A Direct-Indirect Cost Decision Making Assessment Methodology for Seismic Isolation on Bridges

Making decisions of when to intervene on bridges taking into consideration more than owner costs is a growing field of interest in earthquake engineering. In particular, bridges can be considered critical links in highway networks because of their seismic vulnerability in terms of direct and indirect losses. This paper aims at defining a general criteria capable of taking into account both these costs in a simplified and efficient formulation. Indirect losses generally neglected elsewhere, are taken into consideration by applying a formulation that assesses investment efficiency. The presented formulation follows the one proposed for buildings by L. Kantorovich, 1975. Direct costs are computed from a Performance Based Earthquake Engineering （PBEE） methodology by the Pacific Earthquake Engineering Research （PEER） center. The problem considers two competitive objectives （maximizing economic efficiency and minimizing costs） in a multi-objective structural optimization procedure. The formulation has been applied to a case study aimed at strengthening a benchmark bridge. The optimum investment has been assessed between several isolated configurations.

Direct Cost of Primary Open Angle Glaucoma Management

Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.4 and p = 0.012) and prostaglandin analogues (OR of 38.2 and p Conclusion: This first study on the direct cost of POAG management in Lomé showed that the economic burden glaucoma represents for the patient, his family and society. The data from this study will allow health decision-makers to adopt strategies to mitigate the effects of glaucoma on the economy.

Direct Cost of Severe Malaria Treatment Borne by the Families of Children Aged 0 - 5 Years at the Fana Reference Health Centre, Mali

Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.

Estimation of direct and indirect cost of diabetes in Morocco

Due to its chronic nature with severe complications, diabetes needs costly prolonged treatment and care. The high economic burden of diabetes is particularly threatening low and middle income countries. World-wide, studies have shown that the cost of diabetes per person is much higher than the per capita health expenditure. This study is the first to estimate the direct and indirect cost of diabetes in Morocco. The direct cost of diabetes was computed by assuming three scenarios of prices (low, medium and high) due to different prices of insulin, oral drugs and other items used in diabetes treatment and care. Indirect costs of diabetes were estimated by the lifetime forgone earnings caused by premature death and disability due to diabetes. The direct cost of diabetes in Morocco was estimated to be between US $0.47 and US $1.5 billion whereas the indirect cost was estimated to be around US $2 billion accounting for 57% of the total cost of diabetes under the high cost scenario, 69% under the medium scenario and 81% under the low cost scenario. The average per capita indirect cost was estimated to be US $1113, relatively higher than the direct cost of diabetes which was seen to vary from US$ 259 to US $830. The results yielded by this study were compared to those obtained by similar studies in different regions and countries of the world. As a conclusion, the findings of this study indicate a high economic burden of diabetes and stress the importance that Moroccan health decision makers should give to sensitisation, early diagnosis and treatment of diabetes especially with the crucial growing trend of diabetes prevalence.

In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation

Objective: Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrial fibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This study aimed to provide detailed data regarding in-hospital direct costs for these pa-tients, compare the costs at different scenarios, and identify independent factors that may predict the costs. Methods: We collected data regarding in-hospital direct costs among patients with AF who were hospitalized owing to ischemic stroke (IS), transient ischemic attack (TIA), intracranial hemorrhage (ICH), or major gastrointestinal bleeding. All data were collected from 7 representative tertiary referral hospitals and 3 secondary care hospitals from December 2009 to October 2014. Results: In total, 312 eligible patients with thromboembolism and 143 patients with major bleeding were identified, and their hospital charts were reviewed. The median in-hospital direct costs were 17,857 Chinese Yuan (CNY) for IS and 16,589 CNY for TIA (equivalent to 2907 US dollars and 2701 US dollars, respectively). For patients with major bleeding, the costs were 27,924 CNY for ICH and 18,196 CNY for major gastrointestinal bleeding (equivalent to 4546 US dollars and 2962 US dollars, respec-tively). The direct costs were mainly driven by medications, which accounted for approximately 33.4%-36.1% in different groups of patients. The direct costs were highly related to the hospital level and National Institutes of Health Stroke Scale scores in patients with thromboembolism; in patients with ICH, the factors included hospital level, warfarin treatment before admission, and prior hospitalization for stroke. Conclusions: Given the high prevalence, AF-related thromboembolism and bleeding impose considerable economic burden on the Chinese society. Efforts to improve the management of AF may confer substantial economic benefits.

Direct medical cost of radiation therapy for cancer patients in Taiwan

Background and purpose: The rising cost of health care is of concern worldwide, in particular, for cancer care. The costs of treatment, including chemotherapeutic drugs and radiotherapy, are no exceptions. The purpose of this study is to explore the direct medical cost of radiotherapy and the annual increasing trend of expenditures in Taiwan. Methods: This study utilized data retrieving from the original claim data of the reimbursement of the Health Insurance Research Database (HIRD) derived from Taiwan’s Health Insurance (HI) program. Detailed data on the direct medical cost within the radiotherapy process for beneficences were extracted from inpatient expenditures by admissions (DD) and ambulatory care expenditures by visits (CD) database according to the reimbursed expenditure code of radiotherapy from January 1, 2000 to December 31, 2005. Prescriptions for radiotherapy were retrieved and the direct medical costs for radiotherapy were collected based on the NHI reimbursement price list of 2005. The annual increasing trend of expenditures was also explored according to the perspective of Bureau Health Insurance of Taiwan. Results: The total direct medical costs of radiotherapy for cancer patients were increasing from 2000 to 2005, which were estimated to US $7.80 million, US $8.09 million, US $7.58 million, US $10.7 million, US $12.2 million and US $15.9 million in 2000, 2001, 2002, 2003, 2004 and 2005, respectively. The increased percentage corresponded to the total healthcare expenditures claimed was increased substantially from 0.82% in 2000 to 1.22% in 2005. The total direct medical costs within the radiotherapy process were also increased gradually if identified by different types of radiotherapy and teaching hospital levels. The direct medical costs attribute to radiotherapy, compared to total health care expenditures in Taiwan, were similar to the costs of anticancer drugs for cancer patients annually. Conclusions: The direct medical costs of radiation therapy increased substantially each year. Further cost analysis on radiation therapy is needed in years beyond 2005.

一种基于统计分析的多视点视频编码中Direct模式提前终止算法

提出了一种针对多视点视频编码中Direct模式的提前终止算法.该算法基于当前编码宏块相邻视点、时间及空间方向的已编码邻近宏块的编码信息,提出了一个描述当前宏块的邻近块代价影响因子,通过与阈值比较可对多数编码宏块直接选择Direct模式进行编码,从而略过其他模式的相关计算.实验结果表明,与原始的多视点视频编码算法相比,该算法可平均减少约88.2%的编码时间,同时峰值信噪比仅下降约0.29dB,编码比特率增加约0.68%.

Real-world cost-effectiveness associated with infliximab maintenance therapy for moderate to severe Crohn's disease in China

BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease(MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy(IMT) for MS-CD relative to conventional maintenance therapy remained unclarified.AIM To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer.METHODS A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy(CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs.RESULTS Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications(odds ratio: 0.527, P = 0.010), higher utility value for quality of life(coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management(coefficient-0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers $55260 to gain one quality-adjusted life year(QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita(GDPPC)] was 86.4%.CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.

Fingerprint Directional Image Partitioning Based on Genetic Algorithm

In this work, we introduce a method of fingerprint directional image partitioning based on GA. According to the fingerprint topology, A set of dynamic partition masks and a cost estimating function are designed to guide the partitioning procedure. Finding best fitted mask application is converted to an functional optimizing problem, and we give out a GA solution to the problem. At last, we discuss the application of the proposed method in Fingerprint Classification.

Unit cost of CT scan and MRI at a large tertiary care teaching hospital in North India

Imaging department is an important department of a hospital contributing directly to patient care, providing diagnostic support to all specialties which cannot practice efficiently without their support. Hospital administrators are looking for newer tools to control costs without affecting the quality of patient care. It is well known that the escalation of costs for advanced technology has been dramatic and it has been labeled as one of the culprits for great increase in healthcare costs. A prospective study for a period of six months was carried out for calculation of unit cost of radiological investigations CT head, CT chest, CT abdomen and MRI. Unit costs were computed under direct and indirect costs. The actual cost incurred by the hospital on CT head was Rupees 581.40 (US $10.89), CT abdomen Rupees 2339.20 (US $43.83), CT chest Rupees 2339.20 (US $43.83), and MRI Rupees 4497.50 (US $84.28). However, in the hospital patients are charged Rupees 900 (US $16.86) for CT head, Rupees 1200 (US $22.48) for CT abdomen, Rupees 1200 (US $22.48) for CT chest and Rupees 2500 (US $46.85) for MRI. There is a substantial loss of revenue because of subsidies provided to patients in a tertiary care teaching hospital which needs revision of charges.

Supply Side Management for Cost Optimization in Developing Countries Suffering with Power Outage

In this increasingly growing population especially in the developing countries, it is almost impossible to solve the energy crisis. This has led to the extreme growth of the back up power generation industry such as Diesel generators and home invertors. From the last couple of years the solar PV technology has started to penetrate in these geographies. This paper discusses on the supply side management of the electricity sources available to a consumer to manage his outage and also the over all cost optimization, as the cost of energy from every source is different and it also depends on the load curve, last but not the least also as to what time of the day what source or combination of sources have been used.

直接空气捕碳(DAC)的成本评估预测及其影响因素

直接空气捕碳技术能够从大气中直接捕获二氧化碳,是人类应对气候变化的重要手段。为了定量评估和预测中国DAC技术的成本,采用自上而下的工程经济分析方法构建了DAC成本分析及预测模型,并选取基于液体吸收工艺(L-DAC)和固体吸附工艺(S-DAC)的DAC技术,对不同规模情景、技术路径、能源类型下的DAC成本进行了研究。结果表明:未来的部署规模是影响DAC成本的关键因素。到2060年时,若中国DAC的CO_(2)捕集规模仅为0.3亿t/a,则L-DAC和S-DAC的CO_(2)去除成本将分别达到1037~1838元/t和869~922元/t;若部署规模达到3亿t/a,碳去除成本将分别降至729~1237元/t和543~580元/t;若部署规模达到6亿t/a,碳去除成本将进一步降至655~1102元/t和472~505元/t。能源相关的碳排放会降低DAC从空气中去除CO_(2)的效率,造成DAC碳去除成本上升。其中,当使用核电、光伏、风电和水电等非化石能源供能时,DAC碳去除成本在捕集成本的基础上略微增加;当使用电网或外购热供能时,DAC碳去除成本的增加较为明显。到2060年,使用光伏供能比其他供能方式更具成本优势。基于上述研究成果,建议尽早实施DAC技术的规模化示范工程,稳步扩大DAC应用规模,通过规模效应、工程优化降低DAC成本;建议DAC工厂因地制宜选择非化石能源供能,以降低碳去除成本。

A TRUST REGION ALGORITHM VIA BILEVEL LINEAR PROGRAMMING FOR SOLVING THE GENERAL MULTICOMMODITY MINIMAL COST FLOW PROBLEMS

This paper proposes a nonmonotonic backtracking trust region algorithm via bilevel linear programming for solving the general multicommodity minimal cost flow problems.Using the duality theory of the linear programming and convex theory,the generalized directional derivative of the general multicommodity minimal cost flow problems is derived.The global convergence and superlinear convergence rate of the proposed algorithm are established under some mild conditions.

文化感知差异对中国对外直接投资的影响

基于House教授GLOBE项目的数据,重新构建了文化差异衡量指数,并实证考察了文化差异对中国对外直接投资的影响,结果显示:中国感知的文化差异与中国的对外直接投资之间存在着“U”型关系,而东道国感知的文化差异对中国对外直接投资的影响并不显著。经过多种稳健性检验和内生性处理后仍然支持了这一结论。机制检验发现,文化差异主要通过增加交易成本和降低双边投资合作信任度对中国对外直接投资产生影响。异质性分析发现,中国感知的文化差异对中国对外直接投资的影响主要存在于发达国家和产业结构合理性更高的国家,而在东道国文化感知差异较大的国家,文化差异对中国对外直接投资的影响更大。因此,应当重视对外直接投资中的文化差异问题,积极推动文化交流互鉴,增强高层互访,提升投资信任度,因地制宜发掘产业转移和结构调整新机遇。

目标导向模式改善基层血液透析质量的临床研究

目的探讨目标导向模式在提升基层血液透析质量中的效果。方法以2021年10月—2022年3月于郑州大学第一附属医院南院区接受维持性血液透析治疗的基层患者为研究对象,观察目标导向模式管理6 m后,患者血管通路、临床指标、生活质量和卫生经济学指标等的改善情况。结果共纳入85例患者。与基线相比,6 m后带隧道带涤纶套导管的使用比例由42.35%降至27.06%(χ_(2)=6.303,P=0.043),单室尿素清除指数<1.2的患者比例降至7.05%(χ_(2)=21.182,P<0.001),透析间期体质量增加<5%干体质量的患者比例增至70.59%(χ_(2)=43.895,P<0.001),血红蛋白(χ_(2)=15.824,P=0.001)、血钾(χ_(2)=4.541,P=0.033)、血白蛋白(χ_(2)=31.224,P<0.001)、血磷(χ_(2)=17.306,P<0.001)及全段甲状旁腺激素(χ_(2)=17.162,P<0.001)达标率均提高;患者满意度由48.24%上升至100%(χ_(2)=59.365,P<0.001),生活质量评分提高(t=-22.455,P<0.001);直接医疗总成本无明显增加(t=1.387,P=0.167)。结论目标导向模式有效改善了基层患者的血液透析质量,利于患者并发症控制及生活质量提高,且不额外增加医疗花费,具有较强的应用价值。

人口老龄化与外商直接投资:影响机制与实证分析——基于中国省级面板数据的实证研究

基于2003—2020年中国省级面板数据,将储蓄率和劳动力成本纳入同一分析框架,从理论和实证两个层面探究人口老龄化对外商直接投资流入的影响及作用机制。研究结果表明,人口老龄化与外商直接投资流入存在显著的倒U形关系,且存在时空异质性:空间异质性,表现为老龄化对外商直接投资流入的影响呈现东、中、西部逐渐下降趋势;时间异质性,表现为2012—2020年人口老龄化对外商直接投资的影响程度明显高于2003—2011年。储蓄率在人口老龄化影响外商直接投资流入的过程中表现出正向调节效应,起到推动作用,而劳动力成本起到部分中介效应,且劳动力成本对外商直接投资流入的影响力随着老龄化的持续加剧而扩大,阻碍了外商直接投资的流入。为此,各级政府要完善劳动权益保障体系,加大人力资本投入力度,制定完善的外资引入机制,引导外商直接投资区域均衡发展。

抑郁症和双相障碍疾病成本研究

目的:测量抑郁症和双相障碍的直接成本和间接成本,探索疾病总成本的影响因素。方法:选取2019年5月至2021年7月铜陵市某二级甲等精神专科医院招募的抑郁症和双相障碍住院患者230例,收集患者过去一年内门诊及住院的医疗花销总费用和自费花费,以及所花费的非医疗费用作为直接成本,将患者因病无法工作的生产力损失,以及因病损坏财务的其他损失作为间接成本。从个人水平和社会水平上测算直接成本和间接成本。采用多重线性回归模型对疾病总成本影响因素进行分析。结果:个人层面抑郁症人均疾病总成本高于双相障碍,而社会层面,双相障碍人均疾病总成本远高于抑郁症。抑郁症和双相障碍的间接费用均高于直接费用。多重线性回归分析显示,工作状态、婚姻状况、收入水平以及疾病严重程度是影响疾病成本的关联因素。结论:抑郁症和双相障碍的经济负担较重,因精神障碍导致的生产力损失是疾病成本的主要部分。

种养污染防控视角下农业补贴的有机肥增施效应评价

为了精确探究农机购置补贴、农业技术补贴及有机肥价格补贴对农户有机肥施用行为的激励影响,本研究基于2023年1月1日至30日陕西省关中地区12个县的农户随机抽样调查数据,运用结构方程模型(SEM)估算了影响农户有机肥施用行为的相关因素载荷系数。结果表明:农业补贴潜变量(ASF)的标准化路径载荷值为0.690,对农户有机肥施用行为产生了显著正面影响;在各种农业补贴中,农机购置补贴(MAS)的标准化路径载荷最高,为0.690,农业技术补贴在提高农户对有机肥与农产品市场认知上起到了正面作用;农业技术培训(TES)的影响显著,标准化路径载荷值为0.634;有机肥价格补贴(FES)的标准化路径载荷为0.597,是所有补贴中的最低值;农户主要劳动力年龄(AGE)及教育水平(EDU)的标准化路径载荷均达到了显著影响水平。农业补贴对不同经济条件下及不同作物种植户的影响显示出显著差异。研究指出,劳动强度是影响农户施用有机肥的主要障碍,积极的态度是推动农户施用有机肥的根本驱动力,3种农业补贴对提高粮农有机肥利用率的作用有限,需对相关政策标准和实施方法进行针对性的调整。

数字化与对外直接投资新优势——基于我国A股上市工业企业的分析

随着数字技术与实体经济深度融合,数字化已成为企业发展的新优势。本文基于2009—2021年我国A股上市工业企业样本,并匹配具有代表性的对外直接投资(OFDI)数据,研究数字化优势对我国企业OFDI的影响及其作用机制。研究发现,数字化能够显著且稳健地提高我国企业OFDI的可能性、投资广度和投资深度,进而提升我国OFDI的活力和韧性,并且解释力度高达企业OFDI传统优势研发密度的48.3%~53.8%。全要素生产率提升和海外经营成本降低是数字化优势促进企业OFDI的两条潜在机制。异质性分析表明,数字化优势的OFDI促进效应在绿地投资、传统行业和高竞争性行业中表现更加突出。此外,我国OFDI“走进东道国”过程中,跨国公司数字化优势与东道国数字化优势间的竞争效应大于互补效应,因而数字化优势对我国企业OFDI的正向作用在高数字化水平东道国的样本中受到抑制。本文研究结论对新形势下我国如何利用数字化优势推动高水平对外开放,构建以国内大循环为主体、国内国际双循环相互促进的新发展格局具有启示意义。

ESG表现对企业融资成本的影响:一个研究述评

“融资难、融资贵”是阻碍我国企业发展的困难之一,因此解决企业融资困境成为现实问题。现行绿色发展背景下,加强自律、提高ESG评级成为企业积极转型的新途径,然而ESG表现对企业融资成本的影响一直是学术界争议较大的话题。通过系统梳理现有相关研究成果可以发现:目前关于ESG表现对企业融资成本的作用机制、中介因素、经济后果等仍然存在不同的观点。因此,以探究两者直接的内在联系为起点,厘清ESG表现和直接、间接融资成本其中的作用机制。基于目前该领域的研究现状,后续研究注重完善该方向的相关研究角度以及方法,继续深挖ESG表现与融资成本之间存在的驱动机制,构建更为完整的理论模型,并为我国企业高质量发展研究提供思路和参考。