Measurement in a marine environment using low cost sensors of temperature and dissolved oxygen

USGS Publications Warehouse

Godshall, F.A.; Cory, R.L.; Phinney, D.E.

1974-01-01

Continuous records of physical parameters of the marine environment are difficult as well as expensive to obtain. This paper describes preliminary results of an investigative program with the purpose of developing low cost time integrating measurement and averaging devices for water temperature and dissolved oxygen. Measurements were made in an estuarine area of the Chesapeake Bay over two week periods. With chemical thermometers average water temperature for the two week period was found to be equal to average water temperature measured with thermocouples plus or minus 1.0 C. The slow diffusion of oxygen through the semipermiable sides of plastic bottles permitted the use of water filled bottles to obtain averaged oxygen measurements. Oxygen measurements for two week averaging times using 500 ml polyethylene bottles were found to vary from conventionally measured and averaged dissolved oxygen by about 1.8 mg/l. ?? 1974 Estuarine Research Federation.

Student Expenses in Residency Interviewing

PubMed Central

Walling, Anne; Nilsen, Kari; Callaway, Paul; Grothusen, Jill; Gillenwater, Cole; King, Samantha; Unruh, Gregory

2017-01-01

Background The student costs of residency interviewing are of increasing concern but limited current information is available. Updated, more detailed information would assist students and residency programs in decisions about residency selection. The study objective was to measure the expenses and time spent in residency interviewing by the 2016 graduating class of the University of Kansas School of Medicine and assess the impact of gender, regional campus location, and primary care application. Methods All 195 students who participated in the 2016 National Residency Matching Program (NRMP) received a 33 item questionnaire addressing interviewing activity, expenses incurred, time invested and related factors. Main measures were self-reported estimates of expenses and time spent interviewing. Descriptive analyses were applied to participant characteristics and responses. Multivariate analysis of variance (MANOVA) and chi-square tests compared students by gender, campus (main/regional), and primary care/other specialties. Analyses of variance (ANOVA) on the dependent variables provided follow-up tests on significant MANOVA results. Results A total of 163 students (84%) completed the survey. The average student reported 38 (1–124) applications, 16 (1–54) invitations, 11 (1–28) completed interviews, and spent $3,500 ($20–$12,000) and 26 (1–90) days interviewing. No significant differences were found by gender. After MANOVA and ANOVA analyses, non-primary care applicants reported significantly more applications, interviews, and expenditures, but less program financial support. Regional campus students reported significantly fewer invitations, interviews, and days interviewing, but equivalent costs when controlled for primary care application. Cost was a limiting factor in accepting interviews for 63% and time for 53% of study respondents. Conclusions Students reported investing significant time and money in interviewing. After controlling for other variables, primary care was associated with significantly lowered expenses. Regional campus location was associated with fewer interviews and less time interviewing. Gender had no significant impact on any aspect studied. PMID:29472969

Six-year follow-up on work force and finances of the United States anesthesiology training programs: 2000 to 2006.

PubMed

Kheterpal, Sachin; Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2009-01-01

In the mid 1990s, interest in the field of anesthesiology decreased significantly among medical students, resulting in a decreasing resident class size and, subsequently, fewer anesthesiologists entering the United States workforce. This apparent practitioner shortage was associated with increased salary demands, which placed anesthesiology training departments in financial jeopardy. Starting in 1999, a survey was sent to the department chairs of the United States anesthesiology training programs to assess the status of faculty and finances of their departments. Follow-up surveys have been conducted each year thereafter. We present the results of the 2006 survey and 7 yr trend data. Surveys were distributed by e-mail in September 2006 to anesthesiology department chairs of the United States training programs. The responses were received by e-mail. Descriptive statistics were performed on responder data. In addition, a linear regression model to predict institutional support was developed. One-hundred-eighteen departments were surveyed with a response rate of 61%. There were an average of 4 open faculty positions in the 71% of the departments reporting open faculty positions. This would imply an overall 5% open position rate, down from 10% in 2000. Of the 96% of departments who employ certified registered nurse anesthetists, 70% had an average of 4 open positions, or approximately 11% shortage. The average department received $5,500,000 in total institutional support annually ($120,000/faculty). When the portion of this support provided for certified registered nurse anesthetists was removed, the average amount received was $4,600,000 or $100,000/faculty. This is a 10% increase over the previous year and an approximate 300% increase over the year 2000. Faculty academic time averaged 18% (where 20% is 1 day per week). The departments billed an average of 12,200 U/faculty/year. The average anesthesia unit value collected was $31/unit, while departments would require $46/unit to meet expenses. In a linear regression model, clinical revenue per unit billed minus expenses per unit billed predicted faculty support per full-time equivalent. This current survey reveals a continuing need for institutional support to keep anesthesiology training departments financially solvent. The amount of support is associated with the reimbursement for anesthesia work. There is also a continuing, but decreasing, number of open faculty anesthesiologist positions nationwide.

Comparing the Value of Nonprofit Hospitals' Tax Exemption to Their Community Benefits.

PubMed

Herring, Bradley; Gaskin, Darrell; Zare, Hossein; Anderson, Gerard

2018-01-01

The tax-exempt status of nonprofit hospitals has received increased attention from policymakers interested in examining the value they provide instead of paying taxes. We use 2012 data from the Internal Revenue Service (IRS) Form 990, Centers for Medicare and Medicaid Services (CMS) Hospital Cost Reports, and American Hospital Association's (AHA) Annual Survey to compare the value of community benefits with the tax exemption. We contrast nonprofit's total community benefits to what for-profits provide and distinguish between charity and other community benefits. We find that the value of the tax exemption averages 5.9% of total expenses, while total community benefits average 7.6% of expenses, incremental nonprofit community benefits beyond those provided by for-profits average 5.7% of expenses, and incremental charity alone average 1.7% of expenses. The incremental community benefit exceeds the tax exemption for only 62% of nonprofits. Policymakers should be aware that the tax exemption is a rather blunt instrument, with many nonprofits benefiting greatly from it while providing relatively few community benefits.

A proposal on auxiliary business insurance for peritoneal dialysis treatment.

PubMed

Wang, Juan; Wang, Tao; Fang, Ji-qian

2008-06-05

The peritoneal dialysis (PD) therapy for end stage renal disease (ESRD) is expensive. The main reason for non-acceptance onto dialysis programs is the great cost. In the present study, we design an auxiliary business insurance program to provide the potential ESRD patients who have no access to governmental medical insurance or can not afford the remaining part besides the limited reimbursement for peritoneal dialysis therapy. The information applied in this study was extracted from the medical records of 641 PD patients, who were treated in two dialysis centers of the first and the third teaching hospitals of the Peking University respectively. A collective risk model was employed to estimate the expenses on PD therapy. Survival analyses were performed to obtain the average survival time of PD patients and the average length of time from the onset of the primary disease to the beginning of PD. An annuity method was used to determine the pure premium. For chronic nephritis, diabetes mellitus and hyperpietic as primary diseases, the mean survival time +/- standard errors were (55.1 +/- 3.7) months, (38.9 +/- 3.2) months and (61.4 +/- 4.6) months respectively, and they were significantly different from each other (all P = 0.000). The expenses of whole PD therapy were 242 159.05 Yuan, 182 525.02 Yuan and 284 579.24 Yuan respectively. An auxiliary business insurance for PD patients was designed with the pure premium for any individual who had chronic nephritis, diabetes mellitus or hyperpietic as primary disease was RMB 35.94 Yuan/year, 87.73 Yuan/year or 7.71 Yuan/year respectively without considering the additional premium for coping with the business expenditures and accidental risks.

76 FR 19909 - International Terrorism Victim Expense Reimbursement Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... 1121-AA78 International Terrorism Victim Expense Reimbursement Program AGENCY: Office of Justice... promulgating this interim-final rule for its International Terrorism Victim Expense Reimbursement Program... international terrorism. DATES: Effective date: This interim-final rule is effective April 11, 2011. Comment...

41 CFR 300-90.1 - What is a telework travel expenses test program?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false What is a telework... Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS § 300-90.1 What is a telework travel expenses test program? It is a program that permits an agency to test new and...

Behind the Match Process: Is There Any Financial Difference Lurking Below the Specialty of Choice?

PubMed

Oladeji, Lasun O; Raley, James A; Smith, Stephen; Perez, Jorge L; McGwin, Gerald; Ponce, Brent A

2016-12-01

The Match was developed in response to a chaotic residency selection process. While the match has remained relatively unchanged since it was introduced, the number of medical school graduates has increased at a rate outpacing the number of residency positions leading to a more competitive process for applicants. In May 2014, an 18-question mixed-response questionnaire was distributed to fourth year allopathic medical students via an E-mail distribution list for student affairs representatives. The individual surveys were accessible via SurveyMonkey and available for completion over the course of a 4-week period. Approximately 65.1 per cent of students performed at least one audition rotation and documented average expenditures of $2494 on housing, food, and transportation. The average applicant applied to 32 programs and attended 12 interviews while spending $4420 on the interview trail. Applicants for surgical programs applied to approximately 42 programs and attended 13 interviews compared with primary care applicants who averaged 23 programs (P < 0.001) and attended 12 interviews (P = 0.002). Surgical applicants averaged 20 days on the interview trail while spending $5500 ($423/interview) on housing, food, and transportation compared with primary care applicants averaged 19 days away from home (P < 0.05) and spending $3400 ($283/interview) on these same items (P < 0.001). The findings in our study indicate that the "Match process" contributes to the financial burden of graduating medical students and it is more expensive and time consuming for the candidates interested in surgical specialties.

26 CFR 1.162-1 - Business expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

26 CFR 1.162-1 - Business expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

26 CFR 1.162-1 - Business expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

26 CFR 1.162-1 - Business expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... included in business expenses are management expenses, commissions (but see section 263 and the regulations... from such business. In the case of any sports program to which section 114 (relating to sports programs...

Comparing the Value of Nonprofit Hospitals’ Tax Exemption to Their Community Benefits

PubMed Central

Herring, Bradley; Gaskin, Darrell; Zare, Hossein; Anderson, Gerard

2018-01-01

The tax-exempt status of nonprofit hospitals has received increased attention from policymakers interested in examining the value they provide instead of paying taxes. We use 2012 data from the Internal Revenue Service (IRS) Form 990, Centers for Medicare and Medicaid Services (CMS) Hospital Cost Reports, and American Hospital Association’s (AHA) Annual Survey to compare the value of community benefits with the tax exemption. We contrast nonprofit’s total community benefits to what for-profits provide and distinguish between charity and other community benefits. We find that the value of the tax exemption averages 5.9% of total expenses, while total community benefits average 7.6% of expenses, incremental nonprofit community benefits beyond those provided by for-profits average 5.7% of expenses, and incremental charity alone average 1.7% of expenses. The incremental community benefit exceeds the tax exemption for only 62% of nonprofits. Policymakers should be aware that the tax exemption is a rather blunt instrument, with many nonprofits benefiting greatly from it while providing relatively few community benefits. PMID:29436247

26 CFR 1.41-3A - Base period research expense.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Base period research expense. 1.41-3A Section 1... Research Credit-for Taxable Years Beginning Before January 1, 1990 § 1.41-3A Base period research expense... average qualified research expenses during the base period), the taxpayer shall be treated as— (1) Having...

26 CFR 1.41-3A - Base period research expense.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Base period research expense. 1.41-3A Section 1... Research Credit-for Taxable Years Beginning Before January 1, 1990 § 1.41-3A Base period research expense... average qualified research expenses during the base period), the taxpayer shall be treated as— (1) Having...

26 CFR 1.41-3A - Base period research expense.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Base period research expense. 1.41-3A Section 1... Research Credit-for Taxable Years Beginning Before January 1, 1990 § 1.41-3A Base period research expense... average qualified research expenses during the base period), the taxpayer shall be treated as— (1) Having...

26 CFR 1.41-3A - Base period research expense.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Base period research expense. 1.41-3A Section 1... Research Credit-for Taxable Years Beginning Before January 1, 1990 § 1.41-3A Base period research expense... average qualified research expenses during the base period), the taxpayer shall be treated as— (1) Having...

26 CFR 1.41-3A - Base period research expense.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Base period research expense. 1.41-3A Section 1... Research Credit-for Taxable Years Beginning Before January 1, 1990 § 1.41-3A Base period research expense... average qualified research expenses during the base period), the taxpayer shall be treated as— (1) Having...

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

PubMed

Heikkila, Dianna

2002-02-01

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

Using financial incentives to improve the care of tuberculosis patients.

PubMed

Lee, Cheng-Yi; Chi, Mei-Ju; Yang, Shiang-Lin; Lo, Hsiu-Yun; Cheng, Shou-Hsia

2015-01-01

Tuberculosis (TB) is a serious public health concern, and Taiwan has implemented a pay-for-performance (P4P) program to incentivize healthcare professionals to provide comprehensive care to TB patients. This study aims to examine the effects of the TB P4P program on treatment outcomes and related expenses. A population-based natural experimental design with intervention and comparison groups. Propensity score matching was conducted to increase the comparability between the P4P and non-P4P group. A total of 12,018 subjects were included in the analysis, with 6009 cases in each group. Generalized linear models and multinomial logistic regression were employed to examine the effects of the P4P program. The regression models indicated that patients enrolled in the P4P program had 14% more ambulatory visits than non-P4P patients (P < .001), but there were no differences in hospitalization rates. On average, P4P enrollees spent $215 (4.6%) less on TB-related expenses than their counterparts. In addition, P4P enrollees had a higher likelihood of being successfully treated (odds ratio, 1.56; P < .001) and were less likely to die compared with nonenrollees. Patients in the P4P program were less likely to die, were more likely to be treated successfully, and incurred lower costs. Providing financial incentives to healthcare institutions could be a feasible model for better TB control.

Controlling supply expenses through capitated supply contracting.

PubMed

Kowalski, J C

1997-07-01

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

[Expenses of the Brazilian Ministry of Health for high-cost drugs: a demographic and clinical analysis].

PubMed

Brandão, Cristina Mariano Ruas; Guerra, Augusto Afonso; Cherchiglia, Mariângela Leal; Andrade, Eli Iola Gurgel; Almeida, Alessandra Maciel; da Silva, Grazielle Dias; de Queiroz, Odilon Vanni; Faleiros, Daniel Resende; Acurcio, Francisco de Assis

2011-01-01

To describe the expenses of the Ministry of Health of Brazil with users of High-Cost Drug Program that began treatment between 2000-2004, according to their demographic and clinical characteristics. We made a probabilistic-deterministic linkage of national databases of drugs and mortality, resulting in a historical cohort of patients using high-cost medications in 2000-2004. The per capita spending on medicines were stratified by a follow-up period and described according to demographic, clinical and type of drug used. The total population atended by the program was 611,419, being 63.5% female, average age 46 years. 41.9% of patients living in the Southeast and 29.7% in the Northeast of Brazil. 24.5% of patients began treatment in 2000, 12.4% in 2001, with increasing trend until 2004. The most prevalent diagnosis referred to the genitourinary system diseases and the most common use of chemical groups were antianemic preparations. 40,941 deaths were detected (6.7% of total). The total expenditure per capita was R$4.794,34. Higher spending per capita was observed in males, aged 47, who lived in the Southeast of Brazil and began treatment in 2000, had diagnoses of infectious and parasitic diseases and used blood substitutes and perfusions solutions. The understanding of the expenses involved subsidizes restructuring actions and scheduling drug programs, also provides information for therapeutic groups which are priorities for analysis. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Tax Breaks for Law Students.

ERIC Educational Resources Information Center

Button, Alan L.

1981-01-01

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

Five-year follow-up on the work force and finances of United States anesthesiology training programs: 2000 to 2005.

PubMed

Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2007-04-01

In the middle 1990s, there was a decrease in anesthesiology residency class sizes, which contributed to a nationwide shortage of anesthesiologists, resulting in a competitive market with increased salary demands. In 1999, a nationwide survey of the financial status of United States anesthesiology training programs was conducted. Follow-up surveys have been conducted each year thereafter. We present the results of the sixth survey in this series. Surveys were distributed by e-mail to the anesthesiology department chairs of the United States Training Programs. Responses were also received by e-mail. One hundred twenty-one departments were surveyed with a response rate of 60%. The 87% of departments seeking at least one additional faculty had an average of 2.8 faculty open positions (5.5% open positions overall which is down from 9.7% in 2000). Of the 96% of departments that employ certified registered nurse anesthetists (CRNAs) 89% were seeking additional CRNAs, averaging 3.6 open positions. The average department received $4.9 million (or $116,000/faculty) in institutional support. When the portion of this support allocated for CRNA salaries was removed, the average department received $4.1 million (or $95,000/faculty) in institutional support. This is a 16% increase over the previous year. Faculty academic time averaged 17% (where 20% is 1 d/wk). Departments billed an average of 11,320 anesthesia units/faculty/yr. Although the average anesthesia unit value collected was $31, departments required approximately $40/U to meet expenses. Medicaid payments averaged $15, ranging from $5 to $30/U. These results demonstrate the continuing need for institutional support to keep anesthesiology training departments financially stable.

75 FR 58329 - Federal Travel Regulation (FTR); Relocation Expenses Test Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

...; Docket 2010-0016; Sequence 1] RIN 3090-ZA01 Federal Travel Regulation (FTR); Relocation Expenses Test... extended the authority for relocation expenses test programs for Federal employees, made by the passage of..., permits the Administrator of General Services to authorize Federal agencies to test new and innovative...

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

PubMed

Ortenberg, Joseph; Roth, Christopher C

2013-10-01

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

Productivity of Veterans Health Administration laboratories: a College of American Pathologists Laboratory Management Index Program (LMIP) study.

PubMed

Valenstein, Paul N; Wang, Edward; O'Donohue, Tom

2003-12-01

The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P <.001). Technical staff at the median VA facility were paid more than at non-VA facilities (28.11/h dollars vs 22.60/h dollars, salaries plus benefits; P <.001), VA laboratories employed a smaller percentage of nontechnical staff (30.0% vs 41.9%; P <.001), and workers at VA laboratories worked less time per hour paid (85.5% vs 88.5%; P <.001). However, labor productivity was significantly higher at VA than at non-VA facilities (30 448 test results/total full-time equivalent (FTE)/y vs 19 260 results/total FTE; P <.001), resulting in lower labor expense per on-site test at VA sites than at non-VA sites (1.79 dollars/result vs 2.08 dollars/result; P <.001). Veterans Health Administration laboratories paid less per test for consumables (P =.003), depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.

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

ERIC Educational Resources Information Center

Florida Board of Governors, State University System, 2007

2007-01-01

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

41 CFR 300-90.6 - What is authorized under the test programs?

Code of Federal Regulations, 2014 CFR

2014-07-01

... the test programs? 300-90.6 Section 300-90.6 Public Contracts and Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS § 300-90.6 What is authorized under the test programs? Under a telework expenses test program authorized by the Administrator of...

The aurora, Mars, and more! Increasing science content in elementary grades through art and literacy programs in earth and space science

NASA Astrophysics Data System (ADS)

Renfrow, S.; Wood, E. L.

2011-12-01

Although reading, writing, and math examinations are often conducted early in elementary school, science is not typically tested until 4th or 5th grade. The result is a refocus on the tested topics at the expense of the untested ones, despite that standards exist for each topic at all grades. On a national level, science instruction is relegated to a matter of a few hours per week. A 2007 Education Policy study states that elementary school students spend an average of 178 minutes a week on science while spending 500 minutes on literacy. A recent NSTA report in July of elementary and middle school teachers confirms that teachers feel pressured to teach math and literacy at the expense of other programs. One unintended result is that teachers in grades where science is tested must play catch-up with students for them to be successful on the assessment. A unique way to combat the lack of science instruction at elementary grades is to combine literacy, social studies, and math into an integrated science program, thereby increasing the number of science contact hours. The Dancing Lights program, developed at the Laboratory for Atmospheric and Space Physics, is a science, art, and literacy program about the aurora designed to easily fit into a typical 3rd-5th grade instructional day. It mirrors other successful literacy programs and will provide a basis for the literacy program being developed for the upcoming MAVEN mission to Mars. We will present early findings, as well as "lessons learned" during our development and implementation of the Dancing Lights program and will highlight our goals for the MAVEN mission literacy program.

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program.

PubMed

Gans, Daphna; Hadler, Max W; Chen, Xiao; Wu, Shang-Hua; Dimand, Robert; Abramson, Jill M; Ferrell, Betty; Diamant, Allison L; Kominski, Gerald F

2016-09-01

In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. We assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay). A pre-post analysis compared enrollees' health care costs and utilization up to 24 months before enrollment with their costs during participation in the pilot, from January 2010 through December 2012. Analyses were conducted using paid Medicaid claims and program enrollment data. The average PEPM health care costs of program enrollees decreased by $3331 from before their participation in PFC to the enrolled period, driven by a reduction in inpatient costs of $4897 PEPM. PFC enrollees experienced a nearly 50% reduction in the average number of inpatient days per month, from 4.2 to 2.3. Average length of stay per hospitalization dropped from an average of 16.7 days before enrollment to 6.5 days while in the program. Through the provision of home-based therapeutic services, 24/7 access to medical advice, and enhanced, personally tailored care coordination, PFC demonstrated an effective way to reduce costs for children with life-limiting conditions by moving from costly inpatient care to more coordinated and less expensive outpatient care. PFC's home-based care strategy is a cost-effective model for pediatric palliative care elsewhere. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The gynecologic oncology fellowship interview process: Challenges and potential areas for improvement.

PubMed

Gressel, Gregory M; Van Arsdale, Anne; Dioun, Shayan M; Goldberg, Gary L; Nevadunsky, Nicole S

2017-05-01

The application and interview process for gynecologic oncology fellowship is highly competitive, time-consuming and expensive for applicants. We conducted a survey of successfully matched gynecologic oncology fellowship applicants to assess problems associated with the interview process and identify areas for improvement. All Society of Gynecologic Oncology (SGO) list-serve members who have participated in the match program for gynecologic oncology fellowship were asked to complete an online survey regarding the interview process. Linear regression modeling was used to examine association between year of match, number of programs applied to, cost incurred, and overall satisfaction. Two hundred and sixty-nine eligible participants reported applying to a mean of 20 programs [range 1-45] and were offered a mean of 14 interviews [range 1-43]. They spent an average of $6000 [$0-25,000], using personal savings (54%), credit cards (50%), family support (12%) or personal loans (3%). Seventy percent of respondents identified the match as fair, and 93% were satisfied. Interviewees spent a mean of 15 [0-45] days away from work and 37% reported difficulty arranging coverage. Linear regression showed an increase in number of programs applied to and cost per applicant over time ( p  < 0.001) between 1993 and 2016. Applicants who applied to all available programs spent more ( p  < 0.001) than those who applied to programs based on their location or quality. The current fellowship match was identified as fair and satisfying by most respondents despite being time consuming and expensive. Suggested alternative options included clustering interviews geographically or conducting preliminary interviews at the SGO Annual Meeting.

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

PubMed

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

2017-12-01

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

[Costs with personnel and productivity analysis of family health program teams in Fortaleza, Ceará].

PubMed

Rocha Filho, Fernando dos Santos; da Silva, Marcelo Gurgel Carlos

2009-01-01

The research verified the productivity and the operational personnel costs of eight teams of the Family Health Program (PSF) of two Basic Units of Family Health (UBASF) in Fortaleza, Ceará, through the methodology of costs by absorption, in 2004. The largest expenses were with personnel (75%), mainly with the PSF teams, and medicines (18%). The federal allocations received in September, 2004, by each PSF team, were R$ 9,543.33. The total cost by team was R$ 15,719.00. Some professionals of various PSF teams showed productivity above the set objectives, but the average productivity by doctor and nurse was below fifty per cent of objectives, with high idle time making the work onerous. The unity cost of home visits by doctor and prenatal attendance by nurses were checked, and, would be less expensive if the idle time were reduced. Various alternatives of cost reduction were observed, such as scale savings of some resources and services and re-negotiation of contracts with suppliers and cooperatives. The data obtained will contribute to more accurate planning for the installation and maintenance of PSF teams as well as alternatives of cost reductions, higher productivity, and better quality.

Medicaid program; deduction of incurred medical expenses (spenddown)--HCFA. Final rule with comment period.

PubMed

1994-01-12

This final rule with comment period permits States flexibility to revise the process by which incurred medical expenses are considered to reduce an individual's or family's income to become Medicaid eligible. This process is commonly referred to as "spenddown." Only States which cover the medically needy, and States which use more restrictive criteria to determine eligibility of the aged, blind, and disabled, than the criteria used to determine eligibility for Supplemental Security Income (SSI) benefits (section 1902(f) States) have a spenddown. These revisions permit States to: Consider as incurred medical expenses projected institutional expenses at the Medicaid reimbursement rate, and deduct those projected expenses from income in determining eligibility; combine the retroactive and prospective medically needy budget periods; either include or exclude medical expenses incurred earlier than the third month before the month of application (States must, however, deduct current payments on old bills not previously deducted in any budget period); and deduct incurred medical expenses from income in the order in which the services were provided, in the order each bill is submitted to the agency, by type of service. All States with medically needy programs using the criteria of the SS program may implement any of the provisions. States using more restrict criteria than the SSI program under section 1902(f) of the Social Security Act may implement all of these provisions except for the option to exclude medical expenses incurred earlier than the third month before the month of application.

Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

PubMed

Kranker, Keith

2016-03-01

In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.

Doctor pharmaceutical utilization behaviour changed by the global budget programme strategies on hypertensive outpatient prescription.

PubMed

Wei, Ching-Kuo; Wang, Shun-Mu; Yeh, Ming-Kung

2012-04-01

This study was to examine changes in doctor pharmaceutical utilization behaviour in response to Taiwan's newly implemented National Health Insurance individual hospital global budget (GB) programme and the changes in health care costs and prescription trends for hypertensive (HT) patients. We analysed hospital outpatient prescription utilization with a pre-post individual hospital GB group and comparison group (the hospitals who did not join the programme) to evaluate the impact of GB strategies on hypertensive expenditure. Descriptive analyses were performed based on the average daily medication expenditure for each prescription, and average number of items per prescription. This study reviewed 16,770,057 outpatient records and prescription records of 213,568 hypertensive patients. The average total medication expense (+17.6%), HT medication expense (+8.8%), daily medication expense (+16.3%), and daily HT medication expense (+6.3%) significantly increased after the action. After the individual hospital GB action, hospital doctors participating in action switched their patients' prescription drugs to other less expensive drugs such as rennin-angiotensin-aldosterone system inhibitors (-1.1%). The increase in volume of medications prescribed for control group were significantly larger for both alfa- and beta-adrenergic blocking agents (1.5%), and calcium channel blocking agents (3.9%). The individual hospital GB programme slowed down the trend of prescription drug cost increasing rate and reduced the prescription drug volume in hospitals. © 2010 Blackwell Publishing Ltd.

Computerized pediatric telephone triage and advice programs at children's hospitals: operating and financial characteristics.

PubMed

Melzer, S M; Poole, S R

1999-08-01

To describe the operating characteristics, financial performance, and perceived value of computerized children's hospital-based telephone triage and advice (TTA) programs. A written survey of all 32 children's hospital-based TTA programs in the United States that used the same proprietary pediatric TTA software product for at least 6 months. The expense, revenues, and perceived value of children's hospital-based TTA programs. Of 30 programs (94%) responding, 27 (90%) were eligible for the study and reported on their experience with nearly 1.3 million TTA calls over a 12-month period. Programs provided pediatric TTA services for 1560 physicians, serving an average of 82 physicians (range, 10-340 physicians) and answering 38880 calls (range, 8500-140000 calls) annually. The mean call duration was 11.3 minutes and the estimated mean total expense per call was $12.45. Of programs charging fees for TTA services, 16 (59%) used a per-call fee and 7 (26%) used a monthly service fee. All respondents indicated that fees did not cover all associated costs. Telephone triage and advice programs, when examined on a stand-alone basis, were all operating with annual deficits (mean, $447000; median, $325000; range, $74000-$1.3 million), supported by the sponsoring children's hospitals and their companion programs. Using a 3-point Likert scale, the TTA program managers rated the value of the TTA program very highly as a mechanism for marketing to physicians (2.85) and increasing physician (2.92) and patient (2.80) satisfaction. Children's hospital-based TTA programs operate at substantial financial deficits. Ongoing support of these programs may derive from the perception that they are a valuable mechanism for marketing and increase patient and physician satisfaction. Children's hospitals should develop strategies to ensure the long-term financial viability of TTA programs or they may have to discontinue these services.

Trends in workers compensation costs in a hotel-operating company over a six-year period.

PubMed

Kelley, C R; Mark, C R

1995-03-01

A large Honolulu-based hotel-operating company reviewed its workers compensation costs over the last 6 years. Data retrieved from the company's computerized data base is used to describe trends in injury incidence rate, average cost per claim, average medical cost per claim, and medical expenses as a percentage of total costs. Factors that might have influenced these parameters include company reorganization, employee training and safety programs, changes in the economy, company morale, aggressive case management, and the quality of the adjusting services hired. Cause-and-effect relationships, although suggested, cannot be proven. The data is presented, in this year of imminent workers compensation legislative reform, to increase the available factual data base on which rational and efficacious reform proposals can be developed.

Cost of illness among patients with diabetic foot ulcer in Turkey

PubMed Central

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

2016-01-01

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

Direct and indirect costs incurred by Australian living kidney donors.

PubMed

Barnieh, Lianne; Kanellis, John; McDonald, Stephen; Arnold, Jennifer; Sontrop, Jessica M; Cuerden, Meaghan; Klarenbach, Scott; Garg, Amit X; Boudville, Neil

2017-12-07

To describe the direct and indirect costs incurred by Australian living kidney donors. We studied 55 living kidney donors from 3 centres in Perth, Australia and 1 centre in Melbourne, Australia (2010-2014); 49 donors provided information on expenses incurred during the donor evaluation period and up to 3 months after donation. We used a micro-costing approach to measure and value the units of resources consumed. Expenses were grouped as direct costs (ground and air travel, accommodation, and prescription medications) and indirect costs (lost wages and lost productivity). We standardized costs to the year 2016 in Australian dollars. The most common direct costs were for ground travel (100%), parking (76%), and post-donation pain medications or antibiotics (73%). The highest direct costs were for air travel (median $1,986 [3 donors]) and ground travel (median $459 [49 donors]). Donors also reported lost wages (median $9,891 [37 donors]). The inability to perform household activities or care for dependants were reported by 32 (65%) and 23 (47%) donors. Total direct costs averaged $1,682 per donor (median $806 among 49 donors). Total indirect costs averaged $7,249 per donor (median $7,273 among 49 donors). Total direct and indirect costs averaged $8,932 per donor (median $7,963 among 49 donors). Many Australian living kidney donors incur substantial costs during the donation process. Our findings inform the continued development of policies and programs designed to minimize costs incurred by living kidney donors. This article is protected by copyright. All rights reserved.

28 CFR 94.22 - Categories of expenses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Categories of expenses. 94.22 Section 94.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Coverage § 94.22 Categories of expenses. The following...

28 CFR 94.22 - Categories of expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Categories of expenses. 94.22 Section 94.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Coverage § 94.22 Categories of expenses. The following...

28 CFR 94.22 - Categories of expenses.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Categories of expenses. 94.22 Section 94.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Coverage § 94.22 Categories of expenses. The following...

28 CFR 94.22 - Categories of expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Categories of expenses. 94.22 Section 94.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Coverage § 94.22 Categories of expenses. The following...

28 CFR 94.22 - Categories of expenses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Categories of expenses. 94.22 Section 94.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Coverage § 94.22 Categories of expenses. The following...

78 FR 73702 - Federal Travel Regulation (FTR); Telework Travel Expenses Test Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... done to apply for test program authority? The head of the agency or designee must design the test... agency for travel to the pre-existing duty station. Sec. 300-90.7 What is the duration of test programs... Expenses Test Programs AGENCY: Office of Government-wide Policy, U.S. General Services Administration (GSA...

7 CFR 1219.50 - Budgets, programs, plans, and projects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Budgets, programs, plans, and projects. 1219.50... Order Budgets, Expenses, and Assessments § 1219.50 Budgets, programs, plans, and projects. (a) The Board shall submit to the Secretary, on a fiscal period basis, annual budgets of its anticipated expenses and...

26 CFR 1.861-14 - Special rules for allocating and apportioning certain expenses (other than interest expense) of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... chains of includible corporations connected through 80-percent stock ownership with a common parent... basis of assets is chosen, the average amount of assets (tax book value or fair market value) for the...

24 CFR 990.160 - Overview of calculating formula expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... formula expense. The formula expense of any one project is the sum of the project's PEL and the UEL... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Overview of calculating formula... URBAN DEVELOPMENT THE PUBLIC HOUSING OPERATING FUND PROGRAM Calculating Formula Expenses § 990.160...

24 CFR 990.160 - Overview of calculating formula expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... formula expense. The formula expense of any one project is the sum of the project's PEL and the UEL... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Overview of calculating formula... URBAN DEVELOPMENT THE PUBLIC HOUSING OPERATING FUND PROGRAM Calculating Formula Expenses § 990.160...

24 CFR 990.160 - Overview of calculating formula expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... formula expense. The formula expense of any one project is the sum of the project's PEL and the UEL... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Overview of calculating formula... URBAN DEVELOPMENT THE PUBLIC HOUSING OPERATING FUND PROGRAM Calculating Formula Expenses § 990.160...

24 CFR 990.160 - Overview of calculating formula expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... formula expense. The formula expense of any one project is the sum of the project's PEL and the UEL... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Overview of calculating formula... URBAN DEVELOPMENT THE PUBLIC HOUSING OPERATING FUND PROGRAM Calculating Formula Expenses § 990.160...

24 CFR 990.160 - Overview of calculating formula expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... formula expense. The formula expense of any one project is the sum of the project's PEL and the UEL... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Overview of calculating formula... URBAN DEVELOPMENT THE PUBLIC HOUSING OPERATING FUND PROGRAM Calculating Formula Expenses § 990.160...

Financing Residency Training Redesign.

PubMed

Carney, Patricia A; Waller, Elaine; Green, Larry A; Crane, Steven; Garvin, Roger D; Pugno, Perry A; Kozakowski, Stanley M; Douglass, Alan B; Jones, Samuel; Eiff, M Patrice

2014-12-01

Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known. Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P(4)) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign. A total of 6 university-based programs in the study collectively received $5,240,516 over the entire study period, compared with $4,718,943 received by 8 community-based programs. Most of the funding for both settings came from grants, which accounted for 57.8% and 86.9% of funding for each setting, respectively. Department revenue represented 3.4% of university-based support and 13.1% of community-based support. The total average revenue (all years combined) per program for university-based programs was just under $875,000, and the average was nearly $590,000 for community programs. The vast majority of funds were dedicated to salary support (64.8% in university settings versus 79.3% in community-based settings). Based on the estimated ratio of new funding relative to the annual costs of training using national data for a 3-year program with 7 residents per year, training redesign added 3% to budgets for university-based programs and about 2% to budgets for community-based programs. Residencies undergoing training redesign used a variety of approaches to fund these changes. The costs of innovations marginally increased the estimated costs of training. Federal and local funding sources were most common, and costs were primarily salary related. More research is needed on the costs of transforming residency training.

Medical Malpractice Claims in Radiation Oncology: A Population-Based Study 1985-2012

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

Marshall, Deborah C.; Punglia, Rinaa S.; Fox, Dov

Purpose: The purpose of this study was to determine trends in radiation oncology malpractice claims and expenses during the last 28 years and to compare radiation oncology malpractice claims to those of other specialties. Methods and Materials: We performed a retrospective analysis of closed malpractice claims filed from 1985 to 2012, collected by a nationwide medical liability insurance trade association. We analyzed characteristics and trends among closed claims, indemnity payments (payments to plaintiff), and litigation expenses. We also compared radiation oncology malpractice claims to those of 21 other medical specialties. Time series dollar amounts were adjusted for inflation (2012 was themore » index year). Results: There were 1517 closed claims involving radiation oncology, of which 342 (22.5%) were paid. Average and median indemnity payments were $276,792 and $122,500, respectively, ranking fifth and eighth, respectively, among the 22 specialty groups. Linear regression modeling of time trends showed decreasing total numbers of claims (β = −1.96 annually, P=.003), increasing average litigation expenses paid (β = +$1472 annually, P≤.001), and no significant changes in average indemnity payments (β = −$681, P=.89). Conclusions: Medical professional liability claims filed against radiation oncologists are not common and have declined in recent years. However, indemnity payments in radiation oncology are large relative to those of many other specialties. In recent years, the average indemnity payment has been stable, whereas litigation expenses have increased.« less

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

PubMed Central

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

2006-01-01

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

A Program for At-Risk High School Students Informed by Evolutionary Science

PubMed Central

Wilson, David Sloan; Kauffman, Richard A.; Purdy, Miriam S.

2011-01-01

Improving the academic performance of at-risk high school students has proven difficult, often calling for an extended day, extended school year, and other expensive measures. Here we report the results of a program for at-risk 9th and 10th graders in Binghamton, New York, called the Regents Academy that takes place during the normal school day and year. The design of the program is informed by the evolutionary dynamics of cooperation and learning, in general and for our species as a unique product of biocultural evolution. Not only did the Regents Academy students outperform their comparison group in a randomized control design, but they performed on a par with the average high school student in Binghamton on state-mandated exams. All students can benefit from the social environment provided for at-risk students at the Regents Academy, which is within the reach of most public school districts. PMID:22114703

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

PubMed

Lee, Su-Jeong

2004-10-01

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

Does competitive food and beverage legislation hurt meal participation or revenues in high schools?

PubMed

Peart, Tasha; Kao, Janice; Crawford, Patricia B; Samuels, Sarah E; Craypo, Lisa; Woodward-Lopez, Gail

2012-08-01

There is limited evidence to evaluate the influence of competitive food and beverage legislation on school meal program participation and revenues. A representative sample of 56 California high schools was recruited to collect school-level data before (2006–2007) and the year after (2007–2008) policies regarding limiting competitive foods and beverages were required to be implemented. Data were obtained from school records, observations, and questionnaires. Paired t-tests assessed significance of change between the two time points. Average participation in lunch increased from 21.7% to 25.3% (p < 0.001), representing a 17.0% increase, while average participation in breakfast increased from 8.9% to 10.3% (p = 0.02), representing a 16.0% increase. There was a significant (23.0%) increase in average meal revenue, from $0.70 to $0.86 (per student per day) (p < 0.001). There was a nonsignificant decrease (18.0%) in average sales from à la carte foods, from $0.45 to $0.37 (per student per day). Compliance with food and beverage standards also increased significantly. At end point, compliance with beverage standards was higher (71.0%) than compliance with food standards (65.7%). Competitive food and beverage legislation can increase food service revenues when accompanied by increased rates of participation in the meal program. Future studies collecting expense data will be needed to determine impact on net revenues.

[The impacts of the multidisciplinary team model on the length of stay and hospital expenses of patients with lung cancer].

PubMed

Zou, Jing; Xu, Xingxiang; Wang, Daxin; Xu, Jin; Gu, Wenju

2015-05-01

To explore the impacts of the multidisciplinary team model on the average length of stay and hospital expenses of patients with lung cancer. After the multidisciplinary team discussion, 97 patients with lung cancer were selected as the lung cancer group according to the enrollment and elimination criteria the control group was 97 patients with lung cancer managed without team discussion during the same period. All the patients were firstly diagnosed to have lung cancer from December 2011 to December 2013 in Subei People's Hospital. The length of stay, hospital expenses, stages of tumor, types of tumor, Zubrod-ECOG-WHO score, the form of payment, smoking history, sex and age of all the patients were collected. The difference in the average length of stay and hospital expenses between the 2 groups and the associated factors were analyzed by using χ² test, t test and multi-factor stepwise regression analysis. There were 68 males and 29 females with a mean age of (61 ± 9) years in the lung cancer group, while there were 73 males and 24 females with a mean age of (63 ± 10) years in the control group. There were no differences between the 2 groups in tumor staging, tumor types, Zubrod-ECOG-WHO score, the form of payment, smoking history, sex and age (χ² = 4.854, P = 0.563, χ² = 4.248, P = 0.097; χ² = 0.395, P = 0.821; χ² = 1.191, P = 0.554; χ² = 0.108, P = 0.977; χ² = 1.011, P = 0.389; χ² = 0.649, P = 0.519; P = 0.474, P = 0.845, respectively). The average hospital expenses (13 303 vs 16 553, Yuan) were lower and the length of stay (10.33 vs 12.49, days) was shorter in the lung cancer group as compared to the control group (t = 2.616, P = 0.010; t = 2.730, P = 0.007), especially so for the first clinical hospitalization (15 953 vs 19 485 yuan, t = 2.315, P = 0.022; 12.71 vs 14.75 days, t = 1.979, P = 0.049). The average length of stay and the tumor stages were the main factors associated with the average hospital expenses. Except for patients with the limited stage of small cell lung cancer, the average length of stay and hospital expenses showed a tendency to reduce in different stages of the lung cancer group. The hospital cost was lower and the length of stay shorter for patients with stages Ia-IIIa and IIIb-IV in the lung cancer group as compared to the control group (6 722 vs 8 188 yuan; 1.09 vs 2.65 days). The multidisciplinary team model was an effective measure to cut down the hospital expenses and shorten the length of stay of lung cancer patients, especially for the first hospitalization. Patients may benefit from the multidisciplinary team approach according to their stages. On the basis of reducing the hospital costs and the length of stay, it further reduced the gap of the length of stay and hospital expenses between patients with Ia-IIIa and IIIb-IV diseases, while patients with stage Ia-IIIa disease seemed to benefit more.

Expense comparison of a telemedicine practice versus a traditional clinical practice.

PubMed

Barker, Gail P; Krupinski, Elizabeth A; Schellenberg, Bonnie; Weinstein, Ronald S

2004-01-01

This paper compares the expenses of a telemedicine program to those of a traditional clinical practice using data from two fiscal years (FY) 1998/1999 and 2000/2001. As part of that evaluation, we compared expenses of the University of Arizona's clinical practice group, the University Physicians Incorporated (UPI), to those of the Arizona Telemedicine Program (ATP) practice. For this study, we used the reporting categories published in the year-end UPI financial statement. These categories included clinical services, administration, equipment depreciation, and overhead. Results showed that clinical service expenses and administrative expenses for FY 2000/2001 were higher in the traditional UPI practice, whereas equipment depreciation and overhead expenses are higher in the telemedicine practice. This differs somewhat from FY 1998/1999, where clinical expenses and overhead were higher in the UPI practice and administration and equipment depreciation were higher in the telemedicine practice. We will discuss the relevance of these results and the critical factors that contribute to these differences.

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

PubMed

Abdulsalam, Yousef; Schneller, Eugene

2017-07-01

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

The effect of the National Essential Medicines Policy on health expenditures and service delivery in Chinese township health centres: evidence from a longitudinal study

PubMed Central

Zhang, Xin; Wu, Qunhong; Liu, Guoxiang; Li, Ye; Gao, Lijun; Guo, Bin; Fu, Wenqi; Hao, Yanhua; Cui, Yu; Huang, Weidong; Coyte, Peter C

2014-01-01

Objectives The government of China has introduced a National Essential Medicines Policy (NEMP) in the new round of health system reform. The objective of this paper is to analyse whether the NEMP can play a role in curbing the rise of medical expenditures without disrupting the availability of healthcare services at township hospitals in China. Design This study adopted a pre–post treatment-control study design. A difference-in-differences method and fixed-effects model for panel data were employed to estimate the effect of the NEMP. Setting Chongqing, Jiangsu and Henan Province, in China, in 2009 and 2010. Participants 296 township health centres. Outcome measures Outcomes for health expenditures were average outpatient drug expenses per visit, average inpatient drug expenses per discharged patient, average outpatient expenses per visit and average inpatient expenses per discharged patient. Outcomes for care delivery were the numbers of visits per certified doctor per day and the numbers of hospitalised patients per certified doctor per day. Results The township health centres that were enrolled in the NEMP reported 26% (p<0.01) lower drug expenditures for inpatient care. An 11% (p<0.05) decrease in average inpatient expenditures per discharged patient was found following the implementation of the NEMP. The impacts of the NEMP on average outpatient expenditures and outpatient drug expenditures were not statistically significant at the 5% level. No statistically significant associations were found between the NEMP and reduction in quantity of health service delivery. Conclusions The NEMP was significant in its effect in reducing inpatient medication and health service expenditures. This study shows no evidence that the quantity of healthcare service declined significantly after introduction of the NEMP over the study period, which suggests that if appropriate matching policies are introduced, the side effects of the NEMP can be counteracted to some degree. Further research including a long-term follow-up study is needed. PMID:25534214

Assessment of a Novel Point-of-Care Ultrasound Curriculum's Effect on Competency Measures in Family Medicine Graduate Medical Education.

PubMed

Bornemann, Paul

2017-06-01

Point-of-care ultrasound has been shown to decrease the use of expensive diagnostic studies and improve quality outcome measures. Currently, there is a large desire for training in family medicine residencies, but very few programs have established curricula. We sought to develop a family medicine residency curriculum and evaluate it with tools we developed. We wanted our curriculum to be easy to adopt by other residency programs, even if they did not have many well-trained ultrasound faculty. We developed a curriculum in the form of a 4-week rotation in a family medicine residency program. It consisted of self-study videos, hands-on training, and image review. We followed residents in postgraduate years 1 to 3 over a 12-month period. We developed tools, including a knowledge exam, to test image interpretation and clinical decision making, an observed structured clinical exam to assess scanning skills, and a survey to assess perceptions of point-of-care ultrasound in family medicine. The assessments were administered before and after each resident's rotation. Seventeen residents completed the rotation. The average knowledge test score improved significantly, from 62 to 84%. The average observed structured clinical exam scores also improved significantly, from 41 to 85%. The average perception survey scores improved slightly from 4.4 to 4.6. We developed a point-of-care ultrasound curriculum for family medicine residency programs that improves measures of resident attitude, skills, and knowledge. This curriculum can be adopted by residency programs with few faculty members who are experienced in ultrasound. © 2017 by the American Institute of Ultrasound in Medicine.

Cost management of cleft lips under the Universal Health Coverage Program of the Tawanchai Cleft Center, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.

PubMed

Odton, Cheewarat; Rittirod, Theera; Pradubwong, Suteera; Chowchuen, Bowornsilp

2014-10-01

The study ofcost management with regard to cleft lip patients under the Universal Health Coverage Program at Tawanchai Cleft Center Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, was conducted in order to provide fundamental information for the administrative team on how best to administrate and manage the organization. To study the cost management of cleft lip patients under the Universal Health Coverage Program. To compare individual patient management costs and costs from the National Health Security Office (NHSO), and to offer proper guidelines for cost management to the organization. The study was performed retrospectively. The data were collected by reviewing secondary sources of information from patients with cleft lips who consistently underwent treatment at Tawanchai Cleft Center. As for the provider prospects, the cost management did not address the other expenses. The study analyzed the comparison between cost management and income from the Universal Health Coverage Program, which it receivedfrom the National Health Security Office (NHSO). The study was conducted over 2 years (October 1, 2010 to 30 September, 2013). There were 21patients in this study. Microsoft excel was the instrument used to calculate the cost ofmanagement. (1) Total costs were lower than real payments because this cost did not take into account the total cost of the operation room, patient room, common bed, and costs of the medical equipment. Moreover the information regarding the building's price and the facility were not clear enough. The database of materials and equipment was also not yet complete. (2) The average cost ofpatient management was 12,025.14 Bahtperperson, but the compensation receivedfrom the National Health Security Office (NHSO) averaged 10,527.63 Bahtperperson, which was 87.55% ofthe total cost management. The department with the largest expenses was Anesthesia (36.42%). This study indicated that the cost of patient management is lower than usual due to the lack of clear cost information. The cost of medical care, which was received from the National Health Security Office (NHSO), was only 87.55%; the department with the highest costs was Anesthesia (36.42%).

28 CFR 570.33 - Expenses of furlough.

Code of Federal Regulations, 2010 CFR

2010-07-01

....33 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE COMMUNITY PROGRAMS AND RELEASE COMMUNITY PROGRAMS Furloughs § 570.33 Expenses of furlough. (a) Except as provided in paragraphs (b) and (c) of this section, the inmate or the inmate's family or other appropriate source approved by the Warden...

7 CFR 1160.210 - Expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and Orders; Milk), DEPARTMENT OF AGRICULTURE FLUID MILK PROMOTION PROGRAM Fluid Milk Promotion Order National Fluid Milk Processor Promotion Board § 1160.210 Expenses. (a) The Board is authorized to incur... funds to the entity authorized by the laws of the State of California to conduct an advertising program...

7 CFR 4290.520 - Management Expenses of a RBIC.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Cash Management by a RBIC ... 7 Agriculture 15 2011-01-01 2011-01-01 false Management Expenses of a RBIC. 4290.520 Section 4290...) PROGRAM Managing the Operations of a RBIC Management and Compensation § 4290.520 Management Expenses of a...

26 CFR 1.50B-1 - Definitions of WIN expenses and WIN employees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... employee. (c) Trade or business expenses. The term “WIN expenses” includes only salaries and wages which... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Definitions of WIN expenses and WIN employees. 1... INCOME TAXES Rules for Computing Credit for Expenses of Work Incentive Programs § 1.50B-1 Definitions of...

25 CFR 700.173 - Average net earnings of business or farm.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false Average net earnings of business or farm. 700.173 Section... PROCEDURES Moving and Related Expenses, Temporary Emergency Moves § 700.173 Average net earnings of business or farm. (a) Computing net earnings. For purposes of this subpart, the average annual net earnings of...

25 CFR 700.173 - Average net earnings of business or farm.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Average net earnings of business or farm. 700.173 Section... PROCEDURES Moving and Related Expenses, Temporary Emergency Moves § 700.173 Average net earnings of business or farm. (a) Computing net earnings. For purposes of this subpart, the average annual net earnings of...

New Wrinkles on Retirement: Program Notes.

ERIC Educational Resources Information Center

Wray, Robert P.; Thorson, James A.

The program notes were prepared to accompany the television series "New Wrinkles on Retirement." The eight units in the series are: facing inflation, which covers the decreasing value of the dollar, transportation costs, medical expenses, cutting expenses, family budgeting, investments, and places to live; vigor regained, which covers exercise and…

Private and Public Contributions to Financing College Education. A CBO Paper

ERIC Educational Resources Information Center

Alsalam, Nabeel; Giertz, Seth; Zimmerman; Dennis

2004-01-01

The cost of four years of undergraduate education, including living expenses, now averages nearly $80,000 at public colleges and over $100,000 at many private institutions. Tuition and fees have risen steadily since 1980, fueling concern that college is becoming prohibitively expensive for many families. This Congressional Budget Office (CBO)…

Administering Minnesota's tax-forfeited land: some trends in revenues and expenses.

Treesearch

David C. Lothner; Edwin Kallio; David T. Davis

1978-01-01

Revenues received from managing Minnesota county land increased at a slower rate than the expenses incurred in their management over the 1960-74 period. However, due to a substantial land sale program, the revenues received exceeded the expenses incurred throughout the period.

38 CFR 21.7103 - Travel expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Travel expenses. 21.7103...) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Counseling § 21.7103 Travel expenses. (a) Travel for veterans and servicemembers. (1...

A comparative study of orphan drug prices in Europe

PubMed Central

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

2017-01-01

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

13 CFR 108.140 - SBA approval of initial Management Expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false SBA approval of initial Management Expenses. 108.140 Section 108.140 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Organizing A Nmvc Company § 108.140...

Perceived Risk and Risk Reduction Strategies in Study Abroad Programs

ERIC Educational Resources Information Center

Luethge, Denise J.

2004-01-01

The study abroad program (SAP) meets the criteria of a risky purchase, namely of being non-tangible, possessing hidden qualities, being expensive and cannot being able to be tested prior to purchase. In fact, SAPs may score highly on a number of risk components, especially financial risk (expensive), psychological risk (anxiety), physical risk…

Analyzing the prices of the most expensive sheet iron all over the world: Modeling, prediction and regime change

NASA Astrophysics Data System (ADS)

Song, Fu-Tie; Zhou, Wei-Xing

2010-09-01

The private car license plates issued in Shanghai are bestowed the title of “the most expensive sheet iron all over the world”, more expensive than gold. A citizen has to bid in a monthly auction to obtain a license plate for his new private car. We perform statistical analysis to investigate the influence of the minimal price Pmin of the bidding winners, the quota N of private car license plates, the number N of bidders, as well as two external shocks including the legality debate of the auction in 2004 and the auction regime reform in January 2008 on the average price P of all bidding winners. It is found that the legality debate of the auction had marginal transient impact on the average price in a short time period. In contrast, the change of the auction rules has significant permanent influence on the average price, which reduces the price by about 3020 yuan Renminbi. It means that the average price exhibits nonlinear behaviors with a regime change. The evolution of the average price is independent of the number N of bidders in both regimes. In the early regime before January 2008, the average price P was influenced only by the minimal price Pmin in the preceding month with a positive correlation. In the current regime since January 2008, the average price is positively correlated with the minimal price and the quota in the preceding month and negatively correlated with the quota in the same month. We test the predictive power of the two models using 2-year and 3-year moving windows and find that the latter outperforms the former. It seems that the auction market becomes more efficient after the auction reform since the prediction error increases.

45 CFR 1801.40 - Travel expenses of finalists.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Travel expenses of finalists. 1801.40 Section 1801... FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Payments to Finalists and Scholars § 1801.40 Travel expenses of finalists. The Foundation will provide partial funding for intercity round-trip transportation...

7 CFR 4290.520 - Management Expenses of a RBIC.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Management Expenses of a RBIC. 4290.520 Section 4290... SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Managing the Operations of a RBIC Management and Compensation § 4290.520 Management Expenses of a...

45 CFR 1801.40 - Travel expenses of finalists.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Travel expenses of finalists. 1801.40 Section 1801.40 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Payments to Finalists and Scholars § 1801.40 Travel expenses...

45 CFR 1801.40 - Travel expenses of finalists.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Travel expenses of finalists. 1801.40 Section 1801.40 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Payments to Finalists and Scholars § 1801.40 Travel expenses...

45 CFR 1801.40 - Travel expenses of finalists.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Travel expenses of finalists. 1801.40 Section 1801.40 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Payments to Finalists and Scholars § 1801.40 Travel expenses...

45 CFR 1801.40 - Travel expenses of finalists.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Travel expenses of finalists. 1801.40 Section 1801.40 Public Welfare Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM Payments to Finalists and Scholars § 1801.40 Travel expenses...

26 CFR 1.861-13T - Transition rules for interest expenses (temporary regulations).

Code of Federal Regulations, 2011 CFR

2011-04-01

...-in fraction is the general phase-in amount over the current year average debt level of the affiliated... pro rata by the relative amount of interest expense that is directly allocated. (b) General phase-in... does not exceed the general phase-in amount, as defined in paragraph (b)(2) of this section. (2...

26 CFR 1.861-13T - Transition rules for interest expenses (temporary regulations).

Code of Federal Regulations, 2010 CFR

2010-04-01

...-in fraction is the general phase-in amount over the current year average debt level of the affiliated... pro rata by the relative amount of interest expense that is directly allocated. (b) General phase-in... does not exceed the general phase-in amount, as defined in paragraph (b)(2) of this section. (2...

78 FR 68440 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

... Use: The ``Report of Premiums Payable for Exporters Only'' form is used by exporters to report and pay... Expenses Reviewing Time per Year: 7,800 hours. Average Wages per Hour: $42.50. Average Cost per Year: $331...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2011-10-01 2011-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2010-10-01 2010-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

The Cost of Family Medicine Residency Training: Impacts of Federal and State Funding.

PubMed

Pauwels, Judith; Weidner, Amanda

2018-02-01

Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. A group of family medicine residency programs have shared their financial data since 2002 through a biennial survey of program revenues, expenses, and staffing. Data sets over 12 years were collected and analyzed, and results compared to analyze trends. Overall expenses increased 70.4% during this period. Centers for Medicare and Medicaid Services (CMS) GME revenue per resident increased by 15.7% for those programs receiving these monies. Overall, total revenue per resident, including clinical revenues, state funding, and any other revenue stream, increased 44.5% from 2006 to 2016. The median cost per resident among these programs, excluding federal GME funds, is currently $179,353; this amount has increased over the 12 years by 93.7%. For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.

2004-08 NCAA[R] Revenues and Expenses of Division I Intercollegiate Athletics Programs Report

ERIC Educational Resources Information Center

Fulks, Daniel L., Comp.

2009-01-01

This report provides summary information concerning revenues and expenses of National Collegiate Athletic Association (NCAA) Division I athletics programs for the fiscal years 2004 through 2008. It is the result of surveys conducted during the fall of each of those years. Although similar studies have been conducted for the NCAA since 1969,…

The effect of the National Essential Medicines Policy on health expenditures and service delivery in Chinese township health centres: evidence from a longitudinal study.

PubMed

Zhang, Xin; Wu, Qunhong; Liu, Guoxiang; Li, Ye; Gao, Lijun; Guo, Bin; Fu, Wenqi; Hao, Yanhua; Cui, Yu; Huang, Weidong; Coyte, Peter C

2014-12-22

The government of China has introduced a National Essential Medicines Policy (NEMP) in the new round of health system reform. The objective of this paper is to analyse whether the NEMP can play a role in curbing the rise of medical expenditures without disrupting the availability of healthcare services at township hospitals in China. This study adopted a pre-post treatment-control study design. A difference-in-differences method and fixed-effects model for panel data were employed to estimate the effect of the NEMP. Chongqing, Jiangsu and Henan Province, in China, in 2009 and 2010. 296 township health centres. Outcomes for health expenditures were average outpatient drug expenses per visit, average inpatient drug expenses per discharged patient, average outpatient expenses per visit and average inpatient expenses per discharged patient. Outcomes for care delivery were the numbers of visits per certified doctor per day and the numbers of hospitalised patients per certified doctor per day. The township health centres that were enrolled in the NEMP reported 26% (p<0.01) lower drug expenditures for inpatient care. An 11% (p<0.05) decrease in average inpatient expenditures per discharged patient was found following the implementation of the NEMP. The impacts of the NEMP on average outpatient expenditures and outpatient drug expenditures were not statistically significant at the 5% level. No statistically significant associations were found between the NEMP and reduction in quantity of health service delivery. The NEMP was significant in its effect in reducing inpatient medication and health service expenditures. This study shows no evidence that the quantity of healthcare service declined significantly after introduction of the NEMP over the study period, which suggests that if appropriate matching policies are introduced, the side effects of the NEMP can be counteracted to some degree. Further research including a long-term follow-up study is needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

25 CFR 87.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Use or distribution means any utilization or disposition of the judgment funds, including programming... courts. (r) Attorney fees and litigation expenses means all fees and expenses incurred in litigating and...

75 FR 55944 - Walnuts Grown in California; Decreased Assessment Rate

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... Expenses/Annual Audit.. 161,000 208,000 Office Expenses 123,750 118,850 Program Expenses Including Research: Controlled Purchases 5,000 20,000 Crop Acreage Survey 0 95,000 Crop Estimate 120,000 105,000 Production Research Director.... 80,000 88,500 Production Research 725,000 1,042,000 Grades and Standards Research...

76 FR 50703 - Walnuts Grown in California; Increased Assessment Rate

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... Travel/Board Expenses/Annual Audit.. 208,000 218,000 Office Expenses 118,850 117,750 Program Expenses...,000 115,000 Production Research Director.... 88,500 88,500 Production Research 1,042,000 1,036,000... Domestic Market Development..... 4,400,000 4,635,000 Reserve for Contingency......... 32,250 8,700 The...

Mars Atmosphere and Volatile EvolutioN (MAVEN) mission's Red Planet program: Bridging the gap in elementary school science through climate studies of Mars

NASA Astrophysics Data System (ADS)

Wood, E. L.

2012-12-01

Although reading, writing, and math examinations are often conducted early in elementary school, science is not typically tested until 4th or 5th grade. The result is a refocus on the tested topics at the expense of the untested ones, despite that standards exist for each topic at all grades. On a national level, science instruction is relegated to a matter of a few hours per week. A 2007 Education Policy study states that elementary school students spend an average of 178 minutes a week on science while spending 500 minutes on literacy. A recent NSTA report in July of 2011 of elementary and middle school teachers confirms that teachers feel pressured to teach math and literacy at the expense of other programs. In our interaction with elementary teachers, it is also apparent that many are uncomfortable with science concepts. In order for us to successfully address the Next Generation Science Standards, teachers must be able to reconcile all of the different requirements placed on them in a given school day and in a given school environment. A unique way to combat the lack of science instruction at elementary grades is to combine literacy into an integrated science program, thereby increasing the number of science contact hours. The Red Planet: Read, Write, Explore program, developed for the MAVEN mission, is a science, art, and literacy program designed to easily fit into a typical 3rd-5th grade instructional day. Red Planet tackles climate change through Mars' geologic history and makes Mars-Earth comparisons, while encouraging students to reflect on the environmental requirements needed to keep a biological organisms (including humans) happy, healthy, and alive. The Red Planet program is currently being pilot tested at Acres Green Elementary School in Colorado.

Costs and Effectiveness of Treating Homeless Persons with Cocaine Addiction with Alternative Contingency Management Strategies.

PubMed

Mennemeyer, Stephen T; Schumacher, Joseph E; Milby, Jesse B; Wallace, Dennis

2017-03-01

Between 1990 and 2006 in Birmingham, Alabama USA, 4 separate randomized controlled studies, called "Homeless 1" through "Homeless 4", treated cocaine substance abuse among chronically homeless adults, largely black men, many with non-psychotic mental health problems. The 4 studies had 9 treatment arms that used various counseling methods plus, in some arms, the provision of housing and work therapy usually with a contingent requirement of urine-test verified abstinence from substances. Participants in the abstinent-contingent arms who lapsed on abstinence were removed from housing and sent to an evening public shelter from which they were daily transported to day treatment until they returned to abstinence. This paper compares the cost effectiveness of the treatment arms. Societal cost per participant (in 2014 dollars) for each arm is defined as direct treatment cost plus cost of jail or hospital plus societal expense of public shelter use by lapsed participants. An untreated Base Case is defined as 5 percent abstinence with 95 percent usage of a public shelter. Incremental Cost Effectiveness Ratios (ICERs) for paired arms are defined as the change in cost per participant divided by the change in abstinence. Bootstrapping estimates confidence intervals. Average cost per participant at the end of 6 months of active treatment in 7 arms with comparable data ranged from USD 10,447 to USD 36,194 with corresponding average weeks abstinent ranging from 6.1 to 15.3 out of a possible 26 weeks. In contrast, the Base Case would cost USD 6,123 for 1.3 weeks of abstinence. Compared to the Base Case, the least expensive "DT2" treatment has an ICER of USD 901 (95% CI = USD 571 to USD 1,681) per additional week of abstinence and the most expensive "CMP4" has an ICER of USD 2,147 (95% CI = USD 1,701 to USD 2,848). Additionally, the Homeless 3 study found that the abstinent contingent housing (ACH3) treatment compared to the Non Abstinent Contingent Housing (NAC3), analogous to "Housing First", achieved better abstinence (12.1 v. 10 weeks) at higher average cost (USD 22,512 v. USD 17,541) yielding an ICER for this comparison of (USD 2,367, 95% CI=USD -10,587 to USD 12,467). Similar results are found at 12 months (6 months after active treatment). More intensive methods of counseling improved abstinence but 4 of the 7 treatments were inefficient ("dominated"). Bootstrapping shows that results are sensitive to which individuals were randomly assigned to each arm. A limitation of the analysis is that it does not consider the full societal cost of lost wages, crime costs beyond jail expenses and deterioration of neighborhood quality of life. Additionally, populations treated by Housing First programs may differ from the Birmingham Homeless studies in the severity of addiction or co-occuring psychological problems. The Homeless studies show that abstinent contingent safe housing with counseling can substantially improve abstinence for homeless cocaine abusers. Incremental costs rise sharply with more intensive counseling; modest programs of counseling may be more cost effective in a stepped treatment strategy.

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

PubMed

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

2017-01-01

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

28 CFR 94.11 - Purpose; construction and severability.

Code of Federal Regulations, 2013 CFR

2013-07-01

... International Terrorism Victim Expense Reimbursement Program Introduction § 94.11 Purpose; construction and... acts of international terrorism that occur outside the United States, for expenses associated with that...

28 CFR 94.11 - Purpose; construction and severability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... International Terrorism Victim Expense Reimbursement Program Introduction § 94.11 Purpose; construction and... acts of international terrorism that occur outside the United States, for expenses associated with that...

28 CFR 94.11 - Purpose; construction and severability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... International Terrorism Victim Expense Reimbursement Program Introduction § 94.11 Purpose; construction and... acts of international terrorism that occur outside the United States, for expenses associated with that...

28 CFR 94.11 - Purpose; construction and severability.

Code of Federal Regulations, 2014 CFR

2014-07-01

... International Terrorism Victim Expense Reimbursement Program Introduction § 94.11 Purpose; construction and... acts of international terrorism that occur outside the United States, for expenses associated with that...

28 CFR 94.11 - Purpose; construction and severability.

Code of Federal Regulations, 2012 CFR

2012-07-01

... International Terrorism Victim Expense Reimbursement Program Introduction § 94.11 Purpose; construction and... acts of international terrorism that occur outside the United States, for expenses associated with that...

[Measurement of antimicrobial consumption using DDD per 100 bed-days versus DDD per 100 discharges after the implementation of an antimicrobial stewardship program].

PubMed

Collado, Roberto; Losa, Juan Emilio; Álvaro, Elena Alba; Toro, Piedad; Moreno, Leonor; Pérez, Montserrat

2015-12-01

Monitoring antimicrobial consumption in hospitals is a necessary measure. The indicators commonly employed do not clearly reflect the antibiotic selection pressure. The objective of this study is to evaluate two different methods that analyze antimicrobial consumption based on DDD, per stay and per discharge, before and after the implementation an antimicrobial stewardship program. Comparative pre-post study of antimicrobial consumption with the implementation of an antimicrobial stewardship program using DDD per 100 bed-days and DDD per 100 discharges as indicators. Hospital bed days remained stable and discharges increased slightly along the period of study Antibiotic consumption in DDD per 100 bed-days decreased by 2.5% versus 3.8% when expressed as DDD per 100 discharges. Antifungal consumption decreased by more than 50%. When average hospital stay decreases, reductions in the consumption of antimicrobials with an antimicrobial stewardship program system occur at the expense of reducing the number of patients receiving treatment, while increases occur due to longer durations of treatment.

Financial protection mechanisms for inpatients at selected Philippine hospitals.

PubMed

Caballes, Alvin B; Söllner, Walter; Nañagas, Juan

2012-11-01

The study was undertaken to determine, from the patient's perspective, the comparative effectiveness of locally established financial protection mechanisms particularly for indigent and severely-ill hospitalized patients. Data was obtained from a survey conducted in 2010 in Philippine provinces which were part of the Health Systems Development Project and involved 449 patients from selected private and public hospitals. Direct medical expenses incurred during the confinement period, whether already paid for prior to or only billed upon discharge, were initially considered. Expenses were found to be generally larger for the more severely ill and lower for the poor. Hospital-provided discounts and social health insurance (PhilHealth) reimbursements were the financial protection mechanisms evaluated in this study. In average terms, only up to 46% of inpatient expenses were potentially covered by the combined financial support. Depending on the hospital type, 28-42% of submitted PhilHealth claims were invalidated. Multiple linear regression analysis was utilized to determine the relationship of the same set of patients' demographic characteristics, socioeconomic status, severity of illness, and hospital assignments with selected expense categories and financial protection measures. Pre-discharge expenditures were significantly higher in public hospitals. The very ill also faced significantly larger expenses, including those for final hospital charges. Hospital-derived discounts provided significantly more support for indigent as well as very sick patients. The amounts for verified PhilHealth claims were significantly greater for the moderately-ill and, incongruously, the financially better-off patients. Sponsored Program members, supposed indigents enjoying fully-subsidized PhilHealth enrollment, qualified for higher mean reimbursements. However, there was a weak correlation between such patients and those identified as poor by the hospital social service staff. Thus, while hospital discounts, subsidies for practical purposes, and PhilHealth reimbursements progressively supported sicker patients, discounts were more responsive in assisting the poor. PhilHealth processes therefore need to be improved so as to more effectively support indigent patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

Automotive Stirling engine: Mod 2 design report

NASA Technical Reports Server (NTRS)

Nightingale, Noel P.

1986-01-01

The design of an automotive Stirling engine that achieves the superior fuel economy potential of the Stirling cycle is described. As the culmination of a 9-yr development program, this engine, designated the Mod 2, also nullifies arguments that Stirling engines are heavy, expensive, unreliable, demonstrating poor performance. Installed in a General Motors Chevrolet Celebrity car, this engine has a predicted combined fuel economy on unleaded gasoline of 17.5 km/l (41 mpg)- a value 50% above the current vehicle fleet average. The Mod 2 Stirling engine is a four-cylinder V-drive design with a single crankshaft. The engine is also equipped with all the controls and auxiliaries necessary for automotive operation.

Assessment of community food resources: A Latino neighborhood study in upstate New York

PubMed Central

Lopez-Class, Maria; Hosler, Akiko S.

2011-01-01

This study aims to assess availability, affordability, and accessibility of food items in a low-income Latino neighborhood within a small city using an on-site food store survey. Store locations were identified by on-site GPS. Results showed the Latino neighborhood had limited availability and above average cost of high-fiber bread. Fresh vegetables were more expensive compared to the non-Latino neighborhood, and more stores in the Latino neighborhood participated in Supplemental Nutrition Assistance Food Program. The lack of supermarkets, fewer stores with disability access, and the lack of public transportation left Latino residents without a vehicle or with physical disabilities with few food shopping options. PMID:22065468

10 CFR 455.123 - Grantee records and reports for State grants for administrative expenses, technical assistance...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Grantee records and reports for State grants for administrative expenses, technical assistance, program assistance, and marketing. 455.123 Section 455.123 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CAR...

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

76 FR 67320 - Walnuts Grown in California; Increased Assessment Rate

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... Expenses/Annual Audit 208,000 218,000 Office Expenses 118,850 117,750 Program Expenses Including Research: Controlled Purchases 20,000 20,000 Crop Acreage Survey 95,000 95,000 Crop Estimate 105,000 115,000 Production Research Director.. 88,500 88,500 Production Research 1,042,000 1,036,000 Sustainability Project........ 0...

20 CFR 30.702 - How should an employee prepare and submit requests for reimbursement for medical expenses...

Code of Federal Regulations, 2010 CFR

2010-04-01

... expenses? 30.702 Section 30.702 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... expenses? (a) If an employee has paid bills for medical, surgical or other services, supplies or appliances... of such service shall state each diagnosed condition and furnish the applicable ICD-9-CM code and...

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

PubMed Central

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

2011-01-01

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

Cost of providing injectable contraceptives through a community-based social marketing program in Tigray, Ethiopia.

PubMed

Prata, Ndola; Downing, Janelle; Bell, Suzanne; Weidert, Karen; Godefay, Hagos; Gessessew, Amanuel

2016-06-01

To provide a cost analysis of an injectable contraceptive program combining community-based distribution and social marketing in Tigray, Ethiopia. We conducted a cost analysis, modeling the costs and programmatic outcomes of the program's initial implementation in 3 districts of Tigray, Ethiopia. Costs were estimated from a review of program expense records, invoices, and interviews with health workers. Programmatic outcomes include number of injections and couple-year of protection (CYP) provided. We performed a sensitivity analysis on the average number of injections provided per month by community health workers (CHWs), the cost of the commodity, and the number of CHWs trained. The average programmatic CYP was US $17.91 for all districts with a substantial range from US $15.48-38.09 per CYP across districts. Direct service cost was estimated at US $2.96 per CYP. The cost per CYP was slightly sensitive to the commodity cost of the injectable contraceptives and the number of CHWs. The capacity of each CHW, measured by the number of injections sold, was a key input that drove the cost per CYP of this model. With a direct service cost of US $2.96 per CYP, this study demonstrates the potential cost of community-based social marketing programs of injectable contraceptives. The findings suggest that the cost of social marketing of contraceptives in rural communities is comparable to other delivery mechanisms with regards to CYP, but further research is needed to determine the full impact and cost-effectiveness for women and communities beyond what is measured in CYP. Copyright © 2016 Elsevier Inc. All rights reserved.

49 CFR 826.6 - Allowable fees and expenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... these rules may exceed $75 indexed as follows: ER14JN94.001 The CPI to be used is the annual average CPI, All Urban Consumers, U.S. City Average, All Items, except where a local, All Item index is available. Where a local index is available, but results in a manifest inequity vis-a-vis the U.S. City Average...

49 CFR 826.6 - Allowable fees and expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... these rules may exceed $75 indexed as follows: ER14JN94.001 The CPI to be used is the annual average CPI, All Urban Consumers, U.S. City Average, All Items, except where a local, All Item index is available. Where a local index is available, but results in a manifest inequity vis-a-vis the U.S. City Average...

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

PubMed

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

2009-02-01

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

Influence of pharmaceutical marketing on Medicare prescriptions in the District of Columbia.

PubMed

Wood, Susan F; Podrasky, Joanna; McMonagle, Meghan A; Raveendran, Janani; Bysshe, Tyler; Hogenmiller, Alycia; Fugh-Berman, Adriane

2017-01-01

Gifts from pharmaceutical companies are believed to influence prescribing behavior, but few studies have addressed the association between industry gifts to physicians and drug costs, prescription volume, or preference for generic drugs. Even less research addresses the effect of gifts on the prescribing behavior of nurse practitioners (NPs), physician assistants (PAs), and podiatrists. To analyze the association between gifts provided by pharmaceutical companies to individual prescribers in Washington DC and the number of prescriptions, cost of prescriptions, and proportion of branded prescriptions for each prescriber. Gifts data from the District of Columbia's (DC) AccessRx program and the federal Center for Medicare and Medicaid Services (CMS) Open Payments program were analyzed with claims data from the CMS 2013 Medicare Provider Utilization and Payment Data. Washington DC, 2013. Physicians, nurse practitioners, physician assistants, podiatrists, and other licensed Medicare Part D prescribers who participated in Medicare Part D (a Federal prescription drug program that covers patients over age 65 or who are disabled). Gifts to healthcare prescribers (including cash, meals, and ownership interests) from pharmaceutical companies. Average number of Medicare Part D claims per prescriber, number of claims per patient, cost per claim, and proportion of branded claims. In 2013, 1,122 (39.1%) of 2,873 Medicare Part D prescribers received gifts from pharmaceutical companies totaling $3.9 million in 2013. Compared to non-gift recipients, gift recipients prescribed 2.3 more claims per patient, prescribed medications costing $50 more per claim, and prescribed 7.8% more branded drugs. In six specialties (General Internal Medicine, Family Medicine, Obstetrics/Gynecology, Urology, Ophthalmology, and Dermatology), gifts were associated with a significantly increased average cost of claims. For Internal Medicine, Family Medicine, and Ophthalmology, gifts were associated with more branded claims. Gift acceptance was associated with increased average cost per claim for PAs and NPs. Gift acceptance was also associated with higher proportion of branded claims for PAs but not NPs. Physicians who received small gifts (less than $500 annually) had more expensive claims ($114 vs. $85) and more branded claims (30.3% vs. 25.7%) than physicians who received no gifts. Those receiving large gifts (greater than $500 annually) had the highest average costs per claim ($189) and branded claims (39.9%) than other groups. All differences were statistically significant (p<0.05). Gifts from pharmaceutical companies are associated with more prescriptions per patient, more costly prescriptions, and a higher proportion of branded prescriptions with variation across specialties. Gifts of any size had an effect and larger gifts elicited a larger impact on prescribing behaviors. Our study confirms and expands on previous work showing that industry gifts are associated with more expensive prescriptions and more branded prescriptions. Industry gifts influence prescribing behavior, may have adverse public health implications, and should be banned.

A simple approach to lifetime learning in genetic programming-based symbolic regression.

PubMed

Azad, Raja Muhammad Atif; Ryan, Conor

2014-01-01

Genetic programming (GP) coarsely models natural evolution to evolve computer programs. Unlike in nature, where individuals can often improve their fitness through lifetime experience, the fitness of GP individuals generally does not change during their lifetime, and there is usually no opportunity to pass on acquired knowledge. This paper introduces the Chameleon system to address this discrepancy and augment GP with lifetime learning by adding a simple local search that operates by tuning the internal nodes of individuals. Although not the first attempt to combine local search with GP, its simplicity means that it is easy to understand and cheap to implement. A simple cache is added which leverages the local search to reduce the tuning cost to a small fraction of the expected cost, and we provide a theoretical upper limit on the maximum tuning expense given the average tree size of the population and show that this limit grows very conservatively as the average tree size of the population increases. We show that Chameleon uses available genetic material more efficiently by exploring more actively than with standard GP, and demonstrate that not only does Chameleon outperform standard GP (on both training and test data) over a number of symbolic regression type problems, it does so by producing smaller individuals and it works harmoniously with two other well-known extensions to GP, namely, linear scaling and a diversity-promoting tournament selection method.

45 CFR 2528.70 - What steps are necessary to use an education award to pay expenses incurred in enrolling in a G.I...

Code of Federal Regulations, 2010 CFR

2010-10-01

... to pay expenses incurred in enrolling in a G.I. Bill approved program? 2528.70 Section 2528.70 Public... incurred in enrolling in a G.I. Bill approved program? (a) Required Information. Before disbursing an amount from an education award for this purpose, the Corporation must receive— (1) An individual's...

45 CFR 2528.70 - What steps are necessary to use an education award to pay expenses incurred in enrolling in a G.I...

Code of Federal Regulations, 2014 CFR

2014-10-01

... to pay expenses incurred in enrolling in a G.I. Bill approved program? 2528.70 Section 2528.70 Public... incurred in enrolling in a G.I. Bill approved program? (a) Required Information. Before disbursing an amount from an education award for this purpose, the Corporation must receive— (1) An individual's...

45 CFR 2528.70 - What steps are necessary to use an education award to pay expenses incurred in enrolling in a G.I...

Code of Federal Regulations, 2012 CFR

2012-10-01

... to pay expenses incurred in enrolling in a G.I. Bill approved program? 2528.70 Section 2528.70 Public... incurred in enrolling in a G.I. Bill approved program? (a) Required Information. Before disbursing an amount from an education award for this purpose, the Corporation must receive— (1) An individual's...

45 CFR 2528.70 - What steps are necessary to use an education award to pay expenses incurred in enrolling in a G.I...

Code of Federal Regulations, 2011 CFR

2011-10-01

... to pay expenses incurred in enrolling in a G.I. Bill approved program? 2528.70 Section 2528.70 Public... incurred in enrolling in a G.I. Bill approved program? (a) Required Information. Before disbursing an amount from an education award for this purpose, the Corporation must receive— (1) An individual's...

Injury Scheme Claims in Gaelic Games: A Review of 2007–2014

PubMed Central

Roe, Mark; Blake, Catherine; Gissane, Conor; Collins, Kieran

2016-01-01

Context:  Gaelic games (Gaelic football and hurling) are indigenous Irish sports with increasing global participation in recent years. Limited information is available on longitudinal injury trends. Reviews of insurance claims can reveal the economic burden of injury and guide cost-effective injury-prevention programs. Objective:  To review Gaelic games injury claims from 2007–2014 for male players to identify the costs and frequencies of claims. Particular attention was devoted to lower limb injuries due to findings from previous epidemiologic investigations of Gaelic games. Design:  Descriptive epidemiology study. Setting:  Open-access Gaelic Athletic Association Annual Reports from 2007–2014 were reviewed to obtain annual injury-claim data. Patients or Other Participants:  Gaelic Athletic Association players. Main Outcome Measure(s):  Player age (youth or adult) and relationships between lower limb injury-claim rates and claim values, Gaelic football claims, hurling claims, youth claims, and adult claims. Results:  Between 2007 and 2014, €64 733 597.00 was allocated to 58 038 claims. Registered teams had annual claim frequencies of 0.36 with average claim values of €1158.4 ± 192.81. Between 2007 and 2014, average adult claims were always greater than youth claims (6217.88 versus 1036.88), while Gaelic football claims were always greater than hurling claims (5395.38 versus 1859.38). Lower limb injuries represented 60% of all claims. The number of lower limb injury claims was significantly correlated with annual injury-claim expenses (r = 0.85, P = .01) and adult claims (r = 0.96, P = .01) but not with youth claims (r = 0.69, P = .06). Conclusions:  Reducing lower limb injuries will likely reduce injury-claim expenses. Effective injury interventions have been validated in soccer, but whether such changes can be replicated in Gaelic games remains to be investigated. Injury-claim data should be integrated into current elite injury-surveillance databases to monitor the cost effectiveness of current programs. PMID:26967548

7 CFR 1230.70 - Expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE PORK PROMOTION, RESEARCH, AND CONSUMER INFORMATION Pork Promotion, Research, and Consumer Information Order Expenses and Assessments... reasonable reserve that would permit an effective promotion, research, and consumer information program to...

Reimbursing Live Organ Donors for Incurred Non-Medical Expenses: A Global Perspective on Policies and Programs

PubMed Central

Sickand, M.; Cuerden, M. S.; Klarenbach, S. W.; Ojo, A. O.; Parikh, C. R.; Boudville, N.; Garg, A. X.

2015-01-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support. PMID:19788503

Reimbursing live organ donors for incurred non-medical expenses: a global perspective on policies and programs.

PubMed

Sickand, M; Cuerden, M S; Klarenbach, S W; Ojo, A O; Parikh, C R; Boudville, N; Garg, A X

2009-12-01

Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support.

Is Europe still heading to a common price level for on-patent medicines? An exploratory study among 15 Western European countries.

PubMed

Leopold, Christine; Mantel-Teeuwisse, Aukje Katja; Vogler, Sabine; de Joncheere, Kees; Laing, Richard Ogilvie; Leufkens, Hubert G M

2013-10-01

Previous studies have suggested that medicines prices in Europe converge over time as a result of policy measures such as external price referencing. To explore whether ex-factory prices of on-patented medicines in Western European countries have converged over a recent period of time. Prices of ten on-patent medicines in five years (2007, 2008, 2010, 2011, 2012) of 15 European countries were analyzed. The unit of analysis was the ex-factory price in Euro per defined daily dose (exchange rate indexed to 2007). A score (deviation from the average price) per country as well as the ranges were calculated for all medicines. The prices between countries and selected products varied to a great extent from as low as an average price of € 1.3/DDD for sitagliptin in 2010-2012 to an average of € 221.5/DDD for alemtuzumab in 2011. Between 2008 and 2012, a price divergence was seen which was fully driven by two countries, Germany (up to 27% more expensive than the average) and Greece (up to 32% cheaper than the average). All other countries had stable prices and centered around the country average. Prices of less expensive as well as expensive medicines remained relatively stable or decreased over time, while only the price of sirolimus relatively increased. Our study period included the time of the recession and several pricing policy measures may have affected the prices of medicines. Instead of the expected price convergence we observed a price divergence driven by price changes in only two of the 15 countries. All other European countries remained stable around the country average. Further research is needed to expand the study to a bigger sample size, and include prescribing data and Eastern European countries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Design, modeling, and analysis of a feedstock logistics system.

PubMed

Judd, Jason D; Sarin, Subhash C; Cundiff, John S

2012-01-01

Given the location of a bio-energy plant for the conversion of biomass to bio-energy, a feedstock logistics system that relies on the use of satellite storage locations (SSLs) for temporary storage and loading of round bales is proposed. Three equipment systems are considered for handling biomass at the SSLs, and they are either placed permanently or are mobile and thereby travel from one SSL to another. A mathematical programming-based approach is utilized to determine SSLs and equipment routes in order to minimize the total cost. The use of a Side-loading Rack System results in average savings of 21.3% over a Densification System while a Rear-loading Rack System is more expensive to operate than either of the other equipment systems. The utilization of mobile equipment results in average savings of 14.8% over the equipment placed permanently. Furthermore, the Densification System is not justifiable for transportation distances less than 81 km. Copyright © 2011 Elsevier Ltd. All rights reserved.

JPRS Report, East Europe.

DTIC Science & Technology

1990-03-07

is in imbalance, feed dosages are concept, we were to be producing 1 ton of grain per frequently changed, mastitis follows poor hygiene, etc...required 150 grams)-and in expensive foodstuffs are not produced by agriculture, but this country we produced 3,750 liters of milk per cow by our entire...not even thinking is erroneous, agricultural workers are not to penicillin prolongs the life of milk cows on average to blame for expensive

Evaluation of polymorphisms within the genes GSHR and SLC2A2 that are within a region on bovine chromosome 1 (BTA1) previously associated with feed intake and weight gain

USDA-ARS?s Scientific Manuscript database

Cost of feed is the largest expense incurred by cattle producers. The ability to select for animals with beneficial production traits using genetic markers may reduce expenses for producers. A large region on bovine chromosome 1 was identified as significant for average daily feed intake (ADFI) and ...

Start-up and incremental practice expenses for behavior change interventions in primary care.

PubMed

Dodoo, Martey S; Krist, Alex H; Cifuentes, Maribel; Green, Larry A

2008-11-01

If behavior-change services are to be offered routinely in primary care practices, providers must be appropriately compensated. Estimating what is spent by practices in providing such services is a critical component of establishing appropriate payment and was the objective of this study. In-practice expenditure data were collected for ten different interventions, using a standardized instrument in 29 practices nested in ten practice-based research networks across the U.S. during 2006-2007. The data were analyzed using standard templates to create credible estimates of the expenses incurred for both the start-up period and the implementation phase of the interventions. Average monthly start-up expenses were $1860 per practice (SE=$455). Most start-up expenditures were for staff training. Average monthly incremental costs were $58 ($15 for provision of direct care [SE=$5]; $43 in overhead [SE=$17]) per patient participant. The bulk of the intervention expenditures was spent on the recruitment and screening of patient participants. Primary care practices must spend money to address their patients' unhealthy behaviors--at least $1860 to initiate systematic approaches and $58 monthly per participating patient to implement the approaches routinely. Until primary care payment systems incorporate these expenses, it is unlikely that these services will be readily available.

Current practice and usual care of major cervical disorders in Korea

PubMed Central

Choi, A Ryeon; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-riong; Oh, Min-seok; Lee, Eun-Jung; Kim, Sungchul; Kim, Mia; Ha, In-Hyuk

2017-01-01

Abstract Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea. Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia). Although the number of cervical IDD patients was few, total expenses, per-patient expense, average days in care, and average days of visits were highest. The proportion of women was higher than men in all 3 groups with highest prevalence in the ≥50s middle-aged population for IDD compared to sprain/strain. Primary care settings were commonly used for ambulatory care, of which approximately 70% chose orthopedic specialist treatment. In analysis of medical expenditure distribution, costs of visit (consultation) (22%–34%) and physical therapy (14%–16%) were in the top 3 for all 3 disorders. Although heat and electrical therapies were the most frequently used physical therapies, traction use was high in the cervical IDD group. In nonnarcotics, aceclofenac and diclofenac were the most commonly used NSAIDs, and pethidine was their counterpart in narcotics. This study investigated practice trends and cost distribution of treatment regimens for major cervical disorders, providing current usage patterns to healthcare policy decision makers, and the detailed treatment reports are expected to be of use to clinicians and researchers in understanding current usual care. PMID:29145327

Current practice and usual care of major cervical disorders in Korea: A cross-sectional study of Korean health insurance review and assessment service national patient sample data.

PubMed

Choi, A Ryeon; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Oh, Min-Seok; Lee, Eun-Jung; Kim, Sungchul; Kim, Mia; Ha, In-Hyuk

2017-11-01

Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia).Although the number of cervical IDD patients was few, total expenses, per-patient expense, average days in care, and average days of visits were highest. The proportion of women was higher than men in all 3 groups with highest prevalence in the ≥50s middle-aged population for IDD compared to sprain/strain. Primary care settings were commonly used for ambulatory care, of which approximately 70% chose orthopedic specialist treatment. In analysis of medical expenditure distribution, costs of visit (consultation) (22%-34%) and physical therapy (14%-16%) were in the top 3 for all 3 disorders. Although heat and electrical therapies were the most frequently used physical therapies, traction use was high in the cervical IDD group. In nonnarcotics, aceclofenac and diclofenac were the most commonly used NSAIDs, and pethidine was their counterpart in narcotics.This study investigated practice trends and cost distribution of treatment regimens for major cervical disorders, providing current usage patterns to healthcare policy decision makers, and the detailed treatment reports are expected to be of use to clinicians and researchers in understanding current usual care.

The Burden of the Fellowship Interview Process on General Surgery Residents and Programs.

PubMed

Watson, Shawna L; Hollis, Robert H; Oladeji, Lasun; Xu, Shin; Porterfield, John R; Ponce, Brent A

This study evaluated the effect of the fellowship interview process in a cohort of general surgery residents. We hypothesized that the interview process would be associated with significant clinical time lost, monetary expenses, and increased need for shift coverage. An online anonymous survey link was sent via e-mail to general surgery program directors in June 2014. Program directors distributed an additional survey link to current residents in their program who had completed the fellowship interview process. United States allopathic general surgery programs. Overall, 50 general surgery program directors; 72 general surgery residents. Program directors reported a fellowship application rate of 74.4%. Residents most frequently attended 8 to 12 interviews (35.2%). Most (57.7%) of residents reported missing 7 or more days of clinical training to attend interviews; these shifts were largely covered by other residents. Most residents (62.3%) spent over $4000 on the interview process. Program directors rated fellowship burden as an average of 6.7 on a 1 to 10 scale of disruption, with 10 being a significant disruption. Most of the residents (57.3%) were in favor of change in the interview process. We identified potential areas for improvement including options for coordinated interviews and improved content on program websites. The surgical fellowship match is relatively burdensome to residents and programs alike, and merits critical assessment for potential improvement. Published by Elsevier Inc.

Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries.

PubMed

Shmueli, Amir; Israeli, Avi

2013-02-20

Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.

Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries

PubMed Central

2013-01-01

Background Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. Objectives To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. Methods We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. Results While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Conclusions Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps. PMID:23425013

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

PubMed

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

2016-01-20

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

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

PubMed Central

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

2017-01-01

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

Has it become increasingly expensive to follow a nutritious diet? Insights from a new price index for nutritious diets in Sweden 1980-2012.

PubMed

Håkansson, Andreas

2015-01-01

Health-related illnesses such as obesity and diabetes continue to increase, particularly in groups of low socioeconomic status. The increasing cost of nutritious food has been suggested as an explanation. To construct a price index describing the cost of a diet adhering to nutritional recommendations for a rational and knowledgeable consumer and, furthermore, to investigate which nutrients have become more expensive to obtain over time. Linear programming and goal programming were used to calculate two optimal and nutritious diets for each year in the interval under different assumptions. The first model describes the rational choice of a cost-minimizing consumer; the second, the choice of a consumer trying to deviate as little as possible from average consumption. Shadow price analysis was used to investigate how nutrients contribute to the diet cost. The cost of a diet adhering to nutritional recommendations has not increased more than general food prices in Sweden between 1980 and 2012. However, following nutrient recommendations increases the diet cost even for a rational consumer, particularly for vitamin D, iron, and selenium. The cost of adhering to the vitamin D recommendation has increased faster than the general food prices. Not adhering to recommendations (especially those for vitamin D) offers an opportunity for consumers to lower the diet cost. However, the cost of nutritious diets has not increased more than the cost of food in general between 1980 and 2012 in Sweden.

26 CFR 601.804 - Reimbursements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... STATEMENT OF PROCEDURAL RULES Tax Counseling for the Elderly § 601.804 Reimbursements. (a) General. When... or providing tax return assistance and to program sponsors for reimbursement of overhead expenses..., and accounting and financial control systems. (b) Direct, reasonable, and prudent expenses...

Current Canadian initiatives to reimburse live organ donors for their non-medical expenses.

PubMed

Vlaicu, Sorina; Klarenbach, Scott; Yang, Robert C; Dempster, Todd; Garg, Amit X

2007-01-01

Living organ donors frequently incur non-medical expenses for travel, accommodation, prescription drugs, loss of income, and child care in conjunction with organ donation. Despite international precedent and widespread public support, Canada currently lacks a unified strategy to reimburse donors for these expenses. In 2005, we communicated with 78 individuals within the field of Canadian transplantation to identify which initiatives for reimbursement of living donors existed in each province. Saskatchewan was the only province in which public employees were granted paid leave for organ donation. Six provincial governments partially reimbursed travel and accommodation. At the federal level, other expenses could be partially reimbursed through an income tax credit, while the Employment Insurance program and the Canada Pension Plan provided funding for donors who become unemployed or develop long-term disability as a result of donation. Charities helped a limited number of patients in financial need through grants and no-interest loans, but funding was generally limited by contributions received. While reimbursing living donors for their non-medical expenses is considered just, existing programs only partially reimburse expenses and are not available in all provinces. Developing future reimbursement policies will remove a disincentive faced by some potential donors, and may increase rates of transplantation in Canada.

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

PubMed

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

2012-01-01

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

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

PubMed

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

2017-12-01

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

78 FR 54645 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

... Exporters Only'' form is used by exporters to report and pay premiums on insured shipments to various.... Frequency of Reporting of Use: Monthly. Government Expenses: Reviewing time per year: 7,800 hours. Average Wages per Hour: $42.50. Average Cost per Year: $331,500 (time*wages). Benefits and Overhead: 20%. Total...

UCLA Tokamak Program Close Out Report.

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

Taylor, Robert John

2014-02-04

The results of UCLA experimental fusion program are summarized. Starting with smaller devices like Microtor, Macrotor, CCT and ending the research on the large (5 m) Electric Tokamak. CCT was the most diagnosed device for H-mode like physics and the effects of rotation induced radial fields. ICRF heating was also studied but plasma heating of University Type Tokamaks did not produce useful results due to plasma edge disturbances of the antennae. The Electric Tokamak produced better confinement in the seconds range. However, it presented very good particle confinement due to an "electric particle pinch". This effect prevented us from reachingmore » a quasi steady state. This particle accumulation effect was numerically explained by Shaing's enhanced neoclassical theory. The PI believes that ITER will have a good energy confinement time but deleteriously large particle confinement time and it will disrupt on particle pinching at nominal average densities. The US fusion research program did not study particle transport effects due to its undue focus on the physics of energy confinement time. Energy confinement time is not an issue for energy producing tokamaks. Controlling the ash flow will be very expensive.« less

10 CFR 455.80 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS State Administrative Expenses § 455.80 Purpose. This subpart describes what constitutes a State administrative expense that may receive financial assistance under this...

Medical expenditures in division I collegiate athletics: an analysis by sport and gender.

PubMed

Kaeding, Christopher C; Borchers, James; Oman, Janine; Pedroza, Angela

2014-09-01

Medical expenses for collegiate athletics include providing a training room with its supplies, equipment, personnel costs, and insurance coverage. Additional expenses beyond the training room include imaging, diagnostic testing, specialty consultations, and surgeries. We hypothesized that there would be no difference in average expenses or number of claims between male and female athletes over a 5-year period. Prospective patient cohort. A sports medicine center serving athletes in Big 10 Conference intercollegiate sports. All medical claims and charges for 36 varsity teams were analyzed from 2005 to 2010. The teams were categorized into 3 groups: female-only teams, male-only teams, and coed teams. Analysis of sports with corresponding male and female teams was also performed. Claims and charges for medical care for 36 intercollegiate athletic teams over 5 years. Individual team claims and charges were stable over the study period. In 11 of the 14 sex-matched sports, the female teams had higher average annual charges. After normalizing for roster size in the sex-matched sports, females had 0.97 more average annual claims (P < 0.01) and $1459 higher annual charges (P = 0.001) than their male counterparts. The charges per claim were similar between the sexes. The 5 teams with the highest average annual charges were football, wrestling, softball, women's crew, and men's lacrosse. When normalized for roster size, the 5 sports with the highest average annual charges per athlete were softball, women's diving, men's basketball, wrestling, and men's gymnastics. Charges per claim were similar between the sex-matched sports, but the female sports had a higher number of annual claims per athlete and thus higher total charges per athlete/year. Football had the highest average annual total charges as a team, but when normalized for roster size football charges per athlete/year were similar to those of other sports.

78 FR 15047 - Agency Information Collection Activities; Proposed Collection; Comments Requested: International...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... Collection Activities; Proposed Collection; Comments Requested: International Terrorism Victim Expense.../collection: International Terrorism Victim Expense Reimbursement Program (ITVERP) Application. (3) The agency.... Government employees who are victims of acts of international terrorism that occur(red) outside of the United...

32 CFR 202.12 - Administrative support and eligible expenses.

Code of Federal Regulations, 2014 CFR

2014-07-01

... expense of a RAB: (1) RAB establishment. (2) Membership selection. (3) Training if it is: (i) Site... availability of funds, administrative support to RABs may be funded as follows: (1) At active installations... Restoration account for the Formerly Used Defense Sites program. ...

32 CFR 202.12 - Administrative support and eligible expenses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... expense of a RAB: (1) RAB establishment. (2) Membership selection. (3) Training if it is: (i) Site... availability of funds, administrative support to RABs may be funded as follows: (1) At active installations... Restoration account for the Formerly Used Defense Sites program. ...

32 CFR 202.12 - Administrative support and eligible expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... expense of a RAB: (1) RAB establishment. (2) Membership selection. (3) Training if it is: (i) Site... availability of funds, administrative support to RABs may be funded as follows: (1) At active installations... Restoration account for the Formerly Used Defense Sites program. ...

32 CFR 202.12 - Administrative support and eligible expenses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... expense of a RAB: (1) RAB establishment. (2) Membership selection. (3) Training if it is: (i) Site... availability of funds, administrative support to RABs may be funded as follows: (1) At active installations... Restoration account for the Formerly Used Defense Sites program. ...

32 CFR 202.12 - Administrative support and eligible expenses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... expense of a RAB: (1) RAB establishment. (2) Membership selection. (3) Training if it is: (i) Site... availability of funds, administrative support to RABs may be funded as follows: (1) At active installations... Restoration account for the Formerly Used Defense Sites program. ...

7 CFR 1776.13 - Administrative expenses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Administrative expenses. 1776.13 Section 1776.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.13 Administrative...

7 CFR 1776.13 - Administrative expenses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Administrative expenses. 1776.13 Section 1776.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.13 Administrative...

7 CFR 1776.13 - Administrative expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Administrative expenses. 1776.13 Section 1776.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.13 Administrative...

7 CFR 1776.13 - Administrative expenses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Administrative expenses. 1776.13 Section 1776.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.13 Administrative...

7 CFR 1776.13 - Administrative expenses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Administrative expenses. 1776.13 Section 1776.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.13 Administrative...

13 CFR 108.520 - Management Expenses of a NMVC Company.

Code of Federal Regulations, 2011 CFR

2011-01-01

... capital company. Cash Management by a NMVC Company ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Management Expenses of a NMVC... VENTURE CAPITAL (âNMVCâ) PROGRAM Managing the Operations of a NMVC Company Management and Compensation...

A Cost Analysis of Kidney Replacement Therapy Options in Palestine

PubMed Central

Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

2015-01-01

This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. PMID:25765018

Cost-effectiveness of supported employment for veterans with spinal cord injuries.

PubMed

Sinnott, Patricia L; Joyce, Vilija; Su, Pon; Ottomanelli, Lisa; Goetz, Lance L; Wagner, Todd H

2014-07-01

To estimate the cost-effectiveness of a supported employment (SE) intervention that had been previously found effective in veterans with spinal cord injuries (SCIs). Cost-effectiveness analysis, using cost and quality-of-life data gathered in a trial of SE for veterans with SCI. SCI centers in the Veterans Health Administration. Subjects (N=157) who completed a study of SE in 6 SCI centers. Subjects were randomly assigned to the intervention of SE (n=81) or treatment as usual (n=76). A vocational rehabilitation program of SE for veterans with SCI. Costs and quality-adjusted life years, which were estimated from the Veterans Rand 36-Item Health Survey, extrapolated to Veterans Rand 6 Dimension utilities. Average cost for the SE intervention was $1821. In 1 year of follow-up, estimated total costs, including health care utilization and travel expenses, and average quality-adjusted life years were not significantly different between groups, suggesting the Spinal Cord Injury Vocational Integration Program intervention was not cost-effective compared with usual care. An intensive program of SE for veterans with SCI, which is more effective in achieving competitive employment, is not cost-effective after 1 year of follow-up. Longer follow-up and a larger study sample will be necessary to determine whether SE yields benefits and is cost-effective in the long run for a population with SCI. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A cost analysis of kidney replacement therapy options in Palestine.

PubMed

Younis, Mustafa; Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

2015-01-01

This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16,277 for the first year; the estimated cost of HD per patient averaged US$16,085 per year--nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. © The Author(s) 2015.

Medical expenditure for esophageal cancer in China: a 10-year multicenter retrospective survey (2002-2011).

PubMed

Guo, Lan-Wei; Huang, Hui-Yao; Shi, Ju-Fang; Lv, Li-Hong; Bai, Ya-Na; Mao, A-Yan; Liao, Xian-Zhen; Liu, Guo-Xiang; Ren, Jian-Song; Sun, Xiao-Jie; Zhu, Xin-Yu; Zhou, Jin-Yi; Gong, Ji-Yong; Zhou, Qi; Zhu, Lin; Liu, Yu-Qin; Song, Bing-Bing; Du, Ling-Bin; Xing, Xiao-Jing; Lou, Pei-An; Sun, Xiao-Hua; Qi, Xiao; Wu, Shou-Ling; Cao, Rong; Lan, Li; Ren, Ying; Zhang, Kai; He, Jie; Zhang, Jian-Gong; Dai, Min

2017-09-07

Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends. From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan (CNY; 1 CNY = 0.155 USD) based on the 2011 value and inflated using the year-specific health care consumer price index for China. A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002 (25,111 CNY) to 2011 (46,124 CNY). The average expenditures were 34,460 CNY for stage I, 39,302 CNY for stage II, 40,353 CNY for stage III, and 37,432 CNY for stage IV diseases (P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy (P < 0.05). Drugs contributed to 45.02% of the overall expenditure. These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.

Age differences in health care spending, fiscal year 1976.

PubMed

Gibson, R M; Mueller, M S; Fisher, C R

1977-08-01

Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65.

Estimating medical practice expenses from administering adult influenza vaccinations.

PubMed

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

2005-01-04

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

Patterns of use and health expenses associated with triptans among adults with migraines.

PubMed

Wu, Jun; Noxon, Virginia; Lu, Z Kevin

2015-08-01

To determine patterns of use, socioeconomic factors, and the impact on total health expenses associated with triptan therapy among patients with migraines. Patients with migraines were identified from the Medical Expenditure Panel Survey household component files (2006 to 2011) and were restricted to those who were 18 years or older and had a migraine diagnosis. The major outcome measures were triptan use during the 2-year period and annualized average total and migraine-related health care expenses and medical utilization. Socioeconomic factors associated with triptan use were analyzed by using logistic regression. The impact of triptan use on total and migraine-related health expenses was assessed by linear regression models with log transformations. Among 1961 patients with a migraine diagnosis (representing 45.6 million individuals in the United States for years 2006 to 2011), 501 received triptans to treat acute migraines (representing 13.1 million individuals in the United States, 28.6%). Patients who were females and had higher income and education levels were more likely to receive triptans to treat migraines. Triptan expense accounted for 49.6% of total migraine-related expenses and 21.9% of total all-cause prescription drug expenses respectively. Compared with nontriptan users, the annualized total health expenses increased by 19.7% in triptan users after adjusting for demographic and health-related variables. The study suggested that socioeconomic factors were associated with triptan use in migraineurs. Higher total and migraine-related health expenses were observed in triptan users.

Impact of the application of the Value Added Tax to imaging tests on out-of-pocket health expenses of households in Chile.

PubMed

Cuadrado, Cristóbal; Silva-Illanes, Nicolás

2015-12-09

Out-of-pocket healthcare expense represents a challenge for health systems for it constitutes a barrier to health care, impacting the equality of access to healthcare systems, something particularly important in the Chilean health system. In this context, the Government recently raised the possibility of incorporating a tax on imaging tests, creating debate over its potential consequences. To explore the impact on household out-of-pocket healthcare expense by the implementation of a value added tax to imaging tests in Chile. Cross-sectional study using data of household expenditures from the VII Household Budget Survey. Out-of-pocket healthcare expense and catastrophic household expenses are calculated comparing two scenarios, with and without the inclusion of the proposed tax. Analyses are presented by income deciles to explore the differential equality impact. 42.8% of diagnostic test expense on household corresponds to imaging studies. Under a scenario of tax implementation, a relative increase of 1.1% of out-of-pocket expenses and 2.2% of catastrophic household expenses is observed. The groups that suffer the greatest impact are those with lower income levels, concentrating in the first fifth deciles. We conclude that, although the increase in the average out-of- pocket spending is moderate, this policy may involve a significant increase in the catastrophic expense of the population with the lowest incomes, thereby increasing health inequalities. Considering the challenges of health system financing in Chile, it appears that such fiscal policy would only worsen the possibility of moving towards lower levels of out-of-pocket of household expenses.

10 CFR 455.82 - Scope of the grant.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS AND BUILDINGS OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS State Administrative Expenses § 455.82 Scope of the grant. A State's administrative expenses shall be limited to those directly related to...

7 CFR 1767.30 - Sales expenses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Sales expenses. 1767.30 Section 1767.30 Agriculture... service activities. 3. Exhibitions, displays, lectures, and other programs designed to promote use of utility services. 4. Experimental and development work in connection with new and improved appliances and...

7 CFR 235.6 - Use of funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.6 Use of funds. (a) Funds allocated... of Management and Budget Circular A-87. (c) In addition to State Administrative Expense funds made...

7 CFR 235.6 - Use of funds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.6 Use of funds. (a) Funds allocated... of Management and Budget Circular A-87. (c) In addition to State Administrative Expense funds made...

7 CFR 235.6 - Use of funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.6 Use of funds. (a) Funds allocated... of Management and Budget Circular A-87. (c) In addition to State Administrative Expense funds made...

7 CFR 235.6 - Use of funds.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.6 Use of funds. (a) Funds allocated... of Management and Budget Circular A-87. (c) In addition to State Administrative Expense funds made...

7 CFR 235.6 - Use of funds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.6 Use of funds. (a) Funds allocated... of Management and Budget Circular A-87. (c) In addition to State Administrative Expense funds made...

Results of the flight noise measurement program using a standard and modified SH-3A helicopter

NASA Technical Reports Server (NTRS)

Pegg, R. J.; Henderson, H. R.; Hilton, D. A.

1973-01-01

A field noise measurement program has been conducted using both a standard SH-3A helicopter and an SH-3A helicopter modified to reduce external noise levels. Modifications included reducing rotor speed, increasing the number of rotor blades, modifying the blade-tip shapes, and acoustically treating the engine air intakes and exhaust. The purpose of this study was to document the noise characteristics recorded on the ground of each helicopter during flyby, hover, landing, and take-off operations. Based on an analysis of the measured results, the average of the overhead, overall, ontrack noise levels was approximately 4 db lower for the modified helicopter than for the standard helicopter. The improved in-flight noise characteristics, and associated small footprint areas and time durations, were judged to be mainly due to tail-rotor noise reductions. The noise reductions were obtained at the expense of required power increases at airspeeds greater than 70 knots for the modified helicopter.

17 CFR 256.255 - Accumulated deferred investment tax credits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... overall income tax expense in the year in which a tax credit is realized. A proportionate amount shall be debited to account 411.5, Investment tax credit, as determined in relation to the average useful life of... investment tax credits for each year with the weighted-average service life of such properties and any unused...

Influence of pharmaceutical marketing on Medicare prescriptions in the District of Columbia

PubMed Central

Podrasky, Joanna; McMonagle, Meghan A.; Raveendran, Janani; Bysshe, Tyler; Hogenmiller, Alycia

2017-01-01

Importance Gifts from pharmaceutical companies are believed to influence prescribing behavior, but few studies have addressed the association between industry gifts to physicians and drug costs, prescription volume, or preference for generic drugs. Even less research addresses the effect of gifts on the prescribing behavior of nurse practitioners (NPs), physician assistants (PAs), and podiatrists. Objective To analyze the association between gifts provided by pharmaceutical companies to individual prescribers in Washington DC and the number of prescriptions, cost of prescriptions, and proportion of branded prescriptions for each prescriber. Design Gifts data from the District of Columbia’s (DC) AccessRx program and the federal Center for Medicare and Medicaid Services (CMS) Open Payments program were analyzed with claims data from the CMS 2013 Medicare Provider Utilization and Payment Data. Setting Washington DC, 2013 Participants Physicians, nurse practitioners, physician assistants, podiatrists, and other licensed Medicare Part D prescribers who participated in Medicare Part D (a Federal prescription drug program that covers patients over age 65 or who are disabled). Exposure(s) Gifts to healthcare prescribers (including cash, meals, and ownership interests) from pharmaceutical companies. Main outcomes and measures Average number of Medicare Part D claims per prescriber, number of claims per patient, cost per claim, and proportion of branded claims. Results In 2013, 1,122 (39.1%) of 2,873 Medicare Part D prescribers received gifts from pharmaceutical companies totaling $3.9 million in 2013. Compared to non-gift recipients, gift recipients prescribed 2.3 more claims per patient, prescribed medications costing $50 more per claim, and prescribed 7.8% more branded drugs. In six specialties (General Internal Medicine, Family Medicine, Obstetrics/Gynecology, Urology, Ophthalmology, and Dermatology), gifts were associated with a significantly increased average cost of claims. For Internal Medicine, Family Medicine, and Ophthalmology, gifts were associated with more branded claims. Gift acceptance was associated with increased average cost per claim for PAs and NPs. Gift acceptance was also associated with higher proportion of branded claims for PAs but not NPs. Physicians who received small gifts (less than $500 annually) had more expensive claims ($114 vs. $85) and more branded claims (30.3% vs. 25.7%) than physicians who received no gifts. Those receiving large gifts (greater than $500 annually) had the highest average costs per claim ($189) and branded claims (39.9%) than other groups. All differences were statistically significant (p<0.05). Conclusions and relevance Gifts from pharmaceutical companies are associated with more prescriptions per patient, more costly prescriptions, and a higher proportion of branded prescriptions with variation across specialties. Gifts of any size had an effect and larger gifts elicited a larger impact on prescribing behaviors. Our study confirms and expands on previous work showing that industry gifts are associated with more expensive prescriptions and more branded prescriptions. Industry gifts influence prescribing behavior, may have adverse public health implications, and should be banned. PMID:29069085

Report to the Legislature on Senate Concurrent Resolution 118 SD1 HD1: Improving the Community's Understanding of the Department of Education's Programs and School Expenses Including a Comparison with Other States on Adequacy of Funds

ERIC Educational Resources Information Center

Hawaii Educational Policy Center, 2008

2008-01-01

The 2007 Hawai'i State Legislature passed Senate Concurrent Resolution 118 S.D.1 HD 1 Improving the Community's Understanding of the Department of Education's Programs and School Expenses Including a Comparison with Other States on Adequacy of Funds. Among the requests contained in the resolution were the following: "Be it further resolved…

75 FR 3758 - Agency Information Collection Activities: Proposed Collection; Comments Requested

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... Collection Under Review: International Terrorism Victim Expense Reimbursement Program Application. The... which approval has expired. (2) The title of the form/collection: International Terrorism Victim Expense... international terrorism that occur(red) outside of the United States. The application will be used to collect...

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

PubMed

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

2014-02-01

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

The power of engagement: implementation of a career ladder program.

PubMed

Bourgeault, Robert; Newmark, Jason

2012-01-01

At Baystate Health in Massachusetts, the development and implementation of a career ladder program was implemented to reduce turnover and to improve employee satisfaction, morale, and recruitment efforts. There was significant initial expenditure in the program, as a result of promoting the large number of employees with significant experience and seniority. A smaller number of staff are expected to apply for advancement during successive cycles, allowing for decreased incremental expense going forward. Critical to the success of the program was understanding the time commitment, getting senior organizational support and staff buy-in, and justifying the associated expenses. The development and initiation of the program has done much to support a positive work environment with increased morale and higher performance among significant numbers of staff at all levels.

Out-of-pocket costs associated with rotavirus gastroenteritis requiring hospitalization in Malaysia.

PubMed

Chai, P F; Lee, W S

2009-11-20

From August 2006 to July 2007 a prospective study of out-of-pocket costs incurred by care-givers of children hospitalized for rotavirus gastroenteritis was conducted in a hospital in Malaysia. Data on caretaker out-of-pocket costs were collected from 260 children hospitalized with diarrhoea. A stool sample was collected from 198 of these children of which 46 (23%) were positive for rotavirus by latex agglutination assay. The mean (median; interquartile range) out-of-pocket cost incurred by the care-givers was US$194 (US$169; US$47-738), constituting 26% of average monthly income of the households surveyed. Major components of the cost were hospital expenses (45%) and productivity loss (37%). These findings will allow further assessment of the cost-effectiveness of any future rotavirus immunization program in Malaysia.

20 CFR 632.255 - Program planning.

Code of Federal Regulations, 2010 CFR

2010-04-01

... that may be characterized as planning and design but not program operation. (c) Expenses incurred in... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Program planning. 632.255 Section 632.255... EMPLOYMENT AND TRAINING PROGRAMS Summer Youth Employment and Training Programs § 632.255 Program planning. (a...

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

ERIC Educational Resources Information Center

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

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

13 CFR 108.520 - Management Expenses of a NMVC Company.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Management Expenses of a NMVC Company. 108.520 Section 108.520 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Managing the Operations of a NMVC Company Management and Compensation...

75 FR 39619 - Proposed Information Collection (Quarterly Report of State Approving Agency) Activities Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

... information needed to accurately reimburse State Approving Agencies (SAAs) for expenses incurred in the... reimburses SAAs for expenses incurred in the approval and supervision of education and training programs. SAAs are required to report their activities to VA quarterly and provide notices regarding which...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

Recycling Expensive Medication: Why Not?

PubMed Central

Pomerantz, Jay M

2004-01-01

New (and proposed) advances in packaging, preserving, labeling, and verifying product integrity of individual tablets and capsules may allow for the recycling of certain expensive medicines. Previously sold, but unused, medication, if brought back to special pharmacies for resale or donation, may provide a low-cost source of patent-protected medicines. Benefits of such a program go beyond simply providing affordable medication to the poor. This article suggests that medicine recycling may be a possibility (especially if manufacturers are mandated to blister-package and bar-code individual tablets and capsules). This early discussion of medication recycling identifies relevant issues, such as: need, rationale, existing programs, available supplies, expiration dates, new technology for ensuring safety and potency, environmental impact, public health benefits, program focus, program structure, and liability. PMID:15266231

76 FR 55136 - Implementation of the Alternative Dispute Resolution Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... the NRC's ADR program. The ADR program is comprised of two entirely different sub- programs; the first... tends to preserve relationships and generally promotes a safety conscious work environment by... litigation and unnecessary expenses. The second sub-program (commonly referred to as ``Post-Investigation ADR...

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

PubMed

Tai, Teresa; Bame, Sherry I

2011-04-01

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

76 FR 73632 - National Advisory Council for Environmental Policy and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... terms. The Council usually meets 2-3 times annually and the average workload for the members is... provides reimbursement for travel and incidental expenses associated with official government business. EPA...

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

PubMed

1995-06-27

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

Developing an Online Certification Program for Nutrition Education Assistants

ERIC Educational Resources Information Center

Christofferson, Debra; Christensen, Nedra; LeBlanc, Heidi; Bunch, Megan

2012-01-01

Objective: To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses. Design: An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and…

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2011 CFR

2011-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

10 CFR 455.123 - Grantee records and reports for State grants for administrative expenses, technical assistance...

Code of Federal Regulations, 2013 CFR

2013-01-01

....123 Grantee records and reports for State grants for administrative expenses, technical assistance... institutions participating in the technical assistance phase of this program and upon the energy use reports... to time request. (c) Each copy of any report covering grants for State administrative, technical...

10 CFR 455.123 - Grantee records and reports for State grants for administrative expenses, technical assistance...

Code of Federal Regulations, 2012 CFR

2012-01-01

....123 Grantee records and reports for State grants for administrative expenses, technical assistance... institutions participating in the technical assistance phase of this program and upon the energy use reports... to time request. (c) Each copy of any report covering grants for State administrative, technical...

10 CFR 455.123 - Grantee records and reports for State grants for administrative expenses, technical assistance...

Code of Federal Regulations, 2014 CFR

2014-01-01

....123 Grantee records and reports for State grants for administrative expenses, technical assistance... institutions participating in the technical assistance phase of this program and upon the energy use reports... to time request. (c) Each copy of any report covering grants for State administrative, technical...

10 CFR 455.123 - Grantee records and reports for State grants for administrative expenses, technical assistance...

Code of Federal Regulations, 2011 CFR

2011-01-01

....123 Grantee records and reports for State grants for administrative expenses, technical assistance... institutions participating in the technical assistance phase of this program and upon the energy use reports... to time request. (c) Each copy of any report covering grants for State administrative, technical...

78 FR 52827 - Food Distribution Program on Indian Reservations: Income Deductions and Resource Eligibility

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... standard deduction. Both commenters observed that an applicant's statement is acceptable as proof to receive the standard deduction under SNAP. SNAP allows for self-declaration of shelter/utility expenses at or below the applicable standard. However in SNAP, all expenses a household wishes to claim or which...

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

DTIC Science & Technology

2005-03-18

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

78 FR 72255 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... Allocation of Home Health Survey Expenses; Final Rule #0;#0;Federal Register / Vol. 78 , No. 231 / Monday... Requirements, and Cost Allocation of Home Health Survey Expenses AGENCY: Centers for Medicare & Medicaid... HHAs, the state's designated survey agency carry out certain other responsibilities that already apply...

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

7 CFR 4290.860 - Financing fees and expense reimbursements a RBIC may receive from an Enterprise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Financing of Enterprises by RBICs Structuring... reimbursements. You may charge an Enterprise for the reasonable out-of-pocket expenses, other than Management... receive from an Enterprise. 4290.860 Section 4290.860 Agriculture Regulations of the Department of...

Federal employees health program experiences lack of competition in some areas, raising cost concerns for exchange plans.

PubMed

McBride, Timothy D; Barker, Abigail R; Pollack, Lisa M; Kemper, Leah M; Mueller, Keith J

2012-06-01

The Affordable Care Act calls for creation of health insurance exchanges designed to provide private health insurance plan choices. The Federal Employees Health Benefits Program is a national model that to some extent resembles the planned exchanges. Both offer plans at the state level but are also overseen by the federal government. We examined the availability of plans and enrollment levels in the Federal Employees Health Benefits Program throughout the United States in 2010. We found that although plans were widely available, enrollment was concentrated in plans owned by just a few organizations, typically Blue Cross/Blue Shield plans. Enrollment was more concentrated in rural areas, which may reflect historical patterns of enrollment or lack of provider networks. Average biweekly premiums for an individual were lowest ($58.48) in counties where competition was extremely high, rising to $65.13 where competition was extremely low. To make certain that coverage sold through exchanges is affordable, policy makers may need to pay attention to areas where there is little plan competition and take steps through risk-adjustment policies or other measures to narrow differences in premiums and out-of-pocket expenses for consumers.

28 CFR 94.31 - Application procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Terrorism Victim Expense Reimbursement Program Program Administration § 94.31 Application procedures. (a) To... paragraph (a) of this Section, in cases involving incidents of terrorism preceding the establishment of this...

28 CFR 94.31 - Application procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Terrorism Victim Expense Reimbursement Program Program Administration § 94.31 Application procedures. (a) To... paragraph (a) of this Section, in cases involving incidents of terrorism preceding the establishment of this...

28 CFR 94.31 - Application procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Terrorism Victim Expense Reimbursement Program Program Administration § 94.31 Application procedures. (a) To... paragraph (a) of this Section, in cases involving incidents of terrorism preceding the establishment of this...

28 CFR 94.31 - Application procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Terrorism Victim Expense Reimbursement Program Program Administration § 94.31 Application procedures. (a) To... paragraph (a) of this Section, in cases involving incidents of terrorism preceding the establishment of this...

28 CFR 94.31 - Application procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Terrorism Victim Expense Reimbursement Program Program Administration § 94.31 Application procedures. (a) To... paragraph (a) of this Section, in cases involving incidents of terrorism preceding the establishment of this...

American Association of State Colleges and Universities Annual Survey of Tuition and Fees and Room and Board Charges, 1980-81.

ERIC Educational Resources Information Center

American Association of State Colleges and Universities, Washington, DC.

In 1980, full-time state resident undergraduate students attending AASCU-member institutions paid an average of $712 for tuition and fees, and $1,605 for room and board charges. These figures reflect a 10.6 percent average increase over 1979 costs. Including books and supplies, transportation, and personal expenses, the cost of college attendance…

Hillary Clinton impressed by the Centre's work.

PubMed

1995-01-01

In April 1994, US First Lady Hillary Rodham Clinton, her daughter Chelsea, the Bangladesh Minister for Women and Children's Affairs, and the US Ambassador to Bangladesh visited the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). The First Lady remarked that ICDDR,B's research programs on health and family planning have many important lessons for the developing and developed regions alike. She noted the development successes in Bangladesh that can be applied in the US and other countries: the Grameen Bank, oral rehydration solution (ORS), and the community outreach programs for health and family planning services. The First Lady was especially interested in ORS and its cost-effectiveness. Most of the 220,000 children hospitalized each year in the US for severe gastrointestinal illness are treated with expensive intravenous (IV) drips (average cost = $2300), while a few ORS packets would be a small fraction of the cost. The average cost of treatment per patient at ICDDR,B was only $12. Patients receive care free of charge. Less than 0.6% of the patients die. The previous year, a USAID administrator asked ICDDR,B for its expertise in fighting cholera at the Rwandan refugee camps in Goma, Zaire. ICDDR,B staff developed diagnostic antisera for the new cholera strain responsible for the epidemic in the Americas, described its pathophysiology, and established its mode of transmission in surface waters. ICDDR,B also provides technical support to the national family planning and maternal and child health programs. In the Matlab, ICDDR,B's work has contributed to a high contraceptive prevalence rate of more than 64% among poor and largely illiterate persons.

Financial impact of nursing professionals staff required in an Intensive Care Unit 1

PubMed Central

de Araújo, Thamiris Ricci; Menegueti, Mayra Gonçalves; Auxiliadora-Martins, Maria; Castilho, Valéria; Chaves, Lucieli Dias Pedreschi; Laus, Ana Maria

2016-01-01

ABSTRACT Objective: to calculate the cost of the average time of nursing care spent and required by patients in the Intensive Care Unit (ICU) and the financial expense for the right dimension of staff of nursing professionals. Method: a descriptive, quantitative research, using the case study method, developed in adult ICU patients. We used the workload index - Nursing Activities Score; the average care time spent and required and the amount of professionals required were calculated using equations and from these data, and from the salary composition of professionals and contractual monthly time values, calculated the cost of direct labor of nursing. Results: the monthly cost of the average quantity of available professionals was US$ 35,763.12, corresponding to 29.6 professionals, and the required staff for 24 hours of care is 42.2 nurses, with a monthly cost of US$ 50,995.44. Conclusion: the numerical gap of nursing professionals was 30% and the monthly financial expense for adaptation of the structure is US$ 15,232.32, which corresponds to an increase of 42.59% in the amounts currently paid by the institution. PMID:27878219

18 CFR 367.9080 - Account 908, Customer assistance expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... electric equipment. (4) Demonstrations, exhibits, lectures, and other programs designed to instruct..., lectures, and other programs. (2) Loss in value on equipment and appliances used for customer assistance...

18 CFR 367.9080 - Account 908, Customer assistance expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... electric equipment. (4) Demonstrations, exhibits, lectures, and other programs designed to instruct..., lectures, and other programs. (2) Loss in value on equipment and appliances used for customer assistance...

18 CFR 367.9080 - Account 908, Customer assistance expenses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... electric equipment. (4) Demonstrations, exhibits, lectures, and other programs designed to instruct..., lectures, and other programs. (2) Loss in value on equipment and appliances used for customer assistance...

18 CFR 367.9080 - Account 908, Customer assistance expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... electric equipment. (4) Demonstrations, exhibits, lectures, and other programs designed to instruct..., lectures, and other programs. (2) Loss in value on equipment and appliances used for customer assistance...

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

PubMed

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

2015-01-01

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

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study.

PubMed

Kim, Eugene; Kwon, Hye-Young; Baek, Sang Hong; Lee, Haeyoung; Yoo, Byung-Su; Kang, Seok-Min; Ahn, Youngkeun; Yang, Bong-Min

2018-03-01

This study investigated annual medical costs using real-world data focusing on acute heart failure. The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed. On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%. Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated. It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.

Impact of Depression on Health and Medical Care Utilization and Expenses in US Adults With Migraine: A Retrospective Cross Sectional Study.

PubMed

Wu, Jun; Davis-Ajami, Mary L; Kevin Lu, Zhiqiang

2016-07-01

The association between migraine and depression has been extensively examined and a bidirectional hypothesis of the comorbidity between the 2 diseases has been reported. However, the economic impact of comorbid depression on migraine has not been fully explored. The purpose of this study is to determine the impact of depression on medical utilization and health care expenses among subjects reporting migraine. The Medical Expenditure Panel Survey (MEPS) household component longitudinal data files (2006-2012) identified subjects (≥ 18 years) with migraines. Two groups were created from all eligible subjects with migraine based on whether comorbid depression was reported or not. The major outcome measures were annualized average total and migraine-related health care expenses and medical utilization during a 2-year period. The impact of depression on health expenses was assessed by multivariable linear regression models with log transformations. Multivariable logistic regression identified factors associated with depression and examined the likelihood of emergency department (ED) visit adjusting for demographic and health-related variables. Among 2,400 subjects with migraine (approximate 54.3 million United States [US] individuals for years 2006-2012), 804 reported depression (representing 18.4 million individuals in the United States, 33.9%). Among migraineurs, nearly one-third received anti-migraine prescription drugs and approximately 65% with comorbid depression used antidepressants. Race (black vs white, odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.25, 0.52), sex (male vs female, OR: 0.67, 95% CI: 0.51, 0.87), perceived health status (fair to poor vs excellent-very good, OR: 2.58, 95% CI: 2.72. 4.71), insurance coverage (public vs private, OR: 1.59, 95%CI: 1.13, 2.24), and greater comorbidity (OR: 1.70, 95% CI: 1.28, 2.26) were significantly associated with comorbid depression in the subjects with migraine. Compared to migraine subjects without depression, the mean annual total health expenses per person ($10,012 vs. $4,740, P <.001) and mean migraine-related health expenses ($723 vs $499, P = .014) were significantly higher in those with depression. The odds of ED visit in migraineurs with comorbid depression were higher than in those without depression (OR: 1.36, 95% CI: 1.08, 1.71). Comorbid depression in subjects with migraine was associated with higher total and migraine-related health expenses and increased likelihood of all-cause ED visits. Comorbid depression management might be incorporated into migraine intervention program to improve treatment outcomes and produce potential cost savings. Further studies are needed to assess long-term effects of depression on migraine progression and health care utilization patterns. © 2016 American Headache Society.

41 CFR 300-90.3 - What must be done to apply for test program authority?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS... program; and (e) Agency procedures regarding how and when a telework program is terminated for the participating employee when he or she voluntarily relocated to a telework location. ...

30 CFR 872.25 - Are there any restrictions on how OSM may use Federal expense funds?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Federal expense funds? 872.25 Section 872.25 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND... jurisdiction of Indian tribes that do not have an approved abandoned mine reclamation program under section 405...) Projects authorized under section 402(g)(4) in States and on lands within the jurisdiction of Indian tribes...

78 FR 29439 - Proposed Information Collection (Request for Details of Expenses) Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-20

... correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER... techniques or the use of other forms of information technology. Title: Request for Details of Expenses, VA... current rate of pension. Pension is an income-based program, and the payable rate depends on the claimant...

75 FR 45205 - Proposed Information Collection (Request for Details of Expenses) Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER... techniques or the use of other forms of information technology. Title: Request for Details of Expenses, VA... current rate of pension. Pension is an income-based program, and the payable rate depends on the claimant...

School Meal Programs: Revenue and Expense Information from Selected States. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Bellis, David D.

In school year 1996-97, the Department of Agriculture instituted more stringent requirements for the nutritional content of school meals. The General Accounting Office was asked to study school food-service revenues and expenses and how they had changed since the requirements went into effect. This report contains information of the sources of…

Encouraging Low-Income Households to Make Location-Efficient Housing Choices

DOT National Transportation Integrated Search

2016-01-01

Transportation costs are typically a households second-largest expense after housing and, on average, account for about one-fifth of household spending. Low-income households are especially burdened by transportation costs, with low-income househo...

47 CFR 65.302 - Cost of debt.

Code of Federal Regulations, 2010 CFR

2010-10-01

...” is the total interest expense for the most recent two years for all local exchange carriers with... Outstanding Debt” is the average of the total debt for the most recent two years for all local exchange...

47 CFR 65.302 - Cost of debt.

Code of Federal Regulations, 2012 CFR

2012-10-01

...” is the total interest expense for the most recent two years for all local exchange carriers with... Outstanding Debt” is the average of the total debt for the most recent two years for all local exchange...

47 CFR 65.302 - Cost of debt.

Code of Federal Regulations, 2013 CFR

2013-10-01

...” is the total interest expense for the most recent two years for all local exchange carriers with... Outstanding Debt” is the average of the total debt for the most recent two years for all local exchange...

47 CFR 65.302 - Cost of debt.

Code of Federal Regulations, 2011 CFR

2011-10-01

...” is the total interest expense for the most recent two years for all local exchange carriers with... Outstanding Debt” is the average of the total debt for the most recent two years for all local exchange...

47 CFR 65.302 - Cost of debt.

Code of Federal Regulations, 2014 CFR

2014-10-01

...” is the total interest expense for the most recent two years for all local exchange carriers with... Outstanding Debt” is the average of the total debt for the most recent two years for all local exchange...

CT scans for pulmonary surveillance may be overused in lower-grade sarcoma.

PubMed

Miller, Benjamin J; Carmody Soni, Emily E; Reith, John D; Gibbs, C Parker; Scarborough, Mark T

2012-01-01

Chest CT scans are often used to monitor patients after excision of a sarcoma. Although sensitive, CT scans are more expensive than chest radiographs and are associated with possible health risks from a higher radiation dose. We hypothesized that a program based upon limited CT scans in lower-grade sarcoma could be efficacious and less expensive. We retrospectively assigned patients to a high-risk or low-risk hypothetical protocol. Eighty-three low- or intermediate-grade soft tissue sarcomas met our inclusion criteria. Eight patients had pulmonary metastasis. A protocol based on selective CT scans for high-risk patients would have identified seven out of eight lesions. The incremental cost-effectiveness ratio for routine CT scans was $731,400. A program based upon selective CT scans for higher-risk patients is accurate, spares unnecessary radiation to many patients, and is less expensive.

The German and Japanese health care systems: an international comparison using an input-output model.

PubMed

Rump, A; Schöffski, O

2016-12-01

The German and Japanese health care systems have common roots, but have evolved differently. Whereas the German system is often considered as expensive and poorly efficient, people in Japan are viewed as healthy and health care as comparatively cheap. In this study, we compared the quality, the effectiveness and efficiency of the German and Japanese health care systems. This study includes comparative health care data analysis. The quality and effectiveness of the German and Japanese health care systems were analyzed using an input-output model including 12 countries based on health indicators published by the OECD. Besides the invested resources, a risk-related input dimension was used for risk adjustment. The efficiency of the systems was assessed by relating the average output to the health expenses per capita. Health risks seem qualitatively different in Germany and Japan, but at the aggregate level, lifestyle does not seem to be an outstanding explanatory factor for health outcome differences between both countries. For investments in health resources, Germany is in a top position, whereas in the international comparison, the outcome is rather poor. The resources invested in Japan are also high, but slightly less than in Germany, whereas on average, the outcome is better. However, in the international comparison, resources as well as results in Japan show a very high variability. Relating the average output to the health expenses per capita indicates that on the average, the health care system in Japan is more efficient than in Germany. Germany and Japan have a quality problem with their health care systems. In Germany there is a transmission failure from structural to outcome quality that might be related to coordination problems between the outpatient and inpatient sector. Japan shows an unbalanced system that may be suspected to have a quality problem as a whole. As the development of the remuneration system including quality requirements is under the direct responsibility and guidance of the Ministry of Health in Japan, the issue might however be more easily solved in Japan than in Germany. Although on average, health care seems more efficient in Japan than in Germany, taking into account health as well as long-term care expenses and uncertainties related to exchange rate adjustments, the higher efficiency of the Japanese system becomes questionable. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

7 CFR 1218.54 - Programs, plans, and projects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROMOTION, RESEARCH, AND INFORMATION ORDER Blueberry Promotion, Research, and Information Order Expenses and..., effectuation, and administration of appropriate programs for promotion, research, and information, including... ensure that it contributes to an effective program of promotion, research, or information. If it is found...

Unsteady Aerodynamic Modeling of A Maneuvering Aircraft Using Indicial Functions

DTIC Science & Technology

2016-03-30

indicial functions are directly calculated using the results of unsteady Reynolds-averaged Navier - Stokes simulation and a grid-movement tool. Results are...but meanwhile, the full-order model based on Unsteady Reynolds-averaged Navier - Stokes (URANS) equation is too computationally expensive to be used...The flow solver used in this study solves the unsteady, three-dimensional and compressible Navier - Stokes equations. The equations in terms of

Bariatric surgeries performed by the Brazilian National Health System in residents of the Metropolitan Region of Porto Alegre, Rio Grande do Sul, Brazil, 2010-2016.

PubMed

Carvalho, Adriane da Silva; Rosa, Roger Dos Santos

2018-06-11

to characterize caracterize by Brazilian National Health System (SUS) hospitalizations for bariatric surgeries in residents of the Metropolitan Region of Porto Alegre, RS, Brazil, from 2010 to 2016. data analysis of the National Hospital Information System (SIH/SUS); calculation of indicators by sex, age groups, use of Intensive Care Unit and hospitalization expenses; the target population were patients aged 15 years and older. there were 1,249 hospitalizations (178.4/year; 5.4/100 thousand inhab./year), and the average age was 41.3±10.3 years old (average±standard deviation); the female sex was more prevalent (85.0%) and the age group 35-39 years accounted for 234 cases (18.7%); 227 patients (18.2%) needed ICU; there were 2 (0.2%) deaths; the mean for hospital stay was 5.1±3.2 days; the average annual expense was BRL1,073.830.29±223,791.48; and the average cost for hospitalization was BRL6,018.26±851,34 (BRL1,171.03/day). bariatric surgeries were characterized as procedures undergone by young female adults, with relatively frequent use of ICU and low fatality.

Medicare program; delay in implementing the adjustments to the practice expense relative value units under the physician fee schedule for calendar year 1998--HCFA. Notice of intent to regulate.

PubMed

1997-10-31

This notice identifies provisions in the Medicare physician fee schedule regulations that are affected by enactment of the Balanced Budget Act of 1997 (BBA 1997). Section 4505 of the BBA 1997 postpones implementation of a resource-based practice expense relative value unit system until January 1, 1999 and provides for a 4-year transition. In addition, it provides for an adjustment for practice expense relative value units for 1998. It also requires publication of a new proposed rule for practice expense by May 1, 1998, thus requiring significant revision of our proposal contained in the proposed rule published June 18, 1997 (62 FR 33158).

7 CFR 1783.13 - What administrative expenses may be funded with grant proceeds?

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) REVOLVING FUNDS FOR FINANCING WATER AND WASTEWATER PROJECTS (REVOLVING FUND PROGRAM) Revolving Loan Program Grants § 1783.13 What administrative...

Availability, quality and price of produce in low-income neighbourhood food stores in California raise equity issues.

PubMed

Gosliner, Wendi; Brown, Daniel M; Sun, Betty C; Woodward-Lopez, Gail; Crawford, Patricia B

2018-06-01

To assess produce availability, quality and price in a large sample of food stores in low-income neighbourhoods in California. Cross-sectional statewide survey. Between 2011 and 2015, local health departments assessed store type, WIC (Supplemental Nutrition Program for Women, Infants, and Children)/SNAP (Supplemental Nutrition Assistance Program) participation, produce availability, quality and price of selected items in stores in low-income neighbourhoods. Secondary data provided reference chain supermarket produce prices matched by county and month. t Tests and ANOVA examined differences by store type; regression models examined factors associated with price. Large grocery stores (n 231), small markets (n 621) and convenience stores (n 622) in 225 neighbourhoods. Produce in most large groceries was rated high quality (97 % of fruits, 98 % of vegetables), but not in convenience stores (25 % fruits, 14 % vegetables). Small markets and convenience stores participating in WIC and/or SNAP had better produce availability, variety and quality than non-participating stores. Produce prices across store types were, on average, higher than reference prices from matched chain supermarkets (27 % higher in large groceries, 37 % higher in small markets, 102 % higher in convenience stores). Price was significantly inversely associated with produce variety, adjusting for quality, store type, and SNAP and WIC participation. The study finds that fresh produce is more expensive in low-income neighbourhoods and that convenience stores offer more expensive, poorer-quality produce than other stores. Variety is associated with price and most limited in convenience stores, suggesting more work is needed to determine how convenience stores can provide low-income consumers with access to affordable, high-quality produce. WIC and SNAP can contribute to the solution.

Private expenditure and the role of private health insurance in Greece: status quo and future trends.

PubMed

Siskou, Olga; Kaitelidou, Daphne; Economou, Charalampos; Kostagiolas, Peter; Liaropoulos, Lycourgos

2009-10-01

The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece.

76 FR 64124 - Implementation of the Alternative Dispute Resolution Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... Register notice (FRN) for public comment. The NRC's ADR Program is comprised of two entirely different sub... safety conscious work environment by facilitating timely and amicable resolution of discrimination concerns without resorting to prolonged litigation and unnecessary expenses. The second sub-program...

77 FR 1785 - FTA Fiscal Year 2012 Apportionments, Allocations, and Program Information

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-11

... and Research Program Grants, dated September 1, 2008. For more information, contact Victor Austin... Fund of the United States Treasury, which are Administrative Expenses, the New Starts and Research... Planning Program (49 U.S.C. 5305(d)) B. State Planning and Research Program (49 U.S.C. 5305(e)) C...

Integrating Existing Material Into Educational Television Programming. Satellite Technology Demonstration, Technical Report No. 0502.

ERIC Educational Resources Information Center

Beard, Karen L.; Lonsdale, Helen C.

The Satellite Technology Demonstration (STD) produced a series of 81 television programs called the "J-series" for junior high school students. This material was used to illustrate real life situations for a career development program. Because materials were expensive, the decision was made to produce "in-house" programs and…

The Ohio Postsecondary Enrollment Opportunities (PSEO) Program: Understanding its Under-Utilization

ERIC Educational Resources Information Center

Smith, Marc A.; Place, A. William; Biddle, James R.; Raisch, C. Daniel; Johnson, Steven Lee; Wildenhaus, Colleen

2007-01-01

The Ohio PSEO Program is a legislated dual enrollment curricular offering. The program provides higher educational courses that are also credited at the high school and funded at state expense for qualifi ed students. Although individual and institutional benefits of the program abound (i.e., accelerated postsecondary completion, decreased…

Consumer-Directed Supports: Economic, Health, and Social Outcomes for Families

ERIC Educational Resources Information Center

Caldwell, Joe

2006-01-01

The impact of a consumer-directed support program on family caregivers of adults with developmental disabilities was explored. Economic, health, and social outcomes were compared between families in the program and families on the waiting list for the program. Caregivers of adults in the program reported fewer out-of-pocket disability expenses,…

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

20 CFR 10.802 - How should an employee prepare and submit requests for reimbursement for medical expenses...

Code of Federal Regulations, 2010 CFR

2010-04-01

... expenses? 10.802 Section 10.802 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... services, supplies or appliances due to an injury sustained in the performance of duty, he or she may... medical report as provided in § 10.800, to OWCP for consideration. (1) The provider of such service shall...

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2016-01-01

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

Using Colleges and Universities to Meet your Training Department Needs.

ERIC Educational Resources Information Center

Broderick, Richard

1982-01-01

Industries are turning to higher education to deliver programs that would be prohibitively expensive to develop and academic institutions are responding with a willingness to shape a program tailored to industry's needs. (JOW)

BKKBN and the expanding role of private sector FP services and commercial contraceptive sales in Indonesia.

PubMed

Suyono, H

1989-07-01

The Indonesian family planning program is an internationally recognized success. Launched in 1970, the program, coordinated by the National Family Planning Coordinating Board (BKKBN), now enrolls an average of 20,000 new acceptors each day. About 60% of eligible couples participate in the program. The key factors in the BKKBN's strategy are 1) a firm commitment from all government leaders, 2) a positive relationship with religious and other leaders, 3) decentralization and flexibility, 4) a shift from a traditional clinic-based to a community-based program, and 5) the integration of the program with health, family welfare, and other development activities. The next phase of the program emphasizes self-support or self-reliance in family planning. This means taking responsibility for one's own family planning, but it also means that those who are financially able to do so should pay for services and supplies. New projects have begun with the private sector. BKKBN has been working with professional doctors' and midwives' associations to promote private initiatives for family planning. The Kondom Dua Lima, a social marketing project with a private company, distributes and sells condoms in the commercial retail sales market. The Blue Circle Contraceptive Social Marketing Project provides low-cost but high-quality contraceptive supplies to fill the gap between free BKKBN supplies and the expensive contraceptives available through commercial pharmacies. BKKBN is working with the private sector to encourage its participation in the Indonesian goal of institutionalizing the small, happy, and prosperous family norm.

Age differences in health care spending, fiscal year 1977.

PubMed

Gibson, R M; Fisher, C R

1979-01-01

This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65.

Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes

PubMed Central

Grey, Margaret; Liberti, Lauren; Whittemore, Robin

2015-01-01

Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths’ many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5–1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense. PMID:26213677

Costs of Development and Maintenance of an Internet Program for Teens with Type 1 Diabetes.

PubMed

Grey, Margaret; Liberti, Lauren; Whittemore, Robin

2015-07-01

Many adolescents with type 1 diabetes (T1D) have difficulty completing self-management tasks within the context of their social environments. Group-based approaches to psycho-educational support have been shown to prevent declines in glucose control, but are challenging to implement due to youths' many activities and costs. A novel solution is providing psycho-educational support via the internet. The purpose of this study is to describe the cost of developing and maintaining two internet psycho-educational programs, both of which have been shown to improve health outcomes in adolescents with T1D. We calculated actual costs of personnel and programming in the development of TEENCOPE ™ and Managing Diabetes, two highly interactive programs that were evaluated in a multi-site clinical trial (n=320). Cost calculations were set at U.S. dollars and converted to value for 2013 as expenses were incurred over 6 years. Development costs over 1.5 years totaled $324,609, with the majority of costs being for personnel to develop and write content in a creative and engaging format, to get feedback from teens on content and a prototype, and IT programming. Maintenance of the program, including IT support, a part-time moderator to assure safety of the discussion board (0.5-1 hour/week), and yearly update of content was $43,845/year, or $137.00 per youth over 4.5 years. Overall, program and site development were relatively expensive, but the program reach was high, including non-white youth from 4 geographically distinct regions. Once developed, maintenance was minimal. With greater dissemination, cost-per-youth would decrease markedly, beginning to offset the high development expense.

76 FR 10089 - Value-Added Producer Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-23

..., business plans, and marketing strategies. The program will also provide working capital for expenses such as implementing an existing viable marketing strategy. The Agency will implement the program to meet... projects that develop mid-tier value marketing chains. DATES: This interim rule is effective March 25, 2011...

Pilot-in-the-Loop CFD Method Development

DTIC Science & Technology

2015-02-01

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

7 CFR 1207.342 - Assessments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Expenses and Assessments § 1207.342 Assessments. (a) The funds to... the immediate past ten calendar years United States average price received for potatoes by growers as...

7 CFR 1207.342 - Assessments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Expenses and Assessments § 1207.342 Assessments. (a) The funds to... the immediate past ten calendar years United States average price received for potatoes by growers as...

7 CFR 1207.342 - Assessments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Expenses and Assessments § 1207.342 Assessments. (a) The funds to... the immediate past ten calendar years United States average price received for potatoes by growers as...

7 CFR 1207.342 - Assessments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Expenses and Assessments § 1207.342 Assessments. (a) The funds to... the immediate past ten calendar years United States average price received for potatoes by growers as...

7 CFR 1207.342 - Assessments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Expenses and Assessments § 1207.342 Assessments. (a) The funds to... the immediate past ten calendar years United States average price received for potatoes by growers as...

Differences by age groups in health care spending.

PubMed

Fisher, C R

1980-01-01

This paper presents differences by age in health care spending by type of expenditure and by source of funds through 1978. Use of health care services generally increases with age. The average health bill reached $2,026 for the aged in 1978, $764 for the intermediate age group, and $286 for the young. Biological, demographic, and policy factors determine each age group's share of health spending. Public funds financed over three-fifths of the health expenses of the aged, with Medicare and Medicaid together accounting for 58 percent. Most of the health expenses of the young age groups were paid by private sources.

Generic Penetration of the SSRI Market.

PubMed

Cascade, Elisa F; Kalali, Amir H

2008-04-01

In this article, we investigate the penetration of generic selective serotonin reuptake inhibitors (SSRIs) in the US market and the implications for patient out-of-pocket expense. The data suggest that generic penetration into the SSRI market has grown from approximately nine percent in 2000, the year that the patent for Prozac((R)) expired, to 72 percent in 2007. For December, 2007, the difference in patient out-of-pocket expense for branded vs. generic agents was, on average, $55.42 for patients paying by cash (i.e., they had no prescription drug insurance) and $22.39 for patients with insurance coverage.

Generic Penetration of the SSRI Market

PubMed Central

2008-01-01

In this article, we investigate the penetration of generic selective serotonin reuptake inhibitors (SSRIs) in the US market and the implications for patient out-of-pocket expense. The data suggest that generic penetration into the SSRI market has grown from approximately nine percent in 2000, the year that the patent for Prozac® expired, to 72 percent in 2007. For December, 2007, the difference in patient out-of-pocket expense for branded vs. generic agents was, on average, $55.42 for patients paying by cash (i.e., they had no prescription drug insurance) and $22.39 for patients with insurance coverage. PMID:19727306

Child Nutrition Programs: Reauthorization and Budget Issues. Hearing before the Subcommittee on Nutrition of the Committee on Agriculture, Nutrition, and Forestry. United States Senate, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Agriculture, Nutrition, and Forestry.

Witnesses offered testimony bearing on budget issues and the reauthorization of the Women, Infants, and Children (WIC) Programs; the Special Supplemental Summer Food Program; the State Administrative Expense Program; the Commodity Distribution Program; and the Nutrition Education and Training Program. Testimony concerning permanently authorized…

Impact Exerted by Nutritional Risk Screening on Clinical Outcome of Patients with Esophageal Cancer.

PubMed

Wang, Rui; Cai, Hongfei; Li, Yang; Chen, Caiwen; Cui, Youbin

2018-01-01

Preoperative nutritional status of patients is closely associated with their recovery after the surgery. This study aims to ascertain the impact exerted by the nutritional risk screening on clinical outcome of patients with esophageal cancer. 160 patients with esophageal cancer aged over 60, having got therapy at the First Hospital of Jilin University from Jun 2016 to Feb 2017 were evaluated by adopting the NRS2002. 80 cases of patients got active therapy of nutritional support, and the other patients not supported nutritionally were selected as the control group. The comparison was drawn between two groups in serum albumin, serum immunoglobulin, postoperative complications, hospitalization, and hospitalization expenses. For all the patients, in 3 and 7 days after the surgery, the serum albumin in the nutritionally supported group outstripped that in group without nutritional support ( P < 0.05) regardless of the nutritional risk. For the patients in the risk of nutrition, the IgA in the nutritionally supported group outstripped that of group without nutritional support ( P < 0.05) in 3 and 7 days before the surgery, and the serum IgG outstripped that of the group without nutritional support in 1 and 3 days before the surgery ( P < 0.05). In terms of the patients in the risk of nutrition, the average hospitalization of nutritionally supported group was shorter ( P < 0.05), and the average hospitalization expenses were lower compared with those of the group without nutritional support. And for the patients in no risk, the hospitalization expenses of supported group surmounted those of group without nutritional support ( P < 0.05), whereas the average hospitalization took on no statistic difference ( P > 0.05). For the patients in the risk of nutrition, preoperative nutritional support can facilitate the nutritional status and immunization-relative result after surgery, which shall also decrease the average hospitalization and hospitalization cost.

Impact Exerted by Nutritional Risk Screening on Clinical Outcome of Patients with Esophageal Cancer

PubMed Central

Cai, Hongfei; Li, Yang; Chen, Caiwen

2018-01-01

Objective Preoperative nutritional status of patients is closely associated with their recovery after the surgery. This study aims to ascertain the impact exerted by the nutritional risk screening on clinical outcome of patients with esophageal cancer. Methods 160 patients with esophageal cancer aged over 60, having got therapy at the First Hospital of Jilin University from Jun 2016 to Feb 2017 were evaluated by adopting the NRS2002. 80 cases of patients got active therapy of nutritional support, and the other patients not supported nutritionally were selected as the control group. The comparison was drawn between two groups in serum albumin, serum immunoglobulin, postoperative complications, hospitalization, and hospitalization expenses. Results For all the patients, in 3 and 7 days after the surgery, the serum albumin in the nutritionally supported group outstripped that in group without nutritional support (P < 0.05) regardless of the nutritional risk. For the patients in the risk of nutrition, the IgA in the nutritionally supported group outstripped that of group without nutritional support (P < 0.05) in 3 and 7 days before the surgery, and the serum IgG outstripped that of the group without nutritional support in 1 and 3 days before the surgery (P < 0.05). In terms of the patients in the risk of nutrition, the average hospitalization of nutritionally supported group was shorter (P < 0.05), and the average hospitalization expenses were lower compared with those of the group without nutritional support. And for the patients in no risk, the hospitalization expenses of supported group surmounted those of group without nutritional support (P < 0.05), whereas the average hospitalization took on no statistic difference (P > 0.05). Conclusion For the patients in the risk of nutrition, preoperative nutritional support can facilitate the nutritional status and immunization-relative result after surgery, which shall also decrease the average hospitalization and hospitalization cost. PMID:29780831

41 CFR 300-90.4 - How many test programs may be authorized by GSA throughout the Government?

Code of Federal Regulations, 2014 CFR

2014-07-01

...? No more than 10 telework travel expense test programs may be conducted at the same time. ... Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL...

Guaranteed Loans: Just Plain Expensive

ERIC Educational Resources Information Center

Petri, Thomas E.

2007-01-01

The investigation of New York State's attorney general, Andrew M. Cuomo, into the questionable practices of lenders in federal student-loan programs has helped raise public awareness of one of the greatest scams in our government: The Federal Family Education Loan program, otherwise known as the guaranteed-student-loan program, is unnecessarily…

36 CFR 1210.25 - Revision of budget and program plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... may, at its option, restrict the transfer of funds among direct cost categories or programs, functions... or the objective of the project or program (even if there is no associated budget revision requiring... funds allotted for training allowances (direct payment to trainees) to other categories of expense. (8...

A New Approach to Hospital Cost Functions and Some Issues in Revenue Regulation

PubMed Central

Friedman, Bernard; Pauly, Mark V.

1983-01-01

An important aspect of hospital revenue regulation at the State level is the use of retroactive allowances for changes in the volume of service. Arguments favoring non-proportional allowances have been based on statistical studies of marginal cost, together with concerns about fairness toward non-profit enterprises or concerns about various inflationary biases in hospital management. This article attempts to review and clarify the regulatory issues and choices, with the aid of new econometric work that explicitly allows for the effects of transitory as well as expected demand changes on hospital expense. The present analysis is also novel in treating length of stay as an endogenous variable in cost functions. We analyzed cost variation for a panel of over 800 hospitals that reported monthly to Hospital Administrative Services between 1973 and 1978. The central results are that marginal cost of unexpected admissions is about half of average cost, while marginal cost of forecasted admissions is about equal to average cost. We obtained relatively low estimates of the cost of an “empty bed.” The study tends to support proportional volume allowances in revenue regulation programs, with perhaps a residual role for selective case review. PMID:10309853

26 CFR 1.50B-3 - Estates and trusts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Estates and trusts. 1.50B-3 Section 1.50B-3... Computing Credit for Expenses of Work Incentive Programs § 1.50B-3 Estates and trusts. (a) General rule—(1) In general. In the case of an estate or trust, WIN expenses (as defined in paragraph (a) of § 1.50B-1...

41 CFR 300-90.9 - What reports are required for a test program?

Code of Federal Regulations, 2014 CFR

2014-07-01

... required for a test program? 300-90.9 Section 300-90.9 Public Contracts and Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS § 300-90.9 What reports are required for a test program? (a) The Administrator of General Services must submit to...

Energy cost of vessel disturbance to Kittlitz's Murrelets Brachyramphus brevirostris

USGS Publications Warehouse

Agness, Alison M.; Marshall, Kristin N.; Piatt, John F.; Ha, James C.; VanBlaricom, Glenn R.

2013-01-01

We evaluated the energy cost of vessel disturbance for individual Kittlitz’s Murrelets Brachyramphus brevirostris in Glacier Bay National Park and Preserve in Alaska, USA. We used Monte Carlo simulations to model the daily energy expense associated with flight from vessels by both breeding and non-breeding birds and evaluated risk based on both the magnitude of costs incurred and the degree to which the costs may be chronic. We used two scenarios of vessel disturbance for average- and peak-vessel traffic. Because they are more likely to fly away from vessels, non-breeding birds had a greater increase in energy expenditure when disturbed (up to 30% increase under the average scenario and >50% increase under the peak scenario) than breeders (up to 10% and 30% increases under the average and peak scenarios, respectively). Likewise, non-breeding birds were more likely to experience chronic increases in energy expense (i.e. a greater percentage of days with an increase in energy expenditure) than breeding birds. Our modeling results indicated that breeding and non-breeding birds were both susceptible to fitness consequences (e.g. reduced reproductive success and survival) resulting from the energy cost.

Low cost self-made pressure distribution sensors for ergonomic chair: Are they suitable for posture monitoring?

PubMed

Martinaitis, Arnas; Daunoraviciene, Kristina

2018-05-18

Long sitting causes many health problems for people. Healthy sitting monitoring systems, like real-time pressure distribution measuring, is in high demand and many methods of posture recognition were developed. Such systems are usually expensive and hardly available for the regular user. The aim of study is to develop low cost but sensitive enough pressure sensors and posture monitoring system. New self-made pressure sensors have been developed and tested, and prototype of pressure distribution measuring system was designed. Sensors measured at average noise amplitude of a = 56 mV (1.12%), average variation in sequential measurements of the same sensor s = 17 mV (0.34%). Signal variability between sensors averaged at 100 mV (2.0%). Weight to signal dependency graph was measured and hysteresis calculated. Results suggested the use of total sixteen sensors for posture monitoring system with accuracy of < 1.5% after relaxation and repeatability of around 2%. Results demonstrate that hand-made sensor sensitivity and repeatability are acceptable for posture monitoring, and it is possible to build low cost pressure distribution measurement system with graphical visualization without expensive equipment or complicated software.

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

PubMed

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

2014-01-01

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

Private and public cross-subsidization: financing Beijing's health-insurance reform.

PubMed

Wu, Ming; Xin, Ying; Wang, Huihui; Yu, Wei

2005-04-01

In 1998, the Chinese government proposed a universal health-insurance program for urban employees. However, this reform has been advancing slowly, primarily due to an unpractical financing policy. We surveyed over 2000 families and evaluated the financial impacts of Beijing's reform on public and private enterprises. We found that most state-owned enterprises provided effective health insurance, whereas most private firms did not; overall, 33% of employees had little or no coverage. On average, employees of private firms were healthier and earned more compared to public firms. Because the premium was proportional to income, private firms would pay more for insurance than the predicted health-care expense of their employees. International firms subsidize the most, contributing more than 60% of their insurance premiums to the employees of the public sector. Such an aggressive cross-subsidization policy is difficult to be accepted by private firms.

The business of refractive laser assisted cataract surgery (ReLACS).

PubMed

Berdahl, John P; Jensen, Matthew P

2014-01-01

Refractive Laser Assisted Cataract Surgery (ReLACS) combines the femtosecond laser with other noncovered tests and services in an attempt to reduce spectacle dependence in combination with cataract surgery. Significant interest is present among ophthalmologists who are considering adopting this technology, however significant capital outlays and continuing expenses can make the decision to adopt ReLACS foreboding. We review the financial considerations of ReLACS and review the trends seen in early adopters of this technology. Recent findings have shown that ReLACS is a growing segment of cataract surgery. Most practices who have implemented the technology have broken even and have a positive outlook on the financial return of implementing the ReLACS program. The average break-even analysis point for practices is around 230 cases a year. ReLACS is growing and appears to be a financial viable approach for many practices.

Community pediatric hospitalists providing care in the emergency department: an analysis of physician productivity and financial performance.

PubMed

Dudas, Robert A; Monroe, David; McColligan Borger, Melissa

2011-11-01

Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104% of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.

SIMULATING ATMOSPHERIC EXPOSURE IN A NATIONAL RISK ASSESSMENT USING AN INNOVATIVE METEOROLOGICAL SAMPLING SCHEME

EPA Science Inventory

Multimedia risk assessments require the temporal integration of atmospheric concentration and deposition with other media modules. However, providing an extended time series of estimates is computationally expensive. An alternative approach is to substitute long-term average a...

A budget model to determine the financial health of nursing education programs in academic institutions.

PubMed

Donnelly, Gloria

2005-01-01

In the allocation of resources in academic settings, hierarchies of tradition and status often supersede documented need. Nursing programs sometimes have difficulty in getting what they need to maintain quality programs and to grow. The budget is the crucial tool in documenting nursing program needs and its contributions to the entire academic enterprise. Most nursing programs administrators see only an operating expense budget that may grow or shrink by a rubric that may not fit the reality of the situation. A budget is a quantitative expression of how well a unit is managed. Educational administrators should be paying as much attention to analyzing financial outcomes as they do curricular outcomes. This article describes the development of a model for tracking revenue and expense and a simple rubric for analyzing the relationship between the two. It also discusses how to use financial data to improve the fiscal performance of nursing units and to leverage support during times of growth.

Status of Pharmacy Practice Experience Education Programs

PubMed Central

Eccles, Dayl; Kwasnik, Abigail; Craddick, Karen; Heinz, Andrew K.; Harralson, Arthur F.

2014-01-01

Objective. To assess financial, personnel, and curricular characteristics of US pharmacy practice experiential education programs and follow-up on results of a similar survey conducted in 2001. Methods. Experiential education directors at 118 accredited US pharmacy colleges and schools were invited to participate in a blinded, Web-based survey in 2011. Aggregate responses were analyzed using descriptive statistics and combined with data obtained from the American Association of Colleges of Pharmacy to assess program demographics, faculty and administrative organizational structure, and financial support. Results. The number of advanced pharmacy practice experience (APPE) sites had increased by 24% for medium, 50% for large, and 55% for very large colleges and schools. Introductory pharmacy practice experience (IPPE) sites outnumbered APPEs twofold. The average experiential education team included an assistant/associate dean (0.4 full-time equivalent [FTE]), a director (1.0 FTE), assistant/associate director (0.5 FTE), coordinator (0.9 FTE), and multiple administrative assistants (1.3 FTE). Most faculty members (63%-75%) were nontenure track and most coordinators (66%) were staff members. Estimated costs to operate an experiential education program represented a small percentage of the overall expense budget of pharmacy colleges and schools. Conclusion. To match enrollment growth, pharmacy practice experiential education administrators have expanded their teams, reorganized responsibilities, and found methods to improve cost efficiency. These benchmarks will assist experiential education administrators to plan strategically for future changes. PMID:24850934

Effects of alloying elements and heat treatments on mechanical properties of Korean reduced-activation ferritic-martensitic steel

NASA Astrophysics Data System (ADS)

Chun, Y. B.; Kang, S. H.; Noh, S.; Kim, T. K.; Lee, D. W.; Cho, S.; Jeong, Y. H.

2014-12-01

As part of an alloy development program for Korean reduced-activation ferritic-martensitic (RAFM) steel, a total of 37 program alloys were designed and their mechanical properties were evaluated with special attention being paid to the effects of alloying elements and heat treatments. A reduction of the normalizing temperature from 1050 °C to 980 °C was found to have a positive effect on the impact resistance, resulting in a decrease in ductile-brittle transition-temperature (DBTT) of the program alloys by an average of 30 °C. The yield strength and creep rupture time are affected strongly by the tempering time at 760 °C but at the expense of ductility. Regarding the effects of the alloying elements, the addition of trace amounts of Zr enhances both the creep and impact resistance: the lowest DBTT was observed for the alloys containing 0.005 wt.% Zr, whereas the addition of 0.01 wt.% Zr extends the creep rupture-time under an accelerated condition. The enhanced impact resistance owing to the normalizing at lower temperature is attributed to a more refined grain structure, which provides more barriers to the propagation of cleavage cracks. Solution softening by Zr addition is suggested as a possible mechanism for enhanced resistance to both impact and creep of the program alloys.

Status of pharmacy practice experience education programs.

PubMed

Danielson, Jennifer; Eccles, Dayl; Kwasnik, Abigail; Craddick, Karen; Heinz, Andrew K; Harralson, Arthur F

2014-05-15

To assess financial, personnel, and curricular characteristics of US pharmacy practice experiential education programs and follow-up on results of a similar survey conducted in 2001. Experiential education directors at 118 accredited US pharmacy colleges and schools were invited to participate in a blinded, Web-based survey in 2011. Aggregate responses were analyzed using descriptive statistics and combined with data obtained from the American Association of Colleges of Pharmacy to assess program demographics, faculty and administrative organizational structure, and financial support. The number of advanced pharmacy practice experience (APPE) sites had increased by 24% for medium, 50% for large, and 55% for very large colleges and schools. Introductory pharmacy practice experience (IPPE) sites outnumbered APPEs twofold. The average experiential education team included an assistant/associate dean (0.4 full-time equivalent [FTE]), a director (1.0 FTE), assistant/associate director (0.5 FTE), coordinator (0.9 FTE), and multiple administrative assistants (1.3 FTE). Most faculty members (63%-75%) were nontenure track and most coordinators (66%) were staff members. Estimated costs to operate an experiential education program represented a small percentage of the overall expense budget of pharmacy colleges and schools. To match enrollment growth, pharmacy practice experiential education administrators have expanded their teams, reorganized responsibilities, and found methods to improve cost efficiency. These benchmarks will assist experiential education administrators to plan strategically for future changes.

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

PubMed Central

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

2014-01-01

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

An iterative method for hydrodynamic interactions in Brownian dynamics simulations of polymer dynamics

NASA Astrophysics Data System (ADS)

Miao, Linling; Young, Charles D.; Sing, Charles E.

2017-07-01

Brownian Dynamics (BD) simulations are a standard tool for understanding the dynamics of polymers in and out of equilibrium. Quantitative comparison can be made to rheological measurements of dilute polymer solutions, as well as direct visual observations of fluorescently labeled DNA. The primary computational challenge with BD is the expensive calculation of hydrodynamic interactions (HI), which are necessary to capture physically realistic dynamics. The full HI calculation, performed via a Cholesky decomposition every time step, scales with the length of the polymer as O(N3). This limits the calculation to a few hundred simulated particles. A number of approximations in the literature can lower this scaling to O(N2 - N2.25), and explicit solvent methods scale as O(N); however both incur a significant constant per-time step computational cost. Despite this progress, there remains a need for new or alternative methods of calculating hydrodynamic interactions; large polymer chains or semidilute polymer solutions remain computationally expensive. In this paper, we introduce an alternative method for calculating approximate hydrodynamic interactions. Our method relies on an iterative scheme to establish self-consistency between a hydrodynamic matrix that is averaged over simulation and the hydrodynamic matrix used to run the simulation. Comparison to standard BD simulation and polymer theory results demonstrates that this method quantitatively captures both equilibrium and steady-state dynamics after only a few iterations. The use of an averaged hydrodynamic matrix allows the computationally expensive Brownian noise calculation to be performed infrequently, so that it is no longer the bottleneck of the simulation calculations. We also investigate limitations of this conformational averaging approach in ring polymers.

[Paris hospitals budget in 1848, from charity to care].

PubMed

Chast, F

1999-01-01

Paris hospitals budget is, in the year 1848, the last before the "Assistance Publique" foundation. 1848 is characterized by important political troubles in Paris and an increased hospital activity. Nevertheless, the budget could suggest a certain wealth. Receipts are mainly based on financial funding and real estate incomes. Expenses are, for one half, linked to patients considered as hosts: food, heating, cleaning, etc. Staff expenses are moderate (12%). Various expenditures are in the same range within the different hospitals. It is interesting to outline the fact that drug expenses have the same importance than 150 years later: 4%. This feature is only an average insofar as general hospital spend about 10% of their budget in drugs as long-term care hospitals spend 1%. This disparity is clearly the proof of an increasing medicalization of Paris hospitals in the middle of the 19th century.

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

PubMed

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

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

Annual Survey of Optometric Educational Institutions, 1984-85.

ERIC Educational Resources Information Center

Journal of Optometric Education, 1986

1986-01-01

Tabulations include entering class grade point averages and educational backgrounds, loan and non-loan student financial aid granted by the institutions, resident and nonresident student expenses, full-time male and female enrollment in each class, and minority student enrollment in colleges of optometry. (MSE)

Preparing your organization's training program for ICD-10.

PubMed

Carolan, Katie; Reitzel, David

2011-10-01

Training for ICD-10 is going to be expensive, though predictions of how expensive vary widely. Healthcare finance executives should create a flexible, multiyear capital and operating budget to prepare for ICD-10 conversion and the training and support that will be required. Healthcare organizations also should assess staff knowledge in the critical ICD-10 areas and begin training now to be ready for go-live by early 2013.

VEBAs--ordinary and necessary expenses--deductions and constructive dividends. Neonatology Associates, P.A. v. Commissioner of Internal Revenue.

PubMed

2004-01-01

Contributions made by professional medical corporations into voluntary employee benefit program plans (VEBAs), which were well in excess of the cost of the term life insurance provided to the participants, were not ordinary and necessary business expenses, and the distributions of surplus cash to owner physicians upon conversion to individual policies constituted constructive dividends taxable to the individual taxpayers.

Tapping into the Forest Management Assistance Programs

Treesearch

John L. Greene; Terry K. Haines

1998-01-01

Use of federal and state forest management assistance programs can enable nonindustial private forest owners to reduce their management expenses and practice better stewardship. This paper summarizes six federal and twelve state assistance programs available to owners in the North Central states. It also describes how to calculate the amount of a government...

41 CFR 300-90.2 - Who may authorize test programs?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false Who may authorize test programs? 300-90.2 Section 300-90.2 Public Contracts and Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS § 300-90.2 Who may authorize...

Is Software Available for Early Childhood Spanish Speaking Children?

ERIC Educational Resources Information Center

Cardona de Divale, Maria Victoria

A search was conducted on the Internet for software available for bilingual Spanish-speaking children. The only programs found under this heading were 18 programs for learning Spanish. Five of the least expensive were selected for review using a standardized scale for evaluating children's software. Four of the programs were found to be…

75 FR 14184 - Agency Information Collection Activities; Proposed Collection; Comments Requested

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... Collection Under Review: International Terrorism Victim Compensation Program Application. The Department of...: International Terrorism Victim Expense Reimbursement Program (ITVERP) Application. (3) Agency form number, if... of international terrorism that occur outside the United States. Applicants seeking compensation from...

22 CFR 62.10 - Program administration.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., and banks), to the extent possible; (3) Available health care, emergency assistance, and insurance... exchange visitor programs. These responsibilities include: (a) Selection of exchange visitors. Sponsors... visitor will likely incur (e.g., living expenses) while in the United States; (7) Health care and...

22 CFR 62.10 - Program administration.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., and banks), to the extent possible; (3) Available health care, emergency assistance, and insurance... exchange visitor programs. These responsibilities include: (a) Selection of exchange visitors. Sponsors... visitor will likely incur (e.g., living expenses) while in the United States; (7) Health care and...

38 CFR 21.4153 - Reimbursement of expenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance Programs State... administration of an educational program which are costs properly chargeable as tuition costs, such as the... paragraph (d)(4) of this section, “educational institution” includes an organization or entity offering...

Sharing the Load: Amish Healthcare Financing

PubMed Central

Rohrer, Kristyn; Dundes, Lauren

2016-01-01

When settling healthcare bills, the Old Order Amish of Lancaster County, Pennsylvania rely on an ethos of mutual aid, independent of the government. Consonant with this philosophy, many Amish do not participate in or receive benefits from Social Security or Medicare. They are also exempted from the Affordable Care Act of 2010. This study expands the limited documentation of Amish Hospital Aid, an Amish health insurance program that covers major medical costs. Interview data from 11 Amish adults in Lancaster County depict how this aid program supplements traditional congregational alms coverage of medical expenses. The interview data delineate the structure of the program, its operation, and how it encourages cost containment and community interdependence. The manner in which the Amish collaborate to pay for medical expenses provides a thought-provoking paradigm for managing health care costs. PMID:27983624

The financial impact of a clinical academic practice partnership.

PubMed

Greene, Mary Ann; Turner, James

2014-01-01

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

Bias in modeled bi-directional NH3 fluxes associated with temporal averaging of atmospheric NH3 concentrations

EPA Science Inventory

Direct flux measurements of NH3 are expensive, time consuming, and require detailed supporting measurements of soil, vegetation, and atmospheric chemistry for interpretation and model parameterization. It is therefore often necessary to infer fluxes by combining measurements of...

Surgical resident education: what is the department's price for commitment?

PubMed

Meara, Michael P; Schlitzkus, Lisa L; Witherington, Mitzi; Haisch, Carl; Rotondo, Michael F; Schenarts, Paul J

2010-01-01

The current recession has impacted all aspects of our economy. Some residency programs have experienced faculty salary cuts, furlough days, and cessation of funding for travel to academic meetings. This milieu forced many residency programs to reevaluate their commitment to resident education, particularly for those expenses not provided for by Direct Medical Education (DME) and Indirect Medical Education (IME) funds. The purpose of this study was to determine what price a Department of Surgery pays to fulfill its commitment to resident education. A financial analysis of 1 academic year was performed for all expenses not covered by DME or IME funds and is paid for by the faculty practice plan. These expenses were categorized and further analyzed to determine the funds required for resident-related scholarly activity. A university-based general surgery residency program. Twenty-eight surgical residents and a program coordinator. The departmental faculty provided $153,141 during 1 academic year to support the educational mission of the residency. This amount is in addition to the $1.6 million in faculty time, $850,000 provided by the federal government in terms of DME funds, and $14 million of IME funds, which are distributed on an institutional basis. Resident presentations at scientific meetings accounted for $49,672, and program coordinator costs of $44,190 accounted for nearly two-thirds of this funding. The departmental faculty committed $6400 per categorical resident. In addition to DME and IME funds, a department of surgery must commit significant additional monies to meet the educational goals of surgical residency. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A Study of Year-Round Schools. Volume III: Handbook for Conducting Cost Analysis of Year-Round School Programs.

ERIC Educational Resources Information Center

Burnett, Robert W.

This manual is intended for use by district officials undertaking analysis of the costs of year-round school (YRS) programs. To analyze the budgetary impact of YRS, it is necessary to determine the actual costs incurred with the YRS program and to compare these costs to expenses that would be incurred without the YRS program. A simulated…

Techniques to Aid DoD Writers in Developing User-Oriented Directives

DTIC Science & Technology

1990-09-01

received from sales of the recovered materials, expenses incurred in this program, the number and costs of projects for environmental improvement and...components for managing acquisition programs. a. Program direction and guidance for ACAT I programs, to include all matters relating to cost , schedule...documented needs and unfunded ownership costs requirements * Operational deficiencies identified must first be Proposed exit criteria tnat must be

Program to Manage New and Expensive Drugs in Pediatrics: Profile of a New Drug Policy and a 12-Month Descriptive Study.

PubMed

Corny, Jennifer; Cotteret, Camille; Pelletier, Élaine; Ovetchkine, Philippe; Bussières, Jean-François

2017-01-01

With growing financial pressure and the range of new and expensive drugs, hospital administrators, clinicians, and pharmacy directors are facing tough decisions on how to manage drug budgets. At a Canadian mother-child hospital, a policy for new and expensive drugs was developed, with the goal of managing their use and costs. To describe the development and implementation of a policy for new and expensive drugs in a mother-child teaching hospital and to describe the profile of requests for these therapies over a 12-month period. A brainstorming session was conducted with members of the pharmacy and therapeutics committee to define the criteria for new and expensive drugs at the study hospital and a new process to evaluate requests for these drugs. Over the 12-month period following implementation of the policy, all requests for new and expensive drugs were evaluated through collection and analysis of relevant data. The new drug policy was launched on October 1, 2014. Over the following 12-month period, a total of 58 requests for new and expensive drugs were discussed, but only 47 request forms were completed and signed by a physician and a clinical pharmacist. New and expensive drugs represent a challenge for clinicians and hospital stakeholders. This study illustrates the implementation of a new policy for these drugs in a mother-child teaching hospital over a 12-month period.

78 FR 18617 - Recreational Boating Safety Projects, Programs and Activities Funded Under Provisions of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-27

... nationally for more real time accident information and to identify accidents that may involve regulatory non... associated lead and processing times resulting in a lag time between available funds and spending. The total... Factory Visit Program/Boat Testing Program, with an additional $857 for travel expenses. ($1,985,478).\\1...

41 CFR 300-90.7 - What is the duration of test programs?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false What is the duration of test programs? 300-90.7 Section 300-90.7 Public Contracts and Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS § 300-90.7 What is...

41 CFR 300-90.8 - What must we do to apply for a test program extension?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false What must we do to apply for a test program extension? 300-90.8 Section 300-90.8 Public Contracts and Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS...

Doing More with Less: Marketing Educational Programs in Times of Declining Tuition Assistance.

ERIC Educational Resources Information Center

Breckon, Donald J.

Degree completion programs on military installations are large, effective programs, with substantial support. Education will never be more convenient or less expensive for students. Education is a product military personnel need and want. In a time of declining tuition assistance, it is up to colleges that deal with the military to market their…

The Use of a “Hybrid” Trainer in an Established Laparoscopic Skills Program

PubMed Central

Colsant, Brian J.; Lynch, Paul J.; Herman, Björn; Klonsky, Jonathan; Young, Steven M.

2006-01-01

Objectives: Tabletop inanimate trainers have proven to be a safe, inexpensive, and convenient platform for developing laparoscopic skills. Historically, programs that utilize these trainers rely on subjective evaluation of errors and time as the only measures of performance. Virtual reality simulators offer more extensive data collection capability, but they are expensive and lack realism. This study reviews a new electronic proctor (EP), and its performance within the Rosser Top Gun Laparoscopic Skills and Suturing Program. This “hybrid” training device seeks to capture the strengths of both platforms by providing an affordable, reliable, realistic training arena with metrics to objectively evaluate performance. Methods: An electronic proctor was designed for use in conjunction with drills from the Top Gun Program. The tabletop trainers used were outfitted with an automated electromechanically monitored task arena. Subjects performed 10 repetitions of each of 3 drills: “Cup Drop,” “Triangle Transfer,” and “Intracorporeal Suturing.” In real time, this device evaluates for instrument targeting accuracy, economy of motion, and adherence to the rules of the exercises. A buzzer and flashing light serve to alert the student to inaccuracies and breaches of the defined skill transference parameters. Results: Between July 2001 and June 2003, 117 subjects participated in courses. Seventy-three who met data evaluation criteria were assessed and compared with 744 surgeons who had previously taken the course. The total time to complete each task was significantly longer with the EP in place. The Cup Drop drill with the EP had a mean total time of 1661 seconds (average, 166.10) with 54.49 errors (average, 5.45) vs. 1252 seconds (average, 125.2) without the EP (P=0.000, t=6.735, df=814). The Triangle Transfer drill mean total time was 556 seconds (average, 55.63) and 167.57 errors (average. 16.75) (EP) vs. 454 seconds (non-EP) (average. 45.4) (P=0.000, t=4.447, df=814). The mean total times of the suturing task was 1777 seconds (average, 177.73) and 90.46 errors (average. 9.04) (EP) vs. 1682 seconds (non-EP) (average, 168.2) (P=0.040, t=1.150, df=814). When compared with surgeons who had participated in the Top Gun course prior to EP, the participants in the study collectively scored in the 18.3th percentile with the Cup Drop drill, 22.6th percentile with the Triangle Transfer drill, and 36.7th percentile with the Intracorporeal Suturing exercise. When penalizing for errors recorded by the EP, participants scored collectively in the 9.9th, 0.1th, and 17.7th percentile, respectively. No equipment failures occurred, and the agenda of the course did not have to be modified to accommodate the new platform. Conclusions: The EP utilized during the Top Gun Course was introduced without modification of the core curriculum and experienced no device failures. This hybrid trainer offers a cost-effective inanimate simulator that brings quality performance monitoring to traditional inanimate trainers. It appears that the EP influenced student performance by alerting them to errors made, thus causing an increased awareness of and focus on precision and accuracy. This suggests that the EP could have internal guidance capabilities. However, validation studies must be done in the future. PMID:16709348

28 CFR 94.33 - Investigation and analysis of claims.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Investigation and analysis of claims. 94.33 Section 94.33 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Program Administration § 94.33 Investigation and...

28 CFR 94.33 - Investigation and analysis of claims.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Investigation and analysis of claims. 94.33 Section 94.33 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Program Administration § 94.33 Investigation and...

28 CFR 94.33 - Investigation and analysis of claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Investigation and analysis of claims. 94.33 Section 94.33 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Program Administration § 94.33 Investigation and...

28 CFR 94.33 - Investigation and analysis of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Investigation and analysis of claims. 94.33 Section 94.33 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Program Administration § 94.33 Investigation and...

28 CFR 94.33 - Investigation and analysis of claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Investigation and analysis of claims. 94.33 Section 94.33 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Program Administration § 94.33 Investigation and...

41 CFR 105-60.305-1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... duplicating machinery. Overhead expenses such as costs of space, and heating or lighting the facility where... a FOIA request. Copies can take the form of paper, microform audiovisual materials, or magnetic... which operates a program or programs of scholarly research. (h) The term noncommercial scientific...

41 CFR 105-60.305-1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... duplicating machinery. Overhead expenses such as costs of space, and heating or lighting the facility where... a FOIA request. Copies can take the form of paper, microform audiovisual materials, or magnetic... which operates a program or programs of scholarly research. (h) The term noncommercial scientific...

41 CFR 105-60.305-1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... duplicating machinery. Overhead expenses such as costs of space, and heating or lighting the facility where... a FOIA request. Copies can take the form of paper, microform audiovisual materials, or magnetic... which operates a program or programs of scholarly research. (h) The term noncommercial scientific...

41 CFR 105-60.305-1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... duplicating machinery. Overhead expenses such as costs of space, and heating or lighting the facility where... a FOIA request. Copies can take the form of paper, microform audiovisual materials, or magnetic... which operates a program or programs of scholarly research. (h) The term noncommercial scientific...

On Dark Times, Parallel Universes, and Deja Vu.

ERIC Educational Resources Information Center

Starnes, Bobby Ann

2000-01-01

Effectiveness cannot be found in the mediocrity arising from programs that require lessons, teaching strategies, and precisely executed materials to ensure integrity. Expensive, scripted programs like Success for All are designed not to improve teaching, but to render the art of teaching unnecessary. (MLH)

The elimination of healthcare user fees for children under five substantially alleviates the burden on household expenses in Burkina Faso.

PubMed

Abdou Illou, Mahaman Mourtala; Haddad, Slim; Agier, Isabelle; Ridde, Valéry

2015-08-08

Since September 2008, an intervention has made it possible to provide free care to children under five in public health facilities in two districts of Burkina Faso. This study evaluated the intervention's impact on household expenses incurred for services (consultations and medications) to the children targeted. The study is based on a survey of a representative panel of 1,260 households encountered in two waves, one month before and 12 months after the introduction of the intervention. The questions explored the illness episodes of all children under five in the 30 days before each wave. The analysis of health expenses incurred during an illness episode distinguished between total expenses and those incurred in public health facilities (charges for services and medications). Analyses based on multilevel simultaneous equation models were used to estimate the probability of spending and the amount spent, in a context where a large number of observations returned a count of zero. The burden on household expenses was greatly alleviated under the intervention. Average expenditure dropped from US$11 per episode of care to less than US$2 after the intervention was implemented. The risk of incurring an expense at a public health facility was reduced by two-thirds. The facility users' savings were primarily related to medication purchases. In rural areas, where barriers to access health services are more acute, both poor and non-poor families benefited from the intervention. The probability of spending on medications dropped dramatically for both the poor and the non-poor under the exemption (-75% vs.-77%), and the reduction in expenses for medications generated by the intervention was comparable for both groups in relative values (-86% vs.-89%). User fees abolition at the point of service substantially alleviated the burden on household expenses. The intervention benefited both poor and non-poor families and provided financial protection.

Payment system reform: one state's journey.

PubMed

Millwee, Billy; Goldfield, Norbert; Averill, Richard; Hughes, John

2013-01-01

In June 2011, Texas enacted Senate Bill 7, which mandates a Medicaid quality-based outcomes payment program on the basis of a common set of outcomes that apply to all types of provider systems including hospitals, managed care plans, medical homes, managed long-term care plans, and Accountable Care Organizations. The quality-based outcome measures focus on potentially preventable events (services) such as preventable admissions and readmissions that result in unnecessary expense, patient inconvenience, and risk of complications. The payment adjustments relate to a provider system's effectiveness in reducing the rate at which potentially preventable events occur. The program envisioned by Texas Medicaid is one that is administratively simple, establishes the right financial incentives to drive delivery system improvement, and does not intrude on the provider practice or the patient. Rather than imposing a series of processes that must be followed or require rigid adherence to standardized protocols, the payment adjustments are based on risk-adjusted comparisons of the rate of potentially preventable events for an individual provider systems to an empirically derived performance standard such as the state average. This article proposes a payment system design that can meet the ambitious objectives of the Texas legislation.

EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010-11.

PubMed

Brenzel, Logan; Schütte, Carl; Goguadze, Keti; Valdez, Werner; Le Gargasson, Jean-Bernard; Guthrie, Teresa

2016-02-01

Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27-95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking. Project HOPE—The People-to-People Health Foundation, Inc.

Trends in the Newspaper Budget.

ERIC Educational Resources Information Center

Simon, Kathryn; Bishop, Robert L.

Using data published by "Editor & Publisher," annual reports, and confidential material made available by publishers, this paper examines budgets for papers of varying sizes from 1947 to 1974. While expenses have been increasing more rapidly than revenue since 1947, newspapers are above average in rate of return on revenue. Earnings of 15% after…

When Average Is Not Good Enough: Students with Learning Disabilities at Selective, Private Colleges

ERIC Educational Resources Information Center

Weis, Robert; Erickson, Celeste P.; Till, Christina H.

2017-01-01

Adolescents with learning disabilities disproportionately come from lower socioeconomic status backgrounds, show normative deficits in academic skills, and attend 2-year, public colleges instead of 4-year institutions. However, students with learning disabilities are well represented at the United States' most expensive and selective postsecondary…

Wellness programs: a remedy for reducing healthcare costs.

PubMed

Kocakulah, Mehmet C; Joseforsky, Holly

2002-01-01

Offering wellness programs has become a popular method for preserving the health of employees in the hope of generating lower healthcare expenses and, in turn, higher profits. This article offers a cost/benefits analysis of providing wellness programs, to determine whether such programs could add value to a company. Recommendations follow for how to implement a successful wellness program with minimal initial costs should an analysis find that wellness initiatives would prove beneficial.

[Healthcare expenses of Brazilian families living in metropolitan areas: composition and trends during the period from 1995 to 2009].

PubMed

Garcia, Leila Posenato; Sant'Anna, Ana Cláudia; Magalhães, Luís Carlos Garcia de; Aurea, Adriana Pacheco

2013-01-01

Private health insurance plans represent a significant proportion of total health spending in Brazil. In order to establish the evolution and composition of spending on health among families living in metropolitan areas, Family Budget Research findings conducted in 1995-1996, 2002-2003, and 2008-2009 were studied. The categories of spending were standardized and values were adjusted by the Broad Consumer Price Index in order to compare the findings. In the period from 1995 to 2009, average family spending on health fell from R$ 194.68 to R$ 179.01. The components that most contributed to the reduction were dental care, medical consultations and other spending on health. Private health insurance was the component with the greatest increase in participation in relation to total spending - from 29% to 44% - and the highest increase in average spending, from R$ 56.50 to R$ 78.62. The reduction of average spending on health occurred mainly among lower income families, whereas these figures remained stable among families with higher incomes. Family health spending became less regressive, since lower income families began to commit a lower proportion of their income for these expenses, while the opposite was observed in families with higher incomes.

Non-evidence-based policy: how effective is China's new cooperative medical scheme in reducing medical impoverishment?

PubMed

Yip, Winnie; Hsiao, William C

2009-01-01

In recent years, many lower to middle income countries have looked to insurance as a means to protect their populations from medical impoverishment. In 2003, the Chinese government initiated the New Cooperative Medical System (NCMS), a government-run voluntary insurance program for its rural population. The prevailing model of NCMS combines medical savings accounts with high-deductible catastrophic hospital insurance (MSA/Catastrophic). To assess the effectiveness of this approach in reducing medical impoverishment, we used household survey data from 2006 linked to claims records of health expenditures to simulate the effect of MSA/Catastrophic on reducing the share of individuals falling below the poverty line (headcount), and the amount by which household resources fall short of the poverty line (poverty gap) due to medical expenses. We compared the effects of MSA/Catastrophic to Rural Mutual Health Care (RMHC), an experimental model that provides first dollar coverage for primary care, hospital services and drugs with a similar premium but a lower ceiling. Our results show that RMHC is more effective at reducing medical impoverishment than NCMS. Under the internationally accepted poverty line of US$1.08 per person per day, the MSA/Catastrophic models would reduce the poverty headcount by 3.5-3.9% and the average poverty gap by 11.8-16.4%, compared with reductions of 6.1-6.8% and 15-18.5% under the RMHC model. The primary reason for this is that NCMS does not address a major cause of medical impoverishment: expensive outpatient services for chronic conditions. As such, health policymakers need first to examine the disease profile and health expenditure pattern of a population before they can direct resources to where they will be most effective. As chronic diseases impose a growing share of the burden on the population in developing countries, it is not necessarily true that insurance coverage focusing on expensive hospital care alone is the most effective at providing financial risk protection.

An online community improves adherence in an internet-mediated walking program. Part 1: results of a randomized controlled trial.

PubMed

Richardson, Caroline R; Buis, Lorraine R; Janney, Adrienne W; Goodrich, David E; Sen, Ananda; Hess, Michael L; Mehari, Kathleen S; Fortlage, Laurie A; Resnick, Paul J; Zikmund-Fisher, Brian J; Strecher, Victor J; Piette, John D

2010-12-17

Approximately half of American adults do not meet recommended physical activity guidelines. Face-to-face lifestyle interventions improve health outcomes but are unlikely to yield population-level improvements because they can be difficult to disseminate, expensive to maintain, and inconvenient for the recipient. In contrast, Internet-based behavior change interventions can be disseminated widely at a lower cost. However, the impact of some Internet-mediated programs is limited by high attrition rates. Online communities that allow participants to communicate with each other by posting and reading messages may decrease participant attrition. Our objective was to measure the impact of adding online community features to an Internet-mediated walking program on participant attrition and average daily step counts. This randomized controlled trial included sedentary, ambulatory adults who used email regularly and had at least 1 of the following: overweight (body mass index [BMI] ≥ 25), type 2 diabetes, or coronary artery disease. All participants (n = 324) wore enhanced pedometers throughout the 16-week intervention and uploaded step-count data to the study server. Participants could log in to the study website to view graphs of their walking progress, individually-tailored motivational messages, and weekly calculated goals. Participants were randomized to 1 of 2 versions of a Web-based walking program. Those randomized to the "online community" arm could post and read messages with other participants while those randomized to the "no online community" arm could not read or post messages. The main outcome measures were participant attrition and average daily step counts over 16 weeks. Multiple regression analyses assessed the effect of the online community access controlling for age, sex, disease status, BMI, and baseline step counts. Both arms significantly increased their average daily steps between baseline and the end of the intervention period, but there were no significant differences in increase in step counts between arms using either intention-to-treat or completers analysis. In the intention-to-treat analysis, the average step count increase across both arms was 1888 ± 2400 steps. The percentage of completers was 13% higher in the online community arm than the no online community arm (online community arm, 79%, no online community arm, 66%, P = .02). In addition, online community arm participants remained engaged in the program longer than no online community arm participants (hazard ratio = 0.47, 95% CI = 0.25 - 0.90, P = .02). Participants with lower baseline social support posted more messages to the online community (P < .001) and viewed more posts (P < .001) than participants with higher baseline social support. Adding online community features to an Internet-mediated walking program did not increase average daily step counts but did reduce participant attrition. Participants with low baseline social support used the online community features more than those with high baseline social support. Thus, online communities may be a promising approach to reducing attrition from online health behavior change interventions, particularly in populations with low social support. NCT00729040; http://clinicaltrials.gov/ct2/show/NCT00729040 (Archived by WebCite at http://www.webcitation.org/5v1VH3n0A).

75 FR 10492 - Tribal Self-Governance Program; Negotiation Cooperative Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

...-2010-IHS-TSGN-0001] Tribal Self-Governance Program; Negotiation Cooperative Agreement Announcement Type... Description The purpose of the Negotiation Cooperative Agreement is to provide resources to Tribes interested... Negotiation Cooperative Agreement provides a Tribe with funds to help cover the expenses involved in preparing...

English in the Workplace at Mohawk College.

ERIC Educational Resources Information Center

Jones, Jim

1982-01-01

Two different projects in ESL training for immigrant workers, one for a garment company and one for metal workers in a turbine plant, are described and compared. The programs were for Indochinese and Eastern Europeans, respectively, and involved no unions. Extensive preparation made both programs expensive. (MSE)

5 CFR 1303.30 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... included in direct costs are overhead expenses such as costs of space, and heating or lighting the facility... request. Such copies can take the form of paper, microform, audio-visual materials, or electronic records... institution of vocational education, that operates a program or programs of scholarly research. (i) The term...

5 CFR 2502.11 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... included in direct costs are overhead expenses such as costs of space, and heating or lighting the facility... FOIA request. Such copies can take the form of paper copy, microform, audio-visual materials, or... operates a program or programs of scholarly research. (i) The term non-commercial scientific institution...

5 CFR 2502.11 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... included in direct costs are overhead expenses such as costs of space, and heating or lighting the facility... FOIA request. Such copies can take the form of paper copy, microform, audio-visual materials, or... operates a program or programs of scholarly research. (i) The term non-commercial scientific institution...

5 CFR 2502.11 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... included in direct costs are overhead expenses such as costs of space, and heating or lighting the facility... FOIA request. Such copies can take the form of paper copy, microform, audio-visual materials, or... operates a program or programs of scholarly research. (i) The term non-commercial scientific institution...

5 CFR 1303.30 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... included in direct costs are overhead expenses such as costs of space, and heating or lighting the facility... request. Such copies can take the form of paper, microform, audio-visual materials, or electronic records... institution of vocational education, that operates a program or programs of scholarly research. (i) The term...

11 CFR 4.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... duplicating equipment. Direct costs do not include overhead expenses such as the cost of space and heating or... request. Examples of the form such copies can take include, but are not limited to, paper copy, microform... an institution of vocational education, which operates a program or programs of scholarly research...

11 CFR 4.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... duplicating equipment. Direct costs do not include overhead expenses such as the cost of space and heating or... request. Examples of the form such copies can take include, but are not limited to, paper copy, microform... an institution of vocational education, which operates a program or programs of scholarly research...

5 CFR 2411.13 - Fees.

Code of Federal Regulations, 2012 CFR

2012-01-01

... duplicating machinery. Not included in direct costs are overhead expenses such as costs of space, and heating... a FOIA request. Such copies can take the form of paper copy, microfilm, audio-visual materials, or... vocational education, which operates a program or programs of scholarly research. (7) The term non-commercial...

5 CFR 1303.30 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... included in direct costs are overhead expenses such as costs of space, and heating or lighting the facility... request. Such copies can take the form of paper, microform, audio-visual materials, or electronic records... institution of vocational education, that operates a program or programs of scholarly research. (i) The term...

12 CFR 1402.20 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... costs are overhead expenses such as costs of space, and heating or lighting the facility in which the... operates a program or programs of scholarly research. (d) Noncommercial scientific institution refers to an... purpose of conducting scientific research, the results of which are not intended to promote any particular...

5 CFR 2411.13 - Fees.

Code of Federal Regulations, 2014 CFR

2014-01-01

... duplicating machinery. Not included in direct costs are overhead expenses such as costs of space, and heating... a FOIA request. Such copies can take the form of paper copy, microfilm, audio-visual materials, or... vocational education, which operates a program or programs of scholarly research. (7) The term non-commercial...

11 CFR 4.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... duplicating equipment. Direct costs do not include overhead expenses such as the cost of space and heating or... request. Examples of the form such copies can take include, but are not limited to, paper copy, microform... an institution of vocational education, which operates a program or programs of scholarly research...

12 CFR 1402.20 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... costs are overhead expenses such as costs of space, and heating or lighting the facility in which the... operates a program or programs of scholarly research. (d) Noncommercial scientific institution refers to an... purpose of conducting scientific research, the results of which are not intended to promote any particular...

5 CFR 2411.13 - Fees.

Code of Federal Regulations, 2013 CFR

2013-01-01

... duplicating machinery. Not included in direct costs are overhead expenses such as costs of space, and heating... a FOIA request. Such copies can take the form of paper copy, microfilm, audio-visual materials, or... vocational education, which operates a program or programs of scholarly research. (7) The term non-commercial...

11 CFR 4.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... duplicating equipment. Direct costs do not include overhead expenses such as the cost of space and heating or... request. Examples of the form such copies can take include, but are not limited to, paper copy, microform... an institution of vocational education, which operates a program or programs of scholarly research...

12 CFR 1402.20 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... costs are overhead expenses such as costs of space, and heating or lighting the facility in which the... operates a program or programs of scholarly research. (d) Noncommercial scientific institution refers to an... purpose of conducting scientific research, the results of which are not intended to promote any particular...

7 CFR 235.3 - Administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Administration. 235.3 Section 235.3 Agriculture... CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.3 Administration. (a) Within the Department, FNS shall act on behalf of the Department in the administration of the program for payment to...

7 CFR 235.3 - Administration.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 4 2012-01-01 2012-01-01 false Administration. 235.3 Section 235.3 Agriculture... CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.3 Administration. (a) Within the Department, FNS shall act on behalf of the Department in the administration of the program for payment to...

7 CFR 235.3 - Administration.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Administration. 235.3 Section 235.3 Agriculture... CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.3 Administration. (a) Within the Department, FNS shall act on behalf of the Department in the administration of the program for payment to...

7 CFR 235.3 - Administration.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Administration. 235.3 Section 235.3 Agriculture... CHILD NUTRITION PROGRAMS STATE ADMINISTRATIVE EXPENSE FUNDS § 235.3 Administration. (a) Within the Department, FNS shall act on behalf of the Department in the administration of the program for payment to...

[Cost-effectiveness of the HIV screening program carried out in Guangxi Zhuang Autonomous Region infectious disease special demonstration project areas].

PubMed

Lu, Huaxiang; Luo, Liuhong; Chen, Li; Zhang, Shizhen; Liang, Yingfang; Li, Li; Chen, Zhenqiang; Huo, Xiaoxing; Wu, Xinghua

2015-06-01

To analyze the cost effectiveness of HIV screening project in three Guangxi infectious disease special demonstration project countries in 2013. To calculate the funds used for the HIV screening project and to study the data on HIV/AIDS and HAART. A five-tree markov model was used to evaluate the quality adjusted life year (QALY) of this HIV screening project and to analyze the related cost effectiveness of the project. The cost of HIV screening in Guangxi infectious disease special demonstration project areas was 19.205 million Yuan and having identified 1 218 HIV/AIDS patients. The average costs for HIV/AIDS positive detection in three project countries were 14.562, 18.424 and 14.042 thousand Yuan per case. The QALYs gained from finding a HIV/AIDS case were 12.736, 8.523 and 8.321 on average, with the total number of QALYs gained from the project as 5 973.184, 3 613.752 and 2 704.325. The overall cost effectiveness ratio of the project was 1.562 thousand Yuan per QALY, and 1.143, 2.162 and 1.688 thousand Yuan per QALY in these three project countries. Project country "A" showed better cost effectiveness index than country B and C. The HIV screening project in Guangxi seemed relatively cost-effective but the average cost of HIV/AIDS positive detection was expensive. To strengthen HAART work for HIV/AIDS could improve the cost-effective of the project.

Impact of trained oncology financial navigators on patient out-of-pocket spending.

PubMed

Yezefski, Todd; Steelquist, Jordan; Watabayashi, Kate; Sherman, Dan; Shankaran, Veena

2018-03-01

Patients with cancer often face financial hardships, including loss of productivity, high out-of-pocket (OOP) costs, depletion of savings, and bankruptcy. By providing financial guidance and assistance through specially trained navigators, hospitals and cancer care clinics may be able mitigate the financial burdens to patients and also minimize financial losses for the treating institutions. Financial navigators at 4 hospitals were trained through The NaVectis Group, an organization that provides training to healthcare staff to increase patient access to care and assist with OOP expenses. Data regarding financial assistance and hospital revenue were collected after instituting these programs. Amount and type of assistance (free medication, new insurance enrollment, premium/co-pay assistance) were determined annually for all qualifying patients at the participating hospitals. Of 11,186 new patients with cancer seen across the 4 participating hospitals between 2012 and 2016, 3572 (32%) qualified for financial assistance. They obtained $39 million in total financial assistance, averaging $3.5 million per year in the 11 years under observation. Patients saved an average of $33,265 annually on medication, $12,256 through enrollment in insurance plans, $35,294 with premium assistance, and $3076 with co-pay assistance. The 4 hospitals were able to avoid write-offs and save on charity care by an average of $2.1 million per year. Providing financial navigation training to staff at hospitals and cancer centers can significantly benefit patients through decreased OOP expenditures and also mitigate financial losses for healthcare institutions.

Economics of new oncology drug development.

PubMed

DiMasi, Joseph A; Grabowski, Henry G

2007-01-10

Review existing studies and provide new results on the development, regulatory, and market aspects of new oncology drug development. We utilized data from the US Food and Drug Administration (FDA), company surveys, and publicly available commercial business intelligence databases on new oncology drugs approved in the United States and on investigational oncology drugs to estimate average development and regulatory approval times, clinical approval success rates, first-in-class status, and global market diffusion. We found that approved new oncology drugs to have a disproportionately high share of FDA priority review ratings, of orphan drug designations at approval, and of drugs that were granted inclusion in at least one of the FDA's expedited access programs. US regulatory approval times were shorter, on average, for oncology drugs (0.5 years), but US clinical development times were longer on average (1.5 years). Clinical approval success rates were similar for oncology and other drugs, but proportionately more of the oncology failures reached expensive late-stage clinical testing before being abandoned. In relation to other drugs, new oncology drug approvals were more often first-in-class and diffused more widely across important international markets. The market success of oncology drugs has induced a substantial amount of investment in oncology drug development in the last decade or so. However, given the great need for further progress, the extent to which efforts to develop new oncology drugs will grow depends on future public-sector investment in basic research, developments in translational medicine, and regulatory reforms that advance drug-development science.

State-of-the-art software for window energy-efficiency rating and labeling

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

Arasteh, D.; Finlayson, E.; Huang, J.

1998-07-01

Measuring the thermal performance of windows in typical residential buildings is an expensive proposition. Not only is laboratory testing expensive, but each window manufacturer typically offers hundreds of individual products, each of which has different thermal performance properties. With over a thousand window manufacturers nationally, a testing-based rating system would be prohibitively expensive to the industry and to consumers. Beginning in the early 1990s, simulation software began to be used as part of a national program for rating window U-values. The rating program has since been expanded to include Solar Hear Gain Coefficients and is now being extended to annualmore » energy performance. This paper describes four software packages available to the public from Lawrence Berkeley National Laboratory (LBNL). These software packages are used to evaluate window thermal performance: RESFEN (for evaluating annual energy costs), WINDOW (for calculating a product`s thermal performance properties), THERM (a preprocessor for WINDOW that determines two-dimensional heat-transfer effects), and Optics (a preprocessor for WINDOW`s glass database). Software not only offers a less expensive means than testing to evaluate window performance, it can also be used during the design process to help manufacturers produce windows that will meet target specifications. In addition, software can show small improvements in window performance that might not be detected in actual testing because of large uncertainties in test procedures.« less

School Choice: Private School Choice Programs Are Growing and Can Complicate Providing Certain Federally Funded Services to Eligible Students. Report to Congressional Requesters. GAO-16-712

ERIC Educational Resources Information Center

US Government Accountability Office, 2016

2016-01-01

Voucher and education savings account (ESA) programs fund students' private school education expenses, such as tuition. In school year 2014-15, 22 such school choice programs were operating nationwide, all but one of which was state funded. Under two federal grant programs, one for students with disabilities and one for students from disadvantaged…

The advisability of prototypic testing for space nuclear systems

NASA Astrophysics Data System (ADS)

Lenard, Roger X.

2005-07-01

From October 1987 until 1993, the US Department of Defense conducted the Space Nuclear Thermal Propulsion program. This program's objective was to design and develop a high specific impulse, high thrust-to-weight nuclear thermal rocket engine for upper stage applications. The author was the program manager for this program until 1992. Numerous analytical, programmatic and experimental results were generated during this period of time. This paper reviews the accomplishments of the program and highlights the importance of prototypic testing for all aspects of a space nuclear program so that a reliable and safe system compliant with all regulatory requirements can be effectively engineered. Specifically, the paper will recount how many non-prototypic tests we performed only to have more representative tests consistently generate different results. This was particularly true in area of direct nuclear heat generation. As nuclear tests are generally much more expensive than non-nuclear tests, programs attempt to avoid such tests in favor of less expensive non-nuclear tests. Each time this approach was followed, the SNTP program found these tests to not be verified by nuclear heated testing. Hence the author recommends that wherever possible, a spiral development approach that includes exploratory and confirmatory experimental testing be employed to ensure a viable design.

Postprostatectomy urinary incontinence: a comparison of the cost of conservative versus surgical management.

PubMed

Brown, J A; Elliott, D S; Barrett, D M

1998-05-01

Post-radical prostatectomy stress incontinence occurs in up to 20% of patients. Postprostatectomy incontinence is initially treated with undergarments, pads, or drip collectors. Patients with persistent leakage are often treated with a transurethral bulking agent (Contigen) or placement of an artificial genitourinary sphincter (AGUS). We have compared the direct costs of each treatment at our institution over 10 years. The Mayo Clinic estimating office provided the Medicare and non-Medicare charges for patients receiving both collagen injection (outpatient) and AGUS placement (2-day hospitalization) during August 1995. The Mayo Store provided the current price of all undergarments, pads, and drip collectors carried. Two local grocery stores provided the cost of Depends undergarments. The following items were the least expensive carried at the Mayo Clinic Store: Entrust undergarments, Active Style pads, and Conveen drip collectors at $0.99, $0.52, $1.05 each, respectively. The average cost of Depends undergarments was $0.52 each. The cost of wearing 5 of the least expensive undergarments or pads per day for 10 years is $9497. The average estimated Medicare and non-Medicare cost for outpatient (general anesthesia) collagen injection is $4300 and $5625, respectively. The average Medicare and non-Medicare cost for AGUS placement is $15,400 and $20,300, respectively. Factoring in our current 22.4% reoperation rate, the average per patient Medicare and non-Medicare cost for AGUS placement is $18,850 and $24,847, respectively. The cost of the AGUS placement compares favorably with the cost of transurethral collagen injection (under general anesthesia) in patients requiring several (more than three) collagen injection treatments or requiring the continued use of undergarments after collagen injection. Whereas the cost of transurethral collagen injection, when effective, compares favorably with conservative treatment, AGUS placement is significantly more expensive than conservative management for almost all patients except the exceedingly rare patient wearing more than 9 undergarments or pads per day. When the psychosocial benefit of urinary continence is considered, however, transurethral injection of collagen or AGUS placement often becomes the preferred treatment.

76 FR 75509 - Autopsies at VA Expense

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-02

... Administrative practice and procedure; Alcohol abuse; Alcoholism; Claims; Day care; Dental health; Drug abuse...; Health professions; Health records; Homeless; Mental health programs; Nursing homes; Philippines...

Algunos aspectos sicolinguisticos de la Instruccion Programada en el laboratorio de idiomas (Some Psycholinguistic Aspects of Programed Instruction in the Language Laboratory).

ERIC Educational Resources Information Center

Monteverde G., Luisa

1971-01-01

This paper presents ideas on using programed instruction in the language laboratory for second language learning. Linear programing is more suited to language instruction than is branching, because the former more easily allows comparison between the students' and teachers' solutions and is technically less complicated and less expensive to…

Wisconsin Elementary Teacher Education Project. Volume VI, Feasibility Study: Pricing and Economic Analysis Study. Final Report.

ERIC Educational Resources Information Center

Wisconsin Univ., Madison.

This document is the second volume of the feasibility study report for the Wisconsin Elementary Teacher Education Project. It provides in part 1 data on program, planning and budgeting, including cost figures for preparing students in the present and new programs, marginal expenses, and costs for implementing the program on other campuses. Part 2…

The Fiscal Impact of the Kentucky Education Tax Credit Program

ERIC Educational Resources Information Center

Gottlob, Brian J.

2006-01-01

This study examines the fiscal impact of a proposal to create a personal tax credit for educational expenses and a tax-credit scholarship program in Kentucky. It finds that the actual fiscal impact of the program would be much less than its nominal dollar size, due to the reduced public school costs resulting from migration of students from public…

41 CFR 300-90.5 - What factors will GSA consider in approving a request for a telework travel test program?

Code of Federal Regulations, 2014 CFR

2014-07-01

... consider in approving a request for a telework travel test program? 300-90.5 Section 300-90.5 Public Contracts and Property Management Federal Travel Regulation System GENERAL AGENCY REQUIREMENTS 90-TELEWORK TRAVEL EXPENSES TEST PROGRAMS § 300-90.5 What factors will GSA consider in approving a request for a...

The Cost of Getting Into Orthopedic Residency: Analysis of Applicant Demographics, Expenditures, and the Value of Away Rotations.

PubMed

Camp, Christopher L; Sousa, Paul L; Hanssen, Arlen D; Karam, Matthew D; Haidukewych, George J; Oakes, Daniel A; Turner, Norman S

2016-01-01

Little is known about the demographics and expenditures of applicants attempting to match into the competitive field of orthopedic surgery. In attempt to better inform potential applicants, the purposes of this work are to (1) better understand the demographics of successfully matched applicants, (2) determine the monetary cost of applying, and (3) assess the value of away rotations for improving chances of a successful match. Prospective comparative survey. Mayo Clinic Department of Orthopedic Surgery, Rochester, MN. A week following the 2015 Orthopedic Surgery Residency Match, a survey was sent to 1,091. The survey focused on applicant demographics, number of programs applied to, cost of applying, and the value of away rotations. A total of 408 applicants completed the survey (response rate = 37%). Of these, 312 (76%) matched and 96 (24%) did not match into a US Orthopedic Surgery Residency. Of the matched applicants, 300 (96%) were from US allopathic medical schools, 9 (3%) US Osteopathic Schools, and 3 (1%) were international graduates. Males comprised 84% of these applicants whereas 16% were female. The mean number of programs applied to was 71 (range: 20-140). On average, applicants were offered 16 interviews (range: 1-53) and they attended 11 (range: 0-12). Completing a rotation at a program increased an applicant׳s chances of matching into that program by a factor of 1.5 (60% vs 40%). Of the applicants who matched, most applicants matched to an orthopedic residency in the same region where the applicant attended medical school (58%). The average cost of the application was $1,664 (range: $100-$5,000) whereas the cost of interviews (travel, food, etc.) was $3,656 (range: $15-$20,000). Total expenditures ranged from $450 to $25,000 (mean = $5,415). Over 8% of matched applicants spent >$10,000. Gaining acceptance into orthopedic surgery residency remains a very competitive process. Away rotations appear to correlate strongly with match status; however, the process remains quite expensive for applicants. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

How much do Manhattan-arrestees spend on drugs?

PubMed

Golub, Andrew; Johnson, Bruce D

2004-12-07

Information about individuals' drug expenses can indicate much about the size of drug markets, the financial burden of use, drug-related crime, and potential challenges for treatment. Most often, expenses have been estimated holistically by asking respondents to report how much they spent. In 2000, the Arrestee Drug Abuse Monitoring (ADAM) program introduced an advanced questionnaire using a series of highly specific questions like, "how much cash did you pay for crack that last time you bought it?" This paper describes a procedure for estimating arrestees' drug expenses with the new ADAM questionnaire, discusses pitfalls in interpretation, presents findings for 2979 ADAM-Manhattan respondents interviewed 2000-2002, examines covariates of drug expense, and compares the 2000-2002 findings with those obtained from 2256 respondents interviewed 1998-1999 with the previous questionnaire. Among 2000-2002 arrestees, median drug expense in the past 30 days varied widely with frequency of use and drug-user type. Infrequent marijuana-only users spent as little as $5, daily marijuana-only users spent about $600. Arrestees that used both heroin and cocaine spent over $1000. Estimates with the 1998-1999 data were about half as large. ADAM's new drug market questions may greatly advance the quality of estimates of drug expenses. However, further research is needed to better establish the estimator's accuracy.

75 FR 17930 - Privacy Act of 1974; Report of an Altered System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... Training Program; Section 409(b) of the Health Professions Educational Assistance Act of 1976, (42 U.S.C..., performance awards, and adverse or disciplinary actions); commercial credit reports, educational data including tuition and other related education expenses; educational data including academic program and...

20 CFR 626.5 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... apply as appropriate to programs under titles I, II, and III of the Act: Accrued expenditures means charges made to the JTPA program. Expenditures are the sum of actual cash disbursements, the amount of indirect expense incurred, and the net increase (or decrease) in the amounts owed by the recipient for the...

20 CFR 626.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... apply as appropriate to programs under titles I, II, and III of the Act: Accrued expenditures means charges made to the JTPA program. Expenditures are the sum of actual cash disbursements, the amount of indirect expense incurred, and the net increase (or decrease) in the amounts owed by the recipient for the...

20 CFR 626.5 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... apply as appropriate to programs under titles I, II, and III of the Act: Accrued expenditures means charges made to the JTPA program. Expenditures are the sum of actual cash disbursements, the amount of indirect expense incurred, and the net increase (or decrease) in the amounts owed by the recipient for the...

Corporate Financial Assistance for Child Care. The Conference Board Research Bulletin No. 177.

ERIC Educational Resources Information Center

Friedman, Dana

Described are four different corporate initiatives that help employees pay for work-related child care expenses: vouchers, discounts, flexible benefit programs and comprehensive cafeteria plans, and flexible spending accounts with salary reduction. Several other options, such as corporate contributions to community programs, subsidizing on-site…

A Humanistic Approach to Emotional Risk Management.

ERIC Educational Resources Information Center

Rubendall, Robert L.

Adventure programs attempt to control or limit injuries in high-risk programming. This risk management has concentrated on the physical safety of participants at the expense of emotional and developmental security. In the zeal for accident-free statistics, a highly controlled, directive approach is created that treats individuals according to a…

26 CFR 1.482-3 - Methods to determine taxable income in connection with a transfer of tangible property.

Code of Federal Regulations, 2010 CFR

2010-04-01

... range. (4) Examples. The principles of this paragraph (b) are illustrated by the following examples..., marketing, advertising programs and services, (including promotional programs, rebates, and co-op... sold and operating expenses. (4) Examples. The following examples illustrate the principles of this...

Structured FORTRAN Preprocessor

NASA Technical Reports Server (NTRS)

Flynn, J. A.; Lawson, C. L.; Van Snyder, W.; Tsitsivas, H. N.

1985-01-01

SFTRAN3 supports structured programing in FORTRAN environment. Language intended particularly to support two aspects of structured programing -- nestable single-entry control structures and modularization and top-down organization of code. Code designed and written using these SFTRAN3 facilities have fewer initial errors, easier to understand and less expensive to maintain and modify.

"Mini", "Midi" and the Student.

ERIC Educational Resources Information Center

Edwards, Perry; Broadwell, Bruce

Mini- and midi-computers have been introduced into the computer science program at Sierra College to afford students more direct contact with computers. The college's administration combined with the Science and Business departments to share the expense and utilization of the program. The National Cash Register Century 100 and the Data General…

Everyone Eats for Free--Piloting Provision 2.

ERIC Educational Resources Information Center

Rivas, Dora

1994-01-01

The universal feeding program makes school lunches free for all students and uses the resultant increase in participation and reduction in paperwork expense to cover the loss in paid meals. In Brownsville, Texas, careful analysis of projected revenues and innovative marketing strategies have made the program a success. (MLF)

The Affordability Question

ERIC Educational Resources Information Center

LaFee, Scott

2012-01-01

Launching and sustaining a laptop initiative is an expensive proposition. For that reason, districts often begin with modest pilots or roll out programs incrementally, a grade or two at a time. These days, few, if any, public school districts have budgets to finance full-service 1-to-1 programs. Instead, some seek outside assistance. Private…

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

PubMed

Sasaki, Toshiyuki; Izawa, Masahiro; Okada, Yoshikazu

2015-01-01

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

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

I. W. Ginsberg

Multiresolutional decompositions known as spectral fingerprints are often used to extract spectral features from multispectral/hyperspectral data. In this study, the authors investigate the use of wavelet-based algorithms for generating spectral fingerprints. The wavelet-based algorithms are compared to the currently used method, traditional convolution with first-derivative Gaussian filters. The comparison analyses consists of two parts: (a) the computational expense of the new method is compared with the computational costs of the current method and (b) the outputs of the wavelet-based methods are compared with those of the current method to determine any practical differences in the resulting spectral fingerprints. The resultsmore » show that the wavelet-based algorithms can greatly reduce the computational expense of generating spectral fingerprints, while practically no differences exist in the resulting fingerprints. The analysis is conducted on a database of hyperspectral signatures, namely, Hyperspectral Digital Image Collection Experiment (HYDICE) signatures. The reduction in computational expense is by a factor of about 30, and the average Euclidean distance between resulting fingerprints is on the order of 0.02.« less

10 CFR 455.81 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... receive financial assistance for administrative expenses, a State must: (a) Have in place a State Plan... energy conservation measure grants, or technical assistance, program assistance, and marketing (where...

77 FR 38179 - Autopsies at VA Expense

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... 38 CFR Part 17 Administrative practice and procedure; Alcohol abuse; Alcoholism; Claims; Day care... care; Health facilities; Health professions; Health records; Homeless; Mental health programs; Nursing...

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

PubMed

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

2001-09-01

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

SU-E-T-614: Plan Averaging for Multi-Criteria Navigation of Step-And-Shoot IMRT

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

Guo, M; Gao, H; Craft, D

2015-06-15

Purpose: Step-and-shoot IMRT is fundamentally discrete in nature, while multi-criteria optimization (MCO) is fundamentally continuous: the MCO planning consists of continuous sliding across the Pareto surface (the set of plans which represent the tradeoffs between organ-at-risk doses and target doses). In order to achieve close to real-time dose display during this sliding, it is desired that averaged plans share many of the same apertures as the pre-computed plans, since dose computation for apertures generated on-the-fly would be expensive. We propose a method to ensure that neighboring plans on a Pareto surface share many apertures. Methods: Our baseline step-and-shoot sequencing methodmore » is that of K. Engel (a method which minimizes the number of segments while guaranteeing the minimum number of monitor units), which we customize to sequence a set of Pareto optimal plans simultaneously. We also add an error tolerance to study the relationship between the number of shared apertures, the total number of apertures needed, and the quality of the fluence map re-creation. Results: We run tests for a 2D Pareto surface trading off rectum and bladder dose versus target coverage for a clinical prostate case. We find that if we enforce exact fluence map recreation, we are not able to achieve much sharing of apertures across plans. The total number of apertures for all seven beams and 4 plans without sharing is 217. With sharing and a 2% error tolerance, this number is reduced to 158 (73%). Conclusion: With the proposed method, total number of apertures can be decreased by 42% (averaging) with no increment of total MU, when an error tolerance of 5% is allowed. With this large amount of sharing, dose computations for averaged plans which occur during Pareto navigation will be much faster, leading to a real-time what-you-see-is-what-you-get Pareto navigation experience. Minghao Guo and Hao Gao were partially supported by the NSFC (#11405105), the 973 Program (#2015CB856000) and the Shanghai Pujiang Talent Program (#14PJ1404500)« less

Effect of feeding protein supplements of differing degradability on omasal flow of microbial and undegraded protein.

PubMed

Reynal, S M; Broderick, G A; Ahvenjärvi, S; Huhtanen, P

2003-04-01

Ten ruminally cannulated lactating Holstein cows that were part of a larger trial studying the effects of feeding different proteins on milk production were used in a replicated 5 x 5 Latin square to quantify flows of microbial and rumen-undegradable protein (RUP) in omasal digesta. Cows were fed total mixed rations containing (dry matter basis) 44% corn silage, 22% alfalfa silage, 2% urea, and 31% concentrate. The basal diet contained 31% high-moisture corn; equal N from one of four protein supplements was added to the other diets at the expense of corn: 9% solvent soybean meal (SSBM), 10% expeller soybean meal (ESBM), 5.5% blood meal (BM), and 7% corn gluten meal (CGM). Omasal sampling was used to quantify total AA N (TAAN) and nonammonia N (NAN) flows from the rumen. Estimates of RUP were made from differences between total and microbial N flows, including a correction for RUP in the basal diet. Modifying a spectrophotometric assay improved total purine recovery from isolated bacteria and omasal samples and gave estimates of microbial TAAN and NAN flows that were similar to a standard HPLC method. Linear programming, based on AA patterns of the diet and isolated omasal bacteria and ruminal protozoa, appeared to overestimate microbial TAAN and NAN flows compared to the purine assays. Yields of microbial TAAN and NAN determined using any method was not affected by diet and averaged 32 to 35 g NAN per kilogram of organic matter truly digested in the rumen. On average, National Research Council (NRC) equations underpredicted microbial N flows by 152 g/d (vs. HPLC), 168 g/d (vs. spectrophotometry), and 244 g/d (vs. linear programming). Estimates of RUP (means from the HPLC and spectrophotometric methods) were: SSBM, 27%, ESBM, 45%, BM, 60%, and CGM, 73%. Except for CGM, RUP values averaged about 20 percentage units lower than those reported by the NRC.

Financial modelling of femtosecond laser-assisted cataract surgery within the National Health Service using a 'hub and spoke' model for the delivery of high-volume cataract surgery.

PubMed

Roberts, H W; Ni, M Z; O'Brart, D P S

2017-03-16

To develop financial models which offset additional costs associated with femtosecond laser (FL)-assisted cataract surgery (FLACS) against improvements in productivity and to determine important factors relating to its implementation into the National Health Service (NHS). FL platforms are expensive, in initial purchase and running costs. The additional costs associated with FL technology might be offset by an increase in surgical efficiency. Using a 'hub and spoke' model to provide high-volume cataract surgery, we designed a financial model, comparing FLACS against conventional phacoemulsification surgery (CPS). The model was populated with averaged financial data from 4 NHS foundation trusts and 4 commercial organisations manufacturing FL platforms. We tested our model with sensitivity and threshold analyses to allow for variations or uncertainties. The averaged weekly workload for cataract surgery using our hub and spoke model required either 8 or 5.4 theatre sessions with CPS or FLACS, respectively. Despite reduced theatre utilisation, CPS (average £433/case) was still found to be 8.7% cheaper than FLACS (average £502/case). The greatest associated cost of FLACS was the patient interface (PI) (average £135/case). Sensitivity analyses demonstrated that FLACS could be less expensive than CPS, but only if increased efficiency, in terms of cataract procedures per theatre list, increased by over 100%, or if the cost of the PI was reduced by almost 70%. The financial viability of FLACS within the NHS is currently precluded by the cost of the PI and the lack of knowledge regarding any gains in operational efficiency. 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/.

78 FR 26088 - Agency Information Collection Activities: Submission to OMB for a New Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... form relates to a budget or estimate of the legal fees, costs, and expenses that outside counsel would... average number of respondents, burden, and total annual cost appear below. The estimated number of... and the representations and certifications form. The NCUA estimated the total annual cost by...

Twenty Golden Opportunities To Enhance Student Learning: Use Them or Lose Them.

ERIC Educational Resources Information Center

Sponder, Barry

In an average classroom period, a teacher has twenty or more opportunities to interact with students and thereby influence learning outcomes. As such, teachers should use these opportunities to reinforce instruction or give positive corrective feedback. Typical methods used in schools emphasize error correction at the expense of calling attention…

Exploring Open Educational Resources for College Algebra

ERIC Educational Resources Information Center

Chiorescu, Marcela

2017-01-01

It is estimated that the average student spends around 1200 USD on books and supplies every school year; thus, textbook affordability has become more and more of a challenge for students. Replacing traditionally expensive learning resources with open educational resources (OER) can have a great impact in the reduction of cost for post-secondary…

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

PubMed

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

1993-01-01

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

Cost Analysis of an Office-based Surgical Suite

PubMed Central

LaBove, Gabrielle

2016-01-01

Introduction: Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead. Methods: A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates. Results: The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy. Conclusions: Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult. PMID:27536482

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

PubMed Central

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

1993-01-01

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

[Spending on private health insurance plans of Brazilian families: a descriptive study with data from the Family Budget Surveys 2002-2003 and 2008-2009].

PubMed

Garcia, Leila Posenato; Ocké-Reis, Carlos Octávio; de Magalhães, Luís Carlos Garcia; Sant'Anna, Ana Claudia; de Freitas, Lúcia Rolim Santana

2015-05-01

Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R$154.35 to R$183.97. The average spending on health insurance plans was greater with increasing household income, as well as portions of the family income and total expenditure committed to these expenses. Spending on health insurance is concentrated among higher-income families, for which it was the main component of total health expenditure.

24 CFR 200.54 - Project completion funding.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Requirements for Application, Commitment, and... project and to pay the initial service charge, carrying charges, and legal and organizational expenses...

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

PubMed

Krempel, G; Jarosz, C

1999-06-01

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

Affordability of adult HIV/AIDS treatment in developing countries: modelling price determinants for a better insight of the market functioning.

PubMed

Sagaon-Teyssier, Luis; Singh, Sauman; Dongmo-Nguimfack, Boniface; Moatti, Jean-Paul

2016-01-01

This study aims to provide a landscape of the global antiretroviral (ARV) market by analyzing the transactional data on donor-funded ARV procurement between 2003 and 2015, and the ARV price determinants. The data were obtained from the Global Price Reporting Mechanism (GPRM) managed by the AIDS Medicines and Diagnostics Service of the WHO, and it consists of information that covers approximately 80% of the total donor-funded adult ARV transactions procurement. ExWorks prices and procured quantities were standardized according to the guidelines in terms of yearly doses. Descriptive statistics on quantities and prices show the main trends of the ARV market. Ordinary least squares estimation was carried out for the whole sample, then stratified according to the type of supplier (originator and generic) and controlled for time and geographical fixed-effects. Given that analyses were carried out on a public dataset on ARV transactional prices from the GPRM, ethics are respected and consent was not necessary. Originator medicines are on average the least expensive in the sub-Saharan Africa region, where at the same time, generic medicines are on average the most expensive. By contrast, originator medicines are the most expensive in Europe and Central Asia, and generic medicines are the least expensive. In fact, the data suggest mixed strategies by ARV suppliers to exploit opportunities for profit maximization and to adapt to the specific conditions of market competition in each region. Our results also suggest that the expiration of patents is not sufficient to boost additional developments in generic competition (at least in the ARV market) and that formal or informal agreements between generic firms may de facto slow down or even reverse long-term trends towards price decreases. Our findings provide an improved understanding of the ARV market that can help countries strengthen policy measures to increase their bargaining power in price negotiations and the use of TRIPS flexibilities, with a special emphasis on negotiations with generic manufacturers.

Results-driven approach to improving quality and productivity

Treesearch

John Dramm

2000-01-01

Quality control (QC) programs do not often realize their full potential. Elaborate and expensive QC programs can easily get side tracked by the process of building a program with promises of “Someday, this will all pay off.” Training employees in QC methods is no guarantee that quality will improve. Several documented cases show that such activity-centered efforts...

34 CFR 403.173 - What expenses are allowable?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What... and newsletters; and (4) Transportation and child-care services for students necessary to ensure...

34 CFR 403.173 - What expenses are allowable?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What... and newsletters; and (4) Transportation and child-care services for students necessary to ensure...

34 CFR 403.173 - What expenses are allowable?

Code of Federal Regulations, 2011 CFR

2011-07-01

... ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What... and newsletters; and (4) Transportation and child-care services for students necessary to ensure...

34 CFR 403.173 - What expenses are allowable?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What... and newsletters; and (4) Transportation and child-care services for students necessary to ensure...

34 CFR 403.173 - What expenses are allowable?

Code of Federal Regulations, 2012 CFR

2012-07-01

... ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What... and newsletters; and (4) Transportation and child-care services for students necessary to ensure...

Economic impact of a primary care career: a harsh reality for medical students and the nation.

PubMed

Palmeri, Martin; Pipas, Catherine; Wadsworth, Eric; Zubkoff, Michael

2010-11-01

The ranks of U.S. medical students choosing careers in primary care (PC) are declining even as the demand for new PC physicians is increasing. Although the decision to choose a career in PC is multifactorial, financial security in the setting of rising medical student debt is often cited as a reason to pursue other medical specialties. The authors sought to quantify the financial factors associated with a career in PC. The authors used economic modeling, which employs a variety of factors, to develop a net income and expense model. They attempted to account for the variability of factors by looking at best, worst, and average expense scenarios. They used published retrospective data from the Bureau of Labor Statistics, the 2007 Physician Compensation Survey, the National Association of Realtors, the College Board, and U.S. News and World Report regarding medical student debt, physician reimbursement, retirement planning, college savings, and cost-of-living expenses to develop their models. PC salaries, in contrast to other subspecialties, result in an initial budgetary deficit and decreased discretionary spending. This gap closes as PC physician income rises in the first few years of practice. Only under scenarios of optimal low cost assumptions or no debt do a PC physician's initial earnings exceed predicted expenses. PC physicians, in the first three to five years following residency, will have expenses that exceed earnings. This reality greatly increases the financial disincentive for pursuing a career in PC compared with other fields of medicine.

Cost Analysis of Flexible Ureteroscope Repairs: Evaluation of 655 Procedures in a Community-Based Practice.

PubMed

Kramolowsky, Eugene; McDowell, Zachary; Moore, Blake; Booth, Brigette; Wood, Nada

2016-03-01

The frequency of flexible ureteroscopy has increased with the introduction of improved instrumentation. Ureteroscopes allow increased endoscopic access to the ureter and kidney. However, maintenance and repair of scopes may increase the total procedure expense. In 3 years (8/2011-7/2014), 655 flexible ureteroscopies were performed at a single-specialty, urology, ambulatory surgery center. Procedures were performed by 26 board-certified urologists using four Olympus URF P5 flexible ureteroscopes. The instruments were handled by a single team and sterilized through the STERIS System E1. Repairs were performed by the manufacturer on an as needed basis. Patient records were reviewed to determine the preoperative diagnosis, operative time, location and size of the stone, and use of laser or ureteral sheath. The occurrence, nature of flexible ureteroscope damage, and cost of repairs were evaluated. Of the ureteroscopies performed, 78% was for the treatment of calculi (50.1% in the kidney). Mean stone size was 8.5 ± 0.2 mm, with larger stones (11 mm) located in the kidney. The flexible ureteroscope was advanced over a guidewire (88% of cases); a laser fiber was introduced in 70%, and a ureteral sheath was used in 13.4%. Mean procedure time was 40 minutes. The most common reasons for ureteroscope repair were cloudy lens (16 repairs) and broken optic fibers (9 repairs). There were 31 repairs during the study period (average 21 cases per repair). Flexible ureteroscopes were out of service for an average of 11 days per repair (range 3-20). The total cost of repairs was $233,150 or ∼$7521 per repair. The average repair cost per flexible ureteroscopy performed was $355. Expenses associated with instrument repair can significantly impact a procedure's net revenue, thus efforts should be made to minimize instrument breakage. The expense of repairing a flexible ureteroscope per procedure can be significant and needs to be considered when pricing this procedure.

The Hidden Costs of a Free Caesarean Section Policy in West Africa (Kayes Region, Mali).

PubMed

Ravit, Marion; Philibert, Aline; Tourigny, Caroline; Traore, Mamadou; Coulibaly, Aliou; Dumont, Alexandre; Fournier, Pierre

2015-08-01

The fee exemption policy for EmONC in Mali aims to lower the financial barrier to care. The objective of the study was to evaluate the direct and indirect expenses associated with caesarean interventions performed in EmONC and the factors associated with these expenses. Data sampling followed the case control approach used in the large project (deceased and near-miss women). Our sample consisted of a total of 190 women who underwent caesarean interventions. Data were collected from the health workers and with a social approach by administering questionnaires to the persons who accompanied the woman. Household socioeconomic status was assessed using a wealth index constructed with a principal component analysis. The factors significantly associated with expenses were determined using multivariate linear regression analyses. Women in the Kayes region spent on average 77,017 FCFA (163 USD) for a caesarean episode in EmONC, of which 70 % was for treatment. Despite the caesarean fee exemption, 91 % of the women still paid for their treatment. The largest treatment-related direct expenses were for prescriptions, transfusion, antibiotics, and antihypertensive medication. Near-misses, women who presented a hemorrhage or an infection, and/or women living in rural areas spent significantly more than the others. Although abolishing fees of EmONC in Mali plays an important role in reducing maternal death by increasing access to caesarean sections, this paper shows that the fee policy did not benefit to all women. There are still barriers to EmONC access for women of the lowest socio-economic group. These included direct expenses for drugs prescription, treatment and indirect expenses for transport and food.

Simplified and economical 2D IR spectrometer design using a dual acousto-optic modulator

PubMed Central

Skoff, David R.; Laaser, Jennifer E.; Mukherjee, Sudipta S.; Middleton, Chris T.; Zanni, Martin T.

2012-01-01

Over the last decade two-dimensional infrared (2D IR) spectroscopy has proven to be a very useful extension of infrared spectroscopy, yet the technique remains restricted to a small group of specialized researchers because of its experimental complexity and high equipment cost. We report on a spectrometer that is compact, mechanically robust, and is much less expensive than previous designs because it uses a single pixel MCT detector rather than an array detector. Moreover, each axis of the spectrum can be collected in either the time or frequency domain via computer programming. We discuss pulse sequences for scanning the probe axis, which were not previously possible. We present spectra on metal carbonyl compounds at 5 µm and a model peptide at 6 µm. Data collection with a single pixel MCT takes longer than using an array detector, but publishable quality data are still achieved with only a few minutes of averaging. PMID:24659850

Older adults challenged financially when adult children move home.

PubMed

Wallace, Steven P; Padilla-Frausto, D Imelda

2014-02-01

This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that older adults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income older adults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of older adults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs.

Commercializing biomedical research through securitization techniques.

PubMed

Fernandez, Jose-Maria; Stein, Roger M; Lo, Andrew W

2012-10-01

Biomedical innovation has become riskier, more expensive and more difficult to finance with traditional sources such as private and public equity. Here we propose a financial structure in which a large number of biomedical programs at various stages of development are funded by a single entity to substantially reduce the portfolio's risk. The portfolio entity can finance its activities by issuing debt, a critical advantage because a much larger pool of capital is available for investment in debt versus equity. By employing financial engineering techniques such as securitization, it can raise even greater amounts of more-patient capital. In a simulation using historical data for new molecular entities in oncology from 1990 to 2011, we find that megafunds of $5–15 billion may yield average investment returns of 8.9–11.4% for equity holders and 5–8% for 'research-backed obligation' holders, which are lower than typical venture-capital hurdle rates but attractive to pension funds, insurance companies and other large institutional investors.

Do medical out-of-pocket expenses thrust families into poverty?

PubMed

O'Hara, Brett

2004-02-01

This paper estimates the impact of medical out-of-pocket expenses on families' well-being using the Survey of Income and Program Participation. Medical out-of-pocket expenses include the out-of-pocket costs from medical services and the family's share of health insurance premiums. Demographic characteristics, insurance status, and medical usage of the family are analyzed to determine which characteristics are most likely to impoverish a family. Families impoverished because of medical out-of-pocket expenses are far more likely to have older heads of the family, at least one family member in poor health, or some adults without health insurance. Families without at least one person who worked full time for the entire year were also likely to be impoverished. However, children in the family had little effect on the probability that the family became impoverished. This odd result is probably due to the high correlation between parental health insurance coverage and the health insurance coverage of their children.

7 CFR 1150.151 - Expenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and Orders; Milk), DEPARTMENT OF AGRICULTURE DAIRY PROMOTION PROGRAM Dairy Promotion and Research... incurred by the Board for its maintenance and functioning and to enable it to exercise its powers and...

Rural Reflections. Occasional Paper No. 2. Fall 1995.

ERIC Educational Resources Information Center

Literacy Field Research Group, Dundas (Ontario).

This document contains six papers describing program-based research from rural literacy program in Ontario, Canada. Some of the reports describe action research from pilot projects. The papers raise questions about responding to the special challenges of rural needs, such as whether there is an additional expense to providing service of equal…

The Chemical Engineer's Toolbox: A Glass Box Approach to Numerical Problem Solving

ERIC Educational Resources Information Center

Coronell, Daniel G.; Hariri, M. Hossein

2009-01-01

Computer programming in undergraduate engineering education all too often begins and ends with the freshman programming course. Improvements in computer technology and curriculum revision have improved this situation, but often at the expense of the students' learning due to the use of commercial "black box" software. This paper describes the…

Teaching Citizen Science Skills Online: Implications for Invasive Species Training Programs

ERIC Educational Resources Information Center

Newman, Greg; Crall, Alycia; Laituri, Melinda; Graham, Jim; Stohlgren, Tom; Moore, John C.; Kodrich, Kris; Holfelder, Kirstin A.

2010-01-01

Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills…

The College Cost Book, 1982-83. Third Edition.

ERIC Educational Resources Information Center

Lovell, Susan, Ed.

Expenses at 3,200 schools and colleges are identified, and information is presented on applying for student financial aid and on estimating financial need. Recent changes in federal aid programs, eligibility requirements, and major programs are also outlined. In considering the cost of college, the following areas need to be addressed: tuition and…

Focus on Curriculum Design for Middle School Programs.

ERIC Educational Resources Information Center

Kaminski, Lorraine B.; Dornbos, Karen L.

The middle school concept was devised to counteract the tendency of junior high school programs to mimic those of the high school at the expense of addressing the developmental needs of students who are in the process of physical maturation. This book on curriculum design focuses on the importance of the middle school and understanding…

State Financial Aid: Applying Redesign Principles through State Engagement. Special Report

ERIC Educational Resources Information Center

Pingel, Sarah

2016-01-01

College is increasingly expensive for students, but states have an important policy tool to help defray the costs: state financial aid programs. However, many states' programs are misaligned with articulated strategic postsecondary education policy goals. Over the past two years, Education Commission of the States has supported a variety of…

45 CFR 704.1 - Material available pursuant to 5 U.S.C. 552.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... Not included in direct costs are overhead expenses such as costs of space and heating or lighting the... of records. Such copies can take the form of paper or machine readable documentation (e.g., magnetic... vocational education that operates a program or programs of scholarly research. (vii) Noncommercial...

45 CFR 704.1 - Material available pursuant to 5 U.S.C. 552.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... Not included in direct costs are overhead expenses such as costs of space and heating or lighting the... of records. Such copies can take the form of paper or machine readable documentation (e.g., magnetic... vocational education that operates a program or programs of scholarly research. (vii) Noncommercial...

45 CFR 704.1 - Material available pursuant to 5 U.S.C. 552.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... Not included in direct costs are overhead expenses such as costs of space and heating or lighting the... of records. Such copies can take the form of paper or machine readable documentation (e.g., magnetic... vocational education that operates a program or programs of scholarly research. (vii) Noncommercial...

45 CFR 704.1 - Material available pursuant to 5 U.S.C. 552.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... Not included in direct costs are overhead expenses such as costs of space and heating or lighting the... of records. Such copies can take the form of paper or machine readable documentation (e.g., magnetic... vocational education that operates a program or programs of scholarly research. (vii) Noncommercial...

Combining accuracy assessment of land-cover maps with environmental monitoring programs

Treesearch

Stephen V. Stehman; Raymond L. Czaplewski; Sarah M. Nusser; Limin Yang; Zhiliang Zhu

2000-01-01

A scientifically valid accuracy assessment of a large-area, land-cover map is expensive. Environmental monitoring programs offer a potential source of data to partially defray the cost of accuracy assessment while still maintaining the statistical validity. In this article, three general strategies for combining accuracy assessment and environmental monitoring...

Using Program Evaluation to Enhance Student Success

ERIC Educational Resources Information Center

Fairris, David

2012-01-01

Several years ago, when the author was associate dean in the College of Humanities, Arts, and Social Sciences, a new senior administrator on campus expressed the view that one of their premier first-year experience programs in the college was too expensive and that a different model, based on an approach taken at the administrator's previous…

76 FR 27374 - Determination Under the Supplemental Appropriations Act, 2010 (Pub. L. 111-212) Concerning the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-11

... DEPARTMENT OF STATE [Public Notice: 7454] Determination Under the Supplemental Appropriations Act, 2010 (Pub. L. 111-212) Concerning the Government of Iraq's Support for the Iraq Police Program Pursuant... expenses related to the Iraqi police program, the Government of Iraq supports and is cooperating with such...

7 CFR 771.5 - Loan purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Loan purposes. 771.5 Section 771.5 Agriculture... SPECIAL PROGRAMS BOLL WEEVIL ERADICATION LOAN PROGRAM § 771.5 Loan purposes. (a) Loan funds may be used..., travel and office operations; (3) Salaries and benefits. (b) Loan funds may not be used to pay expenses...

T V Classroom. Report of 1968-1969 School Year.

ERIC Educational Resources Information Center

San Diego Unified School District, CA.

The activities of TV Classroom, one of the largest programs designed to educate adults at the high school level through television, in the 1968-1969 school year are reported. In addition, the history of the program since its inception in 1952 is given, together with an historical chart. Course requirements, publicity, registrations, expenses, and…

Report: South Carolina Drinking Water State Revolving Fund Program Financial Statements with Independent Auditor’s Report, June 30, 2002

EPA Pesticide Factsheets

Report #2003-1-00138, September 17, 2003. We have audited the balance sheet of the SCDWSRF Program as of June 30, 2002, the related statement of revenues, expenses, and changes in fund equity, and the statement of cash flows for the year then ended.

Justifying Study Abroad in Financially Difficult Times

ERIC Educational Resources Information Center

Ludlum, Marty; Ice, Randal; Sheetz-Nguyen, Jessica

2013-01-01

In this paper, we will develop the justification for study abroad. We will discuss the current economic climate and its impact on budgets. Next, we will explain the many benefits of the study abroad programs. Then we will propose some less expensive alternatives to the traditional study abroad programs. We will conclude with expectations for the…

The Federal Approach to Education: What Happens After the November Elections?

ERIC Educational Resources Information Center

Frohlicher, Jean S.; Jennings, John F.

1976-01-01

In the absence of any new Presidential initiatives, no new federal intervention looms for education. The congressional mood is concerned with fine-tuning programs already on the books--making them work better for schools and students. It is certainly not with dreaming up expansive (and expensive) new programs. (Author/IRT)

Film Library Information Management System.

ERIC Educational Resources Information Center

Minnella, C. Vincent; And Others

The computer program described not only allows the user to determine rental sources for a particular film title quickly, but also to select the least expensive of the sources. This program developed at SUNY Cortland's Sperry Learning Resources Center and Computer Center is designed to maintain accurate data on rental and purchase films in both…

Work-site health promotion: an economic model.

PubMed

Patton, J P

1991-08-01

Despite a burgeoning interest in and acceptance of corporate health promotion, the overall economic effects of these programs are not clear. Although ultimate resolution of this question awaits detailed empiric research, a theoretical approach can be useful in structuring the problem and understanding the critical issues. The financial model presented views the firm as a value-maximizing enterprise and evaluates health promotion as a use of corporate assets. The model projects the benefits and costs to the firm of a 7-year health promotion program under a variety of assumptions regarding the employee mix and the effects of the health promotion program on health and productivity. The analysis reveals that the base case assumptions result in a program that creates value for the firm when the cost is less than $193 per participating employee per year. Firms with a highly productive, difficult to replace, and older employee group are most likely to find health promotion to be a good investment. Productivity gains produce the majority of the economic benefits of the program. Effects on health care expense alone are projected to be relatively small. Gains from reduction in employee mortality or retiree health expense are found to be insignificant in this model.

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

PubMed

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

2015-01-01

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

Canadian initiatives to prevent hypertension by reducing dietary sodium.

PubMed

Campbell, Norm R C; Willis, Kevin J; L'Abbe, Mary; Strang, Robert; Young, Eric

2011-08-01

Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity). The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO), and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada's dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the recommendations of the Sodium Work Group and report back to them.

Canadian Initiatives to Prevent Hypertension by Reducing Dietary Sodium

PubMed Central

Campbell, Norm R. C.; Willis, Kevin J.; L’Abbe, Mary; Strang, Robert; Young, Eric

2011-01-01

Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity). The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO), and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada’s dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the recommendations of the Sodium Work Group and report back to them. PMID:22254122

De novo establishment and cost-effectiveness of Papanicolaou cytology screening services in the Socialist Republic of Vietnam.

PubMed

Suba, E J; Nguyen, C H; Nguyen, B D; Raab, S S

2001-03-01

Cervical carcinoma is the leading cause of cancer-related death among women in the developing world. The absence of cervical screening in Vietnam and other developing countries is due in large part to the perceived expense of implementing Papanicolaou cytology screening services, although, to the authors' knowledge, the cost-effectiveness of establishing such services has never been studied in a developing country. Using decision analytic methods, the authors assessed cost-effectiveness of Pap screening from a societal perspective in Vietnam, the world's 9th most populous developing country (estimated 1999 population, 79 million). Outcomes measured included life expectancy, cervical carcinoma incidence, cost per woman, and cost-effectiveness. Total costs to establish a nationwide 5-year interval Pap screening program in Vietnam will average less than $148,400 annually during the 10-year time period assumed necessary to develop the program and may be considerably lower if only high risk geographic areas are targeted. Maintenance costs will average less than $0.092 annually per woman in the target screening population. Assuming 70% program participation, cervical carcinoma incidence will decrease from 26 in 100,000 to 14.8 in 100,000, and cost-effectiveness will be $725 per discounted life-year. Several assumptions used in this analysis constitute biases against the effectiveness of Pap screening, which in reality may be significantly more cost-effective than reported here. Contrary to widespread belief, Pap screening in developing countries such as Vietnam is extraordinarily inexpensive and appears to be cost-effective. Because prospects are uncertain regarding useful alternatives to the Pap test, the evidence-based argument for establishing conventional Pap screening services in developing countries such as Vietnam is compelling. Population-based conventional Pap screening services have been established de novo in Vietnam and are now operational. Copyright 2001 American Cancer Society.

78 FR 15379 - Agency Information Collection Activities; Submission to OMB for a New Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... form relates to a budget or estimate of the legal fees, costs, and expenses that outside counsel would... estimates of the average number of respondents, burden, and total annual cost appear below. The estimated... cost by multiplying its estimate of the number of respondents (100) by the burden (2 hours) and...

Community Benefit Spending By Tax-Exempt Hospitals Changed Little After ACA.

PubMed

Young, Gary J; Flaherty, Stephen; Zepeda, E David; Singh, Simone Rauscher; Rosen Cramer, Geri

2018-01-01

Provisions of the Affordable Care Act (ACA) encouraged tax-exempt hospitals to invest broadly in community health benefits. Four years after the ACA's enactment, hospitals had increased their average spending for all community benefits by 0.5 percentage point, from 7.6 percent of their operating expenses in 2010 to 8.1 percent in 2014.

Genetic variance and covariance components for feed intake, average daily gain, and postweaning gain in growing beef cattle

USDA-ARS?s Scientific Manuscript database

Feed is the single most expensive cost related to a beef cattle production enterprise. Data collection to determine feed efficient animals is also costly. Currently a 70 d performance test is recommended for accurate calculation of efficiency. Previous research has suggested intake tests can be l...

Genetic variance and covariance and breed differences for feed intake and average daily gain to improve feed efficiency in growing cattle

USDA-ARS?s Scientific Manuscript database

Feed costs are a major economic expense in finishing and developing cattle; however, collection of feed intake data is costly. Examining relationships among measures of growth and intake, including breed differences, could facilitate selection for efficient cattle. Objectives of this study were to e...

Polymorphisms in POMC are not associated with dry matter intake and average daily gain phenotypes in beef cattle

USDA-ARS?s Scientific Manuscript database

The cost of feed for beef cattle is the largest expense incurred by cattle producers. The ability to genetically select for more efficient animals that require less feed while still achieving acceptable levels of production will result in a substantial cost savings. The purpose of this study was to ...

Open Source and ROI: Open Source Has Made Significant Leaps in Recent Years. What Does It Have to Offer Education?

ERIC Educational Resources Information Center

Guhlin, Miguel

2007-01-01

A switch to free open source software can minimize cost and allow funding to be diverted to equipment and other programs. For instance, the OpenOffice suite is an alternative to expensive basic application programs offered by major vendors. Many such programs on the market offer features seldom used in education but for which educators must pay.…

So, You Want to Move out?!--An Awareness Program of the Real Costs of Moving Away from Home

ERIC Educational Resources Information Center

Hines, Steven L.; Hansen, Lyle; Falen, Christi

2011-01-01

The So, You Want To Move Out?! program was developed to help teens explore the financial realities of moving away from home. This 3-day camp program allows youth the opportunity to interview for a job, work, earn a paycheck, and pay financial obligations. After paying expenses and trying to put some money away in savings, the participants begin to…

42 CFR 68.9 - What loans qualify for repayment?

Code of Federal Regulations, 2013 CFR

2013-10-01

..., TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) LOAN REPAYMENT PROGRAMS (LRPs) § 68.9 What loans qualify for...) Undergraduate, graduate, and health professional school tuition expenses; (b) Other reasonable educational...

42 CFR 68.9 - What loans qualify for repayment?

Code of Federal Regulations, 2014 CFR

2014-10-01

..., TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) LOAN REPAYMENT PROGRAMS (LRPs) § 68.9 What loans qualify for...) Undergraduate, graduate, and health professional school tuition expenses; (b) Other reasonable educational...

Patient navigation significantly reduces delays in breast cancer diagnosis in the District of Columbia.

PubMed

Hoffman, Heather J; LaVerda, Nancy L; Young, Heather A; Levine, Paul H; Alexander, Lisa M; Brem, Rachel; Caicedo, Larisa; Eng-Wong, Jennifer; Frederick, Wayne; Funderburk, William; Huerta, Elmer; Swain, Sandra; Patierno, Steven R

2012-10-01

Patient Navigation (PN) originated in Harlem as an intervention to help poor women overcome access barriers to timely breast cancer treatment. Despite rapid, nationally widespread adoption of PN, empirical evidence on its effectiveness is lacking. In 2005, National Cancer Institute initiated a multicenter PN Research Program (PNRP) to measure PN effectiveness for several cancers. The George Washington Cancer Institute, a project participant, established District of Columbia (DC)-PNRP to determine PN's ability to reduce breast cancer diagnostic time (number of days from abnormal screening to definitive diagnosis). A total of 2,601 women (1,047 navigated; 1,554 concurrent records-based nonnavigated) were examined for breast cancer from 2006 to 2010 at 9 hospitals/clinics in DC. Analyses included only women who reached complete diagnostic resolution. Differences in diagnostic time between navigation groups were tested with ANOVA models including categorical demographic and treatment variables. Log transformations normalized diagnostic time. Geometric means were estimated and compared using Tukey-Kramer P value adjustments. Average-geometric mean [95% confidence interval (CI)]-diagnostic time (days) was significantly shorter for navigated, 25.1 (21.7, 29.0), than nonnavigated women, 42.1 (35.8, 49.6). Subanalyses revealed significantly shorter average diagnostic time for biopsied navigated women, 26.6 (21.8, 32.5) than biopsied nonnavigated women, 57.5 (46.3, 71.5). Among nonbiopsied women, diagnostic time was shorter for navigated, 27.2 (22.8, 32.4), than nonnavigated women, 34.9 (29.2, 41.7), but not statistically significant. Navigated women, especially those requiring biopsy, reached their diagnostic resolution significantly faster than nonnavigated women. Results support previous findings of PN's positive influence on health care. PN should be a reimbursable expense to assure continuation of PN programs. 2012 AACR

39 CFR 3.7 - Information furnished to Board-program review.

Code of Federal Regulations, 2010 CFR

2010-07-01

... visibility or the operating budget (including increases in expense amounts) or the capital investment budget...; (2) Five-year plans, annual operating and investment plans, and significant departures from estimates...

75 FR 26188 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

..., restaurant advertising, labeling, etc.); advertising, administrative, and operational expenses for trade... CFR part 1486 for additional evaluation criteria. 2. Review and Selection Process: All applications...

The DOD-NASA Independent Research and Development Program: Issues and Methodology for an In-Depth Study

DTIC Science & Technology

1981-01-01

for the expenses of certain indep endently chosen R&D projects judged relevant to military needs. These "in- dependent R&D" (IR&D) expenses are...system’s features, from accounting procedures to the system’s fundamental propriety. The Committee on Indep - endent Research and Development Issues...Patent Policy • • • • • • • • • Accountability and Management A SUGGESTED METHODOLOGY FOR A STUDY OF THE ROLE OF IR&D IN DEFENSE AND SPACE

(Almost) Word for Word: As Voice Recognition Programs Improve, Students Reap the Benefits

ERIC Educational Resources Information Center

Smith, Mark

2006-01-01

Voice recognition software is hardly new--attempts at capturing spoken words and turning them into written text have been available to consumers for about two decades. But what was once an expensive and highly unreliable tool has made great strides in recent years, perhaps most recognized in programs such as Nuance's Dragon NaturallySpeaking…

26 CFR 1.50A-3 - Recomputation of credit allowed by section 40.

Code of Federal Regulations, 2010 CFR

2010-04-01

....50A-3 Section 1.50A-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Rules for Computing Credit for Expenses of Work Incentive Programs § 1.50A-3 Recomputation...) In general. If the employment of any employee, with respect to whom work incentive program (WIN...

Research on trust-region algorithms for nonlinear programming. Final technical report, 1 January 1990--31 December 1992

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

Dennis, J.E. Jr.; Tapia, R.A.

Goal of the research was to develop and test effective, robust algorithms for general nonlinear programming (NLP) problems, particularly large or otherwise expensive NLP problems. We discuss the research conducted over the 3-year period Jan. 1990-Dec. 1992. We also describe current and future directions of our research.

Setting Academic Priorities: A Guide to What Boards of Trustees Can Do

ERIC Educational Resources Information Center

Dickeson, Robert C.

2012-01-01

Higher education is in the midst of a deep financial crisis, and the failure of governing boards to focus on academic programs is arguably the single greatest cause of overspending. This brochure shows trustees both why and how to prioritize academic programs. All too often, attempts to reduce expenses have concentrated on the administrative side…

Multilevel geometry optimization

NASA Astrophysics Data System (ADS)

Rodgers, Jocelyn M.; Fast, Patton L.; Truhlar, Donald G.

2000-02-01

Geometry optimization has been carried out for three test molecules using six multilevel electronic structure methods, in particular Gaussian-2, Gaussian-3, multicoefficient G2, multicoefficient G3, and two multicoefficient correlation methods based on correlation-consistent basis sets. In the Gaussian-2 and Gaussian-3 methods, various levels are added and subtracted with unit coefficients, whereas the multicoefficient Gaussian-x methods involve noninteger parameters as coefficients. The multilevel optimizations drop the average error in the geometry (averaged over the 18 cases) by a factor of about two when compared to the single most expensive component of a given multilevel calculation, and in all 18 cases the accuracy of the atomization energy for the three test molecules improves; with an average improvement of 16.7 kcal/mol.

Department of Energy - Office of Science Early Career Research Program

NASA Astrophysics Data System (ADS)

Horwitz, James

The Department of Energy (DOE) Office of Science Early Career Program began in FY 2010. The program objectives are to support the development of individual research programs of outstanding scientists early in their careers and to stimulate research careers in the disciplines supported by the DOE Office of Science. Both university and DOE national laboratory early career scientists are eligible. Applicants must be within 10 years of receiving their PhD. For universities, the PI must be an untenured Assistant Professor or Associate Professor on the tenure track. DOE laboratory applicants must be full time, non-postdoctoral employee. University awards are at least 150,000 per year for 5 years for summer salary and expenses. DOE laboratory awards are at least 500,000 per year for 5 years for full annual salary and expenses. The Program is managed by the Office of the Deputy Director for Science Programs and supports research in the following Offices: Advanced Scientific and Computing Research, Biological and Environmental Research, Basic Energy Sciences, Fusion Energy Sciences, High Energy Physics, and Nuclear Physics. A new Funding Opportunity Announcement is issued each year with detailed description on the topical areas encouraged for early career proposals. Preproposals are required. This talk will introduce the DOE Office of Science Early Career Research program and describe opportunities for research relevant to the condensed matter physics community. http://science.energy.gov/early-career/

Validity of a practitioner-administered observational tool to measure physical activity, nutrition, and screen time in school-age programs.

PubMed

Lee, Rebekka M; Emmons, Karen M; Okechukwu, Cassandra A; Barrett, Jessica L; Kenney, Erica L; Cradock, Angie L; Giles, Catherine M; deBlois, Madeleine E; Gortmaker, Steven L

2014-11-28

Nutrition and physical activity interventions have been effective in creating environmental changes in afterschool programs. However, accurate assessment can be time-consuming and expensive as initiatives are scaled up for optimal population impact. This study aims to determine the criterion validity of a simple, low-cost, practitioner-administered observational measure of afterschool physical activity, nutrition, and screen time practices and child behaviors. Directors from 35 programs in three cities completed the Out-of-School Nutrition and Physical Activity Observational Practice Assessment Tool (OSNAP-OPAT) on five days. Trained observers recorded snacks served and obtained accelerometer data each day during the same week. Observations of physical activity participation and snack consumption were conducted on two days. Correlations were calculated to validate weekly average estimates from OSNAP-OPAT compared to criterion measures. Weekly criterion averages are based on 175 meals served, snack consumption of 528 children, and physical activity levels of 356 children. OSNAP-OPAT validly assessed serving water (r = 0.73), fruits and vegetables (r = 0.84), juice >4oz (r = 0.56), and grains (r = 0.60) at snack; sugary drinks (r = 0.70) and foods (r = 0.68) from outside the program; and children's water consumption (r = 0.56) (all p <0.05). Reports of physical activity time offered were correlated with accelerometer estimates (minutes of moderate and vigorous physical activity r = 0.59, p = 0.02; vigorous physical activity r = 0.63, p = 0.01). The reported proportion of children participating in moderate and vigorous physical activity was correlated with observations (r = 0.48, p = 0.03), as were reports of computer (r = 0.85) and TV/movie (r = 0.68) time compared to direct observations (both p < 0.01). OSNAP-OPAT can assist researchers and practitioners in validly assessing nutrition and physical activity environments and behaviors in afterschool settings. Phase 1 of this measure validation was conducted during a study registered at clinicaltrials.gov NCT01396473.

Innovation in weight loss programs: a 3-dimensional virtual-world approach.

PubMed

Johnston, Jeanne D; Massey, Anne P; Devaneaux, Celeste A

2012-09-20

The rising trend in obesity calls for innovative weight loss programs. While behavioral-based face-to-face programs have proven to be the most effective, they are expensive and often inaccessible. Internet or Web-based weight loss programs have expanded reach but may lack qualities critical to weight loss and maintenance such as human interaction, social support, and engagement. In contrast to Web technologies, virtual reality technologies offer unique affordances as a behavioral intervention by directly supporting engagement and active learning. To explore the effectiveness of a virtual-world weight loss program relative to weight loss and behavior change. We collected data from overweight people (N = 54) participating in a face-to-face or a virtual-world weight loss program. Weight, body mass index (BMI), percentage weight change, and health behaviors (ie, weight loss self-efficacy, physical activity self-efficacy, self-reported physical activity, and fruit and vegetable consumption) were assessed before and after the 12-week program. Repeated measures analysis was used to detect differences between groups and across time. A total of 54 participants with a BMI of 32 (SD 6.05) kg/m(2)enrolled in the study, with a 13% dropout rate for each group (virtual world group: 5/38; face-to-face group: 3/24). Both groups lost a significant amount of weight (virtual world: 3.9 kg, P < .001; face-to-face: 2.8 kg, P = .002); however, no significant differences between groups were detected (P = .29). Compared with baseline, the virtual-world group lost an average of 4.2%, with 33% (11/33) of the participants losing a clinically significant (≥5%) amount of baseline weight. The face-to-face group lost an average of 3.0% of their baseline weight, with 29% (6/21) losing a clinically significant amount. We detected a significant group × time interaction for moderate (P = .006) and vigorous physical activity (P = .008), physical activity self-efficacy (P = .04), fruit and vegetable consumption (P = .007), and weight loss self-efficacy (P < .001). Post hoc paired t tests indicated significant improvements across all of the variables for the virtual-world group. Overall, these results offer positive early evidence that a virtual-world-based weight loss program can be as effective as a face-to-face one relative to biometric changes. In addition, our results suggest that a virtual world may be a more effective platform to influence meaningful behavioral changes and improve self-efficacy.

Innovation in Weight Loss Programs: A 3-Dimensional Virtual-World Approach

PubMed Central

Massey, Anne P; DeVaneaux, Celeste A

2012-01-01

Background The rising trend in obesity calls for innovative weight loss programs. While behavioral-based face-to-face programs have proven to be the most effective, they are expensive and often inaccessible. Internet or Web-based weight loss programs have expanded reach but may lack qualities critical to weight loss and maintenance such as human interaction, social support, and engagement. In contrast to Web technologies, virtual reality technologies offer unique affordances as a behavioral intervention by directly supporting engagement and active learning. Objective To explore the effectiveness of a virtual-world weight loss program relative to weight loss and behavior change. Methods We collected data from overweight people (N = 54) participating in a face-to-face or a virtual-world weight loss program. Weight, body mass index (BMI), percentage weight change, and health behaviors (ie, weight loss self-efficacy, physical activity self-efficacy, self-reported physical activity, and fruit and vegetable consumption) were assessed before and after the 12-week program. Repeated measures analysis was used to detect differences between groups and across time. Results A total of 54 participants with a BMI of 32 (SD 6.05) kg/m2 enrolled in the study, with a 13% dropout rate for each group (virtual world group: 5/38; face-to-face group: 3/24). Both groups lost a significant amount of weight (virtual world: 3.9 kg, P < .001; face-to-face: 2.8 kg, P = .002); however, no significant differences between groups were detected (P = .29). Compared with baseline, the virtual-world group lost an average of 4.2%, with 33% (11/33) of the participants losing a clinically significant (≥5%) amount of baseline weight. The face-to-face group lost an average of 3.0% of their baseline weight, with 29% (6/21) losing a clinically significant amount. We detected a significant group × time interaction for moderate (P = .006) and vigorous physical activity (P = .008), physical activity self-efficacy (P = .04), fruit and vegetable consumption (P = .007), and weight loss self-efficacy (P < .001). Post hoc paired t tests indicated significant improvements across all of the variables for the virtual-world group. Conclusions Overall, these results offer positive early evidence that a virtual-world-based weight loss program can be as effective as a face-to-face one relative to biometric changes. In addition, our results suggest that a virtual world may be a more effective platform to influence meaningful behavioral changes and improve self-efficacy. PMID:22995535

Return on Investment in Disease Management: A Review

PubMed Central

Goetzel, Ron Z.; Ozminkowski, Ronald J.; Villagra, Victor G.; Duffy, Jennifer

2005-01-01

The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes. PMID:17288065

Scholarship Program: 1979-80 Report to Congress. Report of the Secretary of Health and Human Services on the Administration of the National Health Service Corps Scholarship Program as Required by Section 751(i) of Title VII of the Public Health Service Act, as Amended, December 12, 1979.

ERIC Educational Resources Information Center

Health Resources Administration (DHHS/PHS), Hyattsville, MD.

The status of the National Health Service Corps Scholarship Program is examined in this third annual report with cumulative data from inception of the program. The scholarship award includes the payment of a monthly stipend, tuition and fees, and other educational expenses in a federal program of service-conditional awards for students of…

Return on investment in disease management: a review.

PubMed

Goetzel, Ron Z; Ozminkowski, Ronald J; Villagra, Victor G; Duffy, Jennifer

2005-01-01

The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes.

24 CFR 1000.546 - Are audit costs eligible program or administrative expenses?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... attributable to NAHASDA funded activities. For a recipient not covered by the Single Audit Act, but which...

24 CFR 1000.546 - Are audit costs eligible program or administrative expenses?

Code of Federal Regulations, 2014 CFR

2014-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... attributable to NAHASDA funded activities. For a recipient not covered by the Single Audit Act, but which...

24 CFR 1000.546 - Are audit costs eligible program or administrative expenses?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... attributable to NAHASDA funded activities. For a recipient not covered by the Single Audit Act, but which...

24 CFR 1000.546 - Are audit costs eligible program or administrative expenses?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... attributable to NAHASDA funded activities. For a recipient not covered by the Single Audit Act, but which...

24 CFR 1000.546 - Are audit costs eligible program or administrative expenses?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring... attributable to NAHASDA funded activities. For a recipient not covered by the Single Audit Act, but which...

Digital Inject Book v. 1.7

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

Eldridge, Bryce

2016-10-05

Digital Inject Book is a software program designed to generate and managed simulated data for radiation detectors, used to increase the realism of training where real radiation sources are impractical, expensive, or simply not available.

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

PubMed Central

SASAKI, Toshiyuki; IZAWA, Masahiro; OKADA, Yoshikazu

2015-01-01

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

Effectiveness of an educational program to promote pesticide safety among pesticide handlers of South India.

PubMed

Sam, Kishore Gnana; Andrade, Hira H; Pradhan, Lisa; Pradhan, Abhishek; Sones, Shashi J; Rao, Padma G M; Sudhakar, Christopher

2008-05-01

Occupational poisoning with pesticides is common in developing countries because farmers are often under trained, illiterate and consider it impractical and expensive to use safety equipment, especially in tropical climates. Greater benefit of education programs on prevention can be obtained if initiated in areas having higher occurrence of poisoning. Hence, the present study evaluated occurrence of poisoning and effectiveness of educational interventions among pesticide handlers in areas having high occurrence of occupational poisoning. Two villages of Udupi district of South India were identified by spot mapping and targeted for a public education program on safe handling of pesticides, the impact of which was assessed using a knowledge attitude and practice (KAP) questionnaire. Education was provided using a structured individualized training program to 74 pesticide handlers. Three point KAP assessments were carried out at baseline, immediately after training and after 1 month of training. Nonparametric Kruskal-Wallis tests and Friedmann tests were used to compare scores at different time points and between groups. Occurrence of occupation related poisoning was 33% and common in three villages of the district. The average baseline KAP score of 30.88 +/- 10.33 improved after education significantly (P < 0.001) at first follow-up 45.03 +/- 9.16 and at second follow-up 42.9 +/- 9.54. A decline of score between the first and second follow-up may be attributed to decline in knowledge retention. Demographics like gender, literacy and presence of children affected KAP score and there was no influence of geography, age or frequency of pesticide use. Educational intervention among pesticide handlers improved the KAP score for safe pesticide handling. We recommend that continuous education and training programs for agricultural workers will promote awareness and minimize the hazards of occupational pesticide exposure.

The SPACELAB Project: A Transatlantic challenge for Europe

NASA Technical Reports Server (NTRS)

Ottemeyer, D. R.

1981-01-01

The contribution of Europe to the U.S. space program is related to the development of Spacelab. The Federal Republic of Germany is to contribute 53% and Italy 18% of the expenses. The industrial team conducting the development work for the Spacelab consists of experts from firms of the ten nations participating financially in the program. Attention is given to organizational problems, details on the development program, aspects of mission preparation, and future developments.