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Unit Costs (unit + cost)
Selected AbstractsSALES MAXIMIZATION AND PROFIT MAXIMIZATION: A NOTE ON THE DECISION OF A SALES MAXIMIZER TO THE INCREASE OF PER UNIT COSTPACIFIC ECONOMIC REVIEW, Issue 5 2007Ke Li A common mistake in currently used textbooks is pointed out, and a new proposition is proposed for replacing a false statement there. [source] Unit cost of Mohs and Dermasurgery UnitJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2010R Wanitphakdeedecha Abstract Background, Appropriate pricing for medical services of not-for-profit hospital is necessary. The prices should be fair to the public and should be high enough to cover the operative costs of the organization. Objective, The purpose of this study was to determine the cost and unit cost of medical services performed at the Mohs and Dermasurgery Unit (MDU), Department of Dermatology, The University of Texas , MD Anderson Cancer Center, Houston, TX from the healthcare provider's perspective. Methods, MDU costs were retrieved from the Financial Department for fiscal year 2006. The patients' statistics were acquired from medical records for the same period. Unit cost calculation was based on the official method of hospital accounting. Results, The overall unit cost for each patient visit was $673.99 United States dollar (USD). The detailed unit cost of nurse visit, new patient visit, follow-up visit, consultation, Mohs and non-Mohs procedure were, respectively, $368.27, $580.09, $477.82, $585.52, $1,086.12 and $858.23 USD. With respect to a Mohs visit, the unit cost per lesion and unit cost per stage were $867.89 and $242.30 USD respectively. Conclusions, Results from this retrospective study provide information that may be used for pricing strategy and resource allocation by the administrative board of MDU. [source] DNAPL Characterization Methods and Approaches, Part 2: Cost ComparisonsGROUND WATER MONITORING & REMEDIATION, Issue 1 2002Mark L. Kram Contamination from the use of chlorinated solvents, often classified as dense nonaqueous phase liquids (DNAPLs) when in an undissolved state, pose environmental threats to ground water resources worldwide. DNAPL site characterization method performance comparisons are presented in a companion paper (Kram et al. 2001). This study compares the costs for implementing various characterization approaches using synthetic unit model scenarios (UMSs), each with particular physical characteristics. Unit costs and assumptions related to labor, equipment, and consumables are applied to determine costs associated with each approach for various UMSs. In general, the direct-push sensor systems provide cost-effective characterization information in soils that are penetrable with relatively shallow (less than 10 to 15 m) water tables. For sites with impenetrable lithology using direct-push techniques, the Ribbon NAPL Sampler Flexible Liner Underground Technologies Everting (FLUTe) membrane appears to be the most cost-effective approach. For all scenarios studied, partitioning interwell tracer tests (PITTs) are the most expensive approach due to the extensive pre-and post-PITT requirements. However, the PITT is capable of providing useful additional information, such as approximate DNAPL saturation, which is not generally available from any of the other approaches included in this comparison. [source] Costs of neonatal care for low-birthweight babies in English hospitalsACTA PAEDIATRICA, Issue 7 2009Hema Mistry Abstract Aim:, To estimate mean costs of neonatal care for babies with birthweights ,1800 g in a regional Level 3 unit and three Level 2 units providing short-term intensive care. Method:, Babies ,1800 g admitted to units in four hospitals in England over 15 months in 2001,2002 were audited until discharge. Unit costs (2005,2006 prices) were attributed to their resource items, including neonatal cot occupancy, pharmaceuticals, blood products and ambulance transfers. Bootstrapped mean costs were derived for the Level 3 unit and the Level 2 units combined. Results:, The mean gestation period for 199 Level 3 babies was 29.5 weeks compared with 30.4 weeks for 192 Level 2 babies (p = 0.003). Mean costs excluding ambulance journeys were £17 861 per Level 3 baby and £12 344 per Level 2 baby. Level 3 babies <1000 g averaged £26 815, whereas Level 2 babies <1000 g were generally less costly than babies 1000,1499 g. Ambulances transported 76 Level 3 babies and 62 Level 2 babies; their adjusted mean costs were £18 495 and £12 881, respectively. Conclusion:, By comprehensively costing resource components, the magnitude of total costs for low-birthweight babies has been revealed, thus demonstrating the importance of budgets for neonatal units being realistically determined by commissioners of neonatal services. [source] Education for All: How Much Will It Cost?DEVELOPMENT AND CHANGE, Issue 1 2004Enrique Delamonica In 1990, a target of universal access to basic education by the year 2000 was set by two global conferences. Ten years later, however, it was clear that the target had not been met. Too many countries had made insufficient progress, and although many of the reasons for this inadequate progress were country-specific, one factor stood out in virtually all countries: inadequate public finance for primary education. In 2000, the Millennium Summit set a new target date for achieving ,education for all' of 2015. This article updates the global and regional cost estimates for reaching that target. The estimates are based on the most recent country-by-country data on budgetary expenditure, population and enrolment trends, and unit cost. The annual additional cost of achieving ,education for all' in developing countries by 2015 is estimated at US$ 9.1 billion. Although this is affordable at the global level, individual countries will need considerably more resources than are currently available. However, official development assistance (ODA) has been declining, and the share of ODA allocated to basic education has changed little over the past decade. Therefore, although affordable, the target of universal basic education by 2015 is likely to be missed, just as it was in 2000, without a major change both in ODA and national budgets. [source] The Costs of Childhood Epilepsy in Italy: Comparative Findings from Three Health Care SettingsEPILEPSIA, Issue 5 2001R. Guerrini Summary: ,Purpose: To determine the direct costs of epilepsy in a child neurology referral population, stratified by disease, duration, and severity, comparing three different health care settings [i.e., teaching or clinical research (CR) hospitals, general hospitals, and outpatient services]. Methods: Patients were accepted if they had confirmed epilepsy and were resident in the center catchment area. Eligible subjects were grouped in the following categories: (a) newly diagnosed patients; (b) patients with epilepsy in remission; (c) patients with active non,drug-resistant epilepsy; and (d) those with drug-resistant epilepsy. Over a 12-month period, data regarding the consuming of all resources (i.e., consultations, tests, hospital admissions, drugs), were collected for each patient. Using the Italian National Health Service tariffs, the unit cost of each resource was calculated and indicated in Euros, the European currency. Results: A total of 189 patients was enrolled by two teaching-CR hospitals, two general hospitals, and two outpatient services. The patients were evenly distributed across the four categories of epilepsy. The mean annual cost per person with epilepsy was 1,767 Euros. Drug-resistant epilepsy was the most expensive category (3,268 Euros) followed by newly diagnosed epilepsy (1,907 Euros), active non,drug-resistant epilepsy (1,112 Euros), and epilepsy in remission (844 Euros). Costs were generally highest in teaching-CR hospitals and lowest in outpatient services. Hospital services were the major cost in all epilepsy groups, followed by drugs. Conclusions: The cost of epilepsy in children and adolescents in Italy tends to vary significantly depending on the severity and duration of the disease Hospitals services and drugs are the major sources of costs. The setting of health care plays a significant role in the variation of the costs, even for patients in the same category of epilepsy. [source] The long-term average capacity region per unit cost with application to protocols for sensor networksEUROPEAN TRANSACTIONS ON TELECOMMUNICATIONS, Issue 1 2003Daniela Tuninetti We consider a wireless sensor network where K sensors must deliver their messages within a frame of N time slots by spending a given finite energy. If the messages are not transmitted within the required delay they become useless and the residual energy is wasted. The channel is block-fading, with independent fades for each sensor and each slot. Sensors know the fading levels up to the current slot, but do not know the future fading levels. The receiver collects the signal on all the slots of the frame and performs joint decoding of all the messages. We characterize the region of long-term average achievable rates and we show that the optimal policy tends to waterfilling in time (optimal policy without delay constraints) as N increases. In this setting, we also characterize the long-term average capacity region per unit energy by showing that the optimal policy is ,one-shot', totally decentralized and extremely simple, i.e., every user spends all its available energy on the first slot of the frame, the fading gain of which is larger than a pre-computed time-varying threshold. Furthermore, the ,one-shot' policy not only makes the most efficient use of the energy, but also reduces to the minimum the interference to other users as it makes all the users transmit with the minimum energy per bit required for reliable communications. These characteristics make the ,one-shot' policy appealing for systems with severe energy limitation as wireless sensor networks. Copyright © 2003 AEI [source] SEX-RATIO CONFLICT BETWEEN QUEENS AND WORKERS IN EUSOCIAL HYMENOPTERA: MECHANISMS, COSTS, AND THE EVOLUTION OF SPLIT COLONY SEX RATIOSEVOLUTION, Issue 12 2005Ken R. Helms Abstract Because workers in the eusocial Hymenoptera are more closely related to sisters than to brothers, theory predicts that natural selection should act on them to bias (change) sex allocation to favor reproductive females over males. However, selection should also act on queens to prevent worker bias. We use a simulation approach to analyze the coevolution of this conflict in colonies with single, once-mated queens. We assume that queens bias the primary (egg) sex ratio and workers bias the secondary (adult) sex ratio, both at some cost to colony productivity. Workers can bias either by eliminating males or by directly increasing female caste determination. Although variation among colonies in kin structure is absent, simulations often result in bimodal (split) colony sex ratios. This occurs because of the evolution of two alternative queen or two alternative worker biasing strategies, one that biases strongly and another that does not bias at all. Alternative strategies evolve because the mechanisms of biasing result in accelerating benefits per unit cost with increasing bias, resulting in greater fitness for strategies that bias more and bias less than the population equilibrium. Strategies biasing more gain from increased biasing efficiency whereas strategies biasing less gain from decreased biasing cost. Our study predicts that whether queens or workers evolve alternative strategies depends upon the mechanisms that workers use to bias the sex ratio, the relative cost of queen and worker biasing, and the rates at which queen and worker strategies evolve. Our study also predicts that population and colony level sex allocation, as well as colony productivity, will differ diagnostically according to whether queens or workers evolve alternative biasing strategies and according to what mechanism workers use to bias sex allocation. [source] Green Tax Reform and CompetitivenessGERMAN ECONOMIC REVIEW, Issue 1 2001Erkki Koskela This paper studies a revenue-neutral green tax reform that substitutes energy for wage taxes in an open economy with unemployment. As long as the labour tax rate exceeds the energy tax rate, such a reform will increase employment, reduce the domestic firms' unit cost of production and hence increase international competitiveness and output of the economy. The driving force behind these results is the technological substitution process that a green tax reform will bring about. The resulting reduction in unemployment is welfare increasing since energy, which the country has to buy at its true national opportunity cost, is replaced with labour, whose price is above its social opportunity cost. [source] Coding Response to a Case-Mix Measurement System Based on Multiple DiagnosesHEALTH SERVICES RESEARCH, Issue 4p1 2004Colin Preyra Objective. To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. Data Sources. Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. Study Design. Disaggregated trends in hospital case-mix growth are examined for five years following the adoption of an inpatient classification system making extensive use of combinations of secondary diagnoses. Hospital case mix is decomposed into base and complexity components. The longitudinal effects of coding variation on a standard hospital payment model are examined in terms of payment accuracy and impact on adjustment factors. Principal Findings. Introduction of the refined case-mix system provided incentives for hospitals to increase reporting of secondary diagnoses and resulted in growth in highest complexity cases that were not matched by increased resource use over time. Despite a pronounced coding response on the part of hospitals, the increase in measured complexity and case mix did not reduce the unexplained variation in hospital unit cost nor did it reduce the reliance on the teaching adjustment factor, a potential proxy for case mix. The main implication was changes in the size and distribution of predicted hospital operating costs. Conclusions. Jurisdictions introducing extensive refinements to standard diagnostic related group (DRG)-type payment systems should consider the effects of induced changes to hospital coding practices. Assessing model performance should include analysis of the robustness of classification systems to hospital-level variation in coding practices. Unanticipated coding effects imply that case-mix models hypothesized to perform well ex ante may not meet expectations ex post. [source] Cost structure of CGAM cogeneration systemINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 13 2004Ho-Young Kwak Abstract The cost structure of the CGAM system, a predefined cogeneration system suggested to unify the different methodologies of thermoeconomic analysis, was investigated by using a thermoeconomic method called modified productive structure analysis (MOPSA). An emphasis has been specially put on how the cost structure of the system is affected by the chosen level of aggregation that specifies the subsystems. It has been found that the unit cost of products is dependent on the chosen level of aggregation of the system only when one considers the entropy flow as one of the parameters to determine the unit cost of products. Copyright © 2004 John Wiley & Sons, Ltd. [source] Optimal manufacturer's pricing and lot-sizing policies under trade credit financingINTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 6 2006Jinn-Tsair Teng Abstract In this paper, we extend Goyal's economic order quantity (EOQ) model to allow for the following four important facts: (1) the manufacturer's selling price per unit is necessarily higher than its unit cost, (2) the interest rate charged by a bank is not necessarily higher than the manufacturer's investment return rate, (3) the demand rate is a downward-sloping function of the price, and (4) an economic production quantity (EPQ) model is a generalized EOQ model. We then establish an appropriate EPQ model accordingly, in which the manufacturer receives the supplier trade credit and provides the customer trade credit simultaneously. As a result, the proposed model is in a general framework that includes numerous previous models as special cases. Furthermore, we provide an easy-to-use closed-form optimal solution to the problem for any given price. Finally, we develop an algorithm for the manufacturer to determine its optimal price and lot size simultaneously. [source] The value of assessing weights in multi-criteria portfolio decision analysisJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 5-6 2008Jeffrey M. KeislerArticle first published online: 28 SEP 200 Abstract Analytic efforts in support of portfolio decisions can be applied with varying levels of intensity. To gain insight about how to match the effort to the situation, we simulate a portfolio of potential projects and compare portfolio performance under a range of analytic strategies. Each project is scored with respect to several attributes in a linear additive value model. Projects are ranked in order of value per unit cost and funded until the budget is exhausted. Assuming these weights and scores are correct, and the funding decisions made this way are optimal, this process is a gold standard against which to compare other decision processes. In particular, a baseline process would fund projects essentially at random, and we may estimate the value added by various decision processes above this worst case as a percentage of the increase arising from the optimal process. We consider several stylized decision rules and combinations of them: using equal weights, picking one attribute at random, assessing weights from a single randomly selected stakeholder. Simulation results are then used to identify which conditions tend to make which types of analytic strategies valuable, and to identify useful hybrid strategies. Copyright © 2009 John Wiley & Sons, Ltd. [source] Unit cost of Mohs and Dermasurgery UnitJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2010R Wanitphakdeedecha Abstract Background, Appropriate pricing for medical services of not-for-profit hospital is necessary. The prices should be fair to the public and should be high enough to cover the operative costs of the organization. Objective, The purpose of this study was to determine the cost and unit cost of medical services performed at the Mohs and Dermasurgery Unit (MDU), Department of Dermatology, The University of Texas , MD Anderson Cancer Center, Houston, TX from the healthcare provider's perspective. Methods, MDU costs were retrieved from the Financial Department for fiscal year 2006. The patients' statistics were acquired from medical records for the same period. Unit cost calculation was based on the official method of hospital accounting. Results, The overall unit cost for each patient visit was $673.99 United States dollar (USD). The detailed unit cost of nurse visit, new patient visit, follow-up visit, consultation, Mohs and non-Mohs procedure were, respectively, $368.27, $580.09, $477.82, $585.52, $1,086.12 and $858.23 USD. With respect to a Mohs visit, the unit cost per lesion and unit cost per stage were $867.89 and $242.30 USD respectively. Conclusions, Results from this retrospective study provide information that may be used for pricing strategy and resource allocation by the administrative board of MDU. [source] Acceptability, storage stability and costing of ,-amylase-treated maize,beans,groundnuts,bambaranuts complementary blendJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 6 2007Victor O Owino Abstract The effects of ,-amylase treatment on physical properties, acceptability to mothers, and cost of roasted and extruded maize,beans,groundnuts,bambaranuts complementary porridge recipes were assessed prior to their industrial production. Storage stability of the extruded ,-amylase-treated fortified blend was assessed at 2 weeks and 6 months by sensory evaluation, peroxide value, water activity and microbiological load. The use of ,-amylase at 0.04% w/w enhanced porridge acceptability and resulted in 88% and 122% increase in flour concentration for roasted and extrusion-cooked porridge flour, respectively, while maintaining porridge viscosity at 1000-fold lower than that of traditionally used porridges. The extrusion cooked blend was stable for 6 months. ,-Amylase application increased the unit cost of the developed blend by only 1.4%. The total cost was less than US $ 2 kg,1, half the minimum price of commercially available complementary foods. Further work on marketing and the efficacy of this inexpensive food on growth of infants is warranted. Copyright © 2007 Society of Chemical Industry [source] Size Economies of a Pacific Threadfin Polydactylus sexfilis Hatchery in HawaiiJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 4 2002Lotus E. Kam A spreadsheet model has been developed to determine the viable scale for a commercial Pacific threadfin Polydactylus sexfilis hatchery in Hawaii. The production scheme is modeled after current practices performed at the Oceanic Institute in Waimanalo, Hawaii. For a hatchery enterprise producing 1.2 million fry per year, the cost associated with raising one 40-d-old 1.00-g fry is estimated at 22.01ø. The largest variable costs are in labor and supplies, which comprise 49% and 9% of the total production cost. The combined annualized fixed cost for development and equipment is approximately 12% of total production cost. At a sale price of 25ø per fry, the 20-yr internal rate of return (IRR) is 30.63%. In comparison to the 22.01ø unit cost for 1.2 million fry production, analyses of smaller enterprises producing 900,000 and 600,000 fry per year reflected significant size diseconomies with unit costs of 27.41ø and 38.82ø, respectively. Demand to support a large scale Pacific threadfin commercial hatchery is uncertain. Since smaller scale commercial hatcheries may not be economically feasible, facilities may seek to outsource live feed production modules or pursue multiproduct and multiphase approaches to production. An analysis of the production period length, for example, indicates that the cost for producing a day-25 0.05-g fry is 17.25ø before tax and suggests the financial implications of transferring the responsibility of the nursery stage to grow-out farmers. Evaluation of the benefits gained from changes in nursery length, however, must also consider changes in facility requirements, mortality, and shipping costs associated with transit, and the growout performance of and market demand for different size fry. Sensitivity analyses also indicate the potential cost savings associated with the elimination of rotifer, microalgae, and enriched artemia production. Managerial decisions, however, must also consider the quality and associated production efficiencies of substitutes. [source] An Integrated Framework for Measuring Product Development Performance in High Technology IndustriesPRODUCTION AND OPERATIONS MANAGEMENT, Issue 2 2005Debasish N. Mallick We present an integrated framework for measuring product development performance. The framework consists of a three stage model for exploring the relationships between metrics used by design, manufacturing, marketing functions, and overall commercial success. Using a cross-sectional survey of 383 product development professionals working on 38 product development projects in the high-tech electronic assembled goods manufacturing sector, we provide empirical evidence of the proposed framework. The findings indicate that in the high-tech manufacturing sector (1) commercial success of new product development projects is primarily determined by market share, (2) gain in market share is primarily driven by lower unit cost and not by technical performance, and (3) reduction in unit cost is primarily driven by the increased speed of new product development and not by the R&D budget. The study failed to identify any significant association between R&D budget and technical performance, and development speed and technical performance. [source] Value-chain innovation in aquaculture: insights from a New Zealand case studyR & D MANAGEMENT, Issue 4 2006Jayaram K. Sankaran We report a case study of value-chain innovation in a niche, export-oriented aquaculture industry, namely, Chinook/King salmon, that contrasts with the much more common Atlantic/Norwegian salmon. The firm in question is vertically integrated, thus offering a ,cradle-to-grave' vista of innovation that spans ,production' (i.e. farming), processing, marketing, and distribution. A major finding is the need for a delicate balance between the relative expenditures on production research and developmental research in integrated aquaculture firms, especially those that focus on niche species. Interaction effects between the two research strands complicate the trade-off: production research adds value at the fish farm by lowering the unit cost of production , and in turn facilitates new product development as it is easier to add value to a lower-cost product than a higher-cost product. From the case study findings, we synthesize a process model of value-chain innovation that is applicable for integrated aquaculture firms. We also induce several implications for the management of Research & Development and innovation in such firms. [source] Efficient versus Responsive Supply Chain Choice: An Empirical Examination of Influential FactorsTHE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 6 2003Taylor R. Randall Contemporary strategies in operations management suggest that successful firms align supply chain assets with product demand characteristics in order to exploit the profit potential of product lines fully. However, observation suggests that supply chain assets often are longer lived than product line decisions. This suggests that alignment between supply chain assets and demand characteristics is most likely to occur at the time of initial market entry. This article examines the association between product demand characteristics and the initial investment in a supply chain at the time of market entry. We characterize supply chains as responsive or efficient. A responsive supply chain is distinguished by short production lead-times, low set-up costs, and small batch sizes that allow the responsive firm to adapt quickly to market demand, but often at a higher unit cost. An efficient supply chain is distinguished by longer production lead-times, high set-up costs, and larger batch sizes that allow the efficient firm to produce at a low unit cost, but often at the expense of market responsiveness. We hypothesize that a firm's choice of responsive supply chain will be associated with lower industry growth rates, higher contribution margins, higher product variety, and higher demand or technological uncertainty. We further hypothesize that interactions among these variables either can reinforce or can temper the main effects. We report that lower industry growth rates are associated with responsive market entry, but this effect is offset if growth occurs during periods of high variety and high demand uncertainty. We report that higher contribution margins are associated with responsive market entry and that this effect is more pronounced when occurring with periods of high variety. Finally, we report that responsive market entry also is correlated positively with higher technological demand uncertainty. These results are found using data from the North American mountain bike industry. [source] Cost-effectiveness of different caries preventive measures in a high-risk population of Swedish adolescentsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2003N. Oscarson Abstract , Objectives: A total of 3373 12-year-olds agreed to participate in an intervention study evaluating different caries preventive measures. The study, titled ,Evaluation of caries preventive measures', was performed between 1995 and 1999 at 26 dental health clinics throughout Sweden. At the start of the study, the subjects were classified as individuals at high or low risk of developing caries. The high-risk group consisted of 1165 subjects. The children in the high-risk group were randomly assigned to one of four preventive programs. The programs represent a step-wise increase in fluoride content, contact with dental personnel and cost. The aim of the present cost-effectiveness analysis (CEA) study performed from a societal perspective is to compare costs and consequences of caries preventive programs in a caries high-risk population. By ,costs' is meant both treatment costs and costs contributed by the patient and the patient's family. Costs contributed by patients and their families consist of out-of-pocket expenses, transportation costs, and time. Conclusions are that it is important to consider the perspective from which a study is carried out. Costs contributed by the patient and the patient's family have a high impact on total costs for children and younger adolescents but decrease with time as the adolescents get older. The present study shows an incremental cost-effectiveness of 2043 SEK (8.54 SEK = US$ 1, December 1999) per averted decayed enamel and dentine missing and filled surface (DeMFS), of which treatment costs represent 1337 SEK using the unit cost for a nurse. This means a yearly cost of approximately 334 SEK. [source] Employer burden of mild, moderate, and severe major depressive disorder: mental health services utilization and costs, and work performance,DEPRESSION AND ANXIETY, Issue 1 2010Howard G. Birnbaum Ph.D. Abstract Background: Treatment utilization/costs and work performance for persons with major depressive disorder (MDD) by severity of illness is not well documented. Methods: Using National Comorbidity Survey-Replication (2001,2002) data, US workforce respondents (n=4,465) were classified by clinical severity (not clinically depressed, mild, moderate, severe) using a standard self-rating scale [Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR)]. Outcomes included 12-month prevalence of medical services/medications use/costs and workplace performance. Treatment costs (employer's perspective) were estimated by weighing utilization measures by unit costs obtained for similar services used by MDD patients in claims data. Descriptive analysis across three severity groups generated ,2 results. Results: Using a sample of 539 US workforce respondents with MDD, 13.8% were classified mild, 38.5% moderate, and 47.7% severe cases. Mental health services usage, including antidepressants, increased significantly with severity, with average treatment costs substantially higher for severe than for mild cases both regarding mental health services ($697 vs. $388, ,2=4.4, P=.019) and antidepressants ($256 vs. $88, ,2=9.0, P=.001). Prevalence rates of unemployment/disability increased significantly (,2=11.7, P=.003) with MDD severity (15.7, 23.3, and 31.3% for mild, moderate, and severe cases). Severely and moderately depressed workers missed more work than nondepressed workers; the monthly salary-equivalent lost performance of $199 (severely depressed) and $188 (moderately depressed) was significantly higher than for nondepressed workers (,2=10.3, P<.001). Projected to the US workforce, monthly depression-related worker productivity losses had human capital costs of nearly $2 billion. Conclusions: MDD severity is significantly associated with increased treatment usage/costs, treatment adequacy, unemployment, and disability and with reduced work performance. Depression and Anxiety, 2010. © 2009 Wiley-Liss, Inc. [source] A Model of Inequality and Interest Group PoliticsECONOMICS & POLITICS, Issue 2 2001Inderjit Kohli In this paper we examine inequality of process and inequality of outcomes in interest group politics. The model has interest groups that compete for rents in a non-cooperative game. It allows for a self-interested rent-setting political decision-maker, and democratic or popular pressure as a check on that self-interest. We consider differences in the effectiveness and pre-commitment abilities of interest groups. We show that: (i) the costs of influence activities may be highest when groups are relatively equal in their effectiveness; (ii) if social welfare incorporates enough concern for equity of outcomes, that ranking is reversed; (iii) depending on voter responsiveness to rent-setting, the political decision-maker may set rents to be higher or lower, when increases in inequality of effectiveness lower the unit costs of rent-seeking. [source] Health economics of treating haemophilia A with inhibitorsHAEMOPHILIA, Issue 2005C. KNIGHT Summary., Haemophilia is a rare, inherited blood disorder in which blood clotting is impaired such that patients suffer from excessive internal and external bleeding. At present there is no cure for haemophilia A and patients require expensive, life-long treatment involving clotting factor replacement therapy. Treatment costs are perceived to be higher for patients who have developed inhibitory antibodies to factor VIII, the standard therapy for haemophilia A. However, initial cost analyses suggest that clotting factor therapy with alternative haemostatic agents, such as recombinant activated factor VII or activated prothrombin complex concentrate, is no more expensive for the majority of haemophilia A patients with inhibitors than for those without inhibitors. With the availability of effective alternative haemostatic agents, orthopaedic surgery for haemophilia A patients with inhibitors is now a clinical option, and initial cost analyses suggest this may be a cost-effective treatment strategy for patients with inhibitors whose quality of life (QoL) is severely impaired by joint arthropathy. In an era of finite healthcare resourcing it is important to determine whether new treatments justify higher unit costs compared with standard therapies and whether such higher costs are justified from an individual perspective in terms of improved QoL, and from a societal perspective in terms of improved productivity and reduced overall healthcare costs. This paper examines current data on the health economics of treating haemophilia A patients with inhibitors, focusing on the overall costs of clotting factor replacement therapy and the cost consequences of joint replacement. [source] The hospital costs of care for stroke in nine European countriesHEALTH ECONOMICS, Issue S1 2008David Epstein Abstract Stroke is a major cause of mortality and morbidity, but the reasons for differences in costs of care within and between countries are not well understood. The HealthBASKET project used a vignette methodology to compare the mean costs and prices of hospital care across providers in nine European Union countries. Data on resource use, unit costs and prices of care for female stroke patients without co-morbidity were collected from a sample of 50 hospitals. Mean costs for each provider were analysed using multiple regression. Sensitivity analysis explored the effects on cost of using official exchange rates, purchasing power parity (PPP) and proportion of national income per capita. The mean cost of a hospital episode per patient for stroke at PPP was ,3813 (standard error 227) with an additional day in hospital typically associated with 6.9% (95% CI: 4,9%) higher costs and thrombolysis associated with 41% higher costs (10,73%). After adjusting for explanatory factors, about 76% of the variation in cost could be attributed to between-country differences, and the extent of this variation was sensitive to the method of currency conversion. There was considerable variation in the care pathways within and between countries, including differences in the availability of stroke units and access to rehabilitative services, but only the length of stay and use of thrombolytic therapy were significantly associated with higher cost. The vignette methodology appears feasible, but further research needs to consider access to healthcare over a longer follow up and to include both costs and outcomes. Copyright © 2008 John Wiley & Sons, Ltd. [source] International competition and pay, working time and employment: exploring the processes of adjustmentINDUSTRIAL RELATIONS JOURNAL, Issue 2 2001James Arrowsmith The internationalisation of markets, competition and regulation is increasingly recognised. So far, however, debate about the effects has been largely speculative. This article examines the UK engineering industry. Survey evidence suggests that international comparisons are relatively unimportant, little benchmarking is going on and that stability characterises pay and working time arrangements. Further interview evidence explains that this is because pay and working time are set with employee expectations in mind, whereas it is the treatment of unit costs that reflects international pressures. As a consequence there has been substantial reductions in employment as well as some important changes in work organisation, even if there has been little change in pay or working time systems. In effect, it suggests that there is a form of ,implicit contract' taking place. A wider implication is that the main impetus for the ,Europeanisation' of industrial relations is likely to come from the growing convergence of costs rather than pressures for wage parity. [source] The economic costs of dementia in Korea, 2002INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2006Guk-Hee Suh Abstract Objective To estimate the economic costs of dementia in 2002 using an economic evaluation model for dementia care. Methods Data were from the Korea National Survey of the Long-Term Care Need (LTC survey) (n,=,5058), two prospective 1-year studies [one clinical trial (n,=,234), one naturalistic community cohort study (n,=,107)], and two epidemiologic community studies for prevalence of dementia (n,=,1037,+,1481). Daily costs and proportions of different levels of institutional service provided were collected from the LTC survey. Resource use in the community included health care services, social care services, out-of-pocket purchase for self-support, caregiver time and missed work of caregiver. Costs in community were calculated based on resource utilization multiplied by the unit costs for each resource. Results Total annual costs of dementia were estimated to be over 2.4 billion US$ for 272,000 dementia sufferers. Costs in community represent 96% of the total annual costs, while costs of informal care and missed work of caregivers were 1.3 billion US$, or 55% of total annual cost. Average annual costs of full time care (FTC) and pre-FTC in community LTC were 44,121 US$ and 13,273 US$ per person, whereas cost per patient who did not need community LTC was 3986 US$. Conclusion Given that the number of dementia sufferers is projected to increase in the near future and that larger part of the costs are subsidized by the government, the economic and social costs of dementia is significant not only for dementia sufferers and their caregivers, but also for society. Copyright © 2006 John Wiley & Sons, Ltd. [source] Application of activity-based costing (ABC) for a Peruvian NGO healthcare providerINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2001Dr. Hugh Waters Abstract This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries. Copyright © 2001 John Wiley & Sons, Ltd. [source] Size Economies of a Pacific Threadfin Polydactylus sexfilis Hatchery in HawaiiJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 4 2002Lotus E. Kam A spreadsheet model has been developed to determine the viable scale for a commercial Pacific threadfin Polydactylus sexfilis hatchery in Hawaii. The production scheme is modeled after current practices performed at the Oceanic Institute in Waimanalo, Hawaii. For a hatchery enterprise producing 1.2 million fry per year, the cost associated with raising one 40-d-old 1.00-g fry is estimated at 22.01ø. The largest variable costs are in labor and supplies, which comprise 49% and 9% of the total production cost. The combined annualized fixed cost for development and equipment is approximately 12% of total production cost. At a sale price of 25ø per fry, the 20-yr internal rate of return (IRR) is 30.63%. In comparison to the 22.01ø unit cost for 1.2 million fry production, analyses of smaller enterprises producing 900,000 and 600,000 fry per year reflected significant size diseconomies with unit costs of 27.41ø and 38.82ø, respectively. Demand to support a large scale Pacific threadfin commercial hatchery is uncertain. Since smaller scale commercial hatcheries may not be economically feasible, facilities may seek to outsource live feed production modules or pursue multiproduct and multiphase approaches to production. An analysis of the production period length, for example, indicates that the cost for producing a day-25 0.05-g fry is 17.25ø before tax and suggests the financial implications of transferring the responsibility of the nursery stage to grow-out farmers. Evaluation of the benefits gained from changes in nursery length, however, must also consider changes in facility requirements, mortality, and shipping costs associated with transit, and the growout performance of and market demand for different size fry. Sensitivity analyses also indicate the potential cost savings associated with the elimination of rotifer, microalgae, and enriched artemia production. Managerial decisions, however, must also consider the quality and associated production efficiencies of substitutes. [source] Information security: Designing a stochastic-network for throughput and reliability,,NAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 7 2009Jeffrey Schavland Abstract Todas information and communication network requires a design that is secure to tampering. Traditional performance measures of reliability and throughput must be supplemented with measures of security. Recognition of an adversary who can inflict damage leads toward a game-theoretic model. Through such a formulation, guidelines for network designs and improvements are derived. We opt for a design that is most robust to withstand both natural degradation and adversarial attacks. Extensive computational experience with such a model suggests that a Nash-equilibrium design exists that can withstand the worst possible damage. Most important, the equilibrium is value-free in that it is stable irrespective of the unit costs associated with reliability vs. capacity improvement and how one wishes to trade between throughput and reliability. This finding helps to pinpoint the most critical components in network design. From a policy standpoint, the model also allows the monetary value of information-security to be imputed. © 2009 Wiley Periodicals, Inc. Naval Research Logistics, 2009 [source] Inventory policies for a make-to-order system with a perishable component and fixed ordering costNAVAL RESEARCH LOGISTICS: AN INTERNATIONAL JOURNAL, Issue 2 2009Katia C. Frank Abstract We consider a make-to-order production system where two major components, one nonperishable (referred to as part 1) and one perishable (part 2), are needed to fulfill a customer order. In each period, replenishment decisions for both parts need to be made jointly before demand is realized and a fixed ordering cost is incurred for the nonperishable part. We show that a simple (sn,S,S) policy is optimal. Under this policy, S along with the number of backorders at the beginning of a period if any and the availability of the nonperishable part (part 1) determines the optimal order quantity of the perishable part (part 2), while (sn,S) guide when and how much of part 1 to order at each state. Numerical study demonstrates that the benefits of using the joint replenishment policy can be substantial, especially when the unit costs are high and/or the profit margin is low. © 2009 Wiley Periodicals, Inc. Naval Research Logistics, 2009 [source] | |||||||||||||||||||