Total Savings Research Articles

Contemporary roof pattern for energy efficient buildings: Air conditioning cost alleviation, CO2 emission mitigation potential and acceptable payback period

Buildings account for a significant portion of global energy use and consumption. Buildings have substantial energy consumption due to the use of heating, ventilation, and cooling systems. It is evident that the use of insulation materials and phase change materials (PCMs) in the design of buildings can effectively reduce the cost of air conditioning by reducing external heat gains and losses. Additionally, the use of environmentally friendly, cost-effective, and natural materials can be beneficial from an environmental standpoint. This paper aims to evaluate the potential for cost savings in the air conditioning of various PCMs and insulation-stuffed building roof configurations. In that respect, four types of phase change materials (HS29, HS36, FS42, and FS30) and four insulation materials (Therma cork, sawdust, aerogel, and sheep wool) were selected. The thermophysical properties of PCMs (solid and liquid state), insulation materials, and building elements were determined experimentally as per ASTM D 5334 standards. Ten various building roof models (contemporary roof pattern) are studied with four various PCMs and four various insulations. In addition, novel building roof design integrated with PCM/insulation were analysed numerically, related to environmental conditions that refer to two different scenarios in India (hot dry and composite climates). It further analyses the reduction in greenhouse gas emissions associated with different roof configurations. The aforementioned PCM/insulation materials were stuffed in the void spaces of the contemporary roof pattern. Thermo-economic analysis of novel roof design with PCM/insulation materials on air-conditioning costs, carbon dioxide emissions and payback time are compared with conventional roofs (CR) and contemporary roof patterns (CRP). The thermo-economic analysis was carried out based on the number of degree-hours of heating and cooling to determine the building's annual energy usage. HS29 PCM stuffed roof pattern (HS29RP) saved the highest total energy cost savings of 11.89/14.71 $/m2/year when compared with conventional roof and 11.35/13.89 $/m2/year compared with contemporary roof pattern for Jabalpur/Kota climatic conditions. HS29 PCM stuffed roof pattern (HS29RP) exhibits the maximum carbon emission mitigation of 215.32/275.37 kg/kWh when compared with conventional roof and 204.95/259.57 kg/kWh for climatic conditions of Jabalpur/Kota. While considering shortest payback span, sawdust stuffed roof pattern shows the minimum payback period of 0.69 and 2.15 years when compared with conventional roof and contemporary roof pattern. The findings of this research offer significant contributions to the development of energy-efficient building envelopes applicable to a wider range of buildings, including those with and without air conditioning systems.

The Early Access and the Potential Cost Savings by the Compassionate Use of Onco-haematological Drugs: Results from the Italian Study Compass-O.

Compassionate drug use (CDU) provides early access to not yet authorised medicines and is funded by pharmaceutical companies. The observational retrospective study Compass-O monitored the CDU of onco-haematological drugs, managed by seven Italian units for cytotoxic drug preparations (Unità Farmaci Antiblastici [UFA]), between 1 January, 2016 and 31 December, 2021. We aimed to evaluate the CDU of onco-haematological drugs managed by seven Italian UFA, between 2016 and 2021. The seven UFA provided anonymised data concerning CDU approved in the study period. The early access and potential cost savings for the National Health System (Servizio Sanitario Nazionale [SSN]) were analysed for CDU concerning drug-therapeutic indication combinations with complete data and reimbursed by SSN up to December 2023 (date of study execution), according to the executive decision of the Italian Medicines Agency (Agenzia Italiana del Farmaco [AIFA]). Both analyses distinguished solid/liquid tumours and categorised the combinations as innovative (fully/conditionally) or non-innovative based on AIFA assessments. Compass-O collected 783 CDU authorisations, with 572 (73.1%) analysable in terms of early access and cost savings. On average, early access amounted to 514 days and the total cost savings was €376,115,801. Compassionate drug use approvals involved mainly solid tumours (93.7% vs 6.3% for liquid tumours), and the combination of trastuzumab emtansine-breast cancer was the most dispensed (n = 73; early access = 426 days;potential cost savings: €610,388). Out of 572 CDU approvals, 200 (35%) were innovative drug-therapeutic indication combinations, with 598 days of early access and a total potential saving of €113,124,069. The study Compass-O showed a significant economic burden of CDU and a relevant need for early access, particularly for innovative drugs. However, there is currently no structured monitoring of CDU in Italy, suggesting the need for a national observatory, of which Compass-O can be the pilot phase.

Cost-Minimization Analysis for Subcutaneous Daratumumab in the Treatment of Newly Diagnosed Multiple Myeloma in Three Gulf Countries

Background: The second most common hematologic cancer worldwide is multiple myeloma (MM), with incidence and mortality rates that have more than doubled over the past 30 years. The safety and efficacy of daratumumab regimens in the treatment of newly diagnosed MM (NDMM) is demonstrated in clinical trials. Objective: To assess the financial effects of the adoption of subcutaneous daratumumab (dara-SC) rather than intravenous daratumumab (dara-IV) for the treatment of NDMM in three Gulf countries (Qatar, Oman and the United Arab Emirates; UAE), a cost-minimization model was constructed. Methods: We performed static cost minimization analyses from a societal perspective to evaluate the costs and possible reductions in resource utilization associated with a shift from dara-IV infusion to dara-SC injection for NDMM patients over a 5-year time horizon. The model included 2 scenarios: the current scenario in which 100% of patients with NDMM are treated with dara-IV infusion and a future scenario in which dara-SC injection is gradually adopted over the modeled time horizon. The model differentiated precisely between autologous stem cell transplantation (ASCT)–eligible and ASCT-ineligible NDMM patients in terms of their number in each group and the associated therapeutic regimens. One-way sensitivity analyses were also conducted. Results: The model showed that the use of dara-SC in NDMM patients who were eligible or ineligible for ASCT resulted in lower non-drug costs, including premedication drug costs, adverse-effect costs, administration costs, medical staff costs, and indirect costs. The resulting total savings over the 5-year time horizon of the model for Hamad Medical Corporation, Sultan Qaboos University Hospital/Royal Hospital, Sheikh Shakhbout Medical City (SSMC), and Tawam Hospital were QAR −2 522 686, OMR −143 214, AED −30 010 627, and AED −5 003 471, respectively. Conclusion: The introduction of dara-SC as a front-line treatment for NDMM patients in Qatar (Hamad Medical Corporation), Oman (Sultan Qaboos University Hospital, Royal Hospital-MOH), and the UAE (SSMC and Tawam Hospital) can help save resources and minimize constraints on the healthcare system.

The cost of total hip arthroplasty: compare the hospitalization costs of national centralized procurement and national volume-based procurement.

With the increasing demand for joint replacement surgery in China, the government has successively issued the policies of national centralized procurement (NCP) and national volume-based procurement (NVBP) of artificial joints. The purpose of this study is to evaluate the impact of NCP and NVBP policies on hospitalization cost, rehospitalization and reoperation rate of total hip arthroplasty (THA). In total, 347 patients who underwent THA from January 2019 to September 2022 were retrospectively analyzed. According to the implementation of NCP and NVBP, patients were divided into three groups: control group (n = 147), NCP group (n = 130), and NVBP group (n = 70). Patient-level data on the total hospitalization costs, rehospitalization rate, THA reoperation rate and inpatient component costs were collected before and after the implementation of the policies and Consumer Price Index was used to standardize the cost. After the implementation of NCP and NVBP, the total cost of hospitalization decreased by $817.41 and $3950.60 (p < 0.01), respectively. The implantation costs decreased from $5264.29 to $4185.53 and then rapidly to $1143.49 (p < 0.01), contributing to increased total cost savings. However, the cost of surgery and rehabilitation increased after NCP and NVBP implementation (p < 0.01). The proportion of implants decreased from 66.76 to 59.22% and then to 29.07%, whereas that of drugs increased from 7.98 to 10.11% and then to 12.06%. The proportion of operating expenses rose from 4.86 to 8.01% and then to 18.47%. Univariate linear regression analysis showed that hospital stay, NCP and NVBP were correlated with total hospitalization cost (p < 0.01). Multivariate analysis showed that hospital stay, NCP and NVBP were independent predictors of total hospitalization cost (p < 0.01). In this study, hospital stay, NCP, and NVBP were independent predictors of total inpatient costs. After the implementation of NVBP policy, the cost of implants and hospitalization has decreased significantly, and the technical labor value of medical staff has increased, but a multifaceted method is still needed to solve the problem of increasing costs of other consumables. Limitations of the study suggest the need for further and more comprehensive evaluation in the future.

Cost-effectiveness of preoperative pharmaceutical care consultations: a 5-year analysis

ObjectivesPreoperative medication errors can be prevented by screening patients through a preoperative pharmaceutical care consultation. The aim of this study was to analyse the cost-effectiveness of implementing such a consultation...

Impact of Updating Surgical Instrumentation Preference Cards on Operating Room Operations

Hospital systems across the United States have implemented quality improvement initiatives designed to mitigate unnecessary waste and decrease healthcare costs that are frequently passed on to patients. One key source of waste is excess sterile instrumentation in surgical operating rooms. This quality improvement project identified waste by auditing and updating surgical instrumentation preference cards (SIPCs) for the three most common procedures at a multi-center academic health system. Unnecessary items were recorded and savings calculated using 2022 supplier price data. Forty-nine procedures were audited, resulting in changes to 111 unique SIPCs. Although this process produced significant savings for the health system, it was limited to fewer than 10% of the total cases performed. Total savings were observed at $337,007 with savings of $56,254 for open instrumentation. A manual audit of all SIPCs across the institution and regular updates has the potential to decrease instrumentation waste and annual expenditures by approximately $4 million.

Poster 396: Performing Sports Medicine Procedures in Ambulatory Surgery Centers Is More Cost Effective than Hospital Outpatient Departments for Medicare Recipients

Objectives: To compare the overall cost of sports medicine procedures for Medicare beneficiaries in both ambulatory surgery centers (ASC) and hospital outpatient department (HOPD) settings. Secondary aims were to compare facility fees, surgeon fees, Medicare payments, and patient payments between ASCs and HOPDs. Methods: Publicly available data from The Centers for Medicare &amp; Medicaid Services (CMS) was accessed via the Medicare Procedure Price Lookup Tool. Current Procedural Terminology (CPT) codes were used to identify sports medicine procedures approved for the outpatient setting by CMS. Facility fees, surgeon fees, total costs, Medicare payment, and patient payment were extracted. Descriptive statistics were used to calculate means and standard deviations. Cost differences were analyzed using Mann Whitney U tests. Results: Sixty-two CPT codes were identified. Shoulder procedures (n=25) at ASCs had lower total costs (3,622±1,156 vs 6,262±1,759; p&lt;0.001), facility fees (2,777±1,020 vs 5,416±1,606; p&lt;0.001), Medicare payments (2,898±928 vs 5,009±1,407 p&lt;0.001), and patient payments (724±232 vs 1,252±352; p&lt;0.001) compared to HOPDs. Knee procedures (n=31) at ASCs had lower total costs (4,236±2,741 vs 6,668±3,341; p=0.006), facility fees (3,408±2,507 vs 5,840±3,116; p=0.006), Medicare payments (3,389±2,193 vs 5,458±2,955; p=0.006), and patient payments (847±548 vs 1,209±429; p=0.011). Hip procedures (n=6) at ASCs had lower total costs (3,583±698 vs 6,671±1,451; p=0.025), facility fees (2,725±6689 vs 5,813±1,431; p=0.025), Medicare payments (2,866±558 vs 5,336±1,161; p=0.025), and patient payments (716±139 vs 1,333±290; p=0.025). Conclusions: Sports medicine procedures performed at ASCs for Medicare recipients were found to have overall average total cost savings of 40% compared to those performed at HOPDs (42% savings for shoulder, 36% for knee, and 46% for hip procedures). ASC use conferred lower facility fees, patient payments, and Medicare payments in all cohorts. These results inform surgeons, patients, and insurance officials of the cost-effectiveness of outpatient surgical facilities for Medicare recipients undergoing sports medicine procedures.

The Price of Water: Evaluating the Potential Cost Savings of Switching from Saline to Distilled Water for Wound Irrigation

As water becomes an increasingly precious commodity, health systems face difficulties in balancing usage and costs. Numerous studies indicate minimal differences in patient outcomes between the use of normal saline and tap water in wound care and surgical procedures. The aim of this study is to evaluate the potential cost implications for hospitals when shifting from sterile water and saline to in-house distilled water for wound care and surgical procedures. We analyzed a two-facility hospital network, assessing current sterile water and saline solution usage and expenses and compared it with the cost of implementing an in-house water distillation system. In 2022, the hospital network spent $305,180.78 on sterile water and saline solution bottles. By replacing the current expenditure on sterile water and saline solution bottles for irrigation with a water distillation plant at the hospital network, the estimated annual cost of the new system is projected to be significantly lower, at $83,298.87. This results in substantial total savings of $221,881.91 annually, amounting to $361.37 per bed per year, while also considering the additional benefit of reducing plastic disposal costs. Extrapolating the in-house distillery cost savings to all 919,649 staffed hospital beds in the United States could potentially save approximately $565 million annually. Over a decade, this could reach up to $5.65 billion, if all hospitals adopt similar self-hosted water distillation systems.

Intelligent decision modeling for optimizing railway cold chain service networks under uncertainty

Railway cold chain service network design (RCC-SND) aims to optimize the utilization of stations and lines as well as train allocations in a manner that minimizes costs while satisfying the service requirements of shippers. Furthermore, the uncertainties associated with freight demand, transportation costs, quality loss, station handling capacity, and arc capacity make the RCC-SND a complex decision-making problem. To tackle this challenge, we first formulate a Mixed-Integer Nonlinear Programming (MINLP) model to determine hub locations, freight wagon flows, and service frequency. To cope with uncertain parameters with varying degrees of uncertainty incorporated in the model, we extend the problem using fuzzy programming and further convert it to its crisp counterpart. A real-world cases study in Southwest China is performed to validate the proposed model, whose results provide different strategies for decision-makers with varying preferences. There are some main findings: As the number of hubs increases from 5 to 6, a maximum total cost savings of 1.99% can be achieved. Railway operators may opt for different decision preferences, for decisions prioritizing economic efficiency, the cost can decrease by 2.69% compared to deterministic optimization.

Probabilistic assessment of deep geothermal resources in the Cornubian Batholith and their development in Cornwall and Devon, United Kingdom

Geothermal energy could play a pivotal role in decarbonisation as it can provide clean, constant base-load energy which is weather independent. With a growing demand for clean energy and improved energy security, geothermal resources must be quantified to reduce exploration risk. This study aims to quantify the untapped resource-potential of the Cornubian Batholith as a geothermal resource for power generation and direct heat use. Recent field work, laboratory measurements and petrophysical characterization provides a newly compiled dataset which is inclusive of subsurface samples taken from the production well of the United Downs Deep Geothermal Power Project. Deterministic and probabilistic calculations are undertaken to evaluate the: total heat in place, recoverable resource, technical potential and potential carbon savings. The Cornubian Batholith is considered a petrothermal system which may require stimulation as an enhanced geothermal system. This study shows the batholith has significant heat stored of 8988 EJ (P50), corresponding to 366 EJ recoverable and a technical potential of 556 GWth. When evaluating the potential for power generation (i.e., electricity) the P50 is 31 GWe. The total carbon savings when generating electricity (P50) equates to 106 Mt.

Cost Analysis of Oral Phenazopyridine vs Intravesical Lidocaine for Preprocedural Analgesia for Intradetrusor OnabotulinumtoxinA Injections.

Office administration of intradetrusor onabotulinumtoxinA is commonly used to treat overactive bladder. For preprocedure analgesia, either 50 mL 2% intravesical lidocaine instillation for 20 to 30 minutes or 200 mg oral phenazopyridine can be used. Phenazopyridine is associated with shorter appointment times and is noninferior to lidocaine for pain control in this setting. We performed a cost analysis of phenazopyridine vs lidocaine for analgesia before office intradetrusor onabotulinumtoxinA injection for the treatment of idiopathic overactive bladder. A health care sector-perspective cost analysis was performed. The following assumptions were made: (1) similar efficacy of each medication in providing adequate analgesia, (2) similar physician ease of performing the procedure with either analgesic, and (3) similar patient satisfaction with either analgesic. Average cost of medications, adverse reactions, nursing tasks, and office visit time were found in publicly available data. Sensitivity analyses were performed using TreeAge Pro 2021, R1 software. Phenazopyridine is less costly compared to lidocaine per visit for office intradetrusor onabotulinumtoxinA injection ($827 vs $925). A difference of $98 per procedure provides a total annual cost savings of over $24 million if all procedures are performed with phenazopyridine instead of lidocaine. Sensitivity analysis showed that phenazopyridine remained less costly under most circumstances, and threshold analysis provided exact circumstances under which phenazopyridine is no longer cost saving. Phenazopyridine provides cost savings compared to lidocaine for analgesia before office intradetrusor onabotulinumtoxinA injection for the treatment of idiopathic overactive bladder. If adopted by providers nationwide, phenazopyridine may reduce health care spending and minimize office visit time while maintaining patient pain control and satisfaction.

EE83 Total Costs and Cost Savings of Comprehensive Knee Osteoarthritis Management Combined With Total Knee Arthroplasty in an Ambulatory Surgical Center

EE83 Total Costs and Cost Savings of Comprehensive Knee Osteoarthritis Management Combined With Total Knee Arthroplasty in an Ambulatory Surgical Center

Effective stewardship strategies to enhance appropriateness of refer-out test requests in a Canadian tertiary centre laboratory

ObjectivesSpecialized testing conducted in reference laboratories is costly and often not optimally directed. Since 2016, our institution has worked to ensure the appropriateness of refer-out (RO) tests. We examine the impact of utilization initiatives on the patterns of requests and completed tests. Design and methodsIn 2016, 81 RO tests were selected for a more rigorous approval process. Physicians not pre-approved for testing received a prompt to consult with laboratory subject matter experts (SMEs) for further detail. After review, SMEs provided responses, approving or rejecting requests based on clinical relevance. Stewardship activities also included: repatriating tests locally, preferring Canadian over foreign institutions, unbundling tests, distributing educational memos, and introducing staged testing. We collected data on the number of requested (NoR) and number of completed (NoC) tests in 2015, before the implementation of the new vetting procedures, and for the post-implementation phase from 2016−2022. ResultsFor 62 targeted RO tests (including trace metals, vitamins, antibodies, and endocrine-related tests), there was a 33% reduction in NoR and a 51% reduction in NoC in 2022 compared to 2015. The total savings for the study period based on NoC was $807,736. The NoC rate for Neuronal antibody tests decreased to 48.6% in 2022, with cost savings of $17,123, and an additional $50,000 saved by changing the testing site. Insourcing apolipoprotein B and fecal calprotectin tests resulted in cost savings of $3,380 and $3,371, respectively, in 2022. ConclusionsAutomated messaging followed by a formal review of RO test requests is an effective utilization strategy that prevents redundant or clinically unjustified testing. This approach leads to significant economic savings and is expected to improve the efficiency of patient care.

Analysis of the effect of digital hospital efforts on paper savings in inpatient procedures and on the duration of nursing care services.

This study has two primary objectives. Firstly, it aims to measure the time savings achieved through the digitization of paper forms filled out by nurses in the inpatient care process. Secondly, it seeks to reveal the financial savings resulting from reduced paper consumption due to the digitalization. The Health Information Management System Society (HIMSS)-Electronic Medical Record Adaption Model (EMRAM), which makes stage-based (0-7) evaluations, serves as a tool to measure the rate of technology utilization in public hospitals in Turkey. The study is based on the HIMSS EMRAM criteria for 2018. Bahçelievler State Hospital, a public hospital in Turkey, was chosen as the research facility. In 2017, it was accredited as Stage 6 with HIMSS EMRAM. However, not all its wards have been digitalized. Initially, pilot selected wards were digitized. Therefore, digital and non-digital wards serve together. In this context, 4 wards were randomly selected and time, paper and toner savings before and after digitalization were measured. A table was created in Microsoft Excel,listing the forms used by nurses in inpatient care and the time required to fill them out.The time spent for filling paper-based forms and digital-based forms was measured in randomly selected wards. The analysis showed that digital forms saved more time, paper and toner. For example, filling out the patient history form took 45 min when using paper, compared to 12 min in digital environment. Approximately 27% time savings are achieved only for the patient history form. The total time savings delivered by digitalization for 1,153 inpatients during the year were found as 117 care days, and the savings on total paper consumption was 41.289 pages. For 1,153 inpatients throughout the year, the total time savings from digitalization was 117 care days and the total paper consumption savings was 41,289 pages. In addition, in 4 wards with a total bed capacity of 25, annual paper savings of $1,705.86 and toner savings of $283,736 were achieved. This study reveals the benefits of digitalisation in hospitals for nurses. It saves the time that nurses allocate for filling out paper forms with digitalised forms. Thus, it is a good practice example in terms of using the time allocated for form filling for patient care.When we extend this study to Turkey in general, it can be considered that the time savings achieved by nurses by digitizing inpatient forms varies between 10.8% and 13%. The number of nurses working in public hospitals in Turkey is approximately 160,000. Assuming that 60% of the nurses work in the inpatient ward, it is understood that the annual savings achieved by digitizing the forms corresponds to a range of 398-559 nursing hours.

Evaluating Health and Well-Being Returns on Investment in a Cancer Biobank.

Objectives: To evaluate the population health returns from investment in the Victorian Cancer Biobank (VCB), a research consortium including five hospital-integrated sample repositories located in Melbourne, Australia. Methods: This economic evaluation assigned monetary values to the health gains attributable to VCB-supported research. These were then compared with the total investment in VCB infrastructure since inception (2006-2022) to determine the return on investment (ROI). A time lag of 40 years was incorporated, recognizing the delay from investment to impact in scientific research. Health gains were therefore measured for the years 2046-2066, with a 3% discount rate applied. Health gains were measured in terms of disability-adjusted life years (DALYs) attributable to VCB-associated research, with monetary cost assigned via the standardized value of a statistical life year (AU$227,000). The age-standardized DALY rate attributable to cancer was modeled for two standpoints (1) extrapolating the current decreasing trajectory and (2) assuming nil future improvement from current rates, with 33% of the difference attributed to scientific innovation. The proportion of the aggregate health gain attributable to VCB-supported research was estimated from the number of VCB-credited scientific publications as a proportion of total oncology publications over the same period. Results: The AU$32,628,016 of public funding invested in VCB activities over the years 2006-2022 is projected to generate AU$84,561,373 in total (discounted) savings. ROI was AU$1.59 for each AU$1 invested. Conclusions: The VCB offers a strong ROI in terms of impacts on health, justifying the expenditure of public funds and supporting the use of biobanks to advance scientific research.

Prevention is better than healing. Clinical and economic implications of oral antiviral agents in COVID-19: a prospective study

COVID-19 represents a threat for frailty patients. This study compares molnupiravir and nirmatrelvir for fragile COVID- 19 patients' efficacy, safety, and cost. An observational, prospective study allowed us to evaluate molnupiravir’s efficacy and safety in real life, compare it to a subgroup of patients treated with nirmatrelvir-ritonavir, and analyze its cost-effectiveness. From January to December 2022, 435 patients (225 males, 220 females; median age 72 years), were enrolled; 24 patients were unvaccinated, and 280 patients had ≥2 risk factors. Molnupiravir performed better clinically and economically. Compared to literature data, in these patients, hospitalization was 2.5% vs. 6.8% (P&lt;0.005), overall adverse effects 14,3% vs. 30.4% (P&lt;0.0001), severe adverse effects 2.6 vs. 6.9% (P&lt;0.001), thus involving potential total savings of about € 92.954 per patient (8% of standard of care cost). Early molnupiravir treatment helped fragile patients who partially responded to the vaccine, or with absolute contraindications to vaccination, to overcome COVID-19 without the need for hospitalization. In elderly patients with multiple pathologies and multiple drugs, molnupiravir prevents disease progression clinically and economically.

Assessment of the utilization of real-time prescription benefits for patient cost savings within an outpatient setting

BackgroundThis study evaluates the impact of Real-Time Prescription Benefits (RTPB), a tool integrated into electronic health records (EHRs), on patient out-of-pocket costs in an academic institution. RTPB provides prescribers with alternative, less expensive medications based on insurance plans. The primary measure was cost-savings, defined as the difference between the out-of-pocket cost of the prescribed medication and its alternative. MethodsA retrospective analysis of prescriptions from outpatient clinics in a university-based health system was conducted between May 2020 and July 2021. Prescriptions were analyzed at the 2nd level of the Anatomical Therapeutic Chemical (ATC) classification system. Costs were standardized to a 30-day supply. Standardized cost and total cost per prescription, and overall savings for the top 20 medication classes at the 2nd ATC level were calculated. The overall impact of RTPB was estimated based on selecting the least expensive alternative suggested by RTPB. ResultsThe study found that RTPB information was provided for 22% of prescriptions, with suggested alternatives for 1.26%. Among prescriptions with an alternative selected, the standardized average cost saving was $38.83. The study realized $15,416 in patient total cost savings. If the least expensive RTPB-suggested alternative were chosen for all prescriptions, an estimated $276,386 could have been saved. Psychoanaleptic and psycholeptic medications were the most prescribed with an alternative, with most savings in specialty drugs like anthelmintic and immunostimulant medications. ConclusionThe study highlights the importance of RTPB in reducing patient costs. It reports patient cost-savings with RTPB in prescribing decisions. Future research could explore the impact of RTPB on medication adherence using pharmacy claims data.

APPLICATION OF VALUE ENGINEERING IN ARCHITECTURAL WORK ON THE LAHAIROI LATERI CHURCH, AMBON CITY

Effective construction cost control such as saving construction costs will increase the chances of project success and user satisfaction. The biggest component in construction costs is material. High material costs necessitate a review of building functions. Construction savings are made by reviewing the largest cost components in architectural work. Review of material components is carried out using the value engineering method. Value engineering is a method for getting an alternative picture so that the costs incurred are more efficient than the initial planning costs. The application of value engineering to construction projects has a major impact on planning by generating reviews to obtain cost effectiveness. Research was conducted at the Lahairoi Lateri Church Building project located in Ambon City. The aim of this research is to find alternative material substitutes for architectural work and obtain total cost savings by using the concept of value engineering. The use of the value engineering concept is carried out by information phase, analyzing the function of using index function analysis techniques, identifying alternative materials, and evaluating the results of the alternative materials. Research using the value engineering concept on the Lahairoi Lateri Church Building Construction project, Ambon City achieved cost savings of 861,116,841.05 IDR. This amount saves 5.32% of the initial architectural work costs of 16,170,539,500 IDR. These results show that value engineering can eliminate unnecessary costs in church-type building without changing the building function.

ОЦЕНКА ПОТЕНЦИАЛА ЭНЕРГОСБЕРЕЖЕНИЯ В БЮДЖЕТНЫХ УЧРЕЖДЕНИЯХ В СИСТЕМЕ УПРАВЛЕНИЯ ЭНЕРГОРЕСУРСАМИ (СУЭР)

Developed and in operation since 2019, the information and analytical Energy Resources Management System of the Belgorod Region (ERMS) ensures the digitalization of processes related to the provision of measures to improve energy efficiency related to the powers of state authorities of the constituent entities of the Russian Federation and local governments. The SEER uses methods for assessing the energy efficiency of large geographically distributed consumers of utility resources based on an individual analysis of the characteristics and heat consumption of individual buildings. Currently, the SEER includes information for 2,144 municipal and regional institutions in the Belgorod region, which operate in 5,332 buildings. Costs for energy resources and water in 2023 in these institutions amounted to 4.8 billion rubles; over the five years of operation of the SUER, they decreased by 8% under comparable conditions. Based on SEER data, the total savings potential that can be achieved in regional and municipal institutions of the Belgorod region is 14.3% of annual costs for energy resources and water, including 0.8% from organizational activities and 13.5% from technical measures with an average payback period of 6 years. During 2021–2024, pilot projects for the implementation of SEMS were implemented in 9 Russian regions and one organization, which showed savings potential ranging from 4.4 to 29.5%.

Intersection eco-driving for automated vehicles: SMPC-based strategies for handling leading vehicle starting-up uncertainties

Driving at intersections often differs from regular car-following scenarios, particularly in terms of start-up speed uncertainties. Extracting useful information from these uncertainties is crucial for improving traffic and energy efficiency, ultimately achieving eco-driving goals for automated vehicles. However, traditional car-following models are inadequate for describing intersection driving behaviors, while current eco-driving strategies often lack a thorough consideration of intersection traffic uncertainties. To this end, a new eco-driving strategy based on stochastic model predictive control (SMPC) is proposed, specifically addressing uncertainties in the starting-up behavior of leading vehicle (LV). To begin, a naturalistic driving dataset is constructed for a queuing scenario at a signalized intersection, enabling the establishment of probabilistic models for LV starting-up behavior. Next, an SMPC-based motion planning algorithm is introduced to facilitate optimal control of the ego vehicle (EV), directly incorporating the LV’s uncertainties. Specifically, a phantom LV model is introduced to depict LV’s starting-up probability in its initial preparing stage, and then in the accelerating stage a gaussian process regression (GPR) approach is employed for more accurate prediction of LV acceleration. Then the algorithm’s effectiveness is validated through stochastic and playback simulations in SUMO and Matlab. The playback simulations using conditions from naturalistic driving demonstrate that the algorithm significantly enhances energy efficiency, achieving savings of 21% and 37% compared to electric and fueled vehicles in real-world scenarios, respectively. Surprisingly, despite expectations, the algorithm can also improve traffic efficiency by an average of 17.9% and 13.6% for electric and fueled vehicles, respectively. Finally, the road experiment validates that our algorithm can achieve total savings of 15.8% energy in our experimental electric vehicle compared to real drivers. This algorithm has the potential to serve as an effective eco-driving solution for automated vehicle longitudinal planning and control in urban settings.