Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.
Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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v.22
no.2
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pp.63-70
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2008
This paper resents the spatial electric load forecasting algorithm using the multiple regression analysis method which is enhanced from the algorithm of the DISPLAN(Distribution Information System PLAN). In order to improve the accuracy of the spatial electrical load forecasting, input variables are selected for GRDP(Gross Regional Domestic Product), the local population and the electrical load sales of the past year. Tests are performed to analyze the accuracy of the proposed method for Gyeong-San City, Gu-Mi City, Gim-Cheon City and Yeong-Ju City of North Gyeongsang Province. Test results show that the overall accuracy of the proposed method is improved the percentage error 11.2[%] over 12[%] of the DISPLAN. Specially, the accuracy is enhanced a lot in the case of high variability of input variables. The proposed method will be used to forecast local electric loads for the optimal investment of distribution systems.
Welding is critical technique for the joining of materials in the nation's major Manufacturing industries. Since 1998, leaders in welding industry have defined a vision of the issues and opportunities that it will face in 2020. In developing this vision document, more than 25 senior managers and respected experts from various segments of the welding community met to begin a dialog about the future of the welding industry. They were brought together to develop a long-range business plan for their industry that would identify how it would meet the needs of manufacturers, of the marketplace, and of society in 2020. In essence, these decision makers created an ideal vision of the state of their industry in 20 years, and the strategy to reach it. Welding is a precise, reliable, and cost-effective, method for joining materials. No other technique is as widely used by manufacturers to join metals and alloys efficiently. Most of the familiar objects in modern society, form buildings and bridges, to vehicles, computers, and medical devices, could not be produced without the use of welding. Despite the importance of welding to the manufacturing industry, the leaders in this area felt that welding was not appreciated as much as it should be from the society. The welding industry consists of the “users” of welding techniques as well as the companies, universities and other organizations that industry look for improvements in their operations by 2020, and should find their interest addressed in this document. A major economic impact study co sponsored by AWS and EWI and supported by US Navy, State of Ohio, US Department of Commerce, and major companies was kicked off. This two-year study will determine the economic impact of welding on the United States economy. The objective of this study is to break a paradigm about welding-those of us who are heavily involved in welding, believe strongly that much of our gross domestic product is directly dependent on welding. Furthermore, continued advances in the field of welding are necessary to achieving further increases in productivity that makes our economy strong. Yet, despite intuition, anecdotal information, and fragmented analyses, the completing quantitative information that would proved the justification for strategic actions to further develop this critical field is not currently available.
Recently, there has been a gradual growth of retired in-migrants in high-amenity, rural areas in Korea. However, little has known about that the retirement migration is a blessing or a blight for a local economy in Korea. Therefore, in this study, we intend to explore the relationship between retirement migration and economic development of rural communities in Korea. For this purpose, we used the 1995 and 2000 census data and annual regional statistics for 138 counties in Korea. Based on the previous empirical studies, economic development was measured by 3 indicators such as GRDP (Gross Regional Domestic Product), job creation in the wholesale and retail sector, and the increase of local tax. Also, cross-tab, scatter plot, and correlation were analyzed using the SPSS Windows Program. The finding are as follows: First, from 1995 to 2000, nearly 11 percent of rural counties showed 10 percent and over increase of in-migration rate among retirees. Second, correlation statistics showed a close relationship between retirement in-migrant flows and economic resurgence. In particular, retirement in-migration rates were significantly tied to the job creation of the wholesale and retail sector (r=.19, p<.05) as well as car ownership rate (r=.58, p<.001) resulting in the increase of local tax. However, there was non-significantly positive correlation between retirement in-migrant flows and GRDP change (r=.13). Knowledge of these relationships will be important to policy-makers and for understanding the role that retirement in-migration play in stimulating economic growth of rural communities in Korea.
Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.
Younis, Uzma;Athar, Mohammad;Malik, Saeed Ahmad;Bokhari, Tasveer Zahra;Shah, M. Hasnain Raza
Advances in environmental research
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v.6
no.2
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pp.127-137
/
2017
Cotton is the major fiber crop in Pakistan that accounts for 2% of total national gross domestic product (GDP). After picking of cotton, the dry stalks are major organic waste that has no fate except burning to cook food in villages. Present research focuses use of cotton stalks as feedstock for biochar production, its characterization and effects on soil characteristics. Dry cotton stalks collected from agricultural field of Bahauddin Zakariya University, Multan, Pakistan were combusted under anaerobic conditions at $450^{\circ}C$. The physicochemical analysis of biochar and cotton stalks show higher values of % total carbon, phosphorus and potassium concentrations in biochar as compared to cotton stalks. The concentration of nitrogen was decreased in biochar. Similarly biochar had greater values of fixed carbon that suggest its role for carbon sequestration and as a soil amendment. The fourier transformation infrared spectroscopic spectra (FTIR) of cotton stalks and biochar exposed more acidic groups in biochar as compared to cotton stalks. The newly developed functional groups in biochar have vital role in increasing surface properties, cation exchange capacity, and water holding capacity, and are responsible for heavy metal remediation in contaminated soil. In a further test, results show increase in the water holding capacity and nutrient retention by a sandy soil amended with biochar. It is concluded that cotton stalks can be effectively used to prepare biochar.
Cho, Eun;Kang, Moon Hae;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Park, Eun-Cheol
Asian Pacific Journal of Cancer Prevention
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v.14
no.7
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pp.4329-4334
/
2013
Background: Cervical cancer, which is common in developing countries, is also a major health issue in Korea. Our aim was to evaluate the cost-effectiveness of Korea's National Cancer Screening Program (NCSP), implemented in 1999. Materials and Methods: The target population was Korean women 30 years or over who were invited to take part in the NCSP in 2002-2007. By merging NCSP records with Korean Central Cancer Registry data, patients diagnosed with cervical cancer who had been screened were assigned to a "screened group," while patients diagnosed elsewhere were assigned to a "non-screened group." Clinical outcomes were measured in terms of life-years saved (LYS), derived from 5-year mortality rates supplied by the Korean National Health Insurance Corporation and National Statistical Office. Direct and travel costs associated with screening were evaluated from the perspective of the payer, the NCSP. Results: A diagnosis via screening was associated with 2.30 LYS, and the incremental cost-effectiveness ratio (ICER) estimate for screening was 7,581,679 KW/LYS (6,727 USD/LYS). ICER estimates were lower for older patients (${\geq}$ 50 years) than younger patients (4,047,033 KW/LYS vs 5,680,793 KW/LYS). The proportion of early-stage cancers detected was 16.3% higher in the screened group. Conclusions: In light of Korea's per capita gross domestic product (32,272 USD in 2012), the current NCSP's incremental cost per LYS appears acceptable.
Background: Mammography is considered the gold standard of breast cancer mass screening and many countries have implemented this as an established breast cancer screening strategy. However, although the incidence of breast cancer and racial characteristics are different between Western and Asian countries, many Asian countries adopted mammography for mass screening. Therefore, the objective of this research was to determine whether mammography mass screening is cost-effective for both Western and Asian countries. Materials and Methods: A systematic review was performed of 17 national mammography cost-effectiveness data sets. Per capita gross domestic product (GDP), breast cancer incidence rate, and the most optimal cost-effectiveness results [cost per life year saved (LYS)] of a mammography screening strategy for each data set were extracted. The CE/per capita GDP ratio is used to compare the cost-effectiveness of mammography by countries. Non-parametric regression was used to find a cut-off point which indicated the breast cancer incidence rate boundary line determining whether mammography screening is cost-effective or not. Results: We found that the cost-effective cut-off point of breast cancer incidence rate was 45.04; it exactly divided countries into Western and Asian countries (p<0.0014). Conclusions: Mammography screening is cost-effective in most of Western countries, but not in Asian countries. The reason for this result may be the issues of incidence rate or racial characteristics, such as dense breast tissue. The results indicate that mammography screening should be adopted prudently in Asian countries and other countries with low incidence rates.
We propose the statistical modeling and empirical results that can be utilized to identify and interpret the structural factors of international arms exports in recent years. The building blocks of research comprise the following questions; which would be the explanatory variables for the changing trend of international arms exports, whether the statistical significance can be verified on those variables and how those are interpreted for the future policy making purpose. We use the dataset of top 40 countries from SIPRI's Arms Transfers Database and analyze several regression models which consist of explanatory variables derived from research hypotheses. The most noticeable result is that the national fiscal reserve is shown to have consistent influence on the arms exports changes. UN security council members' group also has dominant power to make a formation of arms exports market block. Furthermore, gross domestic product and net exports volume in the national economy would seem to be related to changes of international arms exports in post-2000 period as well.
A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.
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