Facility Costs Research Articles

Estimation of Long-Term Post-Infusion Costs of Care for Patients with Relapsed/Refractory Multiple Myeloma (RRMM) Following Administration of Idecabtagene Vicleucel (ide-cel, bb2121) in the KarMMa Clinical Trial

Introduction: RRMM is associated with poor prognosis and decreased overall survival. Chimeric antigen receptor (CAR) T cell therapies have emerged as a potential single-infusion treatment option for these patients. Ide-cel (bb2121), a B-cell maturation antigen (BCMA)-directed CAR T cell therapy for treatment of RRMM, has demonstrated frequent, deep, and durable responses in heavily pretreated patients in the KarMMa clinical trial (Munshi NC, et al. N Engl J Med 2021;384:705-716). However, evidence on long-term healthcare resource utilization (HCRU) and associated costs of care following ide-cel administration is very limited; this abstract provides a long-term update to a previous 12-month (mo) cost-of-care analysis (Hari P, et al. Value Health 2021;24[Suppl 1]:S29-S30). The objective of this study was to estimate the 2-year (y) post-infusion cost of care for patients with RRMM who received ide-cel in the KarMMa trial. Methods: This retrospective study used the KarMMa clinical trial database to analyze the HCRU and cost associated with ide-cel. We identified resource use and employed a micro-costing methodology to estimate post-infusion costs. Beginning on the index date (day of ide-cel infusion) up to a 2-y follow-up period, we analyzed the following HCRU categories: facility (standard inpatient [IP] and intensive care unit [ICU]), diagnostic (eg, lab work and imaging), medication (eg, supportive care, prophylactic treatment, and adverse event management), and procedure (eg, dialysis and intubation); and length of stay (LOS) (number of standard IP days and ICU days). Given that some patients in the trial were administered ide-cel outside the United States (US), any HCRU inconsistent with US clinical practice were adapted to reflect the US perspective. Next, we applied unit costs to each HCRU in the time period. Unit costs were from the US health system (provider) perspective and adjusted to 2022 USD. Cost per standard IP day ($2944) was estimated from 2018 Healthcare Cost and Utilization Project databases and cost per ICU day ($8426) sourced from Dasta JF, et al. Crit Care Med 2005;33:1266-1271. Medication cost data were obtained from REDBOOKTM using wholesale acquisition cost and were uniformly applied across sites of care. Diagnostic, transfusion, and procedure costs were taken from the Centers for Medicare & Medicaid Services lab fee schedule, physician fee schedule, or outpatient prospective payment system. Unit costs were estimated by applying a payment-to-cost ratio to any Medicare reimbursement rates. Costs were then adjusted to reflect cost to the site of care where the HCRU occurred. Costs were aggregated by HCRU category (facility, medication, procedure, and diagnostic) and partitioned by mo following ide-cel administration. An average total cost by post ide-cel infusion mo was calculated among patients with ongoing status in that mo. Patients censored because of data cut off were excluded. Results: A total of 128 patients were treated with ide-cel in the KarMMa trial. Patients had a mean (standard deviation [SD]) age of 59.8 (9.3) y, and were predominantly male (59.4%), White (80.5%), and non-Hispanic (80.5%). HCRU and LOS, including standard IP and ICU days, are shown in Table 1. Mean (SD) LOS throughout the follow-up period was 22.3 (13.3) days for standard IP and 1.6 (4.8) days for ICU. Total LOS ranged from 14 to 114 days with a median of 19.5 days and a mean (SD) of 23.9 (14.4) days (protocol required IP stay ≥ 14 days post infusion). HCRU, especially in y 2 and for medications, may have been related to management of toxicity or progressive disease. All patients were hospitalized (per trial protocol); 20.3% had an ICU stay. Most patients received antibiotics (96.1%) and tocilizumab + corticosteroids (54.7%), some received corticosteroids only (45.3%), and few had vasopressor use (14.8%). A minority of patients required dialysis (0.8%) or intubation (3.9%). The estimated mean 2-y post-infusion cost of care was $123,157. Most of the 2 y costs post-infusion were incurred in y 1 (85.7%) with 54% in mo 1 and were driven primarily by facility costs, namely standard IP and ICU stays (Figure 1). Conclusions: This study is the first to estimate long-term (national average-based) cost of care following CAR T cell therapy for patients with RRMM. Findings suggest that a single infusion of ide-cel is associated with substantially reduced HCRU and long-term costs following the initial treatment period. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

A joint model of location, inventory and third-party logistics provider in supply chain network design

Integrated supply chain network design plays an increasingly important role in improving the operational efficiency of a company. This paper studies a novel joint supply chain network model that integrates location, inventory and third-party logistics provider decisions for consideration in a three-level supply chain involving manufacturers, distribution centers (DCs), and retailers. Different from traditional location-inventory problems, the proposed model not only determines the locations of manufacturers and DCs, and how to serve DCs and retailers by manufacturers and DCs, but also chooses potential third-party logistics providers to serve DCs and retailers. The goal is to design an efficient supply chain system to reduce the overall cost including facility cost, inventory cost, and transportation cost to meet the demands of retailers. A nonlinear integer programming model based on multigraph is proposed. To deal with the complex nonlinear terms, we reformulate a mixed-integer nonlinear programming model. Moreover, to deal with the difficulties caused by multigraph, a method based on the generalized Benders decomposition (GBD) is developed. Computational results clearly show the effectiveness of the proposed model and the GBD method. Comparative analysis shows the potential benefits of integrating the third-party logistics provider decisions into the location-inventory model.

Emergency medical service location problem based on physical bounds using chance-constrained programming approach

This paper studies a location and sizing problem for an emergency medical service system using distributionally robust chance-constrained programming approach. The medical demands are uncertain and described in an ambiguity set, which is constructed based on Wasserstein-metric. The location problem is modelled through minimising the total expected costs, including construction costs of facilities, purchase of ambulances and maintenance costs. The chance constraints are introduced to guarantee the service level of geographical areas. For the chance constraints, three reformulations such as CVaR-approximation, the mixed integer linear programme exact reformulation and the physically bounded bilinear reformulation are studied. A numerical study is conducted to illustrate the computational performance and objective values.

Sustainable biodiesel supply chain model based on waste animal fat with subsidy and advertisement

The need for sustainable energy generation has grown in response to ascending levels of green house gases emissions and soaring energy demand. Biofuel is viewed as a viable alternative to non-renewable energy sources for energy generation. Animal fat, waste cooking oil, and vegetable oil are all examples of biomass that can be utilized to make biodiesel. In the midst of these sources’ animal fat is an acceptable choice due to its cheap cost and convenience of availability. The multi-objective mathematical optimization model is created to plan a sustainable supply chain for biodiesel made from waste animal fat. The proposed model minimizes the biodiesel supply chain cost, furthermore, minimizing the environmental impact while maximizing social impact. The demand for biodiesel is depending on advertisement costs and subsidies provided by the government. The advertisements promote biodiesel as an alternative to fossil fuels, and the government gives a subsidy for the collection of waste animal fat. The improved “augmented ϵ-constraint approach” is used to solve the proposed model. The multiple supply points for beef, mutton, and chicken fat, multi-collection and rendering plants, multiple biorefineries, and biodiesel depositories are designed. A numerical example is analyzed, and the consequences of a numerical experiment uncover that the transportation cost is 51.34% and installation cost of biodiesel production facilities accounts for 21.26% of the total cost, and the environmental installation impact of biodiesel production facilities accounts for 99.94% of total environmental impact. In the transportation sector, the heterogeneous fleet of trucks is employed to supply materials in the entire supply chain by which environmental transportation impacts account for 0.0005% of total environmental impacts. The social impact is examined by the social impact assessment method focused on life cycle assessment which is 1.363% for this model. The designed model can be appropriate to policymakers and investors engaged in the biodiesel industry.

Peculiarities of International Competition in the Market of Tourism and Hospitality

The global hospitality and tourism market is being transformed through several core factors: new consumer needs of the industry, pandemic, increased competition, in particular the emergence of new regional tourism markets and new companies. The aim of the article is to investigate the competitiveness of the global hospitality and tourism market based on the example of key attractive tourism regions: Africa, the Americas, Asia, the Pacific, the Middle East and Europe. The methodology is based on a statistical analysis of regional hospitality and tourism markets by key indicators of their competitiveness in 2010‒2021. The results show a significant contraction of the global hospitality and tourism market, with transformations in regional markets (Asia due to rising travel costs and restrictions, the Middle East due to rising costs of tourism services). The European hospitality and tourism market is found to be stable due to a slight increase in the cost of travel services and weaker regulatory restrictions introduced during the pandemic. The structure of the industry has changed between 2020 and 2021, with a growing share of regional markets in Europe, resulting in a change in international competition between regional tourism and hospitality markets. The key competitive advantages of European countries in the field of tourism are historical and cultural heritage, developed tourism infrastructure, level of service, safety, cost of tourism services, including transport and accommodation facilities. Despite the development of new regional tourism markets (Asia, Pacific, Middle East) due to increased prosperity and improved infrastructure, the pandemic has caused these destinations to stagnate due to increased costs of tourism services.

Türkiye’de Sanayi Müdahaleciliğinin Etkinliği: Madencilik Sektöründe Sabit Sermaye Yatırımlarının Kliometrik Analizi (1936-1950)

Madencilik eski çağlardan bu yana sanayileşmenin arkasında bir itici güç olarak önemi her geçen gün artan bir iktisadi faaliyet olmuştur. Sanayi Devrimi tarihsel açıdan yol açtığı göz alıcı değişmeleri büyük oranda madencilik alanındaki gelişmelere borçludur. Madencilik alanında yürütülen faaliyetler sanayileşme sürecine sağladıkları katkıların ötesinde yerli kaynakların etkin biçimde kullanılması ve enerjide dışa bağımlılığının azaltılması bakımından da büyük önem arz etmektedir. Türkiye iktisat tarihinde 1930’lu yıllarla birlikte başlayan devletçi politikaların temel amacı sanayileşmenin temin edilmesidir. Sanayileşme odağıyla cumhuriyetin kurulması süreciyle başlayan müdahaleci politikalar doğrultusunda madencilik faaliyetleri önemli bir yer tutmuştur. Çalışmayı kapsayan 1936-1950 dönemi boyunca madencilik sektöründe devleti temsil eden tek kurum Etibank olmuştur. Bu temsil yetkisinin ötesinde, kurum tarafından madencilik alanında yapılan üretim faaliyetleri Türkiye’de yapılan toplam maden üretiminin %100’ünü teşkil etmiştir. Bu bağlamda Etibank hem sanayi müdahaleciliği açısından kurumsal olarak hem de üstlendiği madencilik faaliyetleri ile sınai gelişime katkı sunmuştur. Çalışmada sanayi müdahaleciliğini temsilen Etibank’a ait sabit sermaye yatırımlarına ilişkin veriler kullanılarak, Etibank’ın ekonomik büyüme üzerindeki etkinliği test edilmeye çalışılmıştır. 1936-1950 yılları aralığını kapsayan Bitmemiş Tesisler ve Tesis Masrafları, Müessese ve Teşebbüs Sermayesi ile İştirakler sabit sermaye yatırımları olarak hesaplanmış; değişkenler arasındaki uzun vadeli ilişkiyi araştırmak için Otoregresif Dağılım Gecikmeli (ARDL) sınır testi modeli kullanılmıştır. Elde edilen ampirik bulgular sanayi müdahaleciliğinin ekonomik büyüme üzerinde olumlu bir etkisi olduğu sonucunu desteklemektedir.

Pyroprocessing unit cost estimation for a commercial facility using PRIDE actual costs in Korea

This study presents the process unit cost for a pyroprocessing commercial facility with an annual 400-ton production volume. The pyroprocessing unit cost was calculated as 1723 USD/kgHM. There are mainly-three elements in the cost of the pyroprocess: capital investment, operation and maintenance, and decommissioning and disposal. It is proven that the operation and maintenance cost is the key cost driver, taking up approximately 77% of pyroprocessing costs. This cost is the value estimated based on the actual cost of the PyRoprocess Integrated inactive DEmonstration (PRIDE) facility, which the Korea Atomic Energy Research Institute is currently operating. Accordingly, accuracy level and reliability are judged to be higher than the pyroprocessing unit cost estimated with the engineering estimation method based on the conceptual design published in the existing literature. In addition, the accurate pyroprocessing unit cost will determine the economic viability of the reprocessing option for sustainable nuclear power generation.

Analisis Pendapatan Usaha Ikan Asin di Kelurahan Sumber Jaya Kecamatan Kampung Melayu Kota Bengkulu

This study aims to find out how much income from salted fish business in Sumber Jaya Village, Kampung Melayu District, Bengkulu City. This type of research is descriptive research. The subjects in this study were 21 salted fish business people in Sumber Jaya Village, Kampung Melayu District, Bengkulu City. Data collection techniques using observation, interviews and documentation. Data analysis techniques using data processing, data analysis, interpretation of the results of the analysis. The results of this study found that the capital used in the salted fish business is own capital. The raw materials for this business are fresh sea fish and salt. The production costs in the salted fish business include the cost of production facilities, equipment depreciation costs, labor costs and other costs. The income of salted fish business in Sumber Jaya Village, Kampung Melayu Subdistrict, Bengkulu City in 1 month is the smallest, namely Rp. 3,619,304 and the largest is Rp. 5,707,304. The average income of salted fish business is RP 4,663,304..

Methodological Support for Assessing Development Level of Logistics Infrastructure

The paper presents the results of a study in the field of assessing the level of development of the logistics infrastructure of the regions. The analysis of existing approaches and methods for assessing the logistics infrastructure revealed that most of them take into account mainly the transport component of the logistics infrastructure, and the financial and information components are represented by indicators of foreign direct investment in human capital and the cost of logistics facilities. At the same time, the assessment of some indicators is carried out by researchers mainly with the help of expert methods. To assess the level of development of the logistics infrastructure of the regions of the Republic of Belarus for the purpose of their comparative analysis and study of the dynamics, a methodology has been developed for assessing the logistics infrastructure of the regions. In order to eliminate the identified features of existing approaches to the assessment of the logistics infrastructure, the methodology presented by the authors used indicators that describe the development of both the transport and storage, information and financial components of the logistics infrastructure using economic and mathematical methods for processing and evaluating data. After selecting indicators and collecting data on them, an assessment was made of the correspondence of the distribution of indicator values in the sample to the normal distribution law using the Kolmogorov – Smirnov criterion with a check for multicollinearity. Further, all indicators were transferred to one measurement scale and the internal consistency of the indicators was checked using the a-Cronbach coefficient. To test the developed methodology, a comparison was made of the logistics infrastructure of the regions of the Republic of Belarus and an assessment of its dynamics based on data for 2015, 2018 and 2021, using factor analysis. Calculations for all stages of the developed methodology were carried out using the IBM SPSS Statistics 20 program.

Prenatally diagnosed congenital heart disease: the cost of maternal care

Objective Little is known regarding the effects of a prenatal diagnosis of congenital heart disease (CHD) on the cost of antenatal and delivery care. We sought to compare the maternal costs of care in pregnancies where the fetus or child was diagnosed prenatally vs. postnatally. Methods Costs of maternal care were determined for pregnancies in which the fetus or child was diagnosed with CHD between 1997 and 2012 in the state of Utah. Cases of CHD were identified via a statewide birth defect surveillance program which included data on the timing of diagnosis, maternal demographic and clinical data, and linked to statewide inpatient maternal hospital discharge records. Antenatal testing costs were determined using Medicaid fee estimates and total facility costs were determined for all hospitalizations including delivery. The association of timing of diagnosis of CHD with costs was analyzed using univariable and multivariable models. Results Of 2128 pregnancies included in the study, 36% had a fetus prenatally diagnosed with CHD. The prenatal diagnosis group was more likely to have a termination or stillbirth and were younger at delivery (gestational age 37.3 vs 38.0 weeks, p < .001). Labor induction and cesarean delivery rates were similar between groups. Antenatal testing and delivery hospitalization costs were higher in the prenatal diagnosis group: $5819 vs $4041 (p < .001) and $10,509 vs $7802 (p < .001), respectively. Patients in the prenatal diagnosis group had longer lengths of hospital stays (3.5 vs 2.4 d, p > .001). After controlling for significant differences between the groups, including lesion severity, the prenatal diagnosis remained directly associated with antenatal testing costs (+$1472), maternal hospitalization costs (+$2713), and maternal hospital length of stay (+1.0 d). Conclusion A prenatal diagnosis of fetal CHD was associated with increased prenatal costs, hospitalization costs, and hospital length of stay for affected pregnant patients.

Optimal allocation of dynamic wireless charging facility for electric vehicles

It is widely recognized that electric vehicle (EV) users get frustrated by the limited range of EVs, slow charging, and limited charging facilities available in the vicinity of their journey route. These factors contribute to slowing down the uptake of EVs. Dynamic wireless charging (DWC) system has the potential to offer a cost-effective solution to these issues. This paper investigates the DWC allocation problem from the decision makers’ perspective to minimize individual users’ costs as well as the investment cost for DWC facilities. We propose a mixed-integer optimization model to achieve a cost-effective solution for the optimal placement of DWC facilities on the large road network while maintaining an acceptable state-of-charge level. Sensitivity analysis is conducted on the optimization model parameters to check the feasibility and significance of model solutions for DWC placements. The results provide useful insights into the optimal settings of DWC facilities under multiple route environments.

Charging Station Planning of Electric Vehicle in Battery Swapping Scene

In response to the national green development concept, the electric vehicles quantity continues to surge. However, the cost of electric vehicle charging facilities is hindering the development of electric vehicles. Considering charging facility cost and fuel consumption cost of logistics vehicles, we propose the charging planning for electric vehicle batteries. First, according to the user’s mileage, we simulate the maximum demand for electric vehicle batteries in each time. Then, based on the electric vehicle battery charging planning, we establish an optimization model for the number of battery charging equipment and the fuel consumption cost of logistics vehicles. Finally, through specific examples we show the optimal number of delivery is 4 from the battery charging station to the battery swapping station. The battery charging equipment are 368 units and the fuel consumption cost of the logistics vehicle is 8040 RMB per day. In addition, the number of logistics vehicle departures is reduced by 3 compared to the same amount of delivery, which significantly improves the stability and efficiency of the battery swapping scene.

Engineering requirements for the formation of a system of estimate documents in construction

Introduction. In modern conditions, clearly formulated requirements for the estimated documentation used to justify the estimated construction costs (major repairs, reconstruction) of a capital construction facility contribute to the unambiguous formation of goals, functions, restrictions, requirements for its creation and subsequent operation. During the reformation of the pricing system and the estimated rationing of the construction industry, the issue of methodological support for the process of substantiating the value of estimated costs in construction, as well as full and reliable reflection of costs in the estimated documentation, is acute. The analysis of the main forms of primary estimate documentation on the example of local estimates (estimates), developed using federal or territorial estimate standards, confirmed the need for work on the development of uniform requirements for the preparation of all forms of estimate documentation. In addition, for the introduction and use of information modeling technologies in construction, it is also necessary to develop a set of requirements for estimate documents in order to systematize and unify the information provided in them.&#x0D; &#x0D; Materials and methods. System approach, general theoretical methods of cognition (analysis, synthesis, analogy, generalization, comparison and others), project management methods.&#x0D; &#x0D; Results. It is proposed to use a system for managing the requirements for the estimate documentation. The stages of the development of the system of requirements for the estimate documentation, the processes within each stage, as well as the performance indicators of the process, allowing to evaluate the process itself during its implementation, are determined. The requirements for the composition and design of the estimate documentation are formulated.&#x0D; &#x0D; Conclusions. The implementation of the proposed management system for the requirements for the estimate documentation in practice, of course, will contribute to increasing the reliability of the estimated costs in construction, as well as minimizing the time spent on the implementation of the process of passing the examination of the estimate documentation.

The estimated costs and benefits of a hypothetical supervised consumption site in Providence, Rhode Island.

Overdose deaths have increased dramatically in the United States, including in Rhode Island. In July 2021, the Rhode Island government passed legislation supporting a two-year pilot program authorizing supervised consumption sites (SCSs) in response to this crisis. We estimated the costs and benefits of a hypothetical SCS in Providence, Rhode Island. We utilized a decision analytic mathematical model to compare costs and outcomes for people who inject drugs under two scenarios: (1) a SCS that includes syringe services provision, and (2) a syringe service program only (i.e., status quo). We assumed 0.95% of injections result in overdose, the SCS would serve 400 clients monthly and have a net cost of $783,899 annually, 46% of overdoses occurring outside of the SCS result in an ambulance run and 43% result in an emergency department (ED) visit, 0.79% of overdoses occurring within the SCS result in an ambulance run and ED visit, and the SCS would lead to a 25.7% reduction in fatal overdoses near the site. The model was developed from a modified societal perspective with a one-year time horizon. A hypothetical SCS in Providence would prevent approximately 2 overdose deaths, 261 ambulance runs, 244 ED visits, and 117 inpatient hospitalizations for emergency overdose care annually compared to a scenario that includes a syringe service program only. The SCS would save $1,104,454 annually compared to the syringe service program only, accounting only for facility costs and short-term costs of emergency overdose care and ignoring savings associated with averted deaths. Influential parameters included the percentage of injections resulting in overdose, the total annual injections at the SCS, and the percentage of overdoses outside of the SCS that result in an ED visit. A SCS in would result in substantial cost savings due to prevention of costly emergency overdose care.

교육비특별회계 순세계잉여금 실태와 영향 요인 분석: 불용액을 중심으로

The purpose of this study was conducted with the purpose of responding to external pressure to reduce local education finance, which was raised by inefficiency in the process of budgeting and executing the external local education finance, which is represented by a decrease in the school-age population and excessive net budget surplus. Accordingly, the current status of net budget surplus generation by year and factors influencing the occurrence of the special account for education expenses were analyzed, and policy improvement plans based on this were explored. As a result of the study, the total amount of net budget surplus in the special account for education expenses increased sharply in 2015 and then has been on a downward trend since 2019. Considering that the amount of tax revenue has continuously increased, this seems to be due to the offices of education’s efforts to reduce disuse of appropriation. It was found that the unused budget was mainly generated from reserve contingency fund, facility cost, and labor cost. In general, most of the unused budget came from the budget execution balance, which was due to the difference between successful bids, the reduction in contract review, and the inability to adjust the budget of the amount carried forward due to non-execution of construction during the semester. Based on these analysis results, increase efforts to organize the main budget of net budget surplus, stipulate regulations on the treatment and use of net budget surplus, make it mandatory to deposit a portion of net budget surplus into the rainy day fund, establish a plan for facility-related project expenses from a mid- to long-term perspective, and efforts to improve financial management efficiency through operation and early budget execution were. suggested.

Price and Prejudice? The Value of Chimeric Antigen Receptor (CAR) T-Cell Therapy.

Although chimeric antigen receptor (CAR) T-cell therapy has shown a high response rate in lymphoma patients, its cost-effectiveness is controversial due to the high price and uncertainty of the clinical evidence. In addition to the high acquisition cost of CAR T-cell therapy, procedure and facility cost increase the financial burden considering the frequency of adverse events such as cytokine release syndrome. In clinical research, relatively short follow-up periods were used compared to traditional cancer agents. In addition, head-to-head comparative effectiveness data are unavailable, which is an important factor when evaluating the cost-effectiveness of a new treatment. Additional evidence that will compensate for the uncertainty of existing clinical data is needed for full evaluation of long-term efficacy, safety, and comparative effectiveness.

A Two-Stage Stochastic Programming Model for Emergency Supplies Pre-Position under the Background of Civil-Military Integration

The pre-positioning of emergency supplies is of great significance for a timely and effective rescue after a disaster. Using the background of civil-military integration in China, this paper puts the military storage facilities into the layout scheme of emergency supplies reserve and builds a two-stage stochastic programming model of emergency supplies location–allocation optimization, the aim of which is to effectively use the reserve resources of both military and civilian sides to reduce the reserve cost. Then, an improved whale optimization algorithm (IWOA) with more strategies is designed to solve the model. The applicability of the model is proved via a real-world case study in Tangshan, China. The case study shows that when the unit storage cost of military storage facilities is less than 1.5 times of that of civilian emergency storage, the military and civilian joint reserve mode can reduce the reserve cost-effectively; decision-makers can set different maximum rescue times according to different preferences to adapt to different emergency decision-making needs.

A Multi-Disciplinary Review of Time-Driven Activity-Based Costing: Practical Considerations for Spine Surgery.

A multi-disciplinary review. To provide a roadmap for implementing time-driven activity-based costing (TDABC) for spine surgery. This is achieved by organizing and scrutinizing publications in the spine, neurosurgical, and orthopedic literature which utilize TDABC and related methodologies. PubMed and Google Scholar were searched for relevant articles. The articles were selected by two independent researchers. After article selection, data was extracted and summarized into research domains. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) systematic review process was followed. Of the 524 articles screened, thirty-five articles met the inclusion criteria. Each included article was examined and reviewed to define the primary research question and objective. Comparing different procedures was the most common primary objective. Direct observation along with one other strategy (surveys, interviews, surgical database, or EMR) was most commonly employed during process map development. Across all surgical subspecialties (spine, neurologic, and orthopedic surgery), costs were divided into direct cost, indirect cost, cost to patient, and total costs. The most commonly calculated direct costs included personnel and supply costs. Facility costs, hospital overhead costs, and utilities were the most commonly calculated indirect costs. Transportation costs and parental lost wages were considered when calculating cost to patient. The total cost was a sum of direct costs, indirect costs, and costs to the patient. TDABC provides a common platform to accurately estimate costs of care delivery. Institutions embarking on TDABC for spine surgery should consider the breadth of methodologies highlighted in this review to determine which type of calculations are appropriate for their practice.

Risk Management in Oil and Gas Field Development Project with Marginal Resources: A Case in Mature Field in East Kalimantan

The oil and gas industry and risks are very related to each other. There are several risks known in this industry, from economic risks, political risks, environmental and safety risks, up to geological risks itself. Because oil and gas are a non-renewable source of energy, the more mature an oil and gas field is, the risks for the company to develop a project investment may be lower and higher at the same time. Entering its declining phase, PT MNO who is trusted to operate an ex-termination oil and gas field in East Kalimantan which has been producing for almost 50 years, is required to find a way to survive until end of contract in 2037 by developing the remaining hydrocarbon resources which become more and more marginal. The project development is proposed as a bundling to allow flexibility during execution phase in selecting the well candidates based on recent data acquired from previous wells drilled, hence reducing the risks. Field Development Package (FDP) 2.3 is prepared as part of PT MNO long term plan and commitment after receiving incentive from Government of Indonesia in 2021. According to the Company Guideline, a risk register is mandatory to be developed since beginning of project which covers risks identification, risks analysis, and risks evaluation. The project team is also responsible to define risks treatment to manage the risks borne by the project. This is in line with the requirement for Good Corporate Governance, where risk management is introduced since beginning of the project life-cycle. This study covers the risk assessment on the basis of selected project scope which has been validated technically. The risk assessment will determine the major risks in FDP 2.3 considering available historical data of oil price, drilling cost realization, and facility cost realization. These risks need to be monitored to ensure the FDP 2.3 will create value for the shareholder as per plan or avoid loss at the minimum. The most important risks concluded in this study is oil price lower than economic assumption, production target not achieved, and no fix gas sales contract to absorb production. The company may focus in these risks for the risk management of future project development.

Estimating production costs and retail prices in different poultry housing systems: conventional, enriched cage, aviary, and barn in Japan

For many producers, introduction of improved animal welfare systems is a turning point in their future production strategies as it increases production costs. The increase in egg retail prices is of growing concern not only for producers, but also for retailers and consumers. However, no report has calculated the estimated production costs or retail prices associated with introducing practices that support improved animal welfare in poultry farms in Japan. Therefore, this study aimed to estimate the production costs and table egg prices of 6 types of laying hen systems: conventional cage (CC): 8- and 12-tiers (CC8, CC12), enriched cage (EC): 8- and 12-tiers (EC8, EC12), aviary (AV), and barn systems (BR). Production costs include land purchases, construction costs of facilities, equipment and machinery, quantity of feed provided, farming materials invested, and wages.As a result, farm gate prices were estimated as CC8 = 12.19, CC12 = 12.19, EC8 = 14.52, EC12 = 14.52, AV = 21.14, and BR = 28.74 [yen/egg], and the production cost, including building the new farm, increased by EC8 = 19.1%, EC12 = 19.1%, AV = 73.4%, and BR = 135.7%, respectively, referring to the value of CC. The results show that the prices increase in systems between CC and BN. The retail price or table egg price was estimated to be CC8 = 24.68, CC12 = 24.68, EC8 = 28.07, EC12 = 28.07, AV = 37.27, and BR = 48.53 [yen/egg]. The retail price of BR is approximately twice that of CC. In addition, assuming that all of Japan's eggs were produced in the BR system, the soaring cost of eggs would likely affect the prices of factory eggs, such as liquid eggs and other products, thus affecting the prices of various food products.Understanding the significant management costs that affect the retail price of eggs would facilitate improved policies and practical approaches to support poultry farms and sustainable farming activities while addressing public concerns.