• 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.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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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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• 제13권7호
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• pp.3159-3163
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• 2012

Background: For cervical cancer the epidemiological profile is poorly known in Morocco and no data is available concerning the direct medical costs. The purpose of this work is to estimate the direct cost of medical management of invasive cervical cancer during the first year after diagnosis in Morocco. Methods: The estimation of direct costs of medical management of invasive cervical cancer during the first year after diagnosis in Morocco is based on the estimation of individual cost in each stage which covers diagnosis, treatment and follow-up during first year. The cost was estimated per patient and whole cycle-set using the costs for each drug and procedure as indicated by the Moroccan National Agency for Health Insurance. Extrapolation of the results to the whole country was used to calculate the total annual cost of cervical cancer treatments in Morocco. Results: Overall approximately 1,978 new cases of cervical cancer occur each year in Morocco. The majority (82.96%) of these cases were diagnosed at a late stage (stageII or more). The cost of one case of cervical cancer depends on stage of diagnosis, the lowest cost is $382 for stageCis followed by the cost of stageIA1 for young women (< 40 years) which is $2,952. The highest cost is for stageIV, which is $7,827. The total cost of cervical cancer care for one year after diagnosis is estimated at $13,589,360. The share allocated to treatment is the most important part of the global care budget with an annual sum of $13,027,609 whereas other cost components are represented as follows: $435,694 for annual follow-up activity and $126,057 for diagnosis and preclinical staging. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco.

• 문화기술의 융합
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• 제3권2호
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• pp.21-30
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• 2017

본 연구는 뇌혈관질환자의 년간 총직접비용에 대하여 조사하였다. 본 연구를 위하여 2012년 한국의료패널 조사자 중 2012년 한 해 동안 뇌혈관질환으로 응급, 입원, 외래서비스를 1건 이상 이용하였다고 응답한 265명을 대상으로 하였다. 뇌혈관질환자 일반사항은 2012년에 한국의료패널 응답자 중 뇌혈관질환으로 응급, 입원, 외래서비스를 이용한 응답자의 비율이다. 연구방법은 응급, 입원, 외래서비스의 평균의료비와 가중평균을 적용하여 직접비용을 산출한 후 년간 총직접비용을 산출하였다. 연구결과는 뇌혈관질환자가 1인당 연 평균 본인부담 의료비 지출액은 약 561,934원이고, 남성은 669,557원, 여성은 448,696원이다. 건강보험 가입자의 경우 뇌혈관질환으로 인한 1인당 본인부담액은 평균 634,459원이고 의료급여 수급자는 160,236원이었다. 뇌혈관질환자가 265명의 연 평균 총직접비용은 약 162,165,690이고, 남성은 193,223,955원, 여성은 129,486,685이다. 건강보험가입자의 경우 뇌혈관질환으로 인한 1인당 총직접비용은 평균 183,095,125원이고 의료급여 수급자는 46,241,705원이었다. 가구소득별로 보면, 가구 소득 3분위에 속한 환자는 672,268원으로 가장 높게 나타났으며, 5분위에 속한 환자는 108,970,650원 으로 뇌혈관질환자의 총직접비용이 가장 낮았다.

• 한국식품조리과학회지
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• 제14권4호
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• pp.407-415
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• 1998

The objectives of this study were to analyze the factors that affect the productivity for university food services. In a survey involving four-year university dining centers throughout the country, and correlations among thriteen different variables that affect productivity were determined. Productivity index (PI) was determined by meals per hour, the average score for 38 institutions was found to be 14.2 meals/hour. For serving methods, the fixed ration had a higher PI than the self-serving. When two types of serving trays were considered, the PI of the compartmantalized trays was higher than that of the tray accompanying saparate small dishes. When single (S)-or. multiple(M)-menu was compared with the cafeteria style, a higher PI was obtained by the S-or M-menu. Among the three operation systems, the PI was found to be the highest by direct operation (17.6 meals/hour), followed by contract operation (11.1 meals/hour) and rent operation (7.9 meals/hour). For the factors that affect the productivity of the university food services, the total number sewed (r=0.54, p＜0.001) and the use of convenient food items (r=0.28, P＜0.05) exhibited positive correlations, while food costs and labor costs showed negative correlations. This suggests that the productivity of university food service increases as the total number served and the use of convenient food item increased, but decreases as the food costs and labor costs per meal increased. A regression analysis showed that three variables - total number sewed, labor cost per meal, number of employees-influenced about 73% components of food service showed a negative correlation with PI and a positive correlation with the labor cost per meal.

• 농업과학연구
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• 제25권2호
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• pp.293-309
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• 1998

This study is aimed at identifying the decision making criteria as B/C ratio, IRR and NPV based on the expected benefits and costs of the land utilization and promotion projects which have implemented to improve agricultural structure under WTO system. To carry out the objectives of the study, Sinseok project area located at Dangjin district, Chungnam province was selected. Sinseok project area has 306.2 ha of paddy area with 172 farm households. The project area will be operated by the 33 specialized farm households after completion of the project which will have 20 years of economic life. After completion of the project, farm size will be increased from 1.8ha to 9.3ha. Land intensity of the project area will be increased by 10%. Increase of land productivity and cost saving due to the labor saving technology as farm mechanization will be expected. According to the survey results, the annual amount of production cost savings per farm was estimated 3.884million won and increased total farm income was expected about 43.8million won per year. The total expexted project benefits was expected 174million won per year. The project costs to promote land utilization and structural change consisted of handling charges, and direct payment for land movility. The decision making criteria representing economic feasibility of the project such as B/C ratio, NPV and IRR were estimated 2.49, 483million won and 30% respectively when the cut-off rate was taken into account 10%. In conclusion, the land utilization and promotion project proppeled by the Korean Government under the agricultural land law is considered economically feasible from the view points of expected project benefits and costs. Accordingly the project have to be implemented more strongly under the G't financial support considering WTO and UR negociation which were aimed at achieving the free trade and improvement of international competitiveness of farm products.

• 한국약용작물학회지
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• 제26권1호
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• pp.64-71
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• 2018

Background: The cultivation of ginseng (Panax ginseng C. A. Meyer) in greenhouses could reduce the use of pesticides and result in higher yield; however, construction costs are problematic. The adaptation of direct-sowing culture in greenhouses could reduce the cost of ginseng production. Methods and Results: To improve seedling establishment in direct-sowing culture, effects of sowing density (SD), number of seeds sown per hole (SN), and thinning (TH) treatment on the root yield were investigated after 3 years of seeding. The emergence rate was significantly influenced by SD, but not by SN or TH. Damping-off and rusty roots increased with an increase in SN with diminishing effects of SN on seedling establishment. Root weight and diameter were affected by SD, SN, and TH, however, there were no statistical significances. The total number of roots harvested per unit area increased with increasing SD and SN, and the weight of roots was affected by SD, but not by SN or TH. Conclusions: Multi-seed sowing per hole and/or thinning might not be an efficient method for the direct-sowing culture of ginseng. The SD for direct seeding culture in greenhouses should be approximately $33-42seeds/m^2$ for an optimum yield of 3-year-old ginseng.

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.977-986
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• 2008

목 적 : 사회적 관점에서 로타바이러스의 사회적 비용을 추계하고자 하였다. 방 법 : 로타바이러스 연간 발생 환자수는 2002년 7월에서 2004년 6월까지 정읍지역에서 보고된 5세 미만 인구 1,000명당 입원 환자 11.6명, 외래 환자는 1,000명당 45.3명을 1년 단위로 환산하여 적용하였으며 의료비 자료는 건강보험심사평가원에 로타바이러스(A08.0)로 청구된 자료를 이용하였다. 2006년 12월부터 2007 년 5월까지 환자 보호자 조사를 실시하여 직접 비의료비 및 간접 비용을 산출하는 근거로 사용하였다. 결 과 : 2005년 5세 미만 아동 중 로타바이러스 감염으로 외래 이용한 환자수는 55,030명, 입원 환자수는 14,092명으로 추정하였다. 의료 비용은 110억원으로 전체의 82.8%를 차지했고, 교통비 및 기저귀 사용 등으로 인한 직접 비의료비는 16억원, 간호에 따른 작업 손실 비용은 6억 8000만원으로 로타바이러스 감염으로 인한 총 사회적 비용은 약 132억원 8천만원으로 집계되었다. 결 론 : 로타바이러스 감염은 의료비 뿐 아니라 비의료비와 간접 비용의 추가적인 지출을 가져오며 이는 사회적으로 큰 손실이 될 것이다. 그러나 본 연구에서는 보수적 추정을 하였으며 추후 연구에서 로타바이러스 감염이 보호자의 삶의 질과 건강수준의 저하에 미치는 영향을 비용 항목에서 충분히 고려할 필요가 있다.

• 문화기술의 융합
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• 제1권4호
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• pp.87-101
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• 2015

본 연구는 당뇨병 질환자의 의료이용 및 의료비를 통하여 직접의료비를 조사하고자 하였다. 본 연구를 위하여 2012년 한국의료패널 총 5,434가구, 15,872명을 이용하여 만19세 이상 당뇨병 질환자는 812명을 대상으로 하였다. 연구방법은 응급의료이용, 입원의료이용, 외래의료이용에 대한 평균 의료비와 직접의료비(환자본인부담의료비+공단부담금+비급여본인부담금)를 구하였고, 년간총직접비용은 직접의료비에 당뇨병유병율(N)을 곱하여 산출하였다. 연구결과, 당뇨병 질환자의 100명당 평균 응급의료이용횟수는 1.98회 의료비, 총직접비용, 년간총직접비용은 85,942원, 447,359원, 363,255,508원이었고, 입원의료이용횟수는 5.6회 의료비, 총직접비용, 년간총직접비용은 772,240원, 4,061,982원 3,298,329,384원 이였으며, 외래의료이용횟수는 10회 의료비, 총직접비용, 년간총직접비용은 11,978원, 26,020원, 21,128,240원 이였다. 이상과 같은 결과를 바탕으로 다음과 같은 결론을 얻었다. 당뇨병의 발생은 의료비증가와 직접의료비 증가에 영향을 미칠 수 있으며, 이는 가구 및 환자에 있어 큰 부담이며 삶의 질도 낮아질 것이다. 당뇨병 질환의 감소를 위한 식생활. 운동 혈당, 혈압 등의 조기진단과 예방을 위한 관리가 중요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7701-7706
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• 2013

Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.