• Korean Journal of Radiology
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• v.24 no.12
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• Management & Information Systems Review
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• v.36 no.4
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• pp.1-19
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• 2017

These days, the concept of creating shared value is drawn keen attentions to. This interest comes out of the expectation that Creating Shared Value(CSV) can offer an answer to some social issues by creating societal and economic values on the top of the achievements that existing Corporate Social Responsibility(CSR) has made. However, it is difficult to make a clear distinction between the achievements that the activities of CSR and CSV have made. In this regard, developing a methodology to make an actual proof analysis on the accomplishments of CSV and to verify customer's awareness of and attitude towards the CSV is necessarily required. A company needs to gain a competitive advantage in the marketplace as well as resolve a social issue by innovating value chain. The research has verified the cause and effect relationship between the CSV from the point of view of value chain and the purchase intention aroused by its economic, societal and cultural values through the company image and credibility with actual proof analysis and come up with following results. First, a societal and cultural value resulted in giving positive impact on a company's image, which implies that CSV activities can be the thin end of the wedge through which customers have a good image of the company involved in CSV. Second, a societal value makes a positive influence on the credibility of a company. In this regard, CSV should be recognized not just as a thing that generates a cost, but a way to win-win as well as future development. Third and last, the research results show that both company image and credibility influence on purchase intention. Considering that CSV generates a positive evaluation on a company that will ultimately cause continuous profit-making, the company's ultimate goal of activities, it should be approached from the perspective of making a mid-and-long term strategy.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.14-24
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• 1993

The author discussed present problems and future prospects of psychosomatic medicine in clinical, educational, research, and social aspects. In general, psychosomatic field. particularly. consultation-liaison(C-L) psychiatry in Korea seems to remain on early developmental phase. However, positive change in the general publics' and societal view of psychiatry, specialization of medicine and development of medical technology, implementation of delivery system in medical care could contribute to development of this field. In future, clinically, liaison activity will be more activated. and this field will be developed as main subspecialty of psychiatry. In addition. C-L psychiatry will be subspecialized. and prevention and humanization of medical care could be more emphasized. In education. the main place of education for medical students and psychiatric residents will be changed from closed ward to general ward in which consultation-liaison activity can be performed. In research. consultation liaison model suitable for Koreans will be developed and studies on disease mechanism will be more promoted. In social aspects, this field could influence the general publics' view of psychiatry and change the whole areas of medicine and society toward integration. In order to achieve these goals, medical insurance system and cost relevant to C-L activity should be essentially improved.

• Journal of Environmental Impact Assessment
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• v.11 no.2
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• pp.93-107
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• 2002

The choice of big public investment project needs an appropriate feasibility analysis before it is implemented, bemuse a rot wisely chosen one would bring about big and longrun societal costs. But the feasibility analysis for the big public investment project in Korea has been done without linking the economic benefits and environmental damages. Consequently social conflicts arose frequently during and after project implementation, owing to such concerns asincreasing costs and serious ecological damages. The recent social conflict over the Saemangeum Project is a typical case. This reclamation project began in 1991 and finished 60% of the whole process in 1999, when its feasibility was again assessed under the public pressure by the joint assessment team consisting of both citizen's and government's professionals. Even the assessment report by this joint team could not show the convincing results owing to the improper assessment procedure and failure to set proper feasibility criteria. This paper pointed out the limitations of our current procedure of feasibility assessment and identified the concrete problems that atosee during the recent reassessment process of the Saemangeum reclamation project by the joint team. In order to improve the current problem-ridden practices, it is concluded by the policy recommendation for establishing a right feasibility assessment procedure for the public investment projects.

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.977-986
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• 2008

Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.251-260
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• 2009

Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

• Korean Journal of Computational Design and Engineering
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• v.21 no.4
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• pp.363-377
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• 2016

The introduction of the BIM into the architectural service industry is currently not being conducted smoothly. The purpose of this research is to, considering the current state of the market, establish long-term strategies that will enable the BIM to successfully settle. The survey has been conducted in target of architects in order to understand pending issues. Additionally, the articles regarding BIM have been researched for the purpose of better understanding the current societal demands. Indicated by survey results, the architects agree to a certain extent upon the need of BIM for architectural designs, yet also express concerns that the BIM introduction does not guarantee betterment in efficiency. The problematic aspects of BIM introduction that have already been discussed in some policy-related studies include a multitude of complicated issues that are unable to be resolved within a short period of time: underdeveloped BIM infra, the limit of BIM software itself, political issues regarding licensing and lack of social awareness. Based on the issues mentioned above, three main areas of focus along with their respective practical strategies and tasks have been designated. Finally, this research has analyzed the current situation and its issues along with the political solutions of 12 projects, amongst which include the standard for plan drawings, licensing system improvement, cost standard and BIM introduction support. Finally this research has analyzed the current situations and its' issues along with the political solutions of 12 projects, amongst them are the standard for plan drawings, licensing system improvement, cost standard and BIM introduction support.

• Journal of Korean Society of societal Security
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• v.2 no.4
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• pp.35-41
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• 2009

If any bridge has the monitoring system, the bridge manager can check the history of bridge behavior and the progress of the damage more exactly. When the unexpected event (ex: earthquake and flood) happens, the manager can check the safety condition of the bridge and make the pertinent action for bridge management which is reduction of vehicle speed or traffic control through the system. Additionary the manager can make the well-timed repair or reinforcement through the system, so he can save the management cost or the life cycle cost. This study presents the method of setting the criteria by FEM analysis in bridge monitoring system, and the standard progress for setting the criteria about measurement items of monitoring system for the steel box type bridge.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• Journal of Korean Society of societal Security
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• v.4 no.2
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• pp.57-64
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• 2011

Although it is uncertain that the cause of changed pattern of the natural disaster related to water (i.e. flood and drought) is due to excessive carbon dioxide yielded from economic activity or the increased number of sunspots, it is apparent that there have been unusual climate change that directly affects the water resource management. Due to such a frequent unusual weather activities, there have been increased natural disaster and the most direct and major reason is considered as climate change. As we see, the climate change necessarily causes social costs. Especially, the effects on the water resource due to flood and drought take the considerable part of such costs. Therefore, this study is basic work to develop a new economic analysis technique to be used in pursuing appropriate adaptation project in field of the amount of cost damage through analysis of the effects of the climate change on the water resource. The models appeared in many reports for cost assessment of climate change were various (e.g., PAGE, DICE, AIM, IMAGE, MERGE, and etc.) and this report summarizes general characteristics of each model. To assess the effects of climate change of the water management, we defined the field of the water management on climate change. The results help post-study in field of the climate change's social-economic effect assessment, can be employed for the prioritizing process of the national fund's investment.