Total Financial Cost Research Articles

Математична модель визначення загального обсягу навчальних годин комплексної програми бойової підготовки військового формування типу з’єднання (частина) будь-якого ступеня готовності

На думку авторів статті, одним із можливих шляхів підвищення ефективності планування бойової підготовки (БП) та досягнення потрібного рівня навченості військових формувань є розроблення та запровадження в практику їх БП принципово нового нормативного документа – Комплексної програми бойової підготовки з’єднання (частини) (КПБП). На відміну від існуючих програм БП, КПБП має забезпечити можливість визначення оптимальної кількості навчальних годин та їх раціональний (оптимальний) розподіл між спеціалістами (підрозділами) та періодами підготовки для досягнення заданого рівня навченості з’єднання (частини) Збройних Сил України в цілому, а також його готовності до взаємодії з іншими військовими формуваннями сил оборони під час спільного виконання бойових завдань. Встановлено, що в існуючих методиках оцінювання ефективності БП військових формувань, у тому числі її планування, використовуються зовсім різні методи (шляхи, способи) дослідження процесу розподілу рівня їх навченості в часі. Як стверджують автори, на сьогодні відсутня загальна методологія комплексного вирішення подібних завдань. Враховуючи це, у статті викладено суть та основний зміст Математичної моделі визначення загального обсягу навчальних годин КПБП військового формування типу з’єднання (частина) будь-якого ступеня готовності. Ця модель є основою Методу визначення оптимальної кількості навчальних годин БП спеціалістів (підрозділів) військового формування типу з’єднання (частина) для досягнення заданого рівня їх навченості за критерієм мінімальних фінансових затрат (лінійний варіант оптимізації). Стаття є логічним продовженням попередніх публікацій даного напряму дослідження.

Study of Technological Efficiency of Ginger Processing in East Sikkim- A Case Study

The two processing units namely Sundar Sikkim, Marchak, and Nature Gift, Majhitar were selected based on ginger as major processing products. It was found that most of the raw ginger was processed into ginger flakes and ginger powder. The maximum raw ginger in the study area was found processed into ginger flakes. Sun, solar, mechanical, solar-cum-mechanical and fire drying (smoke-free) were implemented. Among these methods, most of the ginger was dried using the mechanical dryer. The total cost of production, total operating expenses, and total financial costs were calculated. It was found that among the operating expenses, expenditure on raw ginger occupied a major component followed by power and utility. The minimum expenditure for operating expenses was for packing and packaging followed by repair and maintenance. Interest on working capital was found to be an important component of total financial cost in dried ginger flakes production. The profitability estimation of dried ginger flakes revealed that ginger processing was a profitable enterprise. The Break-even point was calculated and the technical efficiency for ginger flakes processing was found to be efficient at given level resources and level of technology. The constraints faced by the processors were collected through a personal interview method using a pre-tested well-structured schedule, analyzed in the tabular form and each of the constraints was ranked. The major problems faced by the ginger processor were found to be lack of labour availability (skilled and unskilled) followed by high price expectations from the farmers.

Production Decisions of Manufacturing and Remanufacturing Hybrid System Considering Downward Substitution: A Comprehensive Model Integrating Financial Operations

Traditional approaches for production decisions of the manufacturing/remanufacturing hybrid system usually focus on physical operations and ignore the corresponding financial aspects. This paper proposes a mixed integer stochastic programming model integrating physical and financial operations based on scenario analysis, which considers the downward substitution between new and remanufactured products and selects financial performance indicator, i.e. economic value added, as the optimal objective function. The prime superiorities of the integrated approach are emphasized through a numerical example, and sensitivity analyses on some critical parameters are conducted. The findings indicate that the integrated approach can not only ensure the stability of hybrid production system, but also significantly improve financial operation efficient and reduce total financial operation cost, and thus eventually brings the manufacturer higher objective value. Furthermore, the advantage of integrated approach in objective optimization is more prominent when manufacturers intend to provide higher service level to customers. Finally, the results proposed in this paper provide applicable suggestions to manufacturers and financial institutions.

The methodological approach to the economic evaluation of the assimilation capacity of bioresources as a component of the eco-system assets of territorial communities

This article presents a methodological approach to the economic evaluation of the assimilation capacity of biological resources as ecosystem assets of territorial communities. The author evaluated the cost of «work» of the assimilation capacity of trees (taking into account the life cycle of the tree) and compared it with the fees for calculating the amount of damage caused by a violation of nature reserve legislation due to illegal felling or damage to trees and plants to the point of cessation of growth (for each tree felled or damaged to the point of cessation of growth) (Annex 1 to the Resolution of the Cabinet of Ministers of Ukraine of July 24, 2013 № 541 «On approval of fees for calculating the amount of damage caused by violations of nature reserve legislation»). The author concluded that the fees of this resolution of the Cabinet of Ministers of Ukraine are quite low compared to the actual cost of the assimilation capacity of trees. That is, the cost of a tree as a component of the ecosystem will be much higher, because trees also emit oxygen, purify water, and so on. Even lower are the fees for calculating the amount of damage caused to forests by enterprises, institutions, organizations, and citizens by illegal felling and damage to trees and shrubs to the point of cessation of growth (for each tree cut down or damaged to the point of cessation of growth) (Annex 1 to the Cabinet Of Ukraine of July 23, 2008 № 665 «On approval of fees for calculating the amount of damage caused to forests»). The facts that there is no correlation between the actual value of the tree and the above fees, and that the current regulations must be reviewed are emphasized. When carrying out a qualitative assessment of the assimilative potential of bioresources of ecosystem assets of territorial communities, it is advisable to use certain indicators and their criteria. This article presents the indicator of environmental costs for the mining industry. This indicator determines the total financial costs of environmental measures in the production of a unit of marketable products.

Resource and replica management strategy for optimizing financial cost and user experience in edge cloud computing system

Edge cloud computing can provide resources that are close to users and reduce response time. However, the edge cloud computing system still faces many challenges on addressing the overload problem due to its limited capacity. In this paper, a resource management strategy is proposed to satisfy the workloads of the edge cloud, while minimizing the financial cost of the rented nodes. Furthermore, the replica management strategy, which consists of the replica allocation and consistency preservation strategy, is studied. A dynamic replica allocation strategy is proposed to satisfy the user experience while reducing the storage overheads. In addition, the replica consistency preservation strategy is proposed for guaranteeing the data consistency and correctness. Finally, extensive experiments are conducted based on a real-world dataset. With the increase in the time, the proposed resource management algorithm can significantly reduce the total financial cost of the rented nodes and SLA default rate and improve the CPU utilization. For instance, the total financial cost of the proposed algorithm averagely achieves up to 32.27% and 53.65% reduction over that of CAAS algorithm and DRM algorithm, respectively. In addition, the proposed replica allocation algorithm can effectively reduce the data transmission time and the storage overhead.

REUTIVAR: Model for Precision Fertigation Scheduling for Olive Orchards Using Reclaimed Water

Olive orchard is the most representative and iconic crop in Andalusia (Southern Spain). It is also considered one of the major economic activities of this region. However, due to its extensive growing area, olive orchard is also the most water-demanding crop in the Guadalquivir River Basin. In addition, its fertilization is commonly imprecise, which causes over-fertilization, especially nitrogen. This leads to pollution problems in both soil and water, threating the environment and the system sustainability. This concern is further exacerbated by the use of reclaimed water to irrigate since water is already a nutrient carrier. In this work, a model which determines the real-time irrigation and fertilization scheduling for olive orchard, applying treated wastewater, has been developed. The precision fertigation model considers weather information, both historical and forecast data, soil characteristics, hydraulic characteristics of the system, water allocation, tree nutrient status, and irrigation water quality. As a result, daily information about irrigation time and fertilizer quantity, considering the most susceptible crop stage, is provided. The proposed model showed that by using treated wastewater, additional fertilization was not required, leading to significant environmental benefits but also benefits in the total farm financial costs.

Evaluating the performance of alternative blended learning designs using DEA

Abstract The extensive demand for blended learning programs imposes the problem of selecting the most appropriate instructional design from amongst a variety of alternatives that may be feasible for a particular program. The decision-making process should consider a number of qualitative factors such as the satisfaction of learning needs, educational efficiency, ease of implementation and total financial cost. In this paper, we propose that Bates’ (1995) e-learning instructional design model ACTIONS, which describes seven qualitative dimensions pertinent to selecting a design, can be used in conjunction with Data Envelopment Analysis to provide a distinct decision-making framework to aid administrators in determining which blended learning programs are the most effective. The first stage in the analysis is to explain which ACTIONS dimensions can be regarded as inputs and which can be treated as outputs for the sake of the decision process, with all seven dimensions being measurable by ordinal scores assessing the expected performance of alternative designs. In the second stage of analysis, we use Data Envelopment Analysis with ordinal data to obtain an overall expected performance index that is able to discriminate the designs most efficient and most suitable for implementation. The methodology is illustrated by an example. Discussion and Conclusions follow.

Estimating the money flow in the economy attributed to rotavirus disease and vaccination in the Netherlands using a Social Accounting Matrix (SAM) framework

ABSTRACT Background: The economics of rotavirus gastroenteritis in infants <5 years old is well-known within healthcare. The financial consequences for families, employers and authorities are not so well explored. The present study evaluates how vaccine prevention changes money flows among those involved in the management of disease, and its consequences. Methods: A Social Accounting Matrix (SAM) framework has been developed reflecting the distribution of income and spending at equilibrium affected by rotavirus disease among all those concerned for 1 year. The data came from official sources and published literature. A comparison of the financial equilibrium between with and without a national rotavirus immunization program has been conducted, along with sensitivity analysis for the results. Results: The total financial cost difference at equilibrium between presence and absence of rotavirus vaccination was +€26.758 million over one year as a net economic surplus. The payment of vaccination (€19.194 million) by the government was offset by the increase in tax revenue (€14.561 million) and by the lower spending in treatment care (€7.998 million). Conclusion: Studying the financial flows between different transacting agents can demonstrate the financial burden of a disease and the benefits of its prevention on agents’ income and spending.

Financial cost analysis of a strategy to improve the quality of administrative vaccination data in Uganda

BackgroundHigh-quality vaccination data are critical to planning, implementation and evaluation of immunization programs. However, sub-optimal administrative vaccination data quality in low- and middle-income countries persist for heterogeneous reasons, though most relate to organizational factors and human behavior. The nationwide Data Improvement Team (DIT) strategy in Uganda aimed to strengthen human resource capacity to generate quality administrative vaccination data at the health facility. MethodsA financial cost analysis of the Uganda DIT strategy (2014–2016) was conducted from the program funder perspective. Activity-based micro-costing from funder financial and program monitoring records was used to estimate total and unit costs by program area (in 2016 US dollars). Hypothetical scenarios were developed to illustrate potential approaches to reducing costs. ResultsOver 25 months the DIT strategy was implemented in all 116 operational districts and 3443 (89%) health facilities in Uganda at a total financial cost of US $575 275. Training and deployment of DITs accounted for the highest proportion of expenditure across program areas (69%). Transport, per diems, lodging, and honoraria for DIT members and national supervisors were the main cost drivers of the strategy. Deployment of 557 DIT members cost US $839 per DIT member, US $4 030 per district, and US $136 per health facility. The estimated opportunity cost of government staff time wasn’t a major cost driver (2.5%) of total cost. ConclusionThe results provide the first estimates of the magnitude and drivers of cost to implement a national workforce capacity building strategy to improve administrative vaccination data quality in a low- or middle-income country. Financial costs are a critical input to combine with future outcome data to describe the cost of strategies relative to performance outcomes. The operational costs of the strategy were modest (0.5–1.6%) relative to the estimated operational costs of Uganda’s national immunization program.

The costs of developing, deploying and maintaining electronic immunisation registries in Tanzania and Zambia

ObjectiveTo determine the costs to develop, roll out and maintain electronic immunisation registries (EIRs) and a related suite of data use interventions.MethodsThe Better Immunisation Data (BID) Initiative conducted the activities...

Addressing inequalities in medical workforce distribution: evidence from a quasi-experimental study in Brazil

BackgroundBrazil faces huge health inequality challenges since not all municipalities have access to primary care physicians. The More Doctors Programme (MDP), which started in 2013, was born out of this...

Program cost analysis of influenza vaccination of health care workers in Albania

BackgroundSince 2012, WHO has recommended influenza vaccination for health care workers (HCWs), which has different costs than routine infant immunization; however, few cost estimates exist from low- and middle-income countries. Albania, a middle-income country, has self-procured influenza vaccine for some HCWs since 2014, supplemented by vaccine donations since 2016 through the Partnership for Influenza Vaccine Introduction (PIVI). We conducted a cost analysis of HCW influenza vaccination in Albania to inform scale-up and sustainability decisions. MethodsWe used the WHO’s Seasonal Influenza Immunization Costing Tool (SIICT) micro-costing approach to estimate incremental costs from the government perspective of facility-based vaccination of HCWs in Albania with trivalent inactivated influenza vaccine for the 2018–19 season based on 2016–17 season data from administrative records, key informant consultations, and a convenience sample of site visits. Scenario analyses varied coverage, vaccine presentation, and vaccine prices. ResultsIn the baseline scenario, 13,377 HCWs (70% of eligible HCWs) would be vaccinated at an incremental financial cost of US$61,296 and economic cost of US$161,639. Vaccine and vaccination supplies represented the largest share of financial (89%) and economic costs (44%). Per vaccinated HCW financial cost was US$4.58 and economic cost was US$12.08 including vaccine and vaccination supplies (US$0.49 and US$6.76 respectively without vaccine and vaccination supplies). Scenarios with higher coverage, pre-filled syringes, and higher vaccine prices increased total economic and financial costs, although the economic cost per HCW vaccinated decreased with higher coverage as some costs were spread over more HCWs. Across all scenarios, economic costs were <0.07% of Albania’s estimated government health expenditure, and <5.07% of Albania’s estimated immunization program economic costs. ConclusionsCost estimates can help inform decisions about scaling up influenza vaccination for HCWs and other risk groups.

Animal Assisted Interventions to Treat Pain and Associated Mental Health Comorbidities: A Systematized Review

Background and Hypothesis: Pain is cited as the primary reason patients access the healthcare system and is estimated to produce total financial cost of 500 billion dollars. However, pain can be difficult to treat, and is often associated with various mental health comorbidities, such as depression, anxiety, and PTSD, which can attenuate the effects of treatment. Thus, it is important to identify novel therapies that can both provide pain relief, and treat any associated mental health comorbidity. Animal Assisted Intervention (AAI) is one such possible treatment. Numerous studies have been published that highlight the potential of AAI in this domain. The aim of this study was to evaluate and synthesize the results of these studies.&#x0D; Experimental Design or Project Methods: A literature search was conducted searching the databases MEDLINE, CINAHL, and EMBASE with search terms related to AAI, pain, anxiety, depression, and PTSD. 110 articles met the inclusion criteria and their results were reviewed.&#x0D; Results: 24 articles analyzed outcomes related to pain, and 17 of these articles found that AAI significantly improved pain. Of these 17 articles, the average absolute magnitude of improvement in pain severity was 15%. 69 articles analyzed outcomes related to anxiety, and 37 found that AAI significantly improved anxiety. Of these 37 articles, the average absolute magnitude of improvement in anxiety symptom severity was 16%. 54 articles analyzed outcomes related to depression, and 29 found that AAI significantly improved depression. Of these 29 articles, the average absolute magnitude of improvement in depression symptom severity was 13%. 15 articles analyzed outcomes related to PTSD, and 11 found that AAI significantly improved PTSD symptoms. Of these 11 articles, the average absolute magnitude of improvement in PTSD symptom severity was 18%.&#x0D; Conclusions and Potential Impact: AAI is promising as a complementary therapy for the treatment of pain as it is able to significantly improve pain while simultaneously treating common mental health comorbidities.

Optimized Scheduling Approach for Scientific Applications Based on Clustering in Cloud Computing Environment

Cloud Computing refers to the use of the computing capabilities of remote computers, where the user has considerable computing power without having powerful units. Scientific applications, usually represented as Directed Acyclic Graphs (DAGs), are an important class of applications that lead to challenging problems for resource management in distributed computing. With the advent of Cloud Computing, particularly the IaaS offers for on demand virtual machines leasing, multiple jobs execution, consisting of a large number of DAGs, needs an elaborated scheduling and resource provisioning policies, for efficient use of resources. Only few works exists that consider this problem in the context of clouds environment. In goal of optimization and fault tolerance, DAGs applications are generally partitioned into multiple parallel DAGs using clustering algorithm and assigned to VM (Virtual Machine) resources independently. In this work, we investigate through simulation, the impact of clustering for both provisioning and scheduling policies in the total makespan and financial costs for execution of user's application. We implemented four scheduling policies well-known in grid computing systems, and adapted clustering algorithm to our resource management policy that leases and destroys dynamically VMs. We show that dynamic policies can achieve equal or even better performance than static management policies.

Societal Cost of Improper Citizen Petitions

The misuse of the Food & Drug Administration’s citizen petition process is one tactic in a large repertoire of legal maneuvering used by pharmaceutical companies to protect their brand-name drug revenue streams from the introduction of low-cost generics. To date, the financial cost to society of these delays has not been calculated in the literature, which likely hinders the push for policy solutions. Drawing from a previously published data set on 249 citizen petitions, this article identifies four petitions that were highly likely to have been the final obstacle to a generic drug entering the market and for which sufficient volume and usage data were available. Using these four dubious citizen petitions, the total financial cost to society of citizen petition delays was $1.9 billion or $3.6 million per day. The total financial cost to government-provided insurance programs in the same period was roughly $782 million. Due to the conservative methodology employed (choosing only four petitions that met the criteria of “but for” this citizen petition the generic would have gone to market), the estimates are likely low. Citizen petitions that contributed to a generic delay as one of many tactics or for which there was not sufficient volume and usage information were eliminated from consideration in this estimate.

Playground-related Extremity Fractures in an Asian Setting over the Last Decade — Are We Safe?

The cost of playground-related injuries remains significant. Measures adopted to prevent such fractures or reduce their severity would translate into appreciable financial savings. Our study looks at the changes in playground-related extremity fracture epidemiology over the past decade after the implementation of latest playground standards. This is a retrospective case series approved by the local ethics board comparing the results of two descriptive studies; one conducted prior to the implementation of the Singapore Productivity and Standards Board Singapore Standards SS 457: 2007 and the other thereafter. The demographics have remained the same. The proportion of public playground injuries has fallen significantly from 89.6% to 76.3% (p < 0.05), whereas school playground injuries have risen from 5.9% to 18.0% (p < 0.05). Fractures related to monkey bars and the flying fox have shown a significant improvement, decreasing to 38.1% from 47.6% (p < 0.05) and 1% from 6.9% (p < 0.05), respectively. There has been a decrease of 33% in playground-related injuries. The total financial cost of sustaining one playground-related extremity fracture has generally increased by 50%. However, considering the 37.4% drop in surgeries, the actual overall costs to the healthcare system have essentially fallen. Safety standards have had a positive effect on playground safety in Singapore. There are now fewer and less severe playground-related extremity fractures.

Optimizing Big Data to Inform the Plausibility of Patient Debt

In 2014, states approving the expansion of Medicaid, a tenet of the Affordable Care Act, received monies to expand health care coverage. Using publicly available national datasets1, we mined data to explore the effects of expanded health care coverage on medical debt, and also to inform continued optimization of these data for health policy research. Between 2012 and 2015, there was a decrease in the percentage of individuals claiming medical debt. States adopting Medicaid expansion showed a 23.31% decrease, while states NOT adopting had a 19.01% decrease. Expansion of health coverage showed no statistical increase in the proportion of respondents with regards to the number of nights spent in a hospital in a year and the number of times visited a health professional in the past two weeks. Additionally, data illustrated significant findings in the proportion of individuals who responded in the affirmative to to the questions associated with cost of care and delay in care, trouble paying for medical bills, and losing coverage after pregnancy. While the data revealed substantive findings, our exploration detected two ways in which these publicly available datasets can be optimized for health policy research: include respondent’s state of residence, and specify codification of data with empty or null values. By including these two variables, health policy researchers can further leverage these invaluable datasets for informing impacts of Medicaid expansion, and possibly informing the plausibility of patient debt as a significant determinant of health. However, publicly available datasets were able to detect the positive ripples of Medicaid expansion within the first year of implementation. These findings can potentially impact public policy by strengthening the argument for expansion of coverage for individuals with scarce resources without drastically increasing the total financial cost of coverage, impacting the workflow of hospitals/clinics, and and limiting uncompensated care provided by hospitals/clinicians.

The Role of Genetic Polymorphisms in Chronic Pain Patients.

It is estimated that the total annual financial cost for pain management in the U.S. exceeds 100 billion dollars. However, when indirect costs are included, such as functional disability and reduction in working hours, the cost can reach more than 300 billion dollars. In chronic pain patients, the role of pharmacogenetics is determined by genetic effects on various pain types, as well as the genetic effect on drug safety and efficacy. In this review article, we discuss genetic polymorphisms present in different types of chronic pain, such as fibromyalgia, low back pain, migraine, painful peripheral diabetic neuropathy and trigeminal neuralgia. Furthermore, we discuss the role of CYP450 enzymes involved in metabolism of drugs, which have been used for treatment of chronic pain (amitriptyline, duloxetine, opioids, etc.). We also discuss how pharmacogenetics can be applied towards improving drug efficacy, shortening the time required to achieve therapeutic outcomes, reducing risks of side effects, and reducing medical costs and reliance upon polypharmacy.

The economic cost of inadequate sleep.

To estimate the economic cost (financial and nonfinancial) of inadequate sleep in Australia for the 2016-2017 financial year and relate this to likely costs in similar economies. Analysis was undertaken using prevalence, financial, and nonfinancial cost data derived from national surveys and databases. Costs considered included the following: (1) financial costs associated with health care, informal care provided outside healthcare sector, productivity losses, nonmedical work and vehicle accident costs, deadweight loss through inefficiencies relating to lost taxation revenue and welfare payments; and (2) nonfinancial costs of loss of well-being. They were expressed in US dollars ($). The estimated overall cost of inadequate sleep in Australia in 2016-2017 (population: 24.8 million) was $45.21 billion. The financial cost component was $17.88 billion, comprised of as follows: direct health costs of $160 million for sleep disorders and $1.08 billion for associated conditions; productivity losses of $12.19 billion ($5.22 billion reduced employment, $0.61 billion premature death, $1.73 billion absenteeism, and $4.63 billion presenteeism); nonmedical accident costs of $2.48 billion; informal care costs of $0.41 billion; and deadweight loss of $1.56 billion. The nonfinancial cost of reduced well-being was $27.33 billion. The financial and nonfinancial costs associated with inadequate sleep are substantial. The estimated total financial cost of $17.88 billion represents 1.55 per cent of Australian gross domestic product. The estimated nonfinancial cost of $27.33 billion represents 4.6 per cent of the total Australian burden of disease for the year. These costs warrant substantial investment in preventive health measures to address the issue through education and regulation.

A Mixed-Integer Programming Model for Assessing Energy-Saving Investments in Domestic Buildings under Uncertainty

A decision support tool has been developed to evaluate energy-saving intervention investments for domestic buildings. Various potential interventions are considered, each affecting energy consumption and savings, as well as the total financial cost of the investment. The decision problem is formulated as a mixed-integer programming problem. The implemented methodologies increase the efficiency and efficacy of the solution algorithms and can be applied to most realistic cases. The tool allows users to customize the problem based on their own preferences and find the optimal combination of investments. Uncertainty complicating the decision process is addressed by using interval analysis; therefore, the robustness of the optimal decision can be evaluated to facilitate the decision-making process. A domestic building in the Mediterranean area is used as a case study to demonstrate the functionality of this tool and to evaluate the impact of the decision-maker’s uncertainty on the optimal decision.