Average Total Cost Research Articles

Analisis Pendapatan Usahatani Cabai Rawit di Desa Raanan Baru Kecamatan Motoling Barat Kabupaten Minahasa Selatan

This research aims to analyze the income obtained from cayenne pepper farming activities in one planting season in Raanan Baru Village, West Motoling District, South Minahasa District. This research was conducted from July to September 2023. The data collection method used was primary and secondary data. Respondents in this study consisted of 10 people using purposive sampling. The data analysis used is quantitative descriptive analysis. The results of this research show that each farmer respondent has a different income. The average income earned by respondents from cayenne pepper farming in Raanan Baru Village, West Motoling Sub-District, South Minahasa District is IDR20,660,303 per planting season is obtained from the difference between the average revenue of IDR29,950,000 and the average total cost of IDR10,619,697.

Analysis of Real Hospital Cost on Ina-Cbgs Rates for Cesarean Section Patients

A caesarean section is an artificial birth that is carried out by making a small incision in the abdominal wall and uterine wall, but the uterus must be intact and the fetus weighs >500 grams. The high cost of a cesarean section has prompted the Indonesian government to launch the National Health Insurance (JKN) program as an implementation of the National Health Insurance (JKN) which has been regulated regarding to the payment patterns to advanced health facilities by applying Indonesian Case Based Groups (INA-CBG's). This study aims to determine the difference between real hospital cost rates and INA-CBGs rates for payment of claims by JKN participants for caesarean section inpatients at Dr. Soedomo Regional Hospital Trenggalek. The research method is analytical observation with a cross sectional approach which refers to the hospital's perspective by comparing the direct medical costs of BPJS’s (Social Security Agency on Health) participant patients and the INA-CBG's rates. The populations of this study were BPJS recipients of class I, II, III inpatients who received mild category of caesarean section at Dr. Soedomo Regional Hospital Trenggalek in 2020. The sample used in this study was medical record documents that met the inclusion and exclusion criteria. Purposive sampling method was used. In treatment of I, II, III classes, a significant difference was found between the average total direct medical costs of mild category of caesarean section patients (O-6-10-I) compared to the INA-CBGs rates. The treatment of class I had a difference of IDR 886,582. (p<0.05). The treatment of class II had a difference of IDR 754,881. (p<0.05) and the treatment of Class III, the difference obtained was IDR 1,109,368. (p<0.05).

Cauda Equina Syndrome: Cost Burden After Spinal Decompression.

Observational cohort study. Cauda equina syndrome (CES) is a rare neurologic condition with potentially devastating consequences. The objective of this study was to compare the 2-year postoperative cost-associated treatments after posterior spinal decompression between patients with and without CES. By analyzing a commercial insurance claims database, patients who underwent posterior spinal decompression with a concurrent diagnosis of lumbar spinal stenosis, radiculopathy, or disk herniation in 2017 were identified and included in the study. The primary outcome was the cost of payments for identified treatments in the 2-year period after surgery. Treatments included were (1) physical therapy (PT), (2) pain medication, (3) injections, (4) bladder management, (5) bowel management, (6) sexual dysfunction treatment, and (7) psychological treatment. In total, 3,140 patients (age, 55.3 ± 12.0 years; male, 62.2%) were included in the study. The average total cost of treatments identified was $2,996 ± 6,368 per patient. The overall cost of identified procedures was $2,969 ± 6,356 in non-CES patients, compared with $4,535 ± 6,898 in patients with CES ( P = 0.079). Among identified treatments, only PT and bladder management costs were significantly higher for patients with CES (PT: +115%, P < 0.001; bladder management: +697%, P < 0.001). The difference in overall cost was significant between patients (non-CES: $1,824 ± 3,667; CES: $3,022 ± 4,679; P = 0.020) in the first year. No difference was found in the second year. A short-term difference was observed in costs occurring in the first postoperative year. Cost of treatments was similar between patients apart from PT and bladder management.

Coping Strategies for Financial Burden of Family for the Children with Autism Spectrum Disorder

Background: Autism Spectrum Disorder (ASD) is a neurodevelopment disorder and an emerging public health issue globally which is associated with huge burden to the family, community and the nation. Study was conducted to find out the coping strategies for financial burden of the family with ASD children. Methods: A cross-sectional study on 154 children with ASD was carried out from July 2015 to June 2016 where data were collected from two special schools and two specialized hospitals of Dhaka city. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Informed written consent was taken from the parents. Results: Majority (73.4%) of the children were male and average monthly family income and total treatment cost was Tk. 41785.7 and Tk. 23076.62 respectively. However, coping strategies were adopted by the family “changing lifestyle” (96.8%), “accepting the reality” (100%), “minimizing family investment” (90.3%). Again, 52.5% families minimized family investment as coping strategies, 52.2% families had financial constraint as consequences of financial burden, which were significantly higher in comparison with others (p&lt;0.05). Conclusion: ASD foist huge financial burden to the families of affected children. To compensate this financial burden, families adopted different coping strategies like changing lifestyle, taking social support, relying on religion, minimizing family investment, accepting reality etc. Appropriate early diagnostic facilities should be available to estimate the actual burden of the country. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 38-44

The costs of Suaahara II, a complex scaled-up multisectoral nutrition programme in Nepal.

Limited evidence exists on the costs of scaled-up multisectoral nutrition programmes. Such evidence is crucial to assess intervention value and affordability. Evidence is also lacking on the opportunity costs of implementers and participants engaging in community-level interventions. We help to fill this gap by estimating the full financial and economic costs of the United States Agency for International Development-funded Suaahara II (SII) programme, a scaled-up multisectoral nutrition programme in Nepal (2016-2023). We applied a standardized mixed methods costing approach to estimate total and unit costs over a 3.7-year implementation period. Financial expenditure data from national and subnational levels were combined with economic cost estimates assessed using in-depth interviews and focus group discussions with staff, volunteers, community members, and government partners in four representative districts. The average annual total cost was US$908,948 per district, with economic costs accounting for 47% of the costs. The annual unit cost was US$132 per programme participant (mother in the 1000-day period between conception and a child's second birthday) reached. Annual costs ranged from US$152 (mountains) to US$118 (plains) per programme participant. Personnel (63%) were the largest input cost driver, followed by supplies (11%). Community events (29%) and household counselling visits (17%) were the largest activity cost drivers. Volunteer cadres contributed significant time to the programme, with female community health volunteers spending a substantial amount of time (27 h per month) on SII activities. Multisectoral nutrition programmes can be costly, especially when taking into consideration volunteer and participant opportunity costs. This study provides much-needed evidence of the costs of scaled-up multisectoral nutrition programmes for future comparison against benefits.

Health Care Utilization by Patients With Chronic Pelvic Pain.

To describe the patterns of health care utilization among patients with chronic pelvic pain. Deidentified administrative claims data from the OptumLabs Data Warehouse were used. Adult female patients who had their first medical claim for chronic pelvic pain between January 1, 2016, and December 31, 2019, were included. Utilization was examined for 12 months after the index diagnosis. The greedy nearest neighbor matching method was used to identify a control group of individuals without chronic pelvic pain. Comparisons were made between those with and those without chronic pelvic pain using χ2 tests for categorical data and Wilcoxon rank-sum tests for continuous data. In total, 18,400 patients were analyzed in the chronic pelvic pain cohort. Patients with chronic pelvic pain had a higher rate of chronic overlapping pain conditions. Patients with chronic pelvic pain had higher rates of health care utilization across all queried indices. They had more outpatient office visits; 55.5% had 10 or more office visits. Patients with chronic pelvic pain showed higher utilization of the emergency department (ED) (6.3 visits vs 1.9 visits; P<.001). Urine culture and pelvic ultrasonography were the most utilized tests. One-third of patients with chronic pelvic pain utilized physical therapy (PT), and 13% utilized psychological or behavioral therapy. Patients with chronic pelvic pain had higher rates of hysterectomy (8.9% vs 0.6%). The average total health care costs per patient with chronic pelvic pain per year was $12,254. Patients with chronic pelvic pain have higher rates of chronic overlapping pain conditions and undergo more ED visits, imaging tests, and hysterectomies than patients without chronic pelvic pain. Improving access to multidisciplinary care, increasing utilization of interventions such as PT and psychological or behavioral therapy, and reducing ED utilization may be possible targets to help reduce overall health care costs and improve patient care.

Is the QCI framework suited for monitoring outcomes and costs in a teaching hospital using value-based healthcare principles? A retrospective cohort study

ObjectivesThe objective is to develop a pragmatic framework, based on value-based healthcare principles, to monitor health outcomes per unit costs on an institutional level. Subsequently, we investigated the association between...

Estimating the Costs of End-of-Life Care in Patients With Advanced Cancer From the Perspective of an Insurance Organization: A Cross-Sectional Study in Iran

ObjectivesCancers are significant medical conditions that contribute to the rising costs of healthcare systems and chronic diseases. This study aimed to estimate the average costs of medical services provided to patients with advanced cancers at the end of life (EOL). MethodsWe analyzed data from the Sata insurance claim database and the Health Information System of Baqiyatallah hospital in Iran. The study included all adult decedents who had advanced cancer without comorbidities, died between March 2020 and September 2020, and had a history of hospitalization in the hospital. We calculated the average total cost of healthcare services per patient during the EOL period, including both cancer-related and noncancer-related costs. ResultsA total of 220 patients met the inclusion criteria. The average duration of the EOL period for these patients was 178 days, with an average total cost of $8278 (SD $5698) for men and $9396 (SD $6593) for women. Cancer-related costs accounted for 64.42% of the total costs, including inpatient and outpatient services. Among these costs, hospitalization was the primary cost driver and had the greatest impact on EOL costs. This observation was supported by the multiple linear regression model, which suggested that hospitalization in the final days of life could potentially drive costs in these patients. Notably, no specialized palliative care was provided to the patients included in this study. ConclusionsThe results demonstrate that there is a significant rise in costs of care in patients receiving routine cancer care rather than optimized EOL care.

Cost analysis of one-time intravenous antibiotic doses in the emergency department

BackgroundResearch shows that one-time doses of intravenous (IV) antibiotics do not improve resolution of infection. However, providers continue to use them—especially in the emergency department (ED). Very few studies have aimed to quantify the cost of this practice. ObjectivesThe primary objective was to evaluate the difference in average total cost of ED stay between patients who received a one-time dose of IV antibiotics in the ED before discharging on oral antibiotics and patients who were just discharged on oral antibiotics. Secondary objectives were to evaluate the differences in durations of stay between the 2 groups, as well as the differences in adverse drug effects and need for health care contact after discharge. MethodsChart review was conducted to identify patients who received and did not receive a one-time dose of IV antibiotics in the ED between April 30, 2020, and April 30, 2022. A microcosting approach was used to determine ED-associated costs per patient. Comparisons in primary and secondary outcomes were performed using statistical inferential tests. ResultsA total of 102 patients were analyzed in each group. Patients who received a one-time dose of IV antibiotics in the ED before being discharged on oral antibiotics had an average length of stay of 4.55 hours, as opposed to patients who did not receive a one-time dose of IV antibiotics before being discharged on oral antibiotics who had an average length of stay of 2.82 hours (absolute difference 1.73 hours, P < 0.001). One-time dosing of IV antibiotics in the ED incurred an additional cost of approximately $556 per patient, totaling to more than $56,000 in our study cohort. ConclusionThe use of one-time IV antibiotics in the ED did not confer any additional benefits to patients. The use of one-time doses resulted in statistically significant reduced throughput in the ED and statistically significant increased health care costs.

Analysis of Profitability and Profit Margins of Rice-Fish Farming (Integrated Rice-Fish System) in Karangbinangun District, Lamongan Regency, East Java

In its development, rice and fish cultivators (pond rice fields) in Karangbinangun District find it difficult to determine whether the production yields they will receive result a profit or a loss. Because remember that there are many problems by cultivators such as the difficulty of getting fertilizer, the high cost of fertilizer, fish seeds are not always available, labor is hard to find, while the majority of cultivators in Karangbinangun District are small scale, so the capital they have is also small. Therefore, there is a need for research on 1) analysis of the costs incurred by pond rice fields cultivators for one year, 2) profit analysis, and 3) Profitability analysis. The analytical method used in this research is business financial analysis which consists of cost analysis, profit analysis and profitability analysis. The result of the research is average total costs incurred by rice-fish cultivation businesses (pond rice fields) are IDR 69,041,732.03/Ha/Year and the revenue is IDR 153,560,000/Ha/Year so that the profit received is IDR 84,518,267.97/Ha/Year. The R/C Ratio value is 2.22 and the net profit ratio (Net Profit Margin) is 55.04%, which means that the rice-fish cultivation business (pond rice fields) is efficient and the farmer's decision to undertake rice-fish cultivation (pond rice fields) it's still very much worth continuing

Do Busier Surgeons Have Lower Intraoperative Costs? An Analysis of Anterior Cervical Discectomy and Fusion Using Time-Driven Activity-Based Costing.

The present study is a single-center, retrospective cohort study of patients undergoing neurosurgical anterior cervical discectomy and fusion (ACDF). Our objective was to use time-driven activity-based costing (TDABC) methodology to determine whether surgeons' case volume influenced the true intraoperative costs of ACDFs performed at our institution. Successful participation in emerging reimbursement models, such as bundled payments, requires an understanding of true intraoperative costs, as well as the modifiable drivers of those costs. Certain surgeons may have cost profiles that are favorable for these "at-risk" reimbursement models, while other surgeons may not. Total cost was divided into direct and indirect costs. Individual costs were obtained by direct observation, electronic medical records, and through querying multiple departments (business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented. All surgeons performing ACDFs at our primary and affiliated hospital sites from 2017 to 2022 were divided into four volume-based cohorts: 1-9 cases (n=10 surgeons, 38 cases), 10-29 cases (n=7 surgeons, 126 cases), 30-100 cases (n=3 surgeons, 234 cases), and > 100 cases (n=2 surgeons, 561 cases). The average total intraoperative cost per case was $7,116 +/- $2,945. The major cost contributors were supply cost ($4,444, 62.5%) and personnel cost ($2,417, 34.0%). A generalized linear mixed model utilizing Poisson distribution was performed with the surgeon as a random effect. Surgeons performing 1-9 total cases, 10-29 cases, and 30-100 cases had increased total cost of surgery (P < 0.001; P < 0.001; and P<0.001, respectively) compared to high-volume surgeons (> 100 cases). Among all volume cohorts, high-volume surgeons also had the lowest mean supply cost, personnel cost, and operative times, while the opposite was true for the lowest-volume surgeons (1-9 cases). It is becoming increasingly important for hospitals to identify modifiable sources of variation in cost. We demonstrate a novel use of TDABC for this purpose. Level-III.

A joint sustainable order-packing vehicle routing optimisation for the cold chain e-fulfilment

AbstractDue to the new normal caused by the pandemic, consumer behaviour has now shifted to online shopping not only for general commodities but also for food and other perishable products. Therefore, e-commerce fulfilment is now integrated with cold chain capabilities to satisfy stringent requirements on time-criticality and product quality, leading to the concept of cold chain e-fulfilment. In the cold chain e-fulfilment process, perishable orders are packed in thermal packaging solutions and delivered to consumers before the quality preservation time window. To secure a sufficient time buffer during last mile delivery, excessive use of thermal packaging materials is applied, which creates an adverse environmental impact on our eco-system. Aligning with low-carbon business practices, this study proposes a novel joint optimization model, namely the Joint Optimization of Sustainable Order Packing and Multi-Temperature Delivery Problem (JOSOPMDP), for order packing and vehicle routing decisions, where the sustainable use of thermal packaging materials is promoted without negatively influencing product quality and customer satisfaction. To evaluate its viability and performance, three sets of computational experiments are subsequently conducted. It is found that the proposed model is feasible to strike a balance between order packing and vehicle routing decisions. Compared with the traditional strategy, the average total cost and satisfaction level are improved by 3.26% and 47.88%, respectively. Consequently, this research fosters sustainable thinking in the cold chain e-fulfilment process, minimizing environmental impact.

Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study

BackgroundCommunities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e., start-up costs). Despite the importance of these start-up costs in investment decisions to stakeholders, they are typically excluded from cost-effectiveness analyses. The objective of this study is to report a detailed analysis of CTH start-up costs pre-intervention implementation and to describe the relevance of these data for stakeholders to determine implementation feasibility.MethodsThis study is guided by the community perspective, reflecting the investments that a real-world community would need to incur to implement the CTH intervention. We adopted an activity-based costing approach, in which resources related to hiring, training, purchasing, and community dashboard creation were identified through macro- and micro-costing techniques from 34 communities with high rates of fatal opioid overdoses, across four states—Kentucky, Massachusetts, New York, and Ohio. Resources were identified and assigned a unit cost using administrative and semi-structured-interview data. All cost estimates were reported in 2019 dollars.ResultsState-level average and median start-up cost (representing 8–10 communities per state) were $268,657 and $175,683, respectively. Hiring and training represented 40%, equipment and infrastructure costs represented 24%, and dashboard creation represented 36% of the total average start-up cost. Comparatively, hiring and training represented 49%, purchasing costs represented 18%, and dashboard creation represented 34% of the total median start-up cost.ConclusionWe identified three distinct CTH hiring models that affected start-up costs: hospital-academic (Massachusetts), university-academic (Kentucky and Ohio), and community-leveraged (New York). Hiring, training, and purchasing start-up costs were lowest in New York due to existing local infrastructure. Community-based implementation similar to the New York model may have lower start-up costs due to leveraging of existing infrastructure, relationships, and support from local health departments.

324 How Much Money Do You Actually Save Your Hospital When You Choose a Posterior Foraminotomy Instead of an ACDF for Cervical Radiculopathy?

INTRODUCTION: To our knowledge, a comparison of the true intraoperative costs of anterior cervical fusion (ACDF) vs. posterior cervical foraminotomy (PCF) has never been done. METHODS: Total cost was divided into direct and indirect costs. Individual costs were obtained by direct observation, electronic medical records, and through querying multiple departments. Timestamps for personnel and material resources were documented. Total intraoperative costs were estimated for all single-level ACDFs and PCFs from 2017 to 2022. Regression analyses were performed to identify factors associated with total cost. RESULTS: A total of 256 and 32 patients underwent single-level ACDFs and PCF for cervical radiculopathy, respectively. The average total intraoperative cost for ACDFs was $7,574 ± $3,175 versus $3,062 ± $547 for PCF. For ACDFs, supply cost (69% for ACDFs vs. 33% for PCF) was the major contributor, while personnel cost (67% for PCF vs. 31% for ACDFs) constituted most of the cost incurred during PCFs. Supply cost, particularly implant cost ($3,818 ± $2,316), appeared to influence cost variability in ACDFs, while personnel cost ($2,051 ± $419) seemingly explained cost variability in PCFs. On linear regression analysis, ACDFs (β coefficient: $4,685 ± $575, p &lt; 0.001), males (p = 0.03), and patients with commercial insurance (p = 0.01) had significantly higher total costs when controlled for age, comorbidities, and smoking status. CONCLUSIONS: TDABC is a feasible methodology for estimating differences in true intraoperative costs between ACDFs and PCFs for cervical radiculopathy. The major cost contributors were supply and personnel costs. Implant cost appeared to influence total cost variability in ACDFs, while personnel costs seemingly explained cost variability among PCFs. ACDFs were associated with an additional $4,685 ± $575 of total intraoperative cost as compared to PCFs. Males and patients with commercial insurance were also associated with significantly higher total costs.

115 Time-driven Activity-based Costing for ACDF: An Automated and Scalable Solution

INTRODUCTION: Understanding the true (intraoperative) cost to the hospital when neurosurgeons perform anterior cervical discectomy and fusion (ACDF) is critical as we move towards value-based purchasing. METHODS: Total cost was divided into direct and indirect costs. Individual costs were obtained by direct observation, electronic medical records, and through querying multiple departments (business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented. Total intraoperative costs were estimated for all ACDFs from 2017 and 2022. RESULTS: A total of 959 patients underwent anterior cervical fusions between 2017 and 2022 (one-level: n = 400, 41.7%; two-level: n = 407, 42.4%; three-level: n = 139, 14.5%; greater than three-level: n = 13, 1.4%). The most common pre-operative diagnosis was myelopathy (n=586, 61.1%), followed by radiculopathy (n = 256, 26.7%). The average total intraoperative cost per case was $5,970 ± $2,137; $7,542 ± $3,119; $8,958 ± $3,096; and $9,297 ± $2,633 for one-, two-, three-, and greater than three-level fusions, respectively. The major cost contributors were supply costs ($4,745, 66%) and personnel costs ($2,417; 34%). Total intraoperative costs displayed more variation with two-level ACDFs as compared to other fusions. Total supply cost, particularly implant cost ($3,399 ± $2,161), followed by total personnel cost (2,417 ± $917) was responsible for most of the observed total cost variability across all anterior cervical fusions. CONCLUSIONS: TDABC is a feasible and scalable methodology for understanding the true intraoperative costs of ACDF, without having to rely on proprietary third-party software. The most common reason for surgery was myelopathy, followed by radiculopathy. The major cost contributors were supply and personnel costs. Two-level ACDFs appeared to display more total cost variability as compared to other fusions. Implant costs, followed by personnel costs, appeared to be responsible for cost variation across all anterior cervical fusions.

Diagnosing and characterizing inflammatory myopathies at an Australian tertiary public hospital: Resource utilization and direct healthcare costs.

To determine the direct health service costs and resource utilization associated with diagnosing and characterizing idiopathic inflammatory myopathies (IIMs), and to assess for limitations and diagnostic delay in current practice. A retrospective, single-center cohort analysis of all patients diagnosed with IIMs between January 2012 and December 2021 in a large tertiary public hospital was conducted. Demographics, resource utilization and costs associated with diagnosing IIM and characterizing disease manifestations were identified using the hospital's electronic medical record and Health Intelligence Unit, and the Medicare Benefits Schedule. Thirty-eight IIM patients were identified. IIM subtypes included dermatomyositis (34.2%), inclusion body myositis (18.4%), immune-mediated necrotizing myopathy (18.4%), polymyositis (15.8%), and anti-synthetase syndrome (13.2%). The median time from symptom onset to diagnosis was 212 days (IQR: 118-722), while the median time from hospital presentation to diagnosis was 30 days (8-120). Seventy-six percent of patients required emergent hospitalization during their diagnosis, with a median length of stay of 8 days (4-15). The average total cost of diagnosing IIM was $15 618 AUD (STD: 11331) per patient. Fifty percent of patients underwent both MRI and EMG to identify affected muscles, 10% underwent both pan-CT and PET-CT for malignancy detection, and 5% underwent both open surgical and percutaneous muscle biopsies. Autoimmune serology was unnecessarily repeated in 37% of patients. The diagnosis of IIMs requires substantial and costly resource use; however, our study has identified potential limitations in current practice and highlighted the need for streamlined diagnostic algorithms to improve patient outcomes and reduce healthcare-related economic burden.

BUSINESS ANALYSIS OF HOUSEHOLD SCALE COW’S MILK INDUSTRY IN SARANGAN VILLAGE MAGETAN REGENCY

The purposes of this research were to determine the total costs, revenues, profits, efficiency, and risks in the household scale pasteurized cow’s milk industry in Sarangan Village, Magetan Regency. The basic method used is descriptive analysis. Determination of the research location purposively with nine respondents, were taken by the census method. Data collection techniques were collected through interviews, observation, recording, documentation, and questionnaires. The data analysis used is costs, revenues, profits, business efficiency, and risk. The results showed that the business has average total cost production in December 2021 of IDR 9.805.292,00/month. The average revenue is IDR 14.729.444,00/month. So that the average profit is IDR 4.924.152,00/month. The business is already efficient because the efficiency value is 1,54. Therefore, the coefficient of variation is 0,53, and the lower profit limit is minus IDR 253.175,00. These values mean that the business is at risk of experiencing a loss of IDR 253,175.00

Сравнительная оценка энергетических затрат при перемещениях кранов-штабелеров

Within the framework of the put forward hypothesis that energy costs of working movements of the links of racking stacker cranes are inextricably linked to the shape of the working area of the warehouse in which the crane operates, to reduce energy costs, it was pro-posed to use a rotating boom in the design of the stacker crane. With the help of program implementations of mathematical models of stacker cranes of traditional bicycle design and the proposed design with a rotating boom, it became possible to determine the average energy costs for all possible movements of loads of the same mass within the corresponding working areas of these designs. For this purpose, systems of differential equations in Cauchy form were developed, where dissipation of energy was taken into account. The total value of work of crane drives during acceleration and braking was determined. The latter were carried out with constant accelerations, and the movement after acceleration — with constant speeds. The developed simulation mathematical models of cranes of traditional design and the proposed design with a rotating boom allow to determine the energy costs in the drives when moving the crane links along the given trajectories. According to the criterion of average total energy costs, adopted for all possible combinations of movements within areas of the same capacity of one hundred square meters, the stacker crane of the proposed design has an advantage over the crane of traditional design. This makes it possible to significantly reduce energy costs when using such cranes in warehouses and hangars. It is reasonable to recommend the use of a stacker crane of the developed design in warehouses of round shape — it will allow to reduce significantly the energy costs when using such cranes in warehouses and hangars.

Economic evaluation of a trial exploring the effects of a web-based support tool for parents of children with juvenile idiopathic arthritis.

To explore the cost-effectiveness of a web-based support tool for parents of children with Juvenile idiopathic arthritis. A multi-centred randomized controlled trial was conducted in paediatric rheumatology centres in England. The WebParC intervention consisted of online information about JIA and its treatment and a toolkit using cognitive-behavioural therapy principles to support parents manage their child's JIA. An economic evaluation was performed alongside the trial involving 220 parents. The primary outcome was the self-report Pediatric Inventory for Parents measure of illness-related parenting stress, with two dimensions: difficulty and frequency. These measures along with costs were assessed post intervention at 4 and 12 months. Costs were calculated for healthcare usage using a UK NHS economic perspective. Data was collected and analysed on the impact of caring costs on families. Uncertainty around cost-effectiveness was explored using bootstrapping and cost-effectiveness acceptability curves. The intervention arm showed improved average Pediatric Inventory for Parents scores for the dimensions of frequency and difficulty, of 1.5 and 3.6 respectively at 4 months and 0.35 and 0.39 at 12 months, representing improved PIP scores for the intervention arm. At both 4 and 12 month follow-up, the average total cost per case was higher in the control group when compared with the intervention arm with mean differences of £360 (95% CI £29.6 to £691) at 4 months and £203 (95% CI £16 to £390) at 12 months. The probability of the intervention being cost-effective ranged between 49% and 54%. The WebParC intervention led to reductions in primary and secondary healthcare resource use and costs at 4 and 12 months. The intervention demonstrated particular savings for rheumatology services at both follow-ups. Future economies of scale could be realised by health providers with increased opportunities for cost-effectiveness over time. ISRCTN, ISRCTN13159730.

A CASE STUDY IN SLEMAN: A FEASIBILITY ANALYSIS OF RICE-FISH FARMING BASED ON RESOURCES PRODUCTIVITY

One of the efforts to optimize resources in order to increase farm income is mina rice, which is rice and fish farming on one land and season in an integrated manner. This study aims to determine the cost, revenue, income, and profit of rice-fish farming. In addition, this study aims to determine the feasibility of rice-fish farming through a resource productivity approach. The method used is descriptive analysis, by taking respondents as many as 35 farmers in Samberembe village, Candibinangun, Pakem, Sleman, and the Special Region of Yogyakarta. The results of the study showed that the average paddy-fish farming area of 1,063 square meters requires an average total cost incurred for one year for production is IDR. 27,591,910.95. Rice-fish farming revenue amounted to IDR. 36,293,686, so that the income obtained amounted to IDR. 21,590,063.81. Meanwhile, the profit of rice-fish farming amounted to IDR. 8,701,774.77 for three seasons per year. The results of the feasibility analysis showed an R/C value of 1.3, a capital productivity value of 62% per year, and a labor productivity value of IDR. 206,125.21 per full time day, and a land productivity value of IDR. 7,292.00 per square meter. These results indicate that rice-fish farming is feasible to develop.