The purpose of this paper is to analyze cost-effectiveness of a train simulators. The cost-effectiveness of training program is assessed by multiplying transfer effectiveness ration(TER) by training cost ration(TCR). If their product is less than one, the program is not cost effective. Even if a program is not cost effective, however, safety considerations may be important to consider.
Present paper deals with the cost effective design of reinforced concrete building frame employing unified particle swarm optimization (UPSO). A building frame with G+8 stories have been adopted to demonstrate the effectiveness of the present algorithm. Effect of seismic loads and wind load have been considered as per Indian Standard (IS) 1893 (Part-I) and IS 875 (Part-III) respectively. Analysis of the frame has been carried out in STAAD Pro software.The design loads for all the beams and columns obtained from STAAD Pro have been given as input of the optimization algorithm. Next, cost optimization of all beams and columns have been carried out in MATLAB environment using UPSO, considering the safety and serviceability criteria mentioned in IS 456. Cost of formwork, concrete and reinforcement have been considered to calculate the total cost. Reinforcement of beams and columns has been calculated with consideration for curtailment and feasibility of laying the reinforcement bars during actual construction. The numerical analysis ensures the accuracy of the developed algorithm in providing the cost optimized design of RC building frame considering safety, serviceability and constructional feasibilities. Further, Monte Carlo simulations performed on the numerical results, proved the consistency and robustness of the developed algorithm. Thus, the present algorithm is capable of giving a cost effective design of RC building frame, which can be adopted directly in construction site without making any changes.
Han, Kyu-Tae;Kim, Sun Jung;Lee, Seo Yoon;Park, Eun-Cheol
Asian Pacific Journal of Cancer Prevention
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제15권19호
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pp.8503-8508
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2014
Background: After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Materials and Methods: Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. Results: In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. Conclusions: The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.
Journal of Construction Engineering and Project Management
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제10권1호
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pp.16-32
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2020
Cost and time control of projects is important in preventing project failure. However, achieving effective cost and time control in practice is often challenging. The challenges of project cost and time control in practice are investigated by carrying out a questionnaire survey on the top 150 construction contractors in the UK followed by in-depth semi-structured interviews of practitioners from 15 construction companies in the country. Quantitative analysis reveals that design change is the most important factor inhibiting the ability of UK contractors from effectively controlling both the cost and time of construction projects. Four of the top five factors inhibiting effective cost control are also the top factors inhibiting effective time control albeit in a different order. These top factors-design changes, inaccurate evaluation of project time/duration, risk and uncertainty, non-performance of subcontractors and nominated suppliers were also found to be endogenous factors to the project. Additionally, qualitative analysis of the interviews reveals 16 key challenges to prevent for effective project cost and time control in practice. These are classified into four categorised based on where they stem from as follows; from the organisation (1. Lack of integration of cost and time during project control, 2. lack of management buy-in, 3. complicated project control systems and processes, 4. lack of a project control training regime); from the construction management/project management approach (5. Lapses in integration of interfaces, 6. project control not being implemented from the early stages of a project, 7. inefficient utilisation and control of labour, 8. limited time devoted to planning how a project will be controlled at the outset); from the client; (9. Excessive authorisation gates, 10. use of adversarial and non-collaborative forms of contracts, 11. communication problems within client set-up, 12. obstructive client representatives) and; from the project team (13. Lack of detailed/complete design, 14. lack of trust among the project partners, 15. limited time devoted to project control on site, 16. non-factual reporting). The study posits that knowledge of these project control inhibiting factors and challenges is the first step at ensuring they are avoided and enable the implementation of a more effective project cost and time control process in practice.
Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.
Recently Life Cycle Cost Analysis for civil infrastructures such as pavements, bridges, and dams has been emphasized However, so far, there are few systems available for life cycle cost analysis of bridges at design stage. Therefore, the objective of this paper is to develop a user-friendly life-cycle cost analysis system for LCC-effective optimal design decision making at design stage. The program is based on the proposed LCC model, formulation, analysis modules and systematic procedure that suit Korean construction conditions. It is expected that the developed system can be effectively utilized for more LCC-effective design of bridges. It is applied to an actual bridge design project in order to demonstrate its effectiveness and applicability.
Objectives: A meta-analysis of the literatures was conducted to evaluate the cost-effectiveness of medical nutrition therapy by dietitians. Methods : The 30 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and the PQD database until May, 2002 and a review of reference lists. The main search terms were“dietitian”,“dietary intervention”,“nutrition intervention”, “cost”,“cost-effectiveness”and“cost-benefit analysis”. The subgroup analysis was performed by publication year, study design, intervention provider, type of patient (in/out-patient) and type of cost (total cost/direct cost). Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. Results : The 30 studies were identified using the electric database search and bibliographies. The 17 trials were eligible for inclusion criteria, then the systematic review and a meta-analysis were conducted on effectiveness and cost-effectiveness of medical nutrition therapy. The quality of the studies was evaluated using the quality assessment tool for observational studies. The quality score was 0.515 $\pm$ 0.121 (range : 0.279-0.711, median : 0.466). The meta-analysis of 17 studies based on the random effect model showed that medical nutrition therapy was highly effective in treating the diseases (effect size 0.3092 : 95% confidence interval 0.2282-0.3303). The vote-counting method, one of meta-analysis methods, was applied to evaluate the cost-effectiveness of medical nutrition therapy conducted by dietitians. Two criteria (method 1, method 2) for voting were used. The calculated p-values for method 1 (more conservative method) and method 2 (less conservative method) were 0.1250 and 0.0106, respectively. Medical nutrition therapy by dietitians was significantly cost-effective in the method 2. Conclusion. This meta-analysis showed that the effectiveness of medical nutrition therapy was statistically significant in treating disease (effect size 0.3092), and that the cost-effectiveness of medical nutrition therapy was statistically significant in the method 2 (less conservative method) of vote counting. (Korean J Nutrition 36(5): 515~527, 2003)
Misra, Swati;Lairson, David R.;Chan, Wenyaw;Chang, Yu-Chia;Bartholomew, L. Kay;Greisinger, Anthony;Mcqueen, Amy;Vernon, Sally W.
Journal of Preventive Medicine and Public Health
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제44권3호
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pp.101-110
/
2011
Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.
This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil. bezafibrate, lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients' travel expenses and time loss as well as resource consumption in the health care sector. Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of ₩31.400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(₩33,100 per percent reduction). Chole styramine(8g/d) was least efficient at ₩90,200. For low-density lipoprotein cholesterol. simvastatin(10mg/d) was most efficient, at ₩23,200 per percent reduction, followed by lovastatin(20mg/d) at ₩28,000. Gemfibrozil was least efficient at ₩77,800 per percent reduction. For high-density lipoprotein cholesterol. bezafibrate(400mg/d) was most efficient at ₩39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at ₩514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk. The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient's needs This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.
As has been expected, economic factors are a major consideration in almost every decision in building design process. Assuming that improving a lighting system, existing or proposed, will reduce operating cost, what preliminary economic guidelines can be established to determine whether any proposed investment appears cost effective? In such a case a reasonable technique to compare system costs is by life-cycle costing. Stated simply, a life-cycle cost represents the total cost of a system over its entire life cycle, that is, the sum of first cost and all future costs. This paper aims to exemplify the benefit of daylighting in term of economic consideration. Four different electric lighting system designs are proposed and a lighting control system that is continuously operating according to the level of daylight in the space has been adapted. The accumulated performance of electric and daylighting is figured out to declare the effective depth of daylight in the space. The analysis on the saving amount of lighting energy due to daylight has been undertaken in answer to the question, that is, several projects are being considered, which is the most desirable from the cost-effectiveness viewpoint. The result shows clearly that although denser layout of lighting fixtures might be more effective to interface to the level of daylight ceaselessly changeable, its economic benefit may not meet the expected criterion the reason of increased initial investment and maintenance cost for the fixtures and control hardware.
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