Understanding the Costs of Surgery: A Bottom-Up Cost Analysis of Both a Hybrid Operating Room and Conventional Operating Room

Background: Over the past decade, many hospitals have adopted hybrid operating rooms (ORs). As resources are limited, these ORs have to prove themselves in adding value. Current estimations on standard OR costs show great variety, while cost analyses of hybrid ORs are lacking. Therefore, this study aims to identify the cost drivers of a conventional and hybrid OR and take a first step in evaluating the added value of the hybrid OR. Methods: A comprehensive bottom-up cost analysis was conducted in five Dutch hospitals taking into account: construction, inventory, personnel and overhead costs by means of interviews and hospital specific data. The costs per minute for both ORs were calculated using the utilization rates of the ORs. Cost drivers were identified by sensitivity analyses. Results: The costs per minute for the conventional OR and the hybrid OR were €9.45 (€8.60-€10.23) and €19.88 (€16.10- €23.07), respectively. Total personnel and total inventory costs had most impact on the conventional OR costs. For the hybrid OR the costs were mostly driven by utilization rate, total inventory and construction costs. The results were incorporated in an open access calculation model to enable adjustment of the input parameters to a specific hospital or country setting. Conclusion: This study estimated a cost of €9.45 (€8.60-€10.23) and €19.88 (€16.10-€23.07) for the conventional and hybrid OR, respectively. The main factors influencing the OR costs are: total inventory costs, total construction costs, utilization rate, and total personnel costs. Our analysis can be used as a basis for future research focusing on evaluating value for money of this promising innovative OR. Furthermore, our results can inform surgeons, and decision and policy-makers in hospitals on the adoption and optimal utilization of new (hybrid) ORs.

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PENDAPATAN USAHA DAN PERSEDIAAN BAHAN BAKU INDUSTRI BAWANG GORENG (Studi Kasus Industri Bawang Goreng “Uda Saprudin”)

AGRIBUSINESS JOURNAL ◽

10.15408/aj.v13i2.13946 ◽

2020 ◽

Vol 13 (2) ◽

pp. 8-17

Author(s):

Herlena Bidi Astuti ◽

Yesmawati Y ◽

Linda Harta ◽

Reswita R

Keyword(s):

Lead Time ◽

Raw Materials ◽

Raw Material ◽

Added Value ◽

Operating Income ◽

Inventory Costs ◽

The Past ◽

Total Inventory ◽

C Value

Processing shallots into fried onions is one of the agro-industry businesses with the main raw material of shallots. The fried onion home industry is a downstreaming of agricultural commodities by providing added value from the raw materials of shallots, in the process of production competition the industry must conduct management that will produce raw materials to ensure obtaining products. The purpose of this study was to determine the operating income of fried onions and determine the management of raw materials in the "Uda Saprudin" fried onion industry in Bengkulu City. The method used in this study is the calculation of income, R / C ratio, and management of raw materials using EOQ, Safety Stock, Reorder Points, lead time and total inventory costs. This research is a case study conducted in February 2019 with the data used is the data of the past year (2018). From the research results obtained R / C value of 1.36 and the management of raw material requirements recognized EOQ value: 6.546 Kg, Reorder Point value: 6.329 Kg / Month, lead time: 0.5 months and Total inventory costs: Rp. 163,676,047 per year.

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Cost Analysis of Methylprednisolone Treatment of Multiple Sclerosis Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100034053 ◽

1998 ◽

Vol 25 (3) ◽

pp. 222-229 ◽

Cited By ~ 9

Author(s):

Lynda S. Robson ◽

Charlene Bain ◽

Shann Beck ◽

Suzanne Guthrie ◽

Peter C. Coyte ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cost Saving ◽

Cost Analysis ◽

Home Care ◽

Care Program ◽

Sensitivity Analyses ◽

Patient Treatment ◽

Fiscal Year ◽

Multiple Sclerosis Patients ◽

The Cost

ABSTRACT:Background:Intravenous methylprednisolone (IVMP) is the treatment of choice for multiple sclerosis (MS) patients undergoing acute exacerbation of disease symptoms and yet its cost has not been accurately determined. Determination of this cost in different settings is also pertinent to consideration of cost-saving alternatives to in-patient treatment.Methods:Cost analysis from the point of view of the health care system of IVMP treatment of MS patients receiving treatment in association with a selected Toronto teaching hospital in fiscal year 1994/95 was carried out. Costs of any concurrent treatments were excluded.Results:Total cost for 92 patients, based on a 4 dose regime, was estimated to be $78,527. The the cost per patient was $1,1181.84 for in-patients (IP), $714.64 for out-patients of the MS Clinic (OP) and $774.21 for patients whose treatment was initiated in the Clinic, but completed in the home (HC). Sensitivity analyses indicated: 1) IP treatment was in all cases more expensive than that of OP or HC; 2) the cost savings of OP vs. HC was sensitive to assumptions made regarding Clinic overhead, Clinic nursing costs and Home Care Program overhead.Conclusion:Alternatives to in-patient care must be considered carefully. In this study, both out-patient and in-home treatment were cost-saving alternatives to in-patient treatment, but large differences in the cost of hospital out-patient vs. in-home care could not be demonstrated.

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An empirical investigation into intelligent cost analysis in purchasing

Supply Chain Management An International Journal ◽

10.1108/scm-11-2020-0563 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Frank Bodendorf ◽

Manuel Lutz ◽

Stefan Michelberger ◽

Joerg Franke

Keyword(s):

Cost Analysis ◽

Cost Estimation ◽

Expert Knowledge ◽

Added Value ◽

Cost Calculation ◽

Content Type ◽

Intelligent Decision Support Systems ◽

The One ◽

Management Recommendations ◽

Intelligent Decision Support

Purpose Cost transparency is of central importance to reach a consensus between supply chain partners. The purpose of this paper is to contribute to the instrument of cost analysis which supports the link between buyers and suppliers. Design/methodology/approach Based on a detailed literature review in the area of cost analysis and purchasing, intelligent decision support systems for cost estimation are identified. Subsequently, expert interviews are conducted to determine the application possibilities for managers. The application potential is derived from the synthesis of motivation, identified applications and challenges in the industry. Management recommendations are to be derived by bringing together scientific and practical approaches in the industry. Findings On the one hand, the results of this study show that machine learning (ML) is a complex technology that poses many challenges for cost and purchasing managers. On the other hand, ML methods, especially in combination with expert knowledge and other analytical methods, offer immense added value for cost analysis in purchasing. Originality/value Digital transformation allows to facilitate the cost calculation process in purchasing decisions. In this context, the application of ML approaches has gained increased attention. While such approaches can lead to high cost reductions on the side of both suppliers and buyers, an intelligent cost analysis is very demanding.

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Analisis Pengendalian Persediaan Bahan Baku dengan Menerapkan Metode EOQ (Economic Order Quantity) pada PT. Jatisari Furniture Work

EKONOMIS Journal of Economics and Business ◽

10.33087/ekonomis.v5i1.304 ◽

2021 ◽

Vol 5 (1) ◽

pp. 215

Author(s):

Arga Sutrisna ◽

Rizki Ginanjar ◽

Suci Putri Lestari

Keyword(s):

Production Costs ◽

Raw Material ◽

Economic Order Quantity ◽

Economic Order ◽

Analysis Tool ◽

Order Quantity ◽

Inventory Cost ◽

Total Cost ◽

Inventory Costs ◽

Total Inventory

This research objectives aims to determine and analyze raw material inventory control, the ideal raw material inventory that the company must provide and the efficiency of production costs carried out by Jatisri Furniture Work in Tasikmalaya for the period 2018.11 – 2020.02. The data collection method in this study is by direct observation at Jatisari Furniture Work in Tasikmalaya. Using techniques such us interviews, observation, and documentation. These observations were made in production reports for the years 2018 – 2020. The analysis tool was carried out using the Economic Order Quantity (EOQ) method such us safety stock, reorder point, and total inventory cost. The result of the Economic Order Quantity (EOQ) analysis show that the total cost of raw the material inventory that must be incurred by the company is greater than the total cost of inventories calculated according to the EOQ method. Companies should follow the calculations from the EOQ method so that they can save on raw material inventory costs, so that production costs are more efficient.

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System Dynamics Simulation and Adjustment on Coal Resource Utilization Based on Circular Economy

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.524-527.3190 ◽

2012 ◽

Vol 524-527 ◽

pp. 3190-3201

Author(s):

Yan Hong Hao ◽

Ling Mei Wang ◽

Li Xia Qiu

Keyword(s):

Sustainable Development ◽

System Dynamics ◽

Resource Utilization ◽

Circular Economy ◽

Waste Recycling ◽

Added Value ◽

Dynamics Simulation ◽

Utilization Rate ◽

Recycling Rate ◽

Coal Resource

Coal resource utilization system, based on circular economy, is an opening, complex and time-varying system. It composes of subsystems such as industry, population, economy and environment etc. Taking the industry subsystem as prime object, this paper builds its system dynamics model adopting the system dynamics method based on full life cycle. The adjustment parameters such as utilization rate of by-product of mining, the proportion of coal use in each industry and waste recycling rate etc. were confirmed. As a case of coal utilization system being designed, thirteen development projects belong to two types of scenarios were run on the model. The efficacy coefficient method was applied to analyze the simulation results and determine the comparatively best project of coal resource utilization system for the first time. The results indicate that the C4 among them are the best project comparatively, its waste emission is the least, and the benefits of economy, environment and society are the maximum. Research shows that extending industrial chain, increasing production proportion of high added-value product and raising waste recycling rate are beneficial to decrease coal-mining quantity for unit output value, protect coal resource and achieve sustainable development, namely that adopting circular economy development pattern is undoubtedly worthy of advocating for sustainable development of economy, environment and society.

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Social Co-operatives in Italy

10.1093/oxfordhb/9780199684977.013.21 ◽

2017 ◽

Author(s):

Sara Depedri

Keyword(s):

Social Services ◽

Organizational Form ◽

Added Value ◽

General Interest ◽

Bottom Up ◽

Economic Context ◽

Welfare Systems ◽

Recent Trends ◽

Work Integration ◽

Disadvantaged People

Starting from the 1970s, some co-operatives distinguished themselves for their interest in producing social services and for their social aims. They emerged in order to answer new needs arising in society, and specifically the difficulties faced by welfare systems. Co-operatives started to assume a new role as welfare providers and suppliers of general-interest services and work integration of disadvantaged people. This new co-operative form first emerged in Italy during the 1980s as a bottom-up phenomenon. The first regulation on social co-operatives was enacted in Italy by Law 381/1991. This chapter illustrates the emergence, the evolution, and the most recent trends of Italian social co-operation in order to define the main traits that helped social co-operatives become a successful organizational form in the provision of welfare services. This chapter also contributes to evaluating the added value of this co-operative form in the socio-economic context.

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Simulation-Based Optimization of a Two-Echelon Continuous Review Inventory Model with Lot Size-Dependent Lead Time

Processes ◽

10.3390/pr8091014 ◽

2020 ◽

Vol 8 (9) ◽

pp. 1014

Author(s):

Ibrahim Alharkan ◽

Mustafa Saleh ◽

Mageed Ghaleb ◽

Abdulsalam Farhan ◽

Ahmed Badwelan

Keyword(s):

Supply Chain ◽

Lead Time ◽

Shop Floor ◽

Lot Size ◽

Continuous Review ◽

Inventory Costs ◽

Size Dependent ◽

Simulation Based ◽

Simulation Based Optimization ◽

Total Inventory

This study analyzes a stochastic continuous review inventory system (Q,r) using a simulation-based optimization model. The lead time depends on lot size, unit production time, setup time, and a shop floor factor that represents moving, waiting, and lot size inspection times. A simulation-based model is proposed for optimizing order quantity (Q) and reorder point (r) that minimize the total inventory costs (holding, backlogging, and ordering costs) in a two-echelon supply chain, which consists of two identical retailers, a distributor, and a supplier. The simulation model is created with Arena software and validated using an analytical model. The model is interfaced with the OptQuest optimization tool, which is embedded in the Arena software, to search for the least cost lot sizes and reorder points. The proposed model is designed for general demand distributions that are too complex to be solved analytically. Hence, for the first time, the present study considers the stochastic inventory continuous review policy (Q,r) in a two-echelon supply chain system with lot size-dependent lead time L(Q). An experimental study is conducted, and results are provided to assess the developed model. Results show that the optimized Q and r for different distributions of daily demand are not the same even if the associated total inventory costs are close to each other.

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Attribution of recent increases in atmospheric methane through 3-D inverse modelling

10.5194/acp-2018-474 ◽

2018 ◽

Author(s):

Joe McNorton ◽

Chris Wilson ◽

Manuel Gloor ◽

Rob Parker ◽

Hartmut Boesch ◽

...

Keyword(s):

Growth Rate ◽

Transport Model ◽

Energy Sector ◽

Total Carbon ◽

Sensitivity Analyses ◽

Northern Eurasia ◽

Atmospheric Methane ◽

Chemical Transport Model ◽

Bottom Up ◽

Source And Sink

Abstract. The atmospheric methane (CH4) growth rate has varied considerably in recent decades. Unexplained renewed growth after 2006 followed seven years of stagnation and coincided with an isotopic trend toward CH4 more depleted in 13C, suggesting changes in sources and/or sinks. Using surface observations of both CH4 and the isotopologue ratio value (δ13CH4) to constrain a global 3D chemical transport model (CTM), we have performed a synthesis inversion for source and sink attribution. Our method extends on previous studies by providing monthly and regional attribution of emissions from 6 different sectors and changes in atmospheric sinks for the extended 2003–2015 period. Regional evaluation of the model CH4 tracer with independent column observations from the Greenhouse gases Observing SATellite (GOSAT) shows improved performance when using posterior fluxes (R = 0.94–0.96, RMSE = 8.3–16.5 ppb), relative to prior fluxes (R = 0.60–0.92, RMSE = 48.6–64.6 ppb). Further independent validation with data from the Total Carbon Column Observing Network (TCCON) shows a similar improvement in the posterior fluxes (R = 0.90, RMSE = 21.4 ppb) compared to the prior (R = 0.71, RMSE = 55.3 ppb). Based on these improved posterior fluxes, the inversion results suggest the most likely cause of the renewed methane growth is a post-2006 1.8 ± 0.4 % decrease in mean OH, a 12.9 ± 2.7 % increase in energy sector emissions, mainly from Africa/Middle East and Southern Asia/Oceania, and a 2.6 ± 1.8 % increase in wetland emissions, mainly from Northern Eurasia. The posterior wetland increases are in general agreement with bottom-up estimates, but the energy sector growth is greater than estimated by bottom-up methods. The model results are consistent across a range of sensitivity analyses performed. When forced to assume a constant (annually repeating) OH distribution, the inversion requires a greater increase in energy sector (13.6 ± 2.7 %) and wetland (3.6 ± 1.8 %) emissions but also introduces an 11.5 ± 3.8 % decrease in biomass burning emissions. Assuming no prior trend in sources and sinks slightly reduces the posterior growth rate in energy sector and wetland emissions and further increases the amplitude of the negative OH trend. We find that possible tropospheric Cl variations do not to influence δ13CH4 and CH4 trends, although we suggest further work on Cl variability is required to fully diagnose this contribution. While the study provides quantitative insight into possible emissions variations which may explain the observed trends, uncertainty in prior source and sink estimates and a paucity of δ13CH4 observations limit the accuracy of the posterior estimates.

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MATERIAL REQUIREMENT PLANNING UNTUK MEMENUHI PRODUKSI PADA CV. BANGUN CIPTA ARTHA DI BADUNG

E-Jurnal Manajemen Universitas Udayana ◽

10.24843/ejmunud.2020.v09.i02.p02 ◽

2020 ◽

Vol 9 (2) ◽

pp. 426

Author(s):

I Made Sugita Yasa ◽

Kastawan Mandala

Keyword(s):

Inventory Management ◽

Lot Sizing ◽

Raw Materials ◽

Raw Material ◽

Exact Order ◽

Lot Size ◽

Inventory Costs ◽

Material Requirement Planning ◽

Material Requirement ◽

Total Inventory

Inventory management without Material Requirement systems in CV. Bangun Cipta Artha resulted in the lot size for each order of raw materials not optimal. One concept that can be used to plan and control raw materials is the Material Requirement Planning. This study is to determine the number of sizes of raw material orders, the exact order time, the method that produces the lowest cost for each raw material, and the effect of using MRP on inventory costs. This research conducted on 160x200cm spring bed products. Data was analyzed by making production master schedules, determining net requirements, determining lot size, and making MRP tables. Based on the results, the determination the best lot sizing is the order quantiy period which results in a total inventory cost of Rp. 26,475,220 where the total cost is lower, compared to lot for lot method which Rp. 43,464,000. part period balancing Rp. 33,106,576, and conventional method Rp.49,472,912. Keywords: Material Requirement Planning (MRP), Sizing Lot, Lot For Lot, Balancing Part Period, Period Order Quantiy

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Bioactive Peptides from Walnut Residue Protein

Molecules ◽

10.3390/molecules25061285 ◽

2020 ◽

Vol 25 (6) ◽

pp. 1285 ◽

Cited By ~ 1

Author(s):

Xiangyang Li ◽

Manli Guo ◽

Jingtian Chi ◽

Jiangang Ma

Keyword(s):

Bioactive Peptides ◽

Added Value ◽

Structure Identification ◽

Antihypertensive Activity ◽

Utilization Rate ◽

Effective Utilization ◽

Active Peptides ◽

Reference Information ◽

Excellent Health ◽

By Products

Walnut residue is a kind of high-quality plant protein resource. The bioactive peptide prepared from walnut residue has excellent health care functions such as antioxidation and antihypertensive activity, but at present, walnut residue is often regarded as waste or low value feed, fertilizer and other materials. The uneconomical use of walnut residue has hindered the development of the walnut industry to some extent. Effective utilization of walnut residue protein to develop bioactive peptides and other products is of great significance to realize the comprehensive utilization of walnut residue, improve the added value of by-products, and change the current low utilization rate of walnut residue. In this paper, the preparation, purification and structure identification of walnut protein bioactive peptides are reviewed, and different functional walnut active peptides (WBPs) are introduced. The potential effects of these bioactivities on human health and their different uses in food, medicine and other industries are discussed. The purpose is to provide reference information for the effective utilization of walnut residue resources and the development of walnut industry.

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