• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.243-250
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• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• Journal of the Korean Society for Railway
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• v.13 no.2
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• pp.236-243
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• 2010

We examine the change in healthcare utilization pattern of cancer patients since the launch of KTX in 2004. It is found that during the year of 2004 and 2005 the rapid increase in the ratio of cancer patients' healthcare utilizations for the tertiary hospitals in Seoul to the total healthcare utilizations has accompanied the rapid decrease in the corresponding ratio for the tertiary hospitals in the local metropolitan areas under the influence of KTX while the corresponding ratio for the tertiary hospitals in the local cities with little influence of KTX on them has exhibited mild change. Since healthcare consumers' choice of hospitals can be characterized by "foot voting" action in the healthcare service market in Korea, such a phenomenon may have strong implication that the introduction of KTX may have affected substantially the inter-area healthcare utilization pattern by cancer patients by reducing various sorts of long-distance travel costs. Therefore, considering the potential contribution of KTX to the increase of cancer patients' accessibility to hospitals with higher qualities, support policies such as fare discount for low-income cancer patients in local areas may need to be taken into consideration where the well-designed fare discount program for low-income cancer patients may increase utilizations of KTX by lowincome cancer patients without incurring additional costs to running of KTX.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• Journal of Preventive Medicine and Public Health
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• v.55 no.6
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

• Journal of Preventive Medicine and Public Health
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• v.54 no.2
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• pp.129-136
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• 2021

Objectives: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand. Methods: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis. Results: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors. Conclusions: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

• Electronics and Telecommunications Trends
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• v.39 no.4
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• pp.73-81
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• 2024

As the demand for a healthy life increases and the use of information technology expands, interest in digital healthcare has increased. Among the digital healthcare technologies, digital therapeutics (DTx), which are capable of disease prevention, management, and treatment rather than simple healthcare, are expected to play a key role in future healthcare services. As interest in untact remote treatment that can minimize the risk of viral infection has rapidly increased since the spread of COVID-19, the application of DTx has received much attention because it can partially replace face-to-face treatment for mental illnesses, chronic diseases, and other diseases, reducing concerns about infection. In addition, because of the nature of software, DTx have lower toxicity and fewer side effects than existing treatments and do not require manufacturing, transportation, and storage like general medicines. Hence, they can be supplied in large quantities at low cost and have the advantage of lowering medical costs. However, despite these advantages, it has been pointed out that there are difficulties in investment and universal use because of the complexity of pricing and malpractice compensation. In other words, if it is difficult to prove and measure the improvements in disease management and treatment using DTx and it takes a considerable amount of time and money to do so, it will be difficult to attract investment from stakeholders such as medical providers and pharmaceutical companies. In this paper, we examine the domestic and global application status and development trends of DTx and determine the relevant implications.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.397-403
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• 2006

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.3007-3013
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• 2016

Background: Gastrointestinal cancers are common malignancies associated with high mortality rates. Healthcare systems are always faced with high costs of treatment of gastrointestinal cancers including stomach cancer. Identification and prioritization of these costs can help determine economic burden and then improve of health planning by policy-makers. This study was performed in 2015 in Kerman City aimed at estimating the direct hospital costs for patients with gastric cancer. Materials and Methods: In this cross-sectional study, the medical records of 160 patients with stomach cancer admitted from 2011 to 2014 to Shafa Hospital were examined, the current stage of the disease and the patients' health status were identified, and the direct costs related to the type of treatment in the public and private sectors were calculated. SPSS-19 was used for statistical analysis of the data. Results: Of the patients studied, 103 (65%) were men and 57 (35%) were women. The mean age of patients was 65 years. Distribution into four stages of the disease was 5%, 20%, 30%, and 45%, respectively. Direct costs in four stages of the disease were calculated as 2191.07, 2642.93, 2877, and 2674.07 USD (63,045,879, 76,047,934, 82,783,019, and 76,943,800 IRR), respectively. The highest percentage of costs was related to surgery in Stage I and to medication in Stages II, III, and IV. According to the results of direct costs of treatment for stomach cancer in Kerman, the mean total cost of treating a patient in the public sector was estimated at 74,705,158 IRR, of which averages of 60,141,384 IRR and 14,563,774 IRR were the shares of insurance and patients, respectively. Conclusions: The high prevalence and diagnosis of disease in old age and at advanced stages of disease impose great costs on the patients and the health system. Early diagnosis through screening and selecting an appropriate treatment method might largely ameliorate the economic burden of the disease.

• International Journal of Computer Science & Network Security
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• v.24 no.8
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• pp.32-42
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• 2024

The Internet of Things (IoT) is set to transform patient care by enhancing data collection, analysis, and management through medical sensors and wearable devices. However, the convergence of IoT device vulnerabilities and the sensitivity of healthcare data raises significant data integrity and privacy concerns. In response, this research introduces the Smart-Coord system, a practical and affordable solution for securing healthcare IoT. Smart-Coord leverages blockchain technology and coordinate-based access management to fortify healthcare IoT. It employs IPFS for immutable data storage and intelligent Solidity Ethereum contracts for data integrity and confidentiality, creating a hierarchical, AES-CBC-secured data transmission protocol from IoT devices to blockchain repositories. Our technique uses a unique coordinate system to embed confidentiality and integrity regulations into a single access control model, dictating data access and transfer based on subject-object pairings in a coordinate plane. This dual enforcement technique governs and secures the flow of healthcare IoT information. With its implementation on the Matic network, the Smart-Coord system's computational efficiency and cost-effectiveness are unparalleled. Smart-Coord boasts significantly lower transaction costs and data operation processing times than other blockchain networks, making it a practical and affordable solution. Smart-Coord holds the promise of enhancing IoT-based healthcare system security by managing sensitive health data in a scalable, efficient, and secure manner. The Smart-Coord framework heralds a new era in healthcare IoT adoption, expertly managing data integrity, confidentiality, and accessibility to ensure a secure, reliable digital environment for patient data management.

• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.25-47
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• 2005

This study was purposed to find out the difference of the accounting of practical cost between the ABC system and the traditional costing system applied in a hospital, to verified general effect of ABC. Methods: This case study deals with the method of calculation, the cost information that is produced at K hospital in Busan. To examine ABC system and traditional costing system, applying them to the clinical pathology, radiology, physics in K hospital. Results: As a result of costing analysis, it is showed maximum difference of 50% between ABC and traditional cost. compared in revenue center, it occurs the difference of 15% of them. considering the result, it is confirmed that ABC could be used as a means to offer more precise information. therefore, ABC makes possible to produce precise costing information and grasp the driver of cost, and it is possible to reduce cost effectively. Conclusion: ABC provide six benefits: (1) more accurate of service delivered (2) inproved pricing and contracting strategies (3) improved management decision making capability (4) greater ease of determining relevant costs (5) reduced nonvalue added costs.