scholarly journals Reducing the Cost of Laparoscopy: Reusable versus Disposable Laparoscopic Instruments

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitrios K. Manatakis ◽  
Nikolaos Georgopoulos
Keyword(s):  
Acquisition Cost ◽  
National Health System ◽  
High Price ◽  
Maintenance Cost ◽  
Potential Cost ◽  
Laparoscopic Procedures ◽  
Laparoscopic Instruments ◽  
Disposable Instruments ◽  
Operative Notes ◽  
The Cost

Cost-effectiveness in health care management is critical. The situation in debt-stricken Greece is further aggravated by the financial crisis and constant National Health System expense cut-downs. In an effort to minimize the cost of laparoscopy, our department introduced reusable laparoscopic instruments in December 2011. The aim of this study was to assess potential cost reduction of laparoscopic operations in the field of general surgery. Hospital records, invoice lists, and operative notes between January 2012 and December 2013, were retrospectively reviewed and data were collected on laparoscopic procedures, instrument failures, and replacement needs. Initial acquisition cost of 5 basic instrument sets was €21,422. Over the following 24 months, they were used in 623 operations, with a total maintenance cost of €11,487. Based on an average retail price of €490 per set, projected cost with disposable instruments would amount to €305,270, creating savings of €272,361 over the two-year period under study. Despite the seemingly high purchase price, each set amortized its acquisition cost after only 9 procedures and instrument cost depreciated to less than €55 per case. Disposable instruments cost 9 times more than reusable ones, and their high price would almost equal the total hospital reimbursement by social security funds for many common laparoscopic procedures.

Reducing the Cost of Ship Maintenance and Repair

2014 ◽  
Author(s):  
Victoria Dlugokecki ◽  
Dennis Fanguy ◽  
Lisa Hepinstall ◽  
Matthew Tedesco
Keyword(s):  
Cost Reduction ◽  
Cost Benefit Analysis ◽  
Good Practice ◽  
Cost Benefit ◽  
Maintenance Cost ◽  
Potential Cost ◽  
Design Rules ◽  
Deck Plate ◽  
General Dynamics ◽  
The Cost

In July 2011, the National Shipbuilding Research Program (NSRP)awarded the project entitled “Reduction of Total Ownership Costs Through Application of Design For Maintenance (DFM) and Repair Methodologies Project” a collaborative shipyard-led research project, supported by Bollinger Shipyards(Prime), BAE Systems Southeast Shipyards, Vigor Shipyards, the Trident Refit Facility in Kingsbay, GA, General Dynamics Electric Boat, General Dynamics NASSCO, and the Naval Center for Cost Analysis at NSWC-Carderock. Through this customer-centric project, nearly 40 DFM workshops were held with the deck-plate repairers at public and private shipyards across the US to identify major maintenance cost drivers, maintenance cost reduction opportunities, and deliver design rules to reduce total ownership costs to ship owners based on Design for Maintainability (DFM) principles. This paper will provide an understanding of the process used to develop the DFM information and will discuss the DFM principles applied and highlight the “good practice” design rules that resulted from this effort. The paper will also describe the Cost Benefit Analysis process and templates developed through the project, along with provide an appreciation of the potential cost benefits associated with the implementation of DFM principles. The DFM database, also developed through the project, with over 1000+ repair-based cost reduction strategies will also be highlighted.

TECHNICAL AND ECONOMIC EVALUATION OF THE DEVELOPMENT OF A DEVICE FOR THE PREVENTION OF APNEA DURING PHYSIOLOGICAL SLEEP IN HUMANS

2020 ◽  
pp. 198-210
Author(s):  
Сергей Борисович Казаков ◽  
Дмитрий Михайлович Шишов ◽  
Антон Игоревич Ларин ◽  
Александр Петрович Николаев ◽  
Аза Валерьевна Писарева
Keyword(s):  
Sleep Apnea ◽  
Humidity Sensor ◽  
Lung Ventilation ◽  
High Price ◽  
Device Structure ◽  
Artificial Lung Ventilation ◽  
Exact Moment ◽  
The Cost ◽  
Technical Solutions ◽  
Physiological Sleep

В статье представлен обзор существующих технических решений в сфере мониторинга и предотвращения апноэ во сне. Произведён анализ существующих аппаратов для предотвращения апноэ, который показал, что на рынке присутствует большое количество импортных моделей, однако они имеют довольно высокую цену. Разработанный нами Российский аналог проектируемого аппарата, при схожих характеристиках, будет иметь более привлекательную цену, чем у импортных приборов. Интегрирование датчика влажности в персональную маску пациента даёт возможность отслеживать остановки дыхания пациента во время сна, и тем самым включать процесс принудительной подачи дыхательной смеси именно в тот момент, когда она необходима для устранения патологии. Целью научной работы является разработка конструкции прибора и создание алгоритма программы для управления аппарата искусственной вентиляции лёгких для предотвращения апноэ во сне. Показана разработка структуры устройства аппарата. Подобран компрессор и датчик влажности с обоснованными характеристиками для создания аппарата, а также основные элементы. Разработана конструкция корпуса аппарата и разработана компоновка. Выполнено технико-экономическое обоснование разработки аппаратно-программного комплекса для предотвращения апноэ во сне. Показано, что себестоимость готового изделия достаточно конкурентна The article presents an overview of existing technical solutions in the field of monitoring and prevention of sleep apnea. An analysis of existing devices for preventing apnea was made, which showed that there are a large number of imported models on the market, but they have a fairly high price. The Russian analog of the designed device developed by us, with similar characteristics, will have a more attractive price than that of imported devices. The integration of the humidity sensor into the patient's personal mask makes it possible to monitor the patient's breathing stops during sleep, and thus enable the process of forced delivery of the respiratory mixture at the exact moment when it is necessary to eliminate the pathology. The purpose of the research is to develop the device design and create a program algorithm for controlling the artificial lung ventilation device to prevent sleep apnea. The development of the device structure is shown. The compressor and humidity sensor with reasonable characteristics for creating the device, as well as the main elements are selected. The design of the device body and its layout were developed. A feasibility study for the development of a hardware and software system for preventing sleep apnea has been completed. It is shown that the cost of the finished product is quite competitive

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

scholarly journals Effects of Increase in the Cost of Building Materials on the Delivery of Affordable Housing in South Africa

2021 ◽  
Vol 13 (4) ◽  
pp. 1772
Author(s):  
Bimpe Alabi ◽  
Julius Fapohunda
Keyword(s):  
South Africa ◽  
Affordable Housing ◽  
Building Materials ◽  
Statistical Technique ◽  
Project Managers ◽  
Maintenance Cost ◽  
Cost Increase ◽  
Sequential Mixed Methods ◽  
Adequate Provision ◽  
The Cost

Adequate provision of affordable human settlements is a huge challenge in South Africa since its independence. This paper investigates the effects of the cost increase of building materials on affordable housing delivery in South Africa. With potential solutions for cost minimisation of building materials, with the aim of achieving affordable housing delivery in South Africa are provided. This study uses a sequential mixed methods approach, wherein surveys were conducted among the construction professionals (project managers, site managers architects, site engineers, quantity surveyors, contractors, building materials suppliers, and government workers) in the construction industry within Cape Town, South Africa, who were considered as the research participants. The qualitative data obtained from the survey exercise were analysed using content analysis, while the quantitative data were analysed using a descriptive statistical technique on SPSS. The findings attained show fluctuation in construction cost and a rise in maintenance cost (caused by poor workmanship) as significant effects in the cost increase of building materials for affordable housing delivery. Adequate application of the recommendations given in this study will minimise the effects of high cost of building materials and enhance affordable housing delivery. Appropriate handling of the findings given in this study will reduce the effects of the high cost of building materials and augment timely delivery of affordable housing and stakeholders’ satisfaction.

scholarly journals Analysis and Optimization of a Novel Hexagonal Waveguide Concentrator for Solar Thermal Applications

Energies ◽  
2021 ◽  
Vol 14 (8) ◽  
pp. 2146
Author(s):  
Karunesh Kant ◽  
Karthik Nithyanandam ◽  
Ranga Pitchumani
Keyword(s):  
Industrial Process ◽  
Cost Effective ◽  
Solar Irradiation ◽  
Maintenance Cost ◽  
Solar Concentrator ◽  
Thermal Desalination ◽  
Process Heat ◽  
Solar Thermal Applications ◽  
The Cost ◽  
Operation And Maintenance Cost

This paper analyzes a novel, cost-effective planar waveguide solar concentrator design that is inspired by cellular hexagonal structures in nature with the benefits of facile installation and low operation and maintenance cost. A coupled thermal and optical analysis of solar irradiation through an ideal hexagonal waveguide concentrator integrated with a linear receiver is presented, along with a cost analysis methodology, to establish the upper limit of performance. The techno-economic model, coupled with numerical optimization, is used to determine designs that maximized power density and minimized the cost of heat in the temperature range of 100–250 °C, which constitutes more than half of the industrial process heat demand. Depending on the incident solar irradiation and the application temperature, the cost of heat for the optimal design configuration ranged between 0.1–0.27 $/W and 0.075–0.18 $/W for waveguide made of ZK7 glass and polycarbonate, respectively. A techno-economic analysis showed the potential of the technology to achieve cost as low as 80 $/m2 and 61 $/m2 for waveguide made of ZK7 glass and polycarbonate material, respectively, which is less than half the cost of state-of-the-art parabolic trough concentrators. Overall, the hexagonal waveguide solar concentrator technology shows immense potential for decarbonizing the industrial process heat and thermal desalination sectors.

scholarly journals Model Predictive Control Strategies to Activate the Energy Flexibility for Zones with Hydronic Radiant Systems

Energies ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1195
Author(s):  
Ali Saberi Derakhtenjani ◽  
Andreas K. Athienitis
Keyword(s):  
Control Strategies ◽  
High Price ◽  
Electricity Prices ◽  
Peak Demand ◽  
Heating Systems ◽  
Electrical Grid ◽  
Demand Reduction ◽  
The Cost ◽  
Floor System ◽  
Radiant Floor Heating

This paper presents control strategies to activate energy flexibility for zones with radiant heating systems in response to changes in electricity prices. The focus is on zones with radiant floor heating systems for which the hydronic pipes are located deep in the concrete and, therefore, there is a significant thermal lag. A perimeter zone test-room equipped with a hydronic radiant floor system in an environmental chamber is used as a case study. A low order thermal network model for the perimeter zone, validated with experimental measurements, is utilized to study various control strategies in response to changes in the electrical grid price signal, including short term (nearly reactive) changes of the order of 10–15 min notice. An index is utilized to quantify the building energy flexibility with the focus on peak demand reduction for specific periods of time when the electricity prices are higher than usual. It is shown that the developed control strategies can aid greatly in enhancing the zone energy flexibility and minimizing the cost of electricity and up to 100% reduction in peak power demand and energy consumption is attained during the high-price and peak-demand periods, while maintaining acceptable comfort conditions.

scholarly journals The cost-effectiveness of transcatheter aortic valve implantation: exploring the Italian National Health System perspective and different patient risk groups

2021 ◽  
Author(s):  
V. Lorenzoni ◽  
G. Barbieri ◽  
F. Saia ◽  
F. Meucci ◽  
G. L. Martinelli ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Aortic Valve ◽  
National Health System ◽  
Risk Groups ◽  
System Perspective ◽  
Transcatheter Aortic Valve ◽  
Life Years ◽  
Italian National Health ◽  
Valve Implantation ◽  
The Cost

Abstract Objectives To assess the cost-effectiveness (CE) of transcatheter aortic valve implantation (TAVI) in Italy, considering patient groups with different surgical risk. Methods A Markov model with a 1-month cycle length, comprising eight different health states, defined by the New York Heart Association functional classes (NYHA I–IV), with and without stroke plus death, was used to estimate the CE of TAVI for intermediate-, high-risk and inoperable patients considering surgical aortic valve replacement or medical treatment as comparators according to the patient group. The Italian National Health System perspective and 15-year time horizon were considered. In the base-case analysis, effectiveness data were retrieved from published efficacy data and total direct costs (euros) were estimated from national tariffs. A scenario analysis considering a micro-costing approach to estimate procedural costs was also considered. The incremental cost-effectiveness ratio (ICER) was expressed both in terms of costs per life years gained (LYG) and costs per quality adjusted life years (QALY). All outcomes and costs were discounted at 3% per annum. Univariate and probabilistic sensitivity analyses (PSA) were performed to assess robustness of results. Results Over a 15-year time horizon, the higher acquisition costs for TAVI were partially offset in all risk groups because of its effectiveness and safety profile. ICERs were €8338/QALY, €11,209/QALY and €10,133/QALY, respectively, for intermediate-, high-risk and inoperable patients. ICER values were slightly higher in the scenario analysis. PSA suggested consistency of results. Conclusions TAVI would be considered cost-effective at frequently cited willingness-to-pay thresholds; further studies could clarify the CE of TAVI in real-life scenarios.

scholarly journals The increased use value of bamboo leaves as silica source for t-type zeolite synthesis

2018 ◽  
Vol 197 ◽  
pp. 05003 ◽  
Author(s):  
Soni Setiadji ◽  
Citra Deliana Dewi Sundari ◽  
Endang Lala ◽  
Denia Febby Nurbaeti ◽  
Ira Novianti ◽  
...  
Keyword(s):  
Sem Analysis ◽  
High Price ◽  
Heating Process ◽  
Zeolite Synthesis ◽  
X Ray Diffraction ◽  
Cost Performance ◽  
Silica Source ◽  
Bamboo Leaves ◽  
Type Zeolite ◽  
The Cost

T-type zeolite can be used as catalyst, adsorbent, and membranes for gas separation. The synthesis of T-type zeolite needs to be optimized in both of the method and source of precursor, because of its relatively high price. In this research, the synthesis is done using silica extracted from bamboo leaves instead of commercial silica. This increases the value of the bamboo leaves and the cost-performance of zeolite synthesis. The silica was extracted from bamboo leaves ash using alkaline solvent. The extracted silica has 81.76% of purity and an amorphous phase. The T-type zeolite was synthesized using the molar composition of 0.15 Na2O : 0.025 Al : 0.15 K2O : 1 SiO2 : 15 H2O : 0.06 TMAOH, under hydrothermal method and heating process for 4 days, 60°C for 2 days and 120°C for the next 2 days. The characterization method using X-Ray Diffraction and Infra-Red Spectroscopy were performed to confirm the formation of T-type zeolite. The results of Scanning Electron Microscope (SEM) analysis show that the formed T-type zeolite has erionite cylindrical crystal shape.

Positive behavioural support for children and adolescents with learning disabilities and behaviour that challenges: an initial exploration of service use and costs

2016 ◽  
Vol 21 (4) ◽  
pp. 169-180 ◽  
Author(s):  
Valentina Iemmi ◽  
Martin Knapp ◽  
Caroline Reid ◽  
Catherine Sholl ◽  
Monique Ferdinand ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Children And Adolescents ◽  
Service Use ◽  
Potential Cost ◽  
Content Type ◽  
Total Cost ◽  
Behavioural Support ◽  
Delphi Exercise ◽  
The Cost

Purpose Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that challenges. While recent evidence suggests it has a positive impact on behaviour and carer ability to cope, there is little evidence of its economic costs or benefits. The paper aims to discuss this issue. Design/methodology/approach An exploratory cross-sectional study was conducted to evaluate the cost of providing positive behavioural support to ten children and adolescents with learning disabilities and behaviour that challenges living in the community in Ealing, West London. Comparison was also made with the cost estimate of possible alternative support packages for children and adolescents with learning disabilities and behaviour that challenges in the UK, as obtained through a Delphi exercise. Findings Total cost of services per child was £1,454 per week for young people supported short-term, and £1,402 supported long-term. Children and adolescents were making use of a range of social care, education and health services. Over the full sample, half of the total cost was accounted for by education services. The Delphi exercise estimated the weekly cost of residential-based care as more expensive than the cost of community-based care for children and adolescents with learning disabilities and behaviour that challenges. At the end of the ITSBS, all ten children and adolescents initially at risk of imminent residential placement were living in the community with less service-intensive and less expensive support. This suggests that avoiding residential-based care could reduce costs in the long term. Originality/value Positive behavioural support has potential to support people with learning disabilities and behaviour that challenges in the community, leading to potential cost advantages. However, this is a small study and more robust research is needed.

scholarly journals Potential Cost-effectiveness of HIV Viral Load Sample Collection and Testing Methods in Malawi

2019 ◽  
Author(s):  
Joseph B. Babigumira ◽  
Solomon J. Lubinga ◽  
Mindy M. Cheng ◽  
James K. Karichu ◽  
Louis P. Garrison
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Treatment Failure ◽  
Test Accuracy ◽  
Sample Collection ◽  
Testing Methods ◽  
Hiv Viral Load ◽  
Potential Cost ◽  
Testing Approach ◽  
The Cost

Abstract Background HIV viral load (VL) monitoring informs antiretroviral therapy failure and helps to guide regimen changes. Typically, VL monitoring is performed using dried blood spot (DBS) samples transported and tested in a centralized laboratory. Novel sample collection technologies based on dried plasma stored on a plasma separation card (PSC) have become available. The cost-effectiveness of these different testing approaches to monitor VL is uncertain, especially in resource-limited settings. The objective of this study is to evaluate the potential cost-effectiveness of HIV VL testing approaches with PSC samples compared to DBS samples in Malawi. Methods We developed a decision-tree model to evaluate the cost-effectiveness of two different sample collection and testing methods—DBS and PSC samples transported and tested at central laboratories. The analysis used data from the published literature and was performed from the Malawi Ministry of Health perspective. We estimated costs of sample collection, transportation, and testing. The primary clinical outcome was test accuracy (proportion of patients correctly classified with or without treatment failure). Sensitivity analysis was performed to assess the robustness of results. Results The estimated test accuracy for a DBS testing approach was 87.5% compared to 97.4% for an approach with PSC. The estimated total cost per patient of a DBS testing approach was $19.39 compared to $17.73 for a PSC approach. Based on this, a PSC-based testing approach “dominates” a DBS-based testing approach (i.e., lower cost and higher accuracy). Conclusion The base-case analysis shows that a testing approach using PSC sample is less costly and more accurate (correctly classifies more patients with or without treatment failure) than with a DBS approach. Our study suggests that a PSC testing approach is likely an optimal strategy for routine HIV VL monitoring in Malawi. However, given the limited data regarding sample viability, additional real-world data are needed to validate the results.

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