Academic literature on the topic 'Waste minimization Australia Cost effectiveness'

Due to the considerable increase in public expenditure with health issues, mainly regarding drugs, several countries, including Australia and England, have already implemented, or are in the process of discussing the adoption of measures to ensure the quality of health care provided to the population. One of the less harmful strategies, rarely used in Brazil, is the adoption of economic techniques applied to health, more specifically, pharmacoeconomic analysis. This paper aims to contribute to the dissemination of concepts and techniques of economic analysis with a view to incorporate these into policy decisions of expenditure rationalization and the search for clinical efficiency. It includes a literature review covering the types of costs and benefits in health issues, the methodologies of pharmacoeconomic analysis, cost-minimization, cost-benefits, cost-effectiveness and cost-utility analysis, as well as its main characteristics, advantages, disadvantages and applicability.

Background Fiscally responsible utilization of anticancer treatments is necessary to combat their continually increasing cost. Dose rounding is one strategy that has been explored to minimize cost and waste without losing clinical effectiveness. Objectives To determine if dose rounding chemotherapy agents is a feasible cost-containment strategy at an institution with a small oncology clinic. Methods This study is a retrospective chart review of all body surface area dosed parenteral chemotherapy prescribed for an oncological diagnosis over a 12-month period (1 October 2015–30 September 2016). Chemotherapy doses were rounded down by 5%. Doses for patients with metastatic diagnoses were also rounded down by 10%. Rounded doses were evaluated for a potential decrease in vial size. Cost was represented as dollar/milligram of drug. Potential for drug waste minimization was also calculated. Results There were 877 total doses of chemotherapy administered to 70 unique patients throughout the 12-month duration of the study. When doses were rounded down by 5%, 140 doses qualified for a decrease in vial number. The potential for cost savings was $22,849 with 83,802 mg saved from wastage. A 10% decrease resulted in the reduction of vials for 248 doses, a potential savings of $30,911 with 129,011 milligrams saved. The targeted agents accounted for the majority of savings, $16,920 of the $22,849 with 5% rounding and $20,086 of the $30,911 with 10% rounding. Conclusion Dose rounding has the potential to be an effective cost-containment strategy in low volume oncology clinics.

Purpose The purpose of this paper is to present a taxonomy of transportation waste in construction production processes based on lean construction (LC) principles. Design/methodology/approach The research methodology used is case study and the main stages for the identification of the transportation waste in two construction projects were: mapping physical flows; measurement of transportation time; and monitoring of transportation waste events; assessment of the taxonomy. Findings The main contribution of this paper is the proposition of a taxonomy of transportation waste in construction production processes through the understanding of the transportation waste causes and consequences. Research limitations/implications Although the literature reviewed addresses sources from different parts of the world, the case studies performed are limited to one country, Brazil. However, the studies were carried out in two different construction sites separated by more than 3,000 km. Practical implications All data collected during the taxonomy application can be organized in order to develop an improvement plan. Moreover, if data collected is disseminated, there is the potential to increase the efficiency and effectiveness of the construction sector. Social implications Although the paper does not explore in depth the impact of the study on society or policy, the theme of waste minimization is focused on cost reduction, and one way to do that is through the flow management for waste minimization. Originality/value The paper discusses the concept of transportation waste of production in construction based on LC philosophy, through the understanding of its causes and consequences.

The 20th century has witnessed a remarkable enhancement in the demand for varieties of consumer products, ranging from food, pharmaceutical, cosmetics, to other industries. To enhance the quality of the product and to reduce the production cost, industries are gradually inclined towards greener processing technologies. Cavitation-based technologies are gaining interest among processing technologies due to their cost effectiveness in operation, minimization of toxic solvent usage, and ability to obtain superior processed products compared to conventional methods. Also, following the recent advancements, cavitation technology with large-scale processing applicability is only denoted to the hydrodynamic cavitation (HC)-based method. This review includes a general overview of hydrodynamic cavitation-based processing technologies and a detailed discussion regarding the process effectiveness. HC has demonstrated its usefulness in food processing, extraction of valuable products, biofuel synthesis, emulsification, and waste remediation, including broad-spectrum contaminants such as pharmaceuticals, bacteria, dyes, and organic pollutants of concern. Following the requirement of a specific process, HC has been implemented either alone or in combination with other process-intensifying steps, for example, catalyst, surfactant, ultraviolet (UV), hydrogen peroxide (H2O2), and ozone (O3), for better performance. The reactor set-up of HC includes orifice, slit venturi, rotor-stator, and sonolator type constrictions that initiate and control the formation of bubbles. Moreover, the future directions have also been pointed out with careful consideration of specific drawbacks.

Cloud manufacturing (CMfg) platform offers an open marketplace, where a Resource Service Provider (RSP) can benefit from Price Discrimination (PD) in return for specific services. However, the literature focused mainly on operator-based pricing and overlooked RSP pricing control. Therefore, this study formulates a profit function in which revenue is enhanced by adjusting prices according to customer types, while cost accounting is done by resource allocation based Material Flow Cost Accounting (MFCA) because MFCA provides a comprehensive guideline towards waste minimization. The proposed model is formulated into MINLP problem with multiple factors such as; part types, batch size, part routes, machine types, energy consumption, worker types and material handling cost as well as price sensitive customer behaviour and demand. Further, ANOVA is applied for factors analysis. The results suggests that customer types and demand are positively correlated, while parts, machines, and worker types are negatively correlated with profit. The model is also compared with reference price effect and fixed pricing strategy. Results validate that to benefit from diverse customer behaviour in CMfg, PD along with optimal resource allocation provides an effective solution for profit maximization. Model is also compared with reference price effect and fixed pricing strategy to validate its effectiveness.

Background: Cardiovascular disease remains the primary cause of death among Australians, despite dramatic improvements in overall cardiovascular health since the 1980s. Treating cardiovascular disease continues to place a significant economic strain on the Australian health care system, with direct healthcare costs exceeding those of any other disease. Coronary artery disease accounts for nearly one third of these costs and spending continues to rise. A range of treatments is available for coronary artery disease yet evidence of cost-effectiveness is missing, particularly for the Australian context. Cost-effectiveness evidence can signal waste and inefficiency and so is essential for an efficient allocation of healthcare resources. Methods: We used systematic review methods to search the literature across several electronic databases for economic evaluations of treatments for coronary artery disease. We critically appraised the literature found in searches, both against the CHEERS statement for quality reporting of economic evaluations and in terms of its usefulness for policy and decision-makers. Results: We retrieved a total of 308 references, 229 once duplicates were removed. Of these, 26 were excluded as they were not full papers (letters, editorials etc.), 55 were review papers, 50 were not cost-effectiveness analyses and 93 related to a highly specific patient sub-group or did not consider all treatment options. This left five papers to be reviewed in full. Conclusions: The current cost-effectiveness evidence does not support the increased use of PCI that has been seen in Australia and internationally. Due to problems with accessibility, clarity and relevance to policy and decision-makers, some otherwise very scientifically rigorous analyses have failed to generate any policy changes.

Background: Cardiovascular disease remains the primary cause of death among Australians, despite dramatic improvements in overall cardiovascular health since the 1980s. Treating cardiovascular disease continues to place a significant economic strain on the Australian health care system, with direct healthcare costs exceeding those of any other disease. Coronary artery disease accounts for nearly one third of these costs and spending continues to rise. A range of treatments is available for coronary artery disease yet evidence of cost-effectiveness is missing, particularly for the Australian context. Cost-effectiveness evidence can signal waste and inefficiency and so is essential for an efficient allocation of healthcare resources. Methods: We used systematic review methods to search the literature across several electronic databases for economic evaluations of treatments for stable coronary artery disease. We critically appraised the literature found in searches, both against the CHEERS statement for quality reporting of economic evaluations and in terms of its usefulness for policy and decision-makers. Results: We retrieved a total of 308 references, 229 once duplicates were removed. Of these, 26 were excluded as they were not full papers (letters, editorials etc.), 55 were review papers, 50 were not cost-effectiveness analyses and 93 related to a highly specific patient sub-group or did not consider all treatment options. This left five papers to be reviewed in full. Conclusions: The current cost-effectiveness evidence does not support the increased use of PCI that has been seen in Australia and internationally. Due to problems with accessibility, clarity and relevance to policy and decision-makers, some otherwise very scientifically rigorous analyses have failed to generate any policy changes.

Treatment with growth hormone (somatropin) is effective in six different medical conditions: growth hormone deficiency (GHD), Turner syndrome (TS), growth retardation in children born small for gestational age (SGA), Prader-Willi syndrome (PWS), growth retardation due to chronic renal insufficiency (CRI), growth retardation associated with a deficiency of the gene SHOX (Short Stature HOmeoboXContaining gene). The treatment proved to be also effective in adults who have an impaired growth hormone (acquired in adulthood or childhood).The growth hormone (GH) is generally cost effective and, therefore, is usually reimbursed by public health services. In financial terms, GH is a major cost item for health systems. According to the Report OSMED 2010, GH ranks first in Italy between systemic hormonal preparations, excluding sex hormones, distributed by public system, with an annual value of approximately € 88 million (+ 12.7% compared to 2009).Considering the increasing need to control pharmaceutical expenditure, there is a strong interest for the efficient supply of the hormone by the regional health service. From this point of view, the comparison of the specialties on the market is normally carried out on the basis of the cost per mg; this approach, also used in the main studies of cost-effectiveness, is derived from a logic of cost minimization, but it may still be distorting, not taking into account the efficiency of devices used for the administration of the hormone.The proposed analysis verifies the efficiency of different available devices, evaluating the potential waste of product, depending both on the device used and on the characteristics of the population exposed to the treatment.Only in the case of single-dose and disposable formulations is theoretically possible to have zero waste and thus an equivalence between the actual cost of the treatment and the price charged. In other cases, the inefficiency causes a deviation between the actual cost and price. In the latter cases, since the theoretical amount of the population exposed to the treatment, it is estimated that the total share of potentially unused product can vary between 208,000 mg / year to 750,000 mg / year, depending on the device used. In particular, there is an actual average cost of treatment ranging between +9.9% and +11.4% of the ex-factory price; depending on the different doses and even between the different devices, the difference between the actual price and the theoretical price varies from a minimum of +6.9% and a maximum of +18.7%.

Objective To articulate the concept of high-value care (i.e. clinically relevant, patient-important benefit at lowest possible cost) and suggest strategies by which clinicians can promote such care in rendering the Australian healthcare system more affordable and sustainable. Methods Strategies were developed by the author based on personal experience in clinical practice, evidence-based medicine and quality improvement. Relevant literature was reviewed in retrieving studies supporting each strategy. Results Ten strategies were developed: (1) minimise errors in diagnosis; (2) discontinue low- or no-value practices that provide little benefit or cause harm; (3) defer the use of unproven interventions; (4) select care options according to comparative cost-effectiveness; (5) target clinical interventions to those who derive greatest benefit; (6) adopt a more conservative approach nearing the end of life; (7) actively involve patients in shared decision making and self-management; (8) minimise day-to-day operational waste; (9) convert healthcare institutions into rapidly learning organisations; and (10) advocate for integrated patient care across all clinical settings. Conclusions Clinicians and their professional organisations, in partnership with managers, can implement strategies capable of maximising value and sustainability of health care in Australia. What is known about this topic? Value-based care has emerged as a unitary concept that integrates quality and cost, and is being increasingly used to inform healthcare policy making and reform. What does this paper add? There is scant literature that translates the concept of high value care into actionable enhancement strategies for clinicians in everyday practice settings. This article provides 10 strategies with supporting studies in an attempt to fill this gap. What are the implications for practitioners? If all practitioners, in partnership with healthcare managers, attempted to enact all 10 strategies in their workplaces, a significant quantum of healthcare resources could be redirected from low- to high-value care, culminating in much greater health benefit from the healthcare dollars currently being spent. However, such reforms will require a shift in clinician thinking and practice away from volume-based care to value-based care.

The Centre for Radiation Protection and Hygiene is the institution responsible for Radioactive Waste Management Service in Cuba. This Service comprises: centralized collection, transportation, treatment, conditioning, long term storage, and disposal of radioactive waste, as well as dismantling, decontamination and decommissioning of small nuclear facilities. Radioactive waste should be managed in such a way as to ensure adequate safety and protection of both human health and the environment. In order to fulfil this principle a Quality Management System has been implemented for the Radioactive Waste Management Service, based on the ISO 9000 Standards. The Quality System provides, as appropriate: • adequate assurance that the requirements specified by the Regulatory Authority relating to protection and safety are satisfied; • adequate assurance that the customer requirements are satisfied; • control of all kind and inventories of radioactive waste through the implementation of a comprehensive system for record keeping; • continuous improvement to guarantee the cost minimization related with the radioactive waste management; • and quality control mechanisms and procedures for reviewing and assessing the overall effectiveness of the system. In the year 2002, as a conclusion of a certification audit performed by the direction of the Centre for Radiation Protection and Hygiene, the Quality Management System implemented for the Radioactive Waste Management Service was successfully certified according to the requirements of the ISO 9001:2000 Standard.

Los Alamos National Laboratory (LANL) is one of two design laboratories in the United States Department of Energy’s (DOE) weapons complex, with over 60 years of experience in handling radioactive materials and, consequently, in radioactive waste management. The focus for actinide research and development is the Plutonium Facility, which has been in operation since 1978. The Nuclear Materials Technology (NMT) Division is responsible for operating the Plutonium Facility. It has a dedicated group of personnel who manage radioactive and hazardous waste, and address environmental regulations. Waste from operations with radioactive materials inside glovebox lines in the Plutonium Facility is packaged for disposal in the Waste Isolation Pilot Plant (WIPP) in Carlsbad, New Mexico. This waste is subject to a prescriptive certification program and is expensive to dispose of. Because the Plutonium Facility generates approximately 140 cubic meters of transuranic (TRU) waste each year, this significant financial burden effectively reduces the funds available to conduct research. To cut waste disposal costs, the NMT Division is making a considerable effort to identify and fund implementation of treatment and size-reduction processes. This study looks at both the effectiveness and probability of successful implementation. The waste management group’s waste minimization specialist has used waste generation information to identify the two largest TRU waste streams: combustible solids would benefit from size reduction, and nonactinide metals can be decontaminated. To reduce the size of combustible solids (polyethylene bottles and rubber hose), an industrial-model granulator, which was purchased for the head end of a molten salt oxidation process, is being adapted. This waste stream can be reduced by about 30% without affecting the ability to perform nuclear material assay. For glovebox decontamination, electrolytic decontamination techniques previously developed will also work on metals (tubing, tools, and equipment). Reducing the TRU levels to low-level contamination will allow onsite disposal, significantly reducing disposal costs (by approximately an order of magnitude). Several other technologies that were developed to address environmental regulatory concerns will also result in modest waste minimization and are in various states of installation and testing; they are vitrification for aqueous TRU waste, pyrolysis for the destruction of mixed waste, and distillation and recycle for nitric acid and trichloroethylene. The successful implementation and coordination of waste minimization and treatment technologies is resulting in cost savings from waste reduction and avoidance for the NMT Division.

Gas-to-gas recuperation with both high thermal effectiveness and order-of-magnitude improvement in cost effectiveness is critical to addressing global energy needs, especially via fuel synthesis from waste CO2 and renewable H2. An uncommon compound recuperator with liquid intermediary (CRLI) has been simulated for high-ε heat exchange between a first shell-side gas stream and a second shell-side gas stream of similar thermal capacity rates (W/K). The compound recuperator uses a first Gas-to-Liquid (GL) recuperator for a nearly complete transfer of available energy from a shell-side gas to an intermediary tube-side heat transfer liquid (HTL), followed by a second GL recuperator to transfer the heat from the liquid intermediary to the second gas stream. Each GL recuperator resembles an arrangement of thermally isolated, serially connected, adjacent, cross-flow, finned-tube cores, such as used in AC condensers. They are arranged so to effectively achieve counterflow exchange between the HTL and the shell-side gas stream. The HTL may be water, an organic liquid, a molten alloy, or a molten salt. Minimization of exergy destruction for the case where there is a substantial temperature difference between the hot and cold sources requires (1) a fairly large number of series connected, thermally isolated cores, (2) similar thermal capacity rates in all three streams (the two gases and the liquid intermediary), (3) a relatively large value for the number of transfer units (NTU), and (4) no phase change. The simulations show that the optimized CRLI recuperator can achieve effectiveness above 97% at very low pumping losses and has the potential for order-of-magnitude reduction in manufacturing costs compared to current technologies for clean gases at pressures above 0.3 MPa at heat transfer rates above ∼200 kW.

Highly selective removal of Cesium and Strontium is critical for waste treatment and environmental remediation. Cesium-137 is a beta-gamma emitter and Strontium-90 is a beta emitter with respective half-lives of 30 and 29 years. Both elements are present at many nuclear sites. Cesium and Strontium can be found in wastewaters at Washington State’s Hanford Site, as well as in wastestreams of many Magnox reactor sites. Cesium and Strontium are found in the Reactor Coolant System of light water reactors at nuclear power plants. Both elements are also found in spent nuclear fuel and in high-level waste (HLW) at DOE sites. Cesium and Strontium are further major contributors to the activity and the heat load. Therefore, technologies to extract Cesium and Strontium are critical for environmental remediation waste treatment and dose minimization. Radionuclides such as Cesium-137 and Strontium-90 are key drivers of liquid waste classification at light water reactors and within the DOE tank farm complexes. The treatment, storage, and disposal of these wastes represents a major cost for nuclear power plant operators, and comprises one of the most challenging technology-driven projects for the DOE Environmental Management (EM) program. Extraction technologies to remove Cesium and Strontium have been an active field of research. Four notable extraction technologies have been developed so far for HLW: solvent extraction, prussian blue, crystalline silicotitanate (CST) and organic ion-exchangers (e.g., resorcinol formaldehyde and SuperLig). The use of one technology over another depends on the specific application. For example, the waste treatment plant (WTP) at Hanford is planning on using a highly-selective organic ion-exchange resin to remove Cesium and Strontium. Such organic ion-exchangers use molecular recognition to selectively bind to Cesium and Strontium. However, these organic ion-exchangers are synthesized using multi-step organic synthesis. The associated cost to synthesize organic ion-exchangers is prohibitive and seriously limits the scope of applications for organic ion-exchangers. Further issues include resin swelling, potential hydrogen generation and precluding final disposal by vitrification without further issues. An alternative to these issues of organic ion-exchangers is emerging. Inorganic ion-exchangers offer a superior chemical, thermal and radiation stability which is simply not achievable with organic compounds. They can be used to remove both Cesium as well as Strontium with a high level of selectivity under a broad pH range. Inorganic ion-exchangers can operate at acidic pH where protons inhibit ion exchange in alternative technologies such as CST. They can also be used at high pH which is typically found in conditions present in many nuclear waste types. For example, inorganic ion-exchangers have shown significant Strontium uptake from pH 1.9 to 14. In contrast to organic ion-exchangers, inorganic ion-exchangers are not synthesized via complex multi-step organic synthesis. Therefore, inorganic ion-exchangers are substantially more cost-effective when compared to organic ion-exchangers as well as CST. Selective removal of specified isotopes through ion exchange is a common and proven treatment method for liquid waste, yet various aspects of existing technologies leave room for improvement with respect to both cost and effectiveness. We demonstrate a novel class of inorganic ion-exchangers for the selective removal of cesium and strontium (with future work planned for uranium removal), the first of a growing family of patent-pending, potentially elutable, and paramagnetic ion-exchange materials [1]. These highly selective inorganic ion-exchangers display strong chemical, thermal and radiation stability, and can be readily synthesized from low-cost materials, making them a promising alternative to organic ion-exchange resins and crystalline silicotitanate (CST). By nature, these inorganic media lend themselves more readily to volume reduction (VR) by vitrification without the issues faced with organic resins. In fact, with a simple melting of the KMS-1 media at 650–670 deg. C (i.e., well below the volatilization temperature of Cs, Sr, Mn, Fe, Sb, etc.), a VR of 4:1 was achieved. With true pyrolysis at higher temperatures or by vitrification, this VR would be much higher. The introduction of this new family of highly specific ion-exchange agents has potential to both reduce the cost of waste processing, and enable improved waste-classification management in both nuclear power plants (for the separation of Class A from B/C wastes) and DOE tank farms [for the separation of low level waste (LLW) from high level waste (HLW)]. In conclusion, we demonstrate for the first time a novel inorganic ion-exchanger for the selective removal of Cesium and Strontium. These inorganic ion-exchangers are chemical, thermal and radiation stable. These inorganic ion-exchangers can be synthesized in a cost-effective way which makes them significantly more effective than organic ion-exchange resin and CST. Finally, new thermal options are afforded for their final volume reduction, storage and disposal.

At present, the 125 GWe of nuclear power in the European Union produce about 3000 tons of spent fuel annually, containing about 25 tons of plutonium, 2.5 tons of minor actinides (MA) and about 100 tons of fission products, of which 3.1 tons are long-lived fission products. Actual reprocessing of LWR fuel and a first recycling as mixed plutonium and depleted uranium oxide fuel (MOX) in LWR already contribute to a significant reduction of waste volumes and radiotoxicity. However HTRs have some characteristics which make them particularly attractive: intrinsic safety, cost-effectiveness, reduced thermal pollution, capability of increasing energy availability (with the use of Pu-Th cycle) and of minimizing actinides radiotoxicity and volume of actinides. In this paper particularly the last item is investigated. Symbiotic fuel cycles of LWR and HTR can reach much better waste minimization performances. It happens because of the specific features of HTRs cores that leads to an ultra-high burnup and, last but not least, the ability to accommodate a wide variety of mixtures of fissile and fertile materials without any significant modification of the core design. This property is due to a decoupling between the parameters of cooling geometry and of neutronic optimization. In our calculations we considered a pebble-bed HTR using a Pu-based fuel (deriving from reprocessing of classical LWR fuel and/or weapons grade plutonium) at the maximum technological discharge burnup. As results, we find, at EOL (End Of Life), a relatively small amounts of residual Pu and MA produced in terms of quantities and of radiotoxicities. Furthermore we used in our calculations a different type of fuel based on a mixture of Pu and Th to try to optimize the previous results and to increase energy availability. Calculations have been done using MCNP-based burnup codes, capable of treating 3-D complex geometry and ultra-high burnup.