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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

24 CFR 908.108 - Cost.

Code of Federal Regulations, 2010 CFR

2010-04-01

... computer hardware or software, or both, the cost of contracting for those services, or the cost of... operating budget. At the HA's option, the cost of the computer software may include service contracts to...

Cost Analysis for Large Civil Transport Rotorcraft

NASA Technical Reports Server (NTRS)

Coy, John J.

2006-01-01

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

Virtual Reference, Real Money: Modeling Costs in Virtual Reference Services

ERIC Educational Resources Information Center

Eakin, Lori; Pomerantz, Jeffrey

2009-01-01

Libraries nationwide are in yet another phase of belt tightening. Without an understanding of the economic factors that influence library operations, however, controlling costs and performing cost-benefit analyses on services is difficult. This paper describes a project to develop a cost model for collaborative virtual reference services. This…

42 CFR 412.6 - Cost reporting periods subject to the prospective payment systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... payment systems. 412.6 Section 412.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES... prospective payment system for inpatient operating costs, the reasonable costs of services furnished before...

Public Health Service--health maintenance organizations: final regulations.

PubMed

1980-01-24

These rules amend the Public Health Service (PHS) regulations by implementing certain changes made by the HMO Amendments of 1978 with respect to grants and loan guarantees for planning and initial development costs (Subpart D) and to loans and loan guarantees for initial costs of operation (Subpart E). These regulations change Subpart D by including projects for the "expansion of services" of an HMO among the projects eligible for initial development assistance. In addition, they change the limits on the amount of assistance permitted for initial development projects. These regulations also change Subpart E by substituting the words "costs of operation" for the words "operating costs," thereby expanding the scope of assistance for initial operations (1) to include costs of certain small capital expenditures for equipment and alterations and renovations of facilities and (2) to incorporate into the regulations a longstanding policy which specifies the amount of preaward balance sheet liabilities which may be paid for with funds under operating loans (whether made directly or guaranteed by the Secretary).

42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Federal rates for inpatient operating costs for fiscal year 1984. 412.62 Section 412.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Basic Methodology for Determining...

42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Federal rates for inpatient operating costs for fiscal year 1984. 412.62 Section 412.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Basic Methodology for Determining...

42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Federal rates for inpatient operating costs for fiscal year 1984. 412.62 Section 412.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Basic Methodology for Determining...

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

NASA Technical Reports Server (NTRS)

Derocher, W. L., Jr.

1975-01-01

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

Determining Usability Versus Cost and Yields of a Regional Transport

NASA Technical Reports Server (NTRS)

Gvozdenovic, Slobodan

1999-01-01

Regional transports are designed to operate on air networks having the basic characteristics of short trip distances and low density passengers/cargo, i.e. small numbers of passengers per flight. Regional transports passenger capacity is from 10 to 100 seats and operate on routes from 350 to 1000 nautical miles (nm). An air network operated by regional transports has the following characteristics: (1) connecting regional centers; (2) operating on low density passengers/cargo flow services with minimum two frequencies per day; (3) operating on high density passengers/cargo flow with more than two frequencies per day; and (4) operating supplemental services whenever market demands in order to help bigger capacity aircraft already operating the same routes. In order to meet passenger requirements providing low fares and high or required number of frequencies, airlines must constantly monitor operational costs and keep them low. It is obvious that costs of operating aircraft must be lower than yield obtained by transporting passengers and cargo. The requirement to achieve favorable yield/cost ratio must provide the answer to the question of which aircraft will best meet a specific air network. An air network is defined by the number of services, the trip distance of each service, and the number of flights (frequencies) per day and week.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

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

Association between patient-centered medical home rating and operating cost at federally funded health centers.

PubMed

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

2012-07-04

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

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

PubMed

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

2017-01-01

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

Estimating Airline Operating Costs

NASA Technical Reports Server (NTRS)

Maddalon, D. V.

1978-01-01

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

Estimating the unit costs of public hospitals and primary healthcare centers.

PubMed

Younis, Mustafa Z; Jaber, Samer; Mawson, Anthony R; Hartmann, Michael

2013-01-01

Many factors have affected the rise of health expenditures, such as high-cost medical technologies, changes in disease patterns and increasing demand for health services. All countries allocate a significant portion of resources to the health sector. In 2008, the gross domestic product of Palestine was estimated to be at $6.108bn (current price) or about $1697 per capita. Health expenditures are estimated at 15.6% of the gross domestic product, almost as much as those of Germany, Japan and other developed countries. The numbers of hospitals, hospital beds and primary healthcare centers in the country have all increased. The Ministry of Health (MOH) currently operates 27 of 76 hospitals, with a total of 3074 beds, which represent 61% of total beds of all hospitals in the Palestinian Authorities area. Also, the MOH is operating 453 of 706 Primary Health Care facilities. By 2007, about 40 000 people were employed in different sectors of the health system, with 33% employed by the MOH. This purpose of this study was to develop a financing strategy to help cover some or all of the costs involved in operating such institutions and to estimate the unit cost of primary and secondary programs and departments. A retrospective study was carried out on data from government hospitals and primary healthcare centers to identify and analyze the costs and output (patient-related services) and to estimate the unit cost of health services provided by hospitals and PHCs during the year 2008. All operating costs are assigned and allocated to the departments at MOH hospitals and primary health care centers (PPHCs) and are identified as overhead departments, intermediate-service and final-service departments. Intermediate-service departments provide procedures and services to patients in the final-service departments. The costs of the overhead departments are distributed to the intermediate-service and final-service departments through a step-down method, according to allocation criteria devised to resemble as closely as possible the actual use of resources by each of the departments. The data were analyzed using spss. Data cleaning was carried out by cross-validating the results through conducting cross-tabulations between the hospital/center and section/program to identify errors from the data collection or entry process. Depreciation of assets and the consumption of capital costs are ignored in this study, as it is difficult to evaluate the MOH facilities owing to a lack of recording of depreciation of assets or other costs of servicing capital assets. Inpatient costs contributed about 75% of all costs, whereas outpatient services contributed the remaining 25% of total costs. The average cost per visit was $13.00 for outpatient departments, whereas the average cost per patient day for inpatient departments was $90.00. As for the unit cost for each department, intensive care unit and intermediate care unit services were the highest among all categories of daily hospital services ($208.00). This is in contrast to surgical operations ($124.00), specialized surgeries ($106.00), delivery department ($99.00), orthopedics ($98.50) and general surgery ($85.00). The lowest unit cost was found in the neonatology department ($72.00). In PHCs, the unit cost per visit was highest for psychiatry programs ($26.00), followed by other programs ($21.50), chronic diseases ($21.00), maternal and child health ($11.50), preventive programs ($9.00) and general medicine ($6.50). The exchange rate listed by The Wall Street Journal as of Wednesday August 25, 2010 is 1 US dollar = 3.82 new Israeli shekel (NIS). The findings have implications for policy and decision making in the health sector in Palestine concerning the cost of services provided by hospitals and PHCs. The availability of a standardized data set for cost assessment would greatly enhance and improve the quality of financial information as well as efficiency in the use of scarce resources. Copyright © 2012 John Wiley & Sons, Ltd.

How Big is Too Big for Hubs: Marginal Profitability in Hub-and-Spoke Networks

NASA Technical Reports Server (NTRS)

Ross, Leola B.; Schmidt, Stephen J.

1997-01-01

Increasing the scale of hub operations at major airports has led to concerns about congestion at excessively large hubs. In this paper, we estimate the marginal cost of adding spokes to an existing hub network. We observe entry/non-entry decisions on potential spokes from existing hubs, and estimate both a variable profit function for providing service in markets using that spoke as well as the fixed costs of providing service to the spoke. We let the fixed costs depend upon the scale of operations at the hub, and find the hub size at which spoke service costs are minimized.

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

PubMed

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

Analysis of Student Loan Special Rate Allowances and Servicing Costs.

ERIC Educational Resources Information Center

Technology Management, Inc., Cambridge, MA.

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

20 CFR 655.211 - Petition for higher meal charges.

Code of Federal Regulations, 2010 CFR

2010-04-01

... relation to food service operations, such as wages of cooks and restaurant supervisors; fuel, water, electricity, and other utilities used for the food service operations; other costs directly related to the food service operation. Charges for transportation, depreciation, overhead, and similar charges may not...

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

PubMed Central

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

2013-01-01

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

Networks and the fiscal performance of rural hospitals in Oklahoma: are they associated?

PubMed

Broyles, R W; Brandt, E N; Biard-Holmes, D

1998-01-01

This paper uses regression analysis to explore the relation of network membership to the financial performance of rural hospitals in Oklahoma during fiscal year 1995. After adjusting for the scope of service, as measured by the number of facilities or services offered by the hospital, indicators of fiscal status are (1) the cash receipts derived from net patient revenue; (2) the cash disbursements related to operating costs, net of interest and depreciation expense, labor costs and nonlabor costs; and (3) net cash flow, defined as the difference between cash receipts and disbursements. Controlling for the effects of the hospital's structural attributes, operating characteristics and market conditions, the results indicate that members of a network reported lower net operating costs, labor costs and nonlabor expenses per service than nonmembers. Hence, the analysis seems to suggest that the membership of rural hospitals in a network is associated with lower cash disbursements and an improved net cash flow, outcomes that may preserve their fiscal viability and the access of the population at risk to service.

Managing Food Service Costs and Satisfying Customers.

ERIC Educational Resources Information Center

Reuther, Anne; Otto, Ione

1987-01-01

Milwaukee Area Technical College, Wisconsin, has four campuses, each with its own food service operation that, combined, serve nearly 3,000 people daily. Several food service-related programs are part of the curriculum. Cost containment and customer satisfaction are the two overriding goals of the food service programs. (MLF)

From Outsourcing to Alliances: Strategies for Sharing Leadership and Exploiting Resources at Metropolitan Universities.

ERIC Educational Resources Information Center

Ender, Kenneth L.; Mooney, Kathleen A.

1994-01-01

University partnerships with private industry to effect service delivery in facilities management, food services, bookstore management, parking management, arena management, housing operations, business services, safety operations, communication services, and purchasing improves the quality of these services, reduces costs, does not affect core…

Ferry Lifecycle Cost Model for Federal Land Management Agencies : User's Guide.

DOT National Transportation Integrated Search

2011-09-30

The Ferry Lifecycle Cost Model (model) is a spreadsheet-based sketch planning tool that estimates capital, operating, and total cost for various vessels that could be used to provide ferry service on a particular route given known service parameters....

In-House vs. Franchise College Food Services and Bookstores.

ERIC Educational Resources Information Center

Stumph, W. J.

In determining whether colleges or universities should operate their own food services or bookstores or lease them to contract operators, school business officers should consider a number of factors. These include whether sales volume is sufficiently large to cover direct operating costs and overhead; inventory investment; appearance, service, and…

Cost-evaluation model for clinical trials in a hospital pharmacy service.

PubMed

Idoate, A; Ortega, A; Carrera, F J; Aldaz, A; Giráldez, J

1995-09-22

A cost-evaluation model was applied to clinical trial protocols to estimate their cost for the hospital pharmacy service. The steps taken in the drug management of clinical research were identified. Fixed costs (common to all clinical trials) and variable costs (peculiar to each clinical trial) were determined for each step. The number of patients, the number of operations, the planned services (receptions, storage, drug dispensing), the timing and difficulty of the study (randomization) were included in the variable costs. The economic assessment of these items was based on the costs of the materials and means used, the cost of staff time and finally the cost of drug storage during the clinical trial. This model was applied to 24 clinical trials carried out in the University Clinic of Navarra. 83% of all pharmacy costs of a clinical trial were variable. Drug dispensing, stock management and return drugs account for 94% of the time expended. The approximate cost of the pharmacy providing investigational services was $1,766 per trial or $174 per patient. Drug storage costs were not an important source of expenditure among the variable costs (7.4%). The best way to determine the cost of a trial is to calculate the number of operations.

Manned Systems Utilization Analysis. Study 2.1: Space Servicing Pilot Program Study. [for automated payloads

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1975-01-01

Space servicing automated payloads was studied for potential cost benefits for future payload operations. Background information is provided on space servicing in general, and on a pilot flight test program in particular. An fight test is recommended to demonstrate space servicing. An overall program plan is provided which builds upon the pilot program through an interim servicing capability. A multipayload servicing concept for the time when the full capability tug becomes operational is presented. The space test program is specifically designed to provide low-cost booster vehicles and a flight test platform for several experiments on a single flight.

The Potential for Helicopter Passenger Service in Major Urban Areas. [cost analysis

NASA Technical Reports Server (NTRS)

Dajani, J. S.; Stortstrom, R. G.; Warner, D. B.

1977-01-01

An interurban helicopter cost model having the capability of selecting an efficient helicopter network for a given city in terms of service and total operating costs was developed. This model which is based upon the relationship between total and direct operating costs and the number of block hours of helicopter operation is compiled in terms of a computer program which simulates the operation of an intracity helicopter fleet over a given network. When applied to specific urban areas, the model produces results in terms of a break-even air passenger market penetration rate, which is the percent of the air travelers in each of those areas that must patronize the helicopter network to make it break even commercially. A total of twenty major metropolitan areas are analyzed and are ranked initially according to cost per seat mile and then according to break-even penetration rate.

46 CFR 282.10 - Basis for determining foreign-flag competition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost disadvantage of operating the subsidized vessels in the essential service. The Maritime... establishing the cost disadvantage of U.S. vessels in the service. (e) The determination of the principal...

77 FR 34460 - Proposed Collection; Comment Request for Form 14411

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... problems may pertain to experiences with the Internal Revenue Service's processes procedures or make...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

Oil prospects attract workover dollars. [Rocky Mountains

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

Stremel, K.

1983-12-01

Anticipating stable crude oil prices and low service costs, Rocky Mountain operators plan to maintain strong workover programs next year. Deflated service costs are allowing operators to complete more workovers without appropriating more capital, and they plan to take advantage of the bargain prices available in the oilpatch. Workover activity next year will be concentrated in major oil producing basins of the Rockies.

Horizontal/Vertical Stock Fund Cost Comparison

DTIC Science & Technology

1974-08-01

units. Installation Supply Division account and other instal- lation operated activities: Self -Service Supply Store, Clothing Initial...installation supply operations are the Self -Service Supply Center, Clothing Sales Store, Central Issue Facility, and Clothing Initial Issue Point. Stock- age...stocks, stocks for installation operated supply activities such as the Self Service Supply Store, Clothing Sales Store and

Alternative Models of Service, Centralized Machine Operations. Phase II Report. Volume II.

ERIC Educational Resources Information Center

Technology Management Corp., Alexandria, VA.

A study was conducted to determine if the centralization of playback machine operations for the national free library program would be feasible, economical, and desirable. An alternative model of playback machine services was constructed and compared with existing network operations considering both cost and service. The alternative model was…

75 FR 59661 - Update of Overflight Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... existing Overflight Fees by using current FAA cost accounting data and air traffic activity data. This action is necessary because operational costs for providing air traffic control and related services for... would result in an increased level of cost recovery for the services being provided. DATES: Send your...

Estimating airline operating costs

NASA Technical Reports Server (NTRS)

Maddalon, D. V.

1978-01-01

A review was made of the factors affecting commercial aircraft operating and delay costs. From this work, an airline operating cost model was developed which includes a method for estimating the labor and material costs of individual airframe maintenance systems. The model, similar in some respects to the standard Air Transport Association of America (ATA) Direct Operating Cost Model, permits estimates of aircraft-related costs not now included in the standard ATA model (e.g., aircraft service, landing fees, flight attendants, and control fees). A study of the cost of aircraft delay was also made and a method for estimating the cost of certain types of airline delay is described.

Constrained Optimization of Average Arrival Time via a Probabilistic Approach to Transport Reliability

PubMed Central

Namazi-Rad, Mohammad-Reza; Dunbar, Michelle; Ghaderi, Hadi; Mokhtarian, Payam

2015-01-01

To achieve greater transit-time reduction and improvement in reliability of transport services, there is an increasing need to assist transport planners in understanding the value of punctuality; i.e. the potential improvements, not only to service quality and the consumer but also to the actual profitability of the service. In order for this to be achieved, it is important to understand the network-specific aspects that affect both the ability to decrease transit-time, and the associated cost-benefit of doing so. In this paper, we outline a framework for evaluating the effectiveness of proposed changes to average transit-time, so as to determine the optimal choice of average arrival time subject to desired punctuality levels whilst simultaneously minimizing operational costs. We model the service transit-time variability using a truncated probability density function, and simultaneously compare the trade-off between potential gains and increased service costs, for several commonly employed cost-benefit functions of general form. We formulate this problem as a constrained optimization problem to determine the optimal choice of average transit time, so as to increase the level of service punctuality, whilst simultaneously ensuring a minimum level of cost-benefit to the service operator. PMID:25992902

Advanced avionics concepts: Autonomous spacecraft control

NASA Technical Reports Server (NTRS)

1990-01-01

A large increase in space operations activities is expected because of Space Station Freedom (SSF) and long range Lunar base missions and Mars exploration. Space operations will also increase as a result of space commercialization (especially the increase in satellite networks). It is anticipated that the level of satellite servicing operations will grow tenfold from the current level within the next 20 years. This growth can be sustained only if the cost effectiveness of space operations is improved. Cost effectiveness is operational efficiency with proper effectiveness. A concept is presented of advanced avionics, autonomous spacecraft control, that will enable the desired growth, as well as maintain the cost effectiveness (operational efficiency) in satellite servicing operations. The concept of advanced avionics that allows autonomous spacecraft control is described along with a brief description of each component. Some of the benefits of autonomous operations are also described. A technology utilization breakdown is provided in terms of applications.

[Management control and operative budget at a radiology center].

PubMed

Ferrari, G; Musconi, V; Zappi, A; Cavina, A; Zanetti, M

1996-06-01

The laws reforming the National Health Service (SSN) (DL 30.12.92 n. 502 converted into DL 7.12.93 n.517) strongly modify the operation rules of the local sociosanitary units (USL) and imply that the rules themselves be reorganized with flexible and agile organization systems, introducing, in addition, a budget system as a tool for programming and checking the results. The essential elements for management evaluation are: -an accurate accounting system for every department, based on a detailed analysis of the productive factors directly used; -a survey of the activity data with uniform and established indices. This work deals with a radiology department as a responsible unit belonging to Imola State Administration. It is an intermediate service as its activity is for both in- and outpatients. To calculate the cost of the service provided to users and to define the use of resources, inpatients and outpatients costs were included. This involves adding the cost of the examinations requested of the intermediate service, that is, the radiology department. The operative tool used to ascribe the cost of these demands to the departments needs a transfer cost system showing the increasing value of the number of services that the intermediate service gives the final user. To evaluate the activity of the radiology department, we tried to identify an index of respective complexity for every examination: a figure which allows us to express the use of resources according to the complexity of the services given and to turn the number of examinations into significant activity.

Health care expenditures and therapeutic outcomes of a pharmacist-managed anticoagulation service versus usual medical care.

PubMed

Hall, Deanne; Buchanan, Julianne; Helms, Bethany; Eberts, Matthew; Mark, Scott; Manolis, Chronis; Peele, Pamela; Docimo, Anne

2011-07-01

To evaluate the differences in health care expenditures and therapeutic outcomes of patients receiving warfarin therapy management by a pharmacist-managed anticoagulation service compared with those receiving warfarin management by usual medical care. Retrospective, matched-cohort study. University of Pittsburgh Medical Center (UPMC) and UPMC Health Plan. Three hundred fifty adults who received warfarin therapy; 175 were managed by the pharmacist-managed anticoagulation service for at least 2 months between October 1, 2007, and September 30, 2008, (case patients) and 175 received usual care (matched comparison group). Medical claims data compared were direct anticoagulation cost and overall medical care costs, anticoagulation-related adverse events, hospitalizations and emergency department visits, frequency of international normalized ratio (INR) testing, and quantity of warfarin refills. Operational costs of the anticoagulation service were also calculated. The INR values and time within therapeutic range were assessed through anticoagulation service reports and laboratory results. The direct anticoagulation care cost was $35,465 versus $111,586 and the overall medical care cost was $754,191 versus $1,480,661 for the anticoagulation service group versus the usual care group. Accounting for operational and drug expenditure costs, the cost savings was $647,024 for the anticoagulation service group. The anticoagulation service group had significantly fewer anticoagulation-related adverse events (14 vs 41, p<0.0001), hospital admissions (3 vs 14, p<0.00001), and emergency department visits (58 vs 134, p<0.00001). The percentage of INR values in range and the percentage of time the INR values were in range were significantly higher in the anticoagulation service group (67.2% vs 54.6%, p<0.0001, and 73.7% vs 61.3%, p<0.0001, respectively). Compared with the usual care group, the anticoagulation service group had significantly more INR tests performed but demonstrated no significant difference in the quantity of drug refills. After accounting for operational costs, pharmacist-managed anticoagulation leads to reduced health care expenditure while improving therapeutic outcomes compared with usual medical care.

The cost structure of routine infant immunization services: a systematic analysis of six countries

PubMed Central

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-01-01

Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

The cost structure of routine infant immunization services: a systematic analysis of six countries.

PubMed

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-10-01

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.79 - Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent, small rural hospitals based on a Federal fiscal year 2002 base period. 412.79 Section 412.79 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 412.79 - Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent, small rural hospitals based on a Federal fiscal year 2002 base period. 412.79 Section 412.79 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 412.79 - Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent, small rural hospitals based on a Federal fiscal year 2002 base period. 412.79 Section 412.79 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.79 - Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent, small rural hospitals based on a Federal fiscal year 2002 base period. 412.79 Section 412.79 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

42 CFR 412.77 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. 412.77 Section 412.77 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT...

42 CFR 412.78 - Determination of the hospital-specific rate for inpatient operating costs for sole community...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. 412.78 Section 412.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

Study of short-haul aircraft operating economics, volume 1

NASA Technical Reports Server (NTRS)

1975-01-01

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

Voice Over Internet Protocol (VoIP) in a Control Center Environment

NASA Technical Reports Server (NTRS)

Pirani, Joseph; Calvelage, Steven

2010-01-01

The technology of transmitting voice over data networks has been available for over 10 years. Mass market VoIP services for consumers to make and receive standard telephone calls over broadband Internet networks have grown in the last 5 years. While operational costs are less with VoIP implementations as opposed to time division multiplexing (TDM) based voice switches, is it still advantageous to convert a mission control center s voice system to this newer technology? Marshall Space Flight Center (MSFC) Huntsville Operations Support Center (HOSC) has converted its mission voice services to a commercial product that utilizes VoIP technology. Results from this testing, design, and installation have shown unique considerations that must be addressed before user operations. There are many factors to consider for a control center voice design. Technology advantages and disadvantages were investigated as they refer to cost. There were integration concerns which could lead to complex failure scenarios but simpler integration for the mission infrastructure. MSFC HOSC will benefit from this voice conversion with less product replacement cost, less operations cost and a more integrated mission services environment.

A mission operations architecture for the 21st century

NASA Technical Reports Server (NTRS)

Tai, W.; Sweetnam, D.

1996-01-01

An operations architecture is proposed for low cost missions beyond the year 2000. The architecture consists of three elements: a service based architecture; a demand access automata; and distributed science hubs. The service based architecture is based on a set of standard multimission services that are defined, packaged and formalized by the deep space network and the advanced multi-mission operations system. The demand access automata is a suite of technologies which reduces the need to be in contact with the spacecraft, and thus reduces operating costs. The beacon signaling, the virtual emergency room, and the high efficiency tracking automata technologies are described. The distributed science hubs provide information system capabilities to the small science oriented flight teams: individual access to all traditional mission functions and services; multimedia intra-team communications, and automated direct transparent communications between the scientists and the instrument.

40 CFR 35.929-1 - Approval of the user charge system.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the grantee's costs of waste water treatment services; (B) The grantee's budgeting and accounting... operation and maintenance; (C) The ad valorem tax system collected tax funds for the costs of waste water..., which required the subscriber to pay its share of the cost of waste water treatment services. (4) A user...

40 CFR 35.929-1 - Approval of the user charge system.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the grantee's costs of waste water treatment services; (B) The grantee's budgeting and accounting... operation and maintenance; (C) The ad valorem tax system collected tax funds for the costs of waste water..., which required the subscriber to pay its share of the cost of waste water treatment services. (4) A user...

40 CFR 35.929-1 - Approval of the user charge system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the grantee's costs of waste water treatment services; (B) The grantee's budgeting and accounting... operation and maintenance; (C) The ad valorem tax system collected tax funds for the costs of waste water..., which required the subscriber to pay its share of the cost of waste water treatment services. (4) A user...

40 CFR 35.929-1 - Approval of the user charge system.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the grantee's costs of waste water treatment services; (B) The grantee's budgeting and accounting... operation and maintenance; (C) The ad valorem tax system collected tax funds for the costs of waste water..., which required the subscriber to pay its share of the cost of waste water treatment services. (4) A user...

40 CFR 35.929-1 - Approval of the user charge system.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the grantee's costs of waste water treatment services; (B) The grantee's budgeting and accounting... operation and maintenance; (C) The ad valorem tax system collected tax funds for the costs of waste water..., which required the subscriber to pay its share of the cost of waste water treatment services. (4) A user...

7 CFR 1.673 - How will the Forest Service analyze a proposed alternative and formulate its modified condition?

Code of Federal Regulations, 2010 CFR

2010-01-01

... evidence on the implementation costs or operational impacts for electricity production of the proposed... alternative: (1) Will, as compared to the Forest Service's preliminary condition: (i) Cost significantly less... alternative not adopted on: (1) Energy supply, distribution, cost, and use; (2) Flood control; (3) Navigation...

Lunar COTS: An Economical and Sustainable Approach to Reaching Mars

NASA Technical Reports Server (NTRS)

Zuniga, Allison F.; Rasky, Daniel; Pittman, Robert B.; Zapata, Edgar; Lepsch, Roger

2015-01-01

The NASA COTS (Commercial Orbital Transportation Services) Program was a very successful program that developed and demonstrated cost-effective development and acquisition of commercial cargo transportation services to the International Space Station (ISS). The COTS acquisition strategy utilized a newer model than normally accepted in traditional procurement practices. This new model used Space Act Agreements where NASA entered into partnerships with industry to jointly share cost, development and operational risks to demonstrate new capabilities for mutual benefit. This model proved to be very beneficial to both NASA and its industry partners as NASA saved significantly in development and operational costs while industry partners successfully expanded their market share of the global launch transportation business. The authors, who contributed to the development of the COTS model, would like to extend this model to a lunar commercial services program that will push development of technologies and capabilities that will serve a Mars architecture and lead to an economical and sustainable pathway to transporting humans to Mars. Over the past few decades, several architectures for the Moon and Mars have been proposed and studied but ultimately halted or not even started due to the projected costs significantly exceeding NASA's budgets. Therefore a new strategy is needed that will fit within NASA's projected budgets and takes advantage of the US commercial industry along with its creative and entrepreneurial attributes. The authors propose a new COTS-like program to enter into partnerships with industry to demonstrate cost-effective, cis-lunar commercial services, such as lunar transportation, lunar ISRU operations, and cis-lunar propellant depots that can enable an economical and sustainable Mars architecture. Similar to the original COTS program, the goals of the proposed program, being notionally referred to as Lunar Commercial Orbital Transfer Services (LCOTS) program will be to: 1) reduce development and operational costs by sharing costs with industry; 2) create new markets in cis-lunar space to further reduce operational costs; and 3) enable NASA to develop an affordable and economical exploration Mars architecture. The paper will describe a plan for a proposed LCOTS program, its potential impact to an eventual Mars architecture and its many benefits to NASA, commercial space industry and the US economy.

Assessing administrative costs of mental health and substance abuse services.

PubMed

Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

2004-05-01

Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

Determining Usability Versus Cost and Yields of a Regional Transport

NASA Technical Reports Server (NTRS)

Gvozdenovic, Slobodan

1999-01-01

Regional transports are designed to operate on air networks having the basic characteristics of short trip distances and low density passengers/cargo, i.e. small numbers of passengers per flight. Regional transports passenger capacity is from 10 to 100 seats and operate on routes from 350 to 1000 nautical miles (nm). In order to meet passenger requirements providing low fares and high or required number of frequencies, airlines must constantly monitor operational costs and keep them low. It is obvious that costs of operating aircraft must be lower than yield obtained by transporting passengers and cargo. The requirement to achieve favorable yield/cost ratio must provide the answer to the question of which aircraft will best meet a specific air network (Simpson, 1972). An air network is defined by the number of services, the trip distance of each service, and the number of flights (frequencies) per day and week.

A Collection of JPME Operational Contract Support Case Studies and Vignettes

DTIC Science & Technology

2016-12-01

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

31 CFR 206.10 - Operation of and payments from the Cash Management Improvements Fund.

Code of Federal Regulations, 2013 CFR

2013-07-01

... members will be the Commissioner and the Assistant Commissioner, Federal Finance, of the Service. The... deposits using such methods, including the costs of personal services and the costs of the lease or... Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT...

31 CFR 206.10 - Operation of and payments from the Cash Management Improvements Fund.

Code of Federal Regulations, 2012 CFR

2012-07-01

... members will be the Commissioner and the Assistant Commissioner, Federal Finance, of the Service. The... deposits using such methods, including the costs of personal services and the costs of the lease or... Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT...

31 CFR 206.10 - Operation of and payments from the Cash Management Improvements Fund.

Code of Federal Regulations, 2014 CFR

2014-07-01

... members will be the Commissioner and the Assistant Commissioner, Federal Finance, of the Service. The... deposits using such methods, including the costs of personal services and the costs of the lease or... Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE FISCAL...

31 CFR 206.10 - Operation of and payments from the Cash Management Improvements Fund.

Code of Federal Regulations, 2011 CFR

2011-07-01

... members will be the Commissioner and the Assistant Commissioner, Federal Finance, of the Service. The... deposits using such methods, including the costs of personal services and the costs of the lease or... Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT...

78 FR 2627 - Fees for Official Inspection and Official Weighing Services Under the United States Grain...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... compensation and benefits, travel, rent, communications, utilities, contractual services, supplies, and...- contract rate, plus the prevailing Toledo field office tonnage fee, plus the actual cost of travel. GIPSA... weighing services to recover its costs and build an operating reserve. Fees for foreign travel would be...

Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

PubMed Central

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2008-01-01

Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

Technical and economic aspects of the Intelsat system

NASA Astrophysics Data System (ADS)

Jefferis, A. K.

1992-03-01

The paper gives some background on the Intelsat system and explains the financial principles of the organization, which operates as a cost sharing cooperative. The members contribute both capital and operating costs in accordance with their use. The determination of the measure of 'use' in such a complex system requires a careful analysis of the factors which cause the cost. Most of these are technical, based on the use of satellite power, bandwidth and similar factors. Others reflect service related features such as priority, long-term commitment and market elasticity. This last element is only taken into account after ensuring that every service fully contributes the marginal cost of providing it.

A series on optimizing satellite systems. I - Restoring interruptions of communications sattelite service: Logistical and cost comparisons of mature and newly operational systems

NASA Astrophysics Data System (ADS)

Snow, Marcellus S.

1989-09-01

A mathematical model is presented of costs and operational factors involved in provision for service interruptions of both a mature and typically large incumbent satellite system and of a smaller, more recently operational system. The equation expresses the required launch frequency for the new system as a function of the launch spacing of the mature system; the time disparity between the inauguration of the two systems; and the rate of capacity depreciation. In addition, a technique is presented to compare the relative extent to which the discounted costs of the new system exceed those of the mature system in furnishing the same effective capacity in orbit, and thus the same service liability, at a given point in time. It is determined that a mature incumbent communications satellite system, having more capacity in orbit, will on balance have a lower probability of service interruption than a newer, smaller system.

45 CFR 1301.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM HEAD START... operating a Head Start program. Development and administrative costs mean costs incurred in accordance with...

42 CFR 56.301 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR MIGRANT HEALTH SERVICES Grants for Operating Migrant Health Centers § 56.301 Applicability. The regulations of this subpart, in... 319(d)(1)(A) of the Act for the costs of operation of migrant health centers in high impact areas. ...

42 CFR 56.401 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR MIGRANT HEALTH SERVICES Grants for Operating Migrant Health Entities § 56.401 Applicability. The regulations of this subpart, in... 319(d)(1)(B) of the Act for the costs of operation of entities which intend to become migrant health...

Bridging the gap between finance and clinical operations with activity-based cost management.

PubMed

Storfjell, J L; Jessup, S

1996-12-01

Activity-based cost management (ABCM) is an exciting management tool that links financial information with operations. By determining the costs of specific activities and processes, nurse managers accurately determine true costs of services more accurately than traditional cost accounting methods, and then can target processes for improvement and monitor them for change and improvement. The authors describe the ABCM process applied to nursing management situations.

Impact of congestion on bus operations and costs.

DOT National Transportation Integrated Search

2003-10-01

Traffic congestion in Northern New Jersey imposes substantial operational and monetary penalty on bus service. The purpose of this project was to quantify the additional time and costs due to traffic congestion. A regression model was developed that ...

42 CFR 137.167 - What cost principles must a Self-Governance Tribe follow when participating in self-governance...

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles § 137.167 What... modified by: (a) Section 106 (k) of the Act [25 U.S.C. 450j-1], (b) Other provisions of law, or (c) Any...

Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach

PubMed Central

2013-01-01

Background There is a paucity of knowledge on the cost of health care services in Ghana. This poses a challenge in the economic evaluation of programmes and inhibits policy makers in making decisions about allocation of resources to improve health care. This study analysed the overall cost of providing health services in selected primary health centres and how much of the cost is attributed to the provision of antenatal and delivery services. Methods The study has a cross-sectional design and quantitative data was collected between July and December 2010. Twelve government run primary health centres in the Kassena-Nankana and Builsa districts of Ghana were randomly selected for the study. All health-care related costs for the year 2010 were collected from a public service provider’s perspective. The step-down allocation approach recommended by World Health Organization was used for the analysis. Results The average annual cost of operating a health centre was $136,014 US. The mean costs attributable to ANC and delivery services were $23,063 US and $11,543 US respectively. Personnel accounted for the largest proportion of cost (45%). Overall, ANC (17%) and delivery (8%) were responsible for less than a quarter of the total cost of operating the health centres. By disaggregating the costs, the average recurrent cost was estimated at $127,475 US, representing 93.7% of the total cost. Even though maternal health services are free, utilization of these services at the health centres were low, particularly for delivery (49%), leading to high unit costs. The mean unit costs were $18 US for an ANC visit and $63 US for spontaneous delivery. Conclusion The high unit costs reflect underutilization of the existing capacities of health centres and indicate the need to encourage patients to use health centres .The study provides useful information that could be used for cost effectiveness analyses of maternal and neonatal care interventions, as well as for policy makers to make appropriate decisions regarding the allocation and sustainability of health care resources. PMID:23890185

Life-cycle cost as basis to optimize waste collection in space and time: A methodology for obtaining a detailed cost breakdown structure.

PubMed

Sousa, Vitor; Dias-Ferreira, Celia; Vaz, João M; Meireles, Inês

2018-05-01

Extensive research has been carried out on waste collection costs mainly to differentiate costs of distinct waste streams and spatial optimization of waste collection services (e.g. routes, number, and location of waste facilities). However, waste collection managers also face the challenge of optimizing assets in time, for instance deciding when to replace and how to maintain, or which technological solution to adopt. These issues require a more detailed knowledge about the waste collection services' cost breakdown structure. The present research adjusts the methodology for buildings' life-cycle cost (LCC) analysis, detailed in the ISO 15686-5:2008, to the waste collection assets. The proposed methodology is then applied to the waste collection assets owned and operated by a real municipality in Portugal (Cascais Ambiente - EMAC). The goal is to highlight the potential of the LCC tool in providing a baseline for time optimization of the waste collection service and assets, namely assisting on decisions regarding equipment operation and replacement.

Contracts and management services site support program plan WBS 6.10.14

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

Knoll, J.M. Jr.

1994-09-01

Contracts and Management Services is recognized as the central focal point for programs having company or sitewide application in pursuit of the Hanford Missions`s financial and operational objectives. Contracts and Management Services actively pursues cost savings and operational efficiencies through: Management Standards by ensuring all employees have an accessible, integrated system of clear, complete, accurate, timely, and useful management control policies and procedures; Contract Reform by restructuring the contract, organization, and cost accounting systems to refocus Hanford contract activities on output products; Systems and Operations Evaluation by directing the Cost Reduction program, Great Ideas, and Span of Management activities; Programmore » Administration by enforcing conditions of Accountability (whether DEAR-based or FAR-based) for WHC, BCSR, ICF KH, and BHI; Contract Performance activities; chairing the WHC Cost Reduction Review Board; and analyzing companywide Performance Measures; Data Standards and Administration by establishing and directing the company data management program; giving direction to the major RL programs and mission areas for implementation of cost-effective and efficient data management practices; directing all operations, application, and interfaces contained within the Hanford PeopleCore System; directing accomplishment and delivery of TPA data management milestones; and directing the sitewide data management processes for Data Standards and the Data Directory.« less

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

Schneider, Kevin; Tuffner, Frank; Elizondo, Marcelo

Regulated electricity utilities are required to provide safe and reliable service to their customers at a reasonable cost. To balance the objectives of reliable service and reasonable cost, utilities build and operate their systems to operate under typical historic conditions. As a result, when abnormal events such as major storms or disasters occur, it is not uncommon to have extensive interruptions in service to the end-use customers. Because it is not cost effective to make the existing electrical infrastructure 100% reliable, society has come to expect disruptions during abnormal events. However, with the increasing number of abnormal weather events, themore » public is becoming less tolerant of these disruptions. One possible solution is to deploy microgrids as part of a coordinated resiliency plan to minimize the interruption of power to essential loads. This paper evaluates the feasibility of using microgrids as a resiliency resource, including their possible benefits and the associated technical challenges. A use-case of an operational microgrid is included.« less

Cost, Emissions, and Customer Service Trade-Off Analysis In Pickup and Delivery Systems.

DOT National Transportation Integrated Search

2011-05-01

This research offers a novel formulation for including emissions into fleet assignment and vehicle routing, and for the : trade-offs faced by fleet operators between cost, emissions, and service quality. This approach enables evaluation of : the impa...

Data Service Provider Cost Estimation Tool

NASA Technical Reports Server (NTRS)

Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel

2011-01-01

The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

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

DTIC Science & Technology

2017-03-01

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

2001 contract management survey.

PubMed

2001-10-01

For the second year running, hospitals are spending more on clinical outsourcing than on business services. The Eleventh Annual Contract Services Survey shows that, in clinical areas, executives use outsourcing to acquire specialized expertise with cost savings secondary. Reducing costs and FTEs are the primary reasons for outsourcing business operations. Business service contracts are more likely to meet expectations for cost savings. Overall, satisfaction levels are up, but in some areas there's still a lot of room for improvement. This report examines current trends in outsourcing, strategies for the future, satisfaction levels, the decisionmaking process, contract features, and costs.

Services provided by community pharmacies in Wayne County, Michigan: a comparison by ZIP code characteristics.

PubMed

Erickson, Steven R; Workman, Paul

2014-01-01

To document the availability of selected pharmacy services and out-of-pocket cost of medication throughout a diverse county in Michigan and to assess possible associations between availability of services and price of medication and characteristics of residents of the ZIP codes in which the pharmacies were located. Cross-sectional telephone survey of pharmacies coupled with ZIP code-level census data. 503 pharmacies throughout the 63 ZIP codes of Wayne County, MI. The out-of-pocket cost for a 30 days' supply of levothyroxine 50 mcg and brand-name atorvastatin (Lipitor-Pfizer) 20 mg, availability of discount generic drug programs, home delivery of medications, hours of pharmacy operation, and availability of pharmacy-based immunization services. Census data aggregated at the ZIP code level included race, annual household income, age, and number of residents per pharmacy. The overall results per ZIP code showed that the average cost for levothyroxine was $10.01 ± $2.29 and $140.45 + $14.70 for Lipitor. Per ZIP code, the mean (± SD) percentages of pharmacies offering discount generic drug programs was 66.9% ± 15.0%; home delivery of medications was 44.5% ± 22.7%; and immunization for influenza was 46.7% ± 24.3% of pharmacies. The mean (± SD) hours of operation per pharmacy per ZIP code was 67.0 ± 25.2. ZIP codes with higher household income as well as higher percentage of residents being white had lower levothyroxine price, greater percentage of pharmacies offering discount generic drug programs, more hours of operation per week, and more pharmacy-based immunization services. The cost of Lipitor was not associated with any ZIP code characteristic. Disparities in the cost of generic levothyroxine, the availability of services such as discount generic drug programs, hours of operation, and pharmacy-based immunization services are evident based on race and household income within this diverse metropolitan county.

Technology management: a perspective on system support, procurement, and replacement planning.

PubMed

Dickerson, M L; Jackson, M E

1992-01-01

The escalating costs associated with medical technology present a host of challenges for the hospital clinical engineering department. As service and support costs comprise ever larger portions of a system's life cycle cost, innovative management of service provider mix and mechanisms can provide substantial savings in operating expenses. In addition to full-service contracts, the use of demand service and independents has become commonplace. Medical equipment maintenance insurance programs provide yet another service alternative, combining the flexibility of demand service with the safety of a capped budget. These programs have gained acceptance among hospitals as their providers have become more focused on the healthcare market and its many needs. In view of the long-term cost impact surrounding technology procurement, the authors recommend that hospitals refine system evaluation methodologies and develop more comprehensive techniques directed at capital equipment replacement planning. One replacement planning approach, based on an estimation of system value changes, is described and illustrated using data collected through client consultations. Although the validity of this method has not been demonstrated, it represents a simplified approach to life cycle cost analysis and is intended to provide a standard method by which system replacement planning may be quantified. As a departure from system devaluation based solely on depreciation, this method estimates prospective system values derived from anticipated operations and maintenance costs, projected revenue, and the availability of new technology.

Pricing of NASA Space Shuttle transportation system cargo

NASA Technical Reports Server (NTRS)

Hale, C. W.

1979-01-01

A two-part pricing policy is investigated as the most feasible method of pricing the transportation services to be provided by NASA's SSTS. Engineering cost estimates and a deterministic operating cost model generate a data base and develop a procedure for pricing the services of the SSTS. It is expected that the SSTS will have a monopoly on space material processing in areas of crystal growth, glass processing, metallurgical space applications, and biomedical processes using electrophoresis which will require efficient pricing. Pricing problems, the SSTS operating costs based on orbit elevation, number of launch sites, and number of flights, capital costs of the SSTS, research and development costs, allocation of joint transportation costs of the SSTS to a particular space processing activity, and rates for the SSTS are discussed. It is concluded that joint costs for commercial cargoes carried in the SSTS can be most usefully handled by making cost allocations based on proportionate capacity utilization.

77 FR 64076 - Vessel Traffic Service Updates, Including Establishment of Vessel Traffic Service Requirements...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-18

... Port Arthur, Texas and Expansion of VTS Special Operating Area in Puget Sound AGENCY: Coast Guard, DHS... Service (VTS) regulations in 33 CFR part 161. The proposed revisions include adding the Maritime Mobile... would impose Automatic Identification System (AIS) equipment costs for owners and operators of the...

The Army Did Not Effectively Monitor Contractor Performance for the Kuwait Base Operations and Security Support Services Contract

DTIC Science & Technology

2017-03-07

H 7 , 2 0 1 7 Report No. DODIG-2017-062 The Army Did Not Effectively Monitor Contractor Performance for the Kuwait Base Operations and Security...The Army Did Not Effectively Monitor Contractor Performance for the Kuwait Base Operations and Security Support Services Contract March 7, 2017... contractor performance for the Kuwait Base Operations and Security Support Services (KBOSSS) contract. The KBOSSS contract is a cost-plus-award-fee

Operation and maintenance cost-cutting

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

Hollingshead, T.W.

This presentation by Timothy W. Hollingshead, Technical Services Manager, Pacific Gas and Electric, is about cutting costs in the Operation and Maintenance phase of geothermal energy production. The necessity of cost control, keeping workers well-trained and avoiding OSHA fines, taking advantages of new technologies, and establishing predictive maintenance programs are some of the issues discussed in this article.

Cost of marking hardwood sawtimber in West Virginia

Treesearch

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

1963-01-01

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

Space Mission Operations Ground Systems Integration Customer Service

NASA Technical Reports Server (NTRS)

Roth, Karl

2014-01-01

The facility, which is now the Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center in Huntsville, AL, has provided continuous space mission and related services for the space industry since 1961, from Mercury Redstone through the International Space Station (ISS). Throughout the long history of the facility and mission support teams, the HOSC has developed a stellar customer support and service process. In this era, of cost cutting, and providing more capability and results with fewer resources, space missions are looking for the most efficient way to accomplish their objectives. One of the first services provided by the facility was fax transmission of documents to, then, Cape Canaveral in Florida. The headline in the Marshall Star, the newspaper for the newly formed Marshall Space Flight Center, read "Exact copies of Documents sent to Cape in 4 minutes." The customer was Dr. Wernher von Braun. Currently at the HOSC we are supporting, or have recently supported, missions ranging from simple ISS payloads requiring little more than "bentpipe" telemetry access, to a low cost free-flyer Fast, Affordable, Science and Technology Satellite (FASTSAT), to a full service ISS payload Alpha Magnetic Spectrometer 2 (AMS2) supporting 24/7 operations at three operations centers around the world with an investment of over 2 billion dollars. The HOSC has more need and desire than ever to provide fast and efficient customer service to support these missions. Here we will outline how our customer-centric service approach reduces the cost of providing services, makes it faster and easier than ever for new customers to get started with HOSC services, and show what the future holds for our space mission operations customers. We will discuss our philosophy concerning our responsibility and accessibility to a mission customer as well as how we deal with the following issues: initial contact with a customer, reducing customer cost, changing regulations and security, and cultural differences, to ensure an efficient response to customer issues using a small Customer Service Team (CST) and adaptability, constant communication with customers, technical expertise and knowledge of services, and dedication to customer service. The HOSC Customer Support Team has implemented a variety of processes, and procedures that help to mitigate the potential problems that arise when integrating ground system services for a variety of complex missions and the lessons learned from this experience will lead the future of customer service in the space operations industry.

Practical aspects of photovoltaic technology, applications and cost (revised)

NASA Technical Reports Server (NTRS)

Rosenblum, L.

1985-01-01

The purpose of this text is to provide the reader with the background, understanding, and computational tools needed to master the practical aspects of photovoltaic (PV) technology, application, and cost. The focus is on stand-alone, silicon solar cell, flat-plate systems in the range of 1 to 25 kWh/day output. Technology topics covered include operation and performance of each of the major system components (e.g., modules, array, battery, regulators, controls, and instrumentation), safety, installation, operation and maintenance, and electrical loads. Application experience and trends are presented. Indices of electrical service performance - reliability, availability, and voltage control - are discussed, and the known service performance of central station electric grid, diesel-generator, and PV stand-alone systems are compared. PV system sizing methods are reviewed and compared, and a procedure for rapid sizing is described and illustrated by the use of several sample cases. The rapid sizing procedure yields an array and battery size that corresponds to a minimum cost system for a given load requirement, insulation condition, and desired level of service performance. PV system capital cost and levelized energy cost are derived as functions of service performance and insulation. Estimates of future trends in PV system costs are made.

Using Cell Phones From Satellites

NASA Technical Reports Server (NTRS)

Horan, Stephen

2000-01-01

During the past several years, an interest has grown in using commercial telecommunications techniques to supply Telemetry and Command (T&C) services. Recently, the National Aeronautics and Space Administration (NASA) Space Operations Management Office (SOMO) has outlined plans to utilize satellite-based telecommunications services to support space operations in space missions over the next several decades. NASA currently obtains the bulk of its telecommunications services for earth-orbiting satellites via the existing government-owned and controlled Space Network (SN) system. This system consists of the constellation of Tracking and Data Relay Satellites (TDRS) in Geostationary Earth Orbit (GEO) and the associated ground terminals and communications intrastructure. This system is valuable and effective for scientific satellites costing over one million dollars. However, for smaller satellites, this system becomes problematic due to the cost of transponders and support infrastructure. The nominal transponders for using the TDRS cannot be obtained for a cost in dollars, and size, weight, or power that the 3 Corner Satellite project can afford. For these types of nanosatellite missions, alternatives that fit the mission cost and satellite profiles are needed. In particular, low-cost access using existing commercial infrastructure would be useful to mission planners. In particular, the ability to obtain low data rate T&C services would be especially valuable. The nanosatellites generally have low T&C requirements and therefore would benefit from using commercial services that could operate in the 2400 bps - 9600 bps range, especially if contact times longer than the 5 - 10 minute ground station passes could be found.

Spaceflight Operations Services Grid (SOSG) Project

NASA Technical Reports Server (NTRS)

Bradford, Robert; Lisotta, Anthony

2004-01-01

The motivation, goals, and objectives of the Space Operations Services Grid Project (SOSG) are covered in this viewgraph presentation. The goals and objectives of SOSG include: 1) Developing a grid-enabled prototype providing Space-based ground operations end user services through a collaborative effort between NASA, academia, and industry to assess the technical and cost feasibility of implementation of Grid technologies in the Space Operations arena; 2) Provide to space operations organizations and processes, through a single secure portal(s), access to all the information technology (Grid and Web based) services necessary for program/project development, operations and the ultimate creation of new processes, information and knowledge.

48 CFR 9905.506-60 - Illustrations.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., installs a computer service center to begin operations on May 1. The operating expense related to the new... operating expenses of the computer service center for the 8-month part of the cost accounting period may be... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Illustrations. 9905.506-60...

Cost containment in laundry and linen service.

PubMed

Ellis, B

1978-03-16

One major problem looms among all others in the area of laundry and linen service, whether a hospital has an in-house operation, is part of a shared or central laundry, or uses a commercial service. That is the costly problem of controling linen consumption and replacement. A recent seminar offers some insight into reasons for the problem and some possible solutions.

Investments and costs of oral health care for Family Health Care

PubMed Central

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

2016-01-01

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

Impact of Patient and Procedure Mix on Finances of Perinatal Centres – Theoretical Models for Economic Strategies in Perinatal Centres

PubMed Central

Hildebrandt, T.; Kraml, F.; Wagner, S.; Hack, C. C.; Thiel, F. C.; Kehl, S.; Winkler, M.; Frobenius, W.; Faschingbauer, F.; Beckmann, M. W.; Lux, M. P.

2013-01-01

Introduction: In Germany, cost and revenue structures of hospitals with defined treatment priorities are currently being discussed to identify uneconomic services. This discussion has also affected perinatal centres (PNCs) and represents a new economic challenge for PNCs. In addition to optimising the time spent in hospital, the hospital management needs to define the “best” patient mix based on costs and revenues. Method: Different theoretical models were proposed based on the cost and revenue structures of the University Perinatal Centre for Franconia (UPF). Multi-step marginal costing was then used to show the impact on operating profits of changes in services and bed occupancy rates. The current contribution margin accounting used by the UPF served as the basis for the calculations. The models demonstrated the impact of changes in services on costs and revenues of a level 1 PNC. Results: Contribution margin analysis was used to calculate profitable and unprofitable DRGs based on average inpatient cost per day. Nineteen theoretical models were created. The current direct costing used by the UPF and a theoretical model with a 100 % bed occupancy rate were used as reference models. Significantly higher operating profits could be achieved by doubling the number of profitable DRGs and halving the number of less profitable DRGs. Operating profits could be increased even more by changing the rates of profitable DRGs per bed occupancy. The exclusive specialisation on pathological and high-risk pregnancies resulted in operating losses. All models which increased the numbers of caesarean sections or focused exclusively on c-sections resulted in operating losses. Conclusion: These theoretical models offer a basis for economic planning. They illustrate the enormous impact potential changes can have on the operating profits of PNCs. Level 1 PNCs require high bed occupancy rates and a profitable patient mix to cover the extremely high costs incurred due to the services they are legally required to offer. Based on our theoretical models it must be stated that spontaneous vaginal births (not caesarean sections) were the most profitable procedures in the current DRG system. Overall, it currently makes economic sense for level I PNCs to treat as many low-risk pregnancies and neonates as possible to cover costs. PMID:24771932

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

Cost characteristics of tilt-rotor, conventional air and high speed rail short-haul intercity passenger service

NASA Technical Reports Server (NTRS)

Schoendorfer, David L.; Morlok, Edward K.

1985-01-01

The cost analysis done to support an assessment of the potential for a small tilt-rotor aircraft to operate in short-haul intercity passenger service is described in detail. Anticipated costs of tilt-rotor air service were compared to the costs of two alternatives: conventional air and high speed rail (HSR). Costs were developed for corridor service, varying key market characteristics including distance, passenger volumes, and minimum frequency standards. The resulting cost vs output information can then be used to compare modal costs for essentially identical service quality and passenger volume or for different service levels and volumes for each mode, as appropriate. Extensive sensitivity analyses are performed. The cost-output features of these technologies are compared. Tilt-rotor is very attractive compared to HSR in terms of costs over the entire range of volume. It also has costs not dramatically different from conventional air, but tilt-rotor costs are generally higher. Thus some of its other advantages, such as the VTOL capability, must offset the cost disadvantage for it to be a preferred or competitive mode in any given market. These issues are addressed in the companion report which considers strategies for tilt-rotor development in commercial air service.

Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services

PubMed Central

Rajabi, A; Dabiri, A

2012-01-01

Background Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990’s. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. Methods: To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. Results: The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Conclusion: Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services. PMID:23113171

Cost effectiveness of a community-based crisis intervention program for people bereaved by suicide.

PubMed

Comans, Tracy; Visser, Victoria; Scuffham, Paul

2013-01-01

Postvention services aim to ameliorate distress and reduce future incidences of suicide. The StandBy Response Service is one such service operating in Australia for those bereaved through suicide. Few previous studies have reported estimates or evaluations of the economic impact and outcomes associated with the implementation of bereavement/grief interventions. To estimate the cost-effectiveness of a postvention service from a societal perspective. A Markov model was constructed to estimate the health outcomes, quality-adjusted life years, and associated costs such as medical costs and time off work. Data were obtained from a prospective cross-sectional study comparing previous clients of the StandBy service with a control group of people bereaved by suicide who had not had contact with StandBy. Costs and outcomes were measured at 1 year after suicide bereavement and an incremental cost-effectiveness ratio was calculated. The base case found that the StandBy service dominated usual care with a cost saving from providing the StandBy service of AUS $803 and an increase in quality-adjusted life years of 0.02. Probabilistic sensitivity analysis indicates there is an 81% chance the service would be cost-effective given a range of possible scenarios. Postvention services are a cost-effective strategy and may even be cost-saving if all costs to society from suicide are taken into account.

SUMMARY OF ELECTRIC SERVICE COSTS FOR TOTALLY AIR CONDITIONED SCHOOLS PREPARED FOR HOUSTON INDEPENDENT SCHOOL DISTRICT, MAY 31, 1967.

ERIC Educational Resources Information Center

WHITESIDES, M.M.

THIS REPORT IS A COMPILATION OF DATA ON ELECTRIC AIR CONDITIONING COSTS, OPERATIONS AND MAINTENANCE. AIR CONDITIONING UNITS ARE COMPARED IN TERMS OF ELECTRIC VERSUS NON-ELECTRIC, AUTOMATIC VERSUS OPERATED, AIR COOLED VERSUS WATER COOLED, RECIPROCATING VERSUS CENTRIFUGAL COMPRESSORS, SPACE AND NOISE, REHEAT, MAINTENANCE AND ORIGINAL COST. DATA ARE…

42 CFR 413.302 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospectively Determined Payment Rates for Low-Volume Skilled Nursing Facilities, for Cost Reporting Periods Beginning Prior to July 1, 1998... Medicare cost report. Routine operating costs means the cost of regular room, dietary, and nursing services...

42 CFR 413.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospectively Determined Payment Rates for Low-Volume Skilled Nursing Facilities, for Cost Reporting Periods Beginning Prior to July 1, 1998... Medicare cost report. Routine operating costs means the cost of regular room, dietary, and nursing services...

42 CFR 413.302 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospectively Determined Payment Rates for Low-Volume Skilled Nursing Facilities, for Cost Reporting Periods Beginning Prior to July 1, 1998... Medicare cost report. Routine operating costs means the cost of regular room, dietary, and nursing services...

Cost-effectiveness of midwifery services vs. medical services in Quebec. LEquipe dEvaluation des Projets-Pilotes Sages-Femmes.

PubMed

Reinharz, D; Blais, R; Fraser, W D; Contandriopoulos, A P

2000-01-01

This study compared the cost-effectiveness of midwife services provided in birth centres operating as pilot projects with current hospital-based medical services in the province of Quebec. One thousand midwives' clients were matched with 1,000 physicians' clients on the basis of socio-demographic characteristics and obstetrical risk. Direct costs for the prenatal, intrapartum and postpartum periods were estimated. Effectiveness was assessed on the basis of three clinical indicators and four indices related to the individualization of care as assessed by women. Results show that the costs of midwife services were barely lower than or equal to those of physician services, but cost-effectiveness ratios were to the advantage of the midwife group, except for one clinical indicator (neonatal ventilation). Overall, this study provides rational support for the process of legalizing midwifery in the province.

Spending Changes and Scale Economies When School Districts Consolidate Services

ERIC Educational Resources Information Center

DeLuca, Thomas Anthony

2012-01-01

Educational policy makers continue to promote non-instructional service consolidation as one method to reduce operating costs through "economies of scale". Unfortunately, there is essentially no empirical evidence on the size or source of cost savings associated with such measures. Using panel data from 2004-2010, this mixed methods…

42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and capital-related costs for each inpatient stay following submission of a bill. (b) Periodic interim payments (PIP...

30 CFR 1220.011 - Schedule of allowable direct and allocable joint costs and credits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... engineering design problems related to equipment or facilities required for NPSL operations. (4) The cost of any contract service related to research and development is specifically excluded, as are contract services calling for feasibility studies not directly related to specific engineering design problems or...

Unintended Consequences of Cost Recovery

ERIC Educational Resources Information Center

Piercey, David

2010-01-01

An Alberta school district that used a cost-recovery model to finance school services for 20 years is finding that the model produces unintended negative results. Some schools didn't spend this money on services but used it for other school operations. Some spent the money on external consultants. Professional relationships were damaged, and…

Clinical governance and operations management methodologies.

PubMed

Davies, C; Walley, P

2000-01-01

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

Low Cost Airline Service Revolution

DOT National Transportation Integrated Search

1996-04-01

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

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2014 CFR

2014-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2011 CFR

2011-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

Operations analysis (study 2.6). Volume 4: Computer specification; logistics of orbiting vehicle servicing (LOVES)

NASA Technical Reports Server (NTRS)

1973-01-01

The logistics of orbital vehicle servicing computer specifications was developed and a number of alternatives to improve utilization of the space shuttle and the tug were investigated. Preliminary results indicate that space servicing offers a potential for reducing future operational and program costs over ground refurbishment of satellites. A computer code which could be developed to simulate space servicing is presented.

LMSS SERVICES FINANCIAL REPORT PROGRAM

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.

1994-01-01

The objective of this Services Finance Report program is to provide a means for comparing alternative designs of LMSS systems or other services systems. This program is actually a Multiplan worksheet. The labels used in the worksheet were chosen for a satellite-based cellular communication service (LMSS - Land Mobile Satellite System) but the analysis is not restricted to such cases. A comprehensive financial model is used to calculate a 'figure of merit' which can be used to compare effects of equipment and operating costs, pricing strategy, and customer demand for different systems. The program also calculates the price that a company would have to charge customers to meet all its expenses and make a specified profit. A price estimate can be obtained for almost any service which is heavily dependent on capital investment and which has operating costs that depend on the amount of service sold. The economic analysis has two main components: supplier finances and customer finances. Supplier finances include amortization, interest, insurance, taxes, and operating and maintenance expenses. Customer finances include usage rate, subscription fees, equipment costs, and estimated traffic. Prices can defined as real or nominal to account for effects of escalation and inflation, and the profits can be regulated or unrestricted This program is written for interactive execution with Multiplan (version 1.2) and has been implemented on an IBM PC series computer operating under DOS (version 2.11). The LMSS worksheet has a space requirement of approximately 38K of 8 bit bytes. This worksheet was developed in 1984.

Cost effectiveness of teratology counseling - the Motherisk experience.

PubMed

Koren, Gideon; Bozzo, Pina

2014-01-01

While the benefits of evidence-based counseling to large numbers of women and physicians are intuitively evident, there is an urgent need to document that teratology counseling, in addition to improving the quality of life of women and families, also leads to cost saving. The objective of the present study was to calculate the cost effectiveness of the Motherisk Program, a large teratology information and counseling service at The Hospital for Sick Children and the University of Toronto. We analyzed data from the Motherisk Program on its 2012 activities in two domains: 1) Calculation of cost-saving in preventing unjustified pregnancy terminations; and 2) prevention of major birth defects. Cost of pregnancy termination and lifelong cost of specific birth defects were identified from primary literature and prorated for cost of living for the year 2013. Prevention of 255 pregnancy terminations per year led to cost savings of $516,630. The total estimated number of major malformations prevented by Motherisk counseling in 2012 was 8.41 cases at a total estimated cost of $9,032,492. With an estimated minimum annual prevention of 8 major malformations, and numerous unnecessary terminations of otherwise- wanted pregnancies, a cost saving of $10 million can be calculated. In 2013 the operating budget of Motherisk counseling totaled $640,000. Even based on the narrow range of activities for which we calculated cost, this service is highly cost- effective. Because most teratology counseling services are operating in a very similar method to Motherisk, it is fair to assume that these results, although dependent on the size of the service, are generalizable to other countries.

Cost effective launch operations of the SSME

NASA Technical Reports Server (NTRS)

Klatt, F. P.

1985-01-01

The Space Shuttle Main Engine (SSME) represents the beginning of reusable rocket engine operations in the space transportation system (STS). Steps taken to reduce the overall cost of flight operations of the SSME by improving turnaround operations, extending the life of the engine, and improving the cost effectiveness of overhaul operations at the Canoga Park home plant are described. Ground certification testing to ensure safe launch operations is described, as well as certification extension testing that leads to a service life equivalent to 40 flights. The proven flight record of the SSME, which has demonstrated the utility of the SSME as a key component of America's space transportation system, is discussed.

Cost Accounting: Production and Equipment Services.

ERIC Educational Resources Information Center

Schmid, William T.

Cost accounting for audiovisual productions should include direct costs, and, in some cases, the media administrator may have to calculate a per-hour surcharge for general operating overhead as well. Such procedures enable the administrator to determine cost effectiveness, to control cost overruns, and to generate more staff efficiency. Cost…

29 CFR 4901.31 - Charges for services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... operating duplicating machinery. Not included in direct costs are overhead expenses such as costs of space... this part, in a form that is reasonably usable by the requester. Copies can take the form of paper copy... scholarly research. (ii) Noncommercial scientific institution means an institution that is not operated on a...

29 CFR 4901.31 - Charges for services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... operating duplicating machinery. Not included in direct costs are overhead expenses such as costs of space... this part, in a form that is reasonably usable by the requester. Copies can take the form of paper copy... scholarly research. (ii) Noncommercial scientific institution means an institution that is not operated on a...

29 CFR 4901.31 - Charges for services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... operating duplicating machinery. Not included in direct costs are overhead expenses such as costs of space... this part, in a form that is reasonably usable by the requester. Copies can take the form of paper copy... scholarly research. (ii) Noncommercial scientific institution means an institution that is not operated on a...

47 CFR 76.924 - Allocation to service cost categories.

Code of Federal Regulations, 2013 CFR

2013-10-01

... franchise, system, regional, and/or company level(s) in a manner consistent with the accounting practices of the operator on April 3, 1993. However, in all events, cable operators shall identify at the franchise level their costs of franchise requirements, franchise fees, local taxes and local programming. (d...

47 CFR 76.924 - Allocation to service cost categories.

Code of Federal Regulations, 2012 CFR

2012-10-01

... franchise, system, regional, and/or company level(s) in a manner consistent with the accounting practices of the operator on April 3, 1993. However, in all events, cable operators shall identify at the franchise level their costs of franchise requirements, franchise fees, local taxes and local programming. (d...

47 CFR 76.924 - Allocation to service cost categories.

Code of Federal Regulations, 2014 CFR

2014-10-01

... franchise, system, regional, and/or company level(s) in a manner consistent with the accounting practices of the operator on April 3, 1993. However, in all events, cable operators shall identify at the franchise level their costs of franchise requirements, franchise fees, local taxes and local programming. (d...

47 CFR 76.924 - Allocation to service cost categories.

Code of Federal Regulations, 2011 CFR

2011-10-01

... franchise, system, regional, and/or company level(s) in a manner consistent with the accounting practices of the operator on April 3, 1993. However, in all events, cable operators shall identify at the franchise level their costs of franchise requirements, franchise fees, local taxes and local programming. (d...

44 CFR 353.6 - Schedule of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... shall be charged the full cost of site-specific services based upon the appropriate professional hourly... will be charged to the licensee by FEMA, at the rate and cost incurred. (a) When a State seeks formal.... This provision does not apply where an operating license has been granted or the application denied or...

78 FR 72151 - Proposed Collection; Comment Request on Information Collection Tools Relating to Using Omnibus...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... satisfying experience with the Agency's programs. This feedback will provide insights into customer or stakeholder perceptions, experiences and expectations, provide an early warning of issues with service, or...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

NALNET book system: Cost benefit study

NASA Technical Reports Server (NTRS)

Dewath, N. V.; Palmour, V. E.; Foley, J. R.; Henderson, M. M.; Shockley, C. W.

1981-01-01

The goals of the NASA's library network system, NALNET, the functions of the current book system, the products and services of a book system required by NASA Center libraries, and the characteristics of a system that would best supply those products and services were assessed. Emphasis was placed on determining the most cost effective means of meeting NASA's requirements for an automated book system. Various operating modes were examined including the current STIMS file, the PUBFILE, developing software improvements for products as appropriate to the Center needs, and obtaining cataloging and products from the bibliographic utilities including at least OCLC, RLIN, BNA, and STIF. It is recommended that NALNET operate under the STIMS file mode and obtain cataloging and products from the bibliographic utilities. The recommendations are based on the premise that given the current state of the art in library automation it is not cost effective for NASA to maintain a full range of cataloging services on its own system. The bibliographic utilities can support higher quality systems with a greater range of services at a lower total cost.

A cost-constrained model of strategic service quality emphasis in nursing homes.

PubMed

Davis, M A; Provan, K G

1996-02-01

This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.

Space station: Cost and benefits

NASA Technical Reports Server (NTRS)

1983-01-01

Costs for developing, producing, operating, and supporting the initial space station, a 4 to 8 man space station, and a 4 to 24 man space station are estimated and compared. These costs include contractor hardware; space station assembly and logistics flight costs; and payload support elements. Transportation system options examined include orbiter modules; standard and extended duration STS fights; reusable spacebased perigee kick motor OTV; and upper stages. Space station service charges assessed include crew hours; energy requirements; payload support module storage; pressurized port usage; and OTV service facility. Graphs show costs for science missions, space processing research, small communication satellites; large GEO transportation; OVT launch costs; DOD payload costs, and user costs.

42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What operational requirements apply to an entity to... Assignment of National Health Service Corps Personnel § 23.8 What operational requirements apply to an entity...; and (g) Establish basic data, cost accounting, and management information and reporting systems as...

A cost analysis of family planning in Bangladesh.

PubMed

Fiedler, J L; Day, L M

1997-01-01

This article presents a step-down cost analysis using secondary data sources from 26 Bangladesh non-government organizations (NGOs) providing family planning services under a US Agency for International Development-funded umbrella organization. The unit costs of the NGOs' Maternal-Child Health (MCH) clinics and community-based distribution (CBD) systems were calculated and found to be minimally different. Several simulations were conducted to investigate the impact of alternative cost-reduction measures. The more general financial analysis proved more insightful than the unit cost analysis in terms of identifying means by which to improve the efficiency of the family planning operations of these NGOs. The analysis revealed that 56 per cent of total expenditures in the two-tiered umbrella's organizational structure are incurred in management operations and overheads. Of the remaining 44 per cent of project expenditures, 39 per cent is spent on the CBD program and 5 per cent on the MCH clinics. Within the CBD program, most resources are spent providing 4 million contacts (two-thirds of the annual total) which do not involve contraceptive re-supply. The clinics devote more resources to providing MCH services than to providing family planning services. The findings suggest that significant savings could be generated by containing administrative costs, improving operational efficiency, and reducing unnecessary or redundant fieldworker contacts. The magnitude of the potential savings raises a fundamental question about the continued viability and sustainability of this supply-driven CBD strategy.

7 CFR Appendix B to Part 4280 - Technical Reports for Projects With Total Eligible Project Costs Greater Than $200,000

Code of Federal Regulations, 2010 CFR

2010-01-01

..., and maintenance of the renewable energy system or energy efficiency improvement will operate or..., installation, and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

7 CFR Appendix B to Part 4280 - Technical Reports for Projects With Total Eligible Project Costs Greater Than $200,000

Code of Federal Regulations, 2011 CFR

2011-01-01

..., and maintenance of the renewable energy system or energy efficiency improvement will operate or..., installation, and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

46 CFR Sec. 3 - Terminal operating contract.

Code of Federal Regulations, 2014 CFR

2014-10-01

... in all respects and seek to avoid any delay, loss or damage whatsoever to United States shipping. The... additional amount in payment or credit for any service, loss, cost of expense, whether or not specifically... the operator. (d) No payment will be made for handling ship stores or providing services properly...

46 CFR Sec. 3 - Terminal operating contract.

Code of Federal Regulations, 2013 CFR

2013-10-01

... in all respects and seek to avoid any delay, loss or damage whatsoever to United States shipping. The... additional amount in payment or credit for any service, loss, cost of expense, whether or not specifically... the operator. (d) No payment will be made for handling ship stores or providing services properly...

47 CFR 54.101 - Supported services for rural, insular and high cost areas.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Dual tone multi-frequency signaling or its functional equivalent. “Dual tone multi-frequency” (DTMF) is a method of signaling that facilitates the transportation of signaling through the network... systems; (6) Access to operator services. “Access to operator services” is defined as access to any...

Organizing for low cost space operations - Status and plans

NASA Technical Reports Server (NTRS)

Lee, C.

1976-01-01

Design features of the Space Transportation System (vehicle reuse, low cost expendable components, simple payload interfaces, standard support systems) must be matched by economical operational methods to achieve low operating and payload costs. Users will be responsible for their own payloads and will be charged according to the services they require. Efficient use of manpower, simple documentation, simplified test, checkout, and flight planning are firm goals, together with flexibility for quick response to varying user needs. Status of the Shuttle hardware, plans for establishing low cost procedures, and the policy for user charges are discussed.

Critical operations capabilities in a high cost environment: a multiple case study

NASA Astrophysics Data System (ADS)

Sansone, C.; Hilletofth, P.; Eriksson, D.

2018-04-01

Operations capabilities have been a popular research area for many years and several frameworks have been proposed in the literature. The current frameworks do not take specific contexts into consideration, for instance a high cost environment. This research gap is of particular interest since a manufacturing relocation process has been ongoing the last decades, leading to a huge amount of manufacturing being moved from high to low cost environments. The purpose of this study is to identify critical operations capabilities in a high cost environment. The two research questions were: What are the critical operations capabilities dimensions in a high cost environment? What are the critical operations capabilities in a high cost environment? A multiple case study was conducted and three Swedish manufacturing firms were selected. The study was based on the investigation of an existing framework of operations capabilities. The main dimensions of operations capabilities included in the framework were: cost, quality, delivery, flexibility, service, innovation and environment. Each of the dimensions included two or more operations capabilities. The findings confirmed the validity of the framework and its usefulness in a high cost environment and a new operations capability was revealed (employee flexibility).

37 CFR 251.54 - Assessment of costs of arbitration panels.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Accounting Operations Section, Financial Services Directorate, Library of Congress, 101 Independence Avenue... Service and similar corporate courier services), use the following address: Copyright Office General... corporate courier services may not be used for correspondence and filings for the Copyright Arbitration...

Applications of Should Cost to Achieve Cost Reductions

DTIC Science & Technology

2014-04-01

Operation of the defense acquisition system . Interim DoD Instruction 5000.02. Washington, DC: Office of the Deputy Secretary of Defense. Gutterman...including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson...FAR) § 15.407-4 that refers primarily to an extensive review of a contractor’s operations to identify and promote more economical and efficient

CCSDS Spacecraft Monitor and Control Mission Operations Interoperability Prototype

NASA Technical Reports Server (NTRS)

Lucord, Steve; Martinez, Lindolfo

2009-01-01

We are entering a new era in space exploration. Reduced operating budgets require innovative solutions to leverage existing systems to implement the capabilities of future missions. Custom solutions to fulfill mission objectives are no longer viable. Can NASA adopt international standards to reduce costs and increase interoperability with other space agencies? Can legacy systems be leveraged in a service oriented architecture (SOA) to further reduce operations costs? The Operations Technology Facility (OTF) at the Johnson Space Center (JSC) is collaborating with Deutsches Zentrum fur Luft- und Raumfahrt (DLR) to answer these very questions. The Mission Operations and Information Management Services Area (MOIMS) Spacecraft Monitor and Control (SM&C) Working Group within the Consultative Committee for Space Data Systems (CCSDS) is developing the Mission Operations standards to address this problem space. The set of proposed standards presents a service oriented architecture to increase the level of interoperability among space agencies. The OTF and DLR are developing independent implementations of the standards as part of an interoperability prototype. This prototype will address three key components: validation of the SM&C Mission Operations protocol, exploration of the Object Management Group (OMG) Data Distribution Service (DDS), and the incorporation of legacy systems in a SOA. The OTF will implement the service providers described in the SM&C Mission Operation standards to create a portal for interaction with a spacecraft simulator. DLR will implement the service consumers to perform the monitor and control of the spacecraft. The specifications insulate the applications from the underlying transport layer. We will gain experience with a DDS transport layer as we delegate responsibility to the middleware and explore transport bridges to connect disparate middleware products. A SOA facilitates the reuse of software components. The prototype will leverage the capabilities of existing legacy systems. Various custom applications and middleware solutions will be combined into one system providing the illusion of a set of homogenous services. This paper will document our journey as we implement the interoperability prototype. The team consists of software engineers with experience on the current command, telemetry and messaging systems that support the International Space Station (ISS) and Space Shuttle programs. Emphasis will be on the objectives, results and potential cost saving benefits.

Ag-Air Service

NASA Technical Reports Server (NTRS)

1981-01-01

Econ, Inc.'s agricultural aerial application, "ag-air," involves more than 10,000 aircraft spreading insecticides, herbicides, fertilizer, seed and other materials over millions of acres of farmland. Difficult for an operator to estimate costs accurately and decide what to charge or which airplane can handle which assignment most efficiently. Computerized service was designed to improve business efficiency in choice of aircraft and determination of charge rates based on realistic operating cost data. Each subscriber fills out a detailed form which pertains to his needs and then receives a custom-tailored computer printout best suited to his particular business mix.

42 CFR 419.2 - Basis of payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... part. (b) Determination of hospital outpatient prospective payment rates: Packaged costs. The..., that includes operating and capital-related costs that are integral, ancillary, supportive, dependent..., these packaged costs may include, but are not limited to, the following items and services, the payment...

Upgrading Food Service Operations.

ERIC Educational Resources Information Center

School Business Affairs, 1983

1983-01-01

The Murphy Elementary School District in Phoenix, Arizona has cut food service costs and improved community relations by cooking and baking from "scratch" and utilizing the staff's ethnic cooking skills. (MLF)

ITOS/space shuttle study

NASA Technical Reports Server (NTRS)

1971-01-01

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

Space Shuttle capabilities, constraints, and cost

NASA Technical Reports Server (NTRS)

Lee, C. M.

1980-01-01

The capabilities, constraints, and costs of the Space Transportation System (STS), which combines reusable and expendable components, are reviewed, and an overview of the current planning activities for operating the STS in an efficient and cost-effective manner is presented. Traffic forecasts, performance constraints and enhancements, and potential new applications are discussed. Attention is given to operating costs, pricing policies, and the steps involved in 'getting on board', which includes all the interfaces between NASA and the users necessary to come to launch service agreements.

14 CFR 1214.202 - Reimbursement policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... according to the reimbursement schedule plus short term call-up additional costs. The additional costs will... services. (2) The price will be based on estimated costs. (3) The price will be held constant for flights...) Subsequent to the first three years, the price will be adjusted annually to insure that total operating costs...

Supplemental/Replacement: An Alternative Approach to Excess Costs.

ERIC Educational Resources Information Center

Hartman, William T.

1990-01-01

This article proposes a new operational definition of excess cost in determining state and federal funding for special education. The new approach is based on programs and services rather than accounting calculations of the difference between special education cost per student and regular education cost per student. (Author/DB)

76 FR 58433 - Proposal To Revise Service Standards for First-Class Mail, Periodicals, and Standard Mail

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... sharp revenue declines associated with falling volumes, as well as other statutorily mandated costs, the... and to bring operating costs in line with revenues, will for the most part be unachievable without a... effectively managed on the workroom floors of a complex logistical network.'' Modern Service Standards for...

78 FR 13402 - Proposed Collection; Comment Request for Tip Reporting Alternative Tip Agreement Used in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-27

... Revenue Service in its tax compliance efforts to assist employers and their employees in understanding and... material in the administration of any internal revenue law. Generally, tax returns and tax return...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

..., as described in § 412.2(c), for the 12-month or longer cost reporting period ending on or after... qualified nonphysician anesthetists' services, as described in § 412.113(c). (c) Hospital's request for...' services for which a physician employer continues to bill under § 405.553(b)(4) of this chapter. (ii) The...

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

Code of Federal Regulations, 2011 CFR

2011-10-01

..., as described in § 412.2(c), for the 12-month or longer cost reporting period ending on or after... qualified nonphysician anesthetists' services, as described in § 412.113(c). (c) Hospital's request for...' services for which a physician employer continues to bill under § 405.553(b)(4) of this chapter. (ii) The...

Differentiated protection method in passive optical networks based on OPEX

NASA Astrophysics Data System (ADS)

Zhang, Zhicheng; Guo, Wei; Jin, Yaohui; Sun, Weiqiang; Hu, Weisheng

2011-12-01

Reliable service delivery becomes more significant due to increased dependency on electronic services all over society and the growing importance of reliable service delivery. As the capability of PON increasing, both residential and business customers may be included in a PON. Meanwhile, OPEX have been proven to be a very important factor of the total cost for a telecommunication operator. Thus, in this paper, we present the partial protection PON architecture and compare the operational expenditures (OPEX) of fully duplicated protection and partly duplicated protection for ONUs with different distributed fiber length, reliability requirement and penalty cost per hour. At last, we propose a differentiated protection method to minimize OPEX.

Longitudinal analysis of high-technology medical services and hospital financial performance.

PubMed

Zengul, Ferhat D; Weech-Maldonado, Robert; Ozaydin, Bunyamin; Patrician, Patricia A; OʼConnor, Stephen J

U.S. hospitals have been investing in high-technology medical services as a strategy to improve financial performance. Despite the interest in high-tech medical services, there is not much information available about the impact of high-tech services on financial performance. The aim of this study was to examine the impact of high-tech medical services on financial performance of U.S. hospitals by using the resource-based view of the firm as a conceptual framework. Fixed-effects regressions with 2 years lagged independent variables using a longitudinal panel sample of 3,268 hospitals (2005-2010). It was hypothesized that hospitals with rare or large numbers (breadth) of high-tech medical services will experience better financial performance. Fixed effects regression results supported the link between a larger breadth of high-tech services and total margin, but only among not-for-profit hospitals. Both breadth and rareness of high-tech services were associated with high total margin among not-for-profit hospitals. Neither breadth nor rareness of high-tech services was associated with operating margin. Although breadth and rareness of high-tech services resulted in lower expenses per inpatient day among not-for-profit hospitals, these lower costs were offset by lower revenues per inpatient day. Enhancing the breadth of high-tech services may be a legitimate organizational strategy to improve financial performance, especially among not-for-profit hospitals. Hospitals may experience increased productivity and efficiency, and therefore lower inpatient operating costs, as a result of newer technologies. However, the negative impact on operating revenue should caution hospital administrators about revenue reducing features of these technologies, which may be related to the payer mix that these technologies may attract. Therefore, managers should consider both the cost and revenue implications of these technologies.

Unit Cost of Medical Services at Different Hospitals in India

PubMed Central

Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

2013-01-01

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

Models Used by the Military Services to Develop Budgets for Activities Associated with Operational Readiness

DTIC Science & Technology

2012-02-01

Operating Tempo and Training ($19.0 billion) Facilities ($18.1 billion) Maintenance ($11.3 billion) Not Modeled ($26.3 billion) Miscellaneous...Adebayo Adedeji, Daniel Frisk, and Derek Trunkey of CBO’s National Secur supervision of Matthew Goldberg and David Mosher. CBO staff members Elizabeth...rs M ce F ciliti e Op nt M aintng Direct Costs for Unit Operating Tempo and Training ng Indirect Costs for Unit Operating Tempo and Training odel

Operations Analysis of the 2nd Generation Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

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

2002-01-01

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

An Evaluation of Food Service Systems at Fort Myer, Bolling Air Force Base and Fort Benjamin Harrison

DTIC Science & Technology

1974-09-01

A comparative evaluation of the food service operations at Fort Myer, Virginia; Bolling Air Force Base, Maryland; and Fort Benjamin Harrison, Indiana...was conducted. These three bases each represent different types of food service systems, which are respectively: contract provided food and labor...Operations Research and Systems Analysis Office had the responsibility for comparing the costs, nutritional aspects and consumer attitudes involved in these three different systems of food service .

Assessment of the commercial viability of selected options for on-orbit servicing (OOS)

NASA Astrophysics Data System (ADS)

Graham, Andrew Robert; Kingston, Jennifer

2015-12-01

The aim of this paper is to determine the commercial viability of on-orbit servicing of communications satellites in geostationary orbit. Previous studies have shown the technical feasibility of servicing as well as the financial viability of some missions, in particular refuelling, therefore this paper analyses these repair missions and life extension missions. A simple parametric model for simulating communications satellite revenue streams is developed and the results are used to determine the maximum possible revenue for a servicing satellite operator. From this, the maximum cost of the servicing satellite as a proportion of the cost of the communications satellite is determined under three profit scenarios representing zero profit, acceptable profit to an operator in a mature industry and acceptable profit to an operator in an emerging industry. The results show that while servicing is financially viable (zero profit scenario), those missions which result in an increase in Comsat life which is a multiple of the mission duration are more likely to be commercially viable. Refuelling is therefore viable in all cases but life extension in most cases is only marginally viable. Repair missions to satellites which are partially operable are also unlikely to deliver sufficient value to justify carrying out servicing. Also the timing of a servicing mission in relation to the expected remaining life expectancy is a major factor in determining the mission's viability.

DORCA II: Dynamic operations requirements and cost analysis program

NASA Technical Reports Server (NTRS)

1976-01-01

Program is written to handle logistics of acquisition and transport of personnel, equipment, and services and to determine costs, transport schedules, acquisition schedules, and fuel requirements of cargo transport.

77 FR 65607 - Internal Revenue Service

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... Form 720 returns a systemic way to order additional tax forms and informational publications. Current... forms of information technology; and (e) estimates of capital or start-up costs and costs of operation...

7 CFR Appendix B to Subpart B of... - Technical Reports for Projects With Total Eligible Project Costs of Greater Than $200,000

Code of Federal Regulations, 2014 CFR

2014-01-01

... maintenance of the renewable energy system or energy efficiency improvement will operate or perform as..., and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

7 CFR Appendix B to Subpart B of... - Technical Reports for Projects With Total Eligible Project Costs of Greater Than $200,000

Code of Federal Regulations, 2013 CFR

2013-01-01

... maintenance of the renewable energy system or energy efficiency improvement will operate or perform as..., and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

7 CFR Appendix B to Subpart B of... - Technical Reports for Projects With Total Eligible Project Costs of Greater Than $200,000

Code of Federal Regulations, 2012 CFR

2012-01-01

... maintenance of the renewable energy system or energy efficiency improvement will operate or perform as..., and maintenance. Authoritative evidence that project team service providers have the necessary... and shakedown, warranties, insurance, financing, professional services, and operations and maintenance...

76 FR 22877 - Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

..., and clarify guidance on the cost effectiveness and accountability of services provided. The... hours for current providers. Estimated Total Burden Hours: 658 hours. Total Burden Cost (capital/startup): None. Total Burden Cost (operating/maintenance): None. Comments submitted in response to this notice...

Cost Estimates For Selected California Smart Traveler Operational Tests, Volume 1, Technical Report

DOT National Transportation Integrated Search

1993-03-01

THIS REPORT ALSO COMPARES THE COSTS OF USING "SMART-TRAVELER" APPROACHES WITH THE COSTS OF EXPANDING CONVENTIONAL TRANSIT SERVICES TO REDUCE TRAFFIC CONGESTION, AIR POLLUTION AND MOBILITY PROBLEMS IN SUBURBAN AREAS, WHERE MOST PEOPLE IN U.S. METROPOL...

Challenges and lessons learned in the application of autonomy to space operations

NASA Technical Reports Server (NTRS)

Forrest, David J.; Statman, Joseph I.

2001-01-01

NASA's Space Operations Management Office (SOMO) is working toward a goal of providing an integrated infrastructure of mission and data services for space missions undertaken by NASA enterprises. A significant portion of this effort is focused on reducing the cost of these services. We are interested in the potential of autonomy to reduce operations costs. Some attempts have already been made to apply autonomy and automation in these areas in the past with varying degrees of success. We present brief case histories and the lessons inferred from them. Combining this past experience with anticipated future needs, we attempt to clarify the challenges that must be met in order to realize the benefits of autonomy.

The relative importance of factors that determine log-hauling costs

Treesearch

A. Jeff Martin; A. Jeff Martin

1971-01-01

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

75 FR 42827 - Proposed Collection; Comment Request for Regulation 209619-93

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... deferred section 1031 exchanges; pre-closing escrows; contingent at-closing escrows; and disputed ownership... costs and costs of operation, maintenance, and purchase of services to provide information. Approved...

77 FR 56192 - Information Collection; Submission for OMB Review, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... National funding. Type of Review: Renewal. Agency: Corporation for National and Community Service. Title... Cost (capital/startup): None. Total Burden Cost (operating/maintenance): None. Dated: September 5, 2012...

78 FR 72152 - Proposed Collection: Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... experience available. Current Actions: There is no change to this existing regulation. Type of Review... costs and costs of operation, maintenance, and purchase of services to provide information. Approved...

Satellite services system analysis study. Volume 5: Programmatics

NASA Technical Reports Server (NTRS)

1981-01-01

The overall program and resources needed for development and operation of a Satellite Services System is reviewed. Program requirements covered system operations through 1993 and were completed in preliminary form. Program requirements were refined based on equipment preliminary design and analysis. Schedules, costs, equipment utilization, and facility/advanced technology requirements were included in the update. Equipment user charges were developed for each piece of equipment and for representative satellite servicing missions.

No cost-saving target too small for this hospital's product reengineering program.

PubMed

1998-02-01

It pays to put every product purchase under the microscope. By creating a multidisciplinary value analysis committee to review staff ideas on potential savings for products, as well as internal services and processes, this New Jersey health care provider is slashing costs and standardizing products across clinical service lines. Learn how the committee operates and what it's doing to get vital employee participation, plus read about specific products targeted for cost reduction.

Variation in Urban Transit Costs and Revenues by Type of Service

DOT National Transportation Integrated Search

1987-01-12

This research explores whether the public authorities that currently provide mass transit service in the nation's urban areas are able to operate any of those services "profitably," where that term is defined to maximize the possibilities for profita...

49 CFR 7.44 - Services performed without charge or at a reduced charge.

Code of Federal Regulations, 2013 CFR

2013-10-01

... charged to any requestor making a request under subpart C of this part for the first two hours of search... search is required two hours of search time will be considered spent when the hourly costs of operating the central processing unit used to perform the search added to the computer operator's salary cost...

49 CFR 7.44 - Services performed without charge or at a reduced charge.

Code of Federal Regulations, 2011 CFR

2011-10-01

... charged to any requestor making a request under subpart C of this part for the first two hours of search... search is required two hours of search time will be considered spent when the hourly costs of operating the central processing unit used to perform the search added to the computer operator's salary cost...

49 CFR 7.44 - Services performed without charge or at a reduced charge.

Code of Federal Regulations, 2012 CFR

2012-10-01

... charged to any requestor making a request under subpart C of this part for the first two hours of search... search is required two hours of search time will be considered spent when the hourly costs of operating the central processing unit used to perform the search added to the computer operator's salary cost...

Ultra violet disinfection: A 3-year history

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

Tubesing, R.R.; Lindeke, D.R.

1998-07-01

The Stillwater Wastewater Treatment Facility is one of nine wastewater treatment facilities operated by the Metropolitan Council Environmental Services in the Minneapolis-St. Paul Metropolitan Area. The facility services the cities of Stillwater, Oak Park Heights, and Bayport. In 1993, an ultra violet disinfection facility began operation to provide the disinfection for the Facility. This presentation discusses the reasons for using ultra violet disinfection in lieu of chlorination/dechlorination facilities, the operating performance, and operating cost factors.

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

PubMed

McPake, Barbara; Hongoro, Charles; Russo, Giuliano

2011-06-02

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

78 FR 62948 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... funds (QFSs) and would provide new rules for qualified escrows and qualified trusts used in deferred... costs and costs of operation, maintenance, and purchase of services to provide information. Approved...

77 FR 43812 - Information Collection; Submission for OMB Review, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... Training. Type of Review: New. Agency: Corporation for National and Community Service. Title: VISTA... Burden Hours: 317.5. Total Burden Cost (capital/startup): None. Total Burden Cost (operating/maintenance...

78 FR 7764 - Information Collection; Submission for OMB Review, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... service to address local community needs. Type of Review: Renewal. Agency: Corporation for National and... Burden Cost (capital/startup): None. Total Burden Cost (operating/maintenance): None. Dated: January 25...

78 FR 41497 - Submission for OMB Review, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-10

... about the reasons for loss of good standing and the homeowner's experience during the HAMP modification... start-up costs and costs of operation, maintenance, and purchase of services to provide information...

Establishing Mobile Financial Services in Ethiopia

ERIC Educational Resources Information Center

Kanagwa, James R.

2016-01-01

Mobile phone service is increasing among low income populations; however, with over 1 billion mobile service users worldwide, many people still lack banking services. Banks do not reach out to the poor because of the high operational costs involved. Scholars and industry practitioners have indicated that mobile phones could be an alternative…

Personal communications: An extension to the mobile satellite

NASA Technical Reports Server (NTRS)

Epstein, Murray; Draper, Francois

1990-01-01

As time progresses, customer demands become far more universal, involving integrated, simple to operate, cost effective services, with technology virtually transparent to the operator. Industry will be in a position of providing the necessary services to meet the subscribers' needs. Our resource based industries, transportation services, and utilities in the more rural and unserviced areas will require quality and affordable services that can only be supplied via satellite. One answer to these needs will be one- and two-way interoperable data messaging.

Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services: Preprint

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

Neubauer, J.; Pesaran, A.

2013-03-01

Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but high upfront costs, battery-limited vehicle range, and concern over high battery replacement costs may discourage potential buyers. A subscription model in which a service provider owns the battery and supplies access to battery swapping infrastructure could reduce upfront and replacement costs for batteries with a predictable monthly fee, while expanding BEV range. Assessing the costs and benefits of such a proposal are complicated by many factors, including customer drive patterns, the amount of required infrastructure, battery life, etc. The National Renewable Energy Laboratorymore » has applied its Battery Ownership Model to compare the economics and utility of BEV battery swapping service plan options to more traditional direct ownership options. Our evaluation process followed four steps: (1) identifying drive patterns best suited to battery swapping service plans, (2) modeling service usage statistics for the selected drive patterns, (3) calculating the cost-of-service plan options, and (4) evaluating the economics of individual drivers under realistically priced service plans. A service plan option can be more cost-effective than direct ownership for drivers who wish to operate a BEV as their primary vehicle where alternative options for travel beyond the single-charge range are expensive, and a full-coverage-yet-cost-effective regional infrastructure network can be deployed. However, when assumed cost of gasoline, tax structure, and absence of purchase incentives are factored in, our calculations show the service plan BEV is rarely more cost-effective than direct ownership of a conventional vehicle.« less

Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services

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

Neubauer, J. S.; Pesaran, A.

2013-01-01

Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but high upfront costs, battery-limited vehicle range, and concern over high battery replacement costs may discourage potential buyers. A subscription model in which a service provider owns the battery and supplies access to battery swapping infrastructure could reduce upfront and replacement costs for batteries with a predictable monthly fee, while expanding BEV range. Assessing the costs and benefits of such a proposal are complicated by many factors, including customer drive patterns, the amount of required infrastructure, battery life, etc. The National Renewable Energy Laboratorymore » has applied its Battery Ownership Model to compare the economics and utility of BEV battery swapping service plan options to more traditional direct ownership options. Our evaluation process followed four steps: (1) identifying drive patterns best suited to battery swapping service plans, (2) modeling service usage statistics for the selected drive patterns, (3) calculating the cost-of-service plan options, and (4) evaluating the economics of individual drivers under realistically priced service plans. A service plan option can be more cost-effective than direct ownership for drivers who wish to operate a BEV as their primary vehicle where alternative options for travel beyond the single-charge range are expensive, and a full-coverage-yet-cost-effective regional infrastructure network can be deployed. However, when assumed cost of gasoline, tax structure, and absence of purchase incentives are factored in, our calculations show the service plan BEV is rarely more cost-effective than direct ownership of a conventional vehicle.« less

Final Environmental Impact Statement. Mankato-North Mankato-Le Hillier Flood Control. Phase I (As Amended 18 January 1972). Final Supplement II-C.

DTIC Science & Technology

1983-11-01

I A 11 Cultural Resources I 11 Noise CC7A&I 1.. Water Resources T, B 12 Traffic Service and Safety _._ 12 Rail Operations and Service 1 13 Avall e.no...Recreation 114 Cultural Resources 15 Noise 15 Water Resources 15 Traffic Service and Safety 16 Rail Operations and Service 16 6.00 Public Involvement 17...renovate the trusses, the disturbance to rail service that would occur during construction, and the small potential cost saving compared to the risks

47 CFR 36.373 - Services-Account 6620.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Retrospective financial analysis of medication therapy management services from the pharmacy's perspective.

PubMed

McDonough, Randal P; Harthan, Aaron A; McLeese, Kelly E; Doucette, William R

2010-01-01

To determine the net financial gain or loss for medication therapy management (MTM) services provided to patients by an independent community pharmacy during 16 months of operation. Retrospective study. Independent community pharmacy in Iowa City, IA, from September 1, 2006, to December 31, 2007. Patients receiving MTM services during the specified period who had proper documentation of reimbursement for the services. MTM services were provided to the patient and documented by the pharmacist or student pharmacist. Net financial gains or losses for providing MTM services. Sensitivity analyses included costs that might be incurred under various conditions of operation. 103 initial and 88 follow-up MTM visits were conducted during a 16-month time period. The total cost for these services to the pharmacy was $11,191.72. Total revenue from these services was $11,195.00; therefore, the pharmacy experienced a net financial gain of $3.28. Sensitivity analyses were conducted, revealing the net gain/loss to the pharmacy if a student pharmacist was used and the net gain/loss if the pharmacist needed extra training to provide the services. Using a student pharmacist resulted in a net gain of $6,308.48, while extra training for the pharmacist resulted in a net loss of $1,602.72. The MTM service programs showed a positive financial gain after 16 months of operation, which should encourage pharmacists to incorporate these services into their practice.

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

Code of Federal Regulations, 2014 CFR

2014-04-01

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

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

Code of Federal Regulations, 2013 CFR

2013-04-01

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

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

Code of Federal Regulations, 2012 CFR

2012-04-01

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

Cost Evaluation of Reproductive and Primary Health Care Mobile Service Delivery for Women in Two Rural Districts in South Africa

PubMed Central

Schnippel, Kathryn; Lince-Deroche, Naomi; van den Handel, Theo; Molefi, Seithati; Bruce, Suann; Firnhaber, Cynthia

2015-01-01

Background Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model. Methods The evaluation was retrospective (October 2012–September 2013 for one district and April–September 2013 for the second district) and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs), breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD. Results Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts); the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost. Conclusions Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to health care without added costs. PMID:25751528

Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

PubMed

Schnippel, Kathryn; Lince-Deroche, Naomi; van den Handel, Theo; Molefi, Seithati; Bruce, Suann; Firnhaber, Cynthia

2015-01-01

Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model. The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district) and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs), breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD. Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts); the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost. Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to health care without added costs.

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

PubMed

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

2017-01-01

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

Economic case for the retirement of geosynchronous communication satellites via space tugs

NASA Astrophysics Data System (ADS)

Galabova, Kalina K.; de Weck, Olivier L.

2006-05-01

Both the United Nations (UN) and the US Federal Communications Commission (FCC) have published a ruling that calls for geostationary earth orbit (GEO) satellites to be placed in a disposal orbit at the end of their operational lives. Current procedures utilize spacecraft residual propellant and represent a major life-limiting factor for GEO satellites. An alternative approach would be to allow a space tug to capture and move the satellites after all of their fuel has been exhausted. This extended lifetime can provide significant additional revenue to some satellite operators. Before committing to such a capability, however, the lifecycle costs of a space tug infrastructure must be carefully weighed against the opportunity costs of the current retirement practice. This paper investigates the questions of tug costs, perceived benefits, and service fee. It builds a framework that can be used in evaluating various on-orbit servicing opportunities and proposes that the service fee should be charged as a percentage of the additional revenue received by the satellite operators and analyzes how cost estimation uncertainties affect the value of on-orbit tugging. The presented analysis concludes that until advanced propulsion systems gain greater use, retirement via a space tug will be of value for the 10-20 most expensive GEO assets.

Optimizing Air Transportation Service to Metroplex Airports. Part 1; Analysis of Historical Data

NASA Technical Reports Server (NTRS)

Donohue, George; Hoffman, Karla; Sherry, Lance; Ferguson, John; Kara, Abdul Qadar

2010-01-01

The air transportation system is a significant driver of the U.S. economy, providing safe, affordable, and rapid transportation. During the past three decades airspace and airport capacity has not grown in step with demand for air transportation (+4% annual growth), resulting in unreliable service and systemic delays. Estimates of the impact of delays and unreliable air transportation service on the economy range from $32B to $41B per year. This report describes the results of an analysis of airline strategic decision-making with regards to: (1) geographic access, (2) economic access, and (3) airline finances. This analysis evaluated markets-served, scheduled flights, aircraft size, airfares, and profit from 2005-2009. During this period, airlines experienced changes in costs of operation (due to fluctuations in hedged fuel prices), changes in travel demand (due to changes in the economy), and changes in infrastructure capacity (due to the capacity limits at EWR, JFK, and LGA). This analysis captures the impact of the implementation of capacity limits at airports, as well as the effect of increased costs of operation (i.e. hedged fuel prices). The increases in costs of operation serve as a proxy for increased costs per flight that might occur if auctions or congestion pricing are imposed.

76 FR 33025 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-07

...-01 (Final). Abstract: The regulations relate to the income, employment, and gift taxation of split...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

75 FR 42832 - Proposed Collection: Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... estate or gift tax return. Current Actions: There is no change to this existing regulation. Type of... capital or start-up costs and costs of operation, maintenance, and purchase of services to provide...

78 FR 39303 - Agency Information Collection Activities: Proposed Collection; Comment Request; FEMA's Grants...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... reporting system designed to help State Administrative Agencies (SAAs) meet all reporting requirements as... annual costs to respondents operations and maintenance costs for technical services. There is no annual...

Contracting for health services in New Zealand: a transaction cost analysis.

PubMed

Ashton, T

1998-02-01

The splitting of the functions of purchaser and provider in the New Zealand health system in 1993 necessitated the use of explicit contracts between the two parties. This paper examines contracting experiences during the first two years of operation. The study focuses on four services: rest homes, primary care clinics, surgical services, and acute mental health services. The insights of transaction cost economics form the theoretical framework. The objective of this study was to examine whether the transaction costs associated with contracting vary across the four different services, and whether different types of contracts and contractual relationships are emerging as transactors attempt to reduce these costs. Information was collected in a series of 53 interviews with purchasers and providers, together with any relevant documentation. The results suggest that the costs of contracting are indeed greater for some services than for others. Other variables such as the style of negotiations, the type and specificity of contracts and the degree of monitoring also differ across the four services. At this early stage of the reform process, there was little evidence that purchasers and providers were attempting to reduce transaction costs by negotiating more flexible, longer-term, relational contracts. The main benefit from contracting to date has been improved accountability of service providers.

Dynamic Modelling of User Decision-Making in Selecting Information Services at a University Research Center.

ERIC Educational Resources Information Center

Evans, John E.

This research is concerned with the pragmatic performance characteristics of competing information technologies (ITs) and services in the university research center, as measured by user demand and choice. Technologies and services studied include: (1) mediated search service operating at cost recovery, open to all; (2) end-user service collecting…

The school bus routing and scheduling problem with transfers

PubMed Central

Doerner, Karl F.; Parragh, Sophie N.

2015-01-01

In this article, we study the school bus routing and scheduling problem with transfers arising in the field of nonperiodic public transportation systems. It deals with the transportation of pupils from home to their school in the morning taking the possibility that pupils may change buses into account. Allowing transfers has several consequences. On the one hand, it allows more flexibility in the bus network structure and can, therefore, help to reduce operating costs. On the other hand, transfers have an impact on the service level: the perceived service quality is lower due to the existence of transfers; however, at the same time, user ride times may be reduced and, thus, transfers may also have a positive impact on service quality. The main objective is the minimization of the total operating costs. We develop a heuristic solution framework to solve this problem and compare it with two solution concepts that do not consider transfers. The impact of transfers on the service level in terms of time loss (or user ride time) and the number of transfers is analyzed. Our results show that allowing transfers reduces total operating costs significantly while average and maximum user ride times are comparable to solutions without transfers. © 2015 Wiley Periodicals, Inc. NETWORKS, Vol. 65(2), 180–203 2015 PMID:28163329

Operations analysis (study 2.1). Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1975-01-01

Subjects related to future STS operations concepts were investigated. The majority of effort was directed at assessing the benefits of automated space servicing concepts as related to improvements in payload procurement and shuttle utilization. Another subject was directed at understanding shuttle upper stage software development and recurring costs relative to total program projections. Space serving of automated payloads is addressed by examining the broad spectrum of payload applications with the belief that shared logistic operations will be a major contributor to reduction of future program costs. However, there are certain requirements for support of payload operations, such as availability of the payload, that may place demands upon the shuttle fleet. Because future projections of the NASA Mission Model are only representative of the payload traffic, it is important to recognize that it is the general character of operations that is significant rather than service to any single payload program.

The Naval Data Automation Command: A Case Study.

DTIC Science & Technology

1982-12-01

34commoa service" or as a "rescurce" to be mada available to users on a reimbur - sable basis and not n-c-ssarily owned and controlled by them. This was...cost reimbursable funding. "If feasible, i- is planned that users will budgmt and pay for NDP services and DPIs and DPPSOs of NAVDAC will be operated...chargeback system where the NARDAC is reimbursed for costs incurred). Services are provided in three general areas; ADP application system dev aonuent

Small City Transit : Evansville, Indiana : A Low Subsidy Transit Service

DOT National Transportation Integrated Search

1976-03-01

Evansville, Indiana, is an illustration of a transit service in which a large percentage of operating costs are obtained from fare-box revenues. This case study is one of thirteen examples of a transit service in a small community. The background of ...

Specialist integrated haematological malignancy diagnostic services: an Activity Based Cost (ABC) analysis of a networked laboratory service model.

PubMed

Dalley, C; Basarir, H; Wright, J G; Fernando, M; Pearson, D; Ward, S E; Thokula, P; Krishnankutty, A; Wilson, G; Dalton, A; Talley, P; Barnett, D; Hughes, D; Porter, N R; Reilly, J T; Snowden, J A

2015-04-01

Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS) were introduced as a standard of care within the UK National Health Service to reduce diagnostic error and improve clinical outcomes. Two broad models of service delivery have become established: 'co-located' services operating from a single-site and 'networked' services, with geographically separated laboratories linked by common management and information systems. Detailed systematic cost analysis has never been published on any established SIHMDS model. We used Activity Based Costing (ABC) to construct a cost model for our regional 'networked' SIHMDS covering a two-million population based on activity in 2011. Overall estimated annual running costs were £1 056 260 per annum (£733 400 excluding consultant costs), with individual running costs for diagnosis, staging, disease monitoring and end of treatment assessment components of £723 138, £55 302, £184 152 and £94 134 per annum, respectively. The cost distribution by department was 28.5% for haematology, 29.5% for histopathology and 42% for genetics laboratories. Costs of the diagnostic pathways varied considerably; pathways for myelodysplastic syndromes and lymphoma were the most expensive and the pathways for essential thrombocythaemia and polycythaemia vera being the least. ABC analysis enables estimation of running costs of a SIHMDS model comprised of 'networked' laboratories. Similar cost analyses for other SIHMDS models covering varying populations are warranted to optimise quality and cost-effectiveness in delivery of modern haemato-oncology diagnostic services in the UK as well as internationally. 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.

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar

PubMed Central

2013-01-01

Introduction This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar’s social franchise operations from 2007 to 2009. Methods The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. Results In 2009 PSI Myanmar’s social franchise devoted $2.02 million towards a 94% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. Conclusion In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every $1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO’s, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers’ cost structures as well as strategic objectives in maintaining the network and its portfolio of services. PMID:23826743

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar.

PubMed

Bishai, David; LeFevre, Amnesty; Theuss, Marc; Boxshall, Matt; Hetherington, John D; Zaw, Min; Montagu, Dominic

2013-01-01

This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar's social franchise operations from 2007 to 2009. The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. In 2009 PSI Myanmar's social franchise devoted $2.02 million towards a 94% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every $1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO's, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers' cost structures as well as strategic objectives in maintaining the network and its portfolio of services.

Spinal Surgeon Variation in Single-Level Cervical Fusion Procedures: A Cost and Hospital Resource Utilization Analysis.

PubMed

Hijji, Fady Y; Massel, Dustin H; Mayo, Benjamin C; Narain, Ankur S; Long, William W; Modi, Krishna D; Burke, Rory M; Canar, Jeff; Singh, Kern

2017-07-01

Retrospective analysis. To compare perioperative costs and outcomes of patients undergoing single-level anterior cervical discectomy and fusions (ACDF) at both a service (orthopedic vs. neurosurgical) and individual surgeon level. Hospital systems are experiencing significant pressure to increase value of care by reducing costs while maintaining or improving patient-centered outcomes. Few studies have examined the cost-effectiveness cervical arthrodesis at a service level. A retrospective review of patients who underwent a primary 1-level ACDF by eight surgeons (four orthopedic and four neurosurgical) at a single academic institution between 2013 and 2015 was performed. Patients were identified by Diagnosis-Related Group and procedural codes. Patients with the ninth revision of the International Classification of Diseases coding for degenerative cervical pathology were included. Patients were excluded if they exhibited preoperative diagnoses or postoperative social work issues affecting their length of stay. Comparisons of preoperative demographics were performed using Student t tests and chi-squared analysis. Perioperative outcomes and costs for hospital services were compared using multivariate regression adjusted for preoperative characteristics. A total of 137 patients diagnosed with cervical degeneration underwent single-level ACDF; 44 and 93 were performed by orthopedic surgeons and neurosurgeons, respectively. There was no difference in patient demographics. ACDF procedures performed by orthopedic surgeons demonstrated shorter operative times (89.1 ± 25.5 vs. 96.0 ± 25.5 min; P = 0.002) and higher laboratory costs (Δ+$6.53 ± $5.52 USD; P = 0.041). There were significant differences in operative time (P = 0.014) and labor costs (P = 0.034) between individual surgeons. There was no difference in total costs between specialties or individual surgeons. Surgical subspecialty training does not significantly affect total costs of ACDF procedures. Costs can, however, vary between individual surgeons based on operative times. Variation between individual surgeons highlights potential areas for improvement of the cost effectiveness of spinal procedures. 4.

Defense Health Care Reform: Actions Needed to Help Realize Potential Cost Savings from Medical Education and Training

DTIC Science & Technology

2014-07-01

services in carrying out their medical missions, manage the military s health plan, oversee the medical operations within and provide 10 shared services , including...oversight of medical education and training. According to DOD, a shared services concept is a combination of common services performed across

76 FR 21393 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition.... Capital and startup costs include, among other items, computers and software you purchase to prepare for...

76 FR 25367 - Agency Information Collection Activities: Proposed Collection, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition.... Capital and startup costs include, among other items, computers and software you purchase to prepare for...

48 CFR 552.270-13 - Proposals for Adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... operation to be performed); (3) Equipment costs; (4) Worker's compensation and public liability insurance... within the general scope of the lease, the Lessor shall submit, in a timely manner, an itemized cost proposal for the work to be accomplished or services to be performed when the cost exceeds $100,000. The...

Application of the Software as a Service Model to the Control of Complex Building Systems

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

Stadler, Michael; Donadee, Jonathan; Marnay, Chris

2011-03-17

In an effort to create broad access to its optimization software, Lawrence Berkeley National Laboratory (LBNL), in collaboration with the University of California at Davis (UC Davis) and OSISoft, has recently developed a Software as a Service (SaaS) Model for reducing energy costs, cutting peak power demand, and reducing carbon emissions for multipurpose buildings. UC Davis currently collects and stores energy usage data from buildings on its campus. Researchers at LBNL sought to demonstrate that a SaaS application architecture could be built on top of this data system to optimize the scheduling of electricity and heat delivery in the building.more » The SaaS interface, known as WebOpt, consists of two major parts: a) the investment& planning and b) the operations module, which builds on the investment& planning module. The operational scheduling and load shifting optimization models within the operations module use data from load prediction and electrical grid emissions models to create an optimal operating schedule for the next week, reducing peak electricity consumption while maintaining quality of energy services. LBNL's application also provides facility managers with suggested energy infrastructure investments for achieving their energy cost and emission goals based on historical data collected with OSISoft's system. This paper describes these models as well as the SaaS architecture employed by LBNL researchers to provide asset scheduling services to UC Davis. The peak demand, emissions, and cost implications of the asset operation schedule and investments suggested by this optimization model are analysed.« less

Application of the Software as a Service Model to the Control of Complex Building Systems

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

Stadler, Michael; Donadee, Jon; Marnay, Chris

2011-03-18

In an effort to create broad access to its optimization software, Lawrence Berkeley National Laboratory (LBNL), in collaboration with the University of California at Davis (UC Davis) and OSISoft, has recently developed a Software as a Service (SaaS) Model for reducing energy costs, cutting peak power demand, and reducing carbon emissions for multipurpose buildings. UC Davis currently collects and stores energy usage data from buildings on its campus. Researchers at LBNL sought to demonstrate that a SaaS application architecture could be built on top of this data system to optimize the scheduling of electricity and heat delivery in the building.more » The SaaS interface, known as WebOpt, consists of two major parts: a) the investment& planning and b) the operations module, which builds on the investment& planning module. The operational scheduling and load shifting optimization models within the operations module use data from load prediction and electrical grid emissions models to create an optimal operating schedule for the next week, reducing peak electricity consumption while maintaining quality of energy services. LBNL's application also provides facility managers with suggested energy infrastructure investments for achieving their energy cost and emission goals based on historical data collected with OSISoft's system. This paper describes these models as well as the SaaS architecture employed by LBNL researchers to provide asset scheduling services to UC Davis. The peak demand, emissions, and cost implications of the asset operation schedule and investments suggested by this optimization model are analyzed.« less

Operating Costs and Characteristics of Minibuses

DOT National Transportation Integrated Search

1981-08-01

There has been considerable interest in minibuses over the last ten years as the public transit industry has introduced innovative services and emphasized special services to elderly and handicapped persons. This report presents an analysis of minibu...

42 CFR 413.94 - Value of services of nonpaid workers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE... provider to carry out the functions of normal patient care and operation of the institution. The value of...

The Biobank Economic Modeling Tool (BEMT): Online Financial Planning to Facilitate Biobank Sustainability

PubMed Central

Odeh, Hana; Miranda, Lisa; Rao, Abhi; Vaught, Jim; Greenman, Howard; McLean, Jeffrey; Reed, Daniel; Memon, Sarfraz; Fombonne, Benjamin; Guan, Ping

2015-01-01

Background: Biospecimens are essential resources for advancing basic and translational research. However, there are little data available regarding the costs associated with operating a biobank, and few resources to enable their long-term sustainability. To support the research community in this effort, the National Institutes of Health, National Cancer Institute's Biorepositories and Biospecimen Research Branch has developed the Biobank Economic Modeling Tool (BEMT). The tool is accessible at http://biospecimens.cancer.gov/resources/bemt.asp. Methods: To obtain market-based cost information and to inform the development of the tool, a survey was designed and sent to 423 biobank managers and directors across the world. The survey contained questions regarding infrastructure investments, salary costs, funding options, types of biospecimen resources and services offered, as well as biospecimen pricing and service-related costs. Results: A total of 106 responses were received. The data were anonymized, aggregated, and used to create a comprehensive database of cost and pricing information that was integrated into the web-based tool, the BEMT. The BEMT was built to allow the user to input cost and pricing data through a seven-step process to build a cost profile for their biobank, define direct and indirect costs, determine cost recovery fees, perform financial forecasting, and query the anonymized survey data from comparable biobanks. Conclusion: A survey was conducted to obtain a greater understanding of the costs involved in operating a biobank. The anonymized survey data was then used to develop the BEMT, a cost modeling tool for biobanks. Users of the tool will be able to create a cost profile for their biobanks' specimens, products and services, establish pricing, and allocate costs for biospecimens based on percent cost recovered, and perform project-specific cost analyses and financial forecasting. PMID:26697911

The Biobank Economic Modeling Tool (BEMT): Online Financial Planning to Facilitate Biobank Sustainability.

PubMed

Odeh, Hana; Miranda, Lisa; Rao, Abhi; Vaught, Jim; Greenman, Howard; McLean, Jeffrey; Reed, Daniel; Memon, Sarfraz; Fombonne, Benjamin; Guan, Ping; Moore, Helen M

2015-12-01

Biospecimens are essential resources for advancing basic and translational research. However, there are little data available regarding the costs associated with operating a biobank, and few resources to enable their long-term sustainability. To support the research community in this effort, the National Institutes of Health, National Cancer Institute's Biorepositories and Biospecimen Research Branch has developed the Biobank Economic Modeling Tool (BEMT). The tool is accessible at http://biospecimens.cancer.gov/resources/bemt.asp. To obtain market-based cost information and to inform the development of the tool, a survey was designed and sent to 423 biobank managers and directors across the world. The survey contained questions regarding infrastructure investments, salary costs, funding options, types of biospecimen resources and services offered, as well as biospecimen pricing and service-related costs. A total of 106 responses were received. The data were anonymized, aggregated, and used to create a comprehensive database of cost and pricing information that was integrated into the web-based tool, the BEMT. The BEMT was built to allow the user to input cost and pricing data through a seven-step process to build a cost profile for their biobank, define direct and indirect costs, determine cost recovery fees, perform financial forecasting, and query the anonymized survey data from comparable biobanks. A survey was conducted to obtain a greater understanding of the costs involved in operating a biobank. The anonymized survey data was then used to develop the BEMT, a cost modeling tool for biobanks. Users of the tool will be able to create a cost profile for their biobanks' specimens, products and services, establish pricing, and allocate costs for biospecimens based on percent cost recovered, and perform project-specific cost analyses and financial forecasting.

Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

PubMed

Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

2015-05-28

Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Customer premise service study for 30/20 GHz satellite system

NASA Technical Reports Server (NTRS)

Milton, R. T.; Ross, D. P.; Harcar, A. R.; Freedenberg, P.; Schoen, D.

1983-01-01

Satellite systems in which the space segment operates in the 30/20 GHz frequency band are defined and compared as to their potential for providing various types of communications services to customer premises and the economic and technical feasibility of doing so. Technical tasks performed include: market postulation, definition of the ground segment, definition of the space segment, definition of the integrated satellite system, service costs for satellite systems, sensitivity analysis, and critical technology. Based on an analysis of market data, a sufficiently large market for services is projected so as to make the system economically viable. A large market, and hence a high capacity satellite system, is found to be necessary to minimize service costs, i.e., economy of scale is found to hold. The wide bandwidth expected to be available in the 30/20 GHz band, along with frequency reuse which further increases the effective system bandwidth, makes possible the high capacity system. Extensive ground networking is required in most systems to both connect users into the system and to interconnect Earth stations to provide spatial diversity. Earth station spatial diversity is found to be a cost effective means of compensating the large fading encountered in the 30/20 GHz operating band.

45 CFR 98.42 - Sliding fee scales.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.42 Sliding fee scales... provides for cost sharing by families that receive CCDF child care services. (b) A sliding fee scale(s...

45 CFR 98.42 - Sliding fee scales.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.42 Sliding fee scales... provides for cost sharing by families that receive CCDF child care services. (b) A sliding fee scale(s...

45 CFR 98.42 - Sliding fee scales.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.42 Sliding fee scales... provides for cost sharing by families that receive CCDF child care services. (b) A sliding fee scale(s...

45 CFR 98.42 - Sliding fee scales.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.42 Sliding fee scales... provides for cost sharing by families that receive CCDF child care services. (b) A sliding fee scale(s...

42 CFR 412.402 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... routine operating, ancillary, and capital-related cost of 1 day of hospital inpatient services in an... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... length of stay or both. Diagnoses that relate to an earlier episode of care that have no bearing on the...

Decentralization in Indonesia: lessons from cost recovery rate of district hospitals.

PubMed

Maharani, Asri; Femina, Devi; Tampubolon, Gindo

2015-07-01

In 1991, Indonesia began a process of decentralization in the health sector which had implications for the country's public hospitals. The public hospitals were given greater authority to manage their own personnel, finance and procurement, with which they were allowed to operate commercial sections in addition to offering public services. These public services are subsidized by the government, although patients still pay certain proportion of fees. The main objectives of health sector decentralization are to increase the ability of public hospitals to cover their costs and to reduce government subsidies. This study investigates the consequences of decentralization on cost recovery rate of public hospitals at district level. We examine five service units (inpatient, outpatient, operating room, laboratory and radiology) in three public hospitals. We find that after 20 years of decentralization, district hospitals still depend on government subsidies, demonstrated by the fact that the cost recovery rate of most service units is less than one. The commercial sections fail to play their role as revenue generator as they are still subsidized by the government. We also find that the bulk of costs are made up of staff salaries and incentives in all units except radiology. As this study constitutes exploratory research, further investigation is needed to find out the reasons behind these results. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Cost accounting in radiation oncology: a computer-based model for reimbursement.

PubMed

Perez, C A; Kobeissi, B; Smith, B D; Fox, S; Grigsby, P W; Purdy, J A; Procter, H D; Wasserman, T H

1993-04-02

The skyrocketing cost of medical care in the United States has resulted in multiple efforts in cost containment. The present work offers a rational computer-based cost accounting approach to determine the actual use of resources in providing a specific service in a radiation oncology center. A procedure-level cost accounting system was developed by using recorded information on actual time and effort spent by individual staff members performing various radiation oncology procedures, and analyzing direct and indirect costs related to staffing (labor), facilities and equipment, supplies, etc. Expenditures were classified as direct or indirect and fixed or variable. A relative value unit was generated to allocate specific cost factors to each procedure. Different costs per procedure were identified according to complexity. Whereas there was no significant difference in the treatment time between low-energy (4 and 6 MV) or high-energy (18 MV) accelerators, there were significantly higher costs identified in the operation of a high-energy linear accelerator, a reflection of initial equipment investment, quality assurance and calibration procedures, maintenance costs, service contract, and replacement parts. Utilization of resources was related to the complexity of the procedures performed and whether the treatments were delivered to inpatients or outpatients. In analyzing time motion for physicians and other staff, it was apparent that a greater effort must be made to train the staff to accurately record all times involved in a given procedure, and it is strongly recommended that each institution perform its own time motion studies to more accurately determine operating costs. Sixty-six percent of our facility's global costs were for labor, 20% for other operating expenses, 10% for space, and 4% for equipment. Significant differences were noted in the cost allocation for professional or technical functions, as labor, space, and equipment costs are higher in the latter. External beam treatment-related procedures accounted for more than 50% of all technical and professional revenues, simulation for 8% to 10%, and other physics/dosimetry procedures for 11% to 14% of revenues. Some discrepancies were identified between the actual cost and level of reimbursement of various procedures. Details are described in the manuscript. It is imperative to develop an equitable reimbursement system for radiation oncology services, based on cost accounting and other measures that may enhance productivity and reduce the cost per procedure unit, while at the same time preserving the highest quality of service provided to patients.

American Recovery and Reinvestment Act (ARRA) FEMP Technical Assistance U.S. General Services Administration – Project 195 John Seiberling Federal Office Building and U.S. Courthouse, Akron, Ohio

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

Arends, J.; Sandusky, William F.

This report documents the findings from an onsite audit of the John Seiberling Federal building located in Akron, Ohio. The Federal landlord for this building is the General Services Administration (GSA). The focus of the audit was to identify various no-cost or low-cost energy efficiency opportunities that, once implemented, would reduce in either electrical and gas consumption and increase the operational efficiency of the building. This audit also provided an opportunity to identify potential capital cost projects that should be considered in the to acquire additional energy (electric and gas) and water savings to further increase the operational efficiency ofmore » the building.« less

Valley Transit District: specialized transportation services for the elderly, handicapped, and low-income in the Lower Naugatuck Valley, Connecticut. Final report

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

Kocur, G.

1979-02-01

A multifaceted demonstration with special emphasis on service to the elderly and handicapped has been operating in the Lower Naugatuck Valley of Connecticut since January 1973. The system has included limited fixed-route service, demand responsive door-to-door service, subscription service, and contract bus service for social-service agencies and other groups in the Valley. An automated fare-collection system using credit cards and monthly billings to eliminate the need for cash payment was used from 1973 to 1975. Fare subsidization for handicapped and elderly citizens is facilitated by this computerized system which bills sponsoring agencies according to the use of the transportation servicesmore » by their clients during the previous billing period. The user-side subsidies and monthly billings were continued after 1975 using manual methods. Of the target population of 12,000 individuals, 600 are regular, heavy users of the Valley Transit District (VTD), with few of the others using the system at all. VTD users are primarily low-income, autoless elderly from small households. The system operates 10 vehicles daily to provide its services; the average hourly cost is near $12. The system has earned revenues equal to almost 50% of its costs, although 40% of its revenues have been derived from user-side subsidy funds. Finally, VTD has withstood several challenges in regulatory and institutional areas from private bus operators and has slowly expanded its services throughout the demonstration. It is currently operating in post-demonstration status under ongoing funding.« less

Testing in Service-Oriented Environments

DTIC Science & Technology

2010-03-01

software releases (versions, service packs, vulnerability patches) for one com- mon ESB during the 13-month period from January 1, 2008 through...impact on quality of service : Unlike traditional software compo- nents, a single instance of a web service can be used by multiple consumers. Since the...distributed, with heterogeneous hardware and software (SOA infrastructure, services , operating systems, and databases). Because of cost and security, it

47 CFR 36.162 - Intangible assets-Account 2690.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 36.162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... the operations on the basis of the separation of the cost of Telecommunications Plant In Service, Account 2001, excluding the Intangible Assets, Account 2690. Telecommunications Plant—Other ...

Statistical Policy Working Paper 24. Electronic Dissemination of Statistical Data

DOT National Transportation Integrated Search

1995-11-01

The report, Statistical Policy Working Paper 24, Electronic Dissemination of Statistical Data, includes several topics, such as Options and Best Uses for Different Media Operation of Electronic Dissemination Service, Customer Service Programs, Cost a...

47 CFR 36.162 - Intangible assets-Account 2690.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 36.162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... the operations on the basis of the separation of the cost of Telecommunications Plant In Service, Account 2001, excluding the Intangible Assets, Account 2690. Telecommunications Plant—Other ...

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

PubMed

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

1993-01-01

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

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

PubMed Central

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

1993-01-01

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

Lessons Learned from Outsourcing the Pearl Harbor MK-48 Intermediate Maintenance Activity

DTIC Science & Technology

2008-03-01

transfer of ownership of assets. However, outsourcing is not simply a procurement decision. All organizations procure elements of their operations...systems, commercialization, and franchising (Office of Management and Budget, 2004). Strengths of Outsourcing Outsourcing is more efficient than...operating the IMA with organic resources vs . the cost of a comparable service provided by a contractor. Activity-based costing would also help managers

Rural Shared Services: General Brochure and Information Sheets.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

The brochure discusses the Shared Services Program of the Northwest Regional Educational Laboratory of Portland, Oregon. The program operates on the premise that it can provide additional programs (frequently of higher quality) to rural school districts at a lower per-capita cost. The shared services are conducted through cooperative efforts…

Operations Handbook for Migrant Student Dental Services.

ERIC Educational Resources Information Center

Hansen, William E.; Resendez, Ignacio V.

Migrant Education and the Superintendent of Public Instruction in the state of Washington have brought several agencies together to provide low cost dental services to migrant children. The program, initiated in 1980 and serving 138 children that year, has focused on the provision of preventative and emergency services. Migrant Education has…

Small unmanned aircraft and the U.S. Forest Service : benefits, costs, and recommendations for using small unmanned aircraft in Forest Service operations

DOT National Transportation Integrated Search

2016-08-01

This paper provides information to Forest Service leadership about how the agency could use unmanned aircraft across different programs, especially in program areas where aircraft use is currently limited. It draws from published uses of unmanned air...

Optimal assignment of workers to supporting services in a hospital

NASA Astrophysics Data System (ADS)

Sawik, Bartosz; Mikulik, Jerzy

2008-01-01

Supporting services play an important role in health care institutions such as hospitals. This paper presents an application of operations research model for optimal allocation of workers among supporting services in a public hospital. The services include logistics, inventory management, financial management, operations management, medical analysis, etc. The optimality criterion of the problem is to minimize operations costs of supporting services subject to some specific constraints. The constraints represent specific conditions for resource allocation in a hospital. The overall problem is formulated as an integer program in the literature known as the assignment problem, where the decision variables represent the assignment of people to various jobs. The results of some computational experiments modeled on a real data from a selected Polish hospital are reported.

24 CFR Appendix to Part 972 - Methodology of Comparing Cost of Public Housing With the Cost of Tenant-Based Assistance

Code of Federal Regulations, 2010 CFR

2010-04-01

..., supportive services, maintenance, tenant, and PHA-paid utilities) will be reduced as a result of post... and utility allowances) shall be expressed as total operating costs per year. For example, if a... $504 per unit month. By this example, the current costs per occupied unit are at least 10 percent...

24 CFR Appendix to Part 972 - Methodology of Comparing Cost of Public Housing With the Cost of Tenant-Based Assistance

Code of Federal Regulations, 2012 CFR

2012-04-01

..., supportive services, maintenance, tenant, and PHA-paid utilities) will be reduced as a result of post... and utility allowances) shall be expressed as total operating costs per year. For example, if a... $504 per unit month. By this example, the current costs per occupied unit are at least 10 percent...

24 CFR Appendix to Part 972 - Methodology of Comparing Cost of Public Housing With the Cost of Tenant-Based Assistance

Code of Federal Regulations, 2011 CFR

2011-04-01

..., supportive services, maintenance, tenant, and PHA-paid utilities) will be reduced as a result of post... and utility allowances) shall be expressed as total operating costs per year. For example, if a... $504 per unit month. By this example, the current costs per occupied unit are at least 10 percent...

42 CFR 137.165 - Are Self-Governance Tribes required to undertake annual audits?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Are Self-Governance Tribes required to undertake annual audits? 137.165 Section 137.165 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles...

Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia

PubMed Central

Ibrahim, Mohamed Izham Mohamed; Abdelrahim, Hisham Elhag Ahmed; Ab Rahman, Ab Fatah

Background Therapeutic drug monitoring (TDM) makes use of serum drug concentrations as an adjunct to decision-making. Preliminary data in our hospital showed that approximately one-fifth of all drugs monitored by TDM service were gentamicin. Objective In this study, we evaluated the costs associated with providing the service in patients with bronchopneumonia and treated with gentamicin. Methods We retrospectively collected data from medical records of patients admitted to the Hospital Universiti Sains Malaysia over a 5-year period. These patients were diagnosed with bronchopneumonia and were on gentamicin as part of their treatment. Five hospitalisation costs were calculated; (i) cost of laboratory and clinical investigations, (ii) cost associated with each gentamicin dose, (iii) fixed and operating costs of TDM service, (iv) cost of providing medical care, and (v) cost of hospital stay during gentamicin treatment. Results There were 1920 patients admitted with bronchopneumonia of which 67 (3.5%) had TDM service for gentamicin. Seventy-three percent (49/67) patients were eligible for final analysis. The duration of gentamicin therapy ranged from 3 to 15 days. The cost of providing one gentamicin assay was MYR25, and the average cost of TDM service for each patient was MYR104. The average total hospitalisation cost during gentamicin treatment for each patient was MYR442 (1EUR approx. MYR4.02). Conclusions Based on the hospital perspective, in patients with bronchopneumonia and treated with gentamicin, the provision of TDM service contributes to less than 25% of the total cost of hospitalization. PMID:24644520

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury.

PubMed

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas R

2014-04-01

To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence-related injury. Benefit-cost analysis. Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared with the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. By contrast, the costs associated with the programme were modest: setup costs of software modifications and prevention strategies were £107 769, while the annual operating costs of the system were estimated as £210 433 (2003 UK pound). The cumulative social benefit-cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit-cost ratio of 14.80 for the health service and 19.1 for the criminal justice system. Each of these benefit-cost ratios is above 1 across a wide range of sensitivity analyses. An effective information-sharing partnership between health services, police and local government in Cardiff, UK, led to substantial cost savings for the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented.

Operational Experience of an Open-Access, Subscription-Based Mass Spectrometry and Proteomics Facility.

PubMed

Williamson, Nicholas A

2018-03-01

This paper discusses the successful adoption of a subscription-based, open-access model of service delivery for a mass spectrometry and proteomics facility. In 2009, the Mass Spectrometry and Proteomics Facility at the University of Melbourne (Australia) moved away from the standard fee for service model of service provision. Instead, the facility adopted a subscription- or membership-based, open-access model of service delivery. For a low fixed yearly cost, users could directly operate the instrumentation but, more importantly, there were no limits on usage other than the necessity to share available instrument time with all other users. All necessary training from platform staff and many of the base reagents were also provided as part of the membership cost. These changes proved to be very successful in terms of financial outcomes for the facility, instrument access and usage, and overall research output. This article describes the systems put in place as well as the overall successes and challenges associated with the operation of a mass spectrometry/proteomics core in this manner. Graphical abstract ᅟ.

Operational Experience of an Open-Access, Subscription-Based Mass Spectrometry and Proteomics Facility

NASA Astrophysics Data System (ADS)

Williamson, Nicholas A.

2018-03-01

This paper discusses the successful adoption of a subscription-based, open-access model of service delivery for a mass spectrometry and proteomics facility. In 2009, the Mass Spectrometry and Proteomics Facility at the University of Melbourne (Australia) moved away from the standard fee for service model of service provision. Instead, the facility adopted a subscription- or membership-based, open-access model of service delivery. For a low fixed yearly cost, users could directly operate the instrumentation but, more importantly, there were no limits on usage other than the necessity to share available instrument time with all other users. All necessary training from platform staff and many of the base reagents were also provided as part of the membership cost. These changes proved to be very successful in terms of financial outcomes for the facility, instrument access and usage, and overall research output. This article describes the systems put in place as well as the overall successes and challenges associated with the operation of a mass spectrometry/proteomics core in this manner. [Figure not available: see fulltext.

42 CFR 405.2470 - Reports and maintenance of records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... reporting period, the RHC or FQHC must submit an estimate of budgeted costs and visits for RHC or FQHC... of: (i) Its operations, including the allowable costs actually incurred for the period and the actual number of visits for RHC or FQHC services furnished during the period; and (ii) The estimated costs and...

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria.

PubMed

Chukwu, Emeka; Garg, Lalit; Eze, Godson

2016-05-17

Nigeria contributes only 2% to the world's population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. The purpose of this study was to document costs associated with a mobile technology-supported, community-based health insurance scheme. This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas-antenatal care, routine immunization, and birth attendance for 1 year-showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted. This study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead.

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

PubMed Central

Garg, Lalit; Eze, Godson

2016-01-01

Background Nigeria contributes only 2% to the world’s population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. Objective The purpose of this study was to document costs associated with a mobile technology–supported, community-based health insurance scheme. Methods This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. Results All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas—antenatal care, routine immunization, and birth attendance for 1 year—showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted. Conclusions This study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead. PMID:27189312

NASA operations: An agency wide approach to reduce cost

NASA Technical Reports Server (NTRS)

Squibb, Gael F.

1996-01-01

The NASA Space Operations Management Office (SOMO) is presented. The SOMO concept is based on continuing the distributed participation of the various NASA field centers and agencies, while employing consolidated management through a single lead center. The aim is to determine the duplicity and the overlap between the different agencies that independently developed their own operations management approaches in order to enable more cost effective mission operations by providing common services to the NASA programs. The space operations management will be performed in a distributed manner with a greater degree of contractor involvement than in the past. The changes, approaches and anticipated benefits of this approach to operations are discussed.

Space Station services and design features for users

NASA Technical Reports Server (NTRS)

Kurzhals, Peter R.; Mckinney, Royce L.

1987-01-01

The operational design features and services planned for the NASA Space Station will furnish, in addition to novel opportunities and facilities, lower costs through interface standardization and automation and faster access by means of computer-aided integration and control processes. By furnishing a basis for large-scale space exploitation, the Space Station will possess industrial production and operational services capabilities that may be used by the private sector for commercial ventures; it could also ultimately support lunar and planetary exploration spacecraft assembly and launch facilities.

Operating and Support Costing Guide: Army Weapon Systems

DTIC Science & Technology

1974-12-23

First US Army 1 Commandant, US Army Logistics Management Center (Director Administration and Services) 2 Commander, US Army Management Systems Support...Army Logistics Management Center (Director, Administration and Services) Commander, US Army Management Systems Support Agency (DACS-AME) Commander

77 FR 4883 - Proposed Collection; Comment Request for Form 8939

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

... gift within three years of death and a gift tax return was required to be filed on the transfer to the...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models.

PubMed Central

Nunamaker, T R

1983-01-01

This article provides an illustrative application of Data Envelopment Analysis (DEA) methodology to the measurement of routine nursing service efficiency at a group of Wisconsin hospitals. The DEA efficiency ratings and cost savings estimates are then compared to those resulting from application of Medicare's routine cost limitation to the sample data. DEA is also used to determine if any changes in the potential for efficient operations occurred during the 1978-1979 period. Empirical results were representative of the fundamental differences existing between the DEA and cost per patient day approaches. No evidence was found to support the notion that the overall potential for efficient delivery of routine services by the sample institutions was greater in one year than another. PMID:6874357

Single Mode Fiber Optic Transceiver Using Short Wavelength Active Devices In Long Wavelength Fiber

NASA Astrophysics Data System (ADS)

Gillham, Frederick J.; Campbell, Daniel R.; Corke, Michael; Stowe, David W.

1990-01-01

Presently, single mode optical fiber technology is being utilized in systems to supply telephone service to the subscriber. However, in an attempt to be competitive with copper based systems, there are many development programs underway to determine the most cost effective solution while still providing a service that will either satisfy or be upgradeable to satisfy the demands of the consumer for the next 10 to 20 years. One such approach is to combine low cost laser transmitters and silicon receivers, which have been developed for the "compact disc" industry, with fiber that operates in the single mode regime at 1300 nm. In this paper, an optical transceiver will be presented, consisting of a compact disc laser, a silicon detector and a single mode coupler at 1300 nm. A possible system layout is presented which operates at 780 nm bi-directionally for POTS and upgradeable to 1300 nm for video services. There are several important design criteria that have to be considered in the development of such a system which will be addressed. These include: 1. Optimization of coupled power from laser to fiber while maintaining stable launched conditions over a wide range of environmental conditions. 2. Consideration of the multimode operation of the 1300 nm single mode fiber while operating in the 780 nm wavelength region. 3. Development of a low cost pseudo-wavelength division multiplexer for 1300 nm single mode/780 nm multimode operation and a low cost dual mode 50/50, 780 nm splitter using 1300 nm fiber. Details will be given of the design criteria and solution in terms of optimized design. Results of the performance of several prototype devices will be given with indications of the merits of this approach and where further development effort should be applied.

Optimizing winter/snow removal operations in MoDOT St. Louis district : includes outcome based evaluation of operations.

DOT National Transportation Integrated Search

2011-10-01

The objective of this project was to develop fleet location, route decision, material selection, and treatment procedures for winter snow removal operations to improve MoDOTs services and lower costs. This work uses a systematic, heuristic-based o...

49 CFR 1139.3 - Cost study.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

49 CFR 1139.3 - Cost study.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

49 CFR 1139.3 - Cost study.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

Getting the most from outsourcing.

PubMed

Mak, C

1996-04-01

Outsourcing is common in the business world for its cost saving benefits. This article examines outsourcing as it is used in the Hong Kong healthcare setting for security services and assesses its outcomes in terms of cost, quality, performance, and control. The author reports on several management problems, and makes suggestions for effective outsourcing practices. Hospitals are advised to prepare and manage their contracts as if they were run in-house. Administrators who manage hospitals must examine their operations and try to add value to services where applicable, including outsourced services.

Resource utilization and costs before and after total joint arthroplasty.

PubMed

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

2012-03-23

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

Fees-for-services, cost recovery, and equity in a district of Burkina Faso operating the Bamako Initiative.

PubMed Central

Ridde, Valéry

2003-01-01

OBJECTIVE: To gauge the effects of operating the Bamako Initiative in Kongoussi district, Burkina Faso. METHODS: Qualitative and quasi-experimental quantitative methodologies were used. FINDINGS: Following the introduction of fees-for-services in July 1997, the number of consultations for curative care fell over a period of three years by an average of 15.4% at "case" health centres but increased by 30.5% at "control" health centres. Moreover, although the operational results for essential drugs depots were not known, expenditure increased on average 2.7 times more than income and did not keep pace with the decline in the utilization of services. Persons in charge of the management committees had difficulties in releasing funds to ensure access to care for the poor. CONCLUSION: The introduction of fees-for-services had an adverse effect on service utilization. The study district is in a position to bear the financial cost of taking care of the poor and the community is able to identify such people. Incentives must be introduced by the state and be swiftly applied so that the communities agree to a more equitable system and thereby allow access to care for those excluded from services because they are unable to pay. PMID:12973646

Worldwide trends in Universal Service Funds and telemedicine.

PubMed

Nakajima, Isao

2010-12-01

A survey of recent worldwide trends in Universal Service Funds (USFs) and the assistance provided for their application indicates that industrialized countries and developing nations alike have offered or plan to offer tax-relief measures or reimbursement for communications costs incurred by telemedicine programs, thus finding a way to actively apply USFs in rural areas. There are three main systems used to calculate the amount of reimbursement from a USF. While many countries adopt a service-area net-loss estimation method, Japan uses a benchmark method and provides financial assistance only to unprofitable areas. The USA has proactively introduced telemedicine to rural areas and isolated islands in order to minimize rapidly rising healthcare costs and to improve the efficiency of healthcare services. In the USA, the USF is used to pay back communications costs incurred through telemedicine programs. For instance, the budget allocated from the USF for reimbursements for telemedicine in Alaska reached USD 30 Mil. in 2007. Developing countries in Africa and Asia are operating various forms of telemedicine on a trial basis, but a tax-relief measure or payback of communications costs, which are a large portion of the running costs, will need to be implemented to ensure sustainable and autonomous operation of telemedicine. In Japan, up until January 2007, the USF system assumed the use of an NTS (non-traffic sensitive cost) system to obtain funds from connection fees, and this system would receive funds from each telecommunications carrier (payer: the telecommunications carriers). The beneficiaries would be limited to two companies, namely NTT East and NTT West. However, the Japanese USF system was revised in February 2007, and a fee is now collected from each telephone number (payer: the user). The collected funds are used to cover losses in unprofitable areas (not limited to remote areas) among 7,000 business areas in Japan. In view of worldwide trends, the author believes that Japan should also start using the USF system to reimburse communications costs (including costs of telemedicine) in order to achieve sustainable and autonomous operation of public communication systems in rural areas.

How much does it cost to achieve coverage targets for primary healthcare services? A costing model from Aceh, Indonesia.

PubMed

Abdullah, Asnawi; Hort, Krishna; Abidin, Azwar Zaenal; Amin, Fadilah M

2012-01-01

Despite significant investment in improving service infrastructure and training of staff, public primary healthcare services in low-income and middle-income countries tend to perform poorly in reaching coverage targets. One of the factors identified in Aceh, Indonesia was the lack of operational funds for service provision. The objective of this study was to develop a simple and transparent costing tool that enables health planners to calculate the unit costs of providing basic health services to estimate additional budgets required to deliver services in accordance with national targets. The tool was developed using a standard economic approach that linked the input activities to achieving six national priority programs at primary healthcare level: health promotion, sanitation and environment health, maternal and child health and family planning, nutrition, immunization and communicable diseases control, and treatment of common illness. Costing was focused on costs of delivery of the programs that need to be funded by local government budgets. The costing tool consisting of 16 linked Microsoft Excel worksheets was developed and tested in several districts enabled the calculation of the unit costs of delivering of the six national priority programs per coverage target of each program (such as unit costs of delivering of maternal and child health program per pregnant mother). This costing tool can be used by health planners to estimate additional money required to achieve a certain level of coverage of programs, and it can be adjusted for different costs and program delivery parameters in different settings. Copyright © 2012 John Wiley & Sons, Ltd.

The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa.

PubMed

Lince-Deroche, Naomi; Fetters, Tamara; Sinanovic, Edina; Devjee, Jaymala; Moodley, Jack; Blanchard, Kelly

2017-01-01

Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32-75.51). The total average cost per MVA was higher at $69.60 (52.62-86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs.

An open system approach to process reengineering in a healthcare operational environment.

PubMed

Czuchry, A J; Yasin, M M; Norris, J

2000-01-01

The objective of this study is to examine the applicability of process reengineering in a healthcare operational environment. The intake process of a mental healthcare service delivery system is analyzed systematically to identify process-related problems. A methodology which utilizes an open system orientation coupled with process reengineering is utilized to overcome operational and patient related problems associated with the pre-reengineered intake process. The systematic redesign of the intake process resulted in performance improvements in terms of cost, quality, service and timing.

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

PubMed Central

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

2017-01-01

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

Application service provider (ASP) financial models for off-site PACS archiving

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Liu, Brent J.; McCoy, J. Michael; Enzmann, Dieter R.

2003-05-01

For the replacement of its legacy Picture Archiving and Communication Systems (approx. annual workload of 300,000 procedures), UCLA Medical Center has evaluated and adopted an off-site data-warehousing solution based on an ASP financial with a one-time single payment per study archived. Different financial models for long-term data archive services were compared to the traditional capital/operational costs of on-site digital archives. Total cost of ownership (TCO), including direct and indirect expenses and savings, were compared for each model. Financial parameters were considered: logistic/operational advantages and disadvantages of ASP models versus traditional archiving systems. Our initial analysis demonstrated that the traditional linear ASP business model for data storage was unsuitable for large institutions. The overall cost markedly exceeds the TCO of an in-house archive infrastructure (when support and maintenance costs are included.) We demonstrated, however, that non-linear ASP pricing models can be cost-effective alternatives for large-scale data storage, particularly if they are based on a scalable off-site data-warehousing service and the prices are adapted to the specific size of a given institution. The added value of ASP is that it does not require iterative data migrations from legacy media to new storage media at regular intervals.

Starting a hospital-based home health agency: Part II--Key success factors.

PubMed

Montgomery, P

1993-09-01

In Part II of a three-part series, the financial, technological and legislative issues of a hospital-based home health-agency are discussed. Beginning a home healthcare service requires intensive research to answer key environmental and operational questions--need, competition, financial projections, initial start-up costs and the impact of delayed depreciation. Assessments involving technology, staffing, legislative and regulatory issues can help project service volume, productivity and cost-control.

Trace saver: A tool for network service improvement and personalised analysis of user centric statistics

NASA Astrophysics Data System (ADS)

Bilal, Muhammad; Asfand-e-Yar, Mockford, Steve; Khan, Wasiq; Awan, Irfan

2012-11-01

Mobile technology is among the fastest growing technologies in today's world with low cost and highly effective benefits. Most important and entertaining areas in mobile technology development and usage are location based services, user friendly networked applications and gaming applications. However, concern towards network operator service provision and improvement has been very low. The portable applications available for a range of mobile operating systems which help improve the network operator services are desirable by the mobile operators. This paper proposes a state of the art mobile application Tracesaver, which provides a great achievement over the barriers in gathering device and network related information, for network operators to improve their network service provision. Tracesaver is available for a broad range of mobile devices with different mobile operating systems and computational capabilities. The availability of Tracesaver in market has proliferated over the last year since it was published. The survey and results show that Tracesaver is being used by millions of mobile users and provides novel ways of network service improvement with its highly user friendly interface.

A statistical analysis of the relationship between land values and freestanding bus facilities.

DOT National Transportation Integrated Search

2010-02-01

Public transit professionals continue to seek methods that offer greater service opportunities, while : not materially increasing the costs of service provision. One strategy is to construct bus transit : centers which operate much like the airline h...

Phoenix Transit Sunday Dial-a-Ride

DOT National Transportation Integrated Search

1983-06-01

A local taxi operator began subsidized dial-a-ride service in Phoenix, AR, when the city found that Sunday fixed-route transit service would be more costly. Regular cabs and wheelchair vans are billed at a fixed hourly rate less fares collected. Over...

Combined truck routing and driver scheduling problems under hours of service regulations.

DOT National Transportation Integrated Search

2009-08-20

Regardless of changing variants, hours-of-service (HOS) regulations are intended to help truck drivers ensure get adequate rest and perform safe operations. The new HOS regulations, however, may lead to substantial cost increases for regional common ...

Spaceflight Operations Services Grid (SOSG) Prototype Implementation and Feasibility Study

NASA Technical Reports Server (NTRS)

Bradford, Robert N.; Thigpen, William W.; Lisotta, Anthony J.; Redman, Sandra

2004-01-01

Science Operations Services Grid is focusing on building a prototype grid-based environment that incorporates existing and new spaceflight services to enable current and future NASA programs with cost savings and new and evolvable methods to conduct science in a distributed environment. The Science Operations Services Grid (SOSG) will provide a distributed environment for widely disparate organizations to conduct their systems and processes in a more efficient and cost effective manner. These organizations include those that: 1) engage in space-based science and operations, 2) develop space-based systems and processes, and 3) conduct scientific research, bringing together disparate scientific disciplines like geology and oceanography to create new information. In addition educational outreach will be significantly enhanced by providing to schools the same tools used by NASA with the ability of the schools to actively participate on many levels in the science generated by NASA from space and on the ground. The services range from voice, video and telemetry processing and display to data mining, high level processing and visualization tools all accessible from a single portal. In this environment, users would not require high end systems or processes at their home locations to use these services. Also, the user would need to know minimal details about the applications in order to utilize the services. In addition, security at all levels is an underlying goal of the project. The Science Operations Services Grid will focus on four tools that are currently used by the ISS Payload community along with nine more that are new to the community. Under the prototype four Grid virtual organizations PO) will be developed to represent four types of users. They are a Payload (experimenters) VO, a Flight Controllers VO, an Engineering and Science Collaborators VO and an Education and Public Outreach VO. The User-based services will be implemented to replicate the operational voice, video, telemetry and commanding systems. Once the User-based services are in place, they will be analyzed to establish feasibility for Grid enabling. If feasible then each User-based service will be Grid enabled. The remaining non-Grid services if not already Web enabled will be so enabled. In the end, four portals will be developed one for each VO. Each portal will contain the appropriate User-based services required for that VO to operate.

42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Determination of the hospital-specific rate for... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determination of Transition Period Payment Rates...

Policy Manual for a Computerized Search Service in an Academic Library.

ERIC Educational Resources Information Center

Jackson, William J.

This proposed policy manual for the computerized information retrieval service of the University of Houston System outlines policies for specific elements of its operation: (1) users--who is/is not eligible for service and for equipment use; (2) cost--rates charged; (3) responsibilities of searchers--maintenance of searching skills, scheduling of…

Twenty Years of Successful Private Management. The Debate over Private vs. Public Management of Food Service.

ERIC Educational Resources Information Center

Riegel, Ronald B.

1994-01-01

Companies such as ARA Services provide lunch every day to more than 1 million students in over 280 school districts nationwide. An Illinois superintendent lists several reasons for school districts to consider "outsourcing" their food-service operations, including cost-saving opportunities, capacity for offering comprehensive services…

14 CFR 1215.114 - Service rates.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Service rates. 1215.114 Section 1215.114... (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.114 Service rates. (a) Non-U.S. Government user rates will reflect TDRSS total operational and maintenance costs prorated to a per-minute...

18 CFR 346.2 - Material in support of initial rates or change in rates.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... This statement must summarize the total cost of service for a carrier (operating and maintenance... in paragraphs (c) (2) through (7) of this section. (2) Statement B—operation and maintenance expense. This statement must set forth the operation, maintenance, administration and general, and depreciation...

18 CFR 346.2 - Material in support of initial rates or change in rates.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... This statement must summarize the total cost of service for a carrier (operating and maintenance... in paragraphs (c) (2) through (7) of this section. (2) Statement B—operation and maintenance expense. This statement must set forth the operation, maintenance, administration and general, and depreciation...

18 CFR 346.2 - Material in support of initial rates or change in rates.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... This statement must summarize the total cost of service for a carrier (operating and maintenance... in paragraphs (c) (2) through (7) of this section. (2) Statement B—operation and maintenance expense. This statement must set forth the operation, maintenance, administration and general, and depreciation...

18 CFR 346.2 - Material in support of initial rates or change in rates.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... This statement must summarize the total cost of service for a carrier (operating and maintenance... in paragraphs (c) (2) through (7) of this section. (2) Statement B—operation and maintenance expense. This statement must set forth the operation, maintenance, administration and general, and depreciation...

36 CFR 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is relatively... issues regarding the application of exemptions. (c) Reproduction fees—(1) Self-service photocopying. At...

36 CFR 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is relatively... issues regarding the application of exemptions. (c) Reproduction fees—(1) Self-service photocopying. At...

36 CFR 1250.56 - Fee schedule for NARA operational records.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the rate is $33 per hour (or fraction thereof) (2) Computer searching. This is the actual cost to NARA of operating the computer and the salary of the operator. When the search is relatively... issues regarding the application of exemptions. (c) Reproduction fees—(1) Self-service photocopying. At...

42 CFR 137.171 - Where do Self-Governance Tribes send their audit reports?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Where do Self-Governance Tribes send their audit reports? 137.171 Section 137.171 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles §...

42 CFR 137.166 - Are there exceptions to the annual audit requirements?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Are there exceptions to the annual audit requirements? 137.166 Section 137.166 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles § 137.16...

42 CFR 137.171 - Where do Self-Governance Tribes send their audit reports?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Where do Self-Governance Tribes send their audit reports? 137.171 Section 137.171 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles §...

42 CFR 137.171 - Where do Self-Governance Tribes send their audit reports?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Where do Self-Governance Tribes send their audit reports? 137.171 Section 137.171 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles §...

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

PubMed

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

2007-01-01

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

Common MD-IS infrastructure for wireless data technologies

NASA Astrophysics Data System (ADS)

White, Malcolm E.

1995-12-01

The expansion of global networks, caused by growth and acquisition within the commercial sector, is forcing users to move away from proprietary systems in favor of standards-based, open systems architectures. The same is true in the wireless data communications arena, where operators of proprietary wireless data networks have endeavored to convince users that their particular implementation provides the best service. However, most of the vendors touting these solutions have failed to gain the critical mass that might have lead to their technologies' adoption as a defacto standard, and have been held back by a lack of applications and the high cost of mobile devices. The advent of the cellular digital packet data (CDPD) specification and its support by much of the public cellular service industry has set the stage for the ubiquitous coverage of wireless packet data services across the Unites States. Although CDPD was developed for operation over the advanced mobile phone system (AMPS) cellular network, many of the defined protocols are industry standards that can be applied to the construction of a common infrastructure supporting multiple airlink standards. This approach offers overall cost savings and operation efficiency for service providers, hardware, and software developers and end-users alike, and could be equally advantageous for those service operators using proprietary end system protocols, should they wish to migrate towards an open standard.

Save medical personnel's time by improved user interfaces.

PubMed

Kindler, H

1997-01-01

Common objectives in the industrial countries are the improvement of quality of care, clinical effectiveness, and cost control. Cost control, in particular, has been addressed through the introduction of case mix systems for reimbursement by social-security institutions. More data is required to enable quality improvement, increases in clinical effectiveness and for juridical reasons. At first glance, this documentation effort is contradictory to cost reduction. However, integrated services for resource management based on better documentation should help to reduce costs. The clerical effort for documentation should be decreased by providing a co-operative working environment for healthcare professionals applying sophisticated human-computer interface technology. Additional services, e.g., automatic report generation, increase the efficiency of healthcare personnel. Modelling the medical work flow forms an essential prerequisite for integrated resource management services and for co-operative user interfaces. A user interface aware of the work flow provides intelligent assistance by offering the appropriate tools at the right moment. Nowadays there is a trend to client/server systems with relational databases or object-oriented databases as repository. The work flows used for controlling purposes and to steer the user interfaces must be represented in the repository.

78 FR 26233 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... Replace fire seal (up to 4) 8 work-hours x $85 per hour = 8,010 8,690 $680. Authority for This Rulemaking... ``New Service Information'' section above: ``Labor cost'' increased to 28 work-hours (14 hours per.... Action Labor cost Parts cost product operators General visual inspection and 28 work-hours x $85 per $2...

An order insertion scheduling model of logistics service supply chain considering capacity and time factors.

PubMed

Liu, Weihua; Yang, Yi; Wang, Shuqing; Liu, Yang

2014-01-01

Order insertion often occurs in the scheduling process of logistics service supply chain (LSSC), which disturbs normal time scheduling especially in the environment of mass customization logistics service. This study analyses order similarity coefficient and order insertion operation process and then establishes an order insertion scheduling model of LSSC with service capacity and time factors considered. This model aims to minimize the average unit volume operation cost of logistics service integrator and maximize the average satisfaction degree of functional logistics service providers. In order to verify the viability and effectiveness of our model, a specific example is numerically analyzed. Some interesting conclusions are obtained. First, along with the increase of completion time delay coefficient permitted by customers, the possible inserting order volume first increases and then trends to be stable. Second, supply chain performance reaches the best when the volume of inserting order is equal to the surplus volume of the normal operation capacity in mass service process. Third, the larger the normal operation capacity in mass service process is, the bigger the possible inserting order's volume will be. Moreover, compared to increasing the completion time delay coefficient, improving the normal operation capacity of mass service process is more useful.

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury

PubMed Central

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas

2018-01-01

Objective To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence related injury. Methods Cost benefit analysis Results Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared to the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. In contrast, the costs associated with the programme are modest: setup costs of software modifications and prevention strategies were £107,769, while the annual operating costs of the system were estimated as £210,433 (2003 UK Pound). The cumulative social benefit/cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit cost ratio of 14.8 for the health service and 19.1 for the criminal justice system. Each of these benefit/cost ratios is above 1 across a wide range of sensitivity analyses. Conclusions An effective information sharing partnership between health services, police, and local government in Cardiff, UK, led to substantial cost savings to the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented. PMID:24048916

Hierarchy of on-orbit servicing interfaces

NASA Technical Reports Server (NTRS)

Moe, Rud V.

1989-01-01

A series of equipment interfaces is involved in on-orbit servicing operations. The end-to-end hierarchy of servicing interfaces is presented. The interface concepts presented include structure and handling, and formats for transfer of resources (power, data, fluids, etc.). Consequences on cost, performance, and service ability of the use of standard designs or unique designs with interface adapters are discussed. Implications of the interface designs compatibility with remote servicing using telerobotic servicers are discussed.

Cost estimates for selected California smart traveler operation tests. Volume 1, technical report

DOT National Transportation Integrated Search

1993-03-01

The original "California Smart Traveler" report describes how telephone-based information systems can be used to develop new types of public transportation services (e.g. single-trip carpools) and to integrate these new services with conventional tra...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

Algorithms for routing vehicles and their application to the paratransit vehicle scheduling problem.

DOT National Transportation Integrated Search

2012-03-01

As the demand for paratransit services increases, there is a constant pressure to maintain the quality of : service provided to the customers while minimizing the cost of operation; this is especially important as : the availability of public funding...

77 FR 27802 - Proposed Collection; Comments Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Costs: 0. Total Annual Costs (Operating/Maintaining systems or Purchasing Services): 0. The National... following public information collection request (ICR) to the Office of Management and Budget (OMB) for... Endowment for the Arts, Office of Management and Budget, Room 10235, Washington, DC 20503 202/395-7316...

77 FR 59455 - Internal Revenue Service

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

...-37 describes documentation and information a taxpayer that uses the fair market value method of... information technology; and (e) estimates of capital or start-up costs and costs of operation, maintenance... on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of...

FERC examines transmission access pricing policies

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

Burkhart, L.A.

1993-02-15

The Federal Energy Regulatory Commission (FERC) has approved two orders dealing with transmission pricing issues that evolved from its March 1992 Pennsylvania Electric Co. (Penelec) decision dealing with cost recovery of transmission plant expansion. Commissioner Betsy Moler said the cases represented the first time the FERC has used incremental rates for wheeling transactions. In the first new order, Public Service Electric Gas Co. proposed charging for third-party transmission services to recover the sum of its standard embedded cost rate and the net incremental cost of making upgrades to its integrated transmission system. Public Service sought to provide service to EEAmore » I Limited, which proposed building and operating a cogeneration facility at a United States Gypsum Co. plant in New Jersey. Consolidated Edison Company of New York Inc. had agreed to purchase the project's output. In rejecting Public Service's proposal, the FERC ruled the utility must charge a transmission rate that is the higher of either its embedded cost rate or its incremental cost rate of accelerated expansion. (In this instance, the incremental rate was higher). In the second new order, Public Service Co. of Colorado (PSCC) filed a proposed open access transmission service tariff related to its acquisition of facilities from Colorado-Ute Electric Association Inc. The FERC rejected PSCC's tariff request that would have required a new transmission customer (in the event PSCC modified its integrated transmission grid) to pay the sum of PSCC's standard transmission rate (reflecting the average cost of the grid facilities) plus the expansion cost (reflecting the incremental facility cost).« less

Case-mix specialization in the market for hospital services.

PubMed Central

Farley, D E; Hogan, C

1990-01-01

Historically, cost-based reimbursement encouraged hospitals to compete on the basis of quality, leading to duplication of services and other inefficient behavior. More recently, prospective payment, selective contracting, and other innovations in reimbursement have strengthened incentives for more efficient hospital operations. In principle, hospitals may be able to reduce their costs by limiting the array of services they provide, but there has been little empirical evidence that U.S. hospitals are moving toward greater specialization or that specialization leads to cost savings. This article explores recent changes in case-mix specialization and the relationship of these changes to hospital costs. It first describes an index of specialization derived from Information Theory and shows that this index provides intuitively reasonable results in characterizing patterns of specialization across hospitals. The analysis then demonstrates that specialization, as measured by this index, in fact increased from 1980 through 1985; that specialization can indeed lower hospital costs; and that increases in specialization have been largest in those hospitals with the greatest incentives to reduce costs. PMID:2123838

Provider cost analysis supports results-based contracting out of maternal and newborn health services: an evidence-based policy perspective.

PubMed

Hatcher, Peter; Shaikh, Shiraz; Fazli, Hassan; Zaidi, Shehla; Riaz, Atif

2014-11-13

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services. This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical and Newborn Care (BEmONC) services provided in one RHC and six Comprehensive Emergency Obstetrical and Newborn Care (CEmONC) services in the other. Data were collected using staff interviews and record review to compile resource inputs and service volumes, and analyzed using the CORE Plus tool. Unit costs are based on actual costs of MNH services and are calculated for actual volumes in 2011 and for volumes projected to meet need with optimal resource inputs. The unit costs per service for actual 2011 volumes at the BEmONC RHC were antenatal care (ANC) visit USD$ 18.78, normal delivery US$ 84.61, newborn care US$ 16.86 and a postnatal care (PNC) visit US$ 13.86; and at the CEmONC RHC were ANC visit US$ 45.50, Normal Delivery US$ 148.43, assisted delivery US$ 167.43, C-section US$ 183.34, Newborn Care US$ 41.07, and PNC visit US$ 27.34. The unit costs for the projected volumes needed were lower due to optimal utilization of resources. The percentage distribution of expenditures at both RHCs was largest for salaries of technical staff, followed by salaries of administrative staff, and then operating costs, medicines, medical and diagnostic supplies. The unit costs of MNH services at the two contracted out government rural facilities remain higher than is optimal, primarily due to underutilization. Provider cost analysis using standard treatment guideline (STG) based service costing frameworks should be applied across a number of health facilities to calculate the cost of services and guide development of evidence based resource envelopes and performance based contracting.

Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

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

Jacobsen, R., E-mail: ray.jacobsen@ugent.be; Buysse, J., E-mail: j.buysse@ugent.be; Gellynck, X., E-mail: xavier.gellynck@ugent.be

2013-01-15

Highlights: Black-Right-Pointing-Pointer The goal is to compare collection costs for residual household waste. Black-Right-Pointing-Pointer We have clustered all municipalities in order to find mutual comparable pairs. Black-Right-Pointing-Pointer Each pair consists of one private and one public operating waste collection program. Black-Right-Pointing-Pointer All cases show that private service has lower costs than public service. Black-Right-Pointing-Pointer Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticedmore » in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.« less

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

Hummon, M.; Kiliccote, S.

Demand response (DR) resources present a potentially important source of grid flexibility however, DR in grid models is limited by data availability and modeling complexity. This presentation focuses on the co-optimization of DR resources to provide energy and ancillary services in a production cost model of the Colorado "test system". We assume each DR resource can provide energy services by either shedding load or shifting its use between different times, as well as operating reserves: frequency regulation, contingency reserve, and flexibility (or ramping) reserve. There are significant variations in the availabilities of different types of DR resources, which affect bothmore » the operational savings as well as the revenue for each DR resource. The results presented include the system-wide avoided fuel and generator start-up costs as well as the composite revenue for each DR resource by energy and operating reserves.« less

A comparison of operational performance : Washington state ferries to ferry operators worldwide.

DOT National Transportation Integrated Search

2010-06-01

This project compares eight measures of performance related to transit service quality (e.g. trip reliability, on-time departures) and cost-efficiency (e.g. farebox recovery, subsidy per passenger) between Washington State Ferries (WSF) and 23 ferry ...

Exploiting New Data Sources to Quantify Arterial Congestion and Performance Measures.

DOT National Transportation Integrated Search

2017-01-01

Transit travel time, operating speed and reliability all influence service attractiveness, operating cost and system efficiency. These metrics have a long-term impact on system effectiveness through a change in ridership. As part of its bus dispatch ...

Evaluation of introduction scenarios for a broadband access network

NASA Astrophysics Data System (ADS)

Bocker, Geert-Jan; Cuthbert, Laurie; Gobbi, Roberta; Inch, Robert; Sara, Lini

1995-02-01

The provision of broadband services at a reasonable cost to residential and small business customers is one of the major challenges facing operators. The introduction of cost-effective systems considering the existing infrastructure is an important study. Within the RACE project 2024 Broadband Access Facilities, the economic and evolution aspects of different introduction scenarios of a broadband access system suitable for providing these services are investigated. This paper presents the final results of this study.

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

PubMed

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

2011-07-01

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

Low cost space operations - Empty promise or future reality. [cost effectiveness problems of NASA programs

NASA Technical Reports Server (NTRS)

Bader, M.

1976-01-01

Organizational obstacles to the achievement of a cost-effective Space Shuttle service are examined. Among the factors considered are the difficulties of fostering concern for cost-effectiveness among the NASA research and development team and elimination of unnecessary systems and personnel. The effect of foreign or commercial competition and the extent to which governmental funding and control should be implemented are considered.

Linking and Combining Distributed Operations Facilities using NASA's "GMSEC" Systems Architectures

NASA Technical Reports Server (NTRS)

Smith, Danford; Grubb, Thomas; Esper, Jaime

2008-01-01

NASA's Goddard Mission Services Evolution Center (GMSEC) ground system architecture has been in development since late 2001, has successfully supported eight orbiting satellites and is being applied to many of NASA's future missions. GMSEC can be considered an event-driven service-oriented architecture built around a publish/subscribe message bus middleware. This paper briefly discusses the GMSEC technical approaches which have led to significant cost savings and risk reduction for NASA missions operated at the Goddard Space Flight Center (GSFC). The paper then focuses on the development and operational impacts of extending the architecture across multiple mission operations facilities.

Costs of a school-based dental mobile service in South Africa.

PubMed

Molete, M P; Chola, L; Hofman, K J

2016-10-19

The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.

Activity-based analyses lead to better decision making.

PubMed

Player, S

1998-08-01

Activity-based costing (ABC) and activity-based management (ABM) are cost-management tools that are relatively new to the healthcare industry. ABC is used for strategic decision making. It assesses the costs associated with specific activities and resources and links those costs to specific internal and external customers of the healthcare enterprise (e.g., patients, service lines, and physician groups) to determine the costs associated with each customer. This cost information then can be adjusted to account for anticipated changes and to predict future costs. ABM, on the other hand, supports operations by focusing on the causes of costs and how costs can be reduced. It assesses cost drivers that directly affect the cost of a product or service, and uses performance measures to evaluate the financial or nonfinancial benefit an activity provides. By identifying each cost driver and assessing the value the element adds to the healthcare enterprise, ABM provides a basis for selecting areas that can be changed to reduce costs.

Text and Mobile Media Smoking Cessation Service for Young Adults in South Texas: Operation and Cost-Effectiveness Estimation.

PubMed

Ramirez, Amelie G; Chalela, Patricia; Akopian, David; Munoz, Edgar; Gallion, Kipling J; Despres, Cliff; Morales, Jafet; Escobar, Rodrigo; McAlister, Alfred L

2017-07-01

To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments were achieved for 798 participants with a mean age of 29.3 years. Seven-month texted follow-up found that 21% (171) of the enrollees reported abstinence at that point. This is consistent with high rates of success found in studies of telephone counseling for young adults and confirms that text and mobile media service specifically designed for young adults provide a feasible and potentially cost-effective approach to promoting cessation.

An Analysis of Medical Imaging Costs in Military Treatment Facilities

DTIC Science & Technology

2014-09-01

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

Supply Operations (DLA-O) Total Quality Management (TQM) Master Plan

DTIC Science & Technology

1989-07-01

This document briefly outlines the DLA Directorate of Supply Operations plan to implement total quality management . It seeks to provide better...service to customers at a lower cost through continuous process improvement and commitment from everyone in the organization. Keywords: TQM (total Quality Management ), Supply operations; Continuous process improvement. (KR)

[Self-owned versus accredited network: comparative cost analysis in a Brazilian health insurance provider].

PubMed

Souza, Marcos Antônio de; Salvalaio, Dalva

2010-10-01

to analyze the cost of a self-owned network maintained by a Brazilian health insurance provider as compared to the price charged by accredited service providers, so as to identify whether or not the self-owned network is economically advantageous. for this exploratory study, the company's management reports were reviewed. The cost associated with the self-owned network was calculated based on medical and dental office visits and diagnostic/laboratory tests performed at one of the company's most representative facilities. The costs associated with third parties were derived from price tables used by the accredited network for the same services analyzed in the self-owned network. The full-cost method was used for cost quantification. Costs are presented as absolute values (in R$) and percent comparisons between self-owned network costs versus accredited network costs. overall, the self-owned network was advantageous for medical and dental consultations as well as diagnostic and laboratory tests. Pediatric and labor medicine consultations and x-rays were less costly in the accredited network. the choice of verticalization has economic advantages for the health care insurance operator in comparison with services provided by third parties.

76 FR 60601 - Proposed Information Collections; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... capital or start-up costs and costs of operation, maintenance, and purchase of services to provide the... of Spirits, Specially Denatured Spirits, or Wines for Exportation. OMB Number: 1513-0037. TTB Form..., denatured spirits, and wines from internal revenue bonded premises, without payment of tax for direct...

78 FR 45013 - Proposed Collection; Comment Request for Form W-11

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... was developed as a template for the convenience of employers who must collect affidavits from... collection. Affected Public: Businesses or other for-profit institutions. Estimated Number of Respondents... capital or start-up costs and costs of operation, maintenance, and purchase of services to provide...

Identifying best practices for managing operating costs for rural and small urban transportation systems: technical report.

DOT National Transportation Integrated Search

2016-08-01

Rural and small urban transit providers across the United States face fiscal challenges caused by the growing : gap between the cost of providing transit service and available federal, state, and local funding. In Texas, the : fiscal challenges facin...

Analysis of transit contracting models and proper incentives for long-term success.

DOT National Transportation Integrated Search

2013-11-01

As transit systems are being challenged to operate in the most cost-effective manner, and budgets are being tightened and demand for services increases, there has been renewed interest in the area of contracting for fixed route service in the United ...

Negotiating with Subscription Agencies.

ERIC Educational Resources Information Center

McQueen, Judy; Basch, N. Bernard

1991-01-01

This first in a two-part series on how librarians can negotiate services and prices with subscription agencies focuses on how vendors operate. Factors that influence agency costs, revenues, and service charges are described, including economies of scale, discounts from publishers, and prepayment and cash flow. (seven references) (LRW)

The Chicago-Iowa City passenger rail service : project summary.

DOT National Transportation Integrated Search

2011-01-12

An Iowa investment of $20.6 million will match a federal investment of $86.8 million for the capital costs of the Iowa segment of the Chicago to Iowa City service. Iowas share of the expected gap between revenues and operating and maintenance expe...

Use of linear programming to estimate impact of changes in a hospital's operating room time allocation on perioperative variable costs.

PubMed

Dexter, Franklin; Blake, John T; Penning, Donald H; Sloan, Brian; Chung, Patricia; Lubarsky, David A

2002-03-01

Administrators at hospitals with a fixed annual budget may want to focus surgical services on priority areas to ensure its community receives the best health services possible. However, many hospitals lack the detailed managerial accounting data needed to ensure that such a change does not increase operating costs. The authors used a detailed hospital cost database to investigate by how much a change in allocations of operating room (OR) time among surgeons can increase perioperative variable costs. The authors obtained financial data for all patients who underwent outpatient or same-day admit surgery during a year. Linear programming was used to determine by how much changing the mix of surgeons can increase total variable costs while maintaining the same total hours of OR time for elective cases. Changing OR allocations among surgeons without changing total OR hours allocated will likely increase perioperative variable costs by less than 34%. If, in addition, intensive care unit hours for elective surgical cases are not increased, hospital ward occupancy is capped, and implant use is tracked and capped, perioperative costs will likely increase by less than 10%. These four variables predict 97% of the variance in total variable costs. The authors showed that changing OR allocations among surgeons without changing total OR hours allocated can increase hospital perioperative variable costs by up to approximately one third. Thus, at hospitals with fixed or nearly fixed annual budgets, allocating OR time based on an OR-based statistic such as utilization can adversely affect the hospital financially. The OR manager can reduce the potential increase in costs by considering not just OR time, but also the resulting use of hospital beds and implants.

42 CFR 412.200 - General provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Operating... the prospective payment system for inpatient operating costs. Except as provided in this subpart, the... for § 412.60, which deals with DRG classification and weighting factors, the provisions of subparts D...

Secure and QoS-Managed Information Exchange Between Enterprise and Constrained Environments

DTIC Science & Technology

2014-01-01

systems and enterprise services during mission operation can enable greater situational awareness and empowerment for the tactical user . For example...April 01, 2007. [17] Robbins, D., Unmanned Aircraft Operational Integration using MITRE’s Cursor on Target, The Edge, Volume 10, Number 2, MITRE...appropriate level of security protection and quality of service (QoS) for the tactical users is one possibility. Such an approach is not cost ef

Defense Inventory: DOD Needs Additional Information for Managing War Reserve Levels of Meals Ready to Eat

DTIC Science & Technology

2015-05-01

to provide operational ration manufacturers with two types of machines to assist with the cooking and filling and sealing process for operational...and (3) any strategies DLA pursues to balance cost with readiness in supplying WRM. GAO obtained information from the services on their processes ...for identifying WRM requirements, reviewed DLA’s inventory-management processes and related guidance, and interviewed DLA and military service

Cost Determinants in the 90-Day Management of Isolated Ankle Fractures at a Large Urban Academic Hospital.

PubMed

Varacallo, Matthew; Mattern, Patrick; Acosta, Jonathan; Toossi, Nader; Denehy, Kevin; Harding, Susan

2018-05-03

To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution. Retrospective cohort study SETTING:: Level I Trauma Center PATIENTS:: Two hundred ninety-nine patients undergoing open reduction internal fixation (ORIF) for the treatment of an acute, isolated ankle fracture between 2010 and 2015. none MAIN OUTCOME MEASUREMENTS:: Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates. Orthopedic (64.9%) and podiatry (35.1%) patients were included. The mean index admission cost was $14,048.65 ± $5,797.48. Outpatient cases were significantly cheaper compared to inpatient cases ($10,164.22 ± $3,899.61 versus $15,942.55 ± $5,630.85, respectively, p < 0.001).Unplanned readmission rates were 5.4% (16/299) and 6.7% (20/299) at 30- and 90-days, respectively, and were often (13/20, 65.0%) due to surgical site infections. Independent risk factors for unplanned hospital readmissions included treatment by the podiatry service (p = 0.024), and an American Society of Anesthesiologists (ASA) score of ≥ 3 (p = 0.017). Risk factors for increasing total post discharge costs included treatment by the podiatry service (p = 0.011), and male gender (p = 0.046). Isolated operative ankle fractures are a prime target for EOC cost containment strategy protocols. Our institutional cost analysis study suggests that independent financial clinical risk factors in this treatment cohort includes podiatry as the treating surgical service and patients with an ASA score ≥ 3, with the former also independently increasing total post-discharge costs in the 90-day EOC. Outpatient procedures were associated with about a one-third reduction in total costs compared to the inpatient subgroup.

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

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

Wu, Jing; Botterud, Audun; Mills, Andrew

2015-06-01

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

Maritime vessel obsolescence, life cycle cost and design service life

NASA Astrophysics Data System (ADS)

Dinu, O.; Ilie, A. M.

2015-11-01

Maritime vessels have long service life and great costs of building, manning, operating, maintaining and repairing throughout their life. Major actions are needed to repair, renovate, sometime built or even replace those scrapped when technology or demand changes determine obsolescence. It is regarded as a concern throughout vessel's entire life cycle and reflects changes in expectation regarding performances in functioning, safety and environmental effects. While service live may differ from physical lives, expectations about physical lives is the main factors that determines design service life. Performance and failure are illustrated conceptually and represented in a simplified form considering the evolution of vessels parameters during its service life. In the proposed methodology an accumulated vessel lifecycle cost is analyzed and obsolescence is characterized from ship's design, performances, maintenance and management parameters point of view. Romanian ports feeding Black Sea are investigated in order to provide comprehensive information on: number and types of vessels, transport capacity and life cycle length. Recommendations are to be made in order to insure a best practice in lifecycle management in order to reduce costs.

Integrated centralized utility services to a chemical complex on Jurong Island, Singapore.

PubMed

Yan, Y G; Wong, P C Y; Tan, C G; Tang, K F

2003-01-01

SUT pioneered centralized utility services for the chemical industry on Jurong Island, which are cost-effective due to economies of scale, reliable due to inter-connection of satellite operations, and customer tailored for special requirements. The utility services range from the supply of steam and water, wastewater treatment, incineration, terminalling, service corridor to fire fighting. Among the services, water management achieves the complete cycle from wastewater treatment to effluent recycling.

A methodology for automation and robotics evaluation applied to the space station telerobotic servicer

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.; Gyanfi, Max; Volkmer, Kent; Zimmerman, Wayne

1988-01-01

The efforts of a recent study aimed at identifying key issues and trade-offs associated with using a Flight Telerobotic Servicer (FTS) to aid in Space Station assembly-phase tasks is described. The use of automation and robotic (A and R) technologies for large space systems would involve a substitution of automation capabilities for human extravehicular or intravehicular activities (EVA, IVA). A methodology is presented that incorporates assessment of candidate assembly-phase tasks, telerobotic performance capabilities, development costs, and effect of operational constraints (space transportation system (STS), attached payload, and proximity operations). Changes in the region of cost-effectiveness are examined under a variety of systems design assumptions. A discussion of issues is presented with focus on three roles the FTS might serve: (1) as a research-oriented testbed to learn more about space usage of telerobotics; (2) as a research based testbed having an experimental demonstration orientation with limited assembly and servicing applications; or (3) as an operational system to augment EVA and to aid the construction of the Space Station and to reduce the programmatic (schedule) risk by increasing the flexibility of mission operations.

The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies.

PubMed

Menzies, Nicolas A; Suharlim, Christian; Geng, Fangli; Ward, Zachary J; Brenzel, Logan; Resch, Stephen C

2017-10-06

Evidence on immunization costs is a critical input for cost-effectiveness analysis and budgeting, and can describe variation in site-level efficiency. The Expanded Program on Immunization Costing and Financing (EPIC) Project represents the largest investigation of immunization delivery costs, collecting empirical data on routine infant immunization in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. We developed a pooled dataset from individual EPIC country studies (316 sites). We regressed log total costs against explanatory variables describing service volume, quality, access, other site characteristics, and income level. We used Bayesian hierarchical regression models to combine data from different countries and account for the multi-stage sample design. We calculated output elasticity as the percentage increase in outputs (service volume) for a 1% increase in inputs (total costs), averaged across the sample in each country, and reported first differences to describe the impact of other predictors. We estimated average and total cost curves for each country as a function of service volume. Across countries, average costs per dose ranged from $2.75 to $13.63. Average costs per child receiving diphtheria, tetanus, and pertussis ranged from $27 to $139. Within countries costs per dose varied widely-on average, sites in the highest quintile were 440% more expensive than those in the lowest quintile. In each country, higher service volume was strongly associated with lower average costs. A doubling of service volume was associated with a 19% (95% interval, 4.0-32) reduction in costs per dose delivered, (range 13% to 32% across countries), and the largest 20% of sites in each country realized costs per dose that were on average 61% lower than those for the smallest 20% of sites, controlling for other factors. Other factors associated with higher costs included hospital status, provision of outreach services, share of effort to management, level of staff training/seniority, distance to vaccine collection, additional days open per week, greater vaccination schedule completion, and per capita gross domestic product. We identified multiple features of sites and their operating environment that were associated with differences in average unit costs, with service volume being the most influential. These findings can inform efforts to improve the efficiency of service delivery and better understand resource needs.

Large-scale data analysis of power grid resilience across multiple US service regions

NASA Astrophysics Data System (ADS)

Ji, Chuanyi; Wei, Yun; Mei, Henry; Calzada, Jorge; Carey, Matthew; Church, Steve; Hayes, Timothy; Nugent, Brian; Stella, Gregory; Wallace, Matthew; White, Joe; Wilcox, Robert

2016-05-01

Severe weather events frequently result in large-scale power failures, affecting millions of people for extended durations. However, the lack of comprehensive, detailed failure and recovery data has impeded large-scale resilience studies. Here, we analyse data from four major service regions representing Upstate New York during Super Storm Sandy and daily operations. Using non-stationary spatiotemporal random processes that relate infrastructural failures to recoveries and cost, our data analysis shows that local power failures have a disproportionally large non-local impact on people (that is, the top 20% of failures interrupted 84% of services to customers). A large number (89%) of small failures, represented by the bottom 34% of customers and commonplace devices, resulted in 56% of the total cost of 28 million customer interruption hours. Our study shows that extreme weather does not cause, but rather exacerbates, existing vulnerabilities, which are obscured in daily operations.

Soft optics in intelligent optical networks

NASA Astrophysics Data System (ADS)

Shue, Chikong; Cao, Yang

2001-10-01

In addition to the recent advances in Hard-optics that pushes the optical transmission speed, distance, wave density and optical switching capacity, Soft-optics provides the necessary intelligence and control software that reduces operational costs, increase efficiency, and enhances revenue generating services by automating optimal optical circuit placement and restoration, and enabling value-added new services like Optical VPN. This paper describes the advances in 1) Overall Hard-optics and Soft-optics 2) Layered hierarchy of Soft-optics 3) Component of Soft-optics, including hard-optics drivers, Management Soft-optics, Routing Soft-optics and System Soft-optics 4) Key component of Routing and System Soft-optics, namely optical routing and signaling (including UNI/NNI and GMPLS signaling). In summary, the soft-optics on a new generation of OXC's enables Intelligent Optical Networks to provide just-in-time service delivery and fast restoration, and real-time capacity management that eliminates stranded bandwidth. It reduces operational costs and provides new revenue opportunities.

Does the company's economic performance affect access to occupational health services?

PubMed

Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

2009-09-02

In Finland like in many other countries, employers are legally obliged to organize occupational health services (OHS) for their employees. Because employers bear the costs of OHS it could be that in spite of the legal requirement OHS expenditure is more determined by economic performance of the company than by law. Therefore, we explored whether economic performance was associated with the companies' expenditure on occupational health services. We used a prospective design to predict expenditure on OHS in 2001 by a company's economic performance in 1999. Data were provided by Statistics Finland and expressed by key indicators for profitability, solidity and liquidity and by the Social Insurance Institution as employers' reimbursement applications for OHS costs. The data could be linked at the company level. Regression analysis was used to study associations adjusted for various confounders. Nineteen percent of the companies (N = 6 155) did not apply for reimbursement of OHS costs in 2001. The profitability of the company represented by operating margin in 1999 and adjusted for type of industry was not significantly related to the company's probability to apply for reimbursement of the costs in 2001 (OR = 1.00, 95%CI: 0.99 to 1.01). Profitability measured as operating profit in 1999 and adjusted for type of industry was not significantly related to costs for curative medical services (Beta -0.001, 95%CI: -0.00 to 0.11) nor to OHS cost of prevention in 2001 (Beta -0.001, 95%CI: -0.00 to 0.00). We did not find a relation between the company's economic performance and expenditure on OHS in Finland. We suppose that this is due to legislation obliging employers to provide OHS and the reimbursement system both being strong incentives for employers.

Does the company's economic performance affect access to occupational health services?

PubMed Central

Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

2009-01-01

Background In Finland like in many other countries, employers are legally obliged to organize occupational health services (OHS) for their employees. Because employers bear the costs of OHS it could be that in spite of the legal requirement OHS expenditure is more determined by economic performance of the company than by law. Therefore, we explored whether economic performance was associated with the companies' expenditure on occupational health services. Methods We used a prospective design to predict expenditure on OHS in 2001 by a company's economic performance in 1999. Data were provided by Statistics Finland and expressed by key indicators for profitability, solidity and liquidity and by the Social Insurance Institution as employers' reimbursement applications for OHS costs. The data could be linked at the company level. Regression analysis was used to study associations adjusted for various confounders. Results Nineteen percent of the companies (N = 6 155) did not apply for reimbursement of OHS costs in 2001. The profitability of the company represented by operating margin in 1999 and adjusted for type of industry was not significantly related to the company's probability to apply for reimbursement of the costs in 2001 (OR = 1.00, 95%CI: 0.99 to 1.01). Profitability measured as operating profit in 1999 and adjusted for type of industry was not significantly related to costs for curative medical services (Beta -0.001, 95%CI: -0.00 to 0.11) nor to OHS cost of prevention in 2001 (Beta -0.001, 95%CI: -0.00 to 0.00). Conclusion We did not find a relation between the company's economic performance and expenditure on OHS in Finland. We suppose that this is due to legislation obliging employers to provide OHS and the reimbursement system both being strong incentives for employers. PMID:19725952

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

PubMed

Waters, H; Abdallah, H; Santillán, D

2001-01-01

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

Geosciences In Action Everyday Supporting B2B Partnerships

NASA Astrophysics Data System (ADS)

Glackin, M. M.; Miller, M.

2015-12-01

The weather and climate industry meets the needs of businesses every day providing services and technology that save dollars and protect lives and property. This industry employs thousands of Americans and exports products and services to the benefit of the U.S. economy and the quality of life for all people. It excels in its ability to understand and the rapidly apply the latest research, innovative technology, and business insights to uniquely solve customer needs. These skills complement the expertise of the research community and federal agencies to improve safety and performance. We will review the broad sectors of industry that are served and share insights into partnerships with other industries including an in depth example for the aviation industry. Turbulence is a major safety risk and operational challenge for airline operations, costing airlines hundreds of millions of dollars in injury claims, operational inefficiencies, maintenance costs, and loss revenue. Leveraging research developed under federal grants with latest technology and decision science, the industry provides an innovative solution to the turbulence challenge, proven to improve safety and reduce turbulence-related cost by nearly 50%.

The Best of Both Worlds: Developing a Hybrid Data System for the ASF DAAC

NASA Astrophysics Data System (ADS)

Arko, S. A.; Buechler, B.; Wolf, V. G.

2017-12-01

The Alaska Satellite Facility (ASF) at the University of Alaska Fairbanks hosts the NASA Distributed Active Archive Center (DAAC) specializing in synthetic aperture radar (SAR). Historically, the ASF DAAC has hosted hardware on-premises and developed DAAC-specific software to operate, manage, and maintain the DAAC data system. In the past year, ASF DAAC has been moving many of the standard DAAC operations into the Amazon Web Services (AWS) cloud. This includes data ingest, basic pre-processing, archiving, and distribution within the AWS environment. While the cloud offers nearly unbounded capacity for expansion and a great host of services, there also can be unexpected and unplanned costs for such. Additionally, these costs can be difficult to forecast even with historic data usage patterns and models for future usage. In an effort to maximize the effectiveness of the DAAC data system, while still managing and accurately forecasting costs, ASF DAAC has developed a hybrid, cloud and on-premises, data system. The goal of this project is to make extensive use of the AWS cloud, and when appropriate, utilize on-premises resources to help constrain costs. This hybrid system attempts to mimic, on premises, a cloud environment using Kubernetes container orchestration in order that software can be run in either location with little change. Combined with hybrid data storage architecture, the new data system makes use of the great capacity of the cloud while maintaining an on-premises options. This presentation will describe the development of the hybrid data system, including the micro-services architecture and design, the container orchestration, and hybrid storage. Additional we will highlight the lessons learned through the development process, cost forecasting for current and future SAR-mission operations, and provide a discussion of the pros and cons of hybrid architectures versus all-cloud deployments. This development effort has led to a system that is capable and flexible for the future while allowing ASF DAAC to continue supporting the SAR community with the highest level of services.

Building an Economical and Sustainable Lunar Infrastructure to Enable Lunar Industrialization

NASA Technical Reports Server (NTRS)

Zuniga, Allison F.; Turner, Mark; Rasky, Daniel; Loucks, Mike; Carrico, John; Policastri, Daniel

2017-01-01

A new concept study was initiated to examine the architecture needed to gradually develop an economical, evolvable and sustainable lunar infrastructure using a public/private partnerships approach. This approach would establish partnership agreements between NASA and industry teams to develop a lunar infrastructure system that would be mutually beneficial. This approach would also require NASA and its industry partners to share costs in the development phase and then transfer operation of these infrastructure services back to its industry owners in the execution phase. These infrastructure services may include but are not limited to the following: lunar cargo transportation, power stations, communication towers and satellites, autonomous rover operations, landing pads and resource extraction operations. The public/private partnerships approach used in this study leveraged best practices from NASA's Commercial Orbital Transportation Services (COTS) program which introduced an innovative and economical approach for partnering with industry to develop commercial cargo services to the International Space Station. This program was planned together with the ISS Commercial Resupply Services (CRS) contracts which was responsible for initiating commercial cargo delivery services to the ISS for the first time. The public/private partnerships approach undertaken in the COTS program proved to be very successful in dramatically reducing development costs for these ISS cargo delivery services as well as substantially reducing operational costs. To continue on this successful path towards installing economical infrastructure services for LEO and beyond, this new study, named Lunar COTS (Commercial Operations and Transport Services), was conducted to examine extending the NASA COTS model to cis-lunar space and the lunar surface. The goals of the Lunar COTS concept are to: 1) develop and demonstrate affordable and commercial cis-lunar and surface capabilities, such as lunar cargo delivery and surface power generation, in partnership with industry; 2) incentivize industry to establish economical and sustainable lunar infrastructure services to support NASA missions and initiate lunar commerce; and 3) encourage creation of new space markets for economic growth and benefit. A phased-development approach was also studied to allow for incremental development and demonstration of capabilities needed to build a lunar infrastructure. This paper will describe the Lunar COTS concept goals, objectives and approach for building an economical and sustainable lunar infrastructure. It will also describe the technical challenges and advantages of developing and operating each infrastructure element. It will also describe the potential benefits and progress that can be accomplished in the initial phase of this Lunar COTS approach. Finally, the paper will also look forward to the potential of a robust lunar industrialization environment and its potential effect on the next 50 years of space exploration.

Low-Earth orbit satellite servicing economics

NASA Technical Reports Server (NTRS)

Davis, R. F.; Cepollina, F. J.

1982-01-01

Servicing economics of low Earth orbit satellites were studied. The following topics are examined: the economic importance of the repair missions; comparison of mission cost as opposed to satellite modulation transfer functions over a 10 year period; the effect of satellite flight rate change due to changes in satellite failure rate; estimated satellite cost reduction with shuttle operation projects from the 1960's to the 1970's; design objectives of the multimission modular spacecraft; and the economic importance of the repair mission.

Visual Decision Support Tool for Supporting Asset Management Performance, Risk, and Cost Analysis (WERF Report INFR5R12)

EPA Science Inventory

Abstract:Managing urban water infrastructures faces the challenge of jointly dealing with assets of diverse types, useful life, cost, ages and condition. Service quality and sustainability require sound long-term planning, well aligned with tactical and operational planning and m...

75 FR 67163 - Proposed Collection; Comment Request for Form 8955-SSA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... be transmitted to the Social Security Administration (SSA) who will provide it to separated participants when those participants file for social security benefits. Current Actions: There is no change in... capital or start-up costs and costs of operation, maintenance, and purchase of services to provide...

76 FR 49537 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... enable taxpayers to take advantage of various benefits provided by OBRA and the Internal Revenue Code... approved collection. Affected Public: Individuals or households and business or other for-profit...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

78 FR 13157 - Proposed Collection; Comment Request for Form 13803

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

... submit the required information necessary to complete the e-services enrollment process for IVES users... information displays a valid OMB control number. Books or records relating to a collection of information must... forms of information technology; and (e) estimates of capital or start-up costs and costs of operation...

75 FR 49025 - Proposed Collection; Comment Request for Form W-11

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... form was developed as a template for the convenience of employers who must collect affidavits from... collection. Affected Public: Businesses or other for-profit institutions. Estimated Number of Respondents...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

75 FR 30905 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

... Deferred Under Section 6166 or 6166A (Section 301.6324A-1). Notice 2007-90 provides additional guidance...: Special Lien for Estate Taxes Deferred Under Section 6166 or 6166A. OMB Number: 1545-0757. Regulation... costs and costs of operation, maintenance, and purchase of services to provide information. Approved...

78 FR 27296 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... taxpayers to defer for 5 years taxation of certain income arising in 2009 or 2010. Taxpayers then must include the deferred amount in income ratably over 5 years. The election statement advises that a taxpayer...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

An Academic Library's Experience with Fee-Based Services.

ERIC Educational Resources Information Center

Hornbeck, Julia W.

1983-01-01

Profile of fee-based information services offered by the Information Exchange Center of Georgia Institute of Technology notes history and background, document delivery to commercial clients and on-campus faculty, online and manual literature searching, staff, cost analysis, fee schedule, operating methods, client relations, marketing, and current…

42 CFR 412.108 - Special treatment: Medicare-dependent, small rural hospitals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System for Inpatient Operating Costs... including days and discharges from units excluded from the prospective payment system under §§ 412.25...

7 CFR 272.2 - Plan of operation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... obesity prevention services as discussed in paragraph (d)(2) of this section. (iv) A plan for the State... in local communities; (iii) Describe the nutrition education and obesity prevention services that the... use the SNAP-Ed nutrition education and obesity prevention grant to fund the administrative costs of...

Operational Benefits of Meeting California's Energy Storage Targets

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

Eichman, Josh; Denholm, Paul; Jorgenson, Jennie

In October 2013, the California Public Utilities Commission (CPUC) finalized procurement targets and other requirements to its jurisdictional utilities for a minimum of 1,325 MW of 'viable and cost-effective' energy storage systems by 2020. The goal of this study is to explore several aspects of grid operations in California and the Western Interconnection resulting from meeting the CPUC storage targets. We perform this analysis using a set of databases and grid simulation tools developed and implemented by the CPUC, the California Independent System Operator (CAISO), and the California Energy Commission (CEC) for the CPUC's Long-term Procurement Plan (LTPP). The 2014more » version of this database contains information about generators, storage, transmission, and electrical demand, for California in the year 2024 for both 33% and 40% renewable energy portfolios. We examine the value of various services provided by energy storage in these scenarios. Sensitivities were performed relating to the services energy storage can provide, the capacity and duration of storage devices, export limitations, and negative price floor variations. Results show that a storage portfolio, as outlined by the CPUC, can reduce curtailment and system-wide production costs for 33% and 40% renewable scenarios. A storage device that can participate in energy and ancillary service markets provides the grid with the greatest benefit; the mandated storage requirement of 1,325 MW was estimated to reduce the total cost of production by about 78 million per year in the 33% scenario and 144 million per year in the 40% scenario. Much of this value is derived from the avoided start and stop costs of thermal generators and provision of ancillary services. A device on the 2024 California grid and participating in only ancillary service markets can provide the system with over 90% of the value as the energy and ancillary service device. The analysis points to the challenge of new storage providing regulation reserve, as the added storage could provide about 75% of the regulation up requirement for all of California, which would likely greatly reduce regulation prices and potential revenue. The addition of storage in California decreases renewable curtailment, particularly in the 40% RPS case. Following previous analysis, storage has a mixed impact on emissions, generally reducing emissions, but also creating additional incentives for increased emissions from out-of-state coal generations. Overall, storage shows significant system cost savings, but analysis also points to additional challenges associated with full valuation of energy storage, including capturing the operational benefits calculated here, but also recovering additional benefits associated avoided generation, transmission, and distribution capacity, and avoided losses.« less

The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa

PubMed Central

Devjee, Jaymala; Moodley, Jack

2017-01-01

Background Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. Methods We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. Results A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32–75.51). The total average cost per MVA was higher at $69.60 (52.62–86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. Conclusion This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs. PMID:28369061

Analysis of Fast Charging Station Network for Electrified Ride-Hailing Services

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

Wood, Eric W; Rames, Clement L; Kontou, Eleftheria

Today's electric vehicle (EV) owners charge their vehicles mostly at home and seldom use public direct current fast charger (DCFCs), reducing the need for a large deployment of DCFCs for private EV owners. However, due to the emerging interest among transportation network companies to operate EVs in their fleet, there is great potential for DCFCs to be highly utilized and become economically feasible in the future. This paper describes a heuristic algorithm to emulate operation of EVs within a hypothetical transportation network company fleet using a large global positioning system data set from Columbus, Ohio. DCFC requirements supporting operation ofmore » EVs are estimated using the Electric Vehicle Infrastructure Projection tool. Operation and installation costs were estimated using real-world data to assess the economic feasibility of the recommended fast charging stations. Results suggest that the hypothetical transportation network company fleet increases daily vehicle miles traveled per EV with less overall down time, resulting in increased demand for DCFC. Sites with overhead service lines are recommended for hosting DCFC stations to minimize the need for trenching underground service lines. A negative relationship was found between cost per unit of energy and fast charging utilization, underscoring the importance of prioritizing utilization over installation costs when siting DCFC stations. Although this preliminary analysis of the impacts of new mobility paradigms on alternative fueling infrastructure requirements has produced several key results, the complexity of the problem warrants further investigation.« less

Reaffirming Some Basic Principles in Purchasing and Maintenance.

ERIC Educational Resources Information Center

Throop, Harold L., Jr.

1985-01-01

Reaffirms necessary elements for the successful operation of college purchasing and maintenance programs (e.g., purchasing calendar, bidding procedures, vendor selection, contracting services, budgeting for maintenance, and workforce analysis). Discusses ways some colleges are saving on operating costs (e.g., solar energy, energy management,…

47 CFR 32.7240 - Operating other taxes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS... of the cost of the items to which the taxes relate. (g) Taxes on rented telecommunications plant... shall be charged by the lessee to the appropriate Plant Specific Operations Expense account. [51 FR...

Space Operations Center - A concept analysis

NASA Technical Reports Server (NTRS)

1980-01-01

The Space Operations Center (SOC) which is a concept for a Shuttle serviced, permanent, manned facility in low earth orbit is viewed as a major candidate for the manned space flight following the completion of an operational Shuttle. The primary objectives of SOC are: (1) the construction, checkout, and transfer to operational orbit of large, complex space systems, (2) on-orbit assembly, launch, recovery, and servicing of manned and unmanned spacecraft, (3) managing operations of co-orbiting free-flying satellites, and (4) the development of reduced dependence on earth for control and resupply. The structure of SOC, a self-contained orbital facility containing several Shuttle launched modules, includes the service, habitation, and logistics modules as well as construction, and flight support facilities. A schedule is proposed for the development of SOC over ten years and costs for the yearly programs are estimated.

An experiment with community health funds in Afghanistan.

PubMed

Rao, Krishna D; Waters, Hugh; Steinhardt, Laura; Alam, Sahibullah; Hansen, Peter; Naeem, Ahmad Jan

2009-07-01

As Afghanistan rebuilds its health system, it faces key challenges in financing health services. To reduce dependence on donor funds, it is important to develop sustainable local financing mechanisms. A second challenge is to reduce high levels of out-of-pocket payments. Community-based health insurance (CBHI) schemes offer the possibility of raising revenues from communities and at the same time providing financial protection. This paper describes the performance of one type of CBHI scheme, the Community Health Fund (CHF), which was piloted for the first time in five provinces of Afghanistan between June 2005 and October 2006. The performance of the CHF programme demonstrates that complex community-based health financing schemes can be implemented in post-conflict settings like Afghanistan, except in areas of high insecurity. The funds raised from the community, via premiums and user fees, enabled the pilot facilities to overcome temporary shortages of drugs and supplies, and to conduct outreach services via mobile clinics. However, enrolment and cost-recovery were modest. The median enrolment rate for premium-paying households was 6% of eligible households in the catchment areas of the clinics. Cost recovery rates ranged up to 16% of total operating costs and 32% of non-salary operating costs. No evidence of reduced out-of-pocket health expenditures was observed at the community level, though CHF members had markedly higher utilization of health services. The main reasons among non-members for not enrolling were being unaware of the programme; high premiums; and perceived low quality of services at the CHF clinics. The performance of Afghanistan's CHF was similar to other CHF-type programmes operating at the primary care level internationally. The solution to building local capacity to finance health services lies in a combination of financing sources rather than any single mechanism. In this context, it is critical that international assistance for Afghanistan's health sector continues.

A time scheduling model of logistics service supply chain based on the customer order decoupling point: a perspective from the constant service operation time.

PubMed

Liu, Weihua; Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng

2014-01-01

In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC.

A Time Scheduling Model of Logistics Service Supply Chain Based on the Customer Order Decoupling Point: A Perspective from the Constant Service Operation Time

PubMed Central

Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng

2014-01-01

In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC. PMID:24715818

Managerial accounting applications in radiology.

PubMed

Lexa, Frank James; Mehta, Tushar; Seidmann, Abraham

2005-03-01

We review the core issues in managerial accounting for radiologists. We introduce the topic and then explore its application to diagnostic imaging. We define key terms such as fixed cost, variable cost, marginal cost, and marginal revenue and discuss their role in understanding the operational and financial implications for a radiology facility by using a cost-volume-profit model. Our work places particular emphasis on the role of managerial accounting in understanding service costs, as well as how it assists executive decision making.

Report by the Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

1981-01-01

The process of preparation for the first two shuttle flights was observed and information from both flights was gathered in order to confirm the concept and performance of the major elements of the space transportation system. To achieve truly operational operating safety, regularity, and minimum practical cost, the organization of efforts between the R&D community and any transportation service organization should be clearly separated with the latter organization assuming responsibilities for marketing its services; planning and acquiring prime hardware and spares; maintainance; certification of procedures; training; and creation of requirements for future development. A technical audit of the application of redundancy concepts to shuttle systems is suggested. The state of the art of space transportation hardware suggests that a number of concept changes may improve reliability, costs, and operational safety. For the remaining R&D flights, it is suggested that a redline audit be made of limits that should not be exceeded for ready to launch.

Engine Development Design Margins Briefing Charts

NASA Technical Reports Server (NTRS)

Bentz, Chuck

2006-01-01

New engines experience durability problems after entering service. The most prevalent and costly is the hot section, particularly the high-pressure turbine. The origin of durability problems can be traced back to: 1) the basic aero-mechanical design systems, assumptions, and design margins used by the engine designers, 2) the available materials systems, and 3) to a large extent, aggressive marketing in a highly competitive environment that pushes engine components beyond the demonstrated capability of the basic technology available for the hardware designs. Unfortunately the user must operate the engine in the service environment in order to learn the actual thrust loading and the time at max effort take-off conditions used in service are needed to determine the hot section life. Several hundred thousand hours of operational service will be required before the demonstrated reliability of a fleet of engines or the design deficiencies of the engine hot section parts can be determined. Also, it may take three to four engine shop visits for heavy maintenance on the gas path hardware to establish cost effective build standards. Spare parts drive the oerator's engine maintenance costs but spare parts also makes lots of money for the engine manufacturer during the service life of an engine. Unless competition prevails for follow-on engine buys, there is really no motivation for an OEM to spend internal money to improve parts durability and reduce earnings derived from a lucrative spare parts business. If the hot section life is below design goals or promised values, the OEM migh argue that the engine is being operated beyond its basic design intent. On the other hand, the airframer and the operator will continue to remind the OEM that his engine was selected based on a lot of promises to deliver spec thrust with little impact on engine service life if higher thrust is used intermittently. In the end, a standoff prevails and nothing gets fixed. This briefing will propose ways to hold competing engine manufacturers more accountable for engine hot section design margins during the entire Engine Development process as well as provide tools to assess the design temperature margins in the hot section parts of Service Engines.

Automatic control of electric thermal storage (heat) under real-time pricing. Final report

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

Daryanian, B.; Tabors, R.D.; Bohn, R.E.

1995-01-01

Real-time pricing (RTP) can be used by electric utilities as a control signal for responsive demand-side management (DSM) programs. Electric thermal storage (ETS) systems in buildings provide the inherent flexibility needed to take advantage of variations in prices. Under RTP, optimal performance for ETS operations is achieved under market conditions where reductions in customers` costs coincide with the lowering of the cost of service for electric utilities. The RTP signal conveys the time-varying actual marginal cost of the electric service to customers. The RTP rate is a combination of various cost components, including marginal generation fuel and maintenance costs, marginalmore » costs of transmission and distribution losses, and marginal quality of supply and transmission costs. This report describes the results of an experiment in automatic control of heat storage systems under RTP during the winter seasons of 1989--90 and 1990--91.« less

An Order Insertion Scheduling Model of Logistics Service Supply Chain Considering Capacity and Time Factors

PubMed Central

Yang, Yi; Wang, Shuqing; Liu, Yang

2014-01-01

Order insertion often occurs in the scheduling process of logistics service supply chain (LSSC), which disturbs normal time scheduling especially in the environment of mass customization logistics service. This study analyses order similarity coefficient and order insertion operation process and then establishes an order insertion scheduling model of LSSC with service capacity and time factors considered. This model aims to minimize the average unit volume operation cost of logistics service integrator and maximize the average satisfaction degree of functional logistics service providers. In order to verify the viability and effectiveness of our model, a specific example is numerically analyzed. Some interesting conclusions are obtained. First, along with the increase of completion time delay coefficient permitted by customers, the possible inserting order volume first increases and then trends to be stable. Second, supply chain performance reaches the best when the volume of inserting order is equal to the surplus volume of the normal operation capacity in mass service process. Third, the larger the normal operation capacity in mass service process is, the bigger the possible inserting order's volume will be. Moreover, compared to increasing the completion time delay coefficient, improving the normal operation capacity of mass service process is more useful. PMID:25276851

Implementation of Advanced Warehouses in a Hospital Environment - Case study

NASA Astrophysics Data System (ADS)

Costa, J.; Sameiro Carvalho, M.; Nobre, A.

2015-05-01

In Portugal, there is an increase of costs in the healthcare sector due to several factors such as the aging of the population, the increased demand for health care services and the increasing investment in new technologies. Thus, there is a need to reduce costs, by presenting the effective and efficient management of logistics supply systems with enormous potential to achieve savings in health care organizations without compromising the quality of the provided service, which is a critical factor, in this type of sector. In this research project the implementation of Advanced Warehouses has been studied, in the Hospital de Braga patient care units, based in a mix of replenishment systems approaches: the par level system, the two bin system and the consignment model. The logistics supply process is supported by information technology (IT), allowing a proactive replacement of products, based on the hospital services consumption records. The case study was developed in two patient care units, in order to study the impact of the operation of the three replenishment systems. Results showed that an important inventory holding costs reduction can be achieved in the patient care unit warehouses while increasing the service level and increasing control of incoming and stored materials with less human resources. The main conclusion of this work illustrates the possibility of operating multiple replenishment models, according to the types of materials that healthcare organizations deal with, so that they are able to provide quality health care services at a reduced cost and economically sustainable. The adoption of adequate IT has been shown critical for the success of the project.

Hubble Space Telescope: cost reduction by re-engineering telemetry processing and archiving

NASA Astrophysics Data System (ADS)

Miebach, Manfred P.

1998-05-01

The Hubble Space Telescope (HST), the first of NASA's Great Observatories, was launched on April 24, 1990. The HST was designed for a minimum fifteen-year mission with on-orbit servicing by the Space Shuttle System planned at approximately three-year intervals. Major changes to the HST ground system are planned to be in place for the third servicing mission in December 1999. The primary objectives of the ground system reengineering effort, a project called 'vision December 1999. The primary objectives of the ground system re-engineering effort, a project called 'vision 2000 control center systems (CCS)', are to reduce both development and operating costs significantly for the remaining years of HST's lifetime. Development costs will be reduced by providing a modern hardware and software architecture and utilizing commercial of f the shelf (COTS) products wherever possible. Operating costs will be reduced by eliminating redundant legacy systems and processes and by providing an integrated ground system geared toward autonomous operation. Part of CCS is a Space Telescope Engineering Data Store, the design of which is based on current Data Warehouse technology. The purpose of this data store is to provide a common data source of telemetry data for all HST subsystems. This data store will become the engineering data archive and will include a queryable database for the user to analyze HST telemetry. The access to the engineering data in the Data Warehouse is platform- independent from an office environment using commercial standards. Latest internet technology is used to reach the HST engineering community. A WEB-based user interface allows easy access to the data archives. This paper will provide a high level overview of the CCS system and will illustrate some of the CCS telemetry capabilities. Samples of CCS user interface pages will be given. Vision 2000 is an ambitious project, but one that is well under way. It will allow the HST program to realize reduced operations costs for the Third Servicing Mission and beyond.

The space station assembly phase: System design trade-offs for the flight telerobotic servicer

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.; Gyamfi, Max; Volkmer, Kent; Zimmerman, Wayne

1988-01-01

The effects of a recent study aimed at identifying key issues and trade-offs associated with using a Flight Telerobotic Servicer (FTS) to aid in Space Station assembly-phase tasks is described. The use of automation and robotic (A and R) technologies for large space systems often involves a substitution of automation capabilities for human EVA or IVA activities. A methodology is presented that incorporates assessment of candidate assembly-phase tasks, telerobotic performance capabilities, development costs, and effects of operational constaints. Changes in the region of cost-effectiveness are examined under a variety of system design assumptions. A discussion of issues is presented with focus on three roles the FTS might serve: as a research-oriented test bed to learn more about space usage of telerobotics; as a research based test bed having an experimental demonstration orientation with limited assembly and servicing applications; or as an operational system to augment EVA and to aid construction of the Space Station and to reduce the program (schedule) risk by increasing the flexibility of mission operations.

2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

Code of Federal Regulations, 2011 CFR

2011-01-01

... Requirements. 1. Each State will submit a plan to the Department of Health and Human Services for each year in... certain additional information is needed, and will likely be needed in future years, it may be routinely.... (1) For each internal service fund or similar activity with an operating budget of $5 million or more...

2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

Code of Federal Regulations, 2012 CFR

2012-01-01

... Requirements. 1. Each State will submit a plan to the Department of Health and Human Services for each year in... certain additional information is needed, and will likely be needed in future years, it may be routinely.... (1) For each internal service fund or similar activity with an operating budget of $5 million or more...

2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

Code of Federal Regulations, 2013 CFR

2013-01-01

... Requirements. 1. Each State will submit a plan to the Department of Health and Human Services for each year in... certain additional information is needed, and will likely be needed in future years, it may be routinely.... (1) For each internal service fund or similar activity with an operating budget of $5 million or more...

Executive summary: Benefit-cost evaluation of an intra-regional air service in the Bay Area and a technology assessment of transportation system investments. [regional planning for the San Francisco Bay area of California

NASA Technical Reports Server (NTRS)

Haefner, L. E.

1978-01-01

The benefits and costs that would result from an intra-regional air service operation in the San Francisco Bay area were determined by utilizing an iterative statistical decision model to evaluate combinations of commuter airport sites and surface transportation facilities in conjunction with service by a given commuter aircraft type in light of area regional growth alternatives and peak and off-peak regional travel patterns. The model evaluates such transportation option with respect to criteria of airline profitability, public acceptance, and public and private non-user costs. In so doing, it incorporates information on modal split, peak and off-peak use of the air commuter fleet, terminal and airport costs, development costs and uses of land in proximity to the airport sites, regional population shifts, and induced zonal shifts in travel demand. The model is multimodal in its analytic capability, and performs exhaustive sensitivity analysis.

Evaluating Trade-offs of a Large, Infrequent Diversion for Restoration of a Forested Wetland and Associated Ecosystem Services in the Mississippi delta

NASA Astrophysics Data System (ADS)

Day, J.; Rutherford, J.; Weigman, A.; D'Elia, C.

2017-12-01

Flood control levees have eliminated the supply of sediment to Mississippi delta coastal wetlands, putting the delta on a trajectory for submergence in the 21st century. River diversions have been proposed as a method to provide a sustainable supply of sediment to the delta. Operating river diversions based on the size and frequency of natural crevasse events that were large (>5000 m3/s) and infrequent (active < once a year). This study assesses tradeoffs for a large, infrequent diversion into the forested wetlands of the Maurepas Swamp using a 2-dimensional model, that predicts land building is simulated for several diversion sizes and intermittencies. A cost-benefit analysis (CBA) was conducted by combining model results with an ecosystem service valuation (ESV) and estimated costs. Land building is proportional to diversion size and inversely proportional to years inactive. Because benefits are assumed to scale linearly with land gain, and costs increase with diversion size, there are disadvantages to operating large diversions less often, compared to smaller diversions more often. However, infrequent operation would provide additional ES benefits to the broader Lake Pontchartrain ecosystem by minimizing long-term changes to water quality and salinity, reducing inundation time, and allowing for greater consolidation of soils between diversion pulses. Compared to diversions, marsh creation costs increase over time due to sea level rise and energy costs.

Framework for Financial Ratio Analysis of Audited Federal Financial Reports

DTIC Science & Technology

1999-12-01

franchising operations, allowing them to lower costs and share administrative support services with other agencies. [Ref. 60:sec. 402-403] The GMRA also...96 Federal Financial Reporting Statement of Net Cost Report Format 97 Federal Financial Reporting Statement of Changes in Net Position Report Format...analysis for sales, profitability, efficiency, marketing, investment, debt and capital analysis. Monitor growth Monitor costs Measure profitability and

A Model for the Determination of the Costs of Special Education as Compared with That for General Education. Appendix: Part 2.

ERIC Educational Resources Information Center

Ernst and Ernst, Chicago, IL.

Part 2 of the appendix to "A Model for the Determination of the Costs of Special Education as Compared with That for General Education" contains information on using 10-minute units of service measure in Ernstville, a hypothetical school district conceived to illustrate operation of a proposed cost accounting system. (LH)

Hospital services and casemix in Western Australia.

PubMed

Hendrie, Delia; Boldy, Duncan

2002-01-01

The Health Department of WA currently operates as a single integrated funder and purchaser of health services for the State. Health Service Agreements defining the level of health provision are negotiated with the various health services in WA. During the latter part of the 1990s, the funding of public hospitals for acute inpatient care moved away from a historical basis to output-based funding using a casemix approach based on Diagnosis Related Groups (DRGs). Other hospital services are still mainly purchased using historical funding levels, negotiated block funding or bedday payments, with output-based funding mechanisms under investigation. WA has developed its own approach to classifying admitted patients that recognises differences in complexity of care among episodes grouped to the same DRG. WA also has a unique cost estimation model for calculating DRG cost weights, which is based on a linear estimate of the relationship between nights of stay in hospital and the cost of hospital care for each DRG. Another emerging trend in the provision of public hospital services in WA has been the greater involvement of the private sector through the contracting of private providers to operate public hospitals. While no close examination has been undertaken of the outcomes of these changes in terms of their effect on efficiency or other relevant indicators of hospital performance, current purchasing arrangements are being reviewed following recommendations made in a report by the Health Administrative Review Committee. No decision has yet been made as to future changes to the funding policy of WA public hospitals.

Performance, Agility and Cost of Cloud Computing Services for NASA GES DISC Giovanni Application

NASA Astrophysics Data System (ADS)

Pham, L.; Chen, A.; Wharton, S.; Winter, E. L.; Lynnes, C.

2013-12-01

The NASA Goddard Earth Science Data and Information Services Center (GES DISC) is investigating the performance, agility and cost of Cloud computing for GES DISC applications. Giovanni (Geospatial Interactive Online Visualization ANd aNalysis Infrastructure), one of the core applications at the GES DISC for online climate-related Earth science data access, subsetting, analysis, visualization, and downloading, was used to evaluate the feasibility and effort of porting an application to the Amazon Cloud Services platform. The performance and the cost of running Giovanni on the Amazon Cloud were compared to similar parameters for the GES DISC local operational system. A Giovanni Time-Series analysis of aerosol absorption optical depth (388nm) from OMI (Ozone Monitoring Instrument)/Aura was selected for these comparisons. All required data were pre-cached in both the Cloud and local system to avoid data transfer delays. The 3-, 6-, 12-, and 24-month data were used for analysis on the Cloud and local system respectively, and the processing times for the analysis were used to evaluate system performance. To investigate application agility, Giovanni was installed and tested on multiple Cloud platforms. The cost of using a Cloud computing platform mainly consists of: computing, storage, data requests, and data transfer in/out. The Cloud computing cost is calculated based on the hourly rate, and the storage cost is calculated based on the rate of Gigabytes per month. Cost for incoming data transfer is free, and for data transfer out, the cost is based on the rate in Gigabytes. The costs for a local server system consist of buying hardware/software, system maintenance/updating, and operating cost. The results showed that the Cloud platform had a 38% better performance and cost 36% less than the local system. This investigation shows the potential of cloud computing to increase system performance and lower the overall cost of system management.

Triple Play over Satellite, Ka-Band Making the Difference

NASA Astrophysics Data System (ADS)

Benoit, Guillaume; Fenech, Hector; Pezzana, Stefano

Over the last years a number of operators have been deploying satellite-based consumer internet access services to reduce the digital divide and capture the market of households not covered by ADSL, cable or wireless broadband. These operators are proposing a step change improvement in the economics of consumer service, with lower terminal costs, broadband access with monthly fees comparable to ADSL and an integrated technology simplifying the process of terminal installation, provisioning and management.

Airport landside operations and air service

NASA Astrophysics Data System (ADS)

Mandle, P. B.; Whitlock, E. M.; Lamagna, F.; Mundy, R. A.; Oberhausen, P. J.

The following areas are discussed: airport curbside planning and design; analysis of New Orleans airport ground transportation system; time series analysis of intercity air travel volume; economic justification of air service to small communities; and general aviation and the airport and airway system (an analysis of cost allocation and recovery).

45 CFR 5.43 - Fee schedule.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION FREEDOM OF INFORMATION REGULATIONS Fees § 5.43... punchcards or blueprints), or reproducing other records (such as tapes)—the actual costs of operating the... service is not required by the FOIA. If we agree to provide it, we will charge $10 per certification. (f...

Building a model-based decision support system for solving vehicle routing and driver scheduling problems under hours of service regulations.

DOT National Transportation Integrated Search

2011-08-27

"In principle, hours-of-service (HOS) regulations are intended to help truck drivers ensure get adequate rest and perform safe operations. The new HOS regulations, however, may lead to substantial cost increases for regional common carriers which hav...

Day Care Services: Industry's Involvement. Bulletin 296.

ERIC Educational Resources Information Center

Besner, Arthur

This bulletin provides an overview of the need for services for the children of working mothers. Topics discussed include historical developments in industry day care programs, alternative roles for industry involvement, costs of operating day care centers, and income tax allowances. Also given are examples of unique programs which suggest various…

Some Comments on Marketing AIP Information Products and Services.

ERIC Educational Resources Information Center

King, Donald W.; Brown, A. M.

This study was addressed to marketing considerations for the American Institute of Physics (AIP) information products and services. The general system and its operation in a marketing environment, including promotion, channels of distribution and pricing are covered. Particular emphasis is placed on the cost/demand/price relationship for four…

A Librarian's Guide to Speaking the Business Language.

ERIC Educational Resources Information Center

Zach, Lisl

2002-01-01

Discusses budgeting in corporate libraries as a basic tool of financial management. Highlights include focusing on goals; developing a list or matrix of services; resources needed for each service; shared costs; types of budgets, including operating budget, capital budget, and cash budget; and approaches to budgeting, including incremental…

42 CFR 412.422 - Basis of payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... as specified in subpart G of part 409 of this chapter) for inpatient operating and capital-related... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... the cost of an approved medical education program as specified in § 413.75 through § 413.85 of this...

Definition of technology development missions for early space station satellite servicing, volume 2

NASA Technical Reports Server (NTRS)

1983-01-01

The results of all aspects of the early space station satellite servicing study tasks are presented. These results include identification of servicing tasks (and locations), identification of servicing mission system and detailed objectives, functional/operational requirements analyses of multiple servicing scenarios, assessment of critical servicing technology capabilities and development of an evolutionary capability plan, design and validation of selected servicing technology development missions (TDMs), identification of space station satellite servicing accommodation needs, and the cost and schedule implications of acquiring both required technology capability development and conducting the selected TDMs.

Reducing Development and Operations Costs using NASA's "GMSEC" Systems Architecture

NASA Technical Reports Server (NTRS)

Smith, Dan; Bristow, John; Crouse, Patrick

2007-01-01

This viewgraph presentation reviews the role of Goddard Mission Services Evolution Center (GMSEC) in reducing development and operation costs in handling the massive data from NASA missions. The goals of GMSEC systems architecture development are to (1) Simplify integration and development, (2)Facilitate technology infusion over time, (3) Support evolving operational concepts, and (4) All for mix of heritage, COTS and new components. First 3 missions (i.e., Tropical Rainforest Measuring Mission (TRMM), Small Explorer (SMEX) missions - SWAS, TRACE, SAMPEX, and ST5 3-Satellite Constellation System) each selected a different telemetry and command system. These results show that GMSEC's message-bus component-based framework architecture is well proven and provides significant benefits over traditional flight and ground data system designs. The missions benefit through increased set of product options, enhanced automation, lower cost and new mission-enabling operations concept options .

Cost effectiveness of stream-gaging program in Michigan

USGS Publications Warehouse

Holtschlag, D.J.

1985-01-01

This report documents the results of a study of the cost effectiveness of the stream-gaging program in Michigan. Data uses and funding sources were identified for the 129 continuous gaging stations being operated in Michigan as of 1984. One gaging station was identified as having insufficient reason to continue its operation. Several stations were identified for reactivation, should funds become available, because of insufficiencies in the data network. Alternative methods of developing streamflow information based on routing and regression analyses were investigated for 10 stations. However, no station records were reproduced with sufficient accuracy to replace conventional gaging practices. A cost-effectiveness analysis of the data-collection procedure for the ice-free season was conducted using a Kalman-filter analysis. To define missing-record characteristics, cross-correlation coefficients and coefficients of variation were computed at stations on the basis of daily mean discharge. Discharge-measurement data were used to describe the gage/discharge rating stability at each station. The results of the cost-effectiveness analysis for a 9-month ice-free season show that the current policy of visiting most stations on a fixed servicing schedule once every 6 weeks results in an average standard error of 12.1 percent for the current $718,100 budget. By adopting a flexible servicing schedule, the average standard error could be reduced to 11.1 percent. Alternatively, the budget could be reduced to $700,200 while maintaining the current level of accuracy. A minimum budget of $680,200 is needed to operate the 129-gaging-station program; a budget less than this would not permit proper service and maintenance of stations. At the minimum budget, the average standard error would be 14.4 percent. A budget of $789,900 (the maximum analyzed) would result in a decrease in the average standard error to 9.07 percent. Owing to continual changes in the composition of the network and the changes in the uncertainties of streamflow accuracy at individual stations, the cost-effectiveness analysis will need to be updated regularly if it is to be used as a management tool. Cost of these updates need to be considered in decisions concerning the feasibility of flexible servicing schedules.

Integrating primary care with occupational health services: a success story.

PubMed

Griffith, Karen; Strasser, Patricia B

2010-12-01

This article describes the process used by a large U.S. manufacturing company to successfully integrate full-service primary care centers at two locations. The company believed that by providing employees with health promotion and disease prevention services, including screening, early diagnosis, and uncomplicated illness treatment, its health care costs could be significantly reduced while saving employees money. To accurately demonstrate the cost-effectiveness of adding primary care to existing occupational health services, a thorough financial analysis projected the return on investment (ROI) of the program. Decisions were made about center size, the scope of services, and staffing. A critical part of the ROI analysis involved evaluating employee health claim data to identify the actual cost of health care services for each center and the projected costs if the services were provided on-site. The pilot initiative included constructing two on-site health center facilities staffed with primary care physicians, nurse practitioners, physical therapists, and other health care professionals. Key outcome metrics from the pilot clinics exceeded goals in three of four categories. In addition, clinic use after 12 months far exceeded benchmarks for similar clinics. Most importantly, the pilot clinics were operating with a positive cash flow within the first year and demonstrated an increasingly positive ROI. Copyright 2010, SLACK Incorporated.

Program evaluation: Weatherization Residential Assistance Partnership (WRAP) Program

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

Not Available

1991-12-01

The Connecticut low income weatherization program was developed in response to a 1987 rate docket order from the Connecticut Department of Public Utility Control (DPUC) to Connecticut Light Power Co., an operating subsidiary of Northeast Utilities (NU). (Throughout this report, NU is referred to as the operator of the program.) This program, known as the Weatherization Residential Assistance Partnership, or WRAP, was configured utilizing input from a collaborative group of interested parties to the docket. It was agreed that this program would be put forth by the electric utility, but would not ignore oil and gas savings (thus, it wasmore » to be fuel- blind''). The allocated cost of conservation services for each fuel source, however, should be cost effective. It was to be offered to those utility customers at or below 200 percent of the federal poverty levels, and provide a wide array of energy saving measures directed toward heating, water heating and lighting. It was felt by the collaborative group that this program would raise the level of expenditures per participant for weatherization services provided by the state, and by linking to and revising the auditing process for weatherization, would lower the audit unit cost. The program plans ranged from the offering of low-cost heating, water heating and infiltration measures, increased insulation levels, carpentry and plumbing services, to furnace or burner replacement. The program was configured to allow for very comprehensive weatherization and heating system servicing.« less

Program evaluation: Weatherization Residential Assistance Partnership (WRAP) Program. Volume 1, Final report

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

Not Available

1991-12-01

The Connecticut low income weatherization program was developed in response to a 1987 rate docket order from the Connecticut Department of Public Utility Control (DPUC) to Connecticut Light & Power Co., an operating subsidiary of Northeast Utilities (NU). (Throughout this report, NU is referred to as the operator of the program.) This program, known as the Weatherization Residential Assistance Partnership, or WRAP, was configured utilizing input from a collaborative group of interested parties to the docket. It was agreed that this program would be put forth by the electric utility, but would not ignore oil and gas savings (thus, itmore » was to be ``fuel- blind``). The allocated cost of conservation services for each fuel source, however, should be cost effective. It was to be offered to those utility customers at or below 200 percent of the federal poverty levels, and provide a wide array of energy saving measures directed toward heating, water heating and lighting. It was felt by the collaborative group that this program would raise the level of expenditures per participant for weatherization services provided by the state, and by linking to and revising the auditing process for weatherization, would lower the audit unit cost. The program plans ranged from the offering of low-cost heating, water heating and infiltration measures, increased insulation levels, carpentry and plumbing services, to furnace or burner replacement. The program was configured to allow for very comprehensive weatherization and heating system servicing.« less

Contrast in low-cost operational concepts for orbiting satellites

NASA Astrophysics Data System (ADS)

Walyus, Keith D.; Reis, James; Bradley, Arthur J.

2002-12-01

Older spacecraft missions, especially those in low Earth orbit with telemetry intensive requirements, required round-the-clock control center staffing. The state of technology relied on control center personnel to continually examine data, make decisions, resolve anomalies, and file reports. Hubble Space Telescope (HST) is a prime example of this description. Technological advancements in hardware and software over the last decade have yielded increases in productivity and operational efficiency, which result in lower cost. The re-engineering effort of HST, which has recently concluded, utilized emerging technology to reduce cost and increase productivity. New missions, of which NASA's Transition Region and Coronal Explorer Satellite (TRACE) is an example, have benefited from recent technological advancements and are more cost-effective than when HST was first launched. During its launch (1998) and early orbit phase, the TRACE Flight Operations Team (FOT) employed continually staffed operations. Yet once the mission entered its nominal phase, the FOT reduced their staffing to standard weekday business hours. Operations were still conducted at night and during the weekends, but these operations occurred autonomously without compromising their high standards for data collections. For the HST, which launched in 1990, reduced cost operations will employ a different operational concept, when the spacecraft enters its low-cost phase after its final servicing mission in 2004. Primarily due to the spacecraft"s design, the HST Project has determined that single-shift operations will introduce unacceptable risks for the amount of dollars saved. More importantly, significant cost-savings can still be achieved by changing the operational concept for the FOT, while still maintaining round-the-clock staffing. It"s important to note that the low-cost solutions obtained for one satellite may not be applicable for other satellites. This paper will contrast the differences between low-cost operational concepts for a satellite launched in 1998 versus a satellite launched in 1990.

76 FR 70765 - National Endowment for the Arts; Submission of OMB Review: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

... submission of responses. Agency: National Endowment for the Arts. Title: General Social Survey Arts... Annualized Capital/Startup Costs: 0. Total Annual Costs (Operating/Maintaining Systems or Purchasing Services): 0. This request is for clearance of an arts supplement for the 2012 General Social Survey (GSS), to...

29 CFR 1208.6 - Schedule of fees and methods of payment for services rendered.

Code of Federal Regulations, 2014 CFR

2014-07-01

... included in direct costs are overhead expenses such as costs of space and heating or lighting the facility... form of paper copy, microfilm, audiovisual materials, or machine readable documentation (e.g., magnetic... scholarly research. (7) Non-commercial scientific institution refers to an institution that is not operated...

29 CFR 1208.6 - Schedule of fees and methods of payment for services rendered.

Code of Federal Regulations, 2012 CFR

2012-07-01

... included in direct costs are overhead expenses such as costs of space and heating or lighting the facility... form of paper copy, microfilm, audiovisual materials, or machine readable documentation (e.g., magnetic... scholarly research. (7) Non-commercial scientific institution refers to an institution that is not operated...

29 CFR 1208.6 - Schedule of fees and methods of payment for services rendered.

Code of Federal Regulations, 2013 CFR

2013-07-01

... included in direct costs are overhead expenses such as costs of space and heating or lighting the facility... form of paper copy, microfilm, audiovisual materials, or machine readable documentation (e.g., magnetic... scholarly research. (7) Non-commercial scientific institution refers to an institution that is not operated...

Determinants of Employment Success Among Ex-Offenders

ERIC Educational Resources Information Center

Knox, George W.; Stacey, William A.

1978-01-01

Use of cost-benefit analysis in evaluation of seven manpower service programs for ex-offenders in Illinois shows these programs have benefit-cost ratios ranging from 4.24 to 16.88. Demographic profiles for the client flows differ somewhat, with Operation DARE's population being somewhat of a more "hard-core" group based on previous law…

75 FR 10018 - Proposed Collection; Comment Request for Notice 98-1 and REG-108639-99

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

... (TD 1969), Retirement Plans; Cash or Deferred Arrangements Under Section 401(k) and Matching... Plans; Cash or Deferred Arrangements Under Section 401(k) and Matching Contributions or Employee...) estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to...

76 FR 12416 - Proposed Collection; Comment Request for Form 8939

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

...,000; or appreciated property is acquired from the decedent that the decedent acquired by gift within three years of death and a gift tax return was required to be filed on the transfer to the decedent... capital or start-up costs and costs of operation, maintenance, and purchase of services to provide...

Cost Accounting and Accountability: One Approach.

ERIC Educational Resources Information Center

Gingold, William

This paper outlines an approach designed to provide an accurate and efficient cost accounting system for use in schools and other social service organizations. In his discussion, the author presents a detailed step-by-step description of how to establish, plan, and operate the system. The basic element of the system is the Daily Event Record…

Using Excel's Matrix Operations to Facilitate Reciprocal Cost Allocations

ERIC Educational Resources Information Center

Leese, Wallace R.; Kizirian, Tim

2009-01-01

The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated direct or step-down methods. Here is a short example demonstrating how Excel's sometimes unknown matrix…

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.

Preliminary benefits study for a public service communications satellite system: Task order 2

NASA Technical Reports Server (NTRS)

1978-01-01

The economic and social benefits to accrue from an operational public service communications satellite system are estimated for the following applications: teleradiology, emergency medical services, teleconferencing for both civilian and defense agencies, data transfer, remote cardiac monitoring, teleconsultation, continuing education for professionals, and severe storm warning. The potential impact of improved communication on the cost and quality of services are assessed for various agencies, professions, and industries.

[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.

An integrated outsourcing solution at York Central Hospital.

PubMed

Marr, Jo-Anne; Tam, Richard; Simms, Stephen; Bacchus, Feria

2011-01-01

Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

Budgeting for International Projects: In-Country Business Operations and Long-Term Residential Assignments.

ERIC Educational Resources Information Center

Richey, John B.

1994-01-01

A discussion of international sponsored research program administration looks at budgeting, costs, and procedures for both projects with in-country business operations in developing nations and projects with long-term residential assignments. It is intended for university administrators providing new services to faculty working on international…

78 FR 69805 - Periodic Reporting (Proposals Six Through Nine)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... MODS Operation Groups for Productivity Calculations The Postal Service states that Proposal Eight would... MODS productivity data (TPF or TPH per workhour) for a variety of operation groups related to letter, flat, parcel, and bundle sorting. The MODS productivity data are used to parameterize a number of cost...

The need for a dedicated public service helicopter design

NASA Technical Reports Server (NTRS)

Morrison, R.

1984-01-01

The need to provide the necessary funding to research, design and contract the building of an advanced technology rotorcraft that will meet the mission demands of public service (fire, police, paramedics and rescue) operators is discussed. Noise and cost factors, the greatest objections on the part of many police and public adminstrators are addressed. The growth of helicopter utilization in public service is documented.

Flat-panel display solutions for ground-environment military displays (Invited Paper)

NASA Astrophysics Data System (ADS)

Thomas, J., II; Roach, R.

2005-05-01

Displays for military vehicles have very distinct operational and cost requirements that differ from other military applications. These requirements demand that display suppliers to Army and Marine ground-environments provide low cost equipment that is capable of operation across environmental extremes. Inevitably, COTS components form the foundation of these "affordable" display solutions. This paper will outline the major display requirements and review the options that satisfy conflicting and difficult operational demands, using newly developed equipment as an example. Recently, a new supplier was selected for the Drivers Vision Enhancer (DVE) equipment, including the Display Control Module (DCM). The paper will outline the DVE and describe development of a new DCM solution. The DVE programme, with several thousand units presently in service and operational in conflicts such as "Operation Iraqi Freedom", represents a critical balance between cost and performance. We shall describe design considerations that include selection of COTS sources, the need to minimise display modification; video interfaces, power interfaces, operator interfaces and new provisions to optimise displayed video content.

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

NASA Technical Reports Server (NTRS)

Steinetz, Bruce M.; Hendricks, Robert C.

1994-01-01

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

Development of augmented reality system for servicing electromechanical equipment

NASA Astrophysics Data System (ADS)

Zhukovskiy, Y.; Koteleva, N.

2018-05-01

Electromechanical equipment is widely used. It is used in industrial enterprises, in the spheres of public services, in everyday life, etc. Maintenance servicing of electromechanical equipment is an important part of its life cycle. High-quality and timely service can extend the life of the electromechanical equipment. The creation of special systems that simplify the process of servicing electromechanical equipment is an urgent task. Such systems can shorten the time for maintenance of electrical equipment, and, therefore, reduce the cost of maintenance in general. This article presents an analysis of information on the operation of service services for maintenance and repair of electromechanical equipment, identifies the list of services, and estimates the time required to perform basic service operations. The structure of the augmented reality system is presented, the ways of interaction of the augmented reality system with the automated control systems working at the enterprise are presented.

A New Activity-Based Financial Cost Management Method

NASA Astrophysics Data System (ADS)

Qingge, Zhang

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

Job Corps: Its Costs, Employment Outcomes, and Service to the Public. Briefing Report to the Chairman, Committee on Labor and Human Resources, United States Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

This report evaluates the cost effectiveness of the Civilian Conservation Centers (CCCs) which are part of the Job Corps program but operated under inter-agency agreement by the Departments of Agriculture and the Interior. Data are from the program year beginning July 1, 1984. Information is presented on: (1) the costs, job placements, and…

An Analysis of the Potential Impacts of Ashton Carter’s Should-Cost Memorandum on Defense Contracting

DTIC Science & Technology

2012-09-17

monopolistic contractors that match distinctive government requirements. Figure 4 portrays the differences found in pure competitive commercial markets ...operate in quasi-competitive environments. Such arenas are characterized as oligopolistic or monopolistic markets . Table 6. Top 10 Companies by...practice will be used to build sufficient cost knowledge of those services within that market segment. You will employ that cost knowledge to inform

Robust planning of sanitation services in urban informal settlements: An analytical framework.

PubMed

Schmitt, Rafael J P; Morgenroth, Eberhard; Larsen, Tove A

2017-03-01

New types of sanitation services are emerging to tackle the sanitation crisis in informal settlements. These services link toilet facilities to semi-decentralized treatment plants via frequent, road-based transport of excreta. However, information for the planning of such sanitation services is scarce, and their future operating conditions are highly uncertain. The key questions of this paper are therefore: a) what are the drivers behind success or failure of a service-based sanitation system in informal settlements and b) on what scales and under which conditions can such a system operate successfully? To answer these questions, already at an early stage of the planning process, we introduce a stochastic model to analyze a wide range of system designs under varying technical designs, socio-economic factors, and spatial condition. Based on these initial results, we design a sanitation service and use the numeric model to study its reliability and costs over a wide range of scales, i.e., system capacities, from very few to many hundred users per semi-decentralized treatment unit. Key findings are that such a system can only operate within a narrow, but realistic range of conditions. Key requirements are toilet facilities, which can be serviced rapidly, and a flexible workforce. A high density of facilities will also lower the costs. Under these premises, we develop a road-based sanitation service and model its functionality in different settings and under many scenarios. Results show that the developed sanitation system using a single vehicle is scalable (100-700 users), can provide reliable service, and can be cheap (<1.5 c/p/day). Hence, this paper demonstrates opportunities for road-based sanitation in informal settlements and presents a quantitative framework for designing such systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2015-11-01

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

A decade of experience with a clinical pharmacokinetics service.

PubMed

Ambrose, P J; Smith, W E; Palarea, E R

1988-09-01

The development, operation, and functions of the pharmacokinetics service at Memorial Medical Center of Long Beach (MMCLB) are described, and the data used to determine the quality and cost-effectiveness of the service are presented. Current functions of the pharmacokinetics service at MMCLB include making brief written comments about the interpretations of serum drug concentrations (SDCs) and oral recommendations to physicians on dosage adjustment; provision of written consultations with dosage recommendations; provision of drug information, education, and research; and development of drug dosing guidelines for the pharmacy and medical staff. During the 10-year existence of this service, costs have been justified on the basis of not only revenue generated by the service (in the form of "drug concentration scheduling" and "drug concentration evaluation" fees charged to patients) but also by cost savings resulting from the prevention of inappropriate, misleading, and potentially dangerous SDCs. An audit conducted in 1986 showed that the policy of having pharmacists schedule the sampling times for SDCs saves about $500,000 annually. Quality assurance has been documented by auditing compliance with and therapeutic effectiveness of dosing guidelines and by working with laboratory personnel to identify and prevent spurious SDC results and assay errors. The methods used by the pharmacokinetics service at MMCLB to document the benefits of the service have been vital in proving both its cost-effectiveness and its positive effect on patient care.

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

NASA Astrophysics Data System (ADS)

Flores, Robert Joseph

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

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

PubMed

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

2018-05-01

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

Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

PubMed

Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

2018-01-01

In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

42 CFR 412.220 - Special treatment of certain hospitals located in Puerto Rico.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Puerto Rico. 412.220 Section 412.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... SERVICES Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico § 412.220 Special treatment of certain hospitals located in Puerto Rico. Subpart G of this part sets...

18 CFR 367.4120 - Account 412, Cost and expenses of construction or other services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... undertakes projects to construct physical property for associate or non-associate companies (see General... HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR..., FEDERAL POWER ACT AND NATURAL GAS ACT Income Statement Chart of Accounts Service Company Operating Income...

42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

Code of Federal Regulations, 2010 CFR

2010-10-01

... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals... payment system. The prospective payment system includes payment for inpatient operating costs of...

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... 42 Public Health 2 2010-10-01 2010-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts...

42 CFR 412.79 - Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent...

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Determination of Transition Period Payment Rates for the Prospective Payment System for Inpatient... 42 Public Health 2 2010-10-01 2010-10-01 false Determination of the hospital-specific rate for...

40 CFR 35.929-2 - General requirements for all user charge systems.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the user charges or ad valorem taxes which are attributable to waste water treatment services. (g... than every 2 years the waste water contribution of users and user classes, the total costs of operation... subscribers receiving waste treatment services from the grantee shall adopt user charge systems in accordance...

40 CFR 35.929-2 - General requirements for all user charge systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of the user charges or ad valorem taxes which are attributable to waste water treatment services. (g... than every 2 years the waste water contribution of users and user classes, the total costs of operation... subscribers receiving waste treatment services from the grantee shall adopt user charge systems in accordance...

Using community partners to deliver low-cost and effective emergency management and business continuity services.

PubMed

Thomas, Joan; Roggiero, Jean Paul; Silva, Brian

2010-11-01

Small to medium-sized organisations enhance their business mission as well as their communities by continuing to offer services in extreme circumstances. Developing emergency preparedness and business continuity plans that are cost-effective, comprehensive and operational for small to medium-sized organisations with limited resources requires a consistent, supportive, hands-on approach over time with professionals to create appropriate and sustainable strategies. Using a unique, multi-layered and applied approach to emergency preparedness training, organisations have successfully created plans that are effective and sustainable.

A nurse-run walk-in clinic: cost-effective alternative to non-urgent emergency department use by the uninsured.

PubMed

Bicki, Alexandra; Silva, Adam; Joseph, Valerie; Handoko, Ryan; Rico, Sheryl-vi; Burns, Jacqueline; Simonelli, Anna; Harrop, Jordan; Nedow, Jennifer; De Groot, Anne S

2013-12-01

Non-urgent healthcare problems are responsible for more than 9 million visits to the emergency department (ED) in US hospitals each year, largely due to patients' lack of access to a primary care physician. To avoid costly and unnecessary ED usage for non-urgent health problems, a walk-in clinic run by nurses (CHEER Clinic) was developed as an extension of the services provided by an existing free clinic in a low-income neighborhood of Providence, RI, with the goal of providing uninsured patients with a convenient, no-cost means of accessing healthcare. An evaluation and cost-effectiveness analysis of the clinic's first 5 months of operation were performed. During this pilot period, 256 patients were seen. When incorporating the quality-adjusted-life-year value of preventive services rendered, an estimated $1.28 million in future healthcare costs was avoided. Dividing these cost-savings by the clinic's operational cost yielded a mean return on investment of $34 per $1 invested. Adding nurse-run walk-in hours at a free clinic significantly expanded access to healthcare for uninsured patients and was cost-effective for both the clinic and the patient. Ultimately, replication of this model in community clinics serving the uninsured could reduce ED burden by treating a substantial number of non-urgent medical concerns at a lower cost than would be incurred for treatment of the same problems in EDs.

Improving clinicians' access to cost data.

PubMed

Kenagy, John; Shah, Ben

2014-08-01

Bringing clinical and financial data together is critical to effectively running and operating service lines. Helping clinicians use cost data to make decisions requires a shared vision and a partnership between finance leaders and physicians. Hosting a "jam session" of technical, financial, and clinical experts can accelerate an organization's business intelligence strategy. Labor and supply costs represent the most actionable cost data for clinicians. Clinician buy-in hinges on education and support. It is important to focus on easy wins at the beginning of the project.

Time-driven Activity-based Costing More Accurately Reflects Costs in Arthroplasty Surgery.

PubMed

Akhavan, Sina; Ward, Lorrayne; Bozic, Kevin J

2016-01-01

Cost estimates derived from traditional hospital cost accounting systems have inherent limitations that restrict their usefulness for measuring process and quality improvement. Newer approaches such as time-driven activity-based costing (TDABC) may offer more precise estimates of true cost, but to our knowledge, the differences between this TDABC and more traditional approaches have not been explored systematically in arthroplasty surgery. The purposes of this study were to compare the costs associated with (1) primary total hip arthroplasty (THA); (2) primary total knee arthroplasty (TKA); and (3) three surgeons performing these total joint arthroplasties (TJAs) as measured using TDABC versus traditional hospital accounting (TA). Process maps were developed for each phase of care (preoperative, intraoperative, and postoperative) for patients undergoing primary TJA performed by one of three surgeons at a tertiary care medical center. Personnel costs for each phase of care were measured using TDABC based on fully loaded labor rates, including physician compensation. Costs associated with consumables (including implants) were calculated based on direct purchase price. Total costs for 677 primary TJAs were aggregated over 17 months (January 2012 to May 2013) and organized into cost categories (room and board, implant, operating room services, drugs, supplies, other services). Costs derived using TDABC, based on actual time and intensity of resources used, were compared with costs derived using TA techniques based on activity-based costing and indirect costs calculated as a percentage of direct costs from the hospital decision support system. Substantial differences between cost estimates using TDABC and TA were found for primary THA (USD 12,982 TDABC versus USD 23,915 TA), primary TKA (USD 13,661 TDABC versus USD 24,796 TA), and individually across all three surgeons for both (THA: TDABC = 49%-55% of TA total cost; TKA: TDABC = 53%-55% of TA total cost). Cost categories with the most variability between TA and TDABC estimates were operating room services and room and board. Traditional hospital cost accounting systems overestimate the costs associated with many surgical procedures, including primary TJA. TDABC provides a more accurate measure of true resource use associated with TJAs and can be used to identify high-cost/high-variability processes that can be targeted for process/quality improvement. Level III, therapeutic study.

Cost Sharing, Health Care Expenditures, and Utilization: An International Comparison.

PubMed

Perkowski, Patryk; Rodberg, Leonard

2016-01-01

Health systems implement cost sharing to help reduce health care expenditure and utilization by discouraging the use of unnecessary health care services. We examine cost sharing in 28 countries in the Organisation for Economic Co-operation and Development from 1999 through 2009 in the areas of medical care, hospital care, and pharmaceuticals. We investigate associations between cost sharing, health care expenditures, and health care utilization and find no significant association between cost sharing and health care expenditures or utilization in these countries. © The Author(s) 2015.

Implementation of an acute care emergency surgical service: a cost analysis from the surgeon’s perspective

PubMed Central

Anantha, Ram Venkatesh; Parry, Neil; Vogt, Kelly; Jain, Vipan; Crawford, Silvie; Leslie, Ken

2014-01-01

Background Acute care surgical services provide comprehensive emergency general surgical care while potentially using health care resources more efficiently. We assessed the volume and distribution of emergency general surgery (EGS) procedures before and after the implementation of the Acute Care and Emergency Surgery Service (ACCESS) at a Canadian tertiary care hospital and its effect on surgeon billings. Methods This single-centre retrospective case–control study compared adult patients who underwent EGS procedures between July and December 2009 (pre-ACCESS), to those who had surgery between July and December 2010 (post-ACCESS). Case distribution was compared between day (7 am to 3 pm), evening (3 pm to 11 pm) and night (11 pm to 7 am). Frequencies were compared using the χ2 test. Results Pre-ACCESS, 366 EGS procedures were performed: 24% during the day, 55% in the evening and 21% at night. Post-ACCESS, 463 operations were performed: 55% during the day, 36% in the evening and 9% at night. Reductions in night-time and evening EGS were 57% and 36% respectively (p < 0.001). Total surgeon billings for operations pre- and post-ACCESS were $281 066 and $287 075, respectively: remuneration was $6008 higher post-ACCESS for an additional 97 cases (p = 0.003). Using cost-modelling analysis, post-ACCESS surgeon billing for appendectomies, segmental colectomies, laparotomies and cholecystectomies all declined by $67 190, $125 215, $66 362, and $84 913, respectively (p < 0.001). Conclusion Acute care surgical services have dramatically shifted EGS from nighttime to daytime. Cost-modelling analysis demonstrates that these services have cost-savings potential for the health care system without reducing overall surgeon billing. PMID:24666462

Implementation of an acute care emergency surgical service: a cost analysis from the surgeon's perspective.

PubMed

Anantha, Ram Venkatesh; Parry, Neil; Vogt, Kelly; Jain, Vipan; Crawford, Silvie; Leslie, Ken

2014-04-01

Acute care surgical services provide comprehensive emergency general surgical care while potentially using health care resources more efficiently. We assessed the volume and distribution of emergency general surgery (EGS) procedures before and after the implementation of the Acute Care and Emergency Surgery Service (ACCESS) at a Canadian tertiary care hospital and its effect on surgeon billings. This single-centre retrospective case-control study compared adult patients who underwent EGS procedures between July and December 2009 (pre-ACCESS), to those who had surgery between July and December 2010 (post-ACCESS). Case distribution was compared between day (7 am to 3 pm), evening (3 pm to 11 pm) and night (11 pm to 7 am). Frequencies were compared using the χ(2) test. Pre-ACCESS, 366 EGS procedures were performed: 24% during the day, 55% in the evening and 21% at night. Post-ACCESS, 463 operations were performed: 55% during the day, 36% in the evening and 9% at night. Reductions in night-time and evening EGS were 57% and 36% respectively (p < 0.001). Total surgeon billings for operations pre- and post-ACCESS were $281 066 and $287 075, respectively: remuneration was $6008 higher post-ACCESS for an additional 97 cases (p = 0.003). Using cost-modelling analysis, post-ACCESS surgeon billing for appendectomies, segmental colectomies, laparotomies and cholecystectomies all declined by $67 190, $125 215, $66 362, and $84 913, respectively (p < 0.001). Acute care surgical services have dramatically shifted EGS from nighttime to daytime. Cost-modelling analysis demonstrates that these services have cost-savings potential for the health care system without reducing overall surgeon billing.

Energy Storage Applications in Power Systems with Renewable Energy Generation

NASA Astrophysics Data System (ADS)

Ghofrani, Mahmoud

In this dissertation, we propose new operational and planning methodologies for power systems with renewable energy sources. A probabilistic optimal power flow (POPF) is developed to model wind power variations and evaluate the power system operation with intermittent renewable energy generation. The methodology is used to calculate the operating and ramping reserves that are required to compensate for power system uncertainties. Distributed wind generation is introduced as an operational scheme to take advantage of the spatial diversity of renewable energy resources and reduce wind power fluctuations using low or uncorrelated wind farms. The POPF is demonstrated using the IEEE 24-bus system where the proposed operational scheme reduces the operating and ramping reserve requirements and operation and congestion cost of the system as compared to operational practices available in the literature. A stochastic operational-planning framework is also proposed to adequately size, optimally place and schedule storage units within power systems with high wind penetrations. The method is used for different applications of energy storage systems for renewable energy integration. These applications include market-based opportunities such as renewable energy time-shift, renewable capacity firming, and transmission and distribution upgrade deferral in the form of revenue or reduced cost and storage-related societal benefits such as integration of more renewables, reduced emissions and improved utilization of grid assets. A power-pool model which incorporates the one-sided auction market into POPF is developed. The model considers storage units as market participants submitting hourly price bids in the form of marginal costs. This provides an accurate market-clearing process as compared to the 'price-taker' analysis available in the literature where the effects of large-scale storage units on the market-clearing prices are neglected. Different case studies are provided to demonstrate our operational-planning framework and economic justification for different storage applications. A new reliability model is proposed for security and adequacy assessment of power networks containing renewable resources and energy storage systems. The proposed model is used in combination with the operational-planning framework to enhance the reliability and operability of wind integration. The proposed framework optimally utilizes the storage capacity for reliability applications of wind integration. This is essential for justification of storage deployment within regulated utilities where the absence of market opportunities limits the economic advantage of storage technologies over gas-fired generators. A control strategy is also proposed to achieve the maximum reliability using energy storage systems. A cost-benefit analysis compares storage technologies and conventional alternatives to reliably and efficiently integrate different wind penetrations and determines the most economical design. Our simulation results demonstrate the necessity of optimal storage placement for different wind applications. This dissertation also proposes a new stochastic framework to optimally charge and discharge electric vehicles (EVs) to mitigate the effects of wind power uncertainties. Vehicle-to-grid (V2G) service for hedging against wind power imbalances is introduced as a novel application for EVs. This application enhances the predictability of wind power and reduces the power imbalances between the scheduled output and actual power. An Auto Regressive Moving Average (ARMA) wind speed model is developed to forecast the wind power output. Driving patterns of EVs are stochastically modeled and the EVs are clustered in the fleets of similar daily driving patterns. Monte Carlo Simulation (MCS) simulates the system behavior by generating samples of system states using the wind ARMA model and EVs driving patterns. A Genetic Algorithm (GA) is used in combination with MCS to optimally coordinate the EV fleets for their V2G services and minimize the penalty cost associated with wind power imbalances. The economic characteristics of automotive battery technologies and costs of V2G service are incorporated into a cost-benefit analysis which evaluates the economic justification of the proposed V2G application. Simulation results demonstrate that the developed algorithm enhances wind power utilization and reduces the penalty cost for wind power under-/over-production. This offers potential revenues for the wind producer. Our cost-benefit analysis also demonstrates that the proposed algorithm will provide the EV owners with economic incentives to participate in V2G services. The proposed smart scheduling strategy develops a sustainable integrated electricity and transportation infrastructure.

Regulation of distribution network business

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

Roman, J.; Gomez, T.; Munoz, A.

1999-04-01

The traditional distribution function actually comprises two separate activities: distribution network and retailing. Retailing, which is also termed supply, consists of trading electricity at the wholesale level and selling it to the end users. The distribution network business, or merely distribution, is a natural monopoly and it must be regulated. Increasing attention is presently being paid to the regulation of distribution pricing. Distribution pricing, comprises two major tasks: global remuneration of the distribution utility and tariff setting by allocation of the total costs among all the users of the network services. In this paper, the basic concepts for establishing themore » global remuneration of a distribution utility are presented. A remuneration scheme which recognizes adequate investment and operation costs, promotes losses reduction and incentivates the control of the quality of service level is proposed. Efficient investment and operation costs are calculated by using different types of strategic planning and regression analysis models. Application examples that have been used during the distribution regulation process in Spain are also presented.« less

Flexible reserve markets for wind integration

NASA Astrophysics Data System (ADS)

Fernandez, Alisha R.

The increased interconnection of variable generation has motivated the use of improved forecasting to more accurately predict future production with the purpose to lower total system costs for balancing when the expected output exceeds or falls short of the actual output. Forecasts are imperfect, and the forecast errors associated with utility-scale generation from variable generators need new balancing capabilities that cannot be handled by existing ancillary services. Our work focuses on strategies for integrating large amounts of wind generation under the flex reserve market, a market that would called upon for short-term energy services during an under or oversupply of wind generation to maintain electric grid reliability. The flex reserve market would be utilized for time intervals that fall in-between the current ancillary services markets that would be longer than second-to-second energy services for maintaining system frequency and shorter than reserve capacity services that are called upon for several minutes up to an hour during an unexpected contingency on the grid. In our work, the wind operator would access the flex reserve market as an energy service to correct for unanticipated forecast errors, akin to paying the generators participating in the market to increase generation during a shortfall or paying the other generators to decrease generation during an excess of wind generation. Such a market does not currently exist in the Mid-Atlantic United States. The Pennsylvania-New Jersey-Maryland Interconnection (PJM) is the Mid-Atlantic electric grid case study that was used to examine if a flex reserve market can be utilized for integrating large capacities of wind generation in a lowcost manner for those providing, purchasing and dispatching these short-term balancing services. The following work consists of three studies. The first examines the ability of a hydroelectric facility to provide short-term forecast error balancing services via a flex reserve market, identifying the operational constraints that inhibit a multi-purpose dam facility to meet the desired flexible energy demand. The second study transitions from the hydroelectric facility as the decision maker providing flex reserve services to the wind plant as the decision maker purchasing these services. In this second study, methods for allocating the costs of flex reserve services under different wind policy scenarios are explored that aggregate farms into different groupings to identify the least-cost strategy for balancing the costs of hourly day-ahead forecast errors. The least-cost strategy may be different for an individual wind plant and for the system operator, noting that the least-cost strategy is highly sensitive to cost allocation and aggregation schemes. The latter may also cause cross-subsidies in the cost for balancing wind forecast errors among the different wind farms. The third study builds from the second, with the objective to quantify the amount of flex reserves needed for balancing future forecast errors using a probabilistic approach (quantile regression) to estimating future forecast errors. The results further examine the usefulness of separate flexible markets PJM could use for balancing oversupply and undersupply events, similar to the regulation up and down markets used in Europe. These three studies provide the following results and insights to large-scale wind integration using actual PJM wind farm data that describe the markets and generators within PJM. • Chapter 2 provides an in-depth analysis of the valuable, yet highly-constrained, energy services multi-purpose hydroelectric facilities can provide, though the opportunity cost for providing these services can result in large deviations from the reservoir policies with minimal revenue gain in comparison to dedicating the whole of dam capacity to providing day-ahead, baseload generation. • Chapter 3 quantifies the system-wide efficiency gains and the distributive effects of PJM's decision to act as a single balancing authority, which means that it procures ancillary services across its entire footprint simultaneously. This can be contrasted to Midwest Independent System Operator (MISO), which has several balancing authorities operating under its footprint. • Chapter 4 uses probabilistic methods to estimate the uncertainty in the forecast errors and the quantity of energy needed to balance these forecast errors at a certain percentile. Current practice is to use a point forecast that describes the conditional expectation of the dependent variable at each time step. The approach here uses quantile regression to describe the relationship between independent variable and the conditional quantiles (equivalently the percentiles) of the dependent variable. An estimate of the conditional density is performed, which contains information about the covariate relationship of the sign of the forecast errors (negative for too much wind generation and positive for too little wind generation) and the wind power forecast. This additional knowledge may be implemented in the decision process to more accurately schedule day-ahead wind generation bids and provide an example for using separate markets for balancing an oversupply and undersupply of generation. Such methods are currently used for coordinating large footprints of wind generation in Europe.

Advanced Launch System (ALS) actuation and power systems impact operability and cost

NASA Technical Reports Server (NTRS)

Sundberg, Gale R.

1990-01-01

To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrical power system and controls for all actuation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a specific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military and civilian aircraft, lunar/Martian vehicles, and a multitude of commercial applications.

Advanced Launch System (ALS): Electrical actuation and power systems improve operability and cost picture

NASA Technical Reports Server (NTRS)

Sundberg, Gale R.

1990-01-01

To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrical power system and controls for all actuation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a specific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military and civilian aircraft, lunar/Martian vehicles, and a multitude of commercial applications.

Advanced launch system (ALS) - Electrical actuation and power systems improve operability and cost picture

NASA Technical Reports Server (NTRS)

Sundberg, Gale R.

1990-01-01

To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrrical power system and controls for all aviation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a sdpecific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military ans civilian aircraft, lunar/Martian vehicles, and a multitude of comercial applications.

Financial analysis of revision knee surgery based on NHS tariffs and hospital costs: does it pay to provide a revision service?

PubMed

Kallala, R F; Vanhegan, I S; Ibrahim, M S; Sarmah, S; Haddad, F S

2015-02-01

Revision total knee arthroplasty (TKA) is a complex procedure which carries both a greater risk for patients and greater cost for the treating hospital than does a primary TKA. As well as the increased cost of peri-operative investigations, blood transfusions, surgical instrumentation, implants and operating time, there is a well-documented increased length of stay which accounts for most of the actual costs associated with surgery. We compared revision surgery for infection with revision for other causes (pain, instability, aseptic loosening and fracture). Complete clinical, demographic and economic data were obtained for 168 consecutive revision TKAs performed at a tertiary referral centre between 2005 and 2012. Revision surgery for infection was associated with a mean length of stay more than double that of aseptic cases (21.5 vs 9.5 days, p < 0.0001). The mean cost of a revision for infection was more than three times that of an aseptic revision (£30 011 (sd 4514) vs £9655 (sd 599.7), p < 0.0001). Current NHS tariffs do not fully reimburse the increased costs of providing a revision knee surgery service. Moreover, especially as greater costs are incurred for infected cases. These losses may adversely affect the provision of revision surgery in the NHS. ©2015 The British Editorial Society of Bone & Joint Surgery.

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Technical Challenges and Opportunities of Centralizing Space Science Mission Operations (SSMO) at NASA Goddard Space Flight Center

NASA Technical Reports Server (NTRS)

Ido, Haisam; Burns, Rich

2015-01-01

The NASA Goddard Space Science Mission Operations project (SSMO) is performing a technical cost-benefit analysis for centralizing and consolidating operations of a diverse set of missions into a unified and integrated technical infrastructure. The presentation will focus on the notion of normalizing spacecraft operations processes, workflows, and tools. It will also show the processes of creating a standardized open architecture, creating common security models and implementations, interfaces, services, automations, notifications, alerts, logging, publish, subscribe and middleware capabilities. The presentation will also discuss how to leverage traditional capabilities, along with virtualization, cloud computing services, control groups and containers, and possibly Big Data concepts.