• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2533-2540
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• 2013

Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

• 한국의료질향상학회지
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• 제12권2호
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

• 대한영양사협회학술지
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• 제9권1호
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• pp.32-39
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• 2003

Although medical nutrition therapy (MNT) is considered as a cornerstone of medical treatment for hypercholesterolemia, few studies have evaluated medical and economical outcome of MNT. This study was conducted to identify whether MNT administered by registered dieticians could lead to a beneficial clinical and cost outcome in persons with hypercholesterolemia. A prospective clinical trial was carried out at outpatient clinics, which involved an initial visit with a dietitian followed by another visit at first 4 weeks during the 6 weeks study periods. Thirty-nine subjects took part in a 6 weeks nutrition intervention program. Clinical and economical outcomes were compared before and after MNT. Medical nutrition therapy lowered total serum cholesterol level 6.1% (P<0.05), low-density lipoprotein cholesterol (LDL-C) 9.4% (P<0.05) and high-density lipoprotein cholesterol (HDL-C) 3.0% (P<0.05). The cost-effective ratio was ￦ 1,520/cholesterol mg/dl and ￦ 1,441/LDL-cholesterol mg/dl, respectively. After dietitian's intervention, lipid drug eligibility was obviated in 16 of 39(41%) subjects. The cost savings from the avoidance of lipid medications was ￦ 151,107 per patient annually. In conclusion, it is suggested that provision of systemic intensive nutritional care for persons with hypercholesterolemia has significant effects on serum cholesterol reduction and clinical cost savings.

• 한국건축시공학회지
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• 제20권5호
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• pp.459-469
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• 2020

이 연구의 목적은 철근콘크리트 기둥에서 띠철근 상세로 이용되는 갈고리 양단 135° 교차시공에 대해 동등이상의 구조적 성능을 확보하면서, 동시에 시공성을 개선할 목적으로 클립형 연결장치를 이용하여 90° 갈고리 띠철근에 결속하는 방법을 제시하였으며, 제안한 클립형 연결장치에 따른 시공성 평가 및 소요비용을 분석하였다. 분석 결과, 기둥 1개 전체 철근 조립하는 데 작업 시간은 클립형 연결장치 사용시 50%의 작업시간을 단축하는 것으로 나타났으며, 비용분석 결과 클립형 연결장치 1개 사용시 절감효과가 가장 효과적이었고, 표준 갈고리 상세 대비 약 32%의 비용 절감효과가 있는 것으로 분석되었다.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.83-89
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• 2019

Objective : This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease. Methods : We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro $2015^{TM}$ (TreeAge Software, Inc, Williamstown, MA, USA). Results : Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard. Conclusion : Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.

• Journal of Korea Trade
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• 제23권5호
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• pp.118-128
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• 2019

Purpose - This paper examines the international R&D contest in which the extent of intellectual property right (IPR) affects both the size of prize for the winning firm and the extent of positive spillover through cost of firms. Recognizing the possibility of incomplete protection of IPR, the present paper analyzes the effect of changes in the extent of IPR on payoffs to firms and social welfare. Design/methodology - This paper examines coordination of IPRs by countries in economic integration. The paper then develops a general model of international R&D contest with incomplete protection of IPR. An increase in the extent of IPR augments the share of the prize the winning firm can appropriate, while decreasing the positive cost externality. To derive sharper results, the paper considers the cases of linear and fixed spillovers. Findings - Under plausible assumptions, an increase in the IPR augments the payoff to each firm and the aggregate payoffs as well. The paper also shows that the number of firms participating in the R&D contest can be endogenously determined in the two-stage R&D contest. The higher the extent of cost spillover, and the larger the effective prize, the more firms participate in the international R&D contest. Originality/value - Existing studies assume that firms winning the R&D contest enjoy perfect IPR to the output of their R&D activities. This is a very restrictive assumption in that other firms can copy the new products or processes. By allowing for the incompleteness of the IPR, the present paper develops a more realistic model of R&D contest. The novelty of the present paper is to allow for the possibility that the higher extent of IPR increases the prize and decreases positive cost externality at the same time. The findings of the present paper can serve as a basis for government policy toward R&D activities of firms and protection of IPRs.

• Current Optics and Photonics
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• 제2권1호
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• pp.59-68
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• 2018

Opto-acoustic systems provide structural and functional information regarding biological tissues. Conventional opto-acoustic systems typically employ continuous or pulsed lasers as transmission sources. Compared to lasers, light emitting diodes (LEDs) are cost-effective and relatively portable excitation sources but are non, coherent. Therefore, in this study, a relatively low cost lens - a type of Ramsden eyepiece - was specially designed to theoretically calculate the illumination and achieve a constant brightness across the pupil of an eye. In order to verify the capability of the developed light-emitting diode-acoustic (LEDA) systems, we carried out experiments on bovine and bigeye tuna eyeball samples, which are of similar size to the human eye, using low frequency (10 MHz) and high frequency (25 MHz) ultrasound transducers. High frequency ultrasound transducers are able to provide higher spatial resolution compared to low frequency ultrasound transducers at the expense of penetration depth. Using the 10 MHz and 25 MHz ultrasound transducers, acceptable echo signals (3.82, 3.94, and 5.84 mV at 10 MHz and 282, 1557, 2356 mV at 25 MHz) from depth greater than 3 cm and 6 cm from the anterior surface of the eye were obtained. We thereby confirmed that the LEDA system using a pulsed LED with the designed Ramsden eyepiece lens, used in conjunction with low and high frequency ultrasound transducers, has the potential to be a cost-effective alternative method, while providing adequate acoustic signals from bovine and bigeye tuna ocular areas.

• 한국농공학회지
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• 제35권2호
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• pp.43-56
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• 1993

The laboratory tests are performed on how the liquefaction potential of the sea dike structures on the saturated sand or silty sand seabed could be affected due to earthquake before and after construction results are given as follows ; 1. Earthquake damages to sea dike structures consist of lateral deformation, settlement, minor abnormality of the structures and differential settlement of embankments, etc. It is known that severe disasters due to this type of damages are not much documented. Because of its high relative cost of the preventive measures against this type of damages, the designing engineer has much freedom for the play of judgement and ingenuity in the selection of the construction methods, that is, by comparing the cost of the preventive design cost at a design stage to reconstruction cost after minor failure. 2. The factors controlling the liquefaction potential of the hydraulic fill structure are magnitude of earthquake(max. surface velocity), N-value(relative density), gradation, consistency(plastic limit), classification of soil(G & vs), ground water level, compaction method, volumetric shear stress and strain, effective confining stress, and primary consolidation. 3. The probability of liquefaction can be evaluated by the simple method based on SPT and CPT test results or the precise method based on laboratory test results. For sandy or silty sand seabed of the concerned area of this study, it is said that evaluation of liquefaction potential can be done by the one-dimensional analysis using some geotechnical parameters of soil such as Ip, Υt' gradation, N-value, OCR and classification of soils. 4. Based on above mentioned analysis, safety factor of liquefaction potential on the sea bed at the given site is Fs =0.84 when M = 5.23 or amax= 0.12g. With sea dike structures H = 42.5m and 35.5m on the same site Fs= 3.M~2.08 and Fs = 1.74~1.31 are obtained, respectively. local liquefaction can be expected at the toe of the sea dike constructed with hydraulic fill because of lack of constrained effective stress of the area.

• Structural Engineering and Mechanics
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• 제86권3호
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• pp.337-348
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• 2023

The optimization of reinforced concrete (RC) cantilever retaining walls is a complex problem and requires the use of advanced techniques like metaheuristic algorithms. For this purpose, an optimization model must first be developed, which involves mathematical complications, multidisciplinary knowledge, and programming skills. This task has proven to be too arduous and has halted the mainstream acceptance of optimization. Therefore, it is necessary to unravel the complications of optimization into an easily applicable form. Currently, the most commonly used method for designing retaining walls is by following the proportioning limits provided by the ACI handbook. However, these limits, derived manually, are not verified by any optimization technique. There is a need to validate or modify these limits, using optimization algorithms to consider them as optimal limits. Therefore, this study aims to propose updated proportioning limits for the economical design of a RC cantilever retaining wall through a comprehensive parametric investigation using the genetic algorithm (GA). Multiple simulations are run to examine various design parameters, and trends are drawn to determine effective ranges. The optimal limits are derived for 5 geometric and 3 reinforcement variables and validated by comparison with their predecessor, ACI's preliminary proportioning limits. The results indicate close proximity between the optimized and code-provided ranges; however, the use of optimal limits can lead to additional cost optimization. Modifications to achieve further optimization are also discussed. Besides the geometric variables, other design parameters not covered by the ACI building code, like reinforcement ratios, bar diameters, and material strengths, and their effects on cost optimization, are also discussed. The findings of this investigation can be used by experienced engineers to refine their designs, without delving into the complexities of optimization.

• Computers and Concrete
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• 제19권6호
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• pp.737-744
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• 2017

Geopolymer Concrete is typically proportioned with activator solution leading to moderately high material cost. Such cost can be enduring in high value added applications especially when cost savings can be recognized in terms of reduction in size of the members. Proper material selection and mix proportioning can diminish the material cost. In the present investigation, a total of 27 mixes were arrived considering the mix parameters as liquid-binder ratio, slag content and sodium hydroxide concentration to study the mechanical properties of geopolymer concrete (GPC) mixes such as compressive strength, split tensile strength and flexural strength. The derived statistical Response Surface Methodology is beleaguered to develop cost effective GPC mixes. The estimated responses are not likely to contrast in linear mode with selected variables; a plan was selected to enable the model of any response in a quadratic manner. The results reveals that a fair correlation between the experimental and the predicted strengths.