• 한국안전학회지
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• 제30권5호
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• pp.29-36
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• 2015

Common utility tunnel is essential to the daily lives of people underground utilities (electricity, gas and supply facilities such as water, communication facilities, sewer facilities, etc.) to improve the appearance by co-acceptance and disaster prevention, important for the conservation of the city's population was concentrated road construction the city-based facilities. There is recognition of the importance of the various supply treatment facilities in common utility tunnel as infrastructure to accommodate joint according to the city expanded, the demand for infrastructure. In this paper, a cost-benefit analysis using a one-time occurrence, without simply relying on cost or current cost, project manager for the city-dimensional feasibility study conducted, the user level of the maintenance costs and user costs, including social costs items from various angles can be investigated and proposed a mechanism of economic feasibility common utility tunnel. Evaluation of the proposed technique is cost-benefit and cost caused by installing common utility tunnel the existing pipeline area - was investigated by the benefit analysis, extended and repeated common utility tunnel installation depends much affected by the excavation, so users of reducing the number of repeat excavation convenience can be seen that this occurs.

• 대한간호학회지
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• 제34권3호
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• pp.449-457
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• 2004

Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.

• The Korean Journal of Pain
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• 제31권1호
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• pp.27-38
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• 2018

Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.20-29
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• 2008

The basis of the economic evaluation of vaccination is the balance between the use of the resources (input) and the improvements that result from the vaccination (output). Techniques used for economic evaluation of vaccination are cost analysis, cost-minimization analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. Cost analysis seeks to characterize the costs of a given vaccination program. Cost-effective analysis is to helps policy-makers decide on the best use of allocated resources, whether cost-benefit analysis is to helps policy-makers decide on the overall allocation of resources. Cost-utility analysis is a specific form of cost-effective analysis in which outcomes are reduced to a common denominator such as the quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Many economic analyses have been conducted on vaccines in the world, but there have been a little studies on economic evaluation on vaccines in Korea. This paper reviewed the methodology used to economic evaluation on vaccines and immunizations and addressed some examples of the methods.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8265-8270
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• 2016

Purpose: A cost-utility analysis was performed to assess the cost-utility of neoadjuvant chemotherapy regimens containing doxorubicin and cyclophosphamide (AC) versus paclitaxel and gemcitabine (PG) for locally advanced breast cancer patients in Iran. Materials and Methods: This cross-sectional study in Namazi hospital in Shiraz, in the south of Iran covered 64 breast cancer patients. According to the random numbers, the patients were divided into two groups, 32 receiving AC and 32 PG. Costs were identified and measured from a community perspective. These items included medical and non-medical direct and indirect costs. In this study, a data collection form was used. To assess the utility of the two regimens, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) was applied. Using a decision tree, we calculated the expected costs and quality adjusted life years (QALYs) for both methods; also, the incremental cost-effectiveness ratio was assessed. Results: The results of the decision tree showed that in the AC arm, the expected cost was 39,170 US$ and the expected QALY was 3.39 and in the PG arm, the expected cost was 43,336 dollars and the expected QALY was 2.64. Sensitivity analysis showed the cost effectiveness of the AC and ICER=-5535 US$. Conclusions: Overall, the results showed that AC to be superior to PG in treatment of patients with breast cancer, being less costly and more effective.

• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.353-358
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• 2004

Objective : To determine the quality of life and cost consequences for deaf adults who received a cochlear implant. Methods : The data from 11 patients, post-lingual deaf adults who received cochlear implants from 1990 to 2002, underwent cost-utility analysis. The average age of the participants was 49.6 years. The main outcomes were direct cost per quality-adjusted life-year (QALY) using the visual analog scale (VAS), health utility index (HUI), EuroQol (EQ-5D), and quality well-being (QWB), with costs and utilities being discounted 3% annually. Results : Recipients had an average of 5.6 years of implant use. Mean VAS scores increased by 0.33, from 0.27 before implantation to 0.60 at survey. HUI scores increased by 0.36, from 0.29 to 0.65, EQ-5D scores increased by 0.26, from 0.52 to 0.78, and QWB scores increased by 0.16, from 0.45 to 0.61. Discounted direct costs were $22,320, yielding $19,223/QALY using VAS, $17,387/QALY using HUI, $24,604/QALY using EQ-5D, and $40,474/QALY using QWB. Cost-utility ratios using VAS, HUI, and EQ-5D were all below $25,000 per QALY, except using QWB. Conclusion : Cochlear implants in post-lingual deaf adult have a positive effect on quality of life at reasonable direct costs and appear to produce a net saving to society.

• 약학회지
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• 제54권2호
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• pp.126-133
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• 2010

This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8503-8508
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• 2014

Background: After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Materials and Methods: Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. Results: In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. Conclusions: The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

• 대한교통학회:학술대회논문집
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• 대한교통학회 1997년도 제32회 학술발표회
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• pp.33-69
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• 1997

This study was conducted to develop a methodology to predict utility pole accident rates and to evaluate cost-effectiveness for safety improvement for utility pole accidents. The utility pole accident rate prediction model was based on the encroachment rate approach introduced in the Transportation Research Board Special Report 214. The utility pole accident rate on a section of highway depends on the roadside encroachment rate and the lateral extent of encroachment. The encroachment rate is influenced by the horizontal and vertical alignment of the highway as well as traffic volume and mean speed. The lateral extent of encroachment is affected by the horizontal and vertical alignment, the mean speed and the roadside slope. An analytical method to generate the probability distribution function for the lateral extent of encroachment was developed for six kinds of encroachment types by the horizontal alignment and encroachment direction. The encroachment rate was calibrated with the information on highway and roadside conditions and the utility pole accident records collected on the sections of 55mph speed limit of the State Trunk Highway 12 in Wisconsin. The encroachment rate on a tangent segment was calibrated as a function of traffic volume with the actual average utility pole accident rates by traffic volume strategies. The adjustment factors for horizontal and vertical alignment were then derived by comparing the actual average utility pole accident rates to the estimations from the model calibrated for tangent and level sections. A computerized benefit-cost analysis procedure was then developed as a means of evaluating alternative countermeasures. The program calculates the benefit-cost ratio and the percent of reduction of utility pole accidents resulting from the implementation of a safety improvement. This program can be used to develop safety improvement: alternatives for utility pole accidents when a predetermined performance level is specified.

• 대한교통학회:학술대회논문집
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• 대한교통학회 1997년도 제32회 학술발표회
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• pp.35-72
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• 1997

This study was conducted to develop a methodology to predict utility pole accident rates and to evaluate cost-effectiveness for safety improvement for utility pole accidents. The utility pole accident rate prediction model was based on the encroachment rate approach introduced in the Transportation Research Board special Report 214. The utility pole accident rate on a section of highway depends on the roadside encroachment rate and the lateral extent of encroachment. The encroachment rate is influenced by the horizontal and vertical alignment of the highway as well as traffic volume and mean speed. The lateral extent of encroachment is affected by the horizontal and vertical alignment, the mean speed and the roadside slope. An analytical method to generate the probability distribution function for the lateral extent of encroachment was developed for six kinds of encroachment types by the horizontal alignment and encroachment direction. The encroachment rate was calibrated with the information on highway and roadside conditions and the utility pole accident records collected on the sections of 55mph speed limit of the State Trunk Highway 12 in Wisconsin. The encroachment rate on tangent segment was calibrated as a function of traffic volume with the actual average utility pole accident rates by traffic volume strategies. The adjustment factors for horizontal and vertical alignment were when derived by comparing the actual average utility pole accident rates to the estimations from the model calibrated for tangent and level sections. A computerized benefit-cost analysis procedure was then developed as a means of evaluating alternative countermeasures. The program calculates the benefit-cost ratio and the percent of reduction of utility pole accidents resulting from the implementation of a safety improvement. This program can be used to develop safety improvement alternatives for utility pole accidents when a predetermined performance level is specified.