Facility Costs Research Articles

Discrete-continuous model for facility location problem with capacity-cost relation constraints

The facility location problem (FLP) involves optimally locating a set of facilities that must satisfy the demands of a group of customers distributed in a planar area. Traditionally, various FLP models have been applied to find new facilities by considering already-existing facilities, and choosing new locations among a given set of discrete candidates. These are unreasonable because a limited set of candidates may not include the optimal locations. In this study, we developed a mathematical model based on mixed-integer linear programming (MILP) for FLP. In this model, the locations of existing facilities are known and categorized as discrete. On the other hand, the locations of new facilities to be found are categorized as continuous and discrete. In addition, the optimal number of new facilities is determined by a judgment formula. The cost of facilities is also considered, including fixed opening costs and variable capacity-related costs. To make the model closer to reality, the entire area is divided into several zones with varying costs. We developed a greedy multiphase location method for the proposed MILP (MPL-MILP) that efficiently determines the exact locations of new facilities in a stepwise manner. For large-scale problems, we developed a two-variable-based dynamic iterative partial optimization (TVB-DIPO) to obtain near-optimal solutions within a given time limit. Computational experiments were conducted to test the performance of the proposed MPL-MILP and TVB-DIPO. The results indicate that MPL-MILP is suitable for small- and medium-sized problems with exact solutions, while TVB-DIPO is more suitable for large-scale problems with higher solution efficiencies.

Financial Implications of Evolving Breast Cancer Radiotherapy Treatment Protocols

Adjuvant radiotherapy for breast cancer represents a significant portion of radiotherapy (RT) treatments. The resource implications of evidence-based changes in treatment protocols must be defined to facilitate RT service planning. We designed a study to calculate the impact of past changes and create a model to allow prediction of costs implications for future changes. Changes in RT treatment (shown in table 1) in the past 3 years were identified in consultation with clinical staff and by reviewing institutional treatment guidelines. Resource and infrastructure costs were calculated for each protocol. Staff time was calculated using standard time slots where known (e.g., CT simulation appointment) and estimates based on discussion with staff (e.g., time to plan whole breast RT). Cost / Gy was calculated based on Linac cost of €2.5M, 10% annual service charge over 12-year lifetime, 2.7 patients treated / hour (verified institutional metric) and standard 2Gy fraction, giving €37.72 / Gy. We did not include facilities costs nor account for differing treatment outcomes. We collected relevant data on a consecutive 6-month sample (Jan - Jun 2019) of women receiving adjuvant RT for breast cancer (n = 224). Total costs were calculated by applying costs for each protocol change to the women in this cohort eligible for the changes. Protocol changes and costs are summarized in table 1. The use of DIBH for women <60 years receiving IMN RT (left and right sided) added a cost. The largest cost saving resulted from more selective tumor bed boost, a saving of €462,138. The potential impact of a 5-fraction boost for women with non-low risk DCIS was estimated. In the cohort analyzed, identified changes in adjuvant breast radiotherapy resulted in overall savings due to updated indications for boost and the implementation of ultra-hypofractionated radiotherapy. We are now analyzing the impact of introducing simultaneous integrated boost and partial breast radiotherapy.

Costs of Coordinated Specialty Care for First-Episode Psychosis: A Microcosting Analysis.

In this study, the authors measured and described the costs of coordinated specialty care (CSC) for first-episode psychosis in Ohio. A microcosting tool was used to estimate personnel and nonpersonnel costs of service delivery at seven CSC programs. Average annual cost per participant (N=511 participants) was estimated as $17,810 (95% CI=$9,141-$26,479). On average, 61% (95% CI=53%-69%) of annual program costs were nonbillable. Key cost drivers included facility costs, administrative tasks, and social services. Novel financing models may redress reimbursement gaps incurred by CSC programs.

Characterization of the Mechanical Properties of Low Stiffness Marine Power Cables through Tension, Bending, Torsion, and Fatigue Testing

The exploitation and harnessing of offshore marine renewable energy have led to an increased demand for reliable marine power cables with long service lives. These cables constitute a considerable share of the total installation cost of offshore renewable energy facilities and have high maintenance and repair costs. The critical characteristics of these power cables must be determined to reduce the risk of exceeding their ultimate strength or fatigue life, which can result in unwanted and unexpected failures. This study investigates dynamic marine power cables that are suitable for application in devices that harness energy from ocean currents, waves, and tides. Tension, bending, torsion, and fatigue tests were conducted on three dynamic power cables (1 kV, 3.6 kV, and 24 kV) that have high flexibility, i.e., low mechanical stiffness. The specimen lengths and axial pretension force were varied during the tests. The results are discussed in terms of the mechanical fatigue degradation and ultimate design load, and the key observations and lessons learned from the tests are clarified. The study’s main contribution is the results from physical component testing of the dynamic marine power cables without metallic armors, which can be used to calibrate numerical models of this type of dynamic marine power cable in the initial design of, e.g., inter-array cables between floating wave energy converters. The benefits offered by this type of cable and the importance of the results for creating reliable numerical simulation models in the future are highlighted.

Prediction of Carbon Price in EU-ETS Using a Geometric Brownian Motion Model and Its Application to Analyze the Economic Competitiveness of Carbon Capture and Storage

To achieve carbon neutrality, many countries and regions are making efforts to promote the commercialization of greenhouse gas (GHG) mitigation technologies using emissions trading systems (ETSs). Accurate predictions of when the cost of GHG reduction technologies will become competitive below carbon prices could be invaluable to engineers and policy makers. In this study, carbon price movement in the EU-ETS was analyzed using a geometric Brownian motion (GBM) model. Using daily price data for the last 10 years, it tested whether the price pattern of the latter three years could be predicted by applying the first seven years of data to the GBM model. The results showed that the GBM model could well predict the upper and lower bounds of the actual carbon price. Based on the acceptable predictability of the GBM model, simulations were performed using carbon price data over the last decade, showing that carbon prices would reach around 200 EUR/tCO2 by the start of 2026. This is higher than the cost of CO2 avoided evaluated from the costs of commercial-scale carbon capture facilities for coal-fired power plants. This means that carbon capture technologies in the coal-fired power sector could become economically competitive within the next several years.

The Effects of Women's Beauty and Health Multi-Shop Consumption Perceptions and Selected Attributes on Use Satisfaction

Purpose: Recently, in Korea, beauty and health consumers are seeking convenience and professionalism, so multi-shop type stores are gradually increasing. Accordingly, this study was conducted with the purpose of confirming the relationship between consumption perception, optional attributes, and use satisfaction with women visiting beauty health multi-shops as participants.&#x0D; Method: The study participants consisted of 183 adult females aged 20 years or older in S-city and G-province using the non-probability sampling method and the judgment sampling method. As for the data analysis method, MANOVA and multiple regression analysis were conducted to analyze the relationship between consumption perception, choice attributes, and use satisfaction.&#x0D; Results: As a result of the study, all independent variables such as consumption necessity factors, consumption process factors, and consumption result factors were statistically significant in the influence relationship between consumption perception variables and selection attributes. And in the relationship between the selected attribute variable and the satisfaction factor, the facility factor, loyalty factor, and cost factor were found to be significant, while the information provision factor was statistically insignificant.&#x0D; Conclusion: The results of this study served as an opportunity to confirm various factors related to the consumer's perception of consumption and the satisfaction of use according to the selected attributes of visiting beauty health multi-shops. Therefore, it suggests the specific and detailed importance of the perception and selection attributes of consumers who visit beauty health multi-shops.

Integrating Electric Vertical Takeoff and Landing Aircraft into Public Airspace: A Scenario Study

The successful deployment of Advanced Air Mobility (AAM) requires the safe integration of electric vertical takeoff and landing (eVTOL) aircraft in non-segregated airspace. However, a lack of practical deployment demonstrations can slow the regulatory progress. This study presents a practical deployment framework for the integration of eVTOL aircraft into public airspace, in accordance with the Federal Aviation Administration (FAA) special airworthiness criteria. This study focused on a corporate use case to provide a comprehensive scenario for enhancing intra-company mobility. The scenario supports early implementation and demonstration goals by removing reliance on air traffic management systems or air traffic controller separation services. The practical deployment framework included facility selection, route planning, terrain mapping, collision avoidance, aircraft selection, infrastructure requirements, vertiport placement, electric chargers, ground handling, operational staff, and cost estimates. Planners can use the framework as a template to inform the implementation of real-world AAM services using eVTOL aircraft.

Диагностика зависимости основного производства от производственной инфраструктуры на основе ансамблевого метода машинного обучения

The rational organization of the production infrastructure of an industrial enterprise has a significant impact on the level of profitability of production. New technologies for integrating business processes are evolving in the face of industrial automation. The aim of the article is to diagnose the level of economic dependence of the core production on the production infrastructure. As a research method, the algorithm of the ensemble method of machine learning “Random Forest” is proposed. The parameters that quantitatively and qualitatively describe the costs of main and auxiliary production, the costs of repair facilities, and the level of production efficiency have been developed. Approbation of the algorithm on the example of chemical enterprises allowed distin-guishing three classes of productions by the nature of the organization of production infrastructure and its par-ticipation in the core production. The quality of the obtained models is evaluated by calculating the risk of mis-classification and the magnitude of cumulative lift, where the class with the most correct classification results is highlighted. Results obtained are primary diagnostics of the organization and capacity utilization of the produc-tion infrastructure in order to make decisions on business process restructuring.

Cost analysis of hydrogen production by high-temperature solid oxide electrolysis

We estimate construction and operation costs of gigawatt-scale solid oxide electrolysis (SOE) facilities for producing high purity hydrogen gas from water. Manufacturing and assembly costs for two types of SOE cell stacks are estimated using a detailed design for manufacture and assembly (DFMA®) analysis. Modular balance of plant (BOP) process equipment is designed and sized with Aspen®, and cost estimated using equipment vendor quotes. Factory and on-site assembly and installation costs for SOEC stack and BOP equipment integration into modular SOE process units are calculated using a simplified DFMA® method. Total stack costs on a stack input power (SIP) basis reduce to <$100/kWe DCSIP for >500 MWe DCSIP/year production rates with electrode cermet, interconnects, and high-temperature heat treatments dominating the total cost. Integration of stacks with larger BOP equipment operating at higher pressures offers ∼36% cost reduction in total facility capital cost due to an economies of physical scale effect since BOP equipment comprises >50% of facility costs. Optimized H2 prices decrease from ∼$4/kgH2 to ∼$2/kgH2 for 1 GWe DCSIP facilities using $0.025/kWh electricity price. All costs are reported in 2021 US dollars.

Research on Intelligent Monitoring of Fire Safety and Fire Rescue Plan for Tunnel Operation under Quasi-Unattended Background

Tunnel structures account for la large proportion of the structures in mountain highway transportation systems. Most tunnels are located in remote areas in which the geological conditions are complex and harsh and in which the layout of the management facilities along the way is complex. Thus, the management and maintenance costs of various facilities are expensive, the cost of fire safety operations and management is high, and disaster prevention and rescue have a difficult time meeting the objective requirements. Therefore, it is urgent to carry out research on quasi-unmanned operations and intelligent remote monitoring. This study firstly proposes a fire safety intelligent monitoring framework for quasi-unattended tunnels. By making full use of various intelligent sensor monitoring data in the tunnel, the tunnel operation status can be grasped in real time. Then, a fire safety evaluation model can be established through the analytic hierarchy process (AHP), and, based on the monitoring data, the AHP model parameters can be evaluated to realize the real-time evaluation and management of tunnel fire safety. Finally, on the basis of the fire safety intelligent monitoring system and the fire safety evaluation system, an adaptive fire rescue plan formulation scheme is proposed for the quasi-unattended tunnels so as to provide guaranteed support for the rapid automatic response of tunnel fire protection and to provide technical data support for the design and realization of intelligent and efficient tunnel management

Post-infusion Costs Associated with Idecabtagene Vicleucel Treatment for Patients with Relapsed/Refractory Multiple Myeloma in the KarMMa Trial.

Patients with triple-class exposed relapsed/refractory multiple myeloma (RRMM) have poor outcomes with substantial healthcare costs. Idecabtagene vicleucel (ide-cel), a B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T cell therapy, showed deep, durable responses in patients with RRMM in the pivotal phase 2 KarMMa trial (NCT03361748). Healthcare resource utilization (HCRU) and costs were estimated for ide-cel-treated patients in the KarMMa trial. Post-infusion costs were estimated based on HCRU data, including facility care, diagnostics, medications, and procedures. Length of stay (LOS) was extracted for inpatient and intensive care unit (ICU) care. All patients had a 14-day post-infusion inpatient stay per trial protocol. Analyses were conducted for patients treated in the United States (US), who received the ide-cel target dose of 450×106 CAR+T cells and assuming a 7-day inpatient stay. Overall, 128 patients received ide-cel and were included in this analysis. Mean age was 60years, 59% were men, and 81% were white. Mean total LOS was 23.9days. Total estimated costs over 24months post-infusion were US$115,614 per patient, driven by facility costs (75%; $86,385). Most costs were incurred in the first month (58%; $67,259). The scenario analysis assuming a 7-day inpatient stay showed estimated 24-month costs of $92,294. For the 54 (42%) patients who received ide-cel high dose, total costs over 24months were $113,298 per patient. Extrapolation of costs based on HCRU data from patients receiving single-infusion of ide-cel in the KarMMa trial showed substantially reduced HCRU and costs over 2years after initial treatment. Most costs were incurred during the first month after ide-cel infusion, likely attributable to the 14-day inpatient stay required by the trial protocol. These findings suggest a nominal, incremental monthly cost of care immediately after treatment, which may be lower in routine clinical practice.

An Integrated Optimization Model of Green Supply Chain Network Design with Inventory Management

Supply chain network design and inventory management are both significant for improving the core competitiveness of enterprises. This study investigates the joint optimization problem of facility locations and inventory for assembly manufacturing enterprises’ multi-echelon supply chain networks, considering the locations of facilities, the selection of suppliers, transport mode choices, and inventory decisions simultaneously. A corresponding integrated optimization model is proposed, which aims to minimize the total cost, consisting of the fixed open cost of facilities, the inventory cost of the open plants and distribution centers, and the transportation cost of vehicles in the entire supply chain network as well as the cost of CO2 emissions. Based on the characteristics of the proposed optimization model, a hybrid genetic algorithm embedded with a local search is developed to solve the proposed model. Numerical examples and a case study are provided to illustrate the effectiveness of the proposed model and the corresponding algorithm. The findings show that the model is reasonable and applicable, and hybrid genetic algorithm (HGA) is more efficient than the standard genetic algorithm (SGA). In addition, plants’ maximum lead-time has a significant impact on the total cost of the supply chain.

Analisis Biaya Pembangunan Site Facilities Proyek Revetment dan Retaining Wall Dermaga Benoa

Process of a construction project is knowing how much a building will cost. Like the main building, the project site facilities also require costs that are not included in the direct financing of the project. The goal is to provide detailed information on the cost of building site facilities and to serve as reference material for the preparation of RAB site facilities. Implemented in the Revetment dan Retaining Wall Harbor Benoa project, the survey it was found that this project had built a number of temporary facilities but did not clearly detail the cost requirements. The research used descriptive quantitative methods and data collection in the form of surveys, observations and interviews. Survey to measure temporary buildings at the project site and find unit prices of tools, materials and labor at shops or foremen around the project area. Observation observes the layout of the building which will be outlined in the field layout drawing.An interview with the project manager was conducted to find out the total cost of the project and the costs incurred by the contractor for construction. Data analysis using Microsoft Excel by entering all components to be analyzed. Based on the results, it is concluded that the site facilities that are built are the contractor's office, health room, motorcycle and car parking, workers' toilets, directors' and consultants' offices, LAB rooms, cement and plywood warehouses, mechanical warehouses, security and K3 posts, workers' beds, trash bins, and water reservoirs. The comparison of site facilities cost to contract is 0.253%.

Professional Fees for U.S. Hospital Care, 2016-2020.

The latest comprehensive diagnosis-specific estimates of hospital professional fees relative to facility fees are from 2004 to 2012. Update professional fee ratio (PFR) estimates to improve cost analysis opportunities with hospital discharge data sources and compare them with previous PFR estimates. 2016-2020 MarketScan inpatient admissions and emergency department (ED) treat and release claims. PFR was calculated as total admission or ED visit payment divided by facility-only payment. This measure can be multiplied by hospital facility costs to yield a total cost estimate. Generalized linear regression models controlling for selected patient and service characteristics were used to calculate adjusted mean PFR per admission or ED visit by health payer type (commercial or Medicaid) and by selected diagnostic categories representing all clinical diagnoses (Major Diagnostic Category, Diagnostic Related Group, and Clinical Classification Software Revised). Mean 2016-2020 PFR was 1.224 for admissions with commercial payers (n = 6.7 million admissions) and 1.178 for Medicaid (n = 4.2 million), indicating professional payments on average increased total payments by 22.4% and 17.8%, respectively, above facility-only payments. This is a 9% and 3% decline in PFR, respectively, compared with 2004 estimates. PFR for ED visits during 2016-2020 was 1.283 for commercial payers (n = 22.2 million visits) and 1.415 for Medicaid (n = 17.7 million). This is a 12% and 5% decline in PFR, respectively, compared with 2004 estimates. Professional fees comprise a declining proportion of hospital-based care costs. Adjustments for professional fees are recommended when hospital facility-only financial data are used to estimate hospital care costs.

Effects of the Indian National Health Insurance Scheme (PM-JAY) on Hospitalizations, Out-of-pocket Expenditures and Catastrophic Expenditures

ABSTRACT India launched one of the world’s largest health insurance programs, the Pradhan Mantri Jan Arogya Yojana (PM-JAY), targeting more than 500 million economically and socially disadvantaged Indians. PM-JAY is publicly funded and covers hospitalization costs in public and private facilities. We examine how PM-JAY has affected hospitalizations and out-of-pocket expenditures (OOPE), and given the high use of private health care in India, we compare these outcomes across public and private facilities. We conducted a household survey to collect data on socioeconomic and demographic information, health status and hospitalizations for more than 57,000 PM-JAY eligible individuals in six Indian states. Using multivariate regression models, we estimated whether PM-JAY was associated with any changes in hospitalizations, OOPE and catastrophic health expenditures (CHE) and whether these differed across public and private facilities. We found that PM-JAY was not associated with an increase in hospitalizations, but it increased the probability of visiting a private facility by 4.6% points (p < .05). PM-JAY was associated with a relative reduction of 13% in OOPE (p < .1) and 21% in CHE (p < .01). This was entirely driven by private facilities, where relative OOPE was reduced by 17% (p < .01) and CHE by 19% (p < .01). This implied that PM-JAY has shifted use from public to private hospitalizations. Given the complex healthcare system with the presence of parallel public and private systems in India, our study concludes that for economically and socially disadvantaged groups, PM-JAY contributes to improved access to secondary and tertiary care services from private providers.

Cost Comparison of Highway Rest Area Operations: In-House Workforce versus Outsourcing Methods

State departments of transportation (DOTs) typically use one of three approaches to operate highway rest areas (RAs): in-house workforce, method-based contracting (MBC), and performance-based contracting (PBC). State DOTs spend over $600 million annually to maintain their facilities and often outsource their work to save costs. Although some studies have calculated the annual cost of facilities operated by the three approaches, their findings are not directly comparable. The primary objective of this study is to compute and compare the average annual operating cost of individual RA facilities and the cost of RA data samples (average annual operating cost of a group of facilities in a specific year under a specific approach in a state) produced from these three approaches to achieve a cost-effective alternative. To achieve the objectives, research hypotheses were developed which state there are significant differences in the average annual costs produced by these three approaches. For data analysis, 6,248 cost data were collected from 29 states. From those individual cost data, 198 data samples were generated. Data sets were not normally distributed; thus, nonparametric tests were conducted to determine the group differences. The results show that outsourcing costs under the MBC are significantly less, followed by in-house and the PBC in both cases. The difference between in-house and PBC is also statistically significant. As the primary contribution, this paper investigated the MBC approach as the cost-effective option, and DOT engineers can utilize this approach in operating regular RA facilities to save costs. Caution should be taken when using the study findings in other types of facilities.

Long-term performance validation of NH3 concentration prediction model for virtual sensor application in livestock facility

Livestock facilities commonly generate NH3, a hazardous substance that may also harm livestock. Therefore, monitoring of NH3 concentrations in livestock facilities is necessary to ensure proper control. However, NH3 is alkaline and toxic, causing corrosion inside detection sensors and making monitoring difficult. This study proposes a virtual sensor concept to complement the durability of NH3 physical sensors. The study also conducts a long-term performance validation of a data-driven NH3 concentration prediction model. Results indicate that the model's prediction performance declines sharply when the data generation pattern inside the livestock facility changes due to changes in outdoor conditions and facility operation. Furthermore, the prediction performance of the model differed depending on the training data period settings when updating the model. Hence, the model needs versioning and update management to respond to the data generation pattern in the livestock facility when operating the NH3 concentration virtual sensor. The virtual sensor is expected to enhance monitoring and reduce sensor management costs in livestock facilities.

Multi-dimension analysis of volatile sulfur compound emissions from an urban wastewater treatment plant

Long-term monitoring of volatile sulfur compounds (VSCs) released at the water-air interface from different treatment units of an anaerobic/oxic (A/O) wastewater treatment plant (WWTP) was carried out to assess the temporal and spatial emission characteristics of VSCs, to explore relationships between wastewater quality and VSC release. The VSC from non-aerated and aerated units were collected using dynamic and static chambers, respectively, and determined using gas chromatography. The VSC emission fluxes diminished in the order of primary sedimentation tank (PST) > anaerobic areas (ANA) > oxic section 1 (OX1). VSCs were not detected in the oxic section 2 (OX2), the oxic areas section 3 (OX3), and the final setting basin (FSB). Release capacities of VSCs descended in the order of summer > fall > spring > winter, with July, August, and September being the months with the highest VSC release capacities. VSC emission fluxes correlated well with wastewater temperatures, sulfate concentrations, and COD. VSC emission flux empirical equations based on wastewater temperature, sulfate concentrations, and COD were established. Based on the established VSC emission empirical equation, a control strategy to reduce the operating costs of deodorization facilities was proposed. This strategy is economically efficient and reduces the consumption of electrical energy.

Costs and intermediate outcomes for the implementation of evidence-based practices of midwifery under a MIDWIZE framework in an urban health facility in Nairobi, Kenya

BackgroundThree evidence-based midwife-led care practices: dynamic birth positions (DBP), immediate skin-to-skin contact (SSC) with zero separation between mother and newborn, and delayed cord clamping (DCC), were implemented in four sub-Saharan African countries after an internet-based capacity building program for midwifery leadership in quality improvement (QI). Knowledge on costs of this QI initiative can inform resource mobilization for scale up and sustainability. MethodsWe estimated the costs and intermediate outcomes from the implementation of the three evidence-based practices under the midwife-led care (MIDWIZE) framework in a single facility in Kenya through a pre- and post-test implementation design. Daily observations for the level of practice on DBP, SSC and DCC was done at baseline for 1 week and continued during the 11 weeks of the training intervention. Three cost scenarios from the health facility perspective included: scenario 1; staff participation time costs ($515 USD), scenario 2; staff participation time costs plus hired trainer time costs, training material and logistical costs ($1318 USD) and scenario 3; staff participation time costs plus total program costs for the head trainer as the QI leader from the capacity building midwifery program ($8548 USD). ResultsAt baseline, the level of DBP and SSC practices per the guidelines was at 0 % while that of DCC was at 80 %. After 11 weeks, we observed an adoption of DBP practice of 36 % (N = 111 births), SSC practice of 79 % (N = 241 births), and no change in DCC practice. Major cost driver(s) were midwives’ participation time costs (56 %) for scenario 1 (collaborative), trainers’ material and logistic costs (55 %) in scenario 2(collaborative) and capacity building program costs for the trainer (QI lead) (94 %) in scenario 3 (programmatic). Costs per intermediate outcome were $2.3 USD per birth and $0.5 USD per birth adopting DBP and SSC respectively in Scenario 1; $6.0 USD per birth adopting DBP and $1.4 USD per birth adopting SSC in Scenario 2; $38.5 USD per birth adopting DBP and $8.8 USD per birth adopting SSC in scenario 3. The average hourly wage of the facility midwife was $4.7 USD. ConclusionImproving adoption of DBP and SSC practices can be done at reasonable facility costs under a collaborative MIDWIZE QI approach. In a programmatic approach, higher facility costs would be needed. This can inform resource mobilization for future QI in similar resource-constrained settings.

Clinic Carpal Tunnel Release Surgery Outcomes and High-Value Care.

As healthcare costs continue to rise, the importance ofdelivering high-value healthcare increases.The volume of carpal tunnel release surgeries performed annually generates a significant cost burden for the healthcare system. The fundamental expenses of carpal tunnel release surgery are facility fees, anesthesia fees, and surgeon fees. Performing open carpal tunnel release surgeries in the clinic utilizing local anesthesia and field sterilization minimizes facility and anesthesia costs. We compared patient outcomes, as measured by infection and revision rates, between hospital-based, ambulatory surgery center-based, and clinic-based carpal tunnel release operations. Three hundred and eighty-eight patients were treated with isolated mini-open carpal tunnel release procedures by three fellowship-trained hand surgeons: 12 patients had hospital-based procedures, 229 had ASC-based procedures, and 147 had clinic-based procedures. All procedures were performed using amini-open approach. No patients were diagnosed with deep infections post-procedurally, irrespective of venue. Our results show no significant difference in outcomes between venues. Therefore, we conclude that the outcomes of open carpal tunnel release surgeries performed in the clinic were not inferior to carpal tunnel release operations performed at the ambulatory surgery center or the hospital. The cost savings from field sterilization, local anesthesia, and the absence of a facility fee provide an opportunity to expand high-value care.