scholarly journals PROTOTYPE EXPERIENCE WITH RUBBLE MOUND BREAKWATERS

1986 ◽  
Vol 1 (20) ◽  
pp. 153
Author(s):  
K.J. MacIntosh ◽  
W.F. Baird
Keyword(s):  
United States ◽  
Cost Savings ◽  
The United States ◽  
Cost Structure ◽  
Simple Construction ◽  
Significant Cost ◽  
Prototype Experience ◽  
Rubble Mound ◽  
The Cost ◽  
Rubble Mound Breakwaters

At the 19th ICE Conference in Houston in 1984 an alternative concept for the design of rubble mound breakwaters was introduced. This concept has the objective of providing a least cost structure by optimizing the use of locally available materials and utilizing simple construction procedures. Contractors' bids demonstrated that significant cost savings could be achieved, when compared to the cost of traditional designs. Considerable prototype experience has now been obtained with this concept of breakwaters. Breakwaters have been built using the concept in Canada, the United States, and Iceland since 1984 and have been subjected to storms and ice action. Prototype observations have supported the performance predicted during the design process. In this paper surveys of a breakwater taken after construction and after storm action are presented. In addition to wave action, this breakwater has also been subjected to extensive ice action. The response of the breakwater has been monitored and observed and is discussed.

scholarly journals Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

2015 ◽  
Vol 4 (6) ◽  
pp. 82 ◽  
Author(s):  
Julie M. Mhlaba ◽  
Emily W. Stockert ◽  
Martin Coronel ◽  
Alexander J. Langerman
Keyword(s):  
United States ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Waste Reduction ◽  
Significant Cost ◽  
Instrument Type ◽  
Hospital Revenue ◽  
Potential Strategy ◽  
The Cost

Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

scholarly journals Economies of Scale in the Floriculture Industry

2003 ◽  
Vol 35 (3) ◽  
pp. 497-507 ◽  
Author(s):  
Sara K. Schumacher ◽  
Thomas L. Marsh
Keyword(s):  
United States ◽  
Cost Function ◽  
Economies Of Scale ◽  
The United States ◽  
Cost Structure ◽  
Cost Advantage ◽  
Quadratic Cost ◽  
Cost Efficiencies ◽  
The Cost ◽  
Quadratic Cost Function

This study investigated the cost structure of the floriculture industry in the United States. Economies of scale and input elasticities were estimated with a normalized quadratic cost function. Results suggest that economies of scale exist in the floriculture industry. As producers become large and more automated, they have a cost advantage relative to smaller producers who are producing the same output product mix. The existence of economies of scale suggests that average grower size can increase in the future as growers increase in size to take advantage of cost efficiencies.

scholarly journals The Cost of Home Birth in the United States

2021 ◽  
Vol 18 (19) ◽  
pp. 10361
Author(s):  
David Anderson ◽  
Gabrielle Gilkison
Keyword(s):  
United States ◽  
Cost Savings ◽  
Home Birth ◽  
The United States ◽  
Low Risk ◽  
Home Births ◽  
Nationwide Study ◽  
Birth Center ◽  
Birth Centers ◽  
The Cost

Policy decisions about the accessibility of home birth hinge on questions of safety and affordability. Families consider safety and cost along with the comfort and familiarity of birthing venues. A substantial literature addresses safety concerns, generally reporting that for low-risk mothers in the care of credentialed midwives, the safety of planned home births is comparable to that in birth centers and hospitals. The lack of notable safety tradeoffs for low-risk mothers elevates the relevance of the economic efficiency of home births. The available cost figures for home births are largely out of date or anecdotal. The purpose of this research is to offer scholars, policymakers, and families improved estimates of both the cost of home births and the potential savings from greater access to home births. On the basis of a nationwide study, we estimate that the average cost of a home birth in the United States is USD 4650, which is significantly below existing cost estimates for an uncomplicated birth center or hospital birth. Further, we find that each shift of one percent of births from hospitals to homes would represent an annual cost savings to society of at least USD 321 million.

scholarly journals Cost effectiveness analysis of implementing tuberculosis screening among applicants for non-immigrant U.S. work visas

Pneumonia ◽  
2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Bisma Ali Sayed ◽  
Drew L. Posey ◽  
Brian Maskery ◽  
La’Marcus T. Wingate ◽  
Martin S. Cetron
Keyword(s):  
United States ◽  
Home Country ◽  
Screening Program ◽  
Cost Savings ◽  
The United States ◽  
Active Tuberculosis ◽  
Multiple Perspectives ◽  
Tuberculosis Screening ◽  
Hospitalization Costs ◽  
The U.S

Abstract Background While persons who receive immigrant and refugee visas are screened for active tuberculosis before admission into the United States, nonimmigrant visa applicants (NIVs) are not routinely screened and may enter the United States with infectious tuberculosis. Objectives We evaluated the costs and benefits of expanding pre-departure tuberculosis screening requirements to a subset of NIVs who arrive from a moderate (Mexico) or high (India) incidence tuberculosis country with temporary work visas. Methods We developed a decision tree model to evaluate the program costs and estimate the numbers of active tuberculosis cases that may be diagnosed in the United States in two scenarios: 1) “Screening”: screening and treatment for tuberculosis among NIVs in their home country with recommended U.S. follow-up for NIVs at elevated risk of active tuberculosis; and, 2) “No Screening” in their home country so that cases would be diagnosed passively and treatment occurs after entry into the United States. Costs were assessed from multiple perspectives, including multinational and U.S.-only perspectives. Results Under “Screening” versus “No Screening”, an estimated 179 active tuberculosis cases and 119 hospitalizations would be averted in the United States annually via predeparture treatment. From the U.S.-only perspective, this program would result in annual net cost savings of about $3.75 million. However, rom the multinational perspective, the screening program would cost $151,388 per U.S. case averted for Indian NIVs and $221,088 per U.S. case averted for Mexican NIVs. Conclusion From the U.S.-only perspective, the screening program would result in substantial cost savings in the form of reduced treatment and hospitalization costs. NIVs would incur increased pre-departure screening and treatment costs.

scholarly journals SWK-11. ASSESSMENT OF THE INDIRECT COSTS ASSOCIATED WITH PROTON THERAPY TREATMENT FOR ALBERTA PATIENTS REFERRED OUT OF COUNTRY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Karina Black ◽  
Jackie Middleton ◽  
Sunita Ghosh ◽  
David Eisenstat ◽  
Samor Patel
Keyword(s):  
United States ◽  
Proton Therapy ◽  
Malignant Tumors ◽  
Indirect Costs ◽  
The United States ◽  
Current Data ◽  
Opportunity Costs ◽  
Proton Treatment ◽  
Out Of Pocket Expenses ◽  
The Cost

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.

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

Importance of Behavioral and Psychological Symptoms of Dementia in Primary Care

2000 ◽  
Vol 12 (S1) ◽  
pp. 67-72 ◽  
Author(s):  
William H. Coleman
Keyword(s):  
United States ◽  
Primary Care ◽  
Psychological Distress ◽  
Direct Relationship ◽  
Psychological Symptoms ◽  
The United States ◽  
Comprehensive Treatment ◽  
The Cost ◽  
Number Of Individuals ◽  
Behavioral And Psychological Symptoms

There is a direct relationship between years lived beyond age 65 and the number of individuals diagnosed with dementia, primarily Alzheimer's disease (AD). The occurrence of AD has no socioeconomic, geographical, or ethnic limitations. The problem is worldwide. Its magnitude is demonstrated by the following facts: (a) approximately 6% to 8% of persons 65 years or older have AD, and the prevalence of the disease doubles each 5 years after 60 years of age; (b) 30% of 85-year-old individuals can be expected to have the disease; (c) AD affects an estimated 4 million people in the United States, and is expected to affect approximately 14 million Americans within the next few decades; (d) AD patients average 6 to 10 years of comprehensive treatment from symptom onset to death; (e) AD is the fourth leading cause of mortality among elderly Americans, more than 100,000 each year; (f) caregiver attempts at management of the behavioral and psychological symptoms of AD result in up to 50% developing significant psychological distress themselves; and (g) the cost for the management of AD patients is estimated to be between US $80 billion and US $120 billion annually. Primary care is essential for the appropriate diagnosis and treatment of the complex set of behavioral and psychological symptoms of dementia (BPSD) associated with AD.

scholarly journals Projections of the Cost of Cancer Care in the United States: 2010-2020

2011 ◽  
Vol 103 (2) ◽  
pp. 117-128 ◽  
Author(s):  
A. B. Mariotto ◽  
K. Robin Yabroff ◽  
Y. Shao ◽  
E. J. Feuer ◽  
M. L. Brown
Keyword(s):  
United States ◽  
Cancer Care ◽  
The United States ◽  
The Cost

LE LETTERE DI GIUSEPPE PEANO NELLA CORRISPONDENZA DI ERNESTO CESÀRO

Nuncius ◽  
1993 ◽  
Vol 8 (1) ◽  
pp. 249-281
Author(s):  
FRANCO PALLADINO
Keyword(s):  
United States ◽  
Nineteenth Century ◽  
The United States ◽  
Cost Of Living ◽  
Infinitesimal Calculus ◽  
Italian School ◽  
Actuarial Mathematics ◽  
Important Member ◽  
The Cost ◽  
Giuseppe Peano

Abstract<title> SUMMARY </title>We have gathered here twenty-six writings from the correspondence of Giuseppe Peano, as well as letters by Alexander Macfarlane and Alexander Ziwet.Peano's letters were addressed to Ernesto Cesaro, an important member of the great Italian school of mathematics founded in the second half of the Nineteenth century. In these writings, Peano discusses various topics: Infinitesimal calculus and Barycentric calculus, the «Rivista di Matematica» and the «Formulario» of which he was editor; didactics and a question about Actuarial mathematics. Some of the writings are confidential in nature: in one letter, Peano proposes exchanging his professorial chair with Cesaro's, and hence transferring from Turin to Naples.The letters written by Macfarlane and Ziwet were sent to Peano; they contain, at the request of Cesaro, information concerning university chairs and the cost of living in the United States.

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