Surgical treatment approaches and reimbursement costs of surgical site infections post hip arthroplasty in Australia : a retrospective analysis

BACKGROUND: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. METHODS: Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. RESULTS: A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following 'failed DAIR' cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. CONCLUSIONS: As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings.

Modeling electricity price events as point processes

Energy prices are highly volatile and often feature unexpected spikes. It is the aim of this paper to examine whether the occurrence of these extreme price events displays any regularities that can be captured using an econometric model. Here we treat these price events as point processes and apply Hawkes and Poisson autoregressive models to model the dynamics in the intensity of this process.We use load and meteorological information to model the time variation in the intensity of the process. The models are applied to data from the Australian wholesale electricity market, and a forecasting exercise illustrates both the usefulness of these models and their limitations when attempting to forecast the occurrence of extreme price events.

Parallel ABM for electricity distribution grids : a case study

This paper introduces a parallel implementation of an agent-based model applied to electricity distribution grids. A fine-grained shared memory parallel implementation is presented, detailing the way the agents are grouped and executed on a multi-threaded machine, as well as the way the model is built (in a composable manner) which is an aid to the parallelisation. Current results show a medium level speedup of 2.6, but improvements are expected by incor-porating newer distributed or parallel ABM schedulers into this implementa-tion. While domain-specific, this parallel algorithm can be applied to similarly structured ABMs (directed acyclic graphs).

Impacts of vehicle-to-grid (V2G) technologies on electricity market operations

The Vehicle-to-Grid (V2G) concept is based on the newly developed and marketed technologies of hybrid petrol-electric vehicles, most notably represented by the Toyota Prius, in combination with significant structural changes to the world's energy economy, and the growing strain on electricity networks. The work described in this presentation focuses on the market and economic impacts of grid connected vehicles. We investigate price reduction effects and transmission system expansion cost reduction. We modelled a large numbers of plug-in-hybrid vehicle batteries by aggregating them into a virtual pumped-storage power station at the Australian national electricity market's (NEM) region level. The virtual power station concept models a centralised control for dispatching (operating) the aggregated electricity supply/demand capabilities of a large number of vehicles and their batteries. The actual level of output could be controlled by human or automated agents to either charge or discharge from/into the power grid. As previously mentioned the impacts of widespread deployments of this technology are likely to be economic, environmental and physical.

Lifecycle costs of ultracapacitors in electric vehicle applications

The pulse power characteristics of ultracapacitors appear well suited to electric vehicle applications, where they may supply the peak power more efficiently than the battery, and can prevent excessive over sizing of the battery pack due to peak power demands. Operation of ultracapacitors in battery electric vehicles is examined for possible improvements in system efficiency, vehicle driving range, battery pack lifetime, and potential reductions in system lifecycle cost. The lifecycle operation of these ultracapacitors is simulated using custom-built, dynamic simulation code constructed in Matlab. Despite apparent gains in system efficiency and driving range, the results strongly suggest that the inclusion of ultracapacitors in the electric vehicle does not make sense from a lifecycle cost perspective. Furthermore, a comparison with results from earlier work shows that this outcome is highly dependant upon the efficiency and cost of the battery under consideration. However, it is likely that the lifecycle cost benefits of ultracapacitors in these electric vehicles would be, at most, marginal and do not justify the additional capital costs and system complexity that would be incurred in the vehicle

Simulated lifecycle costs of ultracapacitors in battery electric vehicles

The pulse power characteristics of ultracapacitors appear well suited to electric vehicle applications, where they may supply the peak power more efficiently than the battery, and can prevent excessive over sizing of the battery pack due to peak power demands. Operation of ultracapacitors in battery electric vehicles (BEVs) is examined for possible improvements in system efficiency, vehicle driving range, battery pack lifetime, and potential reductions in system lifecycle cost. The lifecycle operation of these ultracapacitors is simulated using a custom-built, dynamic simulation code constructed in Matlab. Despite apparent gains in system efficiency and driving range, the lifecycle cost benefits as simulated appear to be marginal, and are heavily influenced by the incremental cost of power components. However, additional factors are identified which, in reality, will drive ultracapacitors towards viability in electric vehicle applications.

Towards a dignified and sustainable electricity generation sector in Australia : a comparative review of three models

Electricity is the cornerstone of modern life. It is essential to economic stability and growth, jobs and improved living standards. Electricity is also the fundamental ingredient for a dignified life; it is the source of such basic human requirements as cooked food, a comfortable living temperature and essential health care. For these reasons, it is unimaginable that today's economies could function without electricity and the modern energy services that it delivers. Somewhat ironically, however, the current approach to electricity generation also contributes to two of the gravest and most persistent problems threatening the livelihood of humans. These problems are anthropogenic climate change and sustained human poverty. To address these challenges, the global electricity sector must reduce its reliance on fossil fuel sources. In this context, the object of this research is twofold. Initially it is to consider the design of the Renewable Energy (Electricity) Act 2000 (Cth) (Renewable Electricity Act), which represents Australia's primary regulatory approach to increase the production of renewable sourced electricity. This analysis is conducted by reference to the regulatory models that exist in Germany and Great Britain. Within this context, this thesis then evaluates whether the Renewable Electricity Act is designed effectively to contribute to a more sustainable and dignified electricity generation sector in Australia. On the basis of the appraisal of the Renewable Electricity Act, this thesis contends that while certain aspects of the regulatory regime have merit, ultimately its design does not represent an effective and coherent regulatory approach to increase the production of renewable sourced electricity. In this regard, this thesis proposes a number of recommendations to reform the existing regime. These recommendations are not intended to provide instantaneous or simple solutions to the current regulatory regime. Instead, the purpose of these recommendations is to establish the legal foundations for an effective regulatory regime that is designed to increase the production of renewable sourced electricity in Australia in order to contribute to a more sustainable and dignified approach to electricity production.

The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia : protocol for a longitudinal cohort investigation

Background Rates of chronic disease are escalating around the world. To date health service evaluations have focused on interventions for single chronic diseases. However, evaluations of the effectiveness of new intervention strategies that target single chronic diseases as well as multimorbidity are required, particularly in areas outside major metropolitan centres where access to services, such as specialist care, is difficult and where the retention and recruitment of health professionals affects service provision. Methods This study is a longitudinal investigation with a baseline and three follow-up assessments comparing the health and health costs of people with chronic disease before and after intervention at a chronic disease clinic, in regional Australia. The clinic is led by students under the supervision of health professionals. The study will provide preliminary evidence regarding the effectiveness of the intervention, and evaluate the influence of a range of factors on the health outcomes and costs of the patients attending the clinic. Patients will be evaluated at baseline (intake to the service), and at 3-, 6-, and 12-months after intake to the service. Health will be measured using the SF-36 and health costs will be measured using government and medical record sources. The intervention involves students and health professionals from multiple professions working together to treat patients with programs that include education and exercise therapy programs for back pain, and Healthy Lifestyle programs; as well as individual consultations involving single professions. Discussion Understanding the effect of a range of factors on the health state and health costs of people attending an interdisciplinary clinic will inform health service provision for this clinical group and will determine which factors need to be controlled for in future observational studies. Preliminary evidence regarding changes in health and health costs associated with the intervention will be a platform for future clinical trials of intervention effectiveness. The results will be of interest to teams investigating new chronic disease programs particularly for people with multimorbidity, and in areas outside major metropolitan centres.

The impact of the clean development mechanism (CDM) on the cost price of wind power electricity : a China study

As a renewable energy source, wind power is playing an increasingly important role in China’s electricity supply. Meanwhile, China is also the world’s largest market for Clean Development Mechanism (CDM) wind power projects. Based on the data of 27 wind power projects of Inner Mongolia registered with the Executive Board of the United Nations (EB) in 2010, this paper constructs a financial model of Net Present Value (NPV) to analyze the cost of wind power electricity. A sensitivity analysis is then conducted to examine the impact of different variables with and without Certified Emission Reduction (CER) income brought about by the CDM. It is concluded that the CDM, along with static investment and annual wind electricity production, is one of the most significant factors in promoting the development of wind power in China. Additionally, wind power is envisaged as a practical proposition for competing with thermal power if the appropriate actions identified in the paper are made.

Semi-parametric forecasting of spikes in electricity prices

The occurrence of extreme movements in the spot price of electricity represents a significant source of risk to retailers. A range of approaches have been considered with respect to modelling electricity prices; these models, however, have relied on time-series approaches, which typically use restrictive decay schemes placing greater weight on more recent observations. This study develops an alternative, semi-parametric method for forecasting, which uses state-dependent weights derived from a kernel function. The forecasts that are obtained using this method are accurate and therefore potentially useful to electricity retailers in terms of risk management.

Data requirements of hedonic models in determining the impact of infrastructure charges on new housing costs

The use of hedonic models to estimate the effects of various factors on house prices is well established. This paper examines a number of international hedonic house price models that seek to quantify the effect of infrastructure charges on new house prices. This work is an important factor in the housing affordability debate, with many governments in high growth areas having user-pays infrastructure charging policies operating in tandem with housing affordability objectives, with no empirical evidence on the impact of one on the other. This research finds there is little consistency between existing models and the data sets utilised. Specification appears dependent upon data availability rather than sound theoretical grounding. This may lead to a lack of external validity with model specification dependent upon data availability rather than sound theoretical grounding.

The operating schedule for battery energy storage companies in electricity market

This paper presents a series of operating schedules for Battery Energy Storage Companies (BESC) to provide peak shaving and spinning reserve services in the electricity markets under increasing wind penetration. As individual market participants, BESC can bid in ancillary services markets in an Independent System Operator (ISO) and contribute towards frequency and voltage support in the grid. Recent development in batteries technologies and availability of the day-ahead spot market prices would make BESC economically feasible. Profit maximization of BESC is achieved by determining the optimum capacity of Energy Storage Systems (ESS) required for meeting spinning reserve requirements as well as peak shaving. Historic spot market prices and frequency deviations from Australia Energy Market Operator (AEMO) are used for numerical simulations and the economic benefits of BESC is considered reflecting various aspects in Australia’s National Electricity Markets (NEM).

Settlement offers on appeal : when might costs be awarded on the indemnity basis?

In Roberts v Prendergast [2013] QCA 89 the respondent had offered to settle the appeal, purporting to make the offer under Chapter 9 Part 5 of the Uniform Civil Procedure Rules 1999 (Qld) (UCPR). Differing views were expressed in the Court of Appeal regarding the impact in the circumstances of the offer to settle, with the majority concluding that the appellant should pay the respondent’s costs on the standard basis.

A clear view of costs ‘of and incidental to’ : Mio Art Pty Ltd v Macequest (No.2) Pty Ltd [2013] QSC 271

In Mio Art Pty Ltd v Macequest (No.2) Pty Ltd [2013] QSC 271 Jackson J provided considered analysis of several aspects of costs law. His Honour regarded various orders which are commonly sought or made as reflecting practice that is inappropriate or unnecessary under the Uniform Civil Procedure Rules 1999 (Qld) (UCPR).