Subways and Urban Air Pollution

We investigate the effect of subway system openings on urban air pollution. On average, particulate concentrations are unchanged by subway openings. For cities with higher initial pollution levels, subway openings reduce particulates by 4 percent in the area surrounding a city center. The effect decays with distance to city center and persists over the longest time horizon that we can measure with our data, about four years. For highly polluted cities, we estimate that a new subway system provides an external mortality benefit of about $1 billion per year. For less polluted cities, the effect is indistinguishable from zero. Back of the envelope cost estimates suggest that reduced mortality due to lower air pollution offsets a substantial share of the construction costs of subways. (JEL I12, L92, O13, O18, Q51, Q53, R41)

A case series of infectious complications in medical tourists requiring hospital admission or outpatient home parenteral therapy

BACKGROUND: Travelling for medical care is increasing, and this medical tourism (MT) may have complications, notably infectious diseases (ID). We sought to identify MT-related infections (MTRIs) in a large Canadian health region and estimate resulting costs. METHODS: Retrospective and prospective capture of post-MT cases requiring hospital admission or outpatient parenteral antimicrobial therapy was completed by canvassing ID physicians practicing in Calgary, Alberta, from January 2017 to July 2019. Cost estimates for management were made with the Canadian Institute for Health Information’s (CIHI’s) patient cost estimator database tool applied to estimated rates of Canadians engaging in MT from a 2017 Fraser Institute report. RESULTS: We identified 12 cases of MT-related infectious syndromes. Eight had microbial aetiologies identified. MTs were young (mean = 40.3 y, SD = 12.2) and female ( n = 11) and pursued surgical treatment ( n = 11). Destination countries and surgical procedures varied but were largely cosmetic ( n = 5) and orthopaedic ( n = 3). Duration to organism identification (mean = 5.3 wk) and treatment courses (mean = 19 wk) appeared lengthy. CIHI cost estimates for management of relevant infectious complications of our cases ranged from $6,288 to $20,741, with total cost for cases with matching codes ( n = 8) totalling $94,290. CONCLUSIONS: In our series of MTRIs, etiologic organisms often found in Canadian-performed post-procedural infections were identified, and prolonged treatment durations were noted. Young women pursuing cosmetic surgery may be a population to target with public health measures to reduce the incidence of MTRIs and burden of disease.

ALTERNATIF VARIABLE COSTING SEBAGAI PENENTUAN HARGA PRODUK PADA IWAI CAKE & BAKERY

During the current pandemic and the movement of society, forcing entrepreneurs to carry out various activities to survive in these difficult times. Various actions such as providing attractive promotions, discounted prices, efficiency in the production process, even innovating and calculating product cost estimates. The variable costing method is an alternative to determine the price of the product that is used to increase the accuracy of the selling price of the product. In general, entrepreneurs use an easier method by adding all the costs incurred in calculating the cost of the product, which we know as the full costing method. The purpose of the counseling is the preparation and application of the variable costing method in calculating the selling price. In order to improve the accuracy, it is necessary to sort costs based on their nature, namely the separation of variable costs and fixed costs. In an effort to help MSME actors to survive, I as a lecturer from Tarumanaga University, Faculty of Economics and Accounting proposed the owner of Iwai Cake & Bakery to help calculate the cost of products through preparation, implementation in business units with the title "Variable Costing as an alternative costing to improve price accuracy productPada masa pandemi saat ini dan pembatasan pergerakan dari masyarakat, memaksa para pengusaha melakukan berbagai aktifitas untuk tetap dapat bertahan dimasa yang sulit ini. Berbagai Tindakan seperti memberikan promo-promo yang menarik, potongan harga, efisiensi dalam proses produksi bahkan melakukan inovasi dan kalkulasi perhitungan penentuan harga pokok produk. Metode variable costing merupakan salah satu alternatif penentuan harga produk yang dipakai untuk meningkatkan keakuratan penentuan harga jual produk. Secara umum para pengusaha menggunakan metode yang lebih mudah dengan menambahkan semua biaya yang dikeluarkan dalam perhitungan harga pokok produk yang kita kenal dengan metode full costing. Tujuan dari penyuluhan adalah penyusunan dan penerapan metode variable costing dalam menghitung harga produknya. Untuk meningkatkan keakuratan harus dilakukan pemilahan biaya berdasarkan sifatnya yaitu pemilahan biaya yang bersifat variable dan biaya-biaya yang bersifat tetap. Dalam upaya membantu pelaku UMKM supaya tetap bertahan, Saya selaku dosen dari Universitas Tarumanaga Fakultas Ekonomi Jurusan Akuntansi mengajukan ke pemilik Iwai Cake & Bakery dengan membantu melakukan perhitungan harga pokok produk melalui penyusunan, implementasi di unit usaha dengan judul “Variable Costing sebagai alternatif costing untuk meningkatkan keakuratan penentuan harga produk

752. Costs Attributable to Clostridioides difficile Infection in the Presence of Differential Mortality

Background CDI imposes a major burden on the U.S. healthcare system. Obtaining accurate estimates of economic costs is critical to determining the cost-effectiveness of preventive measures. This task is complicated by differences in epidemiology, mortality, and baseline health status of infected and uninfected individuals, and by the statistical properties of costs data (e.g., right-skewed, excess of zeros costs). Methods Incident CDI cases were identified from Medicare 5% fee-for-service data between 2011 and 2017 and classified into standard surveillance definitions: hospital-onset (HO); other healthcare facility-onset (OHFO); community-onset, healthcare-associated (CO-HCFA); or community-associated (CA). Cases were frequency matched 1:4 to uninfected controls based on age, sex, and year of CDI. Controls were assigned to surveillance definitions based on location at index dates. Medicare allowed costs were summed in 30-day intervals up to 3 years following index. One- and 3-year cumulative costs attributable to CDI were computed using a 3-part estimator consisting of a parametric survival model and a pair of 2-part models predicting costs separately in intervals where death did and did not occur, adjusting for underlying acute and chronic conditions. Results 60,492 CDI cases (Figure 1) were matched to 241,968 controls. Three-year mortality was higher among CDI cases compared to matched controls for HO (45% vs 26%) and OHFO (42% vs 36%), whereas mortality was slightly lower for CDI cases compared to controls for those with community onset (CO-HCFA: 28% vs 32%; CA: 10% vs 11%). One- and 3-year attributable costs due to CDI are shown in Figure 2. Adjusted 1-year attributable costs amounted to &26,954 (95% CI: &26,154–&27,939) for HO; &10,539 (&9,564–&11,518) for OHFO; &6,525 (&5,012–&8,171) for CO-HCFA; and &3,171 (&1,841–&4,200) for CA. Adjusted 3-year attributable costs were &44,736 (&43,063–&46,483) for HO; &13,994 (&12,529–&15,975) for OHFO; &7,349 (&4,738–&10,246) for CO-HCFA; and &2,377 (&166–&4,722) for CA. Figure 1. Proportion of Cases by CDI Surveillance Definitions Abbreviations: HO: hospital-onset; OHFO: other healthcare facility-onset; CO-HCFA: community-onset, healthcare-associated; CA: community-associated. Figure 2. Estimates of Costs Attributable to CDI by CDI Surveillance Definitions at One and Three Years after Onset Top panels: One-year cost estimates. Bottom panels: Three-year cost estimates. Abbreviations: HO: hospital-onset; OHFO: other healthcare facility-onset; CO-HCFA:community-onset, healthcare-associated; CA:community-associated. Conclusion CDI was associated with increased healthcare costs across surveillance definitions in Medicare fee-for-service patients after adjusting for survival and underlying conditions. Disclosures Dustin Stwalley, MA, AbbVie Inc (Shareholder)Bristol-Myers Squibb (Shareholder) Margaret A. Olsen, PhD, MPH, Pfizer (Consultant, Research Grant or Support) Holly Yu, MSPH, Pfizer (Employee) Erik R. Dubberke, MD, MSPH, Ferring (Grant/Research Support)Merck (Consultant)Pfizer (Consultant, Grant/Research Support)Seres (Consultant)Summit (Consultant)

Cost estimates in designing objects at the modern stage of civil shipbuilding development in Russia: Problems and prospects

Subject. The article addresses cost estimation of designed facilities construction in domestic civil shipbuilding. Objectives. The purpose is to consider the key problems and contradictions in the cost estimating process in this area. Methods. In the study, I apply general scientific methods. Results. The paper presents the analysis of major problems and contradictions in estimating the cost of construction of designed objects of domestic civil shipbuilding at the present stage of its development. I formulate my proposals for improving the system of industry pricing. Conclusions. The paper underpins the need to modernize industry pricing through the introduction of advanced information technologies.

Evaluation of the costing methodology of published studies estimating costs of surgical site infections: A systematic review

Objectives: Surgical site infections (SSIs) are associated with increased length of hospitalization and costs. Epidemiologists and infection control practitioners, who are in charge of implementing infection control measures, have to assess the quality and relevance of the published SSI cost estimates before using them to support their decisions. In this review, we aimed to determine the distribution and trend of analytical methodologies used to estimate cost of SSIs, to evaluate the quality of costing methods and the transparency of cost estimates, and to assess whether researchers were more inclined to use transferable studies. Methods: We searched MEDLINE to identify published studies that estimated costs of SSIs from 2007 to March 2021, determined the analytical methodologies, and evaluated transferability of studies based on 2 evaluation axes. We compared the number of citations by transferability axes. Results: We included 70 studies in our review. Matching and regression analysis represented 83% of analytical methodologies used without change over time. Most studies adopted a hospital perspective, included inpatient costs, and excluded postdischarge costs (borne by patients, caregivers, and community health services). Few studies had high transferability. Studies with high transferability levels were more likely to be cited. Conclusions: Most of the studies used methodologies that control for confounding factors to minimize bias. After the article by Fukuda et al, there was no significant improvement in the transferability of published studies; however, transferable studies became more likely to be cited, indicating increased awareness about fundamentals in costing methodologies.