Cost Analysis Model Research Articles

Outpatient management of pediatric epistaxis: A cost analysis and clinical model.

Pediatric epistaxis is a common, often non-operative condition encountered by Otolaryngologists. The present study seeks to (1) describe our outcomes of epistaxis management, (2) estimate the associated healthcare burden, and (3) propose a clinical model to optimize care coordination with primary care and advanced practice providers. Retrospective case series of pediatric patients treated outpatient for epistaxis by a single otolaryngologist from 2021 to 2022. The primary outcome after treatment with nasal lubricants was defined as (1) refractory epistaxis, (2) improvement, or (3) complete resolution. Cost data for office versus operative nasal cautery were analyzed. In total, 122 patients were included for analysis. Over a follow-up duration of 20.5 months (IQR 8-36), 24.6% of patients experienced refractory epistaxis, 41.8% of patients found improvement, and 33.6% had complete resolution (n = 122). Refractory epistaxis was associated with a family history of coagulopathy (p = .007), daily epistaxis episodes (p = .043), and anemia (p <.001). Average direct hospital costs associated with nasal cautery were $187 for in-office cauterization and $2179 for intraoperative cauterization. Estimated patient/third party payors savings were $1617 and $15,412 for in-office and intraoperative procedures, respectively, and $541.59 for specialty office visits alone. The average charge for laboratory work-up was $576. Approximately 75% of patients with epistaxis experienced improvement or resolution of symptoms with nasal lubrication alone. Refractory epistaxis was associated with a family history of coagulopathy, daily epistaxis episodes, and anemia. Otolaryngology visits for epistaxis were associated with a direct healthcare expense burden. Adaptation of our clinical model may mitigate these costs while improving patient care. Level of Evidence: 4.

A Comprehensive Quantitative Lifecycle Cost and Environmental Impact Analysis Model for Computing Infrastructure

This paper presents a comprehensive quantitative model for quantitative assessment of the lifecycle costs and environmental impacts of computing infrastructure, with a focus on internet data centers (IDCs) and high-performance computing (HPC) facilities. The key innovation lies in the integration of interdisciplinary cost evaluation and carbon emission methods for the establishment of this quantitative model. This framework, which outlines key cost components and carbon emission factors, enables the calculation of total costs, electricity expenses, and greenhouse gas emissions throughout the lifecycle of infrastructure. With IDCs as a case study, the research clarifies the intricate cost structure associated with equipment procurement, energy usage, land acquisition, and operational expenses. This paper provides an in-depth understanding of the cost structure and environmental impact of computing infrastructure in support of sustainable decision-making in its development.•Based on established cost estimation methods, such as Lifecycle Cost Analysis (LCCA) and the Analogous Estimating Method, this study examines costs across construction and operation phases.•The Emission Factor Method is used to quantify environmental impact, emphasizing the significance of regional energy mix and power usage effectiveness (PUE).

Response to Comment on: Patient out-of-pocket costs for guideline-recommended treatments for erectile dysfunction: a medicare cost modeling analysis.

Response to Comment on: Patient out-of-pocket costs for guideline-recommended treatments for erectile dysfunction: a medicare cost modeling analysis.

Assessing the economic burden of vision loss and irreversible legal blindness in Spain (2021–2030): a societal perspective

ObjectiveTo estimate the economic impact for the society, generated as a consequence of the onset of loss of vision and irreversible legal blindness, for the main ophthalmologic diseases in Spain: glaucoma, diabetic retinopathy (DR), diabetic macular edema (DME), age-related macular degeneration (AMD) and high myopia (HM).MethodsA cost analysis model was developed to estimate the economic burden of glaucoma, DR, DME, AMD and HM over a 10-year time horizon (2021-2030), from a societal perspective in Spain.The epidemiological and economic parameters used in the model were obtained through a literature review. Prevalence, incidence, and progression stages were used to establish the epidemiological flows. Annual costs per patient from publications were included and classified into direct healthcare, direct non-healthcare and indirect costs. Costs from other countries were converted based on purchasing-power-parity (€EUR, PPP). Epidemiological parameters about population and cost results were validated by a panel of experts.All costs were adjusted to euros, 2021 (€, 2021), and using the Consumer Price Index (CPI) of the last 10 years, extrapolated to 2030 euros (€, 2030).ResultsIt was estimated that the total population of patients with the main diseases pathologies (glaucoma, DR, DME, AMD and HM) will increase to 7.99 million patients by 2030, representing an increase of 103%.The total cost by 2030 of all pathologies would amount to 99.8 billion euros. Direct non-healthcare costs account for the largest item (44%), followed by loss of productivity costs (38%), and direct healthcare costs (18%). The pathologies with the highest cumulative costs will be glaucoma (€33.6 billion) and DME (€19.8 billion).The greatest increment costs compared to 2021 will likely be generated by pathologies related to diabetes mellitus, such as DR (703%) and DME (317%).ConclusionsKnowing the costs associated with the pathologies that generate loss of vision and irreversible legal blindness is essential to understand the socioeconomic impact associated with these pathologies. Furthermore, the high cost of treating these diseases makes necessary to coordinate efforts between administrations, together with the support of patient associations, to meet their needs.

Cost analysis of cardiac MRI for cardiac transplant surveillance

National health expenditures in the United States have risen steadily since 1960. While lifesaving therapies exist for acquired and congenital heart diseases, for some children heart transplantation is their only chance for a period of durable survival. Like many advanced therapies, however, heart transplantation confers a significant cost to families and the health care system at large. Current heart transplant health surveillance relies on frequent cardiac catheterization with endomyocardial biopsy (cath-EMB) as periodic assessment of graft health and detection of possible life-threatening acute rejection. Cardiac magnetic resonance imaging (MRI) has emerged as a diagnostic tool which can characterize the myocardium, providing insights into graft health and potentially acute/chronic graft rejection. The PEACE study (R01-HL164995-02) aims to systematically evaluate the potential for using cardiac MRI parametric mapping as a pre-cath-EMB screening tool to alleviate both patient anxiety and discomfort, as well as the financial burden of cath-EMB. The PEACE trial aims to establish definitive evidence and criteria for determining when cath EMB is needed. For a technique to be practical in the real world, though, it must also be cost effective.Therefore, the goal of this current research is to determine a minimal set of measurement properties (positive predictive value (PPV), etc.) that cardiac MRI must attain to be cost-effective. These data will guide the decision-making for the PEACE trial results. Consistent with the recent emphasis on “Value MRI,” we sought to understand the potential Medicare savings, through economic cost analysis modeling, if cardiac MRI is used for cardiac transplant surveillance rather than cath-EMB surveillance. At even the most pessimistic positive test rate for MRI considered, these modeling results suggest substantial Medicare cost savings when using cardiac MRI parametric mapping as a screening tool for detecting acute cardiac rejection. Longitudinal cost savings are notable too.

Optimal Multiple Wind Power Transmission Schemes Based on a Life Cycle Cost Analysis Model

Due to the high cost and complex challenges faced by offshore wind power transmission, economic research into offshore wind power transmission can provide a scientific basis for optimal decision-making on offshore wind power projects. Based on the analysis of the topology structure and characteristics of typical wind power transmission schemes, this paper compares the economic benefits of five different transmission schemes with a 3.6 GW sizeable onshore wind farm as the primary case. Research includes traditional high voltage alternating current (HVAC), voltage source converter high voltage direct current transmission (VSC-HVDC), a fractional frequency transmission system (FFTS), and two hybrid DC (MMC-LCC and DR-MMC) transmission scenarios. The entire life cycle cost analysis model (LCCA) is employed to thoroughly assess the cumulative impact of initial investment costs, operational expenses, and eventual scrap costs on top of the overall transmission scheme’s total cost. This comprehensive evaluation ensures a nuanced understanding of the financial implications across the project’s entire lifespan. In this example, HVAC has an economic advantage over VSC-HVDC in the transmission distance range of 78 km, and the financial range of a FFTS is 78–117 km. DR-MMC is better than the flexible DC delivery scheme in terms of transmission capacity, scalability, and offshore working platform construction costs in the DC delivery scheme. Therefore, the hybrid DC delivery scheme of offshore wind power composed of multi-type converters has excellent application prospects.

Cost analysis of patiromer vs sodium zirconium cyclosilicate for the treatment of hyperkalemia in Spain and the UK

Background Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. Published data have shown that potassium-binding polymer patiromer (Veltassa) is associated with reduced rates of severe edema and hospitalization for heart failure compared with sodium zirconium cyclosilicate (SZC, Lokelma) when treating hyperkalemia. The aim of this study was to evaluate the possible costs associated with these interventions in the Spanish and UK settings. Methods A cost-analysis model was developed in Microsoft Excel to compare the costs associated with patiromer and SZC for the management of hyperkalemia. Clinical event rates were taken from a published real-world comparative study, with the base case capturing the statistically significant reduction in severe edema with patiromer vs SZC and a sensitivity analysis also including the non-statistically significant reduction in hospitalization for heart failure. Country-specific costs, expressed in 2022 Euros (EUR) and British pounds sterling (GBP), were evaluated from a healthcare payer perspective and included pharmacy costs and costs of clinical events. Results Patiromer may be associated with cost savings of EUR 107 and GBP 630 per patient-year of treatment vs SZC in Spain and the UK, respectively. The majority of cost savings were due to the possible lower daily cost of patiromer compared with SZC. Including the difference in heart failure hospitalization rates in a sensitivity analysis led to greater cost savings with patiromer over SZC, increasing to EUR 460 and GBP 902 in Spain and the UK, respectively. Extrapolation of patient-level economic outcomes to a population level found that patiromer was associated with annual cost savings of EUR 30.6 million in Spain, and GBP 801.7 million in the UK vs SZC. Conclusions Patiromer has the potential to be cost saving vs SZC for the treatment of hyperkalemia in Spain and the UK based on the results of a real-world evidence analysis.

Similar QALY gain in primary and revision knee arthroplasty: A cost analysis and Markov model.

The aim of this study isto investigate the cost-effectiveness of revision total knee arthroplasty compared to primary total knee arthroplasty in terms of cost-per-quality-adjusted life year (QALY). Data were retrieved for all primary and revision total knee replacement (TKA) procedures performed at a tertiary Swiss hospital between 2006 and 2019. A Markov model was created to evaluate revision riskand we calculated lifetime QALYgain and lifetime procedure costs through individual EuroQol 5 dimension (EQ-5D) scores, hospital costs, national life expectancy tablesand standard discounting processes. Cost-per-QALY gain was calculated for primary and revision procedures. EQ-5D data were available for 1343 primary and 103 revision procedures. Significant QALY gains were seen following surgery in all cases. Similar, but significantly more QALYs were gained following primary TKA (PTKA) (5.67 ± 3.98) than following revision TKA (RTKA) (4.67 ± 4.20). Cost-per-QALY was €4686 for PTKA and €10,364 for RTKA. The highest average cost-per-QALY was seen in two-stage RTKA (€12,292), followed by one-stage RTKA (€8982). RTKA results in a similar QALY gain as PTKA. The costs of achieving health gain are two to threetimes higher in RTKA, but both procedures are highly cost-effective. Economic level II.

Patient out-of-pocket costs for guideline-recommended treatments for erectile dysfunction: a medicare cost modeling analysis.

Patient out-of-pocket (OOP) cost represents an access barrier to erectile dysfunction (ED) treatment. We determined OOP cost for men with ED covered by Fee-for-Service Medicare. Coverage policies were obtained from the Medicare Coverage Database for treatments recommended by the 2018 American Urological Association (AUA) guidelines. OOP cost was retrieved from the 2023 Centers for Medicare & Medicaid Services Final Rule. OOP cost for treatments without Medicare coverage were extracted from GoodRx® or literature and inflated to 2022 dollars. Annual prescription costs were calculated using the published estimate of 52.2 yearly instances of sexual intercourse. Medicare has coverage for inflatable penile prostheses (IPP; strong recommendation), non-coverage for vacuum erection devices (VED; moderate recommendation) and phosphodiesterase type-5 inhibitors (PDE5i; strong recommendation), and no policies for intracavernosal injections (ICI; moderate recommendation), intraurethral alprostadil (IA; conditional recommendation), or low-intensity extracorporeal shock wave therapy (ESWT; conditional recommendation). Annual IA prescription is most costly ($4022), followed by ICI prescription ($3947), one ESWT course ($3445), IPP ($1600), PDE5i prescription ($696), and one VED ($213). PDE5i and IPP, both strongly recommended by AUA guidelines, are associated with lower OOP cost. Better understanding of patient financial burden may inform healthcare decision-making.

Comment on: Patient out-of-pocket costs for guideline-recommended treatments for erectile dysfunction: a medicare cost modeling analysis.

Comment on: Patient out-of-pocket costs for guideline-recommended treatments for erectile dysfunction: a medicare cost modeling analysis.

Research on power allocation strategy and capacity configuration of hybrid energy storage system based on double-layer variational modal decomposition and energy entropy

This paper deals with the study of the power allocation and capacity configuration problems of Hybrid Energy Storage Systems (HESS) and their potential use to handle wind and solar power fluctuation. A double-layer Variable Modal Decomposition (VMD) strategy is proposed. Firstly, using the Sparrow Search Algorithm with Sine-cosine and Cauchy mutation (SCSSA) to optimize the parameters in VMD. Considering the different characteristics of batteries and supercapacitors and the richness of information that may be contained in the high frequency residuals obtained from the primary VMD, the secondary VMD is carried out to decomposition. In response to the modal aliasing phenomenon of the secondary VMD, the high and low frequency demarcation points of the secondary VMD are discriminated by combining the energy entropy (eN) to enable the more accurate power allocation strategy. Secondly, a mathematical model for cost analysis of the HESS is established by considering the daily integrated operating cost of the HESS and the relevant constraints of the renewable generation system. Finally, HESS capacity configuration and validation are based on the power allocation strategy proposed in this paper. The simulation results show that the power allocation strategy proposed in this paper is more accurate and has a better economy for the capacity configuration of HESS.

Models of quality costs by A. Feigenbaum, J. Juran, F. Crosby in the concept of the development of quality economics

Aim. Consider the specifics and features of quality cost models by A. Feigenbaum, J. Juran, F. Crosby in the context of increasing the efficiency of cost management.Objectives. Describe Joseph M. Juran's model (Juran's Spiral); classify quality costs by J. Juran — A. Feigenbaum; describe the classification of costs by F. Crosby.Methods. This work uses general scientific research methods: deduction, induction, generalization, comparative analysis, synthesis (unification), study and theoretical analysis.Results. In the modern economy, product quality plays a critical role, influencing the competitiveness and stability of the country's economic system, which makes quality management not just a formality, but a strategic necessity. Active implementation and development of quality systems is considered by enterprises as a means to improve reputation, increase market share and strengthen customer loyalty, and such systems help reduce costs by preventing defects and optimizing processes.Conclusions. An analysis of quality cost models was carried out as one of the key methods in increasing the economic efficiency of the organization. In modern quality management practice, special attention is paid not only to the identification and assessment of quality costs, but also to their role in the process of making managerial and technical decisions. This is especially true when planning the production activities of an enterprise. Quality cost analysis is becoming an important tool to help management formulate economically sound decisions.

APPLICATION OF TOPOLOGY OPTIMIZATION ON A 3D-PRINTED SHELF BRACKET

In this study, the topology optimization approach was adopted to reduce the material used in manufacturing. Specifically, the mass optimization technique was deemed suitable. Mass optimization eliminates the parts that don't affect a bracket’s overall strength while under load, resulting in weight reduction and material savings. Two shelf brackets were designed to test this theory and were subjected to mass optimization. A static structural analysis of this optimized model was carried out to confirm the optimization findings. These designs were then manufactured using the 3D-printing process. The yield points were next determined by performing a uniaxial tensile test on the shelf brackets. The outcome of the tests was subsequently compared with the simulation results, and a cost analysis model was created as an output. Ultimately, a reduction of 70% in mass was achieved with acceptable structural strength. In related optimization studies, the connecting part of an unmanned aerial vehicle's landing gear has been optimized resulting in fuel savings. The theory that topology optimization may be used to make both light and stiff parts at the same time has been proven by the results of this research as well as other studies that have been done on the same topic.

A systematic review on cost-effectiveness of diagnostic methods and treatments for tuberculosis in India

ObjectiveCost-effectiveness of a treatment is based on additional health benefits offered and for a test it is determined by fast and improved diagnosing capacity. Evidence on cost-effectiveness can help in identifying interventions that give optimal value for money and catalyse the effort of eliminating tuberculosis burden. Our objective is to evaluate and identify the cost-effectiveness of diagnostics and treatments for tuberculosis practiced in India from costing studies. MethodsElectronic databases like PubMed, Web of Science, Scopus, ProQuest, Cochrane Library, and PlosOne are searched, from Jan 1995 to Jan 2023 based on the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Quality of the selected studies is assessed using a consensus health economic criteria checklist. ResultsAmong the twelve studies selected after quality assessment seven studies were on testing methods and five were on treatment interventions. The included, model-based studies used either state transition or decision tree model for cost analysis primarily in a health system perspective. Sputum smear microscopy test being dominated by other testing methods, strategies like public-private with right diagnostic method yields cost-effective results in tuberculosis healthcare. ConclusionFull economic evaluations on interventions for tuberculosis in India are scarce, particularly from patients’ perspective. The study provides holistic knowledge about the economic evaluations of tuberculosis tests and treatments, highlighting its applications and implemental complications for further development of improved strategies and economic evaluation.

Operation, Maintenance, and Decommissioning Cost in Life-Cycle Cost Analysis of Floating Wind Turbines

Offshore wind farms are great options for addressing the world’s energy and climate change challenges, as well as meeting rising energy demand while taking environmental and economic impacts into account. Floating wind turbines, in specific, depict the next horizon in the sustainable renewable energy industry. In this study, a life-cycle cost analysis for floating offshore wind turbines is developed by combining the most recent data and parametric formulas from databases and relevant papers. The cost analysis models focused on cost minimization with special emphasis on Operation and Maintenance Cost (OPEX), Decommissioning Cost (DECOM), and Levelized Cost of Energy (LCOE), which are important factors in wind power economy. Given that floating wind energy is still developing, the presented scenarios should be beneficial in making future decisions. The cost analysis scenarios include on-site and off-site maintenance scenarios for OPEX. In addition, four alternative scenarios for DECOM have been examined: mechanical recycling, mechanical-incineration, incineration processes, and landfill. According to the findings of these scenarios, OPEX varies from 16.89 to 19.93 £/MWh and DECOM between 3.47 and 3.65 £/MWh, whilst the total LCOE varied from 50.67 to 66.73 £/MWh.

Incremental cost analysis model of distribution network based on economic dispatch of distributed new-energy storage system

Incremental cost analysis model of distribution network based on economic dispatch of distributed new-energy storage system

Airfield pavement condition prediction with machine learning models for life-cycle cost analysis

ABSTRACT Accurate pavement condition prediction is a vital aspect of pavement management because it informs the timing, budgeting and operational impact of maintenance and repair. This study developed machine learning models for airfield asphalt pavement condition prediction and its application in life-cycle cost analysis (LCCA). The most effective models were found being Random Forest for original pavement and support vector regression for pavement overlays. A modified Recursive Feature Elimination was used for model optimisation, resulting in 20% decrease in error. For the non-overlay pavement, the aircraft group with heavy takeoff weight had distinguishable effect on predicted pavement condition index (PCI). For the overlay pavement, overlay thickness had higher relative importance than either pavement age or condition before the overlay. A longer original pavement life was found more economical, but the overlay life decreased if the pavement condition before overlay is deteriorated past an optimum point (PCI range of 65–80 depending on overlay thickness). LCCA results showed economic trade-offs between pavement condition before overlay and the subsequent overlay life.

Promoting sustainability in 3D printed sand casting through adaptive sand mold structures

The use of 3D printed sand molds offers a high degree of flexibility in structural design and satisfying customer requirements. The optimization and adjustment of the structure of sand mold module with the required functionality helps to maximize the application potential of binder jet 3D printing technology. In this study, an adaptive sand mold structure design method was proposed to meet the sustainable requirements of 3D printed sand casting. Firstly, the functional modular and module clustering of the sand mold is carried out and then each module is adaptive structure design, to reduce the carbon emission and cost of the 3D printed casting process. Therefore, taking the small casting furnace cover and medium-sized cast engine block as examples, the life cycle framework of the 3D printed sand casting process is established, and the sustainable advantages of the adaptive structure method are explored through the calculation and analysis of carbon emission and cost models. The results show that the adaptive structure method reduces the carbon emissions of the two castings by 9.2% and 11.9%, respectively, and the cost of two castings by 6.7% and 11.1%, respectively. This approach provides more sustainable design ideas for 3D printed sand casting and 3D printed sand mass production.

Technical and cost analysis of zero-emission high-speed ferries: Retrofitting from diesel to green hydrogen

This paper proposes a technical and cost analysis model to assess the change in costs of a zero-emission high-speed ferry when retrofitting from diesel to green hydrogen. Both compressed gas and liquid hydrogen are examined. Different scenarios explore energy demand, energy losses, fuel consumption, and cost-effectiveness. The methodology explores how variation in the ferry's total weight and equipment efficiency across scenarios impact results. Applied to an existing diesel high-speed ferry on one of Norway's longest routes, the study, under certain assumptions, identifies compressed hydrogen gas as the current most economical option, despite its higher energy consumption. Although the energy consumption of the compressed hydrogen ferry is slightly more than the liquid hydrogen counterpart, its operating expenses are considerably lower and comparable to the existing diesel ferry on the route. However, constructing large hydrogen liquefaction plants could reduce liquid hydrogen's cost and make it competitive with both diesel and compressed hydrogen gas. Moreover, liquid hydrogen allows the use of a superconducting motor to enhance efficiency. Operating the ferry with liquid hydrogen and a superconducting motor, besides its technical advantages, offers promising economic viability in the future, comparable to diesel and compressed hydrogen gas options. Reducing the ferry's speed and optimizing equipment improves fuel efficiency and economic viability. This research provides valuable insights into sustainable, zero-emission high-speed ferries powered by green hydrogen.

The emission reduction potential and cost-effectiveness of low-GWP refrigerants in electric vehicle air conditionings

Electric vehicles play a crucial role in the carbon neutrality transformation of urban transportation, provided that they are powered by electricity generated from renewable (rather than fossil-based) generation sources. However, the substantial indirect emissions from electric vehicle air conditioning energy consumption and the significant direct emissions from HFCs (hydrofluorocarbons) refrigerants pose considerable challenges. In order to identify low-GWP (global warming potential) refrigerants -such as R1234yf, R744, and R290 - that can effectively minimize carbon emissions while maintaining certain cost-effectiveness, this paper establishes the relevant life-cycle analysis and life-cycle cost analysis models for electric vehicle air conditioning. The results obtained show that, in 2022, the total carbon emissions of China’s automotive air conditioning fleet were approximately 162 million tons CO2-eq. The nationwide average carbon emissions ranking of various refrigerant heat pumps is R290 &lt; R1234yf &lt; R744 &lt; R134a. The Net Present Value (NPV) of the life cycle cost for R134a electric vehicle heat pump is estimated to be around 11,500 yuan. Among the three low-GWP refrigerants, the life cycle cost of R290 is significantly lower than that of R134a under nationwide average conditions, while R744 exhibits the best life cycle performance in certain cold cities/regions.