Cost Estimates Research Articles

Prenatal Screening for CMV Primary Infection: A Cost-Utility Model.

Congenital cytomegalovirus (CMV) infection is a major cause of deafness and neurodevelopmental disability in children. Our objective was to assess the cost utility of first-trimester serological CMV screening, compared to screening of high-risk pregnancies and no serological screening. A decision-analytic model was created to compare the cost utility of three strategies from a healthcare sector perspective: universal first-trimester serological screening, screening only of high-risk pregnant women (both including antiviral prophylaxis in cases of primary infection) and serological testing triggered by foetal morphological ultrasound (no CMV serological screening). Canada. Hypothetical population of 80 000 pregnant women. Probability, expected values and cost estimates were derived from published literature and local hospital and national insurance data. Cost per maternal and infant quality-adjusted life year (QALY) lost. Universal serological screening was superior to both screening of high-risk women and no screening (utility of -0.42, -0.63 and - 0.87 QALY lost, respectively). Sensitivity analysis demonstrated that universal screening was the most cost-effective strategy regardless of the incidence of primary infection, the acceptability of amniocentesis and the efficacy of antiviral prophylaxis. In the Monte Carlo analyses, universal serological screening was the most cost-effective option in 96.36% of simulations. Universal serological screening would allow detection of 152 cases of primary maternal CMV infection and would prevent 29 cases of congenital CMV infection annually. Our findings support the adoption of a population-based prenatal screening programme for the prevention of congenital CMV infection.

The cost of the production and release of male Aedes aegypti mosquitoes sterilised by irradiation.

Classic vector control tools do not sustainably reduce Aedes populations or prevent the surge of arboviruses. The sterile insect technique (SIT) by irradiation relies on mass-rearing and release of male insects that will not produce viable offspring. It has been successfully integrated into controlling agricultural and livestock pests. Experiments are conducted to determine the effectiveness of the approach for suppressing Aedes aegypti and curbing dengue transmission. Detailed implementation cycle costs have not been reported yet. To detail the costs of producing and releasing male A. aegypti mosquitoes sterilised by irradiation. We carried out a cost analysis during a SIT pilot trial in Havana. We took a provider perspective and used microcosting. From the cost function, we subsequently calculated costs for base case variations in production volume and mosquito release rate per hectare. The setup expenses to establish the capacity to produce and release 450,000 mosquitoes weekly amounted to 155,452.00 and 2456.40 USD in capital means and training, respectively. The average number of sterile mosquitoes released per hectare per week during the trial was 1500, utilising 17% of the installed capacity. Including capital depreciation, the average cost per 10,000 sterile male mosquitoes released was 110.12 USD. When producing at 85% capacity, this reduces nearly threefold, to 41.06 USD. At that production level, releasing 500 or 4500 sterile male mosquitoes per hectare costs on average 2.70 or 16.54 USD per hectare covered. In densely populated areas with 500 inhabitants per hectare, this corresponds to 0.28 or 1.72 USD per inhabitant per year. Our cost estimates for SIT by irradiation are within the range of estimates reported for alternative mass-rearing and release methods to control Aedes populations, and the approach appears competitive with insecticide-based interventions. The cost-effectiveness in different contexts remains to be investigated.

Counting the cost of hospitalised injury using administrative data in Australia: three considerations from a retrospective cohort data linkage study

ObjectivesTo examine the relative differences in injury hospitalisation cost estimates from hospital administrative data when using (1) hospital reimbursement based on National Efficient Price (NEP) versus local hospital costings methods,...

Faktor-Faktor yang Mempengaruhi Keputusan Konsumen dalam Memilih Maxim Sebagai Media Tranportasi Online di Kota Kupang

This research aims to identify and analyze the factors that influence consumer decisions in choosing Maxim as an on line transportation service provider in Kupang City. The method used was qualitative with a phenomenological approach, and information was collected through interviews and online questionnaires from a hundred respondents consisting of students (63%), employees (20%), and the general public (17%). The results showed that the main source of information regarding the use of Maxim came from word of mouth (50%) and social media (41%). Most users (61%) have been using the service for less than a year, with an average frequency of use of 3 times a week. Factors that influence consumer decisions include competitive pricing, good customer service, and features that allow cost estimates and arrival times. However, the accuracy of the map in the app is one that needs improvement. The conclusion of this study shows that Maxim has successfully met consumer expectations, but further improvements are needed, particularly on the navigation system, to increase customer satisfaction and loyalty in Kupang City.

Net Health System Costs of Parkinson Disease: A Propensity Score-Matched Health Administrative Data Cohort Study in Ontario, Canada.

Few estimates of the long-term health system costs of Parkinson disease by phase of disease are available. We estimated 10-year and phase-based net health system costs of Parkinson disease before and after case ascertainment. Using population-based linked administrative databases from Ontario, Canada, we identified 43,149 community-dwelling persons with incident Parkinson disease aged 40 years and older between 2009 and 2018 using a validated algorithm. These individuals were matched 1:1 to controls without Parkinson disease based on demographics and a propensity score. We calculated phase-based, net health system costs from the provincial government perspective during the preascertainment (3 years before index), initial (1 year after index), early continuing (>1-6 years after index), later continuing (>6-10 years after index), and terminal (1 year before death, if applicable) phases (standardized to 2020 $CAD and calculated on an annual basis). By applying survival probabilities to monthly cost estimates, we also determined 10-year net health system costs, stratified by sex and age. Annual mean net costs of Parkinson disease were lowest in the preascertainment phase ($212 CAD, 95% CI [$20-$404]), intermediate in the initial phase ($4,576 (95% CI [$4,217-$4,935]), and higher in the early continuing phase ($7,078, 95% CI [$6,717-$7,438]). The later continuing phase ($12,500, 95% CI [$12,060-$12,940]) and the terminal phase ($13,933, 95% CI [$13,123-$14,743]) showed the highest costs. The 10-year net cost of Parkinson disease was $82,153 (95% CI [$77,965-$86,341]) and was significantly higher in women ($89,773, 95% CI [$83,306-$96,240]) than in men ($76,469, 95% CI [$70,983-$81,953]) and older individuals ($92,197, 95% CI [$87,087-$97,307]), compared with younger individuals ($62,580, 95% CI [$55,346-$69,814]). Over the 10-year period, hospital, nursing home, and home care were the largest contributors to costs of Parkinson disease. Health system costs of Parkinson disease are substantial, particularly in the later phases. Interventions to reduce avoidable use of hospital and nursing home services by persons living with Parkinson disease may provide better quality of life and be cost saving from the health system perspective.

Economic Impact of Respiratory Syncytial Virus Infections in Children Under 5 Years of Age Attending Primary Care in Italy: A Prospective Cohort Study in Two Regions.

Accurate cost estimates of respiratory syncytial virus (RSV) infections in primary care are limited, despite the majority of cases being managed in this setting. This study aims to estimate healthcare costs for children with RSV in primary care and the related costs of parental work absence. Children < 5 years of age with symptoms of acute respiratory infections were recruited via primary care paediatricians in two Italian regions for a prospective cohort study on the RSV burden in primary care, during the 2019/2020 winter. Healthcare utilization, medication use and parental work absence were assessed during a 14-day follow-up period. Average costs were estimated per RSV episode for the overall study population, as well as per age group. Two hundred ninety three children were recruited, of which 119 tested RSV positive (41%) and 109 were included. In total, 89% of RSV-positive children (97/109) had ≥ 1 repeat paediatrician visit(s), and 10% (11/109) visited the ED. The mean number of repeat visits was 3.8 (SD: 4.0) and the mean duration of work absence 4.0 days (SD: 5.0). Average costs per RSV episode were €730 (95% CI: €691-€771), with direct medical costs accounting for 25% (€183 [95% CI: €174-€191]) and indirect costs related to work absence for 75% (€547 [95% CI: €509-€587]). Costs associated with RSV infections in young children in primary care are considerable due to a substantial number of paediatrician visits and high rates of parental work absence. These costs are important to include in decision-making regarding the implementation of new RSV immunization strategies in national immunization programmes.

Epidemiology of dog bite and strike related hospital admissions in Scotland, 1997 to 2022.

To describe the epidemiology of dog-related injuries leading to hospital admission in Scotland and to estimate the direct health care costs. A retrospective, longitudinal analysis of Scottish hospital admissions coded under the W54 ICD-10 code 'bitten or struck by dog', 1997-2022. Hospital admissions episodes coded under W54 were extracted from the SMR1/01 dataset. Descriptive analyses were performed. Incidence rate ratios (IRR) were calculated using negative binomial distribution. Direct NHS health cost estimates were calculated. Incidence of dog bite and strike related admissions near tripled between 1997 and 2022, from 5.9 to 17.2 per 100,000 population with an annual IRR of 1.047 (P<0.001). Incidence has risen most steeply in adults, with all age groups over 15 years having an IRR between 1.040 and 1.065 (P<0.001). Incidence of overnight admissions doubled, and zero-day admissions increased by five times. Hospital admissions were 2.4 times higher in the most deprived quintile compared to the least deprived. Setting of bite was not consistently recorded, but young age groups were more likely to have the home setting recorded. Admissions related to dog bites or strikes resulted in an estimated £28.6 million of direct health care costs, from the admission alone, over the 25-year period. Dog bites and strikes can be devastating injuries. Unfortunately, over the last 25 years there has been a steep rise in incidence in Scotland, despite attempts at control through legislation. Further work to better understand the health and wider costs of these injuries, the epidemiology to inform preventative interventions, and improved co-ordination through inter-sectoral collaboration is recommended.

Hospitalization cost estimates of respiratory syncytial virus and influenza infections in adults in Spain, 2016-2019.

Respiratory syncytial virus (RSV) is increasingly a recognized cause of severe respiratory infection among adults. This retrospective observational study compared the costs of RSV and influenza hospitalizations in adults aged ≥18years admitted to the Spanish National Healthcare System between 2016 and 2019. Mean costs per hospitalization episode were compared using a multivariable log-gamma generalized linear model adjusted by age, risk group and calendar year. Total annual hospitalization costs were estimated from population incidence rates (for RSV we used model-based rates reported in a published study due to the substantial under-ascertainment of cases) and the mean cost per episode. ICD-10 codes identified a total of 11,662 adults hospitalized with RSV and 79,319 with influenza. The mean length of stay was longer for RSV than for influenza in low-risk patients aged 60-79years, moderate-risk patients (those with chronic medical conditions) aged ≥50years and in high-risk (those with immunocompromising conditions) patients aged <80years. There were no differences in intensive care unit (ICU) admission (except for higher admission in high-risk RSV patients aged 70-79years), ICU stay or in-hospital case fatality rate. Mean costs per hospitalization episode were also similar: RSV €3870 (95% CI 3773-3942) vs influenza €3888 (95% CI 3836-3931). Total annual costs for RSV-attributable hospitalizations were estimated at M€194, twice than that of influenza (M€83). Annual costs increased by 11% over the study period for RSV and by 47% for influenza. In 2019, adults aged ≥60years and≥70years contributed 91% and 82%, respectively, of the total RSV-attributable hospitalization costs in adults. RSV has a significant economic burden to the Spanish National Healthcare System, likely greater than influenza. Efficacious RSV vaccines and antivirals have the potential for high public health impact.

Are visitors, biodiversity or timber production better for nature conservation? Findings from an econometric analysis of the management costs of protected areas in Serbia.

Protected areas (PAs) are designed to provide a wide range of ecosystem services (ES) and to conserve biodiversity, alongside cultural values. Understanding the production processes within PAs is crucial to decipher the relationships between different ES, including primary (timber) production and the provision of public goods, and to assess their degree of 'jointness'. This article models PA management as a joint production activity involving multiple outputs, including biodiversity, recreation, and timber production. Using panel data on management costs from 57 PAs in Serbia (representing 82% of the country's protected area), we estimate a variable cost function, that accounts for potential endogeneity due to unobserved PA-specific heterogeneity. Our results show that increasing species richness and extending strict protection zones leads to additional management costs, but with different elasticities. A 10% increase in species richness outside strict zones increases costs by 4.9%, while within strict zones the increase is 5.77%. Timber production shows diseconomies of scale, suggesting that large-scale timber operations should be limited. Marginal cost estimates show that managing one additional species costs €11.80, one additional visitor costs €0.41 and one additional cubic metre of timber costs €44.43. We find no evidence of jointness between timber production and recreation, but there is competition between timber production and biodiversity. Conversely, biodiversity and recreation show complementarity in terms of protection costs. These findings are consistent with the Serbian PA management approach, which uses a land-sparing principle by spatially separating activities. This zoning strategy facilitates coexistence, allowing biodiversity to support local tourism and benefit from recreational activities.

A Model Proposal for Estimate the Approxımate Costs and Contract Fees of Public Education Buildings (School Buildings)

In this study, a method is proposed for the preliminary estimation of school building costs. For this purpose, the projects of 96 school buildings, which were put out to tender by public institutions and the result announcement was published, were provided from the Electronic Public Procurement Platform. These projects are divided into 81 training data and 15 test data. The construction cost of educational buildings through projects may affect the output vectors; “Number of Classrooms, Construction Duration, Total Number of Floors, Floor Height, Building Height, Building Height Class, Basement Height, Earthquake Design Class, Floor Class, Ground Safety Stress, Bed Coefficient, Concrete Class, Number of Elevators, Wet Area, Raft Foundation Height, Floor Area, Basement Area, Total Area" parameters were determined and used in modeling and analysis. Analyzes were carried out with “SPSS Statistics 26” software. Using these parameters, Regression Analyzes (RA) were performed and equations were developed to estimate the costs of educational structures. Approximate Costs and Contract Prices were tried to be estimated with the developed models. The model in which all parameters were used with the created equations was the model with the best correlation level, with the determination coefficient R²=0.900 for the Approximate Cost Price and R²=0.927 for the Contract Price. An error rate of 17,5% was found between the approximate cost estimates obtained using the model and the actual costs. It was determined that there was an 18,2% error between the estimated contract prices and the actual contract prices. The Durbin-Watson criterion was used to check the consistency between predicted results and actual results. As a result, an approach that can estimate the approximate costs and contract prices of school buildings of different types and coefficients with error rates lower than 20% has been created. Both public institutions and contracting construction companies will be able to make realistic cost estimates by benefiting from these modeling, providing time savings. Conducting similar studies by increasing the number of data may be a solution to minimize the error rate in subsequent modeling.

The economic costs and benefits of the European Future Combat Air System

ABSTRACT The Future Combat Air System (FCAS), a sixth-generation advanced combat aircraft, is assumed to be the largest European defence development and production programme of the 21st century and a core pillar of European cooperation in the defence sector. The 2017-initiated collaboration programme is led by Germany and France, with Spain and Belgium joining as partners, and is a who-is-who of the largest European defence companies, including Airbus Defence and Space, Thales, Safran, MBDA, and MTU. While such defence programmes have significant military, political, industrial, and economic impacts, the economic dimension in terms of economic costs and benefits is often under-represented in academic discussions. As the FCAS is still a nascent programme, only rough estimates of the total programme cost are available, and assumptions range from €100 bn to more than a trillion. With our research, we aim to contribute to the academic discussion by estimating the true economic costs and benefits of the FCAS. We use a mixed approach of data triangulation by cross-checking open source intelligence (OSINT) with expert interviews to estimate the full programme life-cycle costs. Furthermore, we estimate its economic impact on the European gross value added, employment, and tax by utilising an input – output (IO) model.

P-1892. Dabbling with Dalbavancin: Implementation and Cost-savings of an Inpatient-to-Outpatient Dalbavancin Pathway

Abstract Background Dalbavancin is a lipoglycopeptide antibiotic with in vitro activity against gram-positive organisms and a terminal half-life of 14.4 days. One dose provides 7 days of therapy whereas a novel 2-dose regimen provides up to 4-6 weeks. These strategies are attractive alternatives to standard of care for patients in whom daily IV antibiotics are not feasible. There also may be a financial benefit as the dosing schedule allows for completion of therapy in the outpatient setting and can reduce hospitalization costs. Methods This study is a retrospective chart review of all patients who received dalbavancin at Tampa General Hospital. Our institution approved the use of dalbavancin at no cost to patients for vancomycin-susceptible gram-positive infections who remain hospitalized only to receive IV antibiotics. All patients received at least one 1500mg dose inpatient to save 7 days of hospitalization; some patients planned to follow up a week later in an outpatient clinic for a second 1500mg dose to save at least 4 weeks of hospitalization. Cost estimates are based on the patient’s hospitalization cost prior to receiving dalbavancin and do not include avoided implicit costs. Results From 12/13/22 to 3/31/24, 28 patients received dalbavancin; 14 (50%) planned to receive a second dose and 11 (78.6%) successfully received their dose in clinic. The majority of patients (60.7%) reported a history of injection drug use. Most infections were monomicrobial (85.7%) with S. aureus being the most common pathogen. An estimated 527 days of hospitalization were avoided, representing a cost savings of $684,712.44. The institutional drug cost for dalbavancin was $104,772, leading to an estimated net hospital cost savings of $579,940.44. The all-cause 30-day readmission or revisit rate was 28.6%, similar to reported readmission rates in this population, however the 30-day infection-related readmission or revisit rate was favorable (10.7%). Conclusion The use of dalbavancin to facilitate discharge resulted in significant cost savings without increasing infection-related readmissions. Further cost-benefit analysis on true economic impact including the reduction in nosocomial infections and avoidance of toxicities is warranted. Disclosures All Authors: No reported disclosures

Determinants of construction project delay and its effect on project beneficiaries: evidence from the Gurage Zone, Ethiopia

Construction projects play a vital role in improving socio-economic development through infrastructure provision, job creation, and facilitation of economic growth. However, delays in the implementation of these projects are a common problem that works against these benefits. In Ethiopia in general, and the Gurage zone in particular, project delays have become a significant problem that needs a careful investigation of its root causes and effective policy responses. Therefore, this study aimed to identify the determinants of project delay and assess its socioeconomic effect on project beneficiaries in the Gurage zone, of Central Ethiopia. While regression analysis and relative importance index were used to identify project delay determinants, Key informant interviews (KII) and focus group discussions (FGD) were used to assess its socioeconomic effect on project beneficiaries. Poorly defined project scope, project control, and management, an incorrect estimate of project cost and schedule, bad economic conditions, political instability, lack of construction inputs, and inadequate communication have contributed to project delays. Project delays limit transport access, and increase unemployment, migration, disputes among project stakeholders, congestion on public service delivery, and health and health-related problems. Before approving a project, the soundness of the feasibility study should be properly checked. Project monitoring, follow-up, and control should be improved as a project implementation strategy. Beyond cost and time overruns, project sponsors consider the broader social and economic implications of project delays. This study contributes valuable insights that can inform project planning and management practices to mitigate delays and maximize socio-economic benefits for project beneficiaries.

Construction Cost Estimation Model For Airport Construction

The development of air transportation infrastructure, especially airports, plays an important role in improving connectivity, mobility, and economic and social growth. Estimating construction costs is an essential step in the development planning process to ensure proper budget allocation. This study aims to develop a special construction cost estimation model for airport construction by analyzing various variables that affect costs. The research uses a quantitative approach with primary data obtained from airport building construction work contracts and interviews with professional practitioners in this field. Sample data was taken from 22 output reports of airport construction work packages that have been completed or are being planned in several provinces in Indonesia. Data analysis techniques include correlation coefficient tests, determination, normality tests, multicollinearity tests, as well as t-tests and model variations. The results of the study are expected to produce an accurate, easy-to-use, and accountable cost estimation model, taking into account independent variables such as job characteristics, contract types, and market conditions. This estimation model is expected to be able to minimize the discrepancy between cost estimates and the realization of implementation costs, thereby contributing to the efficiency and sustainability of airport development. This research provides a scientific basis for decision-making related to the management of the construction budget for airport development in Indonesia.

Economic impact associated with dronedarone use in patients with atrial fibrillation

Objective/Aim In 2009, dronedarone was approved by the United States Food and Drug Administration based on results from the ATHENA trial (NCT00174785), which showed significant reduction of cardiovascular (CV) hospitalization and death in patients with atrial fibrillation (AF) randomized to dronedarone versus placebo. In 2020, a retrospective study by Goehring et al. showed CV hospitalizations and deaths were lower in clinical practice following initiation of dronedarone compared to other antiarrhythmic drugs (AADs) in patients with AF and atrial flutter. However, the economic impact associated with dronedarone use has not been fully assessed. The objective of this study was to estimate the cost associated with CV outcomes reported by Goehring et al. (2020). Methods National average Medicare payments in the Centers for Medicare and Medicaid Services (CMS) database (www.data.CMS.gov) were used to assign cost estimates to CV outcomes evaluated in Goehring et al. (2020) by diagnosis-related grouping. When costs were unavailable in the CMS database, a literature search was performed to identify publications reporting hospitalization costs. Results The weighted average cost for CV hospitalization was calculated to be $20,508. When multiplied by the event rate reported in Goehring et al. (2020), cost per person year for CV hospitalization was 14% lower with dronedarone versus other AADs ($3,679 vs $4,272, respectively). For hospitalizations due to heart failure, cost was 31% lower with dronedarone compared with other AADs ($324 vs $472, respectively). Limitations Costs have been calculated based on national averages reported by CMS (Medicare perspective) and are estimates. Regional differences may be present. Conclusions Patients with AF taking dronedarone had lower costs associated with CV hospitalization compared with patients taking other AADs.

Cost Estimation and Project Completion Time with Earned Value Analysis Approach on Waru-Buduran Frontage Road Project In Sidoarjo

The construction project of the Frontage Road Waru-Buduran in Sidoarjo has faced significant delays, highlighting the critical challenges in maintaining project efficiency. This study aims to analyze the cost and schedule estimates for the remaining work, as well as the total project completion using the Earned Value Analysis (EVA) method. The analysis results reveal a progress deviation of -9.911% by week 14 out of the total planned 21 weeks, indicating substantial schedule delays. Final completion estimates indicate a delay of 16.5 days and cost efficiency of IDR 1,246,797,954.06 (3.8%), demonstrating effective cost management despite schedule setbacks. EVA has proven effective in integrating cost and schedule performance indicators, such as Schedule Performance Index (SPI) and Cost Performance Index (CPI), to provide a comprehensive evaluation of project health. The findings emphasize the importance of early identification of deviations through EVA to implement corrective strategies, such as resource reallocation, schedule adjustments, and improved stakeholder coordination. The application of EVA enables project managers to predict potential risks, mitigate delays, and optimize resource utilization to achieve project objectives. This study provides valuable insights for project management practices, offering practical guidelines for addressing the complexities of construction projects. By utilizing EVA, project managers can ensure better decision-making, improve time and cost efficiency, and minimize conflicts arising from deviations in project execution. The findings serve as a reference for adopting EVA as a standard method in construction management to enhance overall project performance and ensure timely completion within budgetary constraints.

Real-world assessment to estimate multiple attributes related to treatment cost driver for mantle cell lymphoma in Japan by econometric modeling

This study was conducted using a nationwide health care database of Japan between 1 April 2008 and 30 September 2022 to evaluate the economic burden on patients with mantle cell lymphoma (MCL). Structural equation modeling (SEM) is an advanced multivariate analysis framework used to assess the relationships between observed and latent variables within predefined causal models. In this study, SEM was employed to identify cost drivers and estimate variables related to MCL treatment cost. A total of 2,838 patients having at least one confirmed diagnosis of MCL participated in this study. As for the index regimen, a combination of bendamustine rituximab was the most frequently used (n = 328), followed by rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisolone-like regimen (n = 112), and others. The median of total health care cost (unadjusted and adjusted) were 32,228 USD and 31,918 USD, respectively. The mean (SD) of the frequency of bleeding treatment was 23 (35) per year, and that of outpatient visits was 19 (12) per year. SEM analysis revealed Bruton tyrosine kinase inhibitor-based treatment as a cost driver (β: 0.398 [0.340; 0.457], p < 0.001). Key health care resource utilization (HCRU) factors associated with an increased cost were the total length of hospitalization (β: 0.598 [0.551; 0.646], p < 0.001) and number of outpatient visits (β: 0.132 [0.083; 0.180], p < 0.001). This real-world study delivers insights for optimizing MCL care in Japan.

Assessing costs and constraints of forest residue disposal by pile burning

Pile burning of thinned residues is a critical tool to dispose of fuels and to reduce wildfire risk in overstocked, fire-prone forests globally. However, cost estimates of pile burning are limited. In the Western United States, where fuel reduction and pile burning are key strategies to mitigate risk of severe wildfire, previous reports estimate that the average cost of pile burning after machine treatment is $543 ac−1 ($1,343 ha−1). There is, however, limited information on the costs of hand thinning and pile burning. In response, this study quantified the costs of cutting and yarding, piling, and burning residues via two pathways: the USDA Forest Service (USFS) Activity Tracking System (FACTS) database, and interviews with 11 USFS fire management professionals from California, Oregon, and Washington. Interviews highlighted cost drivers, implementation constraints, and opportunities for efficiency improvements. The average costs of piling and burning machine piles as determined from the interviews were $735 ± $464 ac−1 ($1,817 ± $1,146 ha−1; all mean ± SD), 80% higher than reported in the FACTS database and 35% higher than previous reports. The average costs of piling and burning hand piles as determined from the interviews were $1,291 ± $717 ac−1 ($3,190 ± $1,722 ha−1), 135% higher than reported in the FACTS database. Interview participants reported proximity to roads and terrain as key cost drivers, and described common practices, challenges, and constraints to pile burning. Geospatial analyses supported interviewee-identified cost drivers, district road density (a proxy for accessibility) and district maximum elevation (a proxy for terrain). Simulations of direct emissions from pile burning on National Forests included in this study indicated annual emissions of 11,322 metric tons (MT) of particulate matter (PM), 8,029 MT of PM10, and 6,993 MT of PM2.5 across the study area. In addition, pile burning on these National Forests annually emits &amp;gt;1.7 million MT CO2, 61,515 MT of carbon monoxide, 3,823 MT of methane, and 3,211 MT of non-methane hydrocarbons. Given the economic, human health, and climate implications of current pile burning practice, removing residues as feedstocks for carbon-negative utilizations is recommended as a near-term priority. Policy mechanisms, such as feedstock production, transport, or offtake subsidies of a similar magnitude to such avoided costs, could efficiently incentivize residue removal and support such climate-positive utilizations.

Project Performance Analysis Based on Earned Value Method on Infrastructure &amp; Infrastructure Improvement of Yohanis Kapiyau Timika Airstrip

This study analyzes the performance of construction projects using the Earned Value Method (EVM) on the Infrastructure and Facilities Improvement Project at Yohanis Kapiyau Airbase in Timika. Utilizing key performance indicators such as Cost Variance (CV), Cost Performance Index (CPI), Schedule Variance (SV), and Schedule Performance Index (SPI), the research evaluates cost and time deviations to provide a comprehensive understanding of project performance. EVM offers precise insights into the project's current status, including estimates for total costs and completion timelines, which are critical for effective decision-making and ensuring adherence to project plans. The findings demonstrate that EVM is a reliable tool for accurately monitoring and managing construction projects, enabling stakeholders to identify inefficiencies and implement corrective measures in a timely manner. By providing an in-depth evaluation of cost efficiency and schedule performance, the study contributes to the broader application of EVM in enhancing construction project management. This research is expected to benefit academics by advancing theoretical knowledge, assist contractors in optimizing project execution, and inform public stakeholders on best practices for infrastructure development, ultimately contributing to more effective and efficient management of construction projects in Indonesia.

A health economic evaluation of the multinational, randomized controlled CONVINCE trial - cost-utility of high-dose online hemodiafiltration compared to high-flux hemodialysis.

High-flux hemodialysis (HD) and high-dose hemodiafiltration (HDF) are established treatments for patients with kidney failure. Since HDF has been associated with improved survival rates compared to HD, we evaluated the cost-effectiveness of HDF compared to HD. Cost-utility analyses were performed from a societal perspective alongside the multinational randomized controlled CONVINCE trial. A Markov cohort model was used to extrapolate results to a lifetime time horizon. Costs of dialysis sessions were based on published data, with two scenarios reflecting different estimates for costs of dialysis staff. Other healthcare resource use, productivity losses and quality of life were collected in the electronic case report form or by country-adapted, self-reported questionnaires. Scenario and probabilistic sensitivity analyses were performed. In the two-year trial-based analysis, HDF was associated with higher quality-adjusted life years (QALYs) and higher costs, with incremental costs per QALY (ICER) of €31,898 and €37,344, depending on dialysis staff costs. The lifetime Markov cohort model resulted in ICERs of €27,068 and €36,751. Compared to HD, HDF resulted in an additional year in perfect health at increased costs. Sensitivity analyses of the lifetime analyses showed the probability of cost-effectiveness was more than 90% at willingness-to-pay threshold of €50,000/QALY. The ICER was €13,231 when excluding all costs in additional life years. The probability of cost-effectiveness was mainly driven by costs due to additional dialysis sessions in life years gained, and not due to additional costs per dialysis session. As costs may differ between countries and centers, we recommend translating our results to local settings.