Design for Variety: A Methodology for Understanding the Costs of Product Proliferation

Author(s):  
Mark V. Martin ◽  
Kosuke Ishii

Abstract This paper further develops the previously introduced concept of Design for Variety (DFV). Our study seeks a tool that enables product managers to estimate the cost of introducing variety into their product line. This will help them to maximize market coverage while maintaining required profit margins. Variety incurs many indirect costs that are not always well understood or are difficult to capture. These costs are often not considered by people making the decision about introducing variety. Our DFV model attempts to capture these indirect costs through the measurement of three indices: commonality, differentiation point, and set-up cost. These indices will allow the decision makers to estimate some of the generally unmeasurable costs of providing variety. We conclude this paper by discussing our validation plans for testing the model in industry.

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 988
Author(s):  
Ahmed Alghamdi ◽  
Eman Algarni ◽  
Bander Balkhi ◽  
Abdulaziz Altowaijri ◽  
Abdulaziz Alhossan

Heart failure (HF) is considered to be a global health problem that generates a significant economic burden. Despite the growing prevalence in Saudi Arabia, the economic burden of HF is not well studied. The aim of this study was to estimate the health care expenditures associated with HF in Saudi Arabia from a social perspective. We conducted a multicenter cost of illness (COI) study in two large governmental centers in Riyadh, Saudi Arabia using 369 HF patients. A COI model was developed in order to estimate the direct medical costs associated with HF. The indirect costs of HF were estimated based on a human capital approach. Descriptive and inferential statistics were analyzed. The direct medical cost per HF patient was $9563. Hospitalization costs were the major driver in total spending, followed by medication and diagnostics costs. The cost significantly increased in line with the disease progression, ranging from $3671 in class I to $16,447 in class IV. The indirect costs per working HF patient were $4628 due to absenteeism, and $6388 due to presenteeism. The economic burden of HF is significantly high in Saudi Arabia. Decision makers need to focus on allocating resources towards strategies that prevent frequent hospitalizations and improve HF management and patient outcomes in order to lower the growing economic burden.


Author(s):  
Larry Wesemann ◽  
Tijana Hamilton ◽  
Steve Tabaie ◽  
Gerald Bare

On January 17, 1994, the Northridge earthquake in California destroyed structures on four important freeways in the Los Angeles basin. Closure to travel on these damaged freeways had significant local, regional, and statewide impacts for general travel, as well as for commuter and commodities movement. Initial research indicated that the four route closures on the I-5, I-10, CA-14, and CA-118 freeways had significant ramifications on the local and state economies on the order of millions of dollars per day. With this in mind, the state of California set up high-incentive reconstruction contracts that paid private contractors significant bonuses for early reopenings of damaged routes. Further research conducted as part of the comprehensive transportation recovery evaluation justified those bonus clauses and indicated that the quantifiable (direct) transportation-related costs associated with the travel disruption and delay on the four damaged routes combined in the Los Angeles basin exceeded $1.6 million per day. The methodology used to calculate the cost-of-delay estimates for each route was based on detailed counts, surveys, and travel time (delay) data collected during the reconstruction periods, as well as computer simulation and adopted costing techniques. The geographic and systemwide extent of the impacts of closures was simulated through travel demand assignments on EMME/2 modeled highway networks that were modified to represent the earthquake-damaged system. When the economic analysis is broadened to include indirect costs associated with trip elimination, areawide disruption to shipping, or loss of jobs caused by the earthquake emergency, a much higher transportation-related cost to the California economy can be calculated.


2001 ◽  
Vol 2 (1) ◽  
pp. 37-61
Author(s):  
Mario Eandi

Aim of this paper was to analyse the cost effectiveness of the main alternative (and complementary) strategies in the disease menagement of the Community-Acquired Pneumonia (CAP): hospital admission vs home-care, antibiotic parental vs oral therapy, switch vs no-switch therapy, and early discarge vs conventional hospitalization. The cost effectivenessanalysis (CEA) has been performed by implementing a general decision tree model wich describes all the main decisional and change nodes encountered in the clinical course from the firm sign and symptoms of CAP (root) to the final aoutcomes: full recovery or death (terminal nodes). We assumed the perspectives of three main institutional decision-makers: the society, the italian national healthcare system (NACS), and the hospital. In the perspective of society both the direct (health and non-health) costs and the indirect costs have been included, while in the perspective of the NACS only the health-direct costs were considered. In the perspective of the hospital we considered the overall mean expences sustained for each day of staying in the general and in the intensive care unit. Separately, the antibiotic treatement costs to hospital have been accounted. As effectiveness we considered the percentage of recovery for each class of mortality aqccording to fine. Most of the probability data used in the model were obtained or derived from the published literature. The cost were valued according to the Italian NACS charges and prices in use during the year 2000. According to the model structure, the main expenditure factor for the SSN is the hospitalization cost, while the home care is less expensive. The antibiotic parentenal therapy, during hospedalization or home care, is more expensive than the antibiotic oral therapy; but the cost difference between one therapy and the other is clearly lower than the cost difference between the hospitalization and the home care. The optimum expenditure situation for the SSN, the Society and also for the Hospital coul be obtained by decreasing the days of hospital stay in and by choosing to hospitalize the patients according to the death risk. The sensitivity analysies performed confirmed the robusteness of the results obtained with the model. However the model and its usefulness in decision-making will be definitely confirmed when clinical and epidemiological robust data on CAP in Italy will be available.


Author(s):  
Federico Solla ◽  
Eytan Ellenberg ◽  
Virginie Rampal ◽  
Julien Margaine ◽  
Charles Musoff ◽  
...  

Abstract Objective: To analyze the cost of the terror attack in Nice in a single pediatric institution. Methods: We carried out descriptive analyses of the data coming from the Lenval University Children’s Hospital of Nice database after the July 14, 2016 terror attack. The medical cost for each patient was estimated from the invoice that the hospital sent to public insurance. The indirect costs were calculated from the hospital’s accounting, as the items that were previously absent or the difference between costs in 2016 versus the previous year. Results: The costs total 1.56 million USD, corresponding to 2% of Lenval Hospital’s 2016 annual budget. Direct medical costs represented 9% of the total cost. The indirect costs were related to human resources (overtime, sick leave), revenue shortfall, and security and psychiatric reinforcement. Conclusion: Indirect costs had a greater impact than did direct medical costs. Examining the level and variety of direct and indirect costs will lead to a better understanding of the consequences of terror acts and to improved preparation for future attacks.


Author(s):  
Sami Demiroluk ◽  
Hani Nassif ◽  
Kaan Ozbay ◽  
Chaekuk Na

The roadway infrastructure constantly deteriorates because of environmental conditions, but other factors such as exposure to heavy trucks exacerbates the rate of deterioration. Therefore, decision-makers are constantly searching for ways to optimize allocation of the limited funds for repair, maintenance, and rehabilitation of New Jersey’s infrastructure. New Jersey legislation requires operators of overweight (OW) trucks to obtain a permit to use the infrastructure. The New Jersey Department of Transportation (NJDOT) issues a variety of permits based on the types of goods carried. These permits allow OW trucks to use the infrastructure either for a single trip or for multiple trips. Therefore, one major concern is whether the permit revenue of the agency can recoup the actual cost of damage to the infrastructure caused by these OW trucks. This study investigates whether NJDOT’s current permit fee program can collect enough revenue to meet the actual cost of damage to the infrastructure caused by these heavy-weight permit trucks. The infrastructure damage is estimated by using pavement and bridge deterioration models and New Jersey permit data from 2013 to 2018 containing vehicle configuration and vehicle route. The analysis indicates that although the cost of infrastructure damage can be recovered for certain permit types, there is room for improvement in the permit program. Moreover, based on permit rules in other states, the overall rank of the New Jersey permit program is evaluated and possible revisions are recommended for future permit policies.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Karina Black ◽  
Jackie Middleton ◽  
Sunita Ghosh ◽  
David Eisenstat ◽  
Samor Patel

Abstract BACKGROUND Proton therapy for benign and malignant tumors has dosimetric and clinical advantages over photon therapy. Patients in Alberta, Canada are referred to the United States for proton treatment. The Alberta Heath Care Insurance Plan (AHCIP) pays for the proton treatment and the cost of flights to and from the United States (direct costs). This study aimed to determine the out-of-pocket expenses incurred by patients or their families (indirect costs). METHODS Invitation letters linked to an electronic survey were mailed to patients treated with protons between 2008 and 2018. Expenses for flights for other family members, accommodations, transportation, food, passports, insurance, and opportunity costs including lost wages and productivity were measured. RESULTS Fifty-nine invitation letters were mailed. Seventeen surveys were completed (28.8% response rate). One paper survey was mailed at participant request. Nine respondents were from parent/guardian, 8 from patients. All patients were accompanied to the US by a family member/friend. Considerable variability in costs and reimbursements were reported. Many of the accompanying family/friends had to miss work; only 3 patients themselves reported missed work. Time away from work varied, and varied as to whether it was paid or unpaid time off. CONCLUSIONS Respondents incurred indirect monetary and opportunity costs which were not covered by AHCIP when traveling out of country for proton therapy. Prospective studies could help provide current data minimizing recall bias. These data may be helpful for administrators in assessing the societal cost of out-of-country referral of patients for proton therapy.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 514.2-514
Author(s):  
M. Merino ◽  
O. Braçe ◽  
A. González ◽  
Á. Hidalgo-Vega ◽  
M. Garrido-Cumbrera ◽  
...  

Background:Ankylosing Spondylitis (AS) is a disease associated with a high number of comorbidities, chronic pain, functional disability, and resource consumption.Objectives:This study aimed to estimate the burden of disease for patients diagnosed with AS in Spain.Methods:Data from 578 unselected patients with AS were collected in 2016 for the Spanish Atlas of Axial Spondyloarthritis via an online survey. The estimated costs were: Direct Health Care Costs (borne by the National Health System, NHS) and Direct Non-Health Care Costs (borne by patients) were estimated with the bottom-up method, multiplying the resource consumption by the unit price of each resource. Indirect Costs (labour productivity losses) were estimated using the human capital method. Costs were compared between levels of disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (<4 or low inflammation versus ≥4 or high inflammation) and risk of mental distress using the 12-item General Health Questionnaire (GHQ-12) score (<3 or low risk versus ≥3 or high risk).Results:The average annual cost per patient with AS in 2015 amounted to €11,462.3 (± 13,745.5) per patient. Direct Health Care Cost meant an annual average of €6,999.8 (± 9,216.8) per patient, to which an annual average of €611.3 (± 1,276.5) per patient associated with Direct Non-Health Care Cost borne by patients must be added. Pharmacological treatment accounted for the largest percentage of the costs borne by the NHS (64.6%), while for patients most of the cost was attributed to rehabilitative therapies and/or physical activity (91%). The average annual Indirect Costs derived from labour productivity losses were €3,851.2 (± 8,484.0) per patient, mainly associated to absenteeism. All categories showed statistically significant differences (p<0.05) between BASDAI groups (<4 vs ≥4) except for the Direct Non-Healthcare Cost, showing a progressive rise in cost from low to high inflammation. Regarding the 12-item General Health Questionnaire (GHQ-12), all categories showed statistically significant differences between GHQ-12 (<3 vs ≥3), with higher costs associated with higher risk of poor mental health (Table 1).Table 1.Average annual costs per patient according to BASDAI and GHQ-12 groups (in Euros, 2015)NDirect Health CostsDirect Non-Health CostsIndirect CostsTotal CostBASDAI<4917,592.0*557.32,426.5*10,575.8*≥43769,706.9*768.05,104.8*15,579.7*Psychological distress (GHQ-12)<31468,146.8*493.6*3,927.2*12,567.6*≥32609,772.9*807.2*4,512.3*15,092.5*Total5786,999.8611.33,851.211,462.3* p <0.05Conclusion:Direct Health Care Costs, and those attributed to pharmacological treatment in particular, accounted for the largest component of the cost associated with AS. However, a significant proportion of the overall costs can be further attributed to labour productivity losses.Acknowledgments:Funded by Novartis Farmacéutica S.A.Disclosure of Interests:María Merino: None declared, Olta Braçe: None declared, Almudena González: None declared, Álvaro Hidalgo-Vega: None declared, Marco Garrido-Cumbrera: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tuti Ningseh Mohd Dom ◽  
Rasidah Ayob ◽  
Khairiyah Abd Muttalib ◽  
Syed Mohamed Aljunid

Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective.Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis.Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis.Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.


2021 ◽  
Vol 11 (6) ◽  
pp. 689
Author(s):  
Stefan Strilciuc ◽  
Diana Alecsandra Grad ◽  
Vlad Mixich ◽  
Adina Stan ◽  
Anca Dana Buzoianu ◽  
...  

Background: Health policies in transitioning health systems are rarely informed by the economic burden of disease due to scanty access to data. This study aimed to estimate direct and indirect costs for first-ever acute ischemic stroke (AIS) during the first year for patients residing in Cluj, Romania, and hospitalized in 2019 at the County Emergency Hospital (CEH). Methods: The study was conducted using a mixed, retrospective costing methodology from a societal perspective to measure the cost of first-ever AIS in the first year after onset. Patient pathways for AIS were reconstructed to aid in mapping inpatient and outpatient cost items. We used anonymized administrative and clinical data at the hospital level and publicly available databases. Results: The average cost per patient in the first year after stroke onset was RON 25,297.83 (EUR 5226.82), out of which 80.87% were direct costs. The total cost in Cluj, Romania in 2019 was RON 17,455,502.7 (EUR 3,606,505.8). Conclusions: Our costing exercise uncovered shortcomings of stroke management in Romania, particularly related to acute care and neurorehabilitation service provision. Romania spends significantly less on healthcare than other countries (5.5% of GDP vs. 9.8% European Union average), exposing stroke survivors to a disproportionately high risk for preventable and treatable post-stroke disability.


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