scientists, policy makers, and other stakeholders have raised concerns that the approval process for these new crops causes delays that are often scientifically unjustified. This article develops a real option model for the optimal regulation of a risky technology that enhances economic welfare and reduces malnutrition. We consider gradual adoption of the technology and show that delaying approval reduces uncertainty about perceived risks of the technology. Optimal conditions for approval incorporate parameters of the stochastic processes governing the dynamics of risk. The model is applied to three cases of improved crops, which either are, or are expected to be, delayed by the regulatory process. The benefits and costs of the crops are presented in a partial equilibrium that considers changes in adoption over time and the foregone benefits caused by a delay in approval under irreversibility and uncertainty. We derive the equilibrium conditions where the net-benefits of the technology equal the costs that would justify a delay. The sooner information about the safety of the technology arrive, the lower the costs for justifying a delay need to be i.e. it pays more to delay. The costs of a delay can be substantial: e.g. a one year delay in approval of the pod-borer resistant cowpea in Nigeria will cost the country about 33 million USD to 46 million USD and between 100 and 3,000 lives. PMID:28749984

  6. Government mandates and employer-sponsored health insurance: who is still not covered?

    PubMed

    Vanness, David J; Wolfe, Barbara L

    2002-06-01

    We characterize employer-sponsored health insurance offering strategies in light of benefit non-discrimination and minimum wage regulation when workers have heterogeneous earnings and partially unobservable demand for (and cost of) insurance. We then empirically examine how earnings and expected medical expenses are associated with low wage workers' ability to obtain insurance before and after enactment of federal benefit non-discrimination rules. We find no evidence that the non-discrimination rules helped low wage workers (especially those with high own or children's expected medical expenses) to obtain insurance.

  7. Cost Beneftt Analysts of LH2 PadB

    NASA Technical Reports Server (NTRS)

    Mott, Brittany

    2013-01-01

    This analysis is used to evaluate, from a cost and benefit perspective, potential outcomes when replacing the pressurization switches and the pressurization system to meet the needs of the LH2 storage system at Pad B. This also includes alternatives, tangible and intangible benefits, and the results of the analysis.

  8. 76 FR 66346 - Agency Information Collection Activities; Requests for Comments: Clearance of Renewed Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-26

    ... others for safety assessment, planning, forecasting, cost/benefit analysis, and to target areas for... assessment, planning, forecasting, cost/benefit analysis, and to target areas for research. Respondents... invites public comments about our intention to request the Office of Management and Budget (OMB) approval...

  9. 78 FR 75671 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-12

    ... others for safety assessment, planning, forecasting, cost/benefit analysis, and to target areas for... assessment, planning, forecasting, cost/benefit analysis, and to target areas for research. Respondents... invites public comments about our intention to request the Office of Management and Budget (OMB) approval...

  10. Test Basher Benefit-Cost Analysis.

    ERIC Educational Resources Information Center

    Phelps, Richard P.

    1996-01-01

    Starting in the late 1980s, two teams of researchers, well known for their criticism of standardized tests on equity and validity grounds, began attacking standardized testing on efficiency grounds as well, using cost-benefit analysis to do it. Their analyses are reviewed, and their conclusions discussed. The first team, Lorrie A. Shepard, Amelia…

  11. Global eradication of poliomyelitis: benefit-cost analysis.

    PubMed Central

    Bart, K. J.; Foulds, J.; Patriarca, P.

    1996-01-01

    A benefit-cost analysis of the Poliomyelitis Eradication Initiative was undertaken to facilitate national and international decision-making with regard to financial support. The base case examined the net costs and benefits during the period 1986-2040; the model assumed differential costs for oral poliovirus vaccine (OPV) and vaccine delivery in industrialized and developing countries, and ignored all benefits aside from reductions in direct costs for treatment and rehabilitation. The model showed that the "break-even" point at which benefits exceeded costs was the year 2007, with a saving of US$ 13 600 million by the year 2040. Sensitivity analyses revealed only small differences in the break-even point and in the dollars saved, when compared with the base case, even with large variations in the target age group for vaccination, the proportion of case-patients seeking medical attention, and the cost of vaccine delivery. The technical feasibility of global eradication is supported by the availability of an easily administered, inexpensive vaccine (OPV), the epidemiological characteristics of poliomyelitis, and the successful experience in the Americas with elimination of wild poliovirus infection. This model demonstrates that the Poliomyelitis Eradication Initiative is economically justified. PMID:8653814

  12. Causes analysis on the serious defect of enterprise environmental responsibility—Based on the perspective of law and economics

    NASA Astrophysics Data System (ADS)

    Fa, L. N.

    2017-11-01

    As the important Environmental Interests of Subjects, enterprises behoove to undertake the corresponding responsibility of Pollution Control and Environmental Protection. The current situations in our country, however, appear as the serious lack of enterprise environmental responsibility. Based on the analysis of law and economics, this article reaches the conclusion through game analysis and cost-benefit analysis that the prisoners dilemma of environmental interest game between enterprises is the inherent causes for the serious defect of enterprise environmental responsibility. Meanwhile, at the point of cost-benefit, the externality of environment illegal act results in the imbalanced cost-benefit, lacking of the motivation to control pollution and protect environment in an active way.

  13. Benefit-cost analysis of lane departure warning and roll stability control in commercial vehicles.

    PubMed

    Medina-Flintsch, Alejandra; Hickman, Jeffrey S; Guo, Feng; Camden, Matthew C; Hanowski, Richard J; Kwan, Quon

    2017-09-01

    This paper presents the cost benefits of two different onboard safety systems (OSS) installed on trucks as they operated during normal revenue deliveries. Using a formal economic analysis approach, the study quantified the costs and benefits associated with lane departure warning (LDW) systems and roll stability control (RSC) systems. The study used data collected from participating carriers (many of these crashes were not reported to state or Federal agencies), and the research team also reviewed each crash file to determine if the specific OSS would have mitigated or prevented the crash. The deployment of each OSS was anticipated to increase the safety of all road users, but impact different sectors of society in different ways. Benefits that were inherent in each group (e.g., industry, society) were considered, and different benefit-cost analyses (BCAs) were performed. This paper presents two BCAs: a BCA focused on the costs and benefits in the carrier industry by implementing each OSS, and a BCA that measured the societal benefits of each OSS. In addition, a BCA for a theoretical mandatory deployment option for each OSS is presented. BCA results for LDW and RSC clearly showed their benefits outweighed their costs for the carrier and society. Practical applications: Cost information is a crucial factor in purchasing decisions in carriers; similarly, regulators must consider the cost burden prior to mandating technologies. The results in this study provide carrier decision makers and regulators with information necessary to make an informed decision regarding RSC and LDW. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

  14. Effectiveness of landslide risk mitigation strategies in Shihmen Watershed, Taiwan

    NASA Astrophysics Data System (ADS)

    Wu, Chun-Yi; Chen, Su-Chin

    2015-04-01

    The purpose of this study was to establish landslide risk analysis procedures that can be used to analyze landslide risk in a watershed scale and to assess the effectiveness of risk mitigation strategies. Landslide risk analysis encompassed the landslide hazard, the vulnerability of elements at risk, and community resilience capacity. First, landslide spatial probability, landslide temporal probability, and landslide area probability were joined to estimate the probability of landslides with an area exceeding a certain threshold in each slope unit. Second, the expected property and life losses were both analyzed in vulnerability analysis. Different elements at risk were assigned corresponding values, and then used in conjunction with the vulnerabilities to carry out quantitative analysis. Third, the resilience capacity of different communities was calculated based on the scores obtained through community checklists and the weights of individual items, including "the participation experience of disaster prevention drill," "real-time monitoring mechanism of community," "autonomous monitoring of residents," and "disaster prevention volunteer." Finally, the landslide probabilities, vulnerability analysis results, and resilience capacities were combined to assess landslide risk in Shihmen Watershed. In addition, the risks before and after the implementation of non-structural disaster prevention strategies were compared to determine the benefits of various strategies, and subsequently benefit-cost analysis was performed. Communities with high benefit-cost ratios included Hualing, Yisheng, Siouluan, and Gaoyi. The watershed as a whole had a benefit-cost ratio far greater than 1, indicating that the effectiveness of strategies was greater than the investment cost, and these measures were thus cost-effective. The results of factor sensitivity analysis revealed that changes in vulnerability and mortality rates would increase the uncertainty of risk, and that raise in annual interest rates or reduction in life cycle of measures would decrease the benefit-cost ratio. However, with regard to effectiveness analysis, these changes did not reverse the cost-effective inference.

  15. Cost Of Compliance On Munitions Consolidation From Lualualei To West Loch

    DTIC Science & Technology

    2017-12-01

    from the perspective of the Department of Defense in order to capture all costs and benefits associated with the Army and Navy, the main stakeholders...weaknesses of the available alternative options. The model identifies tangible costs and benefits to estimate a net present value for each option. To...the robustness of the average net present value and to show the probability of net costs exceeding the net benefits . The analysis conducted in this

  16. Back-door cost-benefit analysis under a safety-first Clean Air Act

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

    Barnes, D.W.

    The Clean Air Act emphasizes safety over cost considerations, but a cost-conscious administration which emphasizes economic impacts has not enforced the letter of the safety-first law. A solution could be to budget cost-justified rather than safety-first levels of pollution reduction. A comparison of cost-benefit balancing and budgetary control measures examines administrative procedures and probable outcomes in terms of enforcement costs. The author notes that the two concepts require different technology. The higher cost of safety-first technology tend to discourage investment, and could lead to less pollution control than the cost-benefit approach. 59 references, 12 figures. (DCK)

  17. An Analysis of Costs and Cenefits Associated with Initial Contracting Technical Education and Training for Unrestricted Marine Officers

    DTIC Science & Technology

    2017-03-01

    COSTS AND BENEFITS ASSOCIATED WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS by Lee A. White...WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS 5. FUNDING NUMBERS 6. AUTHOR(S) Lee A. White 7. PERFORMING...unlimited. AN ANALYSIS OF COSTS AND BENEFITS ASSOCIATED WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS

  18. The Benefits and Costs of National Service: Methods for Benefit Assessment with Application to Three AmeriCorps Programs.

    ERIC Educational Resources Information Center

    Neumann, George R.; And Others

    A study applied the principles of benefit-cost analysis to three prototype grants programs of AmeriCorps: AmeriCorps for Math and Literacy, Project First, and the East Bay Conservation Corps. It studied the methods these projects used and estimated the benefits using data from projects similar in approach and implementation. Benefits received by…

  19. Fluorescent Lamp Replacement Study

    DTIC Science & Technology

    2017-07-01

    friendly products, advances in efficiency, and lower production costs for lamps. The conversion of fluorescent bulbs to LED technology has many benefits ...of 4727 W. An economic analysis was calculated to compare the various lighting technologies that were implemented at ATC and the cost benefits ...the various lighting technologies that were implemented at ATC and the cost benefits of each, a lifecycle comparison was made between the fluorescent

  20. Comparison of Australian and US Cost-Benefit Approaches to MEPS

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

    McMahon, James E.

    2004-03-12

    The Australian Greenhouse Office contracted with the Collaborative Labeling and Appliance Standards Program (CLASP) for LBNL to compare US and Australian approaches to analyzing costs and benefits of minimum energy performance standards (MEPS). This report compares the approaches for three types of products: household refrigerators and freezers, small electric storage water heaters, and commercial/industrial air conditioners. This report presents the findings of similarities and differences between the approaches of the two countries and suggests changes to consider in the approach taken in Australia. The purpose of the Australian program is to reduce greenhouse gas emissions, while the US program ismore » intended to increase energy efficiency; each program is thus subject to specific constraints. The market and policy contexts are different, with the USA producing most of its own products and conducting pioneering engineering-economic studies to identify maximum energy efficiency levels that are technologically feasible and economically justified. In contrast, Australia imports a large share of its products and adopts MEPS already in place elsewhere. With these differences in circumstances, Australia's analysis approach could be expected to have less analytical detail and still result in MEPS levels that are appropriate for their policy and market context. In practice, the analysis required to meet these different objectives is quite similar. To date, Australia's cost-benefit analysis has served the goals and philosophies of the program well and been highly effective in successfully identifying MEPS that are significantly reducing greenhouse gas emissions while providing economic benefits to consumers. In some cases, however, the experience of the USA--using more extensive data sets and more detailed analysis--suggests possible improvements to Australia's cost-benefit analysis. The principal findings of the comparison are: (1) The Technology and Market Assessments are similar; no changes are recommended. (2) The Australian approach to determining the relationship of price to energy efficiency is based on current market, while the US approach uses prospective estimates. Both approaches may benefit from increased retrospective analysis of impacts of MEPS on appliance and equipment prices. Under some circumstances, Australia may wish to consider analyzing two separate components leading to price impacts: (a) changes in manufacturing costs and (b) markups used to convert from manufacturing costs to consumer price. (3) The Life-Cycle Cost methods are similar, but the USA has statistical surveys that permit a more detailed analysis. Australia uses average values, while the US uses full distributions. If data and resources permit, Australia may benefit from greater depth here as well. If implemented, the changes will provide more information about the benefits and costs of the program, in particular identifying who benefits and who bears net costs so that programs can be designed to offset unintended negative consequences, and may assist the government in convincing affected parties of the justification for some MEPS. However, without a detailed and statistically representative national survey, such an approach may not be practical for Australia at this time. (4) The National Benefits and Costs methods are similar prospective estimates of shipments, costs and energy savings, as well as greenhouse gas emissions. Additional sensitivity studies could further illustrate the ranges in these estimates. Consideration of lower discount rates could lead to more stringent MEPS in some cases. (5) Both the Australian and US analyses of impacts on industry, competition, and trade ultimately depend upon sufficient consultation with industry experts. While the Australian analysis of financial impacts on manufacturers is less detailed than that of the US, the Australian treatment of impacts on market shares imported from different regions of the world is more detailed. No change is recommended. Implementing these changes would increase the depth of analysis, require additional data collection and analysis, and incur associated costs and time. The recommended changes are likely to have incremental rather than dramatic impacts on the substance and implications of the analysis as currently conducted.« less

  1. Report to the Legislature on Scoliosis Screening Cost/Benefit Analysis.

    ERIC Educational Resources Information Center

    Washington Office of the State Superintendent of Public Instruction, Olympia.

    A report is given of an analysis of costs and benefits of scoliosis screening tests given to children in the 9th and 10th grades. For comparison, an analysis is included on the effectiveness of tests in grades 5 through 8. Information was collected on the number of children in the State of Washington who underwent either brace treatment or…

  2. The price of palliative care: toward a complete accounting of costs and benefits.

    PubMed

    Boni-Saenz, Alexander A; Dranove, David; Emanuel, Linda L; Lo Sasso, Anthony T

    2005-02-01

    In this article, currently accepted standards for cost-benefit analysis of health care interventions are outlined, and a framework to evaluate palliative care within these standards is provided. Recent publications on the economic implications of palliative care are reviewed, which are only the "tip of the iceberg" of the potential costs and benefits. Using this framework, the authors offer guidelines for performing comprehensive cost-benefit analyses of palliative care and conclude that many of the issues beneath the surface may be substantial and deserving of closer scrutiny. Methods for gathering relevant cost-benefit information are detailed, along with potential obstacles to implementation. This approach is applicable to palliative care in general, including palliative care for elders.

  3. Cost-benefit analysis of ambulance and rescue helicopters in Norway: reflections on assigning a monetary value to saving a human life.

    PubMed

    Elvik, Rune

    2002-01-01

    This paper reports the results of a cost-benefit analysis undertaken in 1996 for a public commission set up to plan the future operation of state-owned ambulance and rescue helicopters in Norway. The analysis indicates that the benefits of ambulance missions flown by helicopters exceeds the costs by a factor of almost six. To do this analysis it was necessary to assign a monetary value to human life. Traditionally this has not been done in medicine, and may be widely regarded as inconsistent with medical ethics. The results of the cost-benefit analysis serve as the starting point to a more general discussion surrounding the economic value of activities designed to reduce human mortality. It is concluded that human preferences for the provision of health care or other life-saving interventions are probably too complex to be adequately represented by means of a single monetary value expressing the benefits of life-saving. The task of developing an inclusive framework for a normative approach to priority setting in injury prevention is daunting, and may be insoluble. It is important to assess the extent to which current value-of-life estimates depend on study methods and social context.

  4. Hamilton's rule, inclusive fitness maximization, and the goal of individual behaviour in symmetric two-player games.

    PubMed

    Okasha, S; Martens, J

    2016-03-01

    Hamilton's original work on inclusive fitness theory assumed additivity of costs and benefits. Recently, it has been argued that an exact version of Hamilton's rule for the spread of a pro-social allele (rb > c) holds under nonadditive pay-offs, so long as the cost and benefit terms are defined as partial regression coefficients rather than pay-off parameters. This article examines whether one of the key components of Hamilton's original theory can be preserved when the rule is generalized to the nonadditive case in this way, namely that evolved organisms will behave as if trying to maximize their inclusive fitness in social encounters. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

  5. ENGINEERING ECONOMIC ANALYSIS OF A PROGRAM FOR ARTIFICIAL GROUNDWATER RECHARGE.

    USGS Publications Warehouse

    Reichard, Eric G.; Bredehoeft, John D.

    1984-01-01

    This study describes and demonstrates two alternate methods for evaluating the relative costs and benefits of artificial groundwater recharge using percolation ponds. The first analysis considers the benefits to be the reduction of pumping lifts and land subsidence; the second considers benefits as the alternative costs of a comparable surface delivery system. Example computations are carried out for an existing artificial recharge program in Santa Clara Valley in California. A computer groundwater model is used to estimate both the average long term and the drought period effects of artificial recharge in the study area. Results indicate that the costs of artificial recharge are considerably smaller than the alternative costs of an equivalent surface system. Refs.

  6. Novel model of direct and indirect cost-benefit analysis of mechanical embolectomy over IV tPA for large vessel occlusions: a real-world dollar analysis based on improvements in mRS.

    PubMed

    Mangla, Sundeep; O'Connell, Keara; Kumari, Divya; Shahrzad, Maryam

    2016-01-20

    Ischemic strokes result in significant healthcare expenditures (direct costs) and loss of quality-adjusted life years (QALYs) (indirect costs). Interventional therapy has demonstrated improved functional outcomes in patients with large vessel occlusions (LVOs), which are likely to reduce the economic burden of strokes. To develop a novel real-world dollar model to assess the direct and indirect cost-benefit of mechanical embolectomy compared with medical treatment with intravenous tissue plasminogen activator (IV tPA) based on shifts in modified Rankin scores (mRS). A cost model was developed including multiple parameters to account for both direct and indirect stroke costs. These were adjusted based upon functional outcome (mRS). The model compared IV tPA with mechanical embolectomy to assess the costs and benefits of both therapies. Direct stroke-related costs included hospitalization, inpatient and outpatient rehabilitation, home care, skilled nursing facilities, and long-term care facility costs. Indirect costs included years of life expectancy lost and lost QALYs. Values for the model cost parameters were derived from numerous resources and functional outcomes were derived from the MR CLEAN study as a reflective sample of LVOs. Direct and indirect costs and benefits for the two treatments were assessed using Microsoft Excel 2013. This cost-benefit model found a cost-benefit of mechanical embolectomy over IV tPA of $163 624.27 per patient and the cost benefit for 50 000 patients on an annual basis is $8 181 213 653.77. If applied widely within the USA, mechanical embolectomy will significantly reduce the direct and indirect financial burden of stroke ($8 billion/50 000 patients). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial.

    PubMed

    Mori, Amani Thomas; Kampata, Linda; Musonda, Patrick; Johansson, Kjell Arne; Robberstad, Bjarne; Sandøy, Ingvild

    2017-12-19

    Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living. The study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives. While the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be considered seriously when evaluating whether such a program can justify the required investments in a setting with scarce resources. The economic evaluations outlined in this paper will generate valuable information that can be used to guide large-scale implementation of programs to address the problem of the high prevalence of adolescent childbirth and school drop-outs in similar settings. ClinicalTrials.gov, NCT02709967. Registered on 2 March 2016. ISRCTN, ISRCTN12727868. Registered on 4 March 2016.

  8. [Comparative Cost Effectiveness of Clostridium Histolyticum Collagenase (Xiapex®) and Partial Fasciectomy for the Treatment of Dupuytren's Contracture in Austria].

    PubMed

    Neuwirth, M; Binter, A; Pipam, W; Rab, M

    2016-08-01

    Since Dupuytren's contracture is a common disorder, the costs for its surgical treatment impose a considerable burden on the healthcare system. For the first time in the German-speaking area, this study aimed to provide a comparative cost-effectiveness analysis for partial fasciectomy vs. treatment with Clostridium histolyticum collagenase (CCH). A retrospective monocentric study of the period from 2012 to 2014 comprised 40 patients with previously untreated Dupuytren's contracture of one finger. 20 outpatients received one CCH treatment (Group 1), while 20 inpatients underwent partial fasciectomy (Group 2). The direct pre-interventional treatment and post-interventional costs were compared. The direct post-interventional and postoperative results were comparable. Group 1 (CCH) showed a mean reduction in contracture of 96.4%; in Group 2 (partial fasciectomy), this was 97.7%. There were fewer complications in Group 1 than in Group 2. Mean treatment costs in Group 1 were € 1 458.60 and in Group 2, € 5 315.20. Treatment with CCH is more cost effective than with partial fasciectomy. This is due to greater costs for personnel, time and surgical material, as well as the treatment of the more frequent complications in Group 2. Despite the limited comparability, our findings are consistent with the present international literature. © Georg Thieme Verlag KG Stuttgart · New York.

  9. A U.K. cost-benefit analysis of circles of support and accountability interventions.

    PubMed

    Elliott, Ian A; Beech, Anthony R

    2013-06-01

    Circles of Support and Accountability (CoSA) aim to augment sex offender risk management at the point of community reentry by facilitating "Circles" of volunteers who provide support, guidance, and advice, while ensuring that the offender remains accountable for their actions. In this study, the authors provide (a) a rapid evidence assessment of the effectiveness of CoSA in reducing reoffending, and (b) a U.K. cost-benefit analysis for CoSA when compared to the criminal justice costs of reoffending. From the study analysis, the average cost of a "Circle" was estimated to be £11,303 per annum and appears to produce a 50% reduction in reoffending (sexual and nonsexual), as the estimated cost of reoffending was estimated to be £147,161 per offender, per annum. Based on a hypothetical cohort of 100 offenders--50 of whom receive CoSA and 50 of whom do not--investment in CoSA appears to provide a cost saving of £23,494 and a benefit-cost ratio of 1.04. Accounting for estimates that the full extent of the cost to society may be 5 to 10 times the tangible costs substantially increases estimated cost savings related to CoSA.

  10. The costs and benefits of enhanced depression care to employers.

    PubMed

    Wang, Philip S; Patrick, Amanda; Avorn, Jerry; Azocar, Francisca; Ludman, Evette; McCulloch, Joyce; Simon, Gregory; Kessler, Ronald

    2006-12-01

    Although outreach and enhanced treatment interventions improve depression outcomes, uptake has been poor in part because purchasers lack information on their return on investment. To estimate the costs and benefits of enhanced depression care for workers from the societal and employer-purchaser perspectives. Cost-effectiveness and cost-benefit analyses using state-transition Markov models. Simulated movements between health states were based on probabilities drawn from the clinical literature. Hypothetical cohort of 40-year-old workers. Intervention Enhanced depression care consisting of a depression screen and care management for those depressed vs usual care. Our base-case cost-effectiveness analysis was from the societal perspective; costs and quality-adjusted life-years were used to compute the incremental cost-effectiveness of the intervention relative to usual care. A secondary cost-benefit analysis from the employer's perspective tracked monetary costs and monetary benefits accruing to employers during a 5-year time horizon. From the societal perspective, screening and depression care management for workers result in an incremental cost-effectiveness ratio of $19 976 per quality-adjusted life-year relative to usual care. These results are consistent with recent primary care effectiveness trials and within the range for medical interventions usually covered by employer-sponsored insurance. From the employer's perspective, enhanced depression care yields a net cumulative benefit of $2895 after 5 years. In 1-way and probabilistic sensitivity analyses, these findings were robust to a variety of assumptions. If these results can be replicated in effectiveness trials directly assessing effects on work outcomes, they suggest that enhanced treatment quality programs for depression are cost-beneficial to purchasers.

  11. Ecosystem Services in Conservation Planning: Targeted Benefits vs. Co-Benefits or Costs?

    PubMed Central

    Chan, Kai M. A.; Hoshizaki, Lara; Klinkenberg, Brian

    2011-01-01

    There is growing support for characterizing ecosystem services in order to link conservation and human well-being. However, few studies have explicitly included ecosystem services within systematic conservation planning, and those that have follow two fundamentally different approaches: ecosystem services as intrinsically-important targeted benefits vs. substitutable co-benefits. We present a first comparison of these two approaches in a case study in the Central Interior of British Columbia. We calculated and mapped economic values for carbon storage, timber production, and recreational angling using a geographical information system (GIS). These ‘marginal’ values represent the difference in service-provision between conservation and managed forestry as land uses. We compared two approaches to including ecosystem services in the site-selection software Marxan: as Targeted Benefits, and as Co-Benefits/Costs (in Marxan's cost function); we also compared these approaches with a Hybrid approach (carbon and angling as targeted benefits, timber as an opportunity cost). For this analysis, the Co-Benefit/Cost approach yielded a less costly reserve network than the Hybrid approach (1.6% cheaper). Including timber harvest as an opportunity cost in the cost function resulted in a reserve network that achieved targets equivalently, but at 15% lower total cost. We found counter-intuitive results for conservation: conservation-compatible services (carbon, angling) were positively correlated with each other and biodiversity, whereas the conservation-incompatible service (timber) was negatively correlated with all other networks. Our findings suggest that including ecosystem services within a conservation plan may be most cost-effective when they are represented as substitutable co-benefits/costs, rather than as targeted benefits. By explicitly valuing the costs and benefits associated with services, we may be able to achieve meaningful biodiversity conservation at lower cost and with greater co-benefits. PMID:21915318

  12. The Use of Internet FAQs (Frequently Asked Questions) and Files as Cost-Effective Supplements to Textbooks and Substitutions for Photocopies.

    ERIC Educational Resources Information Center

    MacFarland, Thomas W.; Yates, Jan M.

    Gaining access to current and high-quality curriculum resource materials has become more difficult due to escalation in the prices of textbooks and in rigid interpretations of copyright laws which limit photocopying. Internet Frequently Asked Questions (FAQs) and files may offer a partial solution. Originally developed for the benefit of Usenet…

  13. Benefit-cost assessment programs: Costa Rica case study

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

    Clark, A.L.; Trocki, L.K.

    An assessment of mineral potential, in terms of types and numbers of deposits, approximate location and associated tonnage and grades, is a valuable input to a nation's economic planning and mineral policy development. This study provides a methodology for applying benefit-cost analysis to mineral resource assessment programs, both to determine the cost effectiveness of resource assessments and to ascertain future benefits to the nation. In a case study of Costa Rica, the benefit-cost ratio of a resource assessment program was computed to be a minimum of 4:1 ($10.6 million to $2.5 million), not including the economic benefits accuring from themore » creation of 800 mining sector and 1,200 support services jobs. The benefit-cost ratio would be considerably higher if presently proposed revisions of mineral policy were implemented and benefits could be defined for Costa Rica.« less

  14. Policy analysis for prenatal genetic diagnosis.

    PubMed

    Thompson, M; Milunsky, A

    1979-01-01

    Consideration of the analytic difficulties faced in estimating the benefits and costs of prenatal genetic diagnosis, coupled with a brief review of existing benefit-cost studies, leads to the conclusion that public subsidy of prenatal testing can yield benefits substantially in excess of costs. The practical obstacles to such programs include the attitudes of prospective parents, a lack of knowledge, monetary barriers, inadequately organized medical resources, and the political issue of abortion. Policy analysis can now nevertheless formulate principles and guide immediate actions to improve present utilization of prenatal testing and to facilitate possible future expansion of these diagnostic techniques.

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

    PubMed

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

    2016-01-01

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

  16. Benefit-Cost Analysis of Foot-and-Mouth Disease Vaccination at the Farm-Level in South Vietnam.

    PubMed

    Truong, Dinh Bao; Goutard, Flavie Luce; Bertagnoli, Stéphane; Delabouglise, Alexis; Grosbois, Vladimir; Peyre, Marisa

    2018-01-01

    This study aimed to analyze the financial impact of foot-and-mouth disease (FMD) outbreaks in cattle at the farm-level and the benefit-cost ratio (BCR) of biannual vaccination strategy to prevent and eradicate FMD for cattle in South Vietnam. Production data were collected from 49 small-scale dairy farms, 15 large-scale dairy farms, and 249 beef farms of Long An and Tay Ninh province using a questionaire. Financial data of FMD impacts were collected using participatory tools in 37 villages of Long An province. The net present value, i.e., the difference between the benefits (additional revenue and saved costs) and costs (additional costs and revenue foregone), of FMD vaccination in large-scale dairy farms was 2.8 times higher than in small-scale dairy farms and 20 times higher than in beef farms. The BCR of FMD vaccination over 1 year in large-scale dairy farms, small-scale dairy farms, and beef farms were 11.6 [95% confidence interval (95% CI) 6.42-16.45], 9.93 (95% CI 3.45-16.47), and 3.02 (95% CI 0.76-7.19), respectively. The sensitivity analysis showed that varying the vaccination cost had more effect on the BCR of cattle vaccination than varying the market price. This benefit-cost analysis of biannual vaccination strategy showed that investment in FMD prevention can be financially profitable, and therefore sustainable, for dairy farmers. For beef cattle, it is less certain that vaccination is profitable. Additional benefit-cost analysis study of vaccination strategies at the national-level would be required to evaluate and adapt the national strategy to achieve eradication of this disease in Vietnam.

  17. Opinion Expression as a Rational Behavior.

    ERIC Educational Resources Information Center

    Kim, Sei-Hill

    This study looks at individuals' opinion expressions as a rational behavior based on a conscious calculus of expected benefits and costs (economic analysis). The influences of "issue benefit,""opinion congruence," and "issue knowledge," as sources of benefits and costs on opinion expression were hypothesized and tested. The study also examined the…

  18. Mapping the economic costs and benefits of conservation.

    PubMed

    Naidoo, Robin; Ricketts, Taylor H

    2006-10-01

    Resources for biodiversity conservation are severely limited, requiring strategic investment. Understanding both the economic benefits and costs of conserving ecosystems will help to allocate scarce dollars most efficiently. However, although cost-benefit analyses are common in many areas of policy, they are not typically used in conservation planning. We conducted a spatial evaluation of the costs and benefits of conservation for a landscape in the Atlantic forests of Paraguay. We considered five ecosystem services (i.e., sustainable bushmeat harvest, sustainable timber harvest, bioprospecting for pharmaceutical products, existence value, and carbon storage in aboveground biomass) and compared them to estimates of the opportunity costs of conservation. We found a high degree of spatial variability in both costs and benefits over this relatively small (approximately 3,000 km(2)) landscape. Benefits exceeded costs in some areas, with carbon storage dominating the ecosystem service values and swamping opportunity costs. Other benefits associated with conservation were more modest and exceeded costs only in protected areas and indigenous reserves. We used this cost-benefit information to show that one potential corridor between two large forest patches had net benefits that were three times greater than two otherwise similar alternatives. Spatial cost-benefit analysis can powerfully inform conservation planning, even though the availability of relevant data may be limited, as was the case in our study area. It can help us understand the synergies between biodiversity conservation and economic development when the two are indeed aligned and to clearly understand the trade-offs when they are not.

  19. Mapping the Economic Costs and Benefits of Conservation

    PubMed Central

    Naidoo, Robin; Ricketts, Taylor H

    2006-01-01

    Resources for biodiversity conservation are severely limited, requiring strategic investment. Understanding both the economic benefits and costs of conserving ecosystems will help to allocate scarce dollars most efficiently. However, although cost-benefit analyses are common in many areas of policy, they are not typically used in conservation planning. We conducted a spatial evaluation of the costs and benefits of conservation for a landscape in the Atlantic forests of Paraguay. We considered five ecosystem services (i.e., sustainable bushmeat harvest, sustainable timber harvest, bioprospecting for pharmaceutical products, existence value, and carbon storage in aboveground biomass) and compared them to estimates of the opportunity costs of conservation. We found a high degree of spatial variability in both costs and benefits over this relatively small (~3,000 km2) landscape. Benefits exceeded costs in some areas, with carbon storage dominating the ecosystem service values and swamping opportunity costs. Other benefits associated with conservation were more modest and exceeded costs only in protected areas and indigenous reserves. We used this cost-benefit information to show that one potential corridor between two large forest patches had net benefits that were three times greater than two otherwise similar alternatives. Spatial cost-benefit analysis can powerfully inform conservation planning, even though the availability of relevant data may be limited, as was the case in our study area. It can help us understand the synergies between biodiversity conservation and economic development when the two are indeed aligned and to clearly understand the trade-offs when they are not. PMID:17076583

  20. Developing a Value Framework: The Need to Reflect the Opportunity Costs of Funding Decisions.

    PubMed

    Sculpher, Mark; Claxton, Karl; Pearson, Steven D

    2017-02-01

    A growing number of health care systems internationally use formal economic evaluation methods to support health care funding decisions. Recently, a range of organizations have been advocating forms of analysis that have been termed "value frameworks." There has also been a push for analytical methods to reflect a fuller range of benefits of interventions through multicriteria decision analysis. A key principle that is invariably neglected in current and proposed frameworks is the need to reflect evidence on the opportunity costs that health systems face when making funding decisions. The mechanisms by which opportunity costs are realized vary depending on the system's financial arrangements, but they always mean that a decision to fund a specific intervention for a particular patient group has the potential to impose costs on others in terms of forgone benefits. These opportunity costs are rarely explicitly reflected in analysis to support decisions, but recent developments to quantify benefits forgone make more appropriate analyses feasible. Opportunity costs also need to be reflected in decisions if a broader range of attributes of benefit is considered, and opportunity costs are a key consideration in determining the appropriate level of total expenditure in a system. The principles by which opportunity costs can be reflected in analysis are illustrated in this article by using the example of the proposed methods for value-based pricing in the United Kingdom. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis.

    PubMed

    Rocchi, A; Verma, S

    2006-09-01

    To conduct an economic analysis comparing tamoxifen and anastrozole (Arimidex) in the adjuvant treatment of hormone receptor-positive (HR+), post-menopausal early breast cancer patients. An economic model examined typical patients (64 years of age, HR+, 64% node negative) from the Arimidex, tamoxifen alone, or in combination (ATAC) trial over a lifetime horizon. Rates of events were derived from ATAC trial results. Post-trial event rates were drawn from the literature for tamoxifen; event rates for anastrozole were modified by the relative risks observed in the ATAC trial. Resource utilization was drawn from Statistics Canada's Population Health Model for breast cancer, supplemented by an expert panel. A public health care system perspective, 2004 Canadian prices and a 5% discount rate were employed. Anastrozole-taking patients incurred additional hormonal treatment costs compared to tamoxifen-taking patients (incremental lifetime cost, 6,974 Canadian dollars per patient), partially offset by reduced downstream recurrences of breast cancer (1,143 Canadian dollars lifetime savings per patient) for a net incremental cost of 5,796 Canadian dollars per patient on anastrozole. The anastrozole-treated patients were projected to experience a 5.6% absolute risk reduction of first breast cancer recurrence and a 2.8% absolute risk reduction in breast cancer death. This corresponded to 30,000 Canadian dollars per life year gained and 28,000 Canadian dollars per quality-adjusted life year gained (95% confidence interval, 17,428 to 54,605 Canadian dollars). The results were affected by the duration and extent of anastrozole benefit under sensitivity analysis but remained cost-effective. Compared to tamoxifen, anastrozole therapy is effective and cost-effective as initial adjuvant therapy in post-menopausal, HR+ early breast cancer patients.

  2. Cost-effectiveness of an Evidence-Based Childhood Asthma Intervention in Real-World Primary Care Settings.

    PubMed

    Dor, Avi; Luo, Qian; Gerstein, Maya Tuchman; Malveaux, Floyd; Mitchell, Herman; Markus, Anne Rossier

    We present an incremental cost-effectiveness analysis of an evidence-based childhood asthma intervention (Community Healthcare for Asthma Management and Prevention of Symptoms [CHAMPS]) to usual management of childhood asthma in community health centers. Data used in the analysis include household surveys, Medicaid insurance claims, and community health center expenditure reports. We combined our incremental cost-effectiveness analysis with a difference-in-differences multivariate regression framework. We found that CHAMPS reduced symptom days by 29.75 days per child-year and was cost-effective (incremental cost-effectiveness ratio: $28.76 per symptom-free days). Most of the benefits were due to reductions in direct medical costs. Indirect benefits from increased household productivity were relatively small.

  3. 7 CFR 2.71 - Director, Office of Risk Assessment and Cost-Benefit Analysis.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Director, Office of Risk Assessment and Cost-Benefit Analysis. 2.71 Section 2.71 Agriculture Office of the Secretary of Agriculture DELEGATIONS OF AUTHORITY BY THE SECRETARY OF AGRICULTURE AND GENERAL OFFICERS OF THE DEPARTMENT Delegations of Authority by the...

  4. 7 CFR 2.71 - Director, Office of Risk Assessment and Cost-Benefit Analysis.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 1 2012-01-01 2012-01-01 false Director, Office of Risk Assessment and Cost-Benefit Analysis. 2.71 Section 2.71 Agriculture Office of the Secretary of Agriculture DELEGATIONS OF AUTHORITY BY THE SECRETARY OF AGRICULTURE AND GENERAL OFFICERS OF THE DEPARTMENT Delegations of Authority by the...

  5. 7 CFR 2.71 - Director, Office of Risk Assessment and Cost-Benefit Analysis.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Director, Office of Risk Assessment and Cost-Benefit Analysis. 2.71 Section 2.71 Agriculture Office of the Secretary of Agriculture DELEGATIONS OF AUTHORITY BY THE SECRETARY OF AGRICULTURE AND GENERAL OFFICERS OF THE DEPARTMENT Delegations of Authority by the...

  6. 76 FR 81009 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... assessment, planning, forecasting, cost/benefit analysis, and to target areas for research. DATES: Written..., forecasting, cost/benefit analysis, and to target areas for research. Respondents: Approximately 83,500 owners... invites public comments about our intention to request the Office of Management and Budget (OMB) approval...

  7. Risk Benefit Analysis of Health Promotion: Opportunities and Threats for Physical Education.

    ERIC Educational Resources Information Center

    Vertinsky, Patricia

    1985-01-01

    The increasing popularity of health promotion and lifestyle management techniques call for a careful look at the misuse and costs of suasion, imposition of values as science, social inequities and individual consequences, and biases in communication of health risk information. The application of more systematic cost-benefit analysis is…

  8. Dancing on the Bottom Line: An Unruly Cost-Benefit Analysis of Three Academic Development Initiatives

    ERIC Educational Resources Information Center

    Sword, Helen

    2014-01-01

    This article offers an unconventional cost-benefit analysis of three academic development initiatives at a large Australasian university: a three-day foundation course for new academics, a series of one-on-one teaching consultations and a two-year postgraduate certificate program. Weaving together qualitative, quantitative and arts-based…

  9. Executive Summary of Systems Analysis to Develop Future Civil Aircraft Noise Reduction Alternatives.

    DTIC Science & Technology

    1982-05-01

    options in the unit cost analysis. These requirements were that the selected land use options should be applicable nationwide, be amenable to public ... adminstration , provide benefits in terms of direct reduction of noise exposure, and result in costs and benefits that could be readily quantifiable for use

  10. Cost/benefit analysis of advanced material technologies for small aircraft turbine engines

    NASA Technical Reports Server (NTRS)

    Comey, D. H.

    1977-01-01

    Cost/benefit studies were conducted on ten advanced material technologies applicable to small aircraft gas turbine engines to be produced in the 1985 time frame. The cost/benefit studies were applied to a two engine, business-type jet aircraft in the 6800- to 9100-Kg (15,000- to 20,000-lb) gross weight class. The new material technologies are intended to provide improvements in the areas of high-pressure turbine rotor components, high-pressure turbine rotor components, high-pressure turbine stator airfoils, and static structural components. The cost/benefit of each technology is presented in terms of relative value, which is defined as a change in life cycle cost times probability of success divided by development cost. Technologies showing the most promising cost/benefits based on relative value are uncooled single crystal MAR-M 247 turbine blades, cooled DS MAR-M 247 turbine blades, and cooled ODS 'M'CrAl laminate turbine stator vanes.

  11. Economic evaluation of a participatory ergonomics intervention in a textile plant.

    PubMed

    Tompa, Emile; Dolinschi, Roman; Natale, Julianne

    2013-05-01

    In this study we report on the economic evaluation of a participatory ergonomics process undertaken at a clothing manufacturer in Southwestern Ontario, Canada that employs approximately 300 workers. We undertake a cost-benefit analysis from the company perspective. Intervention costs amounted to $65,787 and intervention benefits $360,614 (2011 Canadian dollars). The net present value was $294,827, suggesting that the intervention was worth undertaking based on the costs and consequences over the measurement period spanning more than four years. Based on these costs and benefits, the benefit-to-cost ratio is 5.5. Overall, the findings from this study suggest that participatory ergonomics interventions can be cost beneficial from the company perspective. Even though the changes were typically low-cost and low-tech interventions implemented by the plant mechanics and maintenance personnel, benefits were realized on both the health and financial fronts. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  12. Cost-benefit analysis of safety belts in Texas school buses.

    PubMed

    Begley, C E; Biddle, A K

    1988-01-01

    Although safety belts have been shown to reduce the risk of serious injury or death in automobile crashes, evidence of their effectiveness in school buses is uncertain. In this paper, the potential costs and benefits of mandatory safety belts in Texas school buses are estimated, based on the assumption that their effectiveness is less than or equal to rear seatbelt effectiveness in autos. Costs are based on both retrofitting old buses with belts and installing them in new buses. Benefits include the direct and indirect (forgone earnings) cost-savings from preventable injuries and fatalities. Results indicate that a law mandating safety belts in Texas school buses would not be cost-beneficial. Annual benefits would exceed the annual costs of installing belts in new school buses. However, the benefits would not be large enough to compensate for the five-year costs associated with retrofitting old buses.

  13. Cost-benefit analysis of safety belts in Texas school buses.

    PubMed Central

    Begley, C E; Biddle, A K

    1988-01-01

    Although safety belts have been shown to reduce the risk of serious injury or death in automobile crashes, evidence of their effectiveness in school buses is uncertain. In this paper, the potential costs and benefits of mandatory safety belts in Texas school buses are estimated, based on the assumption that their effectiveness is less than or equal to rear seatbelt effectiveness in autos. Costs are based on both retrofitting old buses with belts and installing them in new buses. Benefits include the direct and indirect (forgone earnings) cost-savings from preventable injuries and fatalities. Results indicate that a law mandating safety belts in Texas school buses would not be cost-beneficial. Annual benefits would exceed the annual costs of installing belts in new school buses. However, the benefits would not be large enough to compensate for the five-year costs associated with retrofitting old buses. PMID:3140273

  14. Cost-benefit analysis of fall injuries prevented by a programme of home modifications: a cluster randomised controlled trial.

    PubMed

    Keall, Michael D; Pierse, Nevil; Howden-Chapman, Philippa; Guria, Jagadish; Cunningham, Chris W; Baker, Michael G

    2017-02-01

    Injuries due to falls in the home impose a huge social and economic cost on society. We have previously found important safety benefits of home modifications such as handrails for steps and stairs, grab rails for bathrooms, outside lighting, edging for outside steps and slip-resistant surfacing for outside areas such as decks. Here we assess the economic benefits of these modifications. Using a single-blinded cluster randomised controlled trial, we analysed insurance payments for medically treated home fall injuries as recorded by the national injury insurer. The benefits in terms of the value of disability adjusted life years (DALYs) averted and social costs of injuries saved were extrapolated to a national level and compared with the costs of the intervention. An intention-to-treat analysis was carried out. Injury costs per time exposed to the modified homes compared with the unmodified homes showed a reduction in the costs of home fall injuries of 33% (95% CI 5% to 49%). The social benefits of injuries prevented were estimated to be at least six times the costs of the intervention. The benefit-cost ratio can be at least doubled for older people and increased by 60% for those with a prior history of fall injuries. This is the first randomised controlled trial to examine the benefits of home modification for reducing fall injury costs in the general population. The results show a convincing economic justification for undertaking relatively low-cost home repairs and installing safety features to prevent falls. ACTRN12609000779279. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State.

    PubMed

    Ding, Yao; Thompson, John D; Kobrynski, Lisa; Ojodu, Jelili; Zarbalian, Guisou; Grosse, Scott D

    2016-05-01

    To evaluate the expected cost-effectiveness and net benefit of the recent implementation of newborn screening (NBS) for severe combined immunodeficiency (SCID) in Washington State. We constructed a decision analysis model to estimate the costs and benefits of NBS in an annual birth cohort of 86 600 infants based on projections of avoided infant deaths. Point estimates and ranges for input variables, including the birth prevalence of SCID, proportion detected asymptomatically without screening through family history, screening test characteristics, survival rates, and costs of screening, diagnosis, and treatment were derived from published estimates, expert opinion, and the Washington NBS program. We estimated treatment costs stratified by age of identification and SCID type (with or without adenosine deaminase deficiency). Economic benefit was estimated using values of $4.2 and $9.0 million per death averted. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost-effectiveness ratio (ICER) of net direct cost per life-year saved. Our model predicts an additional 1.19 newborn infants with SCID detected preclinically through screening, in addition to those who would have been detected early through family history, and 0.40 deaths averted annually. Our base-case model suggests an ICER of $35 311 per life-year saved, and a benefit-cost ratio of either 5.31 or 2.71. Sensitivity analyses found ICER values <$100 000 and positive net benefit for plausible assumptions on all variables. Our model suggests that NBS for SCID in Washington is likely to be cost-effective and to show positive net economic benefit. Published by Elsevier Inc.

  16. 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.

  17. Economic Analysis of Immunization Strategies for PRRS Control [corrected].

    PubMed

    Linhares, Daniel C L; Johnson, Clayton; Morrison, Robert B

    2015-01-01

    Porcine reproductive and respiratory syndrome virus (PRRSv) is a swine-specific pathogen that causes significant increases in production costs. When a breeding herd becomes infected, in an attempt to hasten control and elimination of PRRSv, some veterinarians have adopted a strategy called load-close-expose which consists of interrupting replacement pig introductions into the herd for several weeks (herd closure) and exposing the whole herd to a replicating PRRSv to boost herd immunity. Either modified-live virus (MLV) vaccine or live field-virus inoculation (FVI) is used. This study consisted of partial budget analyses to compare MLV to FVI as the exposure method of load-close-expose program to control and eliminate PRRSv from infected breeding herds, and secondly to estimate benefit / cost of vaccinating sow herds preventatively. Under the assumptions used in this study, MLV held economic advantage over FVI. However, sensitivity analysis revealed that decreasing margin over variable costs below $ 47.32, or increasing PRRSv-attributed cost above $18.89 or achieving time-to-stability before 25 weeks resulted in advantage of FVI over MLV. Preventive vaccination of sow herds was beneficial when the frequency of PRRSv infection was at least every 1 year and 9 months [corrected]. The economics of preventative vaccination was minimally affected by cost attributed to field-type PRRSv infection on growing pigs or by the breeding herd productivity level. The models developed and described in this paper provide valuable tools to assist veterinarians in their efforts to control PRRSv.

  18. The National Map: Benefits at what cost?

    USGS Publications Warehouse

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

    2004-01-01

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

  19. A feasibility study of municipal solid waste incineration fly ash utilisation in Estonia.

    PubMed

    Berber, Hakan; Frey, Ruedi; Voronova, Viktoria; Koroljova, Arina

    2017-09-01

    The purpose of this paper is to discuss the alternative environmental management options for the utilisation of municipal solid waste (MSW) incineration fly ash (FA), which is generated at Iru Power Plant where MSW is incinerated in Estonia. To determine sustainable and economically feasible environmental management options for MSW incineration FA in Estonia, CO 2 sequestration with a further carbonation process was examined. A partial Cost & Benefit Analysis has been conducted to compare the carbonation process to the current situation. Two carbonation options were developed. Option 1 is to use carbonated FA in any other processes based on the waste-to-product principle. Option 2 is to send carbonated FA to the non-hazardous landfill in Tallinn, Estonia. Important parameters, such as Net Present Value (NPV), Internal Rate of Return (IRR), Benefit-Cost Ratio (BCR) and Break Even Point (BEP), have been calculated for carbonation options and the current case. In addition, a sensitivity analysis has been conducted to examine its robustness. The results showed that the best option is carbonation Option 1 with NPV of 9,209,662 EUR, IRR of 43%, BCR of 2.63 and BEP between 2018 and 2019. Both Options 1 and 2 constitute more sustainable and environmentally friendly management options compared to the current situation. It can be concluded that this preliminary feasibility study showed that running a carbonation plant may be profitable and sustainable for Estonia. Currently, there is no treatment technology for MSW incineration FA in Estonia and FA is sent to a neighbouring country for further utilisation. This is the first study to demonstrate FA management options with economic and environmental benefits.

  20. Toward a Cost/Benefit Analysis of Physical Fitness

    PubMed Central

    Shephard, Roy J.

    1986-01-01

    This article, which is based, in part, on a paper presented to the Canadian Association of Sport Sciences, Quebec City, in November 1985, evaluates the principles of cost/benefit and cost-effectiveness analysis in the specific context of fitness programming. Because of difficulties in valuing all aspects of fitness and health—particularly survival after retirement—cost-effectiveness analysis is generally preferred. Allowance must be made for inflation, the discount rate (except in a “steady state” analysis), marginal costs of program expansion, opportunity costs incurred by participants, the changing fabric of society, the economic multiplication of investment in fitness, and anticipated participation rates. Benefits may be observed by the individual (improved health), the corporation (reduced turnover and absenteeism, increased productivity, fewer injuries), and the state (reduced direct and indirect costs of illness, improved lifestyle, reduced demand for geriatric services). Program costs vary widely with the activity that is undertaken, but even daily walking involves the participant in some expense. Employee programs often cost $500-$750 per participant/year, while, depending on the sport and local speculation by land “developers”, community programs may cost $175-$1,000 per participant/year. Cost/effectiveness analyses allow governments to reach informed decisions, but they cannot always answer associated ethical problems such as determining the value of human life, and the rights of the individual as opposed to those of society. PMID:21267294

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

    EPA Science Inventory

    The climate impacts of greenhouse gas (GHG) emissions impose social costs on society. To date, EPA has not had an approach to estimate the economic benefits of reducing emissions of non-CO2 GHGs (or the costs of increasing them) that is consistent with the methodology underlying...

  2. Risk and value analysis of SETI

    NASA Technical Reports Server (NTRS)

    Billingham, J.

    1986-01-01

    The risks, values, and costs of the SETI project are evaluated and compared with those of the Viking project. Examination of the scientific values, side benefits, and costs of the two projects reveal that both projects provide equal benefits at equal costs. The probability of scientific and technical success is analyzed.

  3. Cost benefit analysis of Haemophilus influenzae type b vaccination programme in Israel.

    PubMed Central

    Ginsberg, G M; Kassis, I; Dagan, R

    1993-01-01

    STUDY OBJECTIVE--The recent availability of Haemophilus influenzae type b (HIB) conjugate vaccines prompted an examination of the costs and benefits of four and three dose HIB prevention programmes targeting all newborns in Israel. MEASUREMENTS AND MAIN RESULTS--A four dose programme would reduce the number of childhood (aged 0-13) HIB cases from 184.2 to 31.3 per year, yielding a benefit ($1.03 million) to cost ($3.55 million) ratio of just 0.29/l for health services only, based on a vaccine price of $7.74 per dose. When benefits resulting from a reduction in mild handicaps and severe neurological sequelae are included, the benefit ($4.48 million) to cost ratio rises to 1.26/l and it reaches 1.45/l when the $0.66 million indirect benefits of reduced work absences and mortality are also included. Break even vaccine costs are $2.24 when health service benefits only are considered and $11.21 when all the benefits are included. CONCLUSION--In the absence of other projects with higher benefit to cost ratios, Israel should start to provide a nationwide HIB vaccination programme since the monetary benefits to society of such a programme will exceed the costs to society. A barrier to implementation may occur, however, because the costs of the programme exceed the benefits to the health services alone. PMID:8120505

  4. Industrial Technology Modernization Program. Project 80. Increase Efficiency of Card Test/Device Test Areas by the Usage of Improved Material Handling Systems. Revision 1. Phase 2

    DTIC Science & Technology

    1988-03-01

    INDUSTRY ANALYSIS/FINDINGS 132 12 EQUIPMENT/MACHINERY ALTERNATIVES 134 13 MIS REQUIREMENTS/IMPROVEMENTS 135 14 COST BENEFIT ANALYSIS AND PROCEDURE 137 15...SOFTWARE DIAGRAM 14.0-1 COST BENEFIT ANALYSIS METHODOLOGY 138 14.3-1 PROJECT 80 EXPENDITURE SCHEDULE 141 14.4-1 PROJECT 80 CASH FLOWS 142 15.1-1 PROJECT 80...testing, streamlining work flow, and installation of ergonomically designed work cell/work centers. The benefits associated with the implementation of ITM

  5. A modified cost benefit analysis of coastal development (tourism) with special reference to Longbay Beach--Negril, Jamaica

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

    Hinds, P.W.; Ngandu, M.

    The purpose of this study is to estimate the cost and benefits of the Tourist Industry in Negril over the period 1970-93, including its impact on the environment. Traditional cost benefit analysis will be used with appropriate modifications. The Long Bay stretch has been an area of rapid expansion over the last ten to twenty years. This expansion has rapidly outgrown infrastructure development and this, the potential environmental problems are already showing up in marine pollution and other forms of environmental degradation. Although there is numerous evidence of environmental impacts on tourism, there has not been a lot of workmore » done on quantifying these impacts, and policy makers have not been ensuring that these externalities are internalized by these hotels, in an effort to make them better stewards of the environment. This study will not only look at the economic cost and benefit of the industry from the point of view of revenue and expenditure, but also the environment cost, benefit and policy recommendations necessary to accomplish this.« less

  6. A non-stationary cost-benefit based bivariate extreme flood estimation approach

    NASA Astrophysics Data System (ADS)

    Qi, Wei; Liu, Junguo

    2018-02-01

    Cost-benefit analysis and flood frequency analysis have been integrated into a comprehensive framework to estimate cost effective design values. However, previous cost-benefit based extreme flood estimation is based on stationary assumptions and analyze dependent flood variables separately. A Non-Stationary Cost-Benefit based bivariate design flood estimation (NSCOBE) approach is developed in this study to investigate influence of non-stationarities in both the dependence of flood variables and the marginal distributions on extreme flood estimation. The dependence is modeled utilizing copula functions. Previous design flood selection criteria are not suitable for NSCOBE since they ignore time changing dependence of flood variables. Therefore, a risk calculation approach is proposed based on non-stationarities in both marginal probability distributions and copula functions. A case study with 54-year observed data is utilized to illustrate the application of NSCOBE. Results show NSCOBE can effectively integrate non-stationarities in both copula functions and marginal distributions into cost-benefit based design flood estimation. It is also found that there is a trade-off between maximum probability of exceedance calculated from copula functions and marginal distributions. This study for the first time provides a new approach towards a better understanding of influence of non-stationarities in both copula functions and marginal distributions on extreme flood estimation, and could be beneficial to cost-benefit based non-stationary bivariate design flood estimation across the world.

  7. Cost-utility analysis of radical nephrectomy versus partial nephrectomy in the management of small renal masses: Adjusting for the burden of ensuing chronic kidney disease

    PubMed Central

    Klinghoffer, Zachary; Tarride, Jean-Eric; Novara, Giacomo; Ficarra, Vincenzo; Kapoor, Anil; Shayegan, Bobby; Braga, Luis H.

    2013-01-01

    Objectives: We compare the cost-utility of laparoscopic radical nephrectomy (LRN), laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) in the management of small renal masses (SRMs) when the impact of ensuing chronic kidney disease (CKD) disease is considered. Methods: We designed a Markov decision analysis model with a 10-year time horizon. Estimates of costs, utilities, complication rates and probabilities of developing CKD were derived from the literature. The base case patient was assumed to be a 65-year-old patient with a <4-cm unilateral renal mass, a normal contralateral kidney and a normal preoperative serum creatinine. Univariate and probabilistic sensitivity analyses were conducted to address the uncertainty associated with the study parameters. Results: OPN was the least costly strategy at $25 941 USD and generated 7.161 quality-adjusted life years (QALYs) over 10 years. LPN yielded 0.098 additional QALYs at an additional cost of $888 for an incremental cost-effectiveness ratio of $9057 per QALY, well below a commonly cited willingness-to-pay threshold of $50 000 per QALY. LRN was more costly and yielded fewer QALYs than OPN and LPN. Sensitivity analyses demonstrated our model to be robust to changes to key parameters. Age had no effect on preferred strategy. Conclusions: Partial nephrectomy (PN) is the preferred treatment strategy for SRMs. In centres where LPN is not available, OPN remains considerably more cost-effective than LRN. Furthermore, our study demonstrates that there is no age at which PN is not preferred to LRN. Our study provides additional evidence to advocate PN for the management of all amenable SRMs. PMID:23671525

  8. Who pays for public employee health costs?

    PubMed

    Clemens, Jeffrey; Cutler, David M

    2014-12-01

    We analyze the incidence of public-employee health benefits. Because these benefits are negotiated through the political process, relevant labor market institutions deviate significantly from the competitive, private-sector benchmark. Empirically, we find that roughly 15 percent of the cost of recent benefit growth was passed onto school district employees through reductions in wages and salaries. Strong teachers' unions were associated with relatively strong linkages between benefit growth and growth in total compensation. Our analysis is consistent with the view that the costs of public workers' benefits are difficult to monitor, contributing to benefit oriented, and often under-funded, compensation schemes. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services

    PubMed Central

    Birch, Jennifer C.; Newton, Adrian C.; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

    2010-01-01

    Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost–benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape. PMID:21106761

  10. Quantitative Outcomes of a One Health approach to Study Global Health Challenges.

    PubMed

    Falzon, Laura C; Lechner, Isabel; Chantziaras, Ilias; Collineau, Lucie; Courcoul, Aurélie; Filippitzi, Maria-Eleni; Laukkanen-Ninios, Riikka; Peroz, Carole; Pinto Ferreira, Jorge; Postma, Merel; Prestmo, Pia G; Phythian, Clare J; Sarno, Eleonora; Vanantwerpen, Gerty; Vergne, Timothée; Grindlay, Douglas J C; Brennan, Marnie L

    2018-03-01

    Having gained momentum in the last decade, the One Health initiative promotes a holistic approach to address complex global health issues. Before recommending its adoption to stakeholders, however, it is paramount to first compile quantitative evidence of the benefit of such an approach. The aim of this scoping review was to identify and summarize primary research that describes monetary and non-monetary outcomes following adoption of a One Health approach. An extensive literature search yielded a total of 42,167 references, of which 85 were included in the final analysis. The top two biotic health issues addressed in these studies were rabies and malaria; the top abiotic health issue was air pollution. Most studies described collaborations between human and animal (n = 42), or human and environmental disciplines (n = 41); commonly reported interventions included vector control and animal vaccination. Monetary outcomes were commonly expressed as cost-benefit or cost-utility ratios; non-monetary outcomes were described using disease frequency or disease burden measurements. The majority of the studies reported positive or partially positive outcomes. This paper illustrates the variety of health challenges that can be addressed using a One Health approach, and provides tangible quantitative measures that can be used to evaluate future implementations of the One Health approach.

  11. Smoke Alarm Giveaway and Installation Programs

    PubMed Central

    Liu, Ying; Mack, Karin A.; Diekman, Shane T.

    2015-01-01

    Background The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. Purpose To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Methods Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Results Cost-effectiveness analysis (CEA) resulted in anaverage cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost–benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit–cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Conclusions Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventionsto reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. PMID:22992356

  12. An Analysis of Costs and Health Co-Benefits for a U.S. Power Plant Carbon Standard.

    PubMed

    Buonocore, Jonathan J; Lambert, Kathleen F; Burtraw, Dallas; Sekar, Samantha; Driscoll, Charles T

    2016-01-01

    Reducing carbon dioxide (CO2) emissions from power plants can have important "co-benefits" for public health by reducing emissions of air pollutants. Here, we examine the costs and health co-benefits, in monetary terms, for a policy that resembles the U.S. Environmental Protection Agency's Clean Power Plan. We then examine the spatial distribution of the co-benefits and costs, and the implications of a range of cost assumptions in the implementation year of 2020. Nationwide, the total health co-benefits were $29 billion 2010 USD (95% CI: $2.3 to $68 billion), and net co-benefits under our central cost case were $12 billion (95% CI: -$15 billion to $51 billion). Net co-benefits for this case in the implementation year were positive in 10 of the 14 regions studied. The results for our central case suggest that all but one region should experience positive net benefits within 5 years after implementation.

  13. Financing intersectoral health promotion programmes: some reasons why collaborators are collaborating as indicated by cost-effectiveness analyses.

    PubMed

    Johansson, Pia; Tillgren, Per

    2011-03-01

    Intersectoral collaboration is an important part of many health promotion programmes. The reasons for the local organisations to collaborate, i.e. to finance programmes, are presumably based on benefits they derive from the collaboration. The aim of this study is to discuss whether subsector financial analyses based on data from cost-effectiveness analyses reflect incentives of collaborating organisations in two intersectoral health promotion programmes. Within economics, financial incentives are important reasons for actions. The financial incentives of collaborators are exemplified with two subsector financial analyses containing avoided disease-related costs as estimated in two cost-effectiveness analyses, on an elderly safety promotion programme (Safe Seniors in Sundbyberg) and on a diabetes prevention programme (Stockholm Diabetes Prevention Program, SDPP) from Stockholm, Sweden. The subsector financial analyses indicate that there are financial incentives for the key local community organisation, i.e. the local authority, to collaborate in one of the programmes but not the other. There are no financial benefits for other important community organisations, such as non-governmental organisations. The reasons for collaborating organisations to collaborate within intersectoral health promotion programmes extend beyond financial benefits from averted disease. Thus, the reported subsector financial analyses are only partial reflections of the incentives of collaborators, but they might be used as a starting point for discussions on cost sharing among potential intersectoral collaborators.

  14. The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial.

    PubMed

    Whitty, Jennifer A; McInnes, Elizabeth; Bucknall, Tracey; Webster, Joan; Gillespie, Brigid M; Banks, Merrilyn; Thalib, Lukman; Wallis, Marianne; Cumsille, Jose; Roberts, Shelley; Chaboyer, Wendy

    2017-10-01

    Pressure ulcers are serious, avoidable, costly and common adverse outcomes of healthcare. To evaluate the cost-effectiveness of a patient-centred pressure ulcer prevention care bundle compared to standard care. Cost-effectiveness and cost-benefit analyses of pressure ulcer prevention performed from the health system perspective using data collected alongside a cluster-randomised trial. Eight tertiary hospitals in Australia. Adult patients receiving either a patient-centred pressure ulcer prevention care bundle (n=799) or standard care (n=799). Direct costs related to the intervention and preventative strategies were collected from trial data and supplemented by micro-costing data on patient turning and skin care from a 4-week substudy (n=317). The time horizon for the economic evaluation matched the trial duration, with the endpoint being diagnosis of a new pressure ulcer, hospital discharge/transfer or 28days; whichever occurred first. For the cost-effectiveness analysis, the primary outcome was the incremental costs of prevention per additional hospital acquired pressure ulcer case avoided, estimated using a two-stage cluster-adjusted non-parametric bootstrap method. The cost-benefit analysis estimated net monetary benefit, which considered both the costs of prevention and any difference in length of stay. All costs are reported in AU$(2015). The care bundle cost AU$144.91 (95%CI: $74.96 to $246.08) more per patient than standard care. The largest contributors to cost were clinical nurse time for repositioning and skin inspection. In the cost-effectiveness analysis, the care bundle was estimated to cost an additional $3296 (95%CI: dominant to $144,525) per pressure ulcer avoided. This estimate is highly uncertain. Length of stay was unexpectedly higher in the care bundle group. In a cost-benefit analysis which considered length of stay, the net monetary benefit for the care bundle was estimated to be -$2320 (95%CI -$3900, -$1175) per patient, suggesting the care bundle was not a cost-effective use of resources. A pressure ulcer prevention care bundle consisting of multicomponent nurse training and patient education may promote best practice nursing care but may not be cost-effective in preventing hospital acquired pressure ulcer. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Cost-benefit analysis of establishing and operating radiation oncology services in Fiji.

    PubMed

    Kim, Eunkyoung; Cho, Yoon-Min; Kwon, Soonman; Park, Kunhee

    2017-10-01

    Rising demand for services of cancer patients has been recognised by the Government of Fiji as a national health priority. Increasing attention has been paid to the lack of service of radiation therapy or radiotherapy in Fiji. This study aims to estimate and compare the costs and benefits of introducing radiation oncology services in Fiji from the societal perspective. Time horizon for cost-benefit analysis (CBA) was 15 years from 2021 to 2035. The benefits and costs were converted to the present values of 2016. Estimates for the CBA model were taken from previous studies and expert opinions and data obtained from field visits to Fiji in January 2016. Sensitivity analyses with changing assumptions were undertaken. The estimated net benefit, applying the national minimum wage (NMW) to measure monetary value for life-year gained, was -31,624,421 FJD with 0.69 of benefit-cost (B/C) ratio. If gross national income (GNI) per capita was used for the value of life years, net benefit was 3,975,684 FJD (B/C ratio: 1.04). With a pessimistic scenario, establishing the center appeared to be not cost-beneficial, and the net benefit was -53,634,682 FJD (B/C ratio: 0.46); net benefit with an optimistic scenario was estimated 23,178,189 FJD (B/C ratio: 1.20). Based on the CBA results from using GNI per capita instead of the NMW, this project would be cost-beneficial. Introducing a radiation oncology center in Fiji would have potential impacts on financial sustainability, financial protection, and accessibility and equity of the health system. Copyright © 2017 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  16. Literature Survey of Induced Traffic Due to Transport Cost Savings.

    DTIC Science & Technology

    1985-06-01

    19. KEY WORDS (Continue on reveres aide If necessary and identify by block number) Induced traffic, benefit -cost analysis,discriminant analysis...currently " al"ilable t’ induced movement benefit . The reviewer focused on coal and grain . ’.rade. A jide range of sources were consulted and read...in order to find any research that had been done on induced movement benefit . Findings are sum- marized, and future research topics on feasible models

  17. Missing College Attendance Costs: Opportunity, Financing, and Risk. ACT Student Financial Aid Research Report Series 89-3.

    ERIC Educational Resources Information Center

    Mortenson, Thomas G.

    The way in which costs enter the potential college student's calculation of the benefits of college attendance is examined. In particular, the paper considers how costs not considered in financial aid need analysis can increase college attendance costs and thereby decrease net benefits of college attendance for those who use financial aid. The…

  18. A cost-benefit analysis on the specialization in departments of obstetrics and gynecology in Japan.

    PubMed

    Shen, Junyi; Fukui, On; Hashimoto, Hiroyuki; Nakashima, Takako; Kimura, Tadashi; Morishige, Kenichiro; Saijo, Tatsuyoshi

    2012-03-27

    In April 2008, the specialization in departments of obstetrics and gynecology was conducted in Sennan area of Osaka prefecture in Japan, which aims at solving the problems of regional provision of obstetrical service. Under this specialization, the departments of obstetrics and gynecology in two city hospitals were combined as one medical center, whilst one hospital is in charge of the department of gynecology and the other one operates the department of obstetrics. In this paper, we implement a cost-benefit analysis to evaluate the validity of this specialization. The benefit-cost ratio is estimated at 1.367 under a basic scenario, indicating that the specialization can generate a net benefit. In addition, with a consideration of different kinds of uncertainty in the future, a number of sensitivity analyses are conducted. The results of these sensitivity analyses suggest that the specialization is valid in the sense that all the estimated benefit-cost ratios are above 1.0 in any case.

  19. A cost benefit analysis of outsourced laboratory services.

    PubMed

    Bowers, J A

    1995-11-01

    As healthcare moves toward increased capitation, hospital administrators must be aware of all costs associated with patient services. This article describes the cost benefit analysis process used by northern Indiana hospital consumers during 1994-1995 to evaluate a local laboratory service outsource provider, South Bend Medical Foundation (SBMF). In an effort to meet the best interests of the community at large, three competing hospitals, medical leadership, and the local outsource provider joined forces to ensure that cost effective quality services would be provided. Laboratory utilization patterns for common DRGs were also analyzed. The team created a reconfiguration analysis to help develop benchmark figures for consideration in future contract negotiations.

  20. Cost Benefit of Comprehensive Primary and Preventive School-Based Health Care.

    PubMed

    Padula, William V; Connor, Katherine A; Mueller, Josiah M; Hong, Jonathan C; Velazquez, Gabriela Calderon; Johnson, Sara B

    2018-01-01

    The Rales Health Center is a comprehensive school-based health center at an urban elementary/middle school. Rales Health Center provides a full range of pediatric services using an enriched staffing model consisting of pediatrician, nurse practitioner, registered nurses, and medical office assistant. This staffing model provides greater care but costs more than traditional school-based health centers staffed by part-time nurses. The objective was to analyze the cost benefit of Rales Health Center enhanced staffing model compared with a traditional school-based health center (standard care), focusing on asthma care, which is among the most prevalent chronic conditions of childhood. In 2016, cost-benefit analysis using a decision tree determined the net social benefit of Rales Health Center compared with standard care from the U.S. societal perspective based on the 2015-2016 academic year. It was assumed that Rales Health Center could handle greater patient throughput related to asthma, decreased prescription costs, reduced parental resources in terms of missed work time, and improved student attendance. Univariate and multivariate probabilistic sensitivity analyses were conducted. The expected cost to operate Rales Health Center was $409,120, compared with standard care cost of $172,643. Total monetized incremental benefits of Rales Health Center were estimated to be $993,414. The expected net social benefit for Rales Health Center was $756,937, which demonstrated substantial societal benefit at a return of $4.20 for every dollar invested. This net social benefit estimate was robust to sensitivity analyses. Despite the greater cost associated with the Rales Health Center's enhanced staffing model, the results of this analysis highlight the cost benefit of providing comprehensive, high-quality pediatric care in schools, particularly schools with a large proportion of underserved students. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Ecosystem Services and Opportunity Costs Shift Spatial Priorities for Conserving Forest Biodiversity

    PubMed Central

    Schröter, Matthias; Rusch, Graciela M.; Barton, David N.; Blumentrath, Stefan; Nordén, Björn

    2014-01-01

    Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway) with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone) or partially restricted (partial use zone). Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2%) and the non-use zone (+3.2%). Furthermore, opportunity costs increased (+6.6%), which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1%) of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%. PMID:25393951

  2. Ecosystem services and opportunity costs shift spatial priorities for conserving forest biodiversity.

    PubMed

    Schröter, Matthias; Rusch, Graciela M; Barton, David N; Blumentrath, Stefan; Nordén, Björn

    2014-01-01

    Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway) with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone) or partially restricted (partial use zone). Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2%) and the non-use zone (+3.2%). Furthermore, opportunity costs increased (+6.6%), which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1%) of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%.

  3. The Implications of the Net Fiscal Benefits Criterion for Cost Sharing in Flood Control Projects.

    DTIC Science & Technology

    controversial areas. First, it is concluded that the net fiscal benefits criterion has important advantages in the determination of what local governments...would be willing to contribute to the cost of flood control projects, but somewhat less applicability to the analysis of economic efficiency benefits and

  4. Educational Cost-Benefit Analysis. Education Research Paper. Knowledge & Research.

    ERIC Educational Resources Information Center

    Hough, J. R.

    The use of educational cost-benefit analysis (CBA) is now widely accepted, not least in connection with the development of education systems in Third World countries. It has much to recommend it and is widely seen as preferable, both in theory and in practice, to the major alternative techniques, namely manpower planning and the social-demand…

  5. Real Cost-Benefit Analysis Is Needed in American Public Education

    ERIC Educational Resources Information Center

    Stoneberg, Bert D.

    2015-01-01

    Public school critics often point to rising expenditures and relatively flat test scores to justify their school reform agendas. The claims are flawed because their analyses fail to account for the difference in data types between dollars (ratio) and test scores (interval). A cost-benefit analysis using dollars as a common metric for both costs…

  6. Who Pays for Blended Learning? A Cost-Benefit Analysis

    ERIC Educational Resources Information Center

    Taplin, Ross H.; Kerr, Rosemary; Brown, Alistair M.

    2013-01-01

    Using cost-benefit analysis, the purpose of this study is to analyse the monetary value students place on having access, via the internet, to recorded lectures in a blended learning context. The principal results are that the average price students are willing to pay to download iLectures is approximately $30 per equivalent full time student.…

  7. Comparative Benefit-Cost Analysis of the Abecedarian Program and Its Policy Implications

    ERIC Educational Resources Information Center

    Barnett, W. S.; Masse, Leonard N.

    2007-01-01

    Child care and education are to some extent joint products of preschool programs, but public policy and research frequently approach these two goals independently. We present a benefit-cost analysis of a preschool program that provided intensive education during full-day child care. Data were obtained from a randomized trial with longitudinal…

  8. Cost-Benefit Analysis of U.S. Copyright Formalities. Final Report.

    ERIC Educational Resources Information Center

    King Research, Inc., Rockville, MD.

    This study of the feasibility of conducting a cost-benefit analysis in the complex environment of the formalities used in the United States as part of its administration of the copyright law focused on the formalities of copyright notice, deposit, registration, and recordation. The U.S. system is also compared with the less centralized copyright…

  9. Cost-benefit analysis of an area-wide pest management program to control Asian tiger mosquito in New Jersey

    USDA-ARS?s Scientific Manuscript database

    Area-wide pest management (AWPM) is recommended to control urban mosquitoes, such as Aedes albopictus (Asian tiger mosquito), which limit outdoor activities. We conducted a cost-benefit analysis for an AWPM in Mercer and Monmouth counties, New Jersey, as part of a controlled design with matched area...

  10. Environmental cost-effectiveness analysis in intertemporal natural resource policy: evaluation of selective fishing gear.

    PubMed

    Kronbak, Lone Grønbæk; Vestergaard, Niels

    2013-12-15

    In most decision-making involving natural resources, the achievements of a given policy (e.g., improved ecosystem or biodiversity) are rather difficult to measure in monetary units. To address this problem, the current paper develops an environmental cost-effectiveness analysis (ECEA) to include intangible benefits in intertemporal natural resource problems. This approach can assist managers in prioritizing management actions as least cost solutions to achieve quantitative policy targets. The ECEA framework is applied to a selective gear policy case in Danish mixed trawl fisheries in Kattegat and Skagerrak. The empirical analysis demonstrates how a policy with large negative net benefits might be justified if the intangible benefits are included. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. A Cost Analysis of Direct Cash Compensation In Lieu of Operating Military Commissary Stores

    DTIC Science & Technology

    2016-06-01

    current benefit that DeCA provides them. This thesis will also provide an estimate of the monetary value of the commissary benefit to service members and...the monetary value of the commissary benefit in remote locations. The research will incorporate data extracted from financial statements from DeCA...shopping benefit , military benefit , military stores, DeCA, budget cuts, savings, cost cut, eligible patron, groceries, food, remote military bases

  12. Cost-benefit analysis of administrative license suspensions

    DOT National Transportation Integrated Search

    1991-01-01

    This report summarizes a study of the costs and benefits associated with the implementation of laws calling for the administrative suspension of driver licenses for driving while intoxicated (DWI). Such laws generally call for speedy license suspensi...

  13. Teaching ABC & Cost Behaviors to Non-Numbers People

    ERIC Educational Resources Information Center

    Taylor, Virginia Anne; Rudnick, Martin

    2007-01-01

    Simply put, a cost analysis studies how you spend your money. Activity based costing models associate costs with services and cost benefit analysis weighs whether or not the costs expended were worth the money given the efforts involved and the results achieved. This study seeks to understand the financial choices and information seeking behaviors…

  14. Is 2010 the Year Army Acquisitions Turned the Corner to Affordability

    DTIC Science & Technology

    2017-12-01

    enacted as public law on May 22, 2009. The goal of the legislation, summarized by President Obama will limit cost overruns before they spiral out...mention that one Navy program that did complete a should cost analysis benefited from the newly acquired knowledge by negotiating a 4.5% reduction on a...the cost analysis requirements description indicates that a sole source contract for EMD will be pursued negating any benefits from competition (DOD

  15. An analysis of potassium iodide (KI) prophylaxis for the general public in the event of a nuclear accident

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

    Behling, H.; Behling, K.; Amarasooriya, H.

    1995-02-01

    A generic difficulty encountered in cost-benefit analyses is the quantification of major elements that define the costs and the benefits in commensurate units. In this study, the costs of making KI available for public use, and the avoidance of thyroidal health effects predicted to be realized from the availability of that KI (i.e., the benefits), are defined in the commensurate units of dollars.

  16. Disasters as a necessary part of benefit-cost analyses.

    PubMed

    Mark, R K; Stuart-Alexander, D E

    1977-09-16

    Benefit-cost analyses for water projects generally have not included the expected costs (residual risk) of low-probability disasters such as dam failures, impoundment-induced earthquakes, and landslides. Analysis of the history of these types of events demonstrates that dam failures are not uncommon and that the probability of a reservoir-triggered earth-quake increases with increasing reservoir depth. Because the expected costs from such events can be significant and risk is project-specific, estimates should be made for each project. The cost of expected damage from a "high-risk" project in an urban area could be comparable to project benefits.

  17. A Benefit-Cost Analysis of the Tulsa Universal Pre-K Program. Upjohn Institute Working Paper 16-261

    ERIC Educational Resources Information Center

    Bartik, Timothy J.; Belford, Jonathan A.; Gormley, William T.; Anderson, Sara

    2016-01-01

    In this paper, benefits and costs are estimated for a universal pre-K program, provided by Tulsa Public Schools. Benefits are derived from estimated effects of Tulsa pre-K on retention by grade 9. Retention effects are projected to dollar benefits from future earnings increases and crime reductions. Based on these estimates, Tulsa pre-K has…

  18. Army Initial Acquisition Training: An Analysis of Costs and Benefits

    DTIC Science & Technology

    2015-12-01

    AND BENEFITS December 2015 By: Curtis Brooker Keith Miner Stephanie Montano Advisors: Jesse Cunha Nicholas Dew...COSTS AND BENEFITS 5. FUNDING NUMBERS 6. AUTHOR(S) Curtis Brooker, Keith Miner, and Stephanie Montano 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS... benefits due to the defense focus of the degree and because all of the educational requirements are completed in the shortest amount of time, which

  19. High-dose chemotherapy for patients with high-risk breast cancer: a clinical and economic assessment using a quality-adjusted survival analysis.

    PubMed

    Marino, Patricia; Roché, Henri; Moatti, Jean-Paul

    2008-04-01

    The benefit of high-dose chemotherapy (HDC) has not been clearly demonstrated. It may offer disease-free survival improvement at the expense of major toxicity and increasing cost. We evaluated the trade-offs between toxicity, relapse, and costs using a quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis. The analysis was conducted in the context of a randomized trial (PEGASE 01) evaluating the benefit of HDC for 314 patients with high-risk breast cancer. A Q-TWiST analysis was first performed to compare HDC with standard chemotherapy. We then used the results of this Q-TWiST analysis to inform a cost per quality-adjusted life-year (QALY) comparison between treatments. Q-TWiST durations were in favor of HDC, whatever the weighting coefficients used for the analysis. This benefit was significant when the weighting coefficient related to the time spent after relapse was low (<0.38). For quite high values of this coefficient (>0.78), HDC offered no benefit. For intermediate values, the results depended on the weighting coefficient attributed to the toxicity period. The incremental cost per QALY ranged from 12,691euro/QALY to 26,439euro/QALY, according to the coefficients used to weight toxicity and relapse. The benefits of HDC outweigh the burdens of treatment for a wide range of utility coefficients. Economic impact is not a barrier to HDC diffusion in this situation. Nevertheless, no significant benefit was demonstrated for a certain range of utility values.

  20. The cost-effectiveness of vaccinating chronic hepatitis C patients against hepatitis A.

    PubMed

    Jacobs, R Jake; Koff, Raymond S; Meyerhoff, Allen S

    2002-02-01

    Although hepatitis A vaccination is recommended for persons with chronic liver disease, the cost-effectiveness of vaccinating patients with chronic hepatitis C virus has not been extensively studied. We evaluated its costs and benefits. A Markov model was used to assess cost-effectiveness from the health system and societal perspectives. Costs of hepatitis A screening and vaccination were compared with savings from reduced hepatitis A treatment and work loss to determine net costs of a "screen and vaccinate" strategy. Net costs were compared with longevity gains to assess cost-effectiveness. Based on hypothetical cohorts of 100,000 patients, vaccination would reduce the number of hepatitis A cases 63-72%, depending on patient age. Screening and vaccination costs of $5.2 million would be partially offset by $1.5-$2.8 million reductions in hepatitis A treatment costs and $0.2-$1.0 million reductions in work loss costs. From the health system perspective, vaccination would cost $22,256, $50,391, and $102,064 per life-year saved for patients vaccinated at ages 30, 45, and 60 yr, respectively. Cost-effectiveness ratios improve when work loss prevention is considered. Results are most sensitive to hepatitis A infection and hospitalization rates, and the rate used to discount future benefits to their present values. Hepatitis A vaccination of chronic hepatitis C patients would substantially reduce morbidity and mortality in all age groups examined. Consistent with other medical interventions for chronic hepatitis C patients, cost-effectiveness is most favorable for younger patients.

  1. [Electronic versus paper-based patient records: a cost-benefit analysis].

    PubMed

    Neubauer, A S; Priglinger, S; Ehrt, O

    2001-11-01

    The aim of this study is to compare the costs and benefits of electronic, paperless patient records with the conventional paper-based charts. Costs and benefits of planned electronic patient records are calculated for a University eye hospital with 140 beds. Benefit is determined by direct costs saved by electronic records. In the example shown, the additional benefits of electronic patient records, as far as they can be quantified total 192,000 DM per year. The costs of the necessary investments are 234,000 DM per year when using a linear depreciation over 4 years. In total, there are additional annual costs for electronic patient records of 42,000 DM. Different scenarios were analyzed. By increasing the time of depreciation to 6 years, the cost deficit reduces to only approximately 9,000 DM. Increased wages reduce the deficit further while the deficit increases with a loss of functions of the electronic patient record. However, several benefits of electronic records regarding research, teaching, quality control and better data access cannot be easily quantified and would greatly increase the benefit to cost ratio. Only part of the advantages of electronic patient records can easily be quantified in terms of directly saved costs. The small cost deficit calculated in this example is overcompensated by several benefits, which can only be enumerated qualitatively due to problems in quantification.

  2. The impact of economic evaluation on quality management in spine surgery

    PubMed Central

    2009-01-01

    Health care expenditures are substantially increasing within the last two decades prompting the imperative need for economic evaluations in health care. Historically, economic evaluations in health care have been carried out by four approaches: (1) the human-capital approach (HCA), (2) cost-effectiveness analysis (CEA), (3) cost-utility analysis (CUA) and (4) cost-benefit analysis (CBA). While the HCA cannot be recommended because of methodological shortcomings, CEA and CUA have been used frequently in healthcare. In CEA, costs are measured in monetary terms and health effects are measured in a non-monetary unit, e.g. number of successfully treated patients. In an attempt to develop an effectiveness measure that incorporates effects on both quantity and quality of life, so-called Quality Adjusted Life Years (QUALYs) were introduced. Contingent valuation surveys are used in cost-benefit analyses (CBA) to elicit the consumer’s monetary valuations for program benefits by applying the willingness-to-pay approach. A distinguished feature of CBA is that costs and benefits are expressed in the same units of value, i.e. money. Only recently, economic evaluations have started to explore various spinal interventions particularly the very expensive fusion operations. While most of the studies used CEA or CUA approaches, CBAs are still rare. Most studies fail to show that sophisticated spinal interventions are more cost-effective than conventional treatments. In spite of the lack of therapeutic or cost-effectiveness for most spinal surgeries, there is rapidly growing spinal implant market demonstrating market imperfection and information asymmetry. A change can only be anticipated when physicians start to focus on the improvement of health care quality as documented by outcome research and economic evaluations of cost-effectiveness and net benefits. PMID:19337760

  3. The impact of economic evaluation on quality management in spine surgery.

    PubMed

    Boos, Norbert

    2009-08-01

    Health care expenditures are substantially increasing within the last two decades prompting the imperative need for economic evaluations in health care. Historically, economic evaluations in health care have been carried out by four approaches: (1) the human-capital approach (HCA), (2) cost-effectiveness analysis (CEA), (3) cost-utility analysis (CUA) and (4) cost-benefit analysis (CBA). While the HCA cannot be recommended because of methodological shortcomings, CEA and CUA have been used frequently in healthcare. In CEA, costs are measured in monetary terms and health effects are measured in a non-monetary unit, e.g. number of successfully treated patients. In an attempt to develop an effectiveness measure that incorporates effects on both quantity and quality of life, so-called Quality Adjusted Life Years (QUALYs) were introduced. Contingent valuation surveys are used in cost-benefit analyses (CBA) to elicit the consumer's monetary valuations for program benefits by applying the willingness-to-pay approach. A distinguished feature of CBA is that costs and benefits are expressed in the same units of value, i.e. money. Only recently, economic evaluations have started to explore various spinal interventions particularly the very expensive fusion operations. While most of the studies used CEA or CUA approaches, CBAs are still rare. Most studies fail to show that sophisticated spinal interventions are more cost-effective than conventional treatments. In spite of the lack of therapeutic or cost-effectiveness for most spinal surgeries, there is rapidly growing spinal implant market demonstrating market imperfection and information asymmetry. A change can only be anticipated when physicians start to focus on the improvement of health care quality as documented by outcome research and economic evaluations of cost-effectiveness and net benefits.

  4. The Costs and Benefits of Deferred Giving.

    ERIC Educational Resources Information Center

    Fink, Norman S.; Metzler, Howard C.

    It is argued in this book that while there can be a significant payoff for deferred giving programs, it is important to determine their cost effectiveness. Modern business methods of cost accounting, benefits analysis, and actuarial and econometric forecasting are applied to the Pomona College plan, whose study was supported by Lilly Endowment,…

  5. New Center Applies Cost-Benefit Analysis to Education Policies

    ERIC Educational Resources Information Center

    Viadero, Debra

    2008-01-01

    This article describes the Center for Benefit-Cost Studies of Education, at Teachers College, Columbia University. Launched last year by a pair of economists, the center specializes in calculating and comparing the long- and short-term costs--and probable payoffs--of different educational strategies that promise to improve students' lives. Studies…

  6. The Benefit-Cost Relationship in Entry Job Training in Water Distribution.

    ERIC Educational Resources Information Center

    Reames, J. P. (Jim)

    The benefit-cost relationship analysis concerns the cost effectiveness of employment and training in the Water Distribution Division of the Dallas Water Utilities Department and deals specifically with 104 entry workers hired to become pipe fitters. Half of the entry workers were enrolled in the Public Service Careers (PSC) training program and…

  7. On VLSI Design of Rank-Order Filtering using DCRAM Architecture

    PubMed Central

    Lin, Meng-Chun; Dung, Lan-Rong

    2009-01-01

    This paper addresses on VLSI design of rank-order filtering (ROF) with a maskable memory for real-time speech and image processing applications. Based on a generic bit-sliced ROF algorithm, the proposed design uses a special-defined memory, called the dual-cell random-access memory (DCRAM), to realize major operations of ROF: threshold decomposition and polarization. Using the memory-oriented architecture, the proposed ROF processor can benefit from high flexibility, low cost and high speed. The DCRAM can perform the bit-sliced read, partial write, and pipelined processing. The bit-sliced read and partial write are driven by maskable registers. With recursive execution of the bit-slicing read and partial write, the DCRAM can effectively realize ROF in terms of cost and speed. The proposed design has been implemented using TSMC 0.18 μm 1P6M technology. As shown in the result of physical implementation, the core size is 356.1 × 427.7μm2 and the VLSI implementation of ROF can operate at 256 MHz for 1.8V supply. PMID:19865599

  8. Applying economic evaluation to public health interventions: the case of interventions to promote physical activity.

    PubMed

    Trueman, Paul; Anokye, Nana Kwame

    2013-03-01

    This paper explores the application of alternative approaches to economic evaluation of public health interventions, using a worked example of exercise referral schemes (ERSs). Cost-utility (CUA) and cost-consequence analyses (CCA) were used to assess the cost-effectiveness of ERSs. For the CUA, evidence was synthesized using a decision analytic model that adopts a lifetime horizon and NHS/Personal Social Services perspective. Outcomes were expressed as incremental cost per quality-adjusted life-year (QALY). CCA was conducted from a partial-societal perspective, including health and non-healthcare costs and benefits. Outcomes were reported in natural units, such as cases of strokes or CHD avoided. Compared with usual care, the incremental cost per QALY of ERS is £20 876. Based on a cohort of 100 000 individuals, CCA estimates cost of ERS at £22 million to the healthcare provider and £12 million to participants. The benefits of ERS include additional 3900 people becoming physically active, 51 cases of CHD avoided, 16 cases of stroke avoided, 86 cases of diabetes avoided and a gain of ∼800 QALYs. CCA might provide greater transparency than CUA in reporting the outcomes of public health interventions and have greater resonance with stakeholders involved in commissioning these interventions.

  9. COST–RISK–BENEFIT ANALYSIS IN DIAGNOSTIC RADIOLOGY: A THEORETICAL AND ECONOMIC BASIS FOR RADIATION PROTECTION OF THE PATIENT

    PubMed Central

    Moores, B. Michael

    2016-01-01

    In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost–benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: B=V−(P+X+Y). This article presents a theoretical cost–risk–benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. PMID:26705358

  10. Cost-benefit analysis of using sewage sludge as alternative fuel in a cement plant: a case study.

    PubMed

    Nadal, Martí; Schuhmacher, Marta; Domingo, José L

    2009-05-01

    To enforce the implementation of the Kyoto Protocol targets, a number of governmental/international institutions have launched emission trade schemes as an approach to specify CO(2) caps and to regulate the emission trade in recent years. These schemes have been basically applied for large industrial sectors, including energy producers and energy-intensive users. Among them, cement plants are included among the big greenhouse gas (GHG) emitters. The use of waste as secondary fuel in clinker kilns is currently an intensive practice worldwide. However, people living in the vicinity of cement plants, where alternative fuels are being used, are frequently concerned about the potential increase in health risks. In the present study, a cost-benefit analysis was applied after substituting classical fuel for sewage sludge as an alternative fuel in a clinker kiln in Catalonia, Spain. The economical benefits resulting in the reduction of CO(2) emissions were compared with the changes in human health risks due to exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and carcinogenic metals (As, Cd, Co, and Cr) before and after using sewage sludge to generate 20% of the thermal energy needed for pyro-processing. The exposure to PCDD/Fs and metals through air inhalation, soil ingestion and dermal absorption was calculated according to the environmental levels in soil. The carcinogenic risks were assessed, and the associated cost for the population was estimated by considering the DG Environment's recommended value for preventing a statistical fatality (VPF). In turn, the amount of CO(2) emitted was calculated, and the economical saving, according to the market prices, was evaluated. The use of sewage sludge as a substitute of conventional energy meant a probability cancer decrease of 4.60 for metals and a cancer risk increase of 0.04 for PCDD/Fs. Overall, a net reduction of 4.56 cancers for one million people can be estimated. The associated economical evaluation due to the decreasing cancer for 60,000 people, the current population living near the cement plant, would be of 0.56 million euros (US$ 0.83 million). In turn, a reduction of 144,000 tons of CO(2) emitted between 2003 and 2006 was estimated. Considering a cost of 20 euros per ton of CO(2), the global saving would be 2.88 million euros (US$ 4.26 million). After the partial substitution of the fuel, the current environmental exposure to metals and PCDD/Fs would even mean a potential decrease of health risks for the individuals living in the vicinity of the cement plant. The total benefit of using sewage sludge as an alternative fuel was calculated in 3.44 million euros (US$ 5.09 million). Environmental economics is becoming an interesting research field to convert environmental benefits (i.e., reduction of health risks, emission of pollutants, etc.) into economical value. The results show, that while the use of sewage sludge as secondary fuel is beneficial for the reduction in GHG emissions, no additional health risks for the population derived from PCDD/F and metal emissions are estimated. Cost-benefit analysis seems to be a suitable tool to estimate the environmental damage and benefit associated to industrial processes. Therefore, this should become a generalized practice, mainly for those more impacting sectors such as power industries. On the other hand, the extension of the study could vastly be enlarged by taking into account other potentially emitted GHGs, such as CH(4) and N(2)O, as well as other carcinogenic and non-carcinogenic micropollutants.

  11. Benefits and Costs of Improved Cookstoves: Assessing the Implications of Variability in Health, Forest and Climate Impacts

    PubMed Central

    Jeuland, Marc A.; Pattanayak, Subhrendu K.

    2012-01-01

    Current attention to improved cook stoves (ICS) focuses on the “triple benefits” they provide, in improved health and time savings for households, in preservation of forests and associated ecosystem services, and in reducing emissions that contribute to global climate change. Despite the purported economic benefits of such technologies, however, progress in achieving large-scale adoption and use has been remarkably slow. This paper uses Monte Carlo simulation analysis to evaluate the claim that households will always reap positive and large benefits from the use of such technologies. Our analysis allows for better understanding of the variability in economic costs and benefits of ICS use in developing countries, which depend on unknown combinations of numerous uncertain parameters. The model results suggest that the private net benefits of ICS will sometimes be negative, and in many instances highly so. Moreover, carbon financing and social subsidies may help enhance incentives to adopt, but will not always be appropriate. The costs and benefits of these technologies are most affected by their relative fuel costs, time and fuel use efficiencies, the incidence and cost-of-illness of acute respiratory illness, and the cost of household cooking time. Combining these results with the fact that households often find these technologies to be inconvenient or culturally inappropriate leads us to understand why uptake has been disappointing. Given the current attention to the scale up of ICS, this analysis is timely and important for highlighting some of the challenges for global efforts to promote ICS. PMID:22348005

  12. Cost/benefit analysis of advanced materials technologies for future aircraft turbine engines

    NASA Technical Reports Server (NTRS)

    Stephens, G. E.

    1980-01-01

    The materials technologies studied included thermal barrier coatings for turbine airfoils, turbine disks, cases, turbine vanes and engine and nacelle composite materials. The cost/benefit of each technology was determined in terms of Relative Value defined as change in return on investment times probability of success divided by development cost. A recommended final ranking of technologies was based primarily on consideration of Relative Values with secondary consideration given to changes in other economic parameters. Technologies showing the most promising cost/benefits were thermal barrier coated temperature nacelle/engine system composites.

  13. Implementing a resident lifting system in an extended care hospital. Demonstrating cost-benefit.

    PubMed

    Spiegel, Jerry; Yassi, Analee; Ronald, Lisa A; Tate, Robert B; Hacking, Penny; Colby, Teresa

    2002-03-01

    1. Implemeting mechanical resident lifting equipment in an extended care facility produced a payback from direct savings alone within 4 years. Payback occurred more quickly when the effect of indirect savings or the trend to rising compensation costs was considered. 2. Combining the observations of the occupational health nurses related to staff well being with relevant cost-benefit data is useful in influencing decision makers and in securing funding for prevention measures. 3. Clear identification of a viewpoint is an important part of an economic evaluation and cost-benefit analysis.

  14. Cost-benefit analysis of prophylactic granulocyte colony-stimulating factor during CHOP antineoplastic therapy for non-Hodgkin's lymphoma.

    PubMed

    Dranitsaris, G; Altmayer, C; Quirt, I

    1997-06-01

    Several randomised comparative trials have shown that granulocyte colony-stimulating factor (G-CSF) reduces the duration of neutropenia, hospitalisation and intravenous antibacterial use in patients with cancer who are receiving high-dosage antineoplastic therapy. However, one area that has received less attention is the role of G-CSF in standard-dosage antineoplastic regimens. One such treatment that is considered to have a low potential for inducing fever and neutropenia is the CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone) for non-Hodgkin's lymphoma. We conducted a cost-benefit analysis from a societal perspective in order to estimate the net cost or benefit of prophylactic G-CSF in this patient population. This included direct costs for hospitalisation with antibacterial support, as well as indirect societal costs, such as time off work and antineoplastic therapy delays secondary to neutropenia. The findings were then tested by a comprehensive sensitivity analysis. The administration of G-CSF at a dosage of 5 micrograms/kg/day for 11 doses following CHOP resulted in an overall net cost of $Can1257. In the sensitivity analysis, lowering the G-CSF dosage to 2 micrograms/kg/day generated a net benefit of $Can6564, indicating a situation that was cost saving to society. The results of the current study suggest that the use of G-CSF in patients receiving CHOP antineoplastic therapy produces a situation that is close to achieving cost neutrality. However, low-dosage (2 micrograms/kg/day) G-CSF is an economically attractive treatment strategy because it may result in overall savings to society.

  15. Using economic analyses for local priority setting : the population cost-impact approach.

    PubMed

    Heller, Richard F; Gemmell, Islay; Wilson, Edward C F; Fordham, Richard; Smith, Richard D

    2006-01-01

    Standard methods of economic analysis may not be suitable for local decision making that is specific to a particular population. We describe a new three-step methodology, termed 'population cost-impact analysis', which provides a population perspective to the costs and benefits of alternative interventions. The first two steps involve calculating the population impact and the costs of the proposed interventions relevant to local conditions. This involves the calculation of population impact measures (which have been previously described but are not currently used extensively) - measures of absolute risk and risk reduction, applied to a population denominator. In step three, preferences of policy-makers are obtained. This is in contrast to the QALY approach in which quality weights are obtained as a part of the measurement of benefit. We applied the population cost-impact analysis method to a comparison of two interventions - increasing the use of beta-adrenoceptor antagonists (beta-blockers) and smoking cessation - after myocardial infarction in a scaled-back notional local population of 100,000 people in England. Twenty-two public health professionals were asked via a questionnaire to rank the order in which they would implement four interventions. They were given information on both population cost impact and QALYs for each intervention. In a population of 100,000 people, moving from current to best practice for beta-adrenoceptor antagonists and smoking cessation will prevent 11 and 4 deaths (or gain of 127 or 42 life-years), respectively. The cost per event prevented in the next year, or life-year gained, is less for beta-adrenoceptor antagonists than for smoking cessation. Public health professionals were found to be more inclined to rank alternative interventions according to the population cost impact than the QALY approach. The use of the population cost-impact approach allows information on the benefits of moving from current to best practice to be presented in terms of the benefits and costs to a particular population. The process for deciding between alternative interventions in a prioritisation exercise may differ according to the local context. We suggest that the valuation of the benefit is performed after the benefits have been quantified and that it takes into account local issues relevant to prioritisation. It would be an appropriate next step to experiment with, and formalise, this part of the population cost-impact analysis to provide a standardised approach for determining willingness to pay and provide a ranking of priorities. Our method adds a new dimension to economic analysis, the ability to identify costs and benefits of potential interventions to a defined population, which may be of considerable use for policy makers working at the local level.

  16. A cost benefit analysis of an enhanced seat belt enforcement program in South Africa.

    PubMed

    Harris, G T; Olukoga, I A

    2005-04-01

    To examine whether a program to increase the wearing of seat belts in a South African urban area would be worthwhile in societal terms. A cost benefit analysis of a one year enhanced seat belt enforcement program in eThekwini (Durban) Municipality. Data were drawn from two main sources--a 1998 study of the cost of road crashes in South Africa and, given the absence of other data, a meta-analysis of the effectiveness of various types of interventions to reduce road crash casualties in the United States--and were analyzed using cost benefit analysis. A program designed to enforce greater wearing of seat belts, estimated to cost 2 million rand in one year, could be reasonably expected to increase seat belt usage rates by 16 percentage points and reduce fatalities and injuries by 9.5%. This would result in saved social costs of 13.6 million rand in the following year or a net present value of 11.6 million rand. There would also be favorable consequences for municipal finances. Investment in a program to increase seat belt wearing rates is highly profitable in societal terms.

  17. The role of pharmacoeconomics in current Indian healthcare system.

    PubMed

    Ahmad, Akram; Patel, Isha; Parimilakrishnan, Sundararajan; Mohanta, Guru Prasad; Chung, HaeChung; Chang, Jongwha

    2013-01-01

    Phamacoeconomics can aid the policy makers and the healthcare providers in decision making in evaluating the affordability of and access to rational drug use. Efficiency is a key concept of pharmacoeconomics, and various strategies are suggested for buying the greatest amount of benefits for a given resource use. Phamacoeconomic evaluation techniques such as cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utilization analysis, which support identification and quantification of cost of drugs, are conducted in a similar way, but vary in measurement of value of health benefits and outcomes. This article provides a brief overview about pharmacoeconomics, its utility with respect to the Indian pharmaceutical industry, and the expanding insurance system in India. Pharmacoeconomic evidences can be utilized to support decisions on licensing, pricing, reimbursement, and maintenance of formulary procedure of pharmaceuticals. For the insurance companies to give better facility at minimum cost, India must develop the platform for pharmacoeconomics with a validating methodology and appropriate training. The role of clinical pharmacists including PharmD graduates are expected to be more beneficial than the conventional pharmacists, as they will be able to apply the principles of economics in daily basis practice in community and hospital pharmacy.

  18. The role of pharmacoeconomics in current Indian healthcare system

    PubMed Central

    Ahmad, Akram; Patel, Isha; Parimilakrishnan, Sundararajan; Mohanta, Guru Prasad; Chung, HaeChung; Chang, Jongwha

    2013-01-01

    Phamacoeconomics can aid the policy makers and the healthcare providers in decision making in evaluating the affordability of and access to rational drug use. Efficiency is a key concept of pharmacoeconomics, and various strategies are suggested for buying the greatest amount of benefits for a given resource use. Phamacoeconomic evaluation techniques such as cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utilization analysis, which support identification and quantification of cost of drugs, are conducted in a similar way, but vary in measurement of value of health benefits and outcomes. This article provides a brief overview about pharmacoeconomics, its utility with respect to the Indian pharmaceutical industry, and the expanding insurance system in India. Pharmacoeconomic evidences can be utilized to support decisions on licensing, pricing, reimbursement, and maintenance of formulary procedure of pharmaceuticals. For the insurance companies to give better facility at minimum cost, India must develop the platform for pharmacoeconomics with a validating methodology and appropriate training. The role of clinical pharmacists including PharmD graduates are expected to be more beneficial than the conventional pharmacists, as they will be able to apply the principles of economics in daily basis practice in community and hospital pharmacy. PMID:24991597

  19. Benefit-Cost Analysis of Integrated Paratransit Systems : Volume 1. Executive Summary.

    DOT National Transportation Integrated Search

    1979-09-01

    Integrated Paratransit (IP) is a concept which involves the integration of conventional fixed-route transit with flexibly routed paratransit services to provide the most effective area-wide transit coverage. The report estimates the benefits and cost...

  20. 77 FR 41109 - Margin Requirements for Uncleared Swaps for Swap Dealers and Major Swap Participants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-12

    ... and specifically requests quantitative data and analysis on the comparative costs and benefits of the... quantitative impact study (``QIS'') to assess the costs and benefits of margin requirements. The results of the...

  1. A cost-benefit analysis of varicella vaccination in Aragón.

    PubMed

    Peña Blasco, Guillermo; Blasco Pérez-Aramendía, M Jesús

    2017-10-01

    Varicella, a contagious and infectious disease that is usually benign in children, may become complicated among adults and vulnerable children and may even be life-threatening. There are effective vaccines. A retrospective study was conducted about costs and resulting hospitalizations related to this disease in the population of Aragón in the 2004-2014 period. Costs were compared to the expenses that would have been incurred if those people had received the vaccine and also to the expenses of vaccinating the 1-year-old population over the entire period. A cost-benefit analysis was done to assess the economic impact of varicella vaccination. Data for the 11-year period were provided by the Autonomous Community of Aragón (Spain) and included annual varicella incidence, hospital discharges of varicella cases, costs of primary health care visits and hospitalizations for each year, costs of each workday as per the minimum annual salary and of drugs used). Capitalized costs were estimated and compared to capitalized expenses of vaccination, and a sensitivity analysis was performed. A benefit-cost ratio of 1.6 was obtained considering that all children who had varicella had been vaccinated and had received a booster dose. A benefit-cost ratio of 1.24 was obtained considering that the vaccine had been administered to every 1-year-old individual at a price of EUR 28.59 per vaccine. Over the 11-year period, 53% of hospitalizations corresponded to children younger than 5 years old. Public campaigns for the immunization of children younger than 4 years old with 2 doses lead to cost savings and are cost-effective because the vaccine price results in a benefit-cost ratio greater than 1. A major reduction is expected in the number of hospitalizations among children aged 3-4 years. Sociedad Argentina de Pediatría

  2. A cost-benefit analysis of music therapy in a home hospice.

    PubMed

    Romo, Rafael; Gifford, Lisa

    2007-01-01

    Medicare's fixed daily rates create an absolute cost constraint on hospices; consequently, the growth in hospice brings financial pressures. The patient efficacy of music therapy has been demonstrated in the literature and includes improving pain, agitation, disruptive behaviors, communication, depression, and quality of life. Music therapy is well suited to hospice as it addresses the four domains of palliative care (physiological, emotional, social, and spiritual care). In this small study, the total cost of patients in music therapy was $10,659 and $13,643 for standard care patients, resulting in a cost savings of $2984. The music therapy program cost $3615, yielding a cost benefit ratio of 0.83. When using cost per patient day, the cost benefit ratio is 0.95.

  3. Evaluation of solar electric propulsion technologies for discovery class missions

    NASA Technical Reports Server (NTRS)

    Oh, David Y.

    2005-01-01

    A detailed study examines the potential benefits that advanced electric propulsion (EP) technologies offer to the cost-capped missions in NASA's Discovery program. The study looks at potential cost and performance benefits provided by three EP technologies that are currently in development: NASA's Evolutionary Xenon Thruster (NEXT), an Enhanced NSTAR system, and a Low Power Hall effect thruster. These systems are analyzed on three straw man Discovery class missions and their performance is compared to a state of the art system using the NSTAR ion thruster. An electric propulsion subsystem cost model is used to conduct a cost-benefit analysis for each option. The results show that each proposed technology offers a different degree of performance and/or cost benefit for Discovery class missions.

  4. Systems engineering and integration: Cost estimation and benefits analysis

    NASA Technical Reports Server (NTRS)

    Dean, ED; Fridge, Ernie; Hamaker, Joe

    1990-01-01

    Space Transportation Avionics hardware and software cost has traditionally been estimated in Phase A and B using cost techniques which predict cost as a function of various cost predictive variables such as weight, lines of code, functions to be performed, quantities of test hardware, quantities of flight hardware, design and development heritage, complexity, etc. The output of such analyses has been life cycle costs, economic benefits and related data. The major objectives of Cost Estimation and Benefits analysis are twofold: (1) to play a role in the evaluation of potential new space transportation avionics technologies, and (2) to benefit from emerging technological innovations. Both aspects of cost estimation and technology are discussed here. The role of cost analysis in the evaluation of potential technologies should be one of offering additional quantitative and qualitative information to aid decision-making. The cost analyses process needs to be fully integrated into the design process in such a way that cost trades, optimizations and sensitivities are understood. Current hardware cost models tend to primarily use weights, functional specifications, quantities, design heritage and complexity as metrics to predict cost. Software models mostly use functionality, volume of code, heritage and complexity as cost descriptive variables. Basic research needs to be initiated to develop metrics more responsive to the trades which are required for future launch vehicle avionics systems. These would include cost estimating capabilities that are sensitive to technological innovations such as improved materials and fabrication processes, computer aided design and manufacturing, self checkout and many others. In addition to basic cost estimating improvements, the process must be sensitive to the fact that no cost estimate can be quoted without also quoting a confidence associated with the estimate. In order to achieve this, better cost risk evaluation techniques are needed as well as improved usage of risk data by decision-makers. More and better ways to display and communicate cost and cost risk to management are required.

  5. An Analysis of Costs and Health Co-Benefits for a U.S. Power Plant Carbon Standard

    PubMed Central

    Buonocore, Jonathan J.; Lambert, Kathleen F.; Burtraw, Dallas; Sekar, Samantha; Driscoll, Charles T.

    2016-01-01

    Reducing carbon dioxide (CO2) emissions from power plants can have important “co-benefits” for public health by reducing emissions of air pollutants. Here, we examine the costs and health co-benefits, in monetary terms, for a policy that resembles the U.S. Environmental Protection Agency’s Clean Power Plan. We then examine the spatial distribution of the co-benefits and costs, and the implications of a range of cost assumptions in the implementation year of 2020. Nationwide, the total health co-benefits were $29 billion 2010 USD (95% CI: $2.3 to $68 billion), and net co-benefits under our central cost case were $12 billion (95% CI: -$15 billion to $51 billion). Net co-benefits for this case in the implementation year were positive in 10 of the 14 regions studied. The results for our central case suggest that all but one region should experience positive net benefits within 5 years after implementation. PMID:27270222

  6. Effectiveness and economic analysis of the whole cell/recombinant B subunit (WC/rbs) inactivated oral cholera vaccine in the prevention of traveller's diarrhoea.

    PubMed

    López-Gigosos, Rosa; Garcia-Fortea, Pedro; Calvo, Maria J; Reina, Emilia; Diez-Diaz, Rosa; Plaza, Elena

    2009-05-16

    Nowadays there is a debate about the indication of the oral whole-cell/recombinant B-subunit cholera vaccine (WC/rBS) in traveller's diarrhoea. However, a cost-benefit analysis based on real data has not been published. A cost-effectiveness and cost-benefit study of the oral cholera vaccine (WC/rBS), Dukoral for the prevention of traveller's diarrhoea (TD) was performed in subjects travelling to cholera risk areas. The effectiveness of WC/rBS vaccine in the prevention of TD was analyzed in 362 travellers attending two International Vaccination Centres in Spain between May and September 2005. The overall vaccine efficacy against TD was 42,6%. Direct healthcare-related costs as well as indirect costs (lost vacation days) subsequent to the disease were considered. Preventive vaccination against TD resulted in a mean saving of 79.26 euro per traveller. According to the cost-benefit analysis performed, the recommendation for WC/rBS vaccination in subjects travelling to zones at risk of TD is beneficial for the traveller, regardless of trip duration and visited continent.

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

    NASA Astrophysics Data System (ADS)

    Korytárová, J.; Vaňková, L.

    2017-10-01

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

  8. Cost-benefit of hospitalization compared with outpatient care for pregnant women with pregestational and gestational diabetes or with mild hyperglycemia, in Brazil.

    PubMed

    Cavassini, Ana Claudia Molina; Lima, Silvana Andréa Molina; Calderon, Iracema Mattos Paranhos; Rudge, Marilza Vieira Cunha

    2012-01-01

    Pregnancies complicated by diabetes are associated with increased numbers of maternal and neonatal complications. Hospital costs increase according to the type of care provided. This study aimed to estimate the cost-benefit relationship and social profitability ratio of hospitalization, compared with outpatient care, for pregnant women with diabetes or mild hyperglycemia. This was a prospective observational quantitative study conducted at a university hospital. It included all pregnant women with pregestational or gestational diabetes, or mild hyperglycemia, who did not develop clinical intercurrences during pregnancy and who delivered at the Botucatu Medical School Hospital (Hospital das Clínicas, Faculdade de Medicina de Botucatu, HC-FMB) of Universidade Estadual de São Paulo (Unesp). Thirty pregnant women treated with diet were followed as outpatients, and twenty treated with diet plus insulin were managed through frequent short hospitalizations. Direct costs (personnel, materials and tests) and indirect costs (general expenses) were ascertained from data in the patients' records and the hospital's absorption costing system. The cost-benefit was then calculated. Successful treatment of pregnant women with diabetes avoided expenditure of US$ 1,517.97 and US$ 1,127.43 for patients treated with inpatient and outpatient care, respectively. The cost-benefit of inpatient care was US$ 143,719.16, and outpatient care, US$ 253,267.22, with social profitability of 1.87 and 5.35, respectively. Decision-tree analysis confirmed that successful treatment avoided costs at the hospital. Cost-benefit analysis showed that outpatient management was economically more advantageous than hospitalization. The social profitability of both treatments was greater than one, thus demonstrating that both types of care for diabetic pregnant women had positive benefits.

  9. Fitness consequences of sex-specific selection.

    PubMed

    Connallon, Tim; Cox, Robert M; Calsbeek, Ryan

    2010-06-01

    Theory suggests that sex-specific selection can facilitate adaptation in sexually reproducing populations. However, sexual conflict theory and recent experiments indicate that sex-specific selection is potentially costly due to sexual antagonism: alleles harmful to one sex can accumulate within a population because they are favored in the other sex. Whether sex-specific selection provides a net fitness benefit or cost depends, in part, on the relative frequency and strength of sexually concordant versus sexually antagonistic selection throughout a species' genome. Here, we model the net fitness consequences of sex-specific selection while explicitly considering both sexually concordant and sexually antagonistic selection. The model shows that, even when sexual antagonism is rare, the fitness costs that it imposes will generally overwhelm fitness benefits of sexually concordant selection. Furthermore, the cost of sexual antagonism is, at best, only partially resolved by the evolution of sex-limited gene expression. To evaluate the key parameters of the model, we analyze an extensive dataset of sex-specific selection gradients from wild populations, along with data from the experimental evolution literature. The model and data imply that sex-specific selection may likely impose a net cost on sexually reproducing species, although additional research will be required to confirm this conclusion.

  10. Financial analysis of cardiovascular wellness program provided to self-insured company from pharmaceutical care provider's perspective.

    PubMed

    Wilson, Justin B; Osterhaus, Matt C; Farris, Karen B; Doucette, William R; Currie, Jay D; Bullock, Tammy; Kumbera, Patty

    2005-01-01

    To perform a retrospective financial analysis on the implementation of a self-insured company's wellness program from the pharmaceutical care provider's perspective and conduct sensitivity analyses to estimate costs versus revenues for pharmacies without resident pharmacists, program implementation for a second employer, the second year of the program, and a range of pharmacist wages. Cost-benefit and sensitivity analyses. Self-insured employer with headquarters in Canton, N.C. 36 employees at facility in Clinton, Iowa. Pharmacist-provided cardiovascular wellness program. Costs and revenues collected from pharmacy records, including pharmacy purchasing records, billing records, and pharmacists' time estimates. All costs and revenues were calculated for the development and first year of the intervention program. Costs included initial and follow-up screening supplies, office supplies, screening/group presentation time, service provision time, documentation/preparation time, travel expenses, claims submission time, and administrative fees. Revenues included initial screening revenues, follow-up screening revenues, group session revenues, and Heart Smart program revenues. For the development and first year of Heart Smart, net benefit to the pharmacy (revenues minus costs) amounted to dollars 2,413. All sensitivity analyses showed a net benefit. For pharmacies without a resident pharmacist, the net benefit was dollars 106; for Heart Smart in a second employer, the net benefit was dollars 6,024; for the second year, the projected net benefit was dollars 6,844; factoring in a lower pharmacist salary, the net benefit was dollars 2,905; and for a higher pharmacist salary, the net benefit was dollars 1,265. For the development and first year of Heart Smart, the revenues of the wellness program in a self-insured company outweighed the costs.

  11. Knowing the future: partial foreknowledge effects on the programming of prosaccades and antisaccades.

    PubMed

    Abegg, Mathias; Manoach, Dara S; Barton, Jason J S

    2011-01-01

    Foreknowledge about the demands of an upcoming trial may be exploited to optimize behavioural responses. In the current study we systematically investigated the benefits of partial foreknowledge--that is, when some but not all aspects of a future trial are known in advance. For this we used an ocular motor paradigm with horizontal prosaccades and antisaccades. Predictable sequences were used to create three partial foreknowledge conditions: one with foreknowledge about the stimulus location only, one with foreknowledge about the task set only, and one with foreknowledge about the direction of the required response only. These were contrasted with a condition of no-foreknowledge and a condition of complete foreknowledge about all three parameters. The results showed that the three types of foreknowledge affected saccadic efficiency differently. While foreknowledge about stimulus-location had no effect on efficiency, task foreknowledge had some effect and response-foreknowledge was as effective as complete foreknowledge. Foreknowledge effects on switch costs followed a similar pattern in general, but were not specific for switching of the trial attribute for which foreknowledge was available. We conclude that partial foreknowledge has a differential effect on efficiency, most consistent with preparatory activation of a motor schema in advance of the stimulus, with consequent benefits for both switched and repeated trials. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. A Logistic Life Cycle Cost-Benefit Analysis of Power Quality Management in the Avionics Repair Facility

    DTIC Science & Technology

    1998-06-01

    quality management can have on the intermediate level of maintenance. Power quality management is a preventative process that focuses on identifying and correcting problems that cause bad power. Using cost-benefit analysis we compare the effects of implementing a power quality management program at AIMD Lemoore and AIMD Fallon. The implementation of power quality management can result in wide scale logistical support changes in regards to the life cycle costs of maintaining the DoD’s current inventory

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

    PubMed

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

    2014-09-23

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

  14. A Benefit Cost Analysis of the South Carolina MDTA Program. Preliminary Report.

    ERIC Educational Resources Information Center

    South Carolina Univ., Columbia. Bureau of Business and Economic Research.

    Manpower Development and Training Act (MDTA) programs completed in 1965 were evaluated by benefit-cost ratio and internal rate of return. Initial annual earnings differential figures at $525,650 and $719,629 were projected into the future at various rates of promotion and various rates of discount on the benefit stream. Resulting lifetime benefits…

  15. A Cost Benefits Analysis of International Education: A Case of Zimbabwean Students in South Africa

    ERIC Educational Resources Information Center

    Chimucheka, Tendai

    2012-01-01

    The study investigated the costs and benefits of international education to Zimbabwean students studying in South African Universities. The objectives of the study were to investigate the actual and perceived benefits of international education to students. The study also investigated the impact of international education on the lives of students,…

  16. A benefit-cost analysis of ten tree species in Modesto, California, U.S.A

    Treesearch

    E.G. McPherson

    2003-01-01

    Tree work records for ten species were analyzed to estimate average annual management costs by dbh class for six activity areas. Average annual benefits were calculated by dbh class for each species with computer modeling. Average annual net benefits per tree were greatest for London plane (Platanus acerifolia) ($178.57), hackberry (...

  17. Age 21 Cost-Benefit Analysis of the Title I Chicago Child-Parent Centers. Discussion Paper.

    ERIC Educational Resources Information Center

    Reynolds, Arthur J.; Temple, Judy A.; Robertson, Dylan L.; Mann, Emily A.

    Researchers conducted the first cost-benefit analysis of a federally-financed, comprehensive early childhood program involving the Title I Chicago Child-Parent Centers, which are located in public schools and provide educational and family support services to low-income children ages 3-9 years. Data came from a cohort of children born in 1980 who…

  18. An Evaluation of Facility Maintenance and Repair Strategies of Select Companies

    DTIC Science & Technology

    2002-09-01

    challenge for facility maintenance professionals is balancing the cost of facility Maintenance and Repair (M&R) with the benefits derived from those...maintenance professionals is balancing the cost of facility Maintenance and Repair (M&R) with the benefits derived from those facilities. This thesis...private organizations may also benefit from an analysis of the practices in use by successful corporations. The second group to benefit from this

  19. Economic evaluation of an oral rabies vaccination program for control of a domestic dog-coyote rabies epizootic: 1995-2006.

    PubMed

    Shwiff, Stephanie A; Kirkpatrick, Katy N; Sterner, Ray T

    2008-12-01

    To conduct a benefit-cost analysis of the results of the domestic dog and coyote (DDC) oral rabies vaccine (ORV) program in Texas from 1995 through 2006 by use of fiscal records and relevant public health data. Retrospective benefit-cost analysis. Procedures-Pertinent economic data were collected in 20 counties of south Texas affected by a DDC-variant rabies epizootic. The costs and benefits afforded by a DDC ORV program were then calculated. Costs were the total expenditures of the ORV program. Benefits were the savings associated with the number of potentially prevented human postexposure prophylaxis (PEP) treatments and animal rabies tests for the DDC-variant rabies virus in the epizootic area and an area of potential disease expansion. Total estimated benefits of the program approximately ranged from $89 million to $346 million, with total program costs of $26,358,221 for the study period. The estimated savings (ie, damages avoided) from extrapolated numbers of PEP treatments and animal rabies tests yielded benefit-cost ratios that ranged from 3.38 to 13.12 for various frequen-cies of PEP and animal testing. In Texas, the use of ORV stopped the northward spread and led to the progressive elimination of the DDC variant of rabies in coyotes (Canis latrans). The decision to implement an ORV program was cost-efficient, although many unknowns were involved in the original decision, and key economic variables were identified for consideration in future planning of ORV programs.

  20. Societal and Economic Effect of Meniscus Scaffold Procedures for Irreparable Meniscus Injuries.

    PubMed

    Rongen, Jan J; Govers, Tim M; Buma, Pieter; Grutters, Janneke P C; Hannink, Gerjon

    2016-07-01

    Meniscus scaffolds are currently evaluated clinically for their efficacy in preventing the development of osteoarthritis as well as for their efficacy in treating patients with chronic symptoms. Procedural costs, therapeutic consequences, clinical efficacy, and future events should all be considered to maximize the monetary value of this intervention. To examine the socioeconomic effect of treating patients with irreparable medial meniscus injuries with a meniscus scaffold. Economic and decision analysis; Level of evidence, 2. Two Markov simulation models for patients with an irreparable medial meniscus injury were developed. Model 1 was used to investigate the lifetime cost-effectiveness of a meniscus scaffold compared with standard partial meniscectomy by the possibility of preventing the development of osteoarthritis. Model 2 was used to investigate the short-term (5-year) cost-effectiveness of a meniscus scaffold compared with standard partial meniscectomy by alleviating clinical symptoms, specifically in chronic patients with previous meniscus surgery. For both models, probabilistic Monte Carlo simulations were applied. Treatment effectiveness was expressed as quality-adjusted life-years (QALYs), while costs (estimated in euros) were assessed from a societal perspective. We assumed €20,000 as a reference value for the willingness to pay per QALY. Next, comprehensive sensitivity analyses were performed to identify the most influential variables on the cost-effectiveness of meniscus scaffolds. Model 1 demonstrated an incremental cost-effectiveness ratio of a meniscus scaffold treatment of €54,463 per QALY (€5991/0.112). A threshold analysis demonstrated that a meniscus scaffold should offer a relative risk reduction of at least 0.34 to become cost-effective, assuming a willingness to pay of €20,000. Decreasing the costs of the meniscus scaffold procedure by 33% (€10,160 instead of €15,233; an absolute change of €5073) resulted in an incremental cost-effectiveness ratio of €7876 per QALY. Model 2 demonstrated an incremental cost-effectiveness ratio of a meniscus scaffold treatment of €297,727 per QALY (€9825/0.033). On the basis of the current efficacy data, a meniscus scaffold provides a relative risk reduction of "limited benefit" postoperatively of 0.37 compared with standard treatment. A threshold analysis revealed that assuming a willingness to pay of €20,000, a meniscus scaffold would not be cost-effective within a period of 5 years. Most influential variables on the cost-effectiveness of meniscus scaffolds were the cost of the scaffold procedure, cost associated with osteoarthritis, and quality of life before and after the scaffold procedure. Results of the current health technology assessment emphasize that the monetary value of meniscus scaffold procedures is very much dependent on a number of influential variables. Therefore, before implementing the technology in the health care system, it is important to critically assess these variables in a relevant context. The models can be improved as additional clinical data regarding the efficacy of the meniscus scaffold become available. © 2016 The Author(s).

  1. Extended Cost-Effectiveness Analysis for Health Policy Assessment: A Tutorial.

    PubMed

    Verguet, Stéphane; Kim, Jane J; Jamison, Dean T

    2016-09-01

    Health policy instruments such as the public financing of health technologies (e.g., new drugs, vaccines) entail consequences in multiple domains. Fundamentally, public health policies aim at increasing the uptake of effective and efficient interventions and at subsequently leading to better health benefits (e.g., premature mortality and morbidity averted). In addition, public health policies can provide non-health benefits in addition to the sole well-being of populations and beyond the health sector. For instance, public policies such as social and health insurance programs can prevent illness-related impoverishment and procure financial risk protection. Furthermore, public policies can improve the distribution of health in the population and promote the equalization of health among individuals. Extended cost-effectiveness analysis was developed to address health policy assessment, specifically to evaluate the health and financial consequences of public policies in four domains: (1) the health gains; (2) the financial risk protection benefits; (3) the total costs to the policy makers; and (4) the distributional benefits. Here, we present a tutorial that describes both the intent of extended cost-effectiveness analysis and its keys to allow easy implementation for health policy assessment.

  2. Multilevel selection analysis of a microbial social trait

    PubMed Central

    de Vargas Roditi, Laura; Boyle, Kerry E; Xavier, Joao B

    2013-01-01

    The study of microbial communities often leads to arguments for the evolution of cooperation due to group benefits. However, multilevel selection models caution against the uncritical assumption that group benefits will lead to the evolution of cooperation. We analyze a microbial social trait to precisely define the conditions favoring cooperation. We combine the multilevel partition of the Price equation with a laboratory model system: swarming in Pseudomonas aeruginosa. We parameterize a population dynamics model using competition experiments where we manipulate expression, and therefore the cost-to-benefit ratio of swarming cooperation. Our analysis shows that multilevel selection can favor costly swarming cooperation because it causes population expansion. However, due to high costs and diminishing returns constitutive cooperation can only be favored by natural selection when relatedness is high. Regulated expression of cooperative genes is a more robust strategy because it provides the benefits of swarming expansion without the high cost or the diminishing returns. Our analysis supports the key prediction that strong group selection does not necessarily mean that microbial cooperation will always emerge. PMID:23959025

  3. Economic Insights into Providing Access to Improved Groundwater Sources in Remote, Low-Resource Areas

    NASA Astrophysics Data System (ADS)

    Abramson, A.; Lazarovitch, N.; Adar, E.

    2013-12-01

    Groundwater is often the most or only feasible drinking water source in remote, low-resource areas. Yet the economics of its development have not been systematically outlined. We applied CBARWI (Cost-Benefit Analysis for Remote Water Improvements), a recently developed Decision Support System, to investigate the economic, physical and management factors related to the costs and benefits of non-networked groundwater supply in remote areas. Synthetic profiles of community water services (n = 17,962), defined across 14 parameters' values and ranges relevant to remote areas, were imputed into the decision framework, and the parameter effects on economic outcomes were investigated through regression analysis (Table 1). Several approaches were included for financing the improvements, after Abramson et al, 2011: willingness-to -pay (WTP), -borrow (WTB) and -work (WTW) in community irrigation (';water-for-work'). We found that low-cost groundwater development approaches are almost 7 times more cost-effective than conventional boreholes fitted with handpumps. The costs of electric, submersible borehole pumps are comparable only when providing expanded water supplies, and off-grid communities pay significantly more for such expansions. In our model, new source construction is less cost-effective than improvement of existing wells, but necessary for expanding access to isolated households. The financing approach significantly impacts the feasibility of demand-driven cost recovery; in our investigation, benefit exceeds cost in 16, 32 and 48% of water service configurations financed by WTP, WTB and WTW, respectively. Regressions of total cost (R2 = 0.723) and net benefit under WTW (R2 = 0.829) along with analysis of output distributions indicate that parameters determining the profitability of irrigation are different from those determining costs and other measures of net benefit. These findings suggest that the cost-benefit outcomes associated with groundwater-based water supply improvements vary considerably by many parameters. Thus, a wide variety of factors should be included to inform water development strategies. Abramson, A. et al (2011), Willingness to pay, borrow and work for water service improvements in developing countries, Water Resour Res, 47Table 1: Descriptions, investigated values and regression coefficients of parameters included in our analysis. Rank of standardized β indicates relative importance. Regression dependent variables are in [($ household-1) y-1]. * Parameters relevant to water-for-work program only.† p <.0001‡ p <.05

  4. Cost-benefit analysis of alternative fuels and motive designs.

    DOT National Transportation Integrated Search

    2013-04-01

    This project was funded by the Federal Railroad Administration to better understand the potential cost and benefits of using alternative fuels for U.S. freight and passenger locomotive operations. The framework for a decision model was developed by T...

  5. Examining the effectiveness of municipal solid waste management systems: An integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan

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

    Weng, Yu-Chi, E-mail: clyde.weng@gmail.com; Fujiwara, Takeshi

    2011-06-15

    In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBAmore » framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O and M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities.« less

  6. [Analysis of Late AMNOG Benefit Assessments].

    PubMed

    Rieder, Veronika; Hammerschmidt, Thomas

    2018-04-26

    Since 2011, new drugs are assessed at the time of launch in Germany (AMNOG). Based on this early benefit assessment (EBA), drug prices are negotiated. At this time, the evidence base might be weak. A later benefit assessment (LBA) is not done on a regular basis except for selected drugs. Our objective was to analyze the impact of LBAs of drugs for the same indication. Analysis of all completed LBAs between 2011 and 2016. 228 benefit assessments have been performed since 2011. 26 drugs were assessed twice for the same indication. Oncology and diabetes were the most common therapeutic areas in LBA and more pronounced than in EBA. 15 LBAs were due to the EBAs having a time limitation because of insufficient evidence base partially based on conditional approval. Time between EBA and LBA was 2.6 years. All 15 drugs had added benefit in the EBA, 4 got a better, 5 a worse assessment in the LBA. Seven drugs without added benefit in the EBA were assessed at the request of the manufacturer because of new data after 1.7 years. Three drugs could show added benefit in the LBA. Finally, 4 orphan drugs were reassessed according to the AMNOG regulation after achieving annual sales of 50 million euros. One got a better, 2 got a worse benefit assessment. Average improvement of benefit was +1.5 on a scale between - 3 (worst negative benefit) and +9 (highest positive benefit). Average deterioration of added benefit was - 1.4. Negotiated prices were significantly correlated with the change in the benefit assessment. LBA on a broader evidence base did not result in a significantly changed outcome. A general LBA for all drugs does not appear to be necessary because of the limited effect on the benefit assessment and the price when considering cost and administrative burden of the AMNOG benefit assessment. The selective approach of LBA for specific drugs is sufficient in cases in which the evidence base was limited at launch. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Highway User Benefit Analysis System Research Project #128

    DOT National Transportation Integrated Search

    2000-10-01

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

  8. A Cost-and-Benefit Study of Two Americorps Projects in the State of Washington.

    ERIC Educational Resources Information Center

    Wang, Changhua; And Others

    AmeriCorps is a national initiative that involves citizens in strengthening America's communities through community service. This document presents findings of a cost-benefit analysis of two AmeriCorps programs in Washington State--the Hoquiam Project and the Lake Chelan Project. In calculating annual costs, the study included both federal dollars…

  9. A study of space station needs, attributes and architectural options, volume 2, technical. Book 3: Economic benefits, costs and programmatics

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The economic benefits, cost analysis, and industrial uses of the manned space station are investigated. Mission payload costs are examined in relation to alternative architectures and projected technological evolution. Various approaches to industrial involvement for financing, development, and marketing of space station resources are described.

  10. Examining the Feasibility and Utility of Estimating Partial Expected Value of Perfect Information (via a Nonparametric Approach) as Part of the Reimbursement Decision-Making Process in Ireland: Application to Drugs for Cancer.

    PubMed

    McCullagh, Laura; Schmitz, Susanne; Barry, Michael; Walsh, Cathal

    2017-11-01

    In Ireland, all new drugs for which reimbursement by the healthcare payer is sought undergo a health technology assessment by the National Centre for Pharmacoeconomics. The National Centre for Pharmacoeconomics estimate expected value of perfect information but not partial expected value of perfect information (owing to computational expense associated with typical methodologies). The objective of this study was to examine the feasibility and utility of estimating partial expected value of perfect information via a computationally efficient, non-parametric regression approach. This was a retrospective analysis of evaluations on drugs for cancer that had been submitted to the National Centre for Pharmacoeconomics (January 2010 to December 2014 inclusive). Drugs were excluded if cost effective at the submitted price. Drugs were excluded if concerns existed regarding the validity of the applicants' submission or if cost-effectiveness model functionality did not allow required modifications to be made. For each included drug (n = 14), value of information was estimated at the final reimbursement price, at a threshold equivalent to the incremental cost-effectiveness ratio at that price. The expected value of perfect information was estimated from probabilistic analysis. Partial expected value of perfect information was estimated via a non-parametric approach. Input parameters with a population value at least €1 million were identified as potential targets for research. All partial estimates were determined within minutes. Thirty parameters (across nine models) each had a value of at least €1 million. These were categorised. Collectively, survival analysis parameters were valued at €19.32 million, health state utility parameters at €15.81 million and parameters associated with the cost of treating adverse effects at €6.64 million. Those associated with drug acquisition costs and with the cost of care were valued at €6.51 million and €5.71 million, respectively. This research demonstrates that the estimation of partial expected value of perfect information via this computationally inexpensive approach could be considered feasible as part of the health technology assessment process for reimbursement purposes within the Irish healthcare system. It might be a useful tool in prioritising future research to decrease decision uncertainty.

  11. Low energy stage study. Volume 4: Cost benefits analysis and recommendations. [orbital launching of space shuttle payloads

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The costs and benefits of existing/planned systems, new propulsion concepts, and adaptations of existing/planned systems (as supported by Orbiter interface requirements and operations requirements) were quantified. Scenarios of these propulsion approaches were established which accommodate the low energy regime as defined by the new low energy payload mission model. These scenarios were screened on a cost and then a benefits basis. A propulsion approach comprising existing/planned systems and a new propulsion concept were selected as the most cost effective approach to accommodate the model payloads and the low energy regime they represent. Key cost drivers and sensitivity trends were identified. All costs were derived in 1977 dollars.

  12. Extended benefit cost analysis as an instrument of economic valuated in Petungkriyono forest ecosystem services

    NASA Astrophysics Data System (ADS)

    Damayanti, Irma; Nur Bambang, Azis; Retnaningsih Soeprobowati, Tri

    2018-05-01

    Petungkriyono is the last tropical forest in Java and provides biodiversity including rare flora and fauna that must be maintained, managed and utilized in order to give meaning for humanity and sustainability. Services of Forest Ecosystem in Petungkriyono are included such as goods supply, soil-water conservation, climate regulation, purification environment and flora fauna habitats. The approach of this study is the literature review from various studies before perceiving the influenced of economic valuation in determining the measurement conservation strategies of Petungkriyono Natural Forest Ecosystem in Pekalongan Regency. The aims of this study are to analyzing an extended benefit cost of natural forest ecosystems and internalizing them in decision making. The method of quantification and valuation of forest ecosystem is Cost and Benefit Analysis (CBA) which is a standard economic appraisal tools government in development economics. CBA offers the possibility capturing impact of the project. By using productivity subtitution value and extended benefit cost analysis any comodity such as Backwoods,Pine Woods, Puspa woods and Pine Gum. Water value, preventive buildings of landslide and carbon sequestration have total economic value of IDR.163.065.858.080, and the value of Extended Benefit Cost Ratio in Petungkriyono is 281.35 %. However, from the result is expected the local government of Pekalongan to have high motivation in preserve the existence of Petungkriyono forest.

  13. Lifetime costing of the body-in-white: Steel vs. aluminum

    NASA Astrophysics Data System (ADS)

    Han, Helen N.; Clark, Joel P.

    1995-05-01

    In order to make informed material choice decisions and to derive the maximum benefit from the use of alternative materials, the automobile producer must understand the full range of costs and benefits for each material. It is becoming clear that the conventional cost-benefit analysis structure currently used by the automotive industry must be broadened to include nontraditional costs such as the environmental externalities associated with the use of existing and potential automotive technologies. This article develops a methodology for comparing the costs and benefits associated with the use of alternative materials in automotive applications by focusing on steel and aluminum in the unibody body-in-white. Authors' Note: This is the first of two articles documenting a methodology for evaluating the lifetime monetary and environmental costs of alternative materials in automotive applications. This article addresses the traditional money costs while a subsequent paper, which is planned for the August issue, will address the environmental externalities.

  14. The Cost-Effectiveness of Syphilis Screening Among Men Who Have Sex With Men: An Exploratory Modeling Analysis.

    PubMed

    Chesson, Harrell W; Kidd, Sarah; Bernstein, Kyle T; Fanfair, Robyn Neblett; Gift, Thomas L

    2016-07-01

    We adapted a published model to estimate the costs and benefits of screening men who have sex with men for syphilis, including the benefits of preventing syphilis-attributable human immunodeficiency virus. The cost per quality-adjusted life year gained by screening was

  15. Cost-benefit analysis of first-generation antihistamines in the treatment of allergic rhinitis.

    PubMed

    Sullivan, Patrick W; Follin, Sheryl L; Nichol, Michael B

    2004-01-01

    The majority of individuals with allergic rhinitis in the US take first-generation antihistamines (FGAs). Although FGAs have been proven effective in alleviating allergic rhinitis symptoms, they have been associated with an increased risk of motor vehicle, aviation and occupational injuries and deaths, reduced productivity and impaired learning. The objective of this analysis was to quantify the total costs and benefits of FGA use in the US from the societal perspective. We used a decision-analytic model to quantify the annual societal costs and benefits of treatment with FGAs compared with the hypothetical alternative of no treatment for the population of individuals with allergic rhinitis and taking FGAs in the US in 2001. The benefit associated with FGA use was estimated using the willingness-to-pay framework and projected to the US population using published estimates of the prevalence of allergic rhinitis. The costs of FGA-associated sedation included lost productivity and the direct and indirect cost of unintentional injuries (including motor vehicle, occupational, public and home injuries and fatalities). The incidence of injuries and fatalities associated with FGA use was estimated using the risk of injury attributable to the sedentary effects of FGAs in the allergic rhinitis population. To evaluate uncertainty in the model assumptions, a probabilistic sensitivity analysis was conducted using Bayesian second-order Monte Carlo simulation. Costs and benefits are expressed in 2001 US dollars, using a 3% discount rate. Based on current utilisation, the total societal benefit (95% credible interval) associated with the use of FGAs for the treatment of allergic rhinitis was US 7.7 billion dollars (US 1.3 billion dollars to US 21 billion dollars). The societal cost of purchasing FGAs was only US 697 million dollars. However, the societal cost of FGA-associated sedation was US 11.3 billion dollars (US 2.4 billion dollars to US 50.8 billion dollars). The annual societal net benefit of FGA use for the treatment of allergic rhinitis in the US was -US4.2 billion dollars (-US 36 billion dollars to +US 0.296 billion dollars). The net benefit was negative in 97% of the 10,000 Monte Carlo simulations. The societal benefits of FGA use in alleviating the symptoms of allergic rhinitis are significant. However, based on the assumptions, probability distributions and parameter estimate ranges used in the current model, it is very likely that the costs associated with sedation exceed the benefits of FGA use in the US. The cost of FGA-associated sedation is comparable to estimates of the cost of all medical care expenditures on respiratory conditions in the US (US 12.1 billion dollars to US 31.3 billion dollars) [1996 values] and provides compelling evidence of the economic burden of sedation associated with FGA use.

  16. Costs and benefits of bicycling investments in Portland, Oregon.

    PubMed

    Gotschi, Thomas

    2011-01-01

    Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland's past and planned investments in bicycling relate to health and other benefits. Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings. Levels of bicycling are estimated using past trends, future mode share goals, and a traffic demand model. By 2040, investments in the range of $138 to $605 million will result in health care cost savings of $388 to $594 million, fuel savings of $143 to $218 million, and savings in value of statistical lives of $7 to $12 billion. The benefit-cost ratios for health care and fuel savings are between 3.8 and 1.2 to 1, and an order of magnitude larger when value of statistical lives is used. This first of its kind cost-benefit analysis of investments in bicycling in a US city shows that such efforts are cost-effective, even when only a limited selection of benefits is considered.

  17. Costs and benefits of direct-to-consumer advertising: the case of depression.

    PubMed

    Block, Adam E

    2007-01-01

    Direct-to-consumer advertising (DTCA) is legal in the US and New Zealand, but illegal in the rest of the world. Little or no research exists on the social welfare implications of DTCA. To quantify the total costs and benefits associated with both appropriate and inappropriate care due to DTCA, for the case of depression. A cost-benefit model was developed using parameter estimates from available survey, epidemiological and experimental data. The model estimates the total benefits and costs (year 2002 values) of new appropriate and inappropriate care stimulated by DTCA for depression. Uncertainty in model parameters is addressed with sensitivity analyses. This study provides evidence that 94% of new antidepressant use due to DTCA is from non-depressed individuals. However, the average health benefit to each new depressed user is 63-fold greater than the cost per treatment, creating a positive overall social welfare effect; a net benefit of >72 million US dollars. This analysis suggests that DTCA may lead to antidepressant treatment in 15-fold as many non-depressed people as depressed people. However, the costs of treating non-depressed people may be vastly outweighed by the much larger benefit accruing to treated depressed individuals. The cost-benefit ratio can be improved through better targeting of advertisements and higher quality treatment of depression.

  18. Clean Air Act Second Prospective Report Study Science Advisory Board Review, December 15-16, 2009

    EPA Pesticide Factsheets

    The subcommittee of the 812 council reviewed several materials during this meeting, including benefits analysis, uncertainty analysis and background documents supporting the second section of the 812 cost-benefit analysis.

  19. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression

    PubMed Central

    Lindefors, Nils

    2016-01-01

    Background A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Methods Data was collected from 568 adult patients treated with ICBT for depression during 2013–2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Outcomes Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5) during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during both 2013 and 2014; an additional 35% and 33% were in partial remission during 2013 and 2014, respectively. Confidence ellipses occupied the south-east (SE) and south-west (SW) quadrants of the incremental cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation. Conclusion Treating patients to the target of full remission using psychologists instead of medical specialists for post-treatment assessment is cost-saving and consequently a more valuable use of limited resources. TDABC may be a useful tool for measuring resource costs, identifying quality improvement opportunities and evaluating the consequences of such initiatives. Combining TDABC with clinical outcome measures in CEA is potentially a useful approach in mental healthcare to estimate the value of process improvement initiatives. PMID:27798655

  20. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

    PubMed

    El Alaoui, Samir; Lindefors, Nils

    2016-01-01

    A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5) during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during both 2013 and 2014; an additional 35% and 33% were in partial remission during 2013 and 2014, respectively. Confidence ellipses occupied the south-east (SE) and south-west (SW) quadrants of the incremental cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation. Treating patients to the target of full remission using psychologists instead of medical specialists for post-treatment assessment is cost-saving and consequently a more valuable use of limited resources. TDABC may be a useful tool for measuring resource costs, identifying quality improvement opportunities and evaluating the consequences of such initiatives. Combining TDABC with clinical outcome measures in CEA is potentially a useful approach in mental healthcare to estimate the value of process improvement initiatives.

  1. Financial risk management of pharmacy benefits.

    PubMed

    Saikami, D

    1997-10-01

    Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

  2. A Value Based Justification Process for Aerospace RDT and E Capability Investments

    DTIC Science & Technology

    2017-12-01

    end of MS C by funding the five-year, $350 million T&E infrastructure investment proposed in the DoD plan. This expansion of the cost - benefit “control...expansion of the cost - benefit “control volume” to include projected system development savings, as described in Ref. [3], proved successful in justifying...Fig. 1 The Expanded Cost - Benefit Analysis Control Volume. It is also worth noting that this process has the greatest potential for success when the

  3. San Francisco urban partnership agreement, national evaluation : cost benefit analysis test plan.

    DOT National Transportation Integrated Search

    2011-06-01

    This report presents the test plan for collecting and analyzing cost and benefit data for the San Francisco Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The San Francisco UPA projects ...

  4. Maintenance Decision Support System: Pilot Study and Cost-Benefit Analysis (Phase 2.5)

    DOT National Transportation Integrated Search

    2014-07-01

    This project focused on several tasks: development of in-vehicle hardware that permits implementation of an MDSS, development of software to collect and process road and weather data, a cost-benefit study, and pilot-scale implementation. Two Automati...

  5. Maintenance Decision Support System : Pilot Study and Cost-Benefit Analysis (Phase 2)

    DOT National Transportation Integrated Search

    2014-07-01

    This project focused on several tasks: development of in-vehicle hardware that permits implementation of an MDSS, development of software to collect and process road and weather data, a cost-benefit study, and pilot-scale implementation. Two Automati...

  6. HANDBOOK ON THE BENEFITS, COSTS, AND IMPACTS OF LAND CLEANUP AND REUSE

    EPA Science Inventory

    Summarizes the theoretical and empirical literature addressing benefit-cost and impact assessment of the land cleanup and reuse scenario. When possible, recommendations are provided for conducting economic analysis of land cleanup and reuse sites and programs. The knowledge base ...

  7. Airport surface traffic control TAGS planning alternatives and cost/benefit

    DOT National Transportation Integrated Search

    1977-01-01

    The findings of a cost/benefit analysis of the deployment of a new airport ground surveillance system TAGS (Tower Automated Ground Surveillance) are presented. TAGS will provide a plain view display of aircraft on the airports taxiways and runways li...

  8. Two-part payments for the reimbursement of investments in health technologies.

    PubMed

    Levaggi, Rosella; Moretto, Michele; Pertile, Paolo

    2014-04-01

    The paper studies the impact of alternative reimbursement systems on two provider decisions: whether to adopt a technology whose provision requires a sunk investment cost and how many patients to treat with it. Using a simple economic model we show that the optimal pricing policy involves a two-part payment: a price equal to the marginal cost of the patient whose benefit of treatment equals the cost of provision, and a separate payment for the partial reimbursement of capital costs. Departures from this scheme, which are frequent in DRG tariff systems designed around the world, lead to a trade-off between the objective of making effective technologies available to patients and the need to ensure appropriateness in use. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Reducing the risk of injury from table saw use: the potential benefits and costs of automatic protection.

    PubMed

    Graham, John D; Chang, Joice

    2015-02-01

    The use of table saws in the United States is associated with approximately 28,000 emergency department (ED) visits and 2,000 cases of finger amputation per year. This article provides a quantitative estimate of the economic benefits of automatic protection systems that could be designed into new table saw products. Benefits are defined as reduced health-care costs, enhanced production at work, and diminished pain and suffering. The present value of the benefits of automatic protection over the life of the table saw are interpreted as the switch-point cost value, the maximum investment in automatic protection that can be justified by benefit-cost comparison. Using two alternative methods for monetizing pain and suffering, the study finds switch-point cost values of $753 and $561 per saw. These point estimates are sensitive to the values of inputs, especially the average cost of injury. The various switch-point cost values are substantially higher than rough estimates of the incremental cost of automatic protection systems. Uncertainties and future research needs are discussed. © 2014 Society for Risk Analysis.

  10. The Economics of Information: A Guide to Economic and Cost-Benefit Analysis for Information Professionals. Library and Information Science Text Series.

    ERIC Educational Resources Information Center

    Kingma, Bruce R.

    This book provides readers with an introduction to economics and cost-benefit analysis and will be particularly valuable to individuals who are, or plan to be, managers of information services in academic, public, or special libraries. Part 1 provides a rational for economic studies in librarianship, specifically, gaining understanding of consumer…

  11. Age 21 Cost-Benefit Analysis of the Title I Chicago Child-Parent Centers. Discussion Paper No. 1245-02

    ERIC Educational Resources Information Center

    Reynolds, Arthur J.; Temple, Judy A.; Robertson, Dylan L.; Mann, Emily A.

    2002-01-01

    We conducted the first cost-benefit analysis of a federally financed, comprehensive early childhood program. The Title I Chicago Child-Parent Centers are located in public schools and provide educational and family support services to low-income children from ages 3 to 9. Using data from a cohort of children born in 1980 who participate in the…

  12. Age 26 Cost-Benefit Analysis of the Child-Parent Center Early Education Program

    ERIC Educational Resources Information Center

    Reynolds, Arthur J.; Temple, Judy A.; White, Barry A. B.; Ou, Suh-Ruu; Robertson, Dylan L.

    2011-01-01

    Using data collected up to age 26 in the Chicago Longitudinal Study, this cost-benefit analysis of the Child-Parent Centers (CPC) is the first for a sustained publicly funded early intervention. The program provides services for low-income families beginning at age 3 in 20 school sites. Kindergarten and school-age services are provided up to age 9…

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

    PubMed

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

    2017-06-01

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

  14. Resistance delaying strategies on UK sheep farms: A cost benefit analysis.

    PubMed

    Learmount, Jane; Glover, Mike J; Taylor, Mike A

    2018-04-30

    UK guidelines for the sustainable control of parasites in sheep (SCOPS) were formulated with the primary aim of delaying development of anthelmintic resistance (AR) on UK sheep farms. Promoting their use requires the engagement and commitment of stakeholders. An important driver for behavioural change in sheep farmers is evidence of economic benefits. A recent evaluation of SCOPS guidance in practice demonstrated a significant reduction in anthelmintic use, suggesting economic benefits through a direct reduction in product and labour costs. However, in order to maintain production, a range of alternative control strategies are advised, resulting in additional costs to farmers and so a full cost benefit analysis of best practice management was undertaken. We allocated financial values to the management recommendations described in the SCOPS technical manual. Benefits were calculated using data for production variables and anthelmintic use measured during studies to evaluate the effect of SCOPS recommendations on 16 UK sheep farms and from other published work. As SCOPS control is not prescriptive and a range of different diagnostics are available, best and worst case scenarios were presented, comparing the cheapest methods (e.g. egg counts without larval culture) and management situations (e.g closed flocks not requiring quarantine treatments) with the most laborious and expensive. Simulations were run for farms with a small, medium or large flock (300; 1000; 1900 ewes) as well as comparing scenarios with and without potential production benefits from using effective wormers. Analysis demonstrated a moderate cost for all farms under both scenarios when production benefits were not included. A cost benefit was demonstrated for medium and large farms when production benefits were included and the benefit could be perceived as significant in the case of the large farms for the best case scenario (>£5000 per annum). Despite a significant potential reduction in anthelmintic use by farmers employing SCOPS guidance, the very low price of the older anthelmintic classes meant that the benefit did not always outweigh the additional management/diagnostic costs unless an increase in production was also achieved. This is an important finding. Focussing research on key innovations that will improve the cost effectiveness of diagnostic assays in a diagnostic driven control strategy, as well as designing treatment options that can improve production outcomes, and presenting them in a clear and transparent way, must be high priority goals. Coupling targeted research with improvements in the delivery of messages to the end user is important in the light of increasing global concerns over drug resistance. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  15. Evaluation of School-Based Dental Sealant Programs: An Updated Community Guide Systematic Economic Review.

    PubMed

    Griffin, Susan O; Naavaal, Shillpa; Scherrer, Christina; Patel, Mona; Chattopadhyay, Sajal

    2017-03-01

    A recently updated Community Guide systematic review of the effectiveness of school sealant programs (SSPs) still found strong evidence that SSPs reduced dental caries among schoolchildren. This follow-up systematic review updates SSP cost and benefit information from the original 2002 review. Using Community Guide economic review methods, the authors searched the literature from January 2000 to November 20, 2014. The final body of evidence included 14 studies-ten from the current search and four with cost information from the 2002 review. Nine studies had information on SSP costs; six on sealant benefit (averted treatment costs and productivity losses); four on SSP net cost (cost minus benefit); and three on net cost to Medicaid of clinically delivered sealants. The authors imputed productivity losses and discounted costs/outcomes when this information was missing. The analysis, conducted in 2015, reported all values in 2014 U.S. dollars. The median one-time SSP cost per tooth sealed was $11.64. Labor accounted for two thirds of costs, and time to provide sealants was a major cost driver. The median annual economic benefit was $6.29, suggesting that over 4 years the SSP benefit ($23.37 at a 3% discount rate) would exceed costs by $11.73 per sealed tooth. In addition, two of four economic models and all three analyses of Medicaid claims data found that SSP benefit to society exceeded SSP cost. Recent evidence indicates the benefits of SSPs exceed their costs when SSPs target schools attended by a large number of high-risk children. Published by Elsevier Inc.

  16. National Launch System comparative economic analysis

    NASA Technical Reports Server (NTRS)

    Prince, A.

    1992-01-01

    Results are presented from an analysis of economic benefits (or losses), in the form of the life cycle cost savings, resulting from the development of the National Launch System (NLS) family of launch vehicles. The analysis was carried out by comparing various NLS-based architectures with the current Shuttle/Titan IV fleet. The basic methodology behind this NLS analysis was to develop a set of annual payload requirements for the Space Station Freedom and LEO, to design launch vehicle architectures around these requirements, and to perform life-cycle cost analyses on all of the architectures. A SEI requirement was included. Launch failure costs were estimated and combined with the relative reliability assumptions to measure the effects of losses. Based on the analysis, a Shuttle/NLS architecture evolving into a pressurized-logistics-carrier/NLS architecture appears to offer the best long-term cost benefit.

  17. Systematic review of the economic evidence on home visitation programmes for vulnerable pregnant women.

    PubMed

    Stamuli, Eugena; Richardson, Gerry; Duffy, Steven; Robling, Michael; Hood, Kerry

    2015-09-01

    A systematic review of the economic evidence on home visitation programmes for young or vulnerable pregnant women was undertaken to provide a summary of the existing literature of these interventions. Relevant studies were identified from a number of sources including large databases, free text search on Google Scholar as well as hand-searching of the obtained references. The search yielded a large number of papers, of which 12 were considered appropriate to be included in the review. These were either full or partial economic evaluations: four studies were cost-benefit analyses, three were cost-effectiveness analyses and the remaining were costing studies. The review highlighted the paucity of good quality economic evaluations in the area of home visiting programmes for young or vulnerable pregnant women. Methods varied substantially between the studies spanning from differing data sources (e.g. single randomized trials or meta-analyses) to different perspectives taken, cost items and outcomes included in the analysis. It is difficult to establish a coherent body of economic evidence for these interventions and draw a firm conclusion on their value for money. Home visiting programmes are complex interventions, with impact on the lives of mothers and their children. The funding of such interventions should be based on rigorous effectiveness and economic evidence. There is a need for well-designed economic evaluations which will follow the appropriate methodological guidelines and also take into account the complexity of such interventions. These analyses should preferably consider multiple perspectives and allow for the fact that the majority of the benefits accrue in the long-term future. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost-effectiveness analysis.

    PubMed

    Hoch, Jeffrey S; Briggs, Andrew H; Willan, Andrew R

    2002-07-01

    Economic evaluation is often seen as a branch of health economics divorced from mainstream econometric techniques. Instead, it is perceived as relying on statistical methods for clinical trials. Furthermore, the statistic of interest in cost-effectiveness analysis, the incremental cost-effectiveness ratio is not amenable to regression-based methods, hence the traditional reliance on comparing aggregate measures across the arms of a clinical trial. In this paper, we explore the potential for health economists undertaking cost-effectiveness analysis to exploit the plethora of established econometric techniques through the use of the net-benefit framework - a recently suggested reformulation of the cost-effectiveness problem that avoids the reliance on cost-effectiveness ratios and their associated statistical problems. This allows the formulation of the cost-effectiveness problem within a standard regression type framework. We provide an example with empirical data to illustrate how a regression type framework can enhance the net-benefit method. We go on to suggest that practical advantages of the net-benefit regression approach include being able to use established econometric techniques, adjust for imperfect randomisation, and identify important subgroups in order to estimate the marginal cost-effectiveness of an intervention. Copyright 2002 John Wiley & Sons, Ltd.

  19. Cost-volume-profit analysis and expected benefit of health services: a study of cardiac catheterization services.

    PubMed

    Younis, Mustafa Z; Jabr, Samer; Smith, Pamela C; Al-Hajeri, Maha; Hartmann, Michael

    2011-01-01

    Academic research investigating health care costs in the Palestinian region is limited. Therefore, this study examines the costs of the cardiac catheterization unit of one of the largest hospitals in Palestine. We focus on costs of a cardiac catheterization unit and the increasing number of deaths over the past decade in the region due to cardiovascular diseases (CVDs). We employ cost-volume-profit (CVP) analysis to determine the unit's break-even point (BEP), and investigate expected benefits (EBs) of Palestinian government subsidies to the unit. Findings indicate variable costs represent 56 percent of the hospital's total costs. Based on the three functions of the cardiac catheterization unit, results also indicate that the number of patients receiving services exceed the break-even point in each function, despite the unit receiving a government subsidy. Our findings, although based on one hospital, will permit hospital management to realize the importance of unit costs in order to make informed financial decisions. The use of break-even analysis will allow area managers to plan minimum production capacity for the organization. The economic benefits for patients and the government from the unit may encourage government officials to focus efforts on increasing future subsidies to the hospital.

  20. An Excel Spreadsheet Model for States and Districts to Assess the Cost-Benefit of School Nursing Services.

    PubMed

    Wang, Li Yan; O'Brien, Mary Jane; Maughan, Erin D

    2016-11-01

    This paper describes a user-friendly, Excel spreadsheet model and two data collection instruments constructed by the authors to help states and districts perform cost-benefit analyses of school nursing services delivered by full-time school nurses. Prior to applying the model, states or districts need to collect data using two forms: "Daily Nurse Data Collection Form" and the "Teacher Survey." The former is used to record daily nursing activities, including number of student health encounters, number of medications administered, number of student early dismissals, and number of medical procedures performed. The latter is used to obtain estimates for the time teachers spend addressing student health issues. Once inputs are entered in the model, outputs are automatically calculated, including program costs, total benefits, net benefits, and benefit-cost ratio. The spreadsheet model, data collection tools, and instructions are available at the NASN website ( http://www.nasn.org/The/CostBenefitAnalysis ).

  1. Endogenous patient responses and the consistency principle in cost-effectiveness analysis.

    PubMed

    Liu, Liqun; Rettenmaier, Andrew J; Saving, Thomas R

    2012-01-01

    In addition to incurring direct treatment costs and generating direct health benefits that improve longevity and/or health-related quality of life, medical interventions often have further or "unrelated" financial and health impacts, raising the issue of what costs and effects should be included in calculating the cost-effectiveness ratio of an intervention. The "consistency principle" in medical cost-effectiveness analysis (CEA) requires that one include both the cost and the utility benefit of a change (in medical expenditures, consumption, or leisure) caused by an intervention or neither of them. By distinguishing between exogenous changes directly brought about by an intervention and endogenous patient responses to the exogenous changes, and within a lifetime utility maximization framework, this article addresses 2 questions related to the consistency principle: 1) how to choose among alternative internally consistent exclusion/inclusion rules, and 2) what to do with survival consumption costs and earnings. It finds that, for an endogenous change, excluding or including both the cost and the utility benefit of the change does not alter cost-effectiveness results. Further, in agreement with the consistency principle, welfare maximization implies that consumption costs and earnings during the extended life directly caused by an intervention should be included in CEA.

  2. Benefit-Cost Analysis of Undergraduate Education Programs: An Example Analysis of the Freshman Research Initiative.

    PubMed

    Walcott, Rebecca L; Corso, Phaedra S; Rodenbusch, Stacia E; Dolan, Erin L

    2018-01-01

    Institutions and administrators regularly have to make difficult choices about how best to invest resources to serve students. Yet economic evaluation, or the systematic analysis of the relationship between costs and outcomes of a program or policy, is relatively uncommon in higher education. This type of evaluation can be an important tool for decision makers considering questions of resource allocation. Our purpose with this essay is to describe methods for conducting one type of economic evaluation, a benefit-cost analysis (BCA), using an example of an existing undergraduate education program, the Freshman Research Initiative (FRI) at the University of Texas Austin. Our aim is twofold: to demonstrate how to apply BCA methodologies to evaluate an education program and to conduct an economic evaluation of FRI in particular. We explain the steps of BCA, including assessment of costs and benefits, estimation of the benefit-cost ratio, and analysis of uncertainty. We conclude that the university's investment in FRI generates a positive return for students in the form of increased future earning potential. © 2018 R. L. Walcott et al. CBE—Life Sciences Education © 2018 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  3. A Cost-Benefit Study of a Breaking the Cycle Program for Juveniles

    ERIC Educational Resources Information Center

    Cowell, Alexander J.; Lattimore, Pamela K.; Krebs, Christopher P.

    2010-01-01

    The authors present a cost-benefit analysis of a Juvenile Breaking the Cycle (JBTC) program in Oregon designed to provide juvenile justice system monitoring and coordinated treatment and services to youth who are assessed as at high risk for recidivism and substance use. Detailed cost analyses are presented for youth in the JBTC program and a…

  4. [Implementation of the National Expert Standard Prophylaxis of Pressure Ulcers in nurse practise - a cost-benefit analysis].

    PubMed

    Wolke, R; Hennings, D; Scheu, P

    2007-06-01

    By developing evidence-based, national Expert Standards, agreed-upon by an association of nursing professionals, the German Care Science participates in the international discussion. Up to now, five National Expert Standards on relevant care-related topics have been developed and have been widely implemented in Care Practice. However, sufficient evaluations of these Expert Standards are still required, especially from an economic perspective. The following paper addresses this topic by performing a cost-benefit analysis for the National Expert Standard Prophylaxis of Pressure Ulcers. The authors demonstrate which costs are caused by the implementation of this National Expert Standard for a residential care agency providing services. The benefit of the implementation of the Expert Standard is then being compared to its cost for a period of three years. The evaluation concludes that, in consideration of opportunity costs, the introduction of the National Expert Standard Prophylaxis of Pressure Ulcers appears economically viable for the residential care agency only if the rate of pressure ulcers in the reference agency can be lowered at least by 26.48%. In this case, when exclusively considering direct benefits and direct costs, a positive impact of the implementation will be achieved.

  5. [Value-based medicine in ophthalmology].

    PubMed

    Hirneiss, C; Neubauer, A S; Tribus, C; Kampik, A

    2006-06-01

    Value-based medicine (VBM) unifies costs and patient-perceived value (improvement in quality of life, length of life, or both) of an intervention. Value-based ophthalmology is of increasing importance for decisions in eye care. The methods of VBM are explained and definitions for a specific terminology in this field are given. The cost-utility analysis as part of health care economic analyses is explained. VBM exceeds evidence-based medicine by incorporating parameters of cost and benefits from an ophthalmological intervention. The benefit of the intervention is defined as an increase or maintenance of visual quality of life and can be determined by utility analysis. The time trade-off method is valid and reliable for utility analysis. The resources expended for the value gained in VBM are measured with cost-utility analysis in terms of cost per quality-adjusted life years gained (euros/QALY). Numerous cost-utility analyses of different ophthalmological interventions have been published. The fundamental instrument of VBM is cost-utility analysis. The results in cost per QALY allow estimation of cost effectiveness of an ophthalmological intervention. Using the time trade-off method for utility analysis allows the comparison of ophthalmological cost-utility analyses with those of other medical interventions. VBM is important for individual medical decision making and for general health care.

  6. Integrated Undergraduate Management Education: An Informal Benefit/Cost Analysis

    ERIC Educational Resources Information Center

    Casey, William L., Jr.

    2005-01-01

    This paper seeks to contribute to the literature of management education by evaluating assessment data on Babson College's integrated undergraduate management core program (IMC). Transitions from functionally isolated curricula to more integrated alternatives involve both benefits and costs, accruing to faculty, students and sponsoring…

  7. Benefit-Cost Analysis of Integrated Paratransit Systems : Volume 5. The Impacts of Technological Innovation.

    DOT National Transportation Integrated Search

    1979-09-01

    A number of new technologies have been implemented with or proposed for paratransit systems. As part of the overall IP benefit cost study, the potential impact of two such technologies, digital communications and computer dispatching, have been analy...

  8. Cost-benefit evaluation of short-term warranties for hot mix asphalt pavements.

    DOT National Transportation Integrated Search

    2012-03-01

    The purpose of this report is to provide the reader with the ten-year analysis for the cost-benefit of hot mix asphalt projects : constructed using the three and five-year warranty specifications developed by CDOT. There were eight projects evaluated...

  9. Cost benefit analysis of anti-strip additives in hot mix asphalt with various aggregates.

    DOT National Transportation Integrated Search

    2015-05-01

    This report documents research on moisture sensitivity testing of hot-mix asphalt (HMA) mixes in Pennsylvania and the : associated use of antistrip. The primary objective of the research was to evaluate and compare benefit/cost ratios of mandatory us...

  10. TOWARD COST-BENEFIT ANALYSIS OF ACUTE BEHAVIORAL EFFECTS OF TOLUENE IN HUMANS

    EPA Science Inventory

    There is increasing interest in being able to express the consequences of exposure to potentially toxic compounds in monetary terms in order to evaluate potential cost-benefit relationships of controlling exposure. Behavioral effects of acute toluene exposure could be subjected ...

  11. Cost analysis of postmastectomy reconstruction: A comparison of two staged implant reconstruction using tissue expander and acellular dermal matrix with abdominal-based perforator free flaps.

    PubMed

    Tran, Bao Ngoc N; Fadayomi, Ayotunde; Lin, Samuel J; Singhal, Dhruv; Lee, Bernard T

    2017-09-01

    Two staged tissue expander-implant with acellular dermal matrix (TE/I + ADM) and deep inferior epigastric perforator (DIEP) flap are the most common implant and autologous methods of reconstruction in the U.S. Implant-based techniques are disproportionally more popular, partially due to its presumed cost effectiveness. We performed a comprehensive cost analysis to compare TE/I + ADM and DIEP flap. A comparative cost analysis of TE/I + ADM and DIEP flap was performed. Medicare reimbursement costs for each procedure and their associated complications were calculated. Pooled probabilities of complications including cellulitis, seroma, skin necrosis, implant removal, flap loss, partial flap loss, and fat necrosis, were calculated using published studies from 2010 to 2016. Average actual cost for successful TE/I + ADM and DIEP flap were $13 304.55 and $10 237.13, respectively. Incorporating pooled complication data from published literature resulted in an increase in cost to $13 963.46 for TE/I + ADM and $12 624.29 for DIEP flap. The expected costs for successful TE/I + ADM and DIEP flap were $9700.35 and $8644.23, which are lower than the actual costs. DIEP flap breast reconstruction incurs lower costs compared to TE/I + ADM. These costs are lower at baseline and when additional costs from pooled complications are incorporated. © 2017 Wiley Periodicals, Inc.

  12. Costs and outcomes of an intervention programme for offenders with personality disorders.

    PubMed

    Barrett, Barbara; Byford, Sarah

    2012-04-01

    The dangerous severe personality disorder programme was developed in high secure prisons and hospitals at great expense to identify and treat the most dangerous offenders with personality disorders. To evaluate whether the long-term costs of the programme are greater or less than the long-term outcomes. We used a Markov decision model with a cost-effectiveness analysis to determine the incremental cost of the programme per serious offence prevented and a cost-offset analysis to consider whether monetary benefits were greater than costs. Costs were consistently higher for the intervention programme and the cost per serious offence prevented was over £2 million, although there was some evidence that adjustments to the programme could lead to similar interventions becoming cost-effective. Little evidence was found to support the cost-effectiveness of the intervention programme for offenders with personality disorders, although delivery of the programme in a lower-cost prison would probably yield greater benefits than costs. There are frequent calls for mentally disordered offenders to be detained in secure hospitals rather than prisons; however, if reoffending remains the outcome of interest for policy makers, it is likely that the costs of detention in hospital will remain greater than the benefits for dangerous offenders with a personality disorder.

  13. [Cost-benefit analysis of primary prevention programs for mental health at the workplace in Japan].

    PubMed

    Yoshimura, Kensuke; Kawakami, Norito; Tsusumi, Akizumi; Inoue, Akiomi; Kobayashi, Yuka; Takeuchi, Ayano; Fukuda, Takashi

    2013-01-01

    To determine the cost-benefits of primary prevention programs for mental health at the workplace, we conducted a meta-analysis of published studies in Japan. We searched the literature, published as of 16 November 2011, using the Pubmed database and relevant key words. The inclusion criteria were: conducted in the workplace in Japan; primary prevention focus; quasi-experimental studies or controlled trials; and outcomes including absenteeism or presenteeism. Four studies were identified: one participatory work environment improvement, one individual-oriented stress management, and two supervisor education programs. Costs and benefits in yen were estimated for each program, based on the description of the programs in the literature, and additional information from the authors. The benefits were estimated based on each program's effect on work performance (measured using the WHO Health and Work Performance Questionnaire in all studies), as well as sick leave days, if available. The estimated relative increase in work performance (%) in the intervention group compared to the control group was converted into labor cost using the average bonus (18% of the total annual salary) awarded to employees in Japan as a base. Sensitive analyses were conducted using different models of time-trend of intervention effects and 95% confidence limits of the relative increase in work performance. For the participatory work environment improvement program, the cost was estimated as 7,660 yen per employee, and the benefit was 15,200-22,800 yen per employee. For the individual-oriented stress management program, the cost was 9,708 yen per employee, and the benefit was 15,200-22,920 yen per employee. For supervisor education programs, the costs and benefits were respectively 5,209 and 4,400-6,600 yen per employee, in one study, 2,949 and zero yen per employee in the other study. The 95% confidence intervals were wide for all these studies. For the point estimates based on these cases, the participatory work environment improvement program and the individual-oriented stress management program showed better cost-benefits. For the supervisor education programs, the costs were almost equal to or greater than the benefits. The results of the present study suggest these primary prevention programs for mental health at the workplace are economically advantageous to employers. Because the 95% confidence intervals were wide, further research is needed to clarify if these interventions yield statistically significant cost-benefits.

  14. Current Developments in Cost Accounting/Performance Measuring Systems for Implementing Advanced Manufacturing Technology

    DTIC Science & Technology

    1989-11-01

    incomplete accounting of benefits, few strategic projects will * be adopted. Nanni , et al [21], provide similar discussion regarding a benefit analysis in...management tends to ignore the fact that minimizing costs within departments does not guarantee minimization of overall costs ( Nanni (21]). Sullivan, et...changes in the manufacturing environment. The author also remarks that these cost systems need to be modified or replaced by entirely new systems

  15. The benefits and costs of new fuels and engines for light-duty vehicles in the United States.

    PubMed

    Keefe, Ryan; Griffin, James P; Graham, John D

    2008-10-01

    Rising oil prices and concerns about energy security and climate change are spurring reconsideration of both automobile propulsion systems and the fuels that supply energy to them. In addition to the gasoline internal combustion engine, recent years have seen alternatives develop in the automotive marketplace. Currently, hybrid-electric vehicles, advanced diesels, and flex-fuel vehicles running on a high percentage mixture of ethanol and gasoline (E85) are appearing at auto shows and in driveways. We conduct a rigorous benefit-cost analysis from both the private and societal perspective of the marginal benefits and costs of each technology--using the conventional gasoline engine as a baseline. The private perspective considers only those factors that influence the decisions of individual consumers, while the societal perspective accounts for environmental, energy, and congestion externalities as well. Our analysis illustrates that both hybrids and diesels show promise for particular light-duty applications (sport utility vehicles and pickup trucks), but that vehicles running continuously on E85 consistently have greater costs than benefits. The results for diesels were particularly robust over a wide range of sensitivity analyses. The results from the societal analysis are qualitatively similar to the private analysis, demonstrating that the most relevant factors to the benefit-cost calculations are the factors that drive the individual consumer's decision. We conclude with a brief discussion of marketplace and public policy trends that will both illustrate and influence the relative adoption of these alternative technologies in the United States in the coming decade.

  16. Technology Benefit Estimator (T/BEST): User's Manual

    NASA Technical Reports Server (NTRS)

    Generazio, Edward R.; Chamis, Christos C.; Abumeri, Galib

    1994-01-01

    The Technology Benefit Estimator (T/BEST) system is a formal method to assess advanced technologies and quantify the benefit contributions for prioritization. T/BEST may be used to provide guidelines to identify and prioritize high payoff research areas, help manage research and limited resources, show the link between advanced concepts and the bottom line, i.e., accrued benefit and value, and to communicate credibly the benefits of research. The T/BEST software computer program is specifically designed to estimating benefits, and benefit sensitivities, of introducing new technologies into existing propulsion systems. Key engine cycle, structural, fluid, mission and cost analysis modules are used to provide a framework for interfacing with advanced technologies. An open-ended, modular approach is used to allow for modification and addition of both key and advanced technology modules. T/BEST has a hierarchical framework that yields varying levels of benefit estimation accuracy that are dependent on the degree of input detail available. This hierarchical feature permits rapid estimation of technology benefits even when the technology is at the conceptual stage. As knowledge of the technology details increases the accuracy of the benefit analysis increases. Included in T/BEST's framework are correlations developed from a statistical data base that is relied upon if there is insufficient information given in a particular area, e.g., fuel capacity or aircraft landing weight. Statistical predictions are not required if these data are specified in the mission requirements. The engine cycle, structural fluid, cost, noise, and emissions analyses interact with the default or user material and component libraries to yield estimates of specific global benefits: range, speed, thrust, capacity, component life, noise, emissions, specific fuel consumption, component and engine weights, pre-certification test, mission performance engine cost, direct operating cost, life cycle cost, manufacturing cost, development cost, risk, and development time. Currently, T/BEST operates on stand-alone or networked workstations, and uses a UNIX shell or script to control the operation of interfaced FORTRAN based analyses. T/BEST's interface structure works equally well with non-FORTRAN or mixed software analysis. This interface structure is designed to maintain the integrity of the expert's analyses by interfacing with expert's existing input and output files. Parameter input and output data (e.g., number of blades, hub diameters, etc.) are passed via T/BEST's neutral file, while copious data (e.g., finite element models, profiles, etc.) are passed via file pointers that point to the expert's analyses output files. In order to make the communications between the T/BEST's neutral file and attached analyses codes simple, only two software commands, PUT and GET, are required. This simplicity permits easy access to all input and output variables contained within the neutral file. Both public domain and proprietary analyses codes may be attached with a minimal amount of effort, while maintaining full data and analysis integrity, and security. T/BESt's sotware framework, status, beginner-to-expert operation, interface architecture, analysis module addition, and key analysis modules are discussed. Representative examples of T/BEST benefit analyses are shown.

  17. Technology Benefit Estimator (T/BEST): User's manual

    NASA Astrophysics Data System (ADS)

    Generazio, Edward R.; Chamis, Christos C.; Abumeri, Galib

    1994-12-01

    The Technology Benefit Estimator (T/BEST) system is a formal method to assess advanced technologies and quantify the benefit contributions for prioritization. T/BEST may be used to provide guidelines to identify and prioritize high payoff research areas, help manage research and limited resources, show the link between advanced concepts and the bottom line, i.e., accrued benefit and value, and to communicate credibly the benefits of research. The T/BEST software computer program is specifically designed to estimating benefits, and benefit sensitivities, of introducing new technologies into existing propulsion systems. Key engine cycle, structural, fluid, mission and cost analysis modules are used to provide a framework for interfacing with advanced technologies. An open-ended, modular approach is used to allow for modification and addition of both key and advanced technology modules. T/BEST has a hierarchical framework that yields varying levels of benefit estimation accuracy that are dependent on the degree of input detail available. This hierarchical feature permits rapid estimation of technology benefits even when the technology is at the conceptual stage. As knowledge of the technology details increases the accuracy of the benefit analysis increases. Included in T/BEST's framework are correlations developed from a statistical data base that is relied upon if there is insufficient information given in a particular area, e.g., fuel capacity or aircraft landing weight. Statistical predictions are not required if these data are specified in the mission requirements. The engine cycle, structural fluid, cost, noise, and emissions analyses interact with the default or user material and component libraries to yield estimates of specific global benefits: range, speed, thrust, capacity, component life, noise, emissions, specific fuel consumption, component and engine weights, pre-certification test, mission performance engine cost, direct operating cost, life cycle cost, manufacturing cost, development cost, risk, and development time. Currently, T/BEST operates on stand-alone or networked workstations, and uses a UNIX shell or script to control the operation of interfaced FORTRAN based analyses. T/BEST's interface structure works equally well with non-FORTRAN or mixed software analysis. This interface structure is designed to maintain the integrity of the expert's analyses by interfacing with expert's existing input and output files. Parameter input and output data (e.g., number of blades, hub diameters, etc.) are passed via T/BEST's neutral file, while copious data (e.g., finite element models, profiles, etc.) are passed via file pointers that point to the expert's analyses output files. In order to make the communications between the T/BEST's neutral file and attached analyses codes simple, only two software commands, PUT and GET, are required. This simplicity permits easy access to all input and output variables contained within the neutral file. Both public domain and proprietary analyses codes may be attached with a minimal amount of effort, while maintaining full data and analysis integrity, and security.

  18. Effectiveness, safety, and cost of partial exchange transfusions in patients with sickle-cell anemia at a sickle cell disease center in sub-Saharan Africa.

    PubMed

    Boma Muteb, P; Kaluila Mamba, J F J; Muhau Pfutila, P; Bilo, V; Panda Mulefu, J D; Diallo, D A

    2017-11-01

    The partial exchange transfusions necessary for management of some sickle-cell complications raise the issue of effectiveness in the context of limited resources and inadequate blood safety. This study evaluated the effectiveness, safety, and cost of partial exchange transfusions in 39 patients with sickle-cell anemia in Lubumbashi, looking at the patients' age and gender and the tolerability and direct cost of the transfusions. Excel and SPSS 18 were used for data entry and analysis. Chi2 and Fisher exact tests were used for comparisons. A P-value ≤ 5% was considered statistically significant. The average age of patients was 8.6 ± 6.4 years, and the majority were girls. The most frequent indications were stroke, severe infections, severe vasooclusive crises, and acute chest syndrome. Partial exchange transfusions were effective in improving hemoglobin and hematocrit as well as the percentage of HbS. No acute accident was observed during any partial exchange transfusion; one anti-Kell alloimmunization and 2 cases of iron overload were observed. The annual cost of partial exchange transfusions per patient requiring (and able to afford) regular treatment was US $ 3,345 without iron chelation and more than US $ 5000 with chelation. Partial exchange transfusions are effective and tolerated, but financially inaccessible to the majority of our sickle cell patients. Thus, an assessment is needed of the economic burden of sickle cell complications that require partial exchange transfusions in the context of countries with limited financial resources.

  19. Using Benefit-Cost Analysis to Scale Up Early Childhood Programs through Pay-for-Success Financing

    PubMed Central

    Temple, Judy A.; Reynolds, Arthur J.

    2016-01-01

    Increasing access to high-quality preschool programs is a high priority at local, state, and federal levels. Recently, two initiatives to expand preschool programming in Illinois and Utah have used funds from private investors to scale up existing programs. Private-sector social impact investors provide funding to nonprofit or public preschool providers to increase the number of children served. If the measured outcomes from preschool participation meet pre-determined goals, then the estimated government cost savings arising from these preschool interventions are used to repay the investors. Social impact investing with a “Pay for Success” contract can help budget-constrained governments expand proven or promising preventive interventions without the need to increase taxes. Cost-benefit analysis plays a crucial role in helping to identify which social, educational or health interventions are suitable for this type of innovative financing. Cost-benefit analysts are needed to design the structure of the success payments that the government will make to the private investors. This paper describes social impact borrowing as a new method for financing public services, outlines the contribution of cost-benefit analysis, and discusses the innovative use of social impact financing to promote scaling up of the evidence-based Child Parent Centers and other early childhood programs. PMID:27882288

  20. Adaptive Signal Recovery on Graphs via Harmonic Analysis for Experimental Design in Neuroimaging.

    PubMed

    Kim, Won Hwa; Hwang, Seong Jae; Adluru, Nagesh; Johnson, Sterling C; Singh, Vikas

    2016-10-01

    Consider an experimental design of a neuroimaging study, where we need to obtain p measurements for each participant in a setting where p ' (< p ) are cheaper and easier to acquire while the remaining ( p - p ') are expensive. For example, the p ' measurements may include demographics, cognitive scores or routinely offered imaging scans while the ( p - p ') measurements may correspond to more expensive types of brain image scans with a higher participant burden. In this scenario, it seems reasonable to seek an "adaptive" design for data acquisition so as to minimize the cost of the study without compromising statistical power. We show how this problem can be solved via harmonic analysis of a band-limited graph whose vertices correspond to participants and our goal is to fully recover a multi-variate signal on the nodes, given the full set of cheaper features and a partial set of more expensive measurements. This is accomplished using an adaptive query strategy derived from probing the properties of the graph in the frequency space. To demonstrate the benefits that this framework can provide, we present experimental evaluations on two independent neuroimaging studies and show that our proposed method can reliably recover the true signal with only partial observations directly yielding substantial financial savings.

  1. An exploratory case study of the impact of expanding cost-effectiveness analysis for second-line nivolumab for patients with squamous non-small cell lung cancer in Canada: Does it make a difference?

    PubMed

    Shafrin, Jason; Skornicki, Michelle; Brauer, Michelle; Villeneuve, Julie; Lees, Michael; Hertel, Nadine; Penrod, John R; Jansen, Jeroen

    2018-04-26

    Health technology appraisal agencies often rely on cost-effectiveness analyses to inform coverage decisions for new treatments. These assessments, however, frequently measure a treatment's value from the payer's perspective, and may not capture value generated from reduced caregiving costs, increased productivity, value based on patient risk preferences, option value or the insurance value to non-patients. To examine how using a broader societal perspective of treatment value affects cost-effectiveness estimates, this case study analyzed the net monetary benefit (NMB) of second-line nivolumab treatment of patients with squamous non-small cell lung cancer (NSCLC) in Canada. The comparator was treatment with docetaxel. NMB was measured from three perspectives: (i) traditional payer, (ii) traditional societal and (iii) broad societal. Nivolumab was more effective (increased quality-adjusted life years by 0.66 versus docetaxel), but also increased costs by $100,168 CAD. When valuing a quality-adjusted life year at $150,000, the net monetary benefit from the payer perspective suggested that costs modestly exceed benefits (NMB: -$1031). Adopting a societal perspective, however, nivolumab's benefits outweighed its costs (NMB: +$6752 and +$91,084 from the traditional and broad societal perspectives, respectively). Broadening cost-effectiveness analysis beyond the traditional payer perspective had a significant impact on the result and should be considered in order to capture all treatment benefits and costs of societal relevance. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Costs for Breast Cancer Care in the Military Health System: An Analysis by Benefit Type and Care Source.

    PubMed

    Eaglehouse, Yvonne L; Manjelievskaia, Janna; Shao, Stephanie; Brown, Derek; Hofmann, Keith; Richard, Patrick; Shriver, Craig D; Zhu, Kangmin

    2018-04-11

    Breast cancer care imposes a significant financial burden to U.S. healthcare systems. Health services factors, such as insurance benefit type and care source, may impact costs to the health system. Beneficiaries in the U.S. Military Health System (MHS) have universal healthcare coverage and access to a network of military facilities (direct care) and private practices (purchased care). This study aims to quantify and compare breast cancer care costs to the MHS by insurance benefit type and care source. We conducted a retrospective analysis of data linked between the MHS data repository administrative claims and central cancer registry databases. The institutional review boards of the Walter Reed National Military Medical Center, the Defense Health Agency, and the National Institutes of Health Office of Human Subjects Research reviewed and approved the data linkage. We used the linked data to identify records for women aged 40-64 yr who were diagnosed with breast cancer between 2003 and 2007 and to extract information on insurance benefit type, care source, and cost to the MHS for breast cancer treatment. We estimated per capita costs for breast cancer care by benefit type and care source in 2008 USD using generalized linear models, adjusted for demographic, pathologic, and treatment characteristics. The average per capita (n = 2,666) total cost for breast cancer care was $66,300 [standard error (SE) $9,200] over 3.31 (1.48) years of follow-up. Total costs were similar between benefit types, but varied by care source. The average per capita cost was $34,500 ($3,000) for direct care (n = 924), $96,800 ($4,800) for purchased care (n = 622), and $60,700 ($3,900) for both care sources (n = 1,120), respectively. Care source differences remained by tumor stage and for chemotherapy, radiation, and hormone therapy treatment types. Per capita costs to the MHS for breast cancer care were similar by benefit type and lower for direct care compared with purchased care. Further research is needed in breast and other tumor sites to determine patterns and determinants of cancer care costs between benefit types and care sources within the MHS.

  3. On the feasibility of benefit-cost analysis applied to remote sensing projects. [California water resources

    NASA Technical Reports Server (NTRS)

    Merewitz, L.

    1973-01-01

    The following step-wise procedure for making a benefit-cost analysis of using remote sensing techniques could be used either in the limited context of California water resources, or a context as broad as the making of integrated resource surveys of the entire earth resource complex on a statewide, regional, national, or global basis. (1) Survey all data collection efforts which can be accomplished by remote sensing techniques. (2) Carefully inspect the State of California budget and the Budget of the United States Government to find annual cost of data collection efforts. (3) Decide the extent to which remote sensing can obviate each of the collection efforts. (4) Sum the annual costs of all data collection which can be equivalently accomplished through remote sensing. (5) Decide what additional data could and would be collected through remote sensing. (6) Estimate the value of this information. It is not harmful to do a benefit-cost analysis so long as its severe limitations are recalled and it is supplemented with socio-economic impact studies.

  4. Benefit Cost Analysis of Three Skin Cancer Public Education Mass-Media Campaigns Implemented in New South Wales, Australia.

    PubMed

    Doran, Christopher M; Ling, Rod; Byrnes, Joshua; Crane, Melanie; Shakeshaft, Anthony P; Searles, Andrew; Perez, Donna

    2016-01-01

    Public education mass media campaigns are an important intervention for influencing behaviour modifications. However, evidence on the effectiveness of such campaigns to encourage the population to reduce sun exposure is limited. This study investigates the benefits and costs of three skin cancer campaigns implemented in New South Wales from 2006-2013. This analysis uses Australian dollars (AUD) and 2010-11 as the currency and base year, respectively. Historical data on skin cancer were used to project skin cancer rates for the period 2006-2020. The expected number of skin cancer cases is derived by combining skin cancer rates, sunburn rates and relative risk of skin cancers due to sun exposure. Counterfactual estimates are based on sunburn exposure in the absence of the campaigns. Monetary values are attached to direct (treatment) and indirect (productivity) costs saved due to fewer skin cancer cases. Monetary benefits are compared with the cost of implementing the campaigns and are presented in the form of a benefit-cost ratio. Relative to the counterfactual (i.e., no campaigns) there are an estimated 13,174 fewer skin cancers and 112 averted deaths over the period 2006-2013. The net present value of these benefits is $60.17 million and the campaign cost is $15.63 million. The benefit cost ratio is 3.85, suggesting that for every $1 invested a return of $3.85 is achieved. Skin cancer public education mass media campaigns are a good investment given the likely extent to which they reduce the morbidity, mortality and economic burden of skin cancer.

  5. Benefits of Government Incentives for Reusable Launch Vehicle Development

    NASA Technical Reports Server (NTRS)

    Shaw, Eric J.; Hamaker, Joseph W.; Prince, Frank A.

    1998-01-01

    Many exciting new opportunities in space, both government missions and business ventures, could be realized by a reduction in launch prices. Reusable launch vehicle (RLV) designs have the potential to lower launch costs dramatically from those of today's expendable and partially-expendable vehicles. Unfortunately, governments must budget to support existing launch capability, and so lack the resources necessary to completely fund development of new reusable systems. In addition, the new commercial space markets are too immature and uncertain to motivate the launch industry to undertake a project of this magnitude and risk. Low-cost launch vehicles will not be developed without a mature market to service; however, launch prices must be reduced in order for a commercial launch market to mature. This paper estimates and discusses the various benefits that may be reaped from government incentives for a commercial reusable launch vehicle program.

  6. Pesticides and health: a review of evidence on health effects, valuation of risks, and benefit-cost analysis.

    PubMed

    Tago, Damian; Andersson, Henrik; Treich, Nicolas

    2014-01-01

    This study presents literature reviews for the period 2000-2013 on (i) the health effects of pesticides and on (ii) preference valuation of health risks related to pesticides, as well as a discussion of the role of benefit-cost analysis applied to pesticide regulatory measures. This study indicates that the health literature has focused on individuals with direct exposure to pesticides, i.e. farmers, while the literature on preference valuation has focused on those with indirect exposure, i.e. consumers. The discussion highlights the need to clarify the rationale for regulating pesticides, the role of risk perceptions in benefit-cost analysis, and the importance of inter-disciplinary research in this area. This study relates findings of different disciplines (health, economics, public policy) regarding pesticides, and identifies gaps for future research.

  7. Cost-benefit study of school nursing services.

    PubMed

    Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

    2014-07-01

    In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in the Massachusetts ESHS schools were a cost-beneficial investment of public money, warranting careful consideration by policy makers and decision makers when resource allocation decisions are made about school nursing positions.

  8. Strategically placing green infrastructure: cost-effective land conservation in the floodplain.

    PubMed

    Kousky, Carolyn; Olmstead, Sheila M; Walls, Margaret A; Macauley, Molly

    2013-04-16

    Green infrastructure approaches have attracted increased attention from local governments as a way to lower flood risk and provide an array of other environmental services. The peer-reviewed literature, however, offers few estimates of the economic impacts of such approaches at the watershed scale. We estimate the avoided flood damages and the costs of preventing development of floodplain parcels in the East River Watershed of Wisconsin's Lower Fox River Basin. Results suggest that the costs of preventing conversion of all projected floodplain development would exceed the flood damage mitigation benefits by a substantial margin. However, targeting of investments to high-benefit, low-cost parcels can reverse this equation, generating net benefits. The analysis demonstrates how any flood-prone community can use a geographic-information-based model to estimate the flood damage reduction benefits of green infrastructure, compare them to the costs, and target investments to design cost-effective nonstructural flood damage mitigation policies.

  9. Cost-benefit analysis of comprehensive mental health prevention programs in Japanese workplaces: a pilot study.

    PubMed

    Iijima, Sachiko; Yokoyama, Kazuhito; Kitamura, Fumihiko; Fukuda, Takashi; Inaba, Ryoichi

    2013-01-01

    We examined the implementation of mental health prevention programs in Japanese workplaces and the costs and benefits. A cross-sectional survey targeting mental health program staff at 11 major companies was conducted. Questionnaires explored program implementation based on the guidelines of the Japanese Ministry of Health, Labor and Welfare. Labor, materials, outsourcing costs, overheads, employee mental discomfort, and absentee numbers, and work attendance were examined. Cost-benefit analyses were conducted from company perspectives assessing net benefits per employee and returns on investment. The surveyed companies employ an average of 1,169 workers. The implementation rate of the mental health prevention programs was 66% for primary, 51% for secondary, and 60% for tertiary programs. The program's average cost was 12,608 yen per employee and the total benefit was 19,530 yen per employee. The net benefit per employee was 6,921 yen and the return on investment was in the range of 0.27-16.85. Seven of the 11 companies gained a net benefit from the mental health programs.

  10. Cost-benefit Analysis of Comprehensive Mental Health Prevention Programs in Japanese Workplaces: A Pilot Study

    PubMed Central

    IIJIMA, Sachiko; YOKOYAMA, Kazuhito; KITAMURA, Fumihiko; FUKUDA, Takashi; INABA, Ryoichi

    2013-01-01

    We examined the implementation of mental health prevention programs in Japanese workplaces and the costs and benefits. A cross-sectional survey targeting mental health program staff at 11 major companies was conducted. Questionnaires explored program implementation based on the guidelines of the Japanese Ministry of Health, Labor and Welfare. Labor, materials, outsourcing costs, overheads, employee mental discomfort, and absentee numbers, and work attendance were examined. Cost-benefit analyses were conducted from company perspectives assessing net benefits per employee and returns on investment. The surveyed companies employ an average of 1,169 workers. The implementation rate of the mental health prevention programs was 66% for primary, 51% for secondary, and 60% for tertiary programs. The program’s average cost was 12,608 yen per employee and the total benefit was 19,530 yen per employee. The net benefit per employee was 6,921 yen and the return on investment was in the range of 0.27–16.85. Seven of the 11 companies gained a net benefit from the mental health programs. PMID:24077445

  11. [Cost-benefit analysis of mental health activities in the workplace].

    PubMed

    Tarumi, Kimio; Hagihara, Akihito

    2013-01-01

    In order to examine the cost-benefit of mental health care activities in the workplace, the total costs of the fiscal year 2005, during which the old-type mental health care was conducted, and those of the fiscal years from 2006 to 2008, during which the new-type mental health care was conducted according to the governmental guidelines of each year, were compared using about 3,000 workers in a particular workplace in 2005. The total cost comprised the sum of the medical fees, the payment compensation for sick absences, and expenditures for health care activities of mentally ill health workers. The total costs from 2006 to 2008 were not markedly different from those in 2005, and the benefit due to new-type activity was not shown. However, the following was found: payment compensation for sick absences accounted for 60% of the total cost; personnel expenses which were a large part of the expenditure of health care activities largely changed over the years because of the age structure of the staff in charge. The results show that a cost-benefit analysis may be a useful tool for examining health care activities in the workplace for various members in the workplace although health care issues usually tend to be solved by specialists.

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

    PubMed

    Zhou, Chuanbin; Gong, Zhe; Hu, Junsong; Cao, Aixin; Liang, Hanwen

    2015-01-01

    Landfill mining is an environmentally-friendly technology that combines the concepts of material recycling and sustainable waste management, and it has received a great deal of worldwide attention because of its significant environmental and economic potential in material recycling, energy recovery, land reclamation and pollution prevention. This work applied a cost-benefit analysis model for assessing the economic feasibility, which is important for promoting landfill mining. The model includes eight indicators of costs and nine indicators of benefits. Four landfill mining scenarios were designed and analyzed based on field data. The economic feasibility of landfill mining was then evaluated by the indicator of net present value (NPV). According to our case study of a typical old landfill mining project in China (Yingchun landfill), rental of excavation and hauling equipment, waste processing and material transportation were the top three costs of landfill mining, accounting for 88.2% of the total cost, and the average cost per unit of stored waste was 12.7USDton(-1). The top three benefits of landfill mining were electricity generation by incineration, land reclamation and recycling soil-like materials. The NPV analysis of the four different scenarios indicated that the Yingchun landfill mining project could obtain a net positive benefit varying from 1.92 million USD to 16.63 million USD. However, the NPV was sensitive to the mode of land reuse, the availability of energy recovery facilities and the possibility of obtaining financial support by avoiding post-closure care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Benefit-Cost Analysis of a Randomized Evaluation of Communities That Care: Monetizing Intervention Effects on the Initiation of Delinquency and Substance Use Through Grade 12.

    PubMed

    Kuklinski, Margaret R; Fagan, Abigail A; Hawkins, J David; Briney, John S; Catalano, Richard F

    2015-06-01

    To determine whether the Communities That Care (CTC) prevention system is a cost-beneficial intervention. Data were from a longitudinal panel of 4,407 youth participating in a randomized controlled trial including 24 towns in 7 states, matched in pairs within state and randomly assigned to condition. Significant differences favoring intervention youth in sustained abstinence from delinquency, alcohol use, and tobacco use through Grade 12 were monetized and compared to economic investment in CTC. CTC was estimated to produce $4,477 in benefits per youth (discounted 2011 dollars). It cost $556 per youth to implement CTC for 5 years. The net present benefit was $3,920. The benefit-cost ratio was $8.22 per dollar invested. The internal rate of return was 21%. Risk that investment would exceed benefits was minimal. Investment was expected to be recouped within 9 years. Sensitivity analyses in which effects were halved yielded positive cost-beneficial results. CTC is a cost-beneficial, community-based approach to preventing initiation of delinquency, alcohol use, and tobacco use. CTC is estimated to generate economic benefits that exceed implementation costs when disseminated with fidelity in communities.

  14. Optimal partial mass transportation and obstacle Monge-Kantorovich equation

    NASA Astrophysics Data System (ADS)

    Igbida, Noureddine; Nguyen, Van Thanh

    2018-05-01

    Optimal partial mass transport, which is a variant of the optimal transport problem, consists in transporting effectively a prescribed amount of mass from a source to a target. The problem was first studied by Caffarelli and McCann (2010) [6] and Figalli (2010) [12] with a particular attention to the quadratic cost. Our aim here is to study the optimal partial mass transport problem with Finsler distance costs including the Monge cost given by the Euclidian distance. Our approach is different and our results do not follow from previous works. Among our results, we introduce a PDE of Monge-Kantorovich type with a double obstacle to characterize active submeasures, Kantorovich potential and optimal flow for the optimal partial transport problem. This new PDE enables us to study the uniqueness and monotonicity results for the active submeasures. Another interesting issue of our approach is its convenience for numerical analysis and computations that we develop in a separate paper [14] (Igbida and Nguyen, 2018).

  15. Benefit-cost analysis of Santa Monica's municipal forest

    Treesearch

    E.G. McPherson; J.R. Simpson; P.J. Peper; Q. Xiao

    2001-01-01

    The primary purpose of this report is to answer the question: Do the accrued benefits from Santa Monica's urban forest justify an annual municipal budget that exceeds $1.5 million? Our results indicate that the benefits residents obtain from Santa Monica’s urban forest do exceed management costs by over 50%. Over the years Santa Monica has invested millions in its...

  16. Volpe Center Report on Advanced Automation System Benefit-Cost Study: Final Report

    DOT National Transportation Integrated Search

    1993-10-25

    The Volpe Center study of the benefits and costs of the AAS approached the analysis by segments rather than as a whole system. The study concentrated on the automation aspects of the A TC system and applied conservative assumptions to the estimation ...

  17. Controlling Urban Air Pollution: A Benefit-Cost Assessment.

    ERIC Educational Resources Information Center

    Krupnick, Alan J.; Portney, Paul R.

    1991-01-01

    The pros and cons of air pollution control efforts are discussed. Both national and regional air pollution control plans are described. Topics of discussion include benefit-cost analysis, air quality regulation, reducing ozone in the urban areas, the Los Angeles plan, uncertainties, and policy implications. (KR)

  18. A Benefit-Cost Analysis of a Long-Term Intervention on Social and Emotional Learning in Compulsory School

    ERIC Educational Resources Information Center

    Klapp, Alli; Belfield, Clive; Bowden, Brooks; Levin, Henry; Shand, Robert; Zander, Sabine

    2017-01-01

    There is growing evidence that social and emotional skills can be taught to students in school and teaching these skills can have a positive effect on later outcomes, such as better mental health and less drug use. This paper presents a benefit-cost analysis of a longitudinal social and emotional learning intervention in Sweden, using data for 663…

  19. Examining the effectiveness of municipal solid waste management systems: an integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan.

    PubMed

    Weng, Yu-Chi; Fujiwara, Takeshi

    2011-06-01

    In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O&M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  20. Analysing Costs/Benefits for Distance Education Programmes. Knowledge Series: A Topical, Start-Up Guide to Distance Education Practice and Delivery.

    ERIC Educational Resources Information Center

    Rumble, Greville

    Cost analysis makes it possible to establish how much things costs, set budgets, determine prices, and compare the costs of different options. In distance education (DE), the main areas of cost analysis are as follows: print-based correspondence systems; educational/institutional television and radio systems; multimedia systems, and e-education…

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