Savings Of USD Research Articles

Optimization of a novel Hybrid Wind Bio Battery Solar Photovoltaic System Integrated with Phase Change Material

The intermittent nature of renewable sources, such as solar and wind, leads to the need for a hybrid renewable energy system (HRES) that can provide uninterrupted and reliable energy to a remote and off-grid location with the use of a biogas generator and battery. In the present study, conventional PV panels have been integrated with phase change material (PCM) for power enhancement. In addition, various configurations (i. PV-Wind-Battery system, ii. PV-PCM-Wind-Battery, iii. PV-Wind-Biogas-Battery and iv. PV-PCM-Wind-Biogas-Battery) have been compared for the hot and humid climatic location of Chennai, India. Optimization has been carried out to minimize the cost of energy and the net present cost has also been computed. It has been found that the integration of PCM with the PV-Wind-Biogas-Battery-based off-grid system results in savings of USD 0.22 million in terms of net present cost and reduces the cost of energy from USD 0.099/kWh to USD 0.094/kWh. Similarly, for another off-grid HRES configuration of PV-Wind-Battery, the integration of PCM results in savings of USD 0.17 million, and reduces the cost of energy from USD 0.12/kWh to USD 0.105/kWh.

Potential Cost Savings Associated with Targeted Substitution of Current Guideline-Concordant Inpatient Agents with Omadacycline for the Treatment of Adult Hospitalized Patients with Community-Acquired Bacterial Pneumonia at High Risk for Clostridioides difficile Infections: Results of Healthcare-Decision Analytic Model from the United States Hospital Perspective

Introduction: Approximately 3% of hospitalized patients with community-acquired bacterial pneumonia (CABP) develop healthcare-associated Clostridioides difficile infection (HCA-CDI). The validated Davis risk score (DRS) indicates that patients with a DRS ≥ 6 are at an increased risk of 30-day HCA-CDI. In the phase 3 OPTIC CABP study, 14% of CABP patients with DRS ≥ 6 who received moxifloxacin developed CDI vs. 0% for omadacycline. This study assessed the potential economic impact of substituting current guideline-concordant CABP inpatient treatments with omadacycline in hospitalized CABP patients with a DRS ≥ 6 across US hospitals. Methods: A deterministic healthcare-decision analytic model was developed. The model population was hospitalized adult CABP patients with a DRS ≥ 6 across US hospitals (100,000 patients). In the guideline-concordant arm, 14% of CABP patients with DRS ≥ 6 were assumed to develop an HCA-CDI, each costing USD 20,100. In the omadacycline arm, 5 days of therapy was calculated for the entire model population. Results: The use of omadacycline in place of guideline-concordant CABP inpatient treatments for CABP patients with DRS ≥ 6 was estimated to result in cost savings of USD 55.4 million annually across US hospitals. Conclusion: The findings of this simulated model suggest that prioritizing the use of omadacycline over current CABP treatments in hospitalized CABP with a DRS ≥ 6 may potentially reduce attributable HCA-CDI costs. The findings are not unique to omadacycline and could be applied to any antibiotic that confers a lower risk of HCA-CDI relative to current CABP inpatient treatments.

Energy and economic performances of stump and roots removal of eucalyptus for bioenergy

Traditional logistics of residue removal is expensive and energy demanding, such as the procedures adopted for removing remaining stumps on forest biomass production. When considered as a biomass source, stumps can contribute to minimizing problems related to the restriction of the use of the area in terms of the use of the machines and operational quality, bringing economic and energy benefits or at least, avoiding costs. Therefore, this study aimed at evaluating the operational, economic and energy viability of a mechanized-harvesting system for collection of eucalyptus stumps. So, data related to the work capacity of the equipment were obtained by means of a time and motion of mechanized operations of stumps removal, carrying, processing, and transportation. A model was used to evaluate scenarios and to identify the critical variables. Results showed that the mechanized system used for stumps and roots removal, is operationally and economically viable and provides higher energy performance for this biomass. Total energy input (EI) of the system was 14.3 GJ ha−1, energy intensity 406.8 MJ t−1, EROI was 28.2 for 33 MJ MJ−1 and 4.0 for 4.3 MJ MJ−1 year−1 and a positive energy balance of 434.3 MJ ha−1. The final cost of producing of eucalyptus stump chips was 37.87 USD t−1, savings of USD 2.13 t-1 were obtained for the additional biomass. Restrictions for using this system refer to the minimum area and transportation distance. Additionally, variations in productivity, market price of biomass, and field operational capacity would affect the economic viability of this alternative.

Value-based Healthcare: The Politics of Value-based Care and its Impact on Orthopaedic Surgery.

Value-based Healthcare: The Politics of Value-based Care and its Impact on Orthopaedic Surgery.

High Renewable Energy (Solar Photovoltaics and Wind) Penetration Hybrid Energy Systems for Deep Decarbonization in Philippine Off-grid Areas

The Philippines has many off-grid areas relying on diesel generators for energy access, but have high greenhouse gas emissions, high electricity costs, and intermittent operation. An opportunity to decarbonize the energy system of off-grid islands is by harnessing both solar photovoltaic (PV) and wind power. This work evaluates the techno-economic viability of putting up solar PV-wind-battery-diesel hybrid energy systems in 143 existing off-grid island areas operated by the National Power Corporation-Small Power Utilities Group (NPC-SPUG) using HOMER® Pro. The application obtains the optimal system component sizes with the least levelized cost of electricity (LCOE). The results suggest that there are 137 islands capable of using both solar PV and wind generation, 4 islands using solar PV only, and 2 islands using wind only. The hybrid energy systems in the sample islands require USD 774,171,061 (~ PHP 40,643,980,682) worth of investment cost with potential annual savings of USD 132,403,163 (~ PHP 6,951,166,051). The resulting system capacities and their corresponding LCOEs suggest high sensitivity towards wind potential due to lower capital cost of wind and potential higher energy share up to 58.47 %. Wind generation for off-grid islands should be considered alongside solar PV, especially in areas with high wind potential, to provide reliable energy access and reduce greenhouse gas emissions.

Selective Hepatitis B Birth-Dose Vaccination in São Tomé and Príncipe: A Program Assessment and Cost-Effectiveness Study.

São Tomé and Príncipe (STP) uses a selective hepatitis B birth-dose vaccination (HepB-BD) strategy targeting infants born to mothers who test positive for hepatitis B virus (HBV) surface antigen. We conducted a field assessment and economic analysis of the HepB-BD strategy to provide evidence to guide development of cost-effective policies to prevent perinatal HBV transmission in STP. We interviewed national stakeholders and key informants to understand policies, knowledge, and practices related to HepB-BD, vaccine management, and data recording/reporting. Cost-effectiveness of the existing strategy was compared with an alternate approach of universal HepB-BD to all newborns using a decision analytic model. Incremental cost-effectiveness ratios (ICERs) were calculated in 2015 USD per HBV-associated death and per chronic HBV case prevented, from the STP health-care system perspective. We found that STP lacked national or facility-specific written policies and procedures related to HepB-BD. Timely HepB-BD to eligible newborns was considered a high priority, although timeliness of HepB-BD was not monitored. Compared with the existing selective vaccination strategy, universal HepB-BD would result in a 19% decrease in chronic HBV infections per year at overall cost savings of approximately 44% (savings of USD 5,441 each year). We estimate an ICER of USD 5,012 saved per HBV-associated death averted. The existing selective HepB-BD strategy in STP could be improved through documentation of policies, procedures, and timeliness of HepB-BD. Expansion to universal newborn HepB-BD without maternal screening is feasible and could result in cost savings if actual implementation costs and effectiveness fall within the ranges modeled.

Generation of electric power and air conditioning by cogeneration: a proposal for energy saving

This paper presents the results of a case study carried out in a warehouse, and, in particular, the technical data obtained from field visits and a proposal for energy saving. The proposal entails incorporating a cogeneration system based on a motor generator (400 kWe ISO) to produce electrical energy, and an absorption cooling system (75 TR) that uses residual heat to generate air-conditioning. The absorption chiller consumed 54% less energy than the conventional air-conditioning system. Moreover, the produced energy can supply the plant’s total consumption, in addition to offering an excess of 57,312 kWh per month, which was reflected in the analysis of energy for sale to users with a high domestic consumption rate (DAC, for its Spanish acronym). The proposal’s total investment is USD 1,091,258, with a net monthly savings of USD 30,901, and an investment payback period of 2.9 years, which indicates the viability of this project according to its energy characteristics, notwithstanding that it is for a service provider company.

Budgetary impact of diagnostic tests for visceral leishmaniasis in Brazil.

The aim of the present study was to estimate the financial costs of the incorporation and/or replacement of diagnostic tests for human visceral leishmaniasis (VL) in Brazil. The analysis was conducted from the perspective of the Brazilian Unified National Health System (SUS) over a period of three years. Six diagnostic tests were evaluated: the indirect immunofluorescence antibody test (IFAT), the IT LEISH rapid test, the parasitological examination of bone marrow aspirate, the direct agglutination test (DAT-LPC) standardized in the Clinical Research Laboratory, René Rachou Institute of the Oswaldo Cruz Foundation, the Kalazar Detect rapid test, and polymerase chain reaction (PCR). The assumptions used were the number of suspected cases of VL reported to the Brazilian Ministry of Health in 2014 and the direct cost of diagnostic tests. The costs to diagnose suspected cases of VL over three years using the IFAT and the DAT-LPC were estimated at USD 280,979.91 and USD 121,371.48, respectively. The analysis indicated that compared with the use of the IFAT, the incorporation of the DAT-LPC into the SUS would result in savings of USD 159,608.43. With regard to the budgetary impact of rapid tests, the use of IT LEISH resulted in savings of USD 21.708,72 over three years. Compared with a parasitological examination, diagnosis using PCR resulted in savings of USD 3,125,068.92 over three years. In this study, the replacement of the IFAT with the DAT-LPC proved financially advantageous. In addition, the replacement of the Kalazar Detect rapid test with the IT LEISH in 2015 was economically valuable, and the replacement of parasitological examination with PCR was indicated.

Lagrange Method for Budget Optimization Analysis in Resource Allocation for Antipsychotic Therapies in Colombia

To simulate the optimal budget allocation for first line antipsychotic medications in schizophrenia which minimize relapses. From the health system perspective, a Lagrange budget optimization analysis was performed with the SOLVER application in order to estimate the efficient market share of first line antipsychotics (oral, depot and Long Acting Injectable - LAI). The following parameters were gathered and validated in five psychiatric institutions: target population, current market share, adherence to the treatment, risk of relapse, and the usage of outpatient and inpatient care resources. The tariffs were taken from official and institutional sources. The time frame was one year. Two scenarios were compared: the current and the optimum. Current scenario: assuming a budget constraint of USD 250,000, a target population of 381 patients and a baseline market share (oral 95.7%, depot 2.3% and LAI 2.0%), 150 relapses were avoided (savings of USD 320,086). With the Optimum scenario market share [oral 83.0%, depot 4.0% and LAI 13.0%], 208 relapses were avoided [savings of USD 445,986]. Assuming a fixed budget for first line antipsychotic treatments, increasing the usage of LAI enable a budget optimization and relapses minimization.