• The Journal of Health Technology Assessment
• /
• v.6 no.2
• /
• pp.123-132
• /
• 2018

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3173-3177
• /
• 2016

Background: The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total case-load. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Materials and Methods: Using utilization and spending data accumulated at MOPH during 2008-2013, the cost to the public budget of cancer drugs was assessed per case and per drug type. Results: The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and Non-Hodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Conclusions: Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

• KSII Transactions on Internet and Information Systems (TIIS)
• /
• v.17 no.1
• /
• pp.16-30
• /
• 2023

The elderly population is increasing owing to a low fertility rate and an aging population. In addition, life expectancy is increasing, and the advancement of medicine has increased the importance of health to most people. Therefore, government and companies are developing and supporting smart healthcare, which is a health-related product or industry, and providing related services. Moreover, with the development of the Internet, many people are managing their health through online searches. The most convenient way to achieve such management is by consuming nutritional supplements or seasonal foods to prevent a nutrient deficiency. However, before implementing such methods, knowing the nutrient status of the individual is difficult, and even if a test method is developed, the cost of the test will be a burden. To solve this problem, we developed a questionnaire related to nutrient classification twice, based upon which an adaptive algorithm was designed. This algorithm was designed as a machine learning based algorithm for nutrient classification and its accuracy was much better than the other machine learning algorithm.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3363-3368
• /
• 2013

Background: The burden due to cancers is an emerging public health concern especially in resource-limited countries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS and malaria combined. As people in Nigeria and other developing countries are beginning to survive infectious diseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of 1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks an organized and comprehensive strategy to deal with cancers. Materials and Methods: This article reviewed 30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care in Nigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequate manpower (in terms of quality and quantity) as well as limited treatment options. Results: This review led to the formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies used in Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis on tobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primary cancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDS will improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals, hub-and-spoke implementation of screening services, as well as investment in effective treatment options and increased research in cancer care are essential. International 'twinning collaborations' between institutions in richer countries and Nigeria will enhance effective knowledge translation and improve the quality of patient care. Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcome the present limitations which help contribute to the observed increases in cancer morbidity and mortality rates. Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategies proposed here.

• Korea Journal of Hospital Management
• /
• v.26 no.3
• /
• pp.1-12
• /
• 2021

Purpose: This study aims to examine the effect of the copayment reduction policy on the health care utilization of patients under age 15 after the policy started in 2017. (이하는 아래 methodoloty로 이동) Methodology: Data on the ALOS, the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age from 2015 to 2019 were obtained from the National Health Insurance database. Policy effects were measured by analyzing three dependent variables before and after policy: the average length of stay (ALOS), the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age. The collected data were analyzed using the SAS package, and the analysis methods used in this study were the mean difference test and linear regression analysis. Findings: The study results reveal that, after the copayment reduction policy in the year 2017, the ALOS and the out-of-pocket expenditure were significantly decreased, but the average admission cost was significantly increased. Practical Implications: These results imply that the policy of copayment reduction for the patients under the age of 15 has contributed to mitigating the patients' financial burden with little concern about growing medical utilization.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.12
• /
• pp.4901-4903
• /
• 2015

The gynecologic oncology patients surveillance network program was conducted with the collaboration of 5 provincial hospitals located in the north of Thailand (Chiang Rai, Lamphun Nan, Phayao and Phrae). The aim was to identify ways of reducing the burden and the cost to the gynecologic cancer patients who needed to travel to the tertiary care hospital for follow up. The clinical data of each patient was transferred to the provincial hospital by the internet via the website www.gogcmu.or.th. All the general gynecologists who participated in this project attended the training course set up for the program. From January 2011 to February 2014, 854 patients who were willing to have their next follow-up at the network hospitals close to their home were enrolled this project. Almost of them were residents in Chiang Rai province and the most common disease was cervical cancer. After the project had been running for 1 year, 604 of the enrolled patients and 21 health-care personnel who had participated in this project were interviewed to assess its success. Some 85.3% of the patients and 100% of the health-care personnel were satisfied with this project. However, 60 patients had withdrawn, the most common reason being the lack of confidence in the follow up at the local provincial hospital. In conclusion, it is possible to initiate a gynecologic oncology patients' surveillance network program and the initiation could reduce the problems associated with and the cost the patients incurred as they journeyed to the tertiary care hospital.

• Journal of Convergence Society for SMB
• /
• v.5 no.4
• /
• pp.17-23
• /
• 2015

Due to the development of information and communication technology as health care service is popular variety utilizing bioinformatics patient information services are being provided to the patient. In particular, the healthcare utilizing bioinformatics information, and change in a variety of healthcare trends. However, healthcare services using bioinformatics information of the patient and the complexity of the disease, new diseases (SARS, AIDS, etc .) due to the emergence of increasing health care costs and health promotion services provided to patients may not be smooth. In this paper, we propose a model for low-cost health services and medical care of patients bioinformatics fast access to information. The proposed model can be so big a bioinformatics data formation by the patient's patient information anytime / anywhere providing medical services in the home or the nearest hospital for their own disease management. In particular, the proposed model of health care services is characterized improve work efficiency, reducing the burden on hospitals by passing a medical illness to easily analyze patient information.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.4 s.59
• /
• pp.870-883
• /
• 1997

The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

• Journal of muscle and joint health
• /
• v.1 no.1
• /
• pp.88-96
• /
• 1994

Treatment for the arthritic is mostly on the out-patient basis. The present rheumatologists practicing in Korea do not cover the total number of the patients. Also patients with arthritis need medical treatment for long period of time. Therefore, the number of patients waiting for the treatment is huge in number. This vicious cycle need to be broken in some way. Purpose of this study is to identify the need for home care of the arthritic patients. Nineteen hundred and sixty two subjects were interviewed in one hospital for one month. The following findings were observed : 1. The rates for demanding home care were from 60% to 100% depending on the areas. 2. Reasons for no need of home care were mainly credibility and short distance from the hospital. 3. Time spent for one way transportation was more than 3.3 hours except from Seoul and Kyungki area. The longer they spend time for transportation, the more they want home care services. 4. The number of patients who asked other persons to travel for prescription was 446(22.73%) and average number was 3.26 per year in those 446 cases. 5. Average expenses for transportation and other cost for each time of hospital visit were 21,073won ranged from 8,373 won to 132,571 won. The more spend money for visiting the hospital, the more they want home care services. In order to reduce the physical and economical burden of the arthritic patients living in remote areas, hospital-based home care services are justified on the bases of patients' demand and legislative support.

• Journal of Gastric Cancer
• /
• v.15 no.2
• /
• pp.87-104
• /
• 2015

Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.