Real Savings Research Articles

EBusiness in the pump industry

Used correctly and with the right tools, the Internet can help manufacturers and buyers and sellers of pumps. However, many in the industry remain sceptical about the real cost benefits it can bring and the advantages, if any, it has over traditional business methods. Godard Abel of BigMachines.com, explores the myths surrounding this new technology and argues that the internet still has a great future as a sales tool and can bring real savings.

Water Management in the Rice-Wheat Cropping Zone of Sindh, Pakistan

Summary Rice and wheat are Sindh's most important cereal crops, extensively grown in rotation. Rice-wheat rotations occur most widely in the Upper Sindh. In Sindh, rice is grown on 0.75 million hectares (mha) with an average yield of 2 tons/ha, whereas the area under wheat is over one mha with average yield of 2.1 tons/ha. The current yields of rice and wheat in Sindh are far below their yield potentials. This is partly due to improper water management practices. During the rice season, the major problem of water management is an early season water shortage followed by an excessive amount of water in the region with the onset of the monsoon season. During the wheat season, excess soil moisture in the rice fields could delay wheat planting, and secondly, later in the wheat season, there could be a shortage of irrigation water. This paper presents an overview of current water management practices in the Sindh rice-wheat zone as a case study, reviews water management practices in rice-wheat zones around the world, and identifies measures, which may result in real water savings in the rice-wheat zone of Sindh. Identified measures are at farm level. These measures include water efficient methods of rice establishment, irrigation scheduling, water-saving irrigation regimes, land leveling, improved layout of irrigation ditches and fields, discontinuation of pancho system and improved drainage and farmer's participation.

DEMAND SIDE MANAGEMENT OF WATER IN ONTARIO MUNICIPALITIES: STATUS, PROGRESS, AND OPPORTUNITIES1

ABSTRACT: Demand side management is being used increasingly by Ontario municipalities as a way to improve the efficiency of water use, defer the costs associated with constructing new water treatment works, and minimize the environmental impacts associated with supplying water. A comprehensive survey of 153 Ontario municipalities was completed in mid‐1998. These ranged in size from small rural townships (with populations as low as 500 people) to the province's largest urban center, Metropolitan Toronto, with a population of approximately 2.5 million people. The questionnaire measured the use of six broad types of demand side measures, including water pricing and metering; municipal by‐laws (ordinances) that promote water conservation; operational and maintenance measures to reduce water losses and consumption; water‐saving plumbing fixtures and devices; public participation programs that encourage water conservation; and other measures, such as water audits. Additionally, the survey collected data on implementation barriers and opportunities. Since the last comprehensive Ontario survey, conducted in 1987 by Kreutzwiser and Fea‐gan (1989), there has been an increase in the use of basic tools such as metering and pricing, plumbing fixtures, and public participation programs. Additionally, new initiatives, such as water audits and computerized monitoring equipment, are being used. However, in many areas opportunities exist to make better use of demand side measures. Unfortunately, municipal capacity to do so often is constrained by (among other factors) limited finances, lack of political will, and public resistance. Demonstration of real cost savings to consumers, and the development of specific goals and objectives for demand side management programs, are two important steps needed to overcome these challenges.

E-tailing and Internet-related Real Estate Cost Savings: A Comparative Analysis of E-tailers and Retailers

This article is the winner of the Real Estate and the Internet manuscript prize (sponsored by PricewaterhouseCoopers) presented at the 2000 American Real Estate Society Annual Meeting.This article explores differences in the corporate real estate strategies of traditional retailers and those of electronic retailers, or e-tailers. The primary issue addressed is whether e-tailing companies realize benefits of their non-retail, online operations, specifically in the form of lower real estate-related expense ratios when compared to traditional brick-and-mortar retailers.The study reveals three trends. First, the majority of retailers studied continue to focus their corporate real estate strategies in the retail space world. However, some companies are incorporating their online operations into their real estate strategies and are beginning to see lower real estate-related costs as a result. Second, there are differences among e-tailers in their real estate strategies as well as some indication of differences in the real estate-related costs associated with the strategy chosen. Third, e-tailers are not realizing real estate-related cost savings over their retailing competitors.

Environmental best practice in the PCB industry

The need for the printed circuit board (PCB) industry to minimise its environmental impact is increasingly important, not only because of public lobbying but also because of the potential negative financial implications. For the industry to be competitive and to reduce its costs, it must therefore maximise the benefits of available environmental best practices. Since PCB manufacturing uses many processes that are potentially harmful to the environment, their negative impact can be significant. This also means, however, that there are major opportunities available through the adoption of waste minimisation and environmental best practices. This article outlines the advantages of adopting such practices within PCB manufacturing and details specific examples of where real improvements and savings can be made. Sources of further information are given and specific reference is made to the PCIF’s new PCB Industry Environmental Best Practice Guide.

Outsourcing Public Health Laboratory Services: A Blueprint for Determining Whether to Privatize and How

In a continuing effort to reform and reinvent the way public organizations do business, the outsourcing of services has become a popular tool, particularly as resource constraints limit options available to governments. All too often, the decision is made, for reasons of ideology or resource constraints, to outsource services without giving careful consideration to the impact of privatization on the core missions of an agency, or whether privatization, in fact, offers real cost savings. Purchasing tools designed for traditional commodity purchases are often grossly unsuited for making decisions on specialized technical services.This article suggests a process for the evaluation of an option to outsource laboratory services. It suggests that, prior to contracting or privatizing services, the concerned agency should evaluate:the impact on the agency's core missionthe availability, stability, and reliability of private sector service providersthe relative costs of internal and external (public or private sector) service providersthe potential impact on regulatory enforcementthe ability to monitor the performance of external providerspotential conflicts of interestBased on this model, the ongoing internal evaluation of services offers public agencies management tools to obtain the best value for the taxpayer dollar, not only in terms of the raw cost per test, but also in managing the quality of the services.

A randomised controlled trial of the costs of hospital as compared with hospital in the home for acute medical patients

To test the cost effectiveness of Hospital in the Home compared to hospital admission for acute medical conditions. Randomised controlled trial at the Prince of Wales Hospital, Sydney, from October 1995 to February, 1997; 100 patients with acute medical conditions admitted through the Emergency Department. The Hospital in the Home (HITH) group costs per separation ($1,764, CI 95% $1,416-$2,111, n = 50) were significantly lower (p < 0.0001, Mann-Whitney U-Wilcoxon Rank Sum) than the control group hospital separation ($3,614, CI 95% $2,881.37-$4,347.27, n = 47) with no significant difference in clinical outcomes, and comparable or better user satisfaction. Given the favourable clinical outcomes the HITH model produces at a lower cost, the cost-effectiveness of the care mode is high, and the allocative efficiency favourable. As a care model and critical pathway, HITH offers hospitals real bed day savings that can either be used to rationalise resource usage for a given level of activity, or increase throughput.

On the rebound? Feedback between energy intensities and energy uses in IEA countries

The interaction or feedback between energy efficiencies or energy intensities and energy use has long been the topic of debate. Some have argued that energy efficiency improvements, by reducing energy intensities and therefore lowering the cost of energy services, would lead to 'rebound’ effects offsetting much or all of any initial savings in energy. In this paper we analyse historical data on energy use, efficiency and pricing in different sectors to try and identify 'rebounds'. For the period of our data (since about 1970) we show that key measures of activity (car use, manufacturing output and structure, house area, etc.) have changed little in response to changes in energy prices or efficiency, instead continuing their long-term evolution relative to GDP or other driving factors. While our analysis cannot disentangle more macro-level economic feedbacks in a detailed way, we show indirectly that such effects also appear to have been small over the 1970s and 1980s. Overall, our analysis of disaggregated sectoral and subsectoral energy-use and activity trends in a variety of IEA economies, suggests that any feedback effect is small compared to both the effects on energy use of changes in energy intensities and overall economic growth. We conclude that most of the improvements in energy efficiencies led to reductions in energy intensities observed in the 1970s and 1980s. Weighted by 1990 activity levels, intensities were roughly 15–20% lower in 1994/5 than in 1973, which in turn meant real savings of energy; energy demand in IEA countries is roughly this much below what it would have been for the same GDP had these savings not occurred. “Rebounds” may have taken back some of the overall savings, but most remain, even after the fall of oil prices in 1986. Any boost to GDP as a result of these savings could not have been sufficient to increase energy demand enough to significantly alter these conclusions. That the savings remained after the fall in oil prices supports the notion that net savings — restrained energy growth relative to GDP in some formulations — arise from technological progress, even if energy prices do not increase. How far this effect can reach, however, is a matter of considerable debate.

Implantación de medicamentos genéricos (EFG) en España y Cataluña: posibilidades de ahorro

To analyze the degree of utilization of generic drugs in Spain and Catalonia. To determine real savings and scope for further savings due to the use of generic drugs. Descriptive, crossover study. Public health prescription in Spain and Catalonia in June of 1999 and in Catalonia from January to June of 1999. In June of 1999, the market share of generic drugs in Spain was 1.15% in units and 0.91% in pesetas of the hole drug prescription. The most used were oral ranitidine, oral diclofenac and oral amoxicillin. Catalonia, in this period, has a greater relative utilization of generic drugs, specially in psychotherapeutic agents like alprazolam and fluoxetine. During the first semester of 1999 only in 9.9% of the occasions where generic drugs could be used, were they actually prescribed. Specifically, the drug most used in its generic form was oral diclofenac with 27.1% of the all possible prescriptions. The real savings generated by the generic drugs were 0.2% of the public pharmaceutical bill, and the theoretical capacity of savings with the current generic offer were 2.3%. There is a low but fast-rising utilization of generic drugs in Spain and Catalonia. Nevertheless the possibilities of savings are at the moment, in relative terms, small. A greater use of them and specially a diversification of the offer is necessary to achieve important relative savings in the overall pharmaceutical bill.

A deliberative model of corporate medical management.

Managed care is evolving in ways that pose unique ethical challenges to those interested in the intersection of clinical and organizational ethics. For example, Disease Management (DM) is a form of managed care that has emerged in response to chronic illness. DM is a healthcare management tool that coordinates resources across an entire health care delivery system and throughout the life cycle of chronic disease. Health Maintenance Organizations have reduced some costs in the delivery of acute care, but real cost savings will result only with greater efficiencies in the delivery of costly chronic care. DM is a systematic, population-based approach that identifies persons at risk of chronic ailment, intervenes with specific programs of care, measures clinical and other outcomes, and provides continuous quality improvement. Characterized as a movement to patient-driven services, DM involves a complex web of provider relations.

Daylighting, energy and glazed balconies: a study of a refurbishment project in Engelsby, near Flensberg, Germany

The passive solar glazed sunspace taking the form of a sun-facing conservatory or glazed balcony has been encouraged as an energy-saving feature in both new and refurbished buildings. Doubts have been raised previously as to whether any real energy savings are possible and whether in fact these spaces increase energy consumption. Little attention has been given to the effect on daylighting where these have been added during refurbishment. This paper discusses these issues and describes the refurbishment of a high-rise social housing building in Germany where design solutions were developed to ensure good daylighdng and energy-saving potential. A contrast is provided with a refurbishment in France where glazed balconies were added instead of existing balconies being glazed.

A novel algorithmic approach to the integration of posterior knowledge into condition-monitoring systems

This paper considers the problem of the integration of 'posterior knowledge' into condition-monitoring systems from both the theoretical and practical points of view. The work is presented in the context of aircraft engine maintenance. A methodology for updating posterior probabilities is proposed for cases where fault conditions are rejected or retained on the basis of external knowledge supplied by an end user, that is the posterior knowledge. A possible fault class ranking is generated following the specification of fault class posterior probability functions. Context-free simulations are used to show the effect of posterior knowledge as part of a maintenance strategy. The simulations are independent of any specific condition-monitoring situation. Preliminary results indicate that posterior knowledge reduces the number of subunit inspections required for isolation of all faults. This has the potential to result in real maintenance cost savings.

A review of reciprocal walking systems for paraplegic patients: factors affecting choice and economic justification.

The prescription of treatment systems which include orthoses to enable patients with high level thoracic spinal lesions to walk reciprocally is now widely practised. It remains a clinical option for which the efficacy is frequently called into question. A broad range of experience has now been accumulated with orthoses of this type, and this is reflected in the literature. The indications for prescription and outcomes of treatment have, as a result of the reported research, become clearer. However, the length of time over which the relevant work has been published and the variety of journals in which it has appeared makes it difficult to perceive a coherent message. This review analyses the published work in order to identify the degree to which the therapeutic benefits which can accrue from ambulatory activity produce an economically justified outcome. Provided appropriate supply procedures are observed so that good patient compliance with the treatment is achieved, there is strong evidence that fewer pressure sores and improved independence will occur at a level where real overall cost savings can be made. Factors which affect patient compliance and on which research findings have been published are identified. Comparisons are made between different orthoses with regard to these, so that more informed choice, taking into account preferences of individual patients, can be made by clinicians.

The cost-effectiveness of managed care regarding chronic medicine prescriptions in a selected medical scheme.

The purpose of the study was to examine the cost-effectiveness of managed care interventions with respect to prescriptions for chronic illness sufferers enrolled with a specific medical scheme. The illnesses included, were epilepsy, hypertension, diabetes and asthma. The managed care interventions applied were a primary discount; the use of preferred provider pharmacies, and drug utilization review. It was concluded that the managed care interventions resulted in some real cost savings.

計装 紙パルプ製造工程における多変数プロセスの最適化

The economic cycle for the industry is becoming much less predictable than it was ten to twenty years ago. The ways in which we communicate and use paper are changing. Finally, with the construction of mills all over the world, the pulp and paper industry has truly become a global market. Every mill executive's current objectives are to increase productivity while decreasing costs and delivering added value to their customers, in turn, generating added value for their shareholders.For the past five years, software products utilizing adaptive technologies have been introduced for solving process modeling/control applications in the pulp and paper industry. These adaptive algorithms (Neural Nets, Chaos Theory, Fuzzy Logic) have provided the unique ability to build accurate non-linear process models based on enormous historical data sets. These models are then put on-line using on-line software for continuous real time savings. Over twenty pulp and paper companies are currently using these products with resulting increases in yield, efficiency and throughput.This paper describes a new product that represents the next step in process optimization and its use for paper machine control. The Process PerfecterTM enables closed-loop control and optimization of nonlinear processes. The benefits of this system over traditional techniques delivers increased profitability by 1) the true unification of optimization and control into one discipline, 2) enabling nonlinear control in processes where traditional linear control is not applicable, 3) reducing the plant testing time for identification of process dynamics resulting in significantly reduced installation and process disruption, 4) by reducing maintenance cost and re-identification, and 5) improving quality through the implementation of statistically smart controls. This standard product, built upon and enhancing the previous products, provides a total solution that can be applied to significant pulp and paper unit.

The Successful Implementation of Pharmaceutical Practice Guidelines? Far From Convincing!

Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, North Carolina 27710.In Reply:-We appreciate the concerns that are raised by Drs. Bailey and Egan in their letter. However, their primary contention, that the extra 3 min per case that are spent between the operating room (OR) and the postanesthesia care unit (PACU) would negate all savings in drugs costs, is fallacious. Their misconception is a common one (repeated in Dr. Riley's letter), so it merits a more complete explanation here. Only a partial explanation (because of limitations on length) can be found in the text of our article. Although it is true that the OR is an expensive environment, it is an expensive environment for a variety of reasons, including administration, cleaning, nursing labor, equipment, and so on. The behavior of most OR costs [1] is such that no actual savings are generated from such a small (3 min) change in operational efficiency. A simplified explanation of the way that hospital accounting systems routinely calculate OR costs/min is necessary to understand this. First, all expenditures are summed and put in the numerator, and all minutes of operation become the denominator. Shaving 3 min from each case does not change any cost that goes into figuring the numerator. Labor costs are unlikely to change, even in institutions who pay their nurses by the hour rather than by the shift. The 3 min added per case in our study, at most (see below) would simply increase the number of minutes (the denominator) used by the hospital accounting system and serve to decrease the cost/min for running the OR. Actual dollars spent would not change. The accounting criticism that Drs. Bailey and Egan (and Dr. Riley, see next letter) offer is not valid in the real world of hard currency.Looking at this from another angle, if one were to approach any OR director and say, “I can cut three minutes off of each and every case if you simply hand me 1 million dollars,” not a single OR manager in the United States would make that deal. That is because no real savings in dollars accrue to the institution; all that happens is the cost/min of running the OR would increase slightly to account for the fact that the same costs are spread out over fewer minutes of operation.Further, we did not measure the actual turnover time between cases during this period. It is entirely conceivable that the extra couple of minutes that were required were not wasted by the OR nurses as they broke down their trays, and therefore no extension of operating room time occurred.The same reasoning used in assessing the “costs” of a few added minutes applies to the extra PACU admission. The extra 45 min/day of work, at a random interval, in exchange for 1 million dollars/yr savings, would be considered a good bargain. Patients recovering from MAC anesthesia, if they do need recovery room care, do not usually require the same close supervision as someone recovering from a long general anesthetic. The actual cost to the institution is negligible.There are always physicians who respond strongly to any discussion of practice guidelines. Their concerns may be legitimate, or they may simply reflect a fear of doing things differently from what has been done in the past and which are viewed as “tried and true.” In this case, Drs. Bailey and Egan suggest the superiority of certain narcotics. If it really made a difference what narcotic one chose, we would all choose the best one. We all have our patients' best interests at heart. The fortunate news (or unfortunate news if one is in the narcotic research business) is that it is not what drugs one administers but how one administers them that really makes a difference. We would welcome further outcome studies that would document the advantages of the more expensive drugs in a clinical setting. The differences between drugs seen in randomized, controlled studies cannot always be realized in the complex arena of perioperative patient flow.We are well aware of the limitations of our study, although our conclusions are valid. The cost savings are real. The institution is better because of the efforts we have made. And our patients are just as safe.David A. Lubarsky, M.D.Department of Anesthesiology; Duke University Medical Center; Box 3094; Durham, North Carolina 27710(Accepted for publication July 29, 1997.)

Reply

Department of Anesthesiology, St. Vincents Hospital and Medical Center, 153 West 11th Street, New York, NY 10011.In Reply:-We thank the Drs. Bevan for their kind remarks, and we agree with most of their comments. However, their final conclusions regarding cost considerations are probably premature. As noted in our Table 2, the times to the first train-of-four (TOF) measurement in the postanesthesia care unit (PACU) for pancuronium (30.0 min) versus mivacurium (19.7 min) required an asterisk. [1] These intervals represent whichever came first, the initial TOF value noted in the PACU or the time until the TOF ratio reached a value of 0.90 (as measured in the operating room [OR]). Thus, 52 of 56 patients who received pancuronium had neuromuscular monitoring that continued into the PACU. Only 15 of the 35 patients who received mivacurium required such follow-up evaluation. Consequently, it probably is not correct to assume that 10 min of OR time was “saved” with the mivacurium group.If the average clinical anesthetist was routinely able to accurately quantitate residual block and defer discharge from the OR until satisfactory recovery of neuromuscular function (TOF greater or equal to 0.70) was present, then we suspect that short- to intermediate-acting relaxants would provide real savings in OR recovery time. Unfortunately, subjective evaluation of the extent of TOF fade is notoriously imprecise. Once the TOF ratio exceeds a ratio of 0.40, most clinicians are unable to detect that any fade exists. [2,3] In the “real world” as Bevan's data [4] nicely demonstrate, after antagonism of pancuronium-induced neuromuscular blockade, 15 min is insufficient time to guarantee satisfactory return of neuromuscular function.Aaron F. Kopman, M.D.; Jennifer Ng, M.D.; Lee M. Zank, M.D.; George G. Neuman, M.D.; Pamela S. Yee, M.D.Department of Anesthesiology; St. Vincents Hospital and Medical Center153 West 11th Street; New York, NY 10011(Accepted for publication February 5, 1997.)

Everyone wins: renegotiating purchase power agreements

Electric industry restructuring places pressure on utilities to renegotiate their power purchase agreements, particularly those with nondispatchable provisions. Real economic savings, which can be achieved by replacing purchased power in those hours when it is not economic can be shared by the utility and non-utility generator.

Trade Liberalization and Private Savings: The Spanish Experience, 1960-1995

This paper provides an interpretation of the evolution of Spanish private and national savings over the period 1960-1995. During these 35 years private and national rates oscillated widely from a very high level in the 1960s to historical minima in the early and mid-1980s to a strong recovery in the more recent years. At the same time, Spain transformed itself from an autarkic, underdeveloped and dictatorial country into an advanced, open economy with a fully democratic political life. First, we show that the apparent long-run reduction in Spanish rates is mostly due to a change in relative prices and to the choice of what, in our view, is the incorrect deflator. When Spanish real private savings are measured by using the deflator for the price of capital they appear to behave as a stationary, albeit highly volatile, time series relative to private disposable income. We find that a stable saving function can be derived from first principles and estimated using annual macroeconomic data. We adopt a traditional model of intertemporal optimization by a representative agent, facing a complete set of borrowing/lending opportunities and an exogenous income process. We use a habit formation utility function, to explain the crucial feature of the data, i. e. , the strong and positive impact that innovations in the growth rate of income (either national or private) have on (either national or private).

POST-REFORM DEVELOPMENT IN THE ZHUJIANG DELTA: GROWING EQUALITY OR POLARIZATION?

After the Open Policy, increasing polarization in the Zhujiang Delta when measured by real national income, retail sales, savings and rural income per capita has concealed much about the increasing equality in terms of real average wage, industrialization, export-orientation, urbanization and tertiary sector development. The co-existence of these “opposing” forces towards regional divergence and convergence highlights the pitfalls of looking at one dimension of development only, albeit an important one, in judging whether there has been increasing spatial equality or polarization. When all major aspects of development are taken together, there was a moderate trend of growing intra-regional disparity in the Zhujiang Delta under the Open Policy. By the 1990s, a relatively stable regional hierarchy with Shenzhen, Baoan and Zhuhai at the top and Gaoyao, Conghua and Guangning at the bottom has been formed.