938 resultados para Total annual cost
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In this thesis, the optimal operation of a neighborhood of smart households in terms of minimizing the total energy cost is analyzed. Each household may comprise several assets such as electric vehicles, controllable appliances, energy storage and distributed generation. Bi-directional power flow is considered for each household . Apart from the distributed generation unit, technological options such as vehicle-to-home and vehicle-to-grid are available to provide energy to cover self-consumption needs and to export excessive energy to other households, respectively.
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In this paper, a joint location-inventory model is proposed that simultaneously optimises strategic supply chain design decisions such as facility location and customer allocation to facilities, and tactical-operational inventory management and production scheduling decisions. All this is analysed in a context of demand uncertainty and supply uncertainty. While demand uncertainty stems from potential fluctuations in customer demands over time, supply-side uncertainty is associated with the risk of “disruption” to which facilities may be subject. The latter is caused by external factors such as natural disasters, strikes, changes of ownership and information technology security incidents. The proposed model is formulated as a non-linear mixed integer programming problem to minimise the expected total cost, which includes four basic cost items: the fixed cost of locating facilities at candidate sites, the cost of transport from facilities to customers, the cost of working inventory, and the cost of safety stock. Next, since the optimisation problem is very complex and the number of evaluable instances is very low, a "matheuristic" solution is presented. This approach has a twofold objective: on the one hand, it considers a larger number of facilities and customers within the network in order to reproduce a supply chain configuration that more closely reflects a real-world context; on the other hand, it serves to generate a starting solution and perform a series of iterations to try to improve it. Thanks to this algorithm, it was possible to obtain a solution characterised by a lower total system cost than that observed for the initial solution. The study concludes with some reflections and the description of possible future insights.
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Objective: To measure the cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with established ischaemic heart disease and average baseline cholesterol levels. Design: Prospective economic evaluation within a double-blind randomised trial (Long-Term Intervention with Pravastatin in Ischaemic Disease [LIPID]), in which patients with a history of unstable angina or previous myocardial infarction were randomised to receive 40 mg of pravastatin daily or matching placebo. Patients and setting: 9014 patients aged 35-75 years from 85 centres in Australia and New Zealand, recruited from June 1990 to December 1992. Main outcome measures: Cost per death averted, cost per life-year gained, and cost per quality-adjusted life-year gained, calculated from measures of hospitalisations, medication use, outpatient visits, and quality of life. Results: The LIPID trial showed a 22% relative reduction in all-cause mortality (P < 0.001). Over a mean follow-up of 6 years, hospital admissions for coronary heart disease and coronary revascularisation were reduced by about 20%. Over this period, pravastatin cost $A4913 per patient, but reduced total hospitalisation costs by $A1385 per patient and other long-term medication costs by $A360 per patient. In a subsample of patients, average quality of life was 0.98 (where 0 = dead and 1 = normal good health); the treatment groups were not significantly different. The absolute reduction in all-cause mortality was 3.0% (95% CI, 1.6%-4.4%), and the incremental cost was $3246 per patient, resulting in a cost per life saved of $107730 (95% Cl, $68626-$209881) within the study period. Extrapolating long-term survival from the placebo group, the undiscounted cost per life-year saved was $7695 (and $10 938 with costs and life-years discounted at an annual rate of 5%). Conclusions: Pravastatin therapy for patients with a history of myocardial infarction or unstable angina and average cholesterol levels reduces all-cause mortality and appears cost effective compared with accepted treatments in high-income countries.
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The Iowa Railway Finance Authority (IRFA) was created in 1980 by the 68th General Assembly to provide for the financing of rail facilities and to enhance and continue the operation of essential rail facilities. IRFA was authorized to offer financial assistance for the acquisition, rehabilitation, construction, refinancing, extension, replacement, maintenance, repair, or leasing of any rail facility. Rail Revolving Loan and Grant Program The 2005 legislative session amended Iowa Code 327H.20 by assigning all repayments of IRFA and other Iowa Department of Transportation (Iowa DOT) rail assistance loans to the Rail Revolving Loan and Grant Program (RRLGP). In addition, the following annual appropriations were allocated to the fund: • FY 2007: $235,000 • FY 2008: $2 million • FY 2009: $2 million Since the creation of the RRLGP in 2005, IRFA has awarded funding to 23 projects totaling over $7.2 million in grants and loans in its three rounds of competitive funding. These projects have pledged to create 1,672 jobs within two years of project completion and 1,361 jobs have been retained. Funded projects are associated with over $2 billion in total private capital investment. In 2008, the IRFA Board directed all available funds be used to help repair railroads devastated by summer flooding. On July 31, $3.9 million in deferred payment loans were offered to seven Iowa based railroads to allow for immediate repair of rail beds, including the cost of materials, labor and equipment.
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Objective: Enhanced Recovery After Surgery (ERAS) clinical pathways in¦colorectal surgery are known to reduce postoperative complications leading¦to shortened hospital stay. However, the implementation of such an ERAS¦pathway requires time and financial investment. This study evaluates whether¦the savings related to the reduction in the length of stay (LOS) outweigh the¦costs of implementing an ERAS pathway.¦Methods: An ERAS pathway was implemented in our institution for colorectal¦surgery. The first 50 consecutive patients subjected to this ERAS pathway¦(ERAS group) were compared to 50 consecutive patients that were operated one¦year before its introduction (control group). Primary LOS, readmission within¦30 days, and total costs based on costs per day were compared. The mean costs¦per day were: 3,263 CHF for intensive care, 1,152 CHF for intermediate care,¦and 728 CHF for basic care.¦Results: Primary LOS was shorter in the ERAS group than in the control¦group: median 7 (interquartile range 5-12·25) versus 10 (7-18) days (P =¦0·0025). The readmission within 30 postoperative days was similar in both¦groups (2 patients each). In the ERAS group, the added primary LOS was¦485 days (379 in basic care, 99 in intermediate care, 7 in intensive care) compared¦to 706 days in the control group (533 in basic care, 146 in intermediate care,¦27 in intensive care). The total costs were significantly lower for the 50 ERAS¦patients compared to the control group: 412,801 CHF versus 644,317 CHF (P <¦0·01). Investments required for the 50 first ERAS patients were approximately¦83,544 CHF, including 348 working hours as well a full-time ERAS dedicated¦nurse. The overall cost saving was approximately 2,959 CHF per patient.¦Conclusion: Implementation of an ERAS pathway significantly reduced LOS¦after colorectal surgery. The financial investment to introduce and maintain¦such a pathway is clearly inferior to the cost-saving of reduced hospital stay.
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In the administration, planning, design, and maintenance of road systems, transportation professionals often need to choose between alternatives, justify decisions, evaluate tradeoffs, determine how much to spend, set priorities, assess how well the network meets traveler needs, and communicate the basis for their actions to others. A variety of technical guidelines, tools, and methods have been developed to help with these activities. Such work aids include design criteria guidelines, design exception analysis methods, needs studies, revenue allocation schemes, regional planning guides, designation of minimum standards, sufficiency ratings, management systems, point based systems to determine eligibility for paving, functional classification, and bridge ratings. While such tools play valuable roles, they also manifest a number of deficiencies and are poorly integrated. Design guides tell what solutions MAY be used, they aren't oriented towards helping find which one SHOULD be used. Design exception methods help justify deviation from design guide requirements but omit consideration of important factors. Resource distribution is too often based on dividing up what's available rather than helping determine how much should be spent. Point systems serve well as procedural tools but are employed primarily to justify decisions that have already been made. In addition, the tools aren't very scalable: a system level method of analysis seldom works at the project level and vice versa. In conjunction with the issues cited above, the operation and financing of the road and highway system is often the subject of criticisms that raise fundamental questions: What is the best way to determine how much money should be spent on a city or a county's road network? Is the size and quality of the rural road system appropriate? Is too much or too little money spent on road work? What parts of the system should be upgraded and in what sequence? Do truckers receive a hidden subsidy from other motorists? Do transportation professions evaluate road situations from too narrow of a perspective? In considering the issues and questions the author concluded that it would be of value if one could identify and develop a new method that would overcome the shortcomings of existing methods, be scalable, be capable of being understood by the general public, and utilize a broad viewpoint. After trying out a number of concepts, it appeared that a good approach would be to view the road network as a sub-component of a much larger system that also includes vehicles, people, goods-in-transit, and all the ancillary items needed to make the system function. Highway investment decisions could then be made on the basis of how they affect the total cost of operating the total system. A concept, named the "Total Cost of Transportation" method, was then developed and tested. The concept rests on four key principles: 1) that roads are but one sub-system of a much larger 'Road Based Transportation System', 2) that the size and activity level of the overall system are determined by market forces, 3) that the sum of everything expended, consumed, given up, or permanently reserved in building the system and generating the activity that results from the market forces represents the total cost of transportation, and 4) that the economic purpose of making road improvements is to minimize that total cost. To test the practical value of the theory, a special database and spreadsheet model of Iowa's county road network was developed. This involved creating a physical model to represent the size, characteristics, activity levels, and the rates at which the activities take place, developing a companion economic cost model, then using the two in tandem to explore a variety of issues. Ultimately, the theory and model proved capable of being used in full system, partial system, single segment, project, and general design guide levels of analysis. The method appeared to be capable of remedying many of the existing work method defects and to answer society's transportation questions from a new perspective.
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Supplement to HR-388 - "Total Cost of Transportation Analysis of Road and Highway Issues"
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Please see TR-477 Phase 2 Final Report -- http://publications.iowa.gov/id/eprint/20041
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Annual report of soil conservation in Iowa.
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Annual report of soil conservation in Iowa.
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The costs related to the treatment of infected total joint arthroplasties represent an ever groving burden to the society. Different patient-adapted therapeutic options like débridement and retention, 1- or 2-step exchange can be used. If a 2-step exchange is used we have to consider short (2-4 weeks) or long (>4-6 weeks) interval treatment. The Swiss DRG (Diagnose related Groups) determines the reimboursement the hopsital receives for the treatment of an infected total arthroplasty. The review assesses the cost-effectiveness of hospitalisation practices linked to surgical treatment in the two-stage exchange of a prosthetic-joint infection. The aim of this retrospectiv study is to compare the economical impact between a short (2 to 4 weeks) versus a long (6 weeks and above) interval during a two-satge procedure to determine the financial impact. Retrospectiv study of the patients with a two-stage procedure for a hip or knee prosthetic joint infection at CHUV hospital Lausanne (Switzerland) between 2012 and 2013. The review analyses the correlation between the interval length and the length of the hospital stay as well as with the costs and revenues per hospital stay. In average there is a loss of 40′000 Euro per hospitalisation for the treatment of prosthetic joint infection. Revenues never cover all the costs, even with a short interval procedure. This economical loss increases with the length of the hospital stay if a long-term intervall is choosen. The review explores potential for improvement in reimbourement practices and hospitalisation practices in the current Swiss healthcare setting. There should be alternative setups to decrease the burden of medical costs by a) increase the reimboursment for the treatment of infected total joints or by b) splitting the hospital stay with partners (rapid transfer after first operation from center hospital to level 2 hospital and retransfer for second operation to center) in order to increase revenues.
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Ostotapahtumassa kiinnitetään usein huomiota hintaan, mutta hankintapäätökseen vaikuttavat myös muutkin kustannukset. Ongelman asiassa aiheuttaa kokonaiskustannusvaikutuksien arvioinnin ja mittauksen haasteellisuus, sekä kunnollisen raportointijärjestelmän puuttuminen. Hankinnan kokonaiskustannusten selvittäminen pitkällä aikavälillä on kuitenkin tärkeää, koska hankintojen osuus yritysten liikevaihdoista on jatkuvassa kasvussa. Työn tarkoituksena oli tarkastella Total cost of ownershipia, eli TCO:ta, elinkaarilaskennan sovellusta. Tarkastelun aluksi työlle luotiin teoreettinen pohja käyttäen hyväksi kirjallisuutta, artikkeleita sekä www-dokumentteja. Teoriaosuus rakentui kustannuslaskennan osalta kustannusten tunnistamisesta, jakamisesta ja kohdistamisesta. TCO:sta luotiin mahdollisimman laaja-alainen teoreettinen kuvaus. Seuraavaksi työssä käsiteltiin TCO:n soveltamista sen perinteisimpiin käyttökohteisiin: taloudellisesti merkittäviin hankintoihin, ulkoistamispäätöksiin, hinnoitteluun sekä toimittajien suorituskyvyn seurantaan ja analysointiin. TCO:n soveltamista käsittelevä osuus päätettiin kotimaisilla esimerkeillä TCO:n soveltamisesta IT-hankintojen apuvälineenä. Työ päätettiin käymällä läpi työtä tehdessä kypsyneet ajatukset sekä johtopäätökset.
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Target of this study was to develop a total cost calculation model to compare all costs from manufacturing and logistics from own factories or from partner factories to global distribution centers in a case company. Especially the total cost calculation model was needed to simulate an own factory utilization effect in the total cost calculation context. This study consist of the theoretical literature review and the empirical case study. This study was completed using the constructive research approach. The result of this study was a new total cost calculation model. The new total cost calculation model includes not only all the costs caused by manufacturing and logistics, but also the relevant capital costs. Using the new total cost calculation model, case company is able to complete the total cost calculations taking into account the own factory utilization effect in different volume situations and volume shares between an own factory and a partner factory.
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Letter of estimate sent to S.D. Woodruff for the total cost of construction and equipment of the extension of the line to Port Colborne [this is unsigned]. There is an envelope with this letter that suggests that it is from Mr. Shanly, Mar. 12, 1857.