Actual Cost Research Articles

Infective Versus Non-Infective Respiratory Illness Admissions: Comparative cost analysis in a tertiary hospital in Malaysia

Background: Severe Acute Respiratory Infection (SARI) that is mainly caused by the Influenza virus, poses a significant public health threat, demanding timely detection and preventive measures. This study assesses the financial implications of managing two distinct respiratory conditions: SARI and Acute Exacerbation of Bronchial Asthma (AEBA). Method: Data were collected for 100 patients, with 50 cases of SARI and 50 cases of AEBA, admitted to Hospital Canselor Tuanku Muhriz (HCTM) from July to December 2022. Cost analysis was conducted from a provider perspective, considering factors such as building, asset, emolument, overhead, utility, medication, consumables, and laboratory and imaging expenses. Results: The study revealed that the average total cost of treating SARI patients was RM 1,587.11 ($US334.80), significantly higher (30.7%) than AEBA patients at RM 1,214.41 ($US256.18).This was mainly due to the acute and severe nature of SARI, requiring more intensive medical interventions, potentially leading to complications and greater strain on healthcare resources. The study highlighted the economic challenges posed by SARI, provided valuable insights for resource allocation and public health planning. The study's limitations include retrospective data collection and potential underestimation of actual costs due to top-down costing methodology. Conclusion: SARI, especially in the elderly population, leads to substantial healthcare costs and economic impact. Effective preventive measures, such as vaccination, are crucial in reducing the burden of influenza-related illnesses. Health financing plays a vital role in addressing communicable diseases and ensuring the well-being of the population.

Out-of-Pocket Cost Modeling of Adjuvant Antiestrogen and Radiation Therapy After Lumpectomy for Early-Stage Breast Cancer Across Medicaid and Medicare Plans

The optimal adjuvant therapy (antiestrogen therapy [ET] + radiation therapy or ET alone, or in some reports radiation therapy alone) in older women with early-stage breast cancer has been highly debated. However, granular details on the role of insurance in the out-of-pocket cost for patients receiving ET with or without radiation therapy are lacking. This project disaggregates out-of-pocket costs by insurance plans to increase treatment cost transparency. Several radiation therapy schedules are accepted standards as per the National Comprehensive Cancer Network guidelines. For our financial estimate model, we used the 5-fraction and 15-fraction radiation therapy and ET prescribed over a 5-year duration. The total aggregate out-of-pocket costs were determined from the sum of treatment costs, deductibles, and copays/coinsurance based on Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D Rx plans. The model assumes a Medicare- and/or Medicaid-eligible patient ≥70 years of age with node-negative, early-stage estrogen-receptor-positive breast cancer. Patient out-of-pocket costs were estimated from publicly available insurance data from plan-specific benefit coverage materials using a 5-year time horizon. Original Medicare beneficiaries face a total out-of-pocket treatment charge of $2738.52 for ET alone, $2221.26 for 5-fraction radiation therapy alone, $2573.92 for 15-fraction radiation therapy alone, $3361.26 for combined ET+ 5-fraction radiation therapy, and $3713.92 for combined ET + 15-fraction radiation therapy. Medigap Plan G beneficiaries have an out-of-pocket charge of $1130.00 with radiation therapy alone and face an out-of-pocket of $2270.00 for ET alone and combined ET+ radiation therapy. For Medicaid beneficiaries, all treatments approved by Medicaid are covered without limit, resulting in no out-of-pocket expense for either adjuvant treatment option. This model (based on actual cost estimates per insurance plan rather than claims data), by estimating expenses within Medicare and Medicaid plans, provides a level of transparency to patient cost. With knowledge of the costs borne by patients themselves, treatment decisions informed by patients' individual priorities and preferences may be further enhanced.

Mathematical model in the optimization of the cost of heavy agricultural cargo transportation

This work aimed to design a mathematical model to optimize the cost of heavy agricultural load transport using linear programming. The model was based on studying fixed and variable costs, including distance, cargo volume, arrival and departure times, lubricants, fuels, and other variables that influence transport pricing. The work had a quantitative approach, descriptive type, and its design of the non-experimental character with a cross-section. The methods were used, inductive, deductive, and systemic. For the collection of information, the survey was used as a technique and the questionnaire as an instrument, evidencing that most carriers do not know the calculation of the actual cost of transport, thus visualizing the need for a mathematical model in cost optimization, an achievement validated in the WINQSB program (Network Modeling Module).

AREA BASE OF COST ESTIMATION FOR BUILDING CONSTRUCTION PROJECTS USING AN ARTIFICIAL NEURAL NETWORK

Managers of projects monitor the project schedule and compare planning values with the actual cost into the project and how much of it is earned value. One of success methods for managing the construction projects is to find the effective cost factors and investigate the correlations between them. In order to determine the discrepancies, the Execution Phase performance measures are compared to the baseline metrics decided upon in the Planning Phase. The significance of these deviations is assessed by factoring them into the control methods at every stage. For that, the present paper developed an ANN technique for project management to monitor the cost of project based on the correlation between the project size and the project cite area within the implementation process. The contribution in this paper is to present a project planning cost mimic the real actual cost. Modifications to the project can be monitored using this method, which takes into account both the nature of the work being done and the time frame during which it is being performed. To gauge the system's efficacy, the ANN system was applied to structural concrete and building walls. The system's final output demonstrated a straightforward and reliable method of tracking and observing progress.

SYSTEM OF COST INDICATORS FOR ANALOGOUS OBJECTS

The military aggression of the Russian Federation in Ukraine has resulted in a significant number of damaged and destroyed buildings and structures. The challenge of determining the extent of material losses and damage, within tight timelines and under the conditions of active combat in the country, becomes more pressing than ever. To restore normal life in areas that were under occupation or in conflict zones, a series of tasks must be undertaken, including the initial assessment of the extent of destruction, conducting surveys of damaged buildings, and subsequently determining the corresponding requirements for the restoration of real estate. The purpose of the work. To demonstrate the feasibility and appropriateness of applying the Handbook System of cost indicators for analogous objects to determine the reproduction cost (replacement) of objects, with the aim of assessing damages and determining the needs for the restoration of real estate. The Handbook System of cost indicators is developed based on actual cost indicators of analogous objects and consolidated cost estimates or consolidated indicators of construction costs (types of work, structural elements, etc.), adjusted to current price levels. This involves analyzing all possible sources containing accumulated cost information from project and estimate documentation, determining necessary corrective coefficients, and developing models to ascertain the cost of all types of real estate, including specialized properties. Methodology. The statistical analysis methodology was employed, specifically using the method of grouping and consolidating indicators to assess the costs of restoring residential real estate in one of the districts of Dnipro city. This involves the application of the developed Handbook System of cost indicators for analogous objects, determining the structure of the real estate object as a construction object in a two-dimensional system of physical/cost indicators. Scientific novelty. A model for determining restoration costs using the Handbook System of cost indicators for analogous objects has been developed and implemented in the Sobornyi district of Dnipro city. Practical significance. The determination of the structure of any real estate object in the system of physical/cost indicators, based on the results of using the Handbook System of cost indicators for analogous objects, addresses a range of crucial economic, managerial, and legal issues. Specifically, it opens the way for the application of rapid screening of investment projects, assessment of actual damages, standardized and analytical damage assessments. This contributes to making effective managerial decisions in the country's recovery process, ensuring the efficient use of resources in society, and can be applied for other purposes in case of open access to this information, following the experience of leading countries worldwide. Results. A Handbook System of cost indicators for analogous objects has been developed and tested to determine the reproduction cost (replacement) of objects, aiming to assess damages and needs for the restoration of real estate. The results obtained from testing the Handbook System provide grounds for practical application, enabling the acquisition of logically comprehensible outcomes. It can be implemented not only for determining the needs for the restoration of real estate and assessing damages but also for various other purposes.

Estimating the costs and perceived benefits of oral pre-exposure prophylaxis (PrEP) delivery in ten counties of Kenya: a costing and a contingent valuation study.

Kenya included oral PrEP in the national guidelines as part of combination HIV prevention, and subsequently began providing PrEP to individuals who are at elevated risk of HIV infection in 2017. However, as scale-up continued, there was a recognized gap in knowledge on the cost of delivering oral PrEP. This gap limited the ability of the Government of Kenya to budget for its PrEP scale-up and to evaluate PrEP relative to other HIV prevention strategies. The following study calculated the actual costs of oral PrEP scale-up as it was being delivered in ten counties in Kenya. This costing also allowed for a comparison of various models of service delivery in different geographic regions from the perspective of service providers in Kenya. In addition, the analysis was also conducted to understand factors that indicate why some individuals place a greater value on PrEP than others, using a contingent valuation technique. Data collection was completed between November 2017 and September 2018. Costing data was collected from 44 Kenyan health facilities, consisting of 23 public facilities, 5 private facilities and 16 drop-in centers (DICEs) through a cross-sectional survey in ten counties. Financial and programmatic data were collected from financial and asset records and through interviewer administered questionnaires. The costs associated with PrEP provision were calculated using an ingredients-based costing approach which involved identification and costing of all the economic inputs (both direct and indirect) used in PrEP service delivery. In addition, a contingent valuation study was conducted at the same 44 facilities to understand factors that reveal why some individuals place a greater value on PrEP than others. Interviews were conducted with 2,258 individuals (1,940 current PrEP clients and 318 non-PrEP clients). A contingent valuation method using a "payment card approach" was used to determine the maximum willingness to pay (WTP) of respondents regarding obtaining access to oral PrEP services. The weighted cost of providing PrEP was $253 per person year, ranging from $217 at health centers to $283 at dispensaries. Drop-in centers (DICEs), which served about two-thirds of the client volume at surveyed facilities, had a unit cost of $276. The unit cost was highest for facilities targeting MSM ($355), while it was lowest for those targeting FSW ($248). The unit cost for facilities targeting AGYW was $323 per person year. The largest percentage of costs were attributable to personnel (58.5%), followed by the cost of drugs, which represented 25% of all costs. The median WTP for PrEP was $2 per month (mean was $4.07 per month). This covers only one-third of the monthly cost of the medication (approximately $6 per month) and less than 10% of the full cost of delivering PrEP ($21 per month). A sizable proportion of current clients (27%) were unwilling to pay anything for PrEP. Certain populations put a higher value on PrEP services, including: FSW and MSM, Muslims, individuals with higher education, persons between the ages of 20 and 35, and households with a higher income and expenditures. This is the most recent and comprehensive study on the cost of PrEP delivery in Kenya. These results will be used in determining resource requirements and for resource mobilization to facilitate sustainable PrEP scale-up in Kenya and beyond. This contingent valuation study does have important implications for Kenya's PrEP program. First, it indicates that some populations are more motivated to adopt oral PrEP, as indicated by their higher WTP for the service. MSM and FSW, for example, placed a higher value on PrEP than AGYW. Higher educated individuals, in turn, put a much higher value on PrEP than those with less education (which may also reflect the higher "ability to pay" among those with more education). This suggests that any attempt to increase demand or improve PrEP continuation should consider these differences in client populations. Cost recovery from existing PrEP clients would have potentially negative consequences for uptake and continuation.

Validation of a Costing Algorithm and Cost Drivers for Neonates Admitted to the Neonatal Intensive Care Unit.

Neonatal intensive care units (NICUs) account for over 35% of pediatric in-hospital costs. A better understanding of NICU expenditures may help identify areas of improvements. This study aimed to validate the Canadian Neonatal Network (CNN) costing algorithm for seven case-mix groups with actual costs incurred in a tertiary NICU and explore drivers of cost. A retrospective cohort study of infants admitted within 24 hours of birth to a Level-3 NICU from 2016 to 2019. Patient data and predicted costs were obtained from the CNN database and were compared to actual obtained from the hospital accounting system (Coût par Parcours de Soins et de Services). Cost estimates (adjusted to 2017 Canadian Dollars) were compared using Spearman correlation coefficient (rho). Among 1,795 infants included, 169 (9%) had major congenital anomalies, 164 (9%) with <29 weeks' gestational age (GA), 189 (11%) with 29 to 32 weeks' GA, and 452 (25%) with 33 to 36 weeks' GA. The rest were term infants: 86 (5%) with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia, 194 (11%) requiring respiratory support, and 541 (30%) admitted for other reasons. Median total NICU costs varied from $6,267 (term infants admitted for other reasons) to $211,103 (infants born with <29 weeks' GA). Median daily costs ranged from $1,613 to $2,238. Predicted costs correlated with actual costs across all case-mix groups (rho range 0.78-0.98, p < 0.01) with physician and nursing representing the largest proportion of total costs (65-82%). The CNN algorithm accurately predicts NICU total costs for seven case-mix groups. Personnel costs account for three-fourths of in-hospital total costs of all infants in the NICU. · Very preterm infants born below 33 weeks of gestation account for most of NICU resource use.. · Human resources providing direct patient care represented the largest portion of costs.. · The algorithm strongly predicted total costs for all case-mix groups..

Goods in wholesalers: Valuation at recognition, accounting considerations

Subject. This article deals with the issues of formation of the actual cost of goods when they are purchased in wholesale trade organizations. Objectives. The article aims to substantiate the method of formation of the actual cost of purchased goods of wholesale organizations, consider options for reflecting its components in the accounts, and highlight controversial issues in the valuation of goods when they are recognized. Methods. For the study, we used the methods of comparative analysis, content analysis, systematization, analogy, and generalization. Results. According to Federal Accounting Standard FSBU 5/2019 – Inventories, if goods are recognized in the accounting of a wholesale organization, there is a variability in the understanding of the actual cost. The article finds that the choice of components of the actual cost of purchased goods has a direct impact on many aspects of accounting. The article systematizes the methods of reflecting the received goods in accounting depending on the method of valuation, and formulates the peculiarities of their application. An analysis of regulatory documents shows that the procedure for calculating the write-off of deviations for goods has not been established yet. Conclusions and Relevance. Based on international practices, FAS FSBU 5/2019 – Inventories helps exercise professional judgment of an accountant in matters of valuation of goods of wholesale organizations upon recognition. The results obtained can be used both in theory and practice of reflecting commodity operations of wholesale organizations.

On the Importance of Service Parts When Taking Commonality and Reliability Decisions

Competitive Original Equipment Manufacturers (OEMs) do not only sell equipment, but also provide service contracts that ensure proper functioning and uptime of equipment after the sale. This makes OEMs responsible for a large part of an equipment’s life cycle. Therefore, OEMs aim to minimize the total life cycle costs of their equipment, in particular by commonality and reliability level decisions during the design phase. We consider these decisions for one component occurring in a family of systems. The commonality decision is about choosing a common component or dedicated components for the systems. The life cycle costs consist of design and production costs of all components, repair costs, inventory holding costs of service parts, and logistic downtime costs (i.e., downtime costs due to insufficient spare parts inventory). At many OEMs, the design department tends to exclude service parts considerations for the commonality and reliability level decisions. Excluding service parts leads to a simpler decision model, however, this may lead to non–optimal decisions. We compare two approaches for the commonality and reliability decisions: the anticipating approach, which includes inventory holding costs of service parts and logistic downtime costs, and the nonanticipating approach, which excludes these costs. Since the cost function under the anticipating approach is intractable, we first derive a cost function that approximates the actual costs via an asymptotic analysis. Next, we show that the anticipating approach selects the common component more frequently in comparison with the nonanticipating approach. For many problem instances, the nonanticipating approach leads to decisions that have a much higher overall cost than using the anticipating approach. The relative cost difference can become arbitrarily large when the family of systems consists of many systems. Funding: J. Driessen was funded by the Netherlands Organisation for Scientific Research [Grant 407-12-001].

Penetapan Biaya Standar Sebagai Pengendalian Biaya Produksi Pada Avos Coffee And Resto Medan

Avos Coffee and Resto Medan produces 1,000 cups of coffee every day with a predetermined sales target. However, this target is difficult to achieve and uncontrolled production costs can reduce profits, so control is needed. The aim of this research is to analyze the application of standard costs to control production costs at Avos Coffee and Resto Medan. This research is a descriptive qualitative research using data on actual production costs and standard production costs with one difference model deviation analysis calculations. Data collection techniques using observation, interviews and documentation. The results of this research show that the implementation of standard costs that has been carried out at Avos Coffee and Resto Medan is not optimal, this is because the main indicators are raw material costs, direct labor costs and factory overhead costs which are quite optimal. However, there were adverse deviations in raw material costs caused by price increases in December, causing them to be less than optimal, while direct labor costs and factory overhead costs were in a fairly optimal condition. Even though it is not optimal and there are many obstacles experienced, Avos Coffee and Resto Medan is able to maintain its business and continue producing. So by implementing these standard costs, Avos Coffee and Resto Medan can maintain its consistency and become better in the future.

Empirical Analysis of Mining Costs Amid Energy Price Volatility for Secondary Deposits in Quarrying

The outlined methodology for calculating operating costs in open-cast mines and quarries not only facilitates the selection of optimal mining equipment and systems for working lower-grade secondary deposits but also adds significant value in navigating the challenges of fluctuating prices of energy carriers and fuels. Moreover, the study rigorously assesses the impact of mining operations on the performance of deployed mining equipment and the overall viability of the rock mining project. The selection procedure relies on a comprehensive analysis of the technical and economic parameters of selected solutions, providing critical insights to guide decisions regarding the continuation or discontinuation of mining operations. We analyse, based on empirical data, the technical and economic parameters of several variants of mining equipment to be used for the extraction of rocks and stones from secondary deposits in conditions of fluctuation depending on the level of energy prices, in order to find the best configuration in terms of operating costs and potential revenue. In addition to analysing the structure of operating costs, the article presents their correlation with the required profit from the sale of raw materials using the linear correlation method. The results clearly demonstrate the economic viability of mining secondary deposits, taking into account the actual costs incurred by mining companies.

Abstract WP86: Data Collection Impacts on Study Costs: A Real-World Analysis

Introduction: Costs are a major barrier to conducting high-quality clinical trials, yet specific determinants of operational costs are understudied. Budgets are frequently planned assuming additional data fields increase cost in a proportional manner. We compared estimated costs for adding data fields to real-world costs as data fields increase. Methods: We studied the impact of data fields on operational costs for three Phase III acute stroke clinical trials of similar design, clinical complexity, and logistics. We retrospectively reviewed records of coordinator time logged for completion of data fields per study during 2021 and 2022. Study data management hours included time for data entry, query resolution, and data verification as requested by the study monitor. Our standard rate per hour was used to calculate actual cost for each clinical trial. We estimated the cost of a single data field by dividing the averaged cost per subject by the total data fields collected for the least expensive study. We used this value to estimate cost and compared that to the actual costs. Results: Study 1 was the least expensive study, and thus used to calculate the estimated cost of a single data field. There were 277 data fields and a cost of $513 per patient, the cost per data field was calculated as $1.85. Study 2 had 775 data fields collected per subject and should have an estimated cost of $1,436.40. The actual cost was $2,291.57 which is 1.6 times higher than expected. Study 3 had 2245 data fields collected per patient and should have an estimated cost of $4,155.30. The actual cost was $20,176.65 which is 4.86 times higher than expected. Results are summarized in Figure 1. Conclusion: Our analysis of real-world study data management costs demonstrate that additional data fields have a disproportionate increase in cost. Assuming a proportional increase could lead to inaccurate estimates with large budget and operational cost impacts when a study is implemented.

Cost modelling rehabilitation in the home for reconditioning in the Australian context

BackgroundInpatient rehabilitation services are challenged by increasing demand. Where appropriate, a shift in service models towards more community-oriented approaches may improve efficiency. We aimed to estimate the hypothetical cost of delivering a consensus-based rehabilitation in the home (RITH) model as hospital substitution for patients requiring reconditioning following medical illness, surgery or treatment for cancer, compared to the cost of inpatient rehabilitation.MethodsData were drawn from the following sources: the results of a Delphi survey with health professionals working in the field of rehabilitation in Australia; publicly available data and reports; and the expert opinion of the project team. Delphi survey data were analysed descriptively. The costing model was developed using assumptions based on the sources described above and was restricted to the Australian National Subacute and Non-Acute Patient Classification (AN-SNAP) classes 4AR1 to 4AR4, which comprise around 73% of all reconditioning episodes in Australia. RITH cost modelling estimates were compared to the known cost of inpatient rehabilitation. Where weighted averages are provided, these were determined based on the modelled number of inpatient reconditioning episodes per annum that might be substitutable by RITH.ResultsThe cost modelling estimated the weighted average cost of a RITH reconditioning episode (which mirrors an inpatient reconditioning episode in intensity and duration) for AN-SNAP classes 4AR1 to 4AR4, to be A$11,371, which is 28.1% less than the equivalent weighted average public inpatient cost (of A$15,820). This represents hypothetical savings of A$4,449 per RITH reconditioning substituted episode of care.ConclusionsThe hypothetical cost of a model of RITH which would provide patients with as comprehensive a rehabilitation service as received in inpatient rehabilitation, has been determined. Findings suggest potential cost savings to the public hospital sector. Future research should focus on trials which compare actual clinical and cost outcomes of RITH for patients in the reconditioning impairment category, to inpatient rehabilitation.

Cost of implementing CAR-T activity and managing CAR-T patients: an exploratory study.

Chimeric antigen receptor T cells (CAR-T) represent an innovation but raise issues for healthcare payers because of the uncertainty on impact at market launch, high cost and important organisational impact. The literature has focused on their assessment, appraisal and market access solutions. No evidence on the costs sustained to implement CAR-T is available and a few studies reported the cost of the CAR-T clinical pathway, including the activities that are remunerated through inpatient or outpatient fee-for-service/episode. This paper aims at filling the information gap, assessing the cost of implementing CAR-T activity and the full cost of managing the CAR-T clinical pathway. Cost analysis relied on the Activity Based Costing approach, which was applied to two Italian healthcare organisations, both CAR-T Centres authorized by the regional governments with a minimum of 20 patients treated with the first two CAR-T therapies launched on the market. The cost of implementing CAR-T was estimated at €1.31million (calculated for one of the organizations with complete data). Most of these costs (77%) were generated by quality assurance activity. The mean cost per patient entering the CAR-T pathway (59 and 27) and surviving at follow-up (21 and 5) ranges from €48K to €57K and from €96K to €106K, respectively. Fees for hospitalization and infusion of gene therapy accounts for more than 70% of these costs. The actual hospitalisation cost varies greatly across patients and is in general lower than the fee-for-episode paid by the region to the hospital. Despite its limitations (exploratory nature; the time spent by staff on activities which are not remunerated through fees was estimated through interviews with the CAR-T coordinators; cost items are not fully comparable), this research highlighted the relevant organisational and economic impact of CAR-T and provided important insights for policy makers and healthcare managers: the necessity to invest resources in CAR-T implementation; the need for assessing activities which are not remunerated through fees for service / episode; the opportunity to shift from fee-for-episode/service to bundled payments for CAR-T clinical pathway.

Cost And Time Analysis Using Methods Earned Value

The earned value concept is one of the tools used in project management that integrates cost and time. The earned value concept presents three dimensions, namely the physical completion of the project (the percent complete) which reflects the planned absorption of costs (budgeted cost), the actual costs that have been incurred or what is called actual cost and what is obtained from the costs that have been incurred or what is called earned value. From these three dimensions, with the concept of earned value, it can be connected between cost and time performance derived from the calculation of the variance of cost and time. In the earned value method, monitoring or evaluation is required at a time to determine the performance of a project. Control was carried out on the Tanjung Uncang Pier Construction Project in Batam City, because the project implementation was delayed from planning. The research objectives are to analyze the estimated time required to complete the project and analyze the estimated final cost of the project. The result of the research is based on Schedule Variance (SV) and Schedule Performance Index (SPI), the work performance of the Tanjung Uncang Pier Development Project Batam City is not as expected and does not achieve the planned work target and is experiencing delays. The estimated time required to complete the Tanjung Uncang Pier Development Project Batam City based on week 22 is 257 days while the planned time is 245 days. This shows that the completion time is 12 days later than planned. The estimated cost of the project implementation of the Tanjung Uncang Pier Construction Project of Batam City is smaller than the contract value, which is Rp 40,038,455,635.00.

Trust-and-Evaluate: A Dynamic Nonmonetary Mechanism for Internal Capital Allocation

To stay competitive, firms regularly invest in innovation by supporting internal capital projects (funded and executed in-house) that explore new products and operational improvements. Each year, in a highly competitive process, managers from different functional units of the firm submit proposals (that include estimated costs and benefits) for such projects. Managers, because of their domain knowledge and expertise, are naturally better informed about the costs and benefits of their respective projects and can use this information strategically to secure funding. An example of such behavior is the under-reporting of the cost estimate of a project and subsequently requesting additional funding during the execution phase. Such strategic behavior not only affects the firm’s ability to fund the best projects but is also costly. Motivated by this challenge of deciding the funding of such projects at a global agribusiness firm, we seek a mechanism that is both provably near-optimal for the firm and guarantees truthful reporting from managers. Our setting consists of a principal and multiple agents. In each time period, over an infinite horizon, each agent requests funding for a potential project from the principal. Before submitting his proposal, each agent privately estimates the project’s cost and its benefit. If funded, each project is executed in one period. The principal’s funding decisions are binary; that is, each project is either funded in full or not funded. The actual cost (benefit) of a funded project is realized on its completion and incurred (earned) by the principal. The agents earn utility from the experience and reputation gained in completing projects. In each period, the principal desires to keep the total spend below a budget but can borrow external money at a cost. Our main contribution is a practically appealing dynamic nonmonetary mechanism for internal capital allocation under which, for any [Formula: see text], (a) truth-telling forms an ϵ-Bayesian Nash equilibrium and (b) the principal’s expected utility is within ϵ of the expected utility in the first-best setting. This paper was accepted by Karan Girotra, operations management. Supplemental Material: The online appendices and data files are available at https://doi.org/10.1287/mnsc.2022.01121 .

ANALYSIS OF IMPLEMENTATION DELAYS USING THE EARNED VALUE METHOD (ON THE PURWOSARI - SEKARMOJO ROAD WORKS, PASURUAN DISTRICT)

Along with the very rapid development of infrastructure and construction in Indonesia in the era of globalization, the Indonesian government has carried out various large-scale projects to achieve the increasingly complex expectations of society. This will trigger the growth of the construction industry in Indonesia and become one of the main goals in the framework of national development. An infrastructure development project is an activity carried out with limited time and resources to achieve a specified final result. One of the construction projects currently being developed is Road Works. The Earned Value method can be used to determine cost performance and implementation time during the project and the indicators used for analysis include: BCWP (Budget Cost of Work Performance), BCWS (Budget Cost of Work Schedule), ACWP (Actual Cost of Work Performance), SV (Schedule Variance), CV (Cost Variance), SPI (Schedule Performance Index), CPI (Cost Performance Index), EAC (Estimated At Complete) and ET (Estimated To Complete) and TE (Time Estimate). Conclusions from this research is to determine the estimated costs and time for project completion. In the data analysis in the 9th week, the project schedule performance (CPI) was 1.14, greater than 1, while (SPI) was 0.587, less than 1. The results of the calculation of projected costs for the remaining work (ETC) were IDR. 1,586,686,537.62 and total project costs (EAC) of Rp. 2,509,041,243.08.

COST ANALYSIS ON THE CONSTRUCTION OF SPORTS FACILITIES IN KEDEWAN SUB-DISTRICT, BOJONEGORO DISTRICT WITH EVM (EARNED VALUE METHOD)

The implementation of construction work has the main targets in construction management, such as construction costs, quality of construction work and construction implementation time. Construction activities can be declared successful in their management if they produce work products with the quality criteria that have been determined, on time, and according to the agreed costs. Using EVM (Earned Value Method) in project management can be used to determine cost performance and implementation time during the project and the indicators used for analysis include: BCWP (Budget Cost of Work Performance), BCWS (Budget Cost of Work Schedule), ACWP (Actual Cost of Work Performance), SV (Schedule Variance), CV (Cost Variance), SPI (Schedule Performance Index), CPI (Cost Performance Index), EAS (Estimated At Schedule) and ETS (Estimated Temporary Schedule). By using this method in the Sports Facilities Construction Project, Kecamatan Kedewan, Kabupaten Bojonegoro, the ACWP (Actual Cost of Work Performed), BCWP (Budgeted Cost of Work Performed), and BCWS (Budgeted Cost of Scheduled) values were obtained. The CV value obtained &lt;0 in weeks 1 to 7 indicates that the costs incurred were greater than the plan, but in weeks 8 to 15 the CV value &gt;0 means that in that week the costs incurred were less than the plan. Meanwhile, meaning the project is experiencing a delay from plan. The estimated of the completion budget requirement obtained from the ETC (Estimate to Compile) value is Rp. 3,345,105,521.28, while the estimated final total project cost obtained from the EAC (Estimate at Complete) value is Rp. 5,680,868,593.22.

The incidence, trends, and costs of treatment of femoral shaft fractures among Finnish children aged 2-12 years between 1998 and 2016.

The purpose of this study was to determine the incidence and trends of both hip spica casting and elastic stable intramedullary nailing in children aged 2-12 years who sustained femoral diaphyseal fracture between 1998 and 2016 in Finland. We also evaluated the actual hospital costs of both treatment methods as well as calculating the length of hospital stay. This study included all 2- to 12-year-old children with femoral diaphyseal fracture who were treated in Finland between 1998 and 2016. Data were collected from the National Hospital Discharge Register of Finland. Children were classified by age into five groups. The annual incidences per 100,000 persons were calculated using annual mid-year population census data obtained from Statistics Finland. Data on the annual actual daily hospital costs were collected from the Finnish Institute for Health and Welfare. In total, 1064 patients aged 2-12 years who had sustained femoral diaphyseal fracture were treated with elastic stable intramedullary nailing or hip spica casting between 1998 and 2016. In children aged 4-5 years, the incidence of elastic stable intramedullary nailing increased during the study period from 5.4 per 100,000 persons in 1998 to 8.1 per 100,000 persons in 2016. The length of hospitalization in patients treated with elastic stable intramedullary nailing was shorter and, therefore, the total costs of hospital treatment were lower than in those children treated with hip spica cast. level III.

Applied denitrifying bioreactor cost efficiencies based on empirical construction costs and nitrate removal

Adoption of edge-of-field conservation practices, such as denitrifying bioreactors, may be intrinsically linked to barriers associated with cost. However, most previous bioreactor cost efficiency assessments assumed values for either costs and/or nitrate removal. The objective of this work was to use actual construction costs as well as monitored nitrate removal to develop empirical cost efficiencies for eight full-size bioreactors in Illinois, USA. Capital construction costs were obtained via invoices or personal communications. A cash-flow discounting procedure was used to develop an equal annualized cost for each bioreactor assuming two media recharges over a 24-y planning horizon. These costs were combined with monitored nitrate removal based on one to six years of monitoring per site. Construction costs averaged $12,250 ± $7520 across the eight sites (or, $16,020 ± $9960 in 2023 price levels) but considering one of the sites was a paired bioreactor system, costs averaged $10,890 per bioreactor unit. Drainage treatment area-based cost averaged $132/ha-y and treatment area was strongly correlated with capital costs (R2 = 0.90; p = 0.001). The bioreactors averaged $108/m3 of woodchips and available federal government conservation programs could have offset an average of 70% of this cost. Monitored nitrate removal across 27 site-years resulted in a median of $33/kg N-y removed. This mass-based cost efficiency was higher than most previous assessments because the monitored nitrate removal for the study sites was lower than has been previously assumed or modeled. Future reporting about bioreactor recharge timing and cost will help guide assessment and planning. Water quality planning efforts should also consider the increasingly important engineering design costs, which were not included here. Suggested research and outreach to improve bioreactor cost efficiencies involves scaling the physical capacity of this technology for larger treatment areas, revisiting the use of low-cost non-standard fill media, and providing practical construction training.