Operational cost drivers

To be economically viable, the operations cost of launch vehicles must be reduced by an order of magnitude as compared to the Space Transportation System (STS). A summary of propulsion-related operations cost drivers derived from a two-year study of Shuttle ground operations is presented. Examples are given of the inordinate time and cost of launch operations caused by propulsion systems designs that did not adequately consider impacts on prelaunching processing. Typical of these cost drivers are those caused by central hydraulic systems, storable propellants, gimballed engines, multiple propellants, He and N2 systems and purges, hard starts, high maintenance turbopumps, accessibility problems, and most significantly, the use of multiple, nonintegrated RCS, OMS, and main propulsion systems. Recovery and refurbishment of SRBs have resulted in expensive crash and salvage operations. Vehicle system designers are encouraged to be acutely aware of these cost drivers and to incorporate solutions (beginning with the design concepts) to avoid business as usual and costs as usual

An empirical study of environmental cost drivers

This paper draws on Environmental Management Accounting (EMA) literature and cost driver theory to study the nature and role of environmental cost drivers. More specifically, two types of operations related to environmental protection were empirically examined: the removal of asbestos from buildings and soil remediation. Findings from a series of case studies are presented and discussed. The paper contributes to existing literature in three ways: (1) by testing the adaptability of cost drivers typologies in a non-traditional, non-industrial setting (2) by proposing a more dynamic vision of the cost of social and environmental responsibility of the firm, and (3) by shedding light on the complex interrelationships of environmental cost drivers.Environmental Management Accounting, Cost Driver, Social & Environmental Responsibility

Offering the Choice of Self-Administered Oral HIV Testing (CHIVST) among Long-distance Truck Drivers in Kenya: A Trial-based Cost-effectiveness Analysis

Background: Long distance truck drivers (LDTD) are a high-HIV-risk population facing unique healthcare barriers due to continuous travel and irregular schedules, and may require targeted, resource-intensive strategies for HIV-test uptake. We conducted a trial-based cost-effectiveness of CHIVST among LDTD in Kenya. Methods: Effectiveness data came from a randomized-controlled trial of CHIVST (n=150) versus provider-administered testing (n=155). Economic cost data came from the literature and reflected a societal perspective. Generalized Poisson and linear-gamma regression models estimated the effectiveness (relative-risk) and incremental costs (2017 I$), respectively, with incremental effectiveness calculated as the reciprocal of the absolute risk difference and reported as the number needing to receive CHIVST for an additional HIV-test uptake. We reported incremental cost-effectiveness ratios (ICERs), with 95$9,774). Results: HIV-test uptake was 23% more likely for CHIVST versus provider-administered HIVtesting, with six individuals needing to be offered CHIVST for an additional HIV-test uptake (6.25, 95%CI 5.00-8.33). The mean cost per patient was more than double for CHIVST (I$26.56 vs I$10.47). The incremental cost-effectiveness of CHIVST was I$97.21 [95$140. Conclusion: CHIVST is an efficient use of resources compared to provider-administered testing.https://scholarscompass.vcu.edu/gradposters/1114/thumbnail.jp

Existence of optima and equilibria for traffic flow on networks

This paper is concerned with a conservation law model of traffic flow on a network of roads, where each driver chooses his own departure time in order to minimize the sum of a departure cost and an arrival cost. The model includes various groups of drivers, with different origins and destinations and having different cost functions. Under a natural set of assumptions, two main results are proved: (i) the existence of a globally optimal solution, minimizing the sum of the costs to all drivers, and (ii) the existence of a Nash equilibrium solution, where no driver can lower his own cost by changing his departure time or the route taken to reach destination. In the case of Nash solutions, all departure rates are uniformly bounded and have compact support.Comment: 22 pages, 5 figure

Aggregate cost implications of selected Cost-Drivers \ud in the Tanzanian Health Sector\ud

\ud Health is an important aspect of life of which one of its determinants is healthcare which is consumed in order to restore back deteriorated health to optimal pre-illness levels. The consumption of healthcare however has cost implications and accounts for a large share of resources directed towards the health sector. In health sector financing, it is vital to identify major cost components and create awareness about the costs of decisions. It is thus vital to identify factors that can cause changes in the cost of identified activities. A number of costly programs have been initiated and some others are on the horizon. In order to create awareness about the financial consequences of these decisions and to draw attention to the financing needs of the health sector, it is considered necessary to analyze the major health sector programs and initiatives with regard to the changes in costs brought about by new strategies, guidelines and interventions (including the adoption of new technologies), and aggregate these costs. The main objective of this study was to identify cost-driving decisions in the health sector. The study methodology comprised of three independent but complementary methodologies and activities: (a) Desk review of literature and documents; (b) Interviews with officials from MOHSW, programs and agencies involved in setting and promoting standards at international level; (c) collection of primary data/information and subsequent analysis of the same. The study reviewed 11 plans, including summary plans like the Health Sector Strategic Plan III and the Primary Health Services Development Program 2007 -2017 and national disease control programme plans/strategies. However, not all of cost-driving decisions in these plans could be integrated into the analysis because the plans are undergoing reprogramming, as the previous cost estimates are regarded not to be realistic relative to achieving plan objectives. In addition the costs of some decisions in some plans/strategies HRH, infrastructure, health care financing strategy, mhealth, etc. are not established or are in the process of being costed or reviewed. It should also be noted that the consultants did not assess all plans/strategies and their associated costs as to their plausibility. This was neither task of the consultants, nor would the time allocated to the study have allowed such an in-depth review. The study reviewed a total of 11 multi-year plans/strategies and found four plans to be affected by costs of decisions. Such decisions are: the adaption of WHO recommendations on Anti-retroviral Treatment eligibility criteria; re-treatment of conventional nets; indoor residual spraying; sustaining availability of long lasting insecticide treated nets (LLINs); provision of delivery kits to pregnant women in public health facilities, and the potential future introduction of a malaria vaccine, human papilloma virus and pneumococcal vaccines, which affect the Health Sector HIV and AIDS Strategic Plan II (HSHSP II) 2008 – 2012, the Malaria Mid-Term Strategic Plan 2008 – 2013 (NMCP), the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008 – 2015 (the Road Map), and the Expanded Program on Immunization 2010 - 2015 Comprehensive Multi Year Plan (EPI), respectively. The study found that these decisions have a significant cost implication to a tune of US$706,688,405 over a five year period 2011- 2015. The initially estimated costs of programs that are currently being updated (HSHSP II, EPI, NMCP and the Road Map) is US$ 2,297,009,378 exclusive of the identified cost drivers. The estimated cost of decisions is about 8 % of the total costs for health sector in Tanzania (HSSP III estimate) and about 3.3% of the 2009 GDP and added nominal per capita health spending/cost of US$17.3 (2009 population estimate) for five year period (annual per capita cost of US$ 3.46). This expenditure will definitely boost per capita health spending (US$13.45 in 2008/9). However, concerted revenue effort is needed if we are to hit HSSP III target of US$ 26.6 in 2014/15. The National Strategy for Non-communicable Diseases 2009 – 2015 did not include estimates, while most parts of the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008 – 2015 are undergoing reprogramming, as the previous cost estimates are regarded not to be realistic relative to achieving plan objectives. The rest of the programs are not significantly affected by cost of decisions. However, the estimated cost is likely to be higher owing to the fact that costs of some decisions in MMAM components such as HRH, infrastructure, health care financing strategy, mhealth, etc. are not established or are in the process of being costed or reviewed. Prevention and treatment of illness are the major strategies used to maintain or improve the health status of a population. Allocation of health resources are usually skewed towards treatment probably because addressing existing illnesses seem a present and clear danger than addressing potential illnesses which is what prevention is all about. Prevention and health promotion however lead to greater benefits than treatment in the long run in the sense that it reduces future demand for treatment than treatment alone does and has stronger merit good characteristics than treatment of illness. Health planning should thus intensify focus on prevention through promoting lifestyle and behaviour changes as well as intensifying prevention and health promotion at community level. Most health sector multi-year plans are characterized by heavy resource dependence on development partners. Such levels of dependence tend to compromise control over some decisions especially those supported by financiers. That is, recipients may be tempted to accept a full funded activity even if there is an ongoing similar activity which ends up creating parallel rather than complementary activities with cost implications. Thus, the financiers and recipients should undertake thorough analysis of potential decisions based on their cost implications (direct and indirect) as well as the time parameters, while avoiding decisions that spin off similar activities rather than complementing the existing ones. This can be facilitated by coordinated analysis from the MOHSW by keeping and monitoring comprehensive cost driver table enriched by inputs from all health sector programs and plans. Continuous reviews of the plans enhance the capacity of programs to adequately identify cost drivers and therefore enhance the planning process. However, reviews are not always undertaken on time and as regular as possible due to lack of resources or transfer of resources set aside for review process to implement other pressing components of the plan. MOHSW should make costing part of the plan a compulsory exercise for approval by the management and should not endorse plans which have not been adequately costed. MOHSW should also consider making reviews of multi-year plans a prerequisite for release of fund for subsequent implementation. Moreover, the reviews should integrate all stakeholders and involve technical people who are knowledgeable in costing and planning. The fact that most of the multi-year plans had indicative budgets, while others are not costed at all, warrants the conclusion that the basic knowledge in costing such as collaboration, parameter assumptions, time, manpower, and resources is lacking. Emphasis should thus be placed on developing and improving costing capacity in the programs as well as the MOHSW in terms of acquiring costing tools and exposure. The MOHSW should ensure that the priority activities of the strategies/plans are funded. This could be done through lobbying the government and other stakeholders for more resources. Protocols such as Abuja Declaration 2001, in which African governments committed themselves to scale up health budget to 15% of the annual budget, could be useful in this end. Also the government and local authorities through laws/bylaws could establish and commit specific sources of resources for the health sector. This should be pursued by keeping a close eye on the ratio of available resources to required resources which can indicate opportunities which development partners can be of help as well as providing an indication of the realism of planning. A review of the plans found the ratio of available resources to required resources to be 76 and 84 percent, respectively, for the Health Sector Strategic Plan III and the Expanded Program on Immunization 2010 – 2015 Comprehensive Multi Year Plan. The Malaria Medium Term Strategic Plan 2008-2013 on the other hand had the lowest ratio of available resources to required resources of 35 percent.\u

Spacecraft Systems Working Group report

Issues addressed include: definition of user/commercial/government needs by function; criteria for prioritization of needs; overall criteria for technology assessment; system configuration drivers (key trade studies); space infrastructure interface; and cost drivers (pros and cons of standardization, manufacturing, test, serviceability, and supportability)

Current Knowledge and Attitudes Concerning Cost-Effectiveness in Glaucoma Pharmacotherapy: A Glaucoma Specialists Focus Group Study.

Background:Rising healthcare costs motivate continued cost-reduction efforts. To help lower costs associated with open-angle glaucoma (OAG), a prevalent, progressive disease with substantial direct and indirect costs, clinicians need to understand the cost-effectiveness of intraocular pressure (IOP)-lowering pharmacotherapies. There is little published information on clinicians' knowledge and attitudes about cost-effectiveness in glaucoma treatment. Purpose:This pilot focus group study aimed to explore clinician attitudes and perspectives around the costs and cost drivers of glaucoma therapy; the implementation of cost-effectiveness decisions; the clinical utility of cost-effectiveness studies; and the cost-effectiveness of available treatments. Methods:Six US glaucoma specialists participated in two separate teleconferencing sessions (three participants each), managed by an independent, skilled moderator (also a glaucoma specialist) using a discussion guide. Participants reviewed recent publications (n=25) on health economics outcomes research in glaucoma prior to the sessions. Results:Participants demonstrated a clear understanding of the economic burden of glaucoma therapy and identified medications, diagnostics, office visits, and treatment changes as key cost drivers. They considered cost-effectiveness an appropriate component of treatment decision-making but identified the need for additional data to inform these decisions. Participants indicated that there were only a few recent studies on health economics outcomes in glaucoma which evaluate parameters important to patient care, such as quality of life and medication adherence, and that longitudinal data were scant. In addition to efficacy, participants felt patient adherence and side-effect profile should be included in economic evaluations of glaucoma pharmacotherapy. Recently approved medications were evaluated in this context. Conclusion:Clinicians deem treatment decisions based on cost-effectiveness data as clinically appropriate. Newer IOP-lowering therapies with potentially greater efficacy and favorable side-effect and adherence profiles may help optimize cost-effectiveness. Future studies should include: clinicians' perspectives; lack of commercial bias; analysis of long-term outcomes/costs; more comprehensive parameters; real-world (including quality-of-life) data; and a robust Markov model

Glider: A GPU Library Driver for Improved System Security

Legacy device drivers implement both device resource management and isolation. This results in a large code base with a wide high-level interface making the driver vulnerable to security attacks. This is particularly problematic for increasingly popular accelerators like GPUs that have large, complex drivers. We solve this problem with library drivers, a new driver architecture. A library driver implements resource management as an untrusted library in the application process address space, and implements isolation as a kernel module that is smaller and has a narrower lower-level interface (i.e., closer to hardware) than a legacy driver. We articulate a set of device and platform hardware properties that are required to retrofit a legacy driver into a library driver. To demonstrate the feasibility and superiority of library drivers, we present Glider, a library driver implementation for two GPUs of popular brands, Radeon and Intel. Glider reduces the TCB size and attack surface by about 35% and 84% respectively for a Radeon HD 6450 GPU and by about 38% and 90% respectively for an Intel Ivy Bridge GPU. Moreover, it incurs no performance cost. Indeed, Glider outperforms a legacy driver for applications requiring intensive interactions with the device driver, such as applications using the OpenGL immediate mode API

The Growth & Increasing Cost of the Federal Prison System: Drivers and Potential Solutions

The federal prison population has been growing dramatically; its current population exceeds 218,000, with projections of continued growth for the foreseeable future. A wide array of actors -- Members of Congress, administration officials, a bipartisan cast of policy advocates, and researchers -- has concluded that this growth and its associated costs are unsustainable. The basis for this conclusion varies:Fiscal impact. Resources spent on the Bureau of Prisons (BOP) eclipse other budget priorities.Overcrowding risks. Overcrowded facilities can jeopardize the safety of inmates and staff and limit opportunities for effective programming that can reduce recidivism.Fairness/equity concerns. High levels of incarceration may have disproportionate impacts on certain subpopulations and communities.Inefficient resource allocation. Current research and recent evidence-based policy changes implemented in states raise questions about the cost-effectiveness of existing federal sentencing and corrections policies.The focus on this burgeoning population provides an opportunity to explore the drivers of population growth and costs and to develop options for stemming future growth that are consistent with public safety goals