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

• 한국병원경영학회지
• /
• 제4권1호
• /
• pp.1-20
• /
• 1999

Since the late 1980s, there have been radical changes in the managerial environment of Y University Medical Center(YUMC). Externally, the competition among hospitals has intensified due to the establishment of universal health insurance in 1939 and the entrance of large enterprises into the health care industry in the early 1990s. In addition, government regulation of medical institution is becoming stricter. Also, consumer groups have continued to demand the respect for patient rights and improvement of the quality of medical services. Internally, the financial condition of YUMC has worsened, not only because weak control and poor mediation in its large-scale structure have made its operation inefficient, but also because the rates of increase in the prices of goods and labor have grown faster than any increases in revenues. This study on materials management at YUMC presents a way for YUMC to reduce costs and increase its productivity, thereby overcoming its financial difficulties and dealing with external pressures. This study utilized the case studies of the materials purchasing and medical supply management in the United States and the comparative analysis of management to suggest short-term and long-term alternatives for innovation in YUMC. The goals of the short-term alternatives for innovation are to centralize the purchasing and supply departments and to simplify the decision-making processes. Through these attempts, it is estimated that YUMC's costs could be reduced by $600,000 per year. In the long-term, it is necessary to consider introducing a Supply Processing Distribution(SPD) system and setting up a centralized electronic system for supply and inventory management, although it is difficult to estimate the effect of cost-cutting because of the lack of analysis data. Thus, YUMC should thoroughly analyze initial investment costs and economical efficiency generated from long-term alternatives.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권12호
• /
• pp.5309-5314
• /
• 2016

Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.

• 한방안이비인후피부과학회지
• /
• 제23권1호
• /
• pp.215-223
• /
• 2010

Objective : The aim of this study is to assess the impact of chronic atopic dermatitis (AD) on quality of life (QoL) as well as the economic burden associated with oriental medical treatment on adult patients with chronic AD in Korea. Methods : The EQ-5D health states, existence and duration of AD in the 2007 National Health and Nutrition Examination Survey (NHANES) were used to obtain the study subjects. A questionnaire including the questions on direct medical and direct non-medical costs associated with oriental medical treatment for adult patients with AD was specifically designed. Twenty-nine, members of the Korean Oriental Medical Ophthalmology, Otolaryngology and Dermatology Society (KOMOODS), completed the questionnaires. Results : The incidence of AD was around 3.09% in 2007 NHANES (sample survey, n=2981). Three months and above in duration of disease was 1.35%. The QoL data revealed as follows: 0.932 in non-chronic AD, 0.916 in chronic AD, and 0.908 in non-AD. We also stratified our analysis by age. The QoL data in 40's was statistically significant (P<0.023). But, no significant differences were reported in 20's, 30's, and 50's. The total direct medical costs of oriental medical treatment for AD was about 2,560,717 Won, and total direct non-medical costs was about 605,125 Won in a year. Conclusions : This study might be applied to find the evidence of economic evaluation in oriental medicine for AD. More rigorous studies are warranted.

• 의료법학
• /
• 제14권1호
• /
• pp.275-302
• /
• 2013

The Unites States has been plagued with soaring health care costs and an alarmingly large number of uninsured population. The Patient Protection and Affordable Care Act of 2010 ushered in the most sweeping health care reform in the United States since the introduction of Medicare and Medicaid in 1965 to address these issues. The law's requirement for individuals to purchase health insurance (the so-called "individual mandate"), however, not only caused a political stir but also prompted constitutional challenges. Some questioned whether the federal government, lacking general police power, could require its citizens to buy unwanted insurance based on its enumerated powers under the U.S. Constitution. This paper summarizes the decision of the U.S. Supreme Court on the constitutionality of individual mandate, and explores how the decision relates to Korea's own universal health care.

• Journal of Preventive Medicine and Public Health
• /
• 제24권1호
• /
• pp.29-36
• /
• 1991

A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of health expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical da. Finally, the difference in parameters between the two estimations were explained through residual analysis.

• 보건행정학회지
• /
• 제28권3호
• /
• pp.257-262
• /
• 2018

This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

• Smart Structures and Systems
• /
• 제6권9호
• /
• pp.1079-1105
• /
• 2010

Railway transport of goods and passengers is effective in terms of energy conservation and travel time savings. Safety and ride quality have become important issues as train speeds have increased. Due to increased speeds, minor damage to railway structures and abnormal interactions between trains and structures have given rise to increasingly serious accidents. Therefore, structural health and operational conditions must be monitored continuously in all service environments. Currently, various health and operation management systems are being developed and these are reducing both maintenance frequency and costs associated with disassembly. In this review, major damage and malfunctions and their locations are first analyzed based on numerous references. Then advanced train health and operation management technologies are classified into wayside detection methods and advanced integrated sensor methods and their operating principle and functions are reviewed and analyzed.

• Journal of Preventive Medicine and Public Health
• /
• 제54권4호
• /
• pp.251-258
• /
• 2021

Hepatitis C infection is responsible for high morbidity and mortality rates globally as well as for significant indirect costs. The disease burden caused by the hepatitis C virus (HCV) is comparable to the one caused by human immunodeficiency virus or tuberculosis. Today, simple detection methods, highly effective and easy to administer therapies and efficient preventative measures are available to combat hepatitis C. Nevertheless, in most countries around the world, the World Health Organization target of eliminating this infectious disease and its consequences by 2030 are not being met. Significant gaps in care for hepatitis C sufferers still exist, the shortcomings ranging from education and treatment to aftercare. Hepatitis C infection was and still is not on the radar of most politicians and health authorities. National programmes and strategies to combat the disease exist or are being developed in many countries. However, for these to be implemented efficiently and successfully, clear political commitment, strong civil society actors, well-functioning public health structures and the relevant support from global donors are needed.

• International Journal of Advanced Culture Technology
• /
• 제6권4호
• /
• pp.226-232
• /
• 2018

The rapid pace of growth in internet usage and rich mobile applications and with the advantage of incredible usage of internet enabled mobile devices the Green Mobile Crowd Computing will be the suitable area to research combining with cloud services architecture. Our proposed Framework will deploy the eHealth among various health care sectors and pave a way to create a Green Mobile Application to provide a better and secured way to access the Products/ Information/ Knowledge, eHealth services, experts / doctors globally. This green mobile crowd computing and cloud architecture for healthcare information systems are expected to lower costs, improve efficiency and reduce error by also providing better consumer care and service with great transparency to the patient universally in the field of medical health information technology. Here we introduced novel architecture to use of cloud services with crowd sourcing.