Direct costs utilities

Table 12.1 summarizes five major types of pharmacoeconomic evaluations cost-consequence, cost-benefit, cost-effectiveness, cost-minimization, and cost-utility (Drummond et al., 1997 Kielhorn and Graf von der Schulenburg, 2000). In a cost-consequence analysis, a comprehensive list of relevant costs and outcomes (consequences) of alternative therapeutic approaches are presented in tabular form. Costs and outcomes are typically organized according to their relationship to cost (direct and indirect), quality of life, patient preferences, and clinical outcomes (see taxonomy below). No attempt is made to combine the costs and outcomes into an economic ratio, and the interpretation of the analysis is left in large part to the reader. 

It is also possible to understand the fixed capital cost as the sum of direct and indirect costs. Direct costs are the installed-equipment costs plus the price of plants built separately from the production line, where utilities, such as steam, are produced. Indirect costs contain engineering costs, fees, supervision costs, etc. [15] that the investor needs to sustain during plant construction. 

Remark 2 In Figure 8.20 we have discussed the optimization loop of HRAT. Specifying a value of H RAT allows the calculation of the minimum utility loads using the LP transshipment model, The optimization loop of HRAT had to be introduced so as to determine the optimal value of HRAT that gives the trade-off of operating and investment cost. Note, however, that in the approach of this section, in which we perform no decomposition at all, we do not specify the H RAT, but we treat the hot and cold utility loads as explicit unknown optimization variables. As a result, there is no need for the optimization loop of HRAT since we will determine directly the utility loads. 

Mostly, direct costs of health care utilization of OSAS patients have been reported. Indirect costs, productivity loss including sick days and costs of absenteeism, and costs of transportation have not yet been tabulated for OSAS. 

Ronald et al. analyzed the direct costs of physician claims and the number of hospital admissions for OSAS patients in the Canadian Manitoba governmental health agency database. They found that 181 patients (145 men, 36 women) with untreated OSAS were shown to utilize health care at twice the rate of controls up to 10 years before diagnosis (48). The most significant increase in physician claims was noted up to 3 years before diagnosis. The total physician claims were 686,365 (Canadian) with a mean of 3792/patient, whereas controls generated 356,376 with a mean of 1969/patient. OSAS patients had almost a twofold increase in hospitalizations compared to controls over the 10-year period ... 

Another way to classify costs is direct versus indirect. Direct costs are costs that are completely attributable to the prescription department (e.g., the costs of prescription vials and the prescription department computer). Pharmacist labor is considered a direct expense unless the pharmacist has managerial responsibilities in nonprescription departments. Indirect costs are costs that are shared between the prescription department and the rest of the store. Rent, clerical labor costs, utilities, and advertising for the pharmacy are examples of indirect expenses. Methods for allocating indirect expenses to the prescription department are discussed in the example in Table 16-2. 

Cost-utility analysis is used when quality of fife is the most important outcome being examined. This is common in disease states in which how one feels or what one can do is more important than a clinical laboratory value or economic outcome (e.g., chronic diseases such as heart disease, diabetes, arthritis, cancer, or HIV/AIDS). Cost-utility analyses compare the direct and indirect costs of an intervention with some measurable level of humanistic outcome, such quality of life or level of satisfaction. The direct and indirect costs of treatment alternatives again are expressed in monetary terms. The humanistic outcomes associated with each intervention can be expressed as an SF-12 or SF-36 health survey score for quality of life (Ware, 1997), as a satisfaction survey score (Mac-Keigan and Larson, 1989), or as quality-adjusted life-years (QALYs). QALYs represent the number of full years at full health that are valued equivalently with... 

When determining which method of economic analysis she should use, she eliminated cost-minimization analysis because the treatment alternatives (service versus no service) will not result in equivalent outcomes. A cost-effectiveness analysis would not be appropriate because she is only interested in one particular program. A cost-utility analysis is also not appropriate because quality of life, while included in the project, is not the focus of her project. A cost-benefit analysis could be appropriate. A cost-benefit analysis requires that both the interventions and outcomes be valued in monetary units. She can determine the direct medical and/or nonmedical costs for each patient from data captured by her HMO. The HMO is very interested in costs, both those to implement the service and those it may save as a result. Cynthia decides that the most understandable analysis to present to the HMO is a cost-benefit analysis. 

Direct Costs Methanol plants MTG plant Offsites and utilities Total direct costs 169,100 91,300 122,000 382,400... 

The impact on employment is of particular concern in the diseases that most often affect young and middle-aged adults. Studies on several diseases have reported that a large percentage (30% or more) of patients are unable to work, and this figure increases with disease duration (Woolf Pfleger, 2003 Lacaille, 2005 Alarcon et al., 2006). Furthermore, the indirect costs associated with job or productivity loss may be greater than the direct costs associated with health-care utilization (Phillips, 2004 Rat Boissier, 2004 Hulsemann et al., 2006). 

Direct costs (DC) Raw materials Operating labour (OL) Direct Supervisory Utilities Maintenance and repairs Operating supplies Laboratory charges Patents and royalties From material balance (10-50% )TOC From manpower (10-20% TOC) 20% OL From energy balance (10-20% TOC) 10% Fc 1 % Ff. (6%OL) 10-20%OL 0-6% TOC... 

Direct costs are composed from the costs of raw materials RAf), utilities Ut), operating labour (OL), direct supervision and clerical labour Ds), maintenance and repairs (M), operating supplies (Os), laboratory charges (Lab), patents and royalties. We may neglect the last term. By using the factors in Table 15.10 we obtain ... 

A comparison of direct labor utilization is shown in Table 12. Total overhead costs of 25 million remain the same, at least in the short run, and per hour costs thus increase from 25 per hour (before the price increase) to 25 miUion/857,500 hr = 29.15/hr (after the price increase). Recomputation of overhead allocations on model profitability via a conventional cost system is presented in Table 13. 

TABLE 12 Revised Schedule of Direct Labor Utilization—Conventional Cost Management System— for the Next Model Year... 

Sector 19.03 - Public utility construction Sector 19.03 - Public utility construction total direct cost ( 2000 million) avoidable cost ( 315 million)... 

Electrical Utilities There are seven generic types of electricitygenerating plants such as fossil fuel, nuclear hydroelectric, cogeneration, geothermal, solar, and wind. The major sources in use in the United States are fossil fuel and nuclear supply systems. The direct cost attributed to corrosion was 6.9 billion with the largest amount for nuclear power ( 4.2 billion), fossil fuel (1.9 billion), hydraulic power ( 0.15 billion), transmission, and distribution (0.6 billion). 

Maintenance and Direct Labor Costs Utilities Costs... 

One can approach the task of measuring population density in three ways. Collectively, these may be categorized as either direct or indirect. Direct techniques utilize microscopic counting methods in which viability is estimated by the inclusion of a viable dye or stain (see C.4). By comparison, indirect methods require plating (see C.2, C.3) and, subsequendy, growth of colonies. Additionally, monitoring some specific component unique to the viable cells in the population (i.e., ATP) or a component specific to the cell envelope continues to be of interest. Each has inherent merits, deficiencies, and cost considerations in terms of both equipment and supplies, and personnel that should be evaluated. 

A utihty knife designed for heavy industrial use with maximum blade length can, in some cases, violate a company s Deadly Weaponry policy. Not only has the company purchased an unsafe utility knife, but it has also paid extra retail dollars when a safety cutter can be acquired on a direct cost-based purchase. Workers using a utility knife can suffer cut injuries, resulting in medical and workers compensation costs. A utility knife can also damage products... 

Aside from direct costs from utility companies for low-PF operation, the end-user experiences a number of indirect costs as well. When a facility operates with a low overall PF, the amount of useful electrical energy available inside the plant at the distribution transformer is reduced considerably because of the amount of reactive energy that the transformer(s) must carry. Figure 10.209 illustrates the reduction in available power from a distribution transformer when presented with varying PF loads. Figure 10.210 illustrates the increase in PR losses in feeder and branch circuits with varying PF loads. These conditions result in the need for oversized cables, transformers, switchgear, and protection circuits. 

Indirect-to-Direct Accident Cost Ratios Uniformly accepted computation methods to determine indirect and direct accident cost ratios are not available. Differences in the systems utilized are substantial. More importantly, no published ratios are valid because the increase in direct costs from about 1995 through 2011 (indemnity payments and medical costs) has substantially exceeded the increase in indirect costs. This chapter presents a review of selected data pertaining to indirect and direct accident costs, shows computations made to update ratios resulting from the only plausible research located to give an approximation of what the current ratio of indirect to direct costs might be, comments on the inappropriateness of using additional sales needed to cover indirect and direct costs, and pleads for research to provide substantiated cost ratios. 

For decades, safety practitioners have used the ratio of indirect-to-direct costs of accidents to inform managements on total accident costs and to achieve improvements in safety management systems. The most commonly used ratio is 4 to 1, but the literature contains a wide range of ratios and an even broader range of methods for determining the ratios. Uniformly accepted computation methods to determine indirect and direct costs have not evolved. Differences in the systems utilized are substantial. 

The uncertainty about the direct costs and revenues for 2000 is inherent in the budgeting process. More avoidable is the excessively optimistic character of the predictions. What is being predicted is an increase in staff of about 16 per cent an increase in the already high level of staff utilization and a substantial increase in charging rates. The author s experience suggests that this combination of performance improvements will only be possible in a very... 

Shop Overhead. In addithm to the direct costs involved for materials and labor, idl fabricators must add an indinvt cost often termed the shop overhead or burden. This overhead includes a variety of items, such as the cost of supervision, administration, engineering, sales, utilities, maintenance, depreciation, taxes, and other fixed and indirect costs. These cc ts vary from shop to shop, area to area, and year to year, and are estahlMted hy the ctmrfitions for a particular shop and hy Ifie acA ouiiting pnictice followed. I his overhead usually rang ftxmi 100% to 200% of the total cowit for labor and materials. 

Variable costs (operating costs) tend to vary with the production level. They include cost of raw materials, cost of product degradation, costs of energy and utilities, direct labor (operating, works transport, supervision, and laboratory control), interest on working capital, royalties, variable part of maintenance costs, and miscellaneous direct costs. 

Direct costs. The costs of raw materials, utilities (effluent treatment, water and energy for heating, pumping, etc. as well as electrolysis), labour, maintenance and replacement of components (in electrolyses, particularly electrodes or... 

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