scholarly journals Analysis of the Cost Effectiveness of a Suicide Barrier on the Golden Gate Bridge

Crisis ◽  
2013 ◽  
Vol 34 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Dayna Atkins Whitmer ◽  
David Lauren Woods
Keyword(s):  
Cost Effectiveness ◽  
San Francisco ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Alternative Methods ◽  
Suicide Mortality ◽  
Golden Gate ◽  
Golden Gate Bridge ◽  
The Cost

Background: The Golden Gate Bridge (GGB) is a well-known “suicide magnet” and the site of approximately 30 suicides per year. Recently, a suicide barrier was approved to prevent further suicides. Aims: To estimate the cost-effectiveness of the proposed suicide barrier, we compared the proposed costs of the barrier over a 20-year period ($51.6 million) to estimated reductions in mortality. Method: We reviewed San Francisco and Golden Gate Bridge suicides over a 70-year period (1936–2006). We assumed that all suicides prevented by the barrier would attempt suicide with alternative methods and estimated the mortality reduction based on the difference in lethality between GGB jumps and other suicide methods. Cost/benefit analyses utilized estimates of value of statistical life (VSL) used in highway projects. Results: GGB suicides occur at a rate of approximately 30 per year, with a lethality of 98%. Jumping from other structures has an average lethality of 47%. Assuming that unsuccessful suicides eventually committed suicide at previously reported (12–13%) rates, approximately 286 lives would be saved over a 20-year period at an average cost/life of approximately $180,419 i.e., roughly 6% of US Department of Transportation minimal VSL estimate ($3.2 million). Conclusions: Cost-benefit analysis suggests that a suicide barrier on the GGB would result in a highly cost-effective reduction in suicide mortality in the San Francisco Bay Area.

scholarly journals Cost–effectiveness and cost-benefit analysis of oliceridine in the treatment of acute pain

2021 ◽  
Author(s):  
Kit N Simpson ◽  
Michael J Fossler ◽  
Linda Wase ◽  
Mark A Demitrack
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Protein Signaling ◽  
Opioid Receptor Agonist ◽  
Cost Effective Alternative ◽  
Μ Opioid Receptor ◽  
The Cost

Aim: Oliceridine, a new class of μ-opioid receptor agonist, is selective for G-protein signaling (analgesia) with limited recruitment of β-arrestin (associated with adverse outcomes) and may provide a cost-effective alternative versus conventional opioid morphine for postoperative pain. Patients & methods: Using a decision tree with a 24-h time horizon, we calculated costs for medication and management of three most common adverse events (AEs; oxygen saturation <90%, vomiting and somnolence) following postoperative oliceridine or morphine use. Results: Using oliceridine, the cost for managing AEs was US$528,424 versus $852,429 for morphine, with a net cost savings of $324,005. Conclusion: Oliceridine has a favorable overall impact on the total cost of postoperative care compared with the use of the conventional opioid morphine.

Cost benefit analysis of measures to reduce industrial effluent discharges

2010 ◽  
Vol 62 (7) ◽  
pp. 1623-1628
Author(s):  
Åsa Sivard ◽  
Tomas Ericsson ◽  
Nippe Hylander ◽  
Magnus Karlsson ◽  
Mikael Malmaeus
Keyword(s):  
Organic Material ◽  
Cost Benefit Analysis ◽  
Industrial Effluent ◽  
Oxygen Demand ◽  
Cost Benefit ◽  
Cost Effective ◽  
Paper Mill ◽  
Pulp And Paper Mill ◽  
Cost Efficient ◽  
The Cost

In an environmentally harmonized society the most cost effective measures to reduce the total effluent discharges should be taken into account. Generalised discharge values are presented for organic material and nutrients in this paper. Depending on conditions in the receiving water any of these parameters can be the determining factor for the eutrophication and oxygen demand. These parameters can be generalized into equivalent loads of TOC, nitrogen or phosphorus by recalculation according to the Redfield ratio. The cost for reduction of organic material and nutrients from a pulp and paper mill is calculated as a cost per unit pollutant (cost equivalent). This cost equivalent is compared with alternative costs, expressed in the same way, for reduction of organic material and nutrients in adjacent industries, municipal treatment plants, impact from transportation, farming, air deposits etc. In order to find where the most cost efficient measures for the society should be taken the cost equivalent for the mill is compared with the alternative measures and their equivalent costs.

scholarly journals Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress

2020 ◽  
Vol 17 (14) ◽  
pp. 5234
Author(s):  
Marijke Keus Van De Poll ◽  
Gunnar Bergström ◽  
Irene Jensen ◽  
Lotta Nybergh ◽  
Lydia Kwak ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Problem Solving ◽  
Mental Disorders ◽  
Sickness Absence ◽  
Common Mental Disorders ◽  
Cost Benefit ◽  
Cost Effective ◽  
Production Loss ◽  
The Cost

The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer’s perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer’s perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

Field Evaluation and Cost Effectiveness of Crack Sealing in Flexible and Composite Pavements

2018 ◽  
Vol 2672 (12) ◽  
pp. 51-61 ◽  
Author(s):  
Momen Mousa ◽  
Mostafa A. Elseifi ◽  
Mohammad Bashar ◽  
Zhongjie Zhang ◽  
Kevin Gaspard
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Field Performance ◽  
Cost Benefit ◽  
Cost Effective ◽  
Field Evaluation ◽  
Asphalt Emulsion ◽  
Transverse Cracks ◽  
Crack Sealing ◽  
Composite Pavements

One of the most common methods used to treat longitudinal and transverse cracks is crack sealing (CS), which is categorized as a preventive maintenance method. Field performance and cost-effectiveness of this treatment widely vary depending on pavement conditions and installation of the material. The objective of this study was to evaluate the field performance and cost-effectiveness of CS in flexible and composite pavements in hot and wet climates such as Louisiana, and to develop a model that would quantify the expected benefits of CS given project conditions. To achieve this objective, 28 control sections that were crack-sealed between 2003 and 2010 were monitored for at least four years. These sections included flexible and composite pavements, sealed and unsealed segments, and varying traffic levels. The performance of these sections was evaluated for the random cracking index (RCI) and roughness index (RI). Based on the results of this analysis, it was concluded that CS only has a significant impact on random cracking. When compared with untreated segments, CS extended pavement service life (PSL) by two years. When compared with the original pavement, CS extended PSL by 5.6 and 3.2 years for flexible and composite pavements, respectively, if applied at the correct time. The cost-benefit analysis indicated that CS is cost-effective whether asphalt emulsion or rubberized asphalt sealant is used. A non-linear regression model was developed to predict the extension in PSL because of CS without the need for performance data based on the average daily traffic (ADT), pavement type, and prior pavement conditions.

A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA

2016 ◽  
Vol 47 (2) ◽  
pp. 164-184 ◽  
Author(s):  
Amos Irwin ◽  
Ehsan Jozaghi ◽  
Ricky N. Bluthenthal ◽  
Alex H. Kral
Keyword(s):  
Public Health ◽  
United States ◽  
San Francisco ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
The United States ◽  
Local Public Health ◽  
Supervised Injection ◽  
Overdose Deaths

Supervised injection facilities (SIFs) have been shown to reduce infection, prevent overdose deaths, and increase treatment uptake. The United States is in the midst of an opioid epidemic, yet no sanctioned SIF currently operates in the United States. We estimate the economic costs and benefits of establishing a potential SIF in San Francisco using mathematical models that combine local public health data with previous research on the effects of existing SIFs. We consider potential savings from five outcomes: averted HIV and hepatitis C virus (HCV) infections, reduced skin and soft tissue infection (SSTI), averted overdose deaths, and increased medication-assisted treatment (MAT) uptake. We find that each dollar spent on a SIF would generate US$2.33 in savings, for total annual net savings of US$3.5 million for a single 13-booth SIF. Our analysis suggests that a SIF in San Francisco would not only be a cost-effective intervention but also a significant boost to the public health system.

A cost-benefit analysis for sonographic screening for renal tumors.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 665-665
Author(s):  
Shmuel Roizman ◽  
Moshe Leshno ◽  
Miki Haifler ◽  
Yishai Hode Rappaport ◽  
Amnon Zisman
Keyword(s):  
Targeted Therapy ◽  
Cost Effectiveness ◽  
Cost Benefit ◽  
Cost Effective ◽  
Screening Strategy ◽  
Renal Tumors ◽  
Stage Migration ◽  
Mathematical Framework ◽  
Abdominal Ultrasonography ◽  
The Cost

665 Background: In the last 2 decades, the rates of metastatic Renal Cell Carcinoma (RCC) at diagnosis declined from 33% to 17%This fact is attributed to massive penetration of cross sectional imaging leading to a marked stage migration. The cost of targeted therapy for metastatic RCC patients is very high. These trends led us to hypothesize that screening for RCC with ultrasound may be cost effective. Objective: To assess the cost effectiveness of screening with ultrasound for renal tumors in the general population over 60 years of age. Methods: Using the Markov model, a mathematical framework was set up describing the course of disease with and without screening for RCC using abdominal ultrasonography. Quality Adjusted Life Year (QALY) and financial costs were the outputs of the model. Results: Average costs for the screening strategy was 137.4 U$ and for non-screening was 31.4 U$. Screening and non-screening strategy would add an average of 21.7396 and 21.7385 QALY, respectively. An increase of 0.001 QALY equates to Incremental Cost Effectiveness Ratio (ICER) of 86,4 U$ per QALY, Currently, the cost which is considered cost effective for 1 QALY point is approximately 27,548.21 U$. The two variables most influential on the model output were prevalence of RCC and US cost. Conclusions: To our knowledge, this is the sole cost benefit screening study performed for RCC in the targeted therapy era. Screening for renal tumors using abdominal ultrasonography at a cost of 35.81 U$ per exam is cost effective. Our findings are highly suggestive that early screening for RCC may be cost effective for preventing RCC metastatic disease and nevertheless will save lives.

Study of Nanjing Demand Side Management Based on Cost-Benefit Analysis - Take Green Lighting as an Example

2015 ◽  
Vol 737 ◽  
pp. 260-268
Author(s):  
Qiu Hua Liu ◽  
Kun Xu ◽  
Hao Min Wang
Keyword(s):  
Cost Effectiveness ◽  
Electric Power ◽  
Development Strategy ◽  
Power Supply ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Demand Side Management ◽  
Demand Side ◽  
Electric Power Supply ◽  
The Cost

Electric power supply is one of the most important aspects of China’s national energy development strategy (NEDS). As major economic unit as well as major energy consumer, Jiangsu province is facing serious energy supply challenges. Under such circumstances, positive actions are taken by local government in respond to NEDS which put energy saving in the first place, and demand side management (DSM) is implemented. DSM is an important measure which can release rush hour electric supply pressure, enhance energy efficiency, optimize electric power utilization, and it is beneficial for sustainable development. This paper is based on the analysis of the current DSM situation of Nanjing, and green lighting is taken as an example. An empirical analysis is given to cost-effectiveness of the implementation of green lighting. Finally, the conclusion that the cost-effectiveness of the implementation of green lighting is economically viable to power supply companies, electric customers and the whole society is drawn.

Cost Benefit Analysis of Inert Gas Systems for Chemical and Product Tankers

2009 ◽  
Author(s):  
Martyn Thomas ◽  
Rolf Skjong
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Inert Gas ◽  
Real Risk ◽  
Formal Safety Assessment ◽  
Potential Loss ◽  
The Cost ◽  
Oil Tankers ◽  
Potential Pollution

This paper details the work carried out to complete a Formal Safety Assessment (FSA) to assess the effectiveness of inert gas systems (IGS) in reducing the risk associated with cargo tank fire and explosions on chemical and oil tankers &lt;20,000dwt. Two different IGSs are considered; N2 for chemical tankers and conventional oil burning type for oil tankers. N2 IGS is required on chemical tankers to preserve the quality of the chemicals transported on these ships. These IGS systems are evaluated with Cost Benefit Assessments (CBA) to ascertain their cost effectiveness with regards to reducing potential loss of life, potential loss of cargo, potential pollution and potential loss of property. In this respect, the Gross Cost of Averting a Fatality (GCAF) and Net Cost of Averting a Fatality (NCAF) are calculated using the standard FSA method recognized by the International Maritime Organization (IMO). Further, the Cost of Averting one Tonne of oil Spilled (CATS) (Skjong et al., 2005 & Vanem et al., 2008) is applied to understand the cost effectiveness of IGSs in preventing environmental pollution. The risk reduction is estimated from detailed considerations of the accident statistics for tankers &gt;20,000dwt, where mandatory requirements for IGS was introduced in 1990. Comparison was made on risks resulting from accidents involving fire and/or explosion in the cargo tank of tankers of &gt;20,000dwt for the period of 1978–1983, in which most such tankers were not provided with IGS; and for the period 1990–2005, in which all such tankers were provided with IGSs under the requirement of SOLAS Chapter II-2. The paper further assumes that tankers &lt;20,000dwt that carry cargo with flashpoint &lt;60°C should have IGS installed, whilst ships without IGS may continue carrying cargo with flashpoint &gt;60°C. This way the question of requiring IGS is answered based on real risk of fire and explosion, and avoid introducing a rather arbitrary limit based on size of the ships.

scholarly journals Cost-effectiveness of a physician-nurse supplementary triage assessment team at an academic tertiary care emergency department

CJEM ◽  
2015 ◽  
Vol 18 (3) ◽  
pp. 191-204 ◽  
Author(s):  
Ivy Cheng ◽  
Maaret Castren ◽  
Alex Kiss ◽  
Merrick Zwarenstein ◽  
Mats Brommels ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cost Effectiveness ◽  
Tertiary Care ◽  
Cost Benefit ◽  
Cost Effective ◽  
Additional Patient ◽  
Patient Volume ◽  
Benefit Ratio ◽  
Cost Benefit Ratio ◽  
The Cost

ABSTRACTObjectiveThe purpose of this study was to evaluate the cost-effectiveness of physician-nurse supplementary triage assistance team (MDRNSTAT) from a hospital and patient perspective.MethodsThis was a cost-effectiveness evaluation of a cluster randomized control trial comparing the MDRNSTAT with nurse-only triage in the emergency department (ED) between the hours of 0800 and 1500. Cost was MDRNSTAT salary. Revenue was from Ontario’s Pay-for-Results and patient volume-case mix payment programs. The incremental cost-effectiveness ratio was based on MDRNSTAT cost and three consequence assessments: 1) per additional patient-seen; 2) per physician initial assessment (PIA) hour saved; and 3) per ED length of stay (EDLOS) hour saved. Patient opportunity cost was determined. Patient satisfaction was quantified by a cost-benefit ratio. A sensitivity analysis extrapolating MDRNSTAT to different working hours, salary, and willingness-to-pay data was performed.ResultsThe added cost of the MDRNSTAT was $3,597.27 [$1,729.47 to ∞] per additional patient-seen, $75.37 [$67.99 to $105.30] per PIA hour saved, and $112.99 [$74.68 to $251.43] per EDLOS hour saved. From the hospital perspective, the cost-benefit ratio was 38.6 [19.0 to ∞] and net present value of –$447,996 [–$435,646 to –$459,900]. For patients, the cost-benefit ratio for satisfaction was 2.8 [2.3 to 4.6]. If MDRNSTAT performance were consistently implemented from noon to midnight, it would be more cost-effective.ConclusionsThe MDRNSTAT is not a cost-effective daytime strategy but appears to be more feasible during time periods with higher patient volume, such as late morning to evening.

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