The high cost of emergency department (ED) care is often viewed as an area for achieving cost savings through reduced utilization for inappropriate conditions. The implementation of outpatient prospective payment for Medicare ED patients heightens scrutiny of costs and utilization in the ED versus primary care settings. Data from hospital clinical records, financial records, and a provider survey was used to develop a costing methodology and complete a comparative analysis of the cost of care for three diagnoses by setting. Total costs were significantly higher in the ED due primarily to differences in ancillary tests and prescription drugs ordered.

The purpose of this research was to quantify the impact of the log variables: length, grade, and scaling diameter, on the cost of producing hardwood lumber, using the activity-based costing technique. The usual technique of calculating hardwood lumber product costs is based upon traditional cost accounting, where manufacturing costs are allocated to the products based upon the volume of each product that is produced. With the traditional cost accounting procedure, the variation in the resources used to process the logs is not taken into consideration. As a result, when the cost to manufacture the products is subtracted from the market value of the products, the resulting profit levels of the products may not be truly representative of the actual resources consumed in manufacturing the product. Using discrete-event simulation, two hardwood sawmills were modeled and a series of experiments were conducted which would not have been feasible to conduct on the mill floors. Results from the simulation experiments illustrated that the activity-based and traditional cost accounting techniques allocated different amounts of manufacturing costs to the products. The largest difference between the two cost accounting techniques was found to be the amount of raw material costs allocated to the products. For one of the sawmills modeled, log grade was identified as having the greatest influence on determining product costs and total manufacturing costs. Results from the model of the second sawmill however demonstrated that log diameter had a greater impact on determining product costs and total manufacturing costs. The commonality of the results from the two simulation models was that the differences in the volume of lumber produced, between the logs that were studied, was a critical component in determining which log parameter had the most effect on changing the dynamics of the sawmill system. To enable hardwood managers a more precise method of allocating raw material costs to the lumber products, a methodology was developed that uses the principles of activity-based costing to allocate raw material costs. The proposed methodology, termed the lumber yield method, uses lumber yield values from logs with similar characteristics to allocate raw material costs to the lumber products. Analysis of the output from the simulation models illustrated that with the lumber yield method, the amount of raw material costs allocated to the products was not significantly different than the amount allocated by the activity-based costing method. The calculated raw material costs of the products were however, found to be significantly different between the lumber yield method and the traditional volume costing method. / Ph. D.

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Student Number : 9910519W - M Med research report - School of Public Health - Faculty of Health Sciences / Introduction: This study sought to determine the costs of providing health care to HIV/AIDS patients in a tertiary level hospital in Gauteng Province. The study also determined what the implications were for the hospital in terms of planning and resource allocation. Methodology Study design: Retrospective Record Review Study Period: 03 May 2005 – 15 June 2005 Study setting: Chris Hani Baragwanath Hospital, Gauteng. Study population: Medical & Pediatric inpatient discharges and deaths Results: 1185 records reviewed (812 HIV positive) HIV positive patients were staying longer than others and costing the hospital more as well. Those on ARV therapy cost the most. Conclusion: More resources were being spent on HIV/AIDS patients. Increased lengths of stay and expenditure on drugs and investigations were the reasons for higher costs compared to HIV negative inpatients. Identifying ways of reducing admission and other costs must be seen as strategies in reducing the financial burden of HIV/AIDS to the facility.

University of Technology, Sydney. Faculty of Design, Architecture & Building. / Past analyses of design solutions for building projects have concentrated on initial capital costs, often to the extent where the effects of subsequent operating costs are completely ignored. However, even in cases where a wider view of cost has been adopted, the discounting process has commonly disadvantaged future expenditure so heavily as to make performance after the short term irrelevant to the outcome, resulting in projects which display low capital and high operating costs to be given favour. Thus design solutions that aim to avoid repetitive maintenance, reduce waste, save nonrenewable energy resources or protect the environment through selection of better quality materials and systems, usually having a higher capital cost, are often rejected on the basis of the discounting process. Furthermore, the formulation of the discount rate has normally lacked rigour and has often resulted in an assumed rate that has implied profit and risk and has ignored taxation. Discounted present value is a measure of equivalence for time-phased costs and benefits derived from consideration of the theoretical investment return, preferably after tax. As it takes account of the cost of money, discounting can be described as leading to the determination of equivalent value using an investment-based or capital productivity approach. It is hypothesized and verified that the value of future costs and benefits is additionally susceptible to fluctuations in their base worth over time as reflected by changes in incremental escalation and the affordability of goods and services between present and future generations. Making adjustments for changes in worth may thus be described as contributing to the determination of equivalent value using a prosperity-based or time preference approach. The analysis of Australian sectorial income and expenditure data over a forty-year period shows that affordability changes can be measured and represented as an index. The discount rate is identified as a combination of the real weighted cost of capital, differential price level changes and diminishing marginal utility, where the latter is depicted by changes in the affordability of goods and services. This results in a composite discount rate that encompasses project-related, product-related and investor-related attributes. Tangible (financial) costs and benefits are discounted by this rate while intangible (environmental and social) costs and benefits are left as real value. Recommendations concerning the determination of equivalent value should ensure that the future operating performance of projects is more equitably assessed and that sustainable development remains an achievable objective in life-cost studies.

The construction industry is in the midst of a progressive change in the way projects unfold from design and development to closeout and maintenance. There is a greater demand on contractors to build projects faster, with higher quality and an increased level of detail, while keeping costs lower than ever. Therefore, to meet such demands contractors must turn to an alternative approach of improving product and process with target costing. However, the adoption of target costing by the construction industry has been slow due to limitations in user understanding of the system. The objective of this paper is to identify an effective approach for teaching target costing to construction-focused individuals, by establishing improved user understanding with visual aids, and by determining if user comprehension is influenced by the complexity of the visual supports provided in the lessons. The study challenged the long-implied assumption that the construction community is composed of visual learners, while also differentiating between the levels of success for supporting figures based upon their degree of detail. Results of this study will provide the basis for the development of target costing material that is designed specifically for use in the education of construction industry professionals in Target Cost Estimating.

The real-estate faced serious recession recently in Taiwan, it caused several famous listed constructional investment companies to result in financial crisis. The constructional investment companies made high profit due to real-estate¡¦s prosperity in the past. Currently, it, however, faces heavy pressure on business operation due to recession in the real-estate. The auto-makers in Japan accepts target costing, because it helps companies to combine the cost management and strategic goals to enhance the companies¡¦ competition. The key point of this thesis, therefore, tries to analyze the target costing that applies to constructional investment companies; and ultimately attempts to provide a conceptual system that helps the companies to make decision. The research makes some propositions based on literatures, and other sources. Secondly, the difference between the current operations and target costing is understood. The final step attempts to modify the propositions according to company interviews; and as a result, contributions are made when the constructional investment companies evaluate and implement the target costing.

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Thesis (MAppSc (Project Management))--University of South Australia, 1995