• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.209-220
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• 2014

This study found a relationship between the characteristics of the elderly with disabilities and extra health care monthly costs caused by disability and suggests methods for effectively managing health care spending of the elderly with disabilities. This study used data from the 2011 Survey on the Disabled conducted by the Ministry of Health and Welfare and the Korea Institute for Health and Social Affairs. The results of the analysis indicate that the relations between the socio-demographic characteristics of the elderly with disabilities and extra health care monthly costs caused by disability of the elderly are influenced by factors such as gender, age, members of the household, average monthly income and type of health insurance. Elderly people with disabilities spend too much for their medical care. To solve this problem, the government needs to find a variety of policy approaches to improve administrative procedure, establish a medical delivery system and enhance health care services.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1547-1551
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• 2012

Background: Lung cancer is the leading cause of cancer morbidity and mortality. Its management has a significant economic impact on society. Despite a high incidence of cancer, so far, there is no national register for this disease in Morocco. The main goal of this report was to estimate the medical costs of lung cancer in our country. Methods: We first estimated the number of annual new cases according to stage of the disease on the basis of the Grand-Casablanca-Region Cancer Registry data. For each sub-group, the protocol of treatment was described taking into account the international guidelines, and an evaluation of individual costs during the first year following diagnosis was made. Extrapolation of the results to the whole country was used to calculate the total annual cost of treatments for lung cancer in Morocco. Results: Overall approximately 3,500 new cases of lung cancer occur each year in the country. Stages I and II account for only 4% of cases, while 96% are diagnosed at locally advanced or metastatic stages III and IV. The total medical cost of lung cancer in Morocco is estimated to be around USD 12 million. This cost represents approximately 1% of the global budget of the Health Department. According to AROME Guidelines, about 86% of the newly diagnosed lung cancer cases needed palliative treatment while 14% required curative intent therapy. The total cost of early and advanced stages lung cancer management during the first year were estimated to be 4,600 and 3,420 USD, respectively. 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. A substantial proportion of the burden of lung cancer could be prevented through the application of existing cancer control knowledge and by implementing tobacco control programs.

• Health Policy and Management
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• v.17 no.3
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.167-174
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• 1997

Purpose : The main Purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. Material and Methods : A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as Payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current Payment rates of individual services. Results : The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12-2.55 times lower in total body irradiation. Conclusion : We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.1
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• pp.72-82
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• 2010

Purpose: This study was conducted to estimate the annual socioeconomic costs of menopausal syndrome treated with oriental medicine in Korea 2008. Methods: Study subjects selected were patients aged 40 years or older who had national health insurance(NHI) claims record with menopausal syndrome(KCDO codes: K04, K04.0, K04.2, K04.3, K04.4) for oriental medicine treatment in 2008. Direct medical cost of oriental medicine treatment for menopausal syndrome were measured from NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting hospitals. Indirect costs were defined as patients' productivity loss associated with office visits or hospitalization. Also, the costs of unpaid-household chores were calculated. Results: The total cost for the oriental medicine treatment of menopausal syndrome in the nation was estimated to be 743,091,219 Korean won(KRW) which included direct costs at 442,971,637 KRW and indirect costs at 300,119,583 KRW. Conclusion: This study provides an important perspective of socioecnomic influence due to menopausal syndrome treated with oriental medicine. And this results can be used as elementary data for menopausal syndrome-related health policy of oriental medicine.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7499-7503
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• 2014

Physical inactivity has reached epidemic levels in developed countries and is being recognized as a serious public health problem. Recent evidence shows a high percentages of individuals worldwide who are physically inactive, i.e. do not achieve the WHO's present recommendation of 150 minutes of moderate to vigorous intensity per week in addition to usual activities. Living in sedentary lifestyle is one of the leading causes of deaths and a high risk factor for several chronic diseases, like cancer, cardiovascular disease, diabetes type 2, and osteoporosis. This article summarizes evidence for relative risk of the civilization diseases attributable to physical inactivity and the most important conclusions available from the recent investigations computing the economic costs specific to physical inactivity. The findings provide health and economic arguments needed for people to understand the meaning of a sedentary lifestyle. This may be also useful for public health policy in the creation of programmes for prevention of physical inactivity.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4729-4733
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• 2016

Objectives: Lung cancer is a major public health problem and one of the most costly illnesses. The study aimed to estimate the economic burden of lung cancer in Iran in 2014. Methods: A cross-sectional study was conducted to estimate the direct and indirect costs for patients with lung cancer using a prevalence-based approach. A human capital approach was employed to estimate the indirect costs. Data were obtained from several sources such as through patient interview using structured questionnaire, medical records, the GLOBOCAN databases, the Iranian Statistical Center, the Iranian Ministry of Cooperation, Labor and Social Welfare, and the Institute for Health Metrics and Evaluation (IHME). Results: The economic burden of lung cancer in Iran in the year 2014 was 3,225,998,555,090 IR. The main components of the cost were associated with mortality (81.9 %) and hospitalization (7.6 %). The costs of direct medical care, non-medical aspects, patient time, and mortality accounted for 10.8%, 2.7%, 4.5%, and 81.5% of the total cost, respectively. Conclusion: Findings from this study indicated that the economic burden of lung cancer is substantial both to Iran's health system and to society as a whole. Early diagnosis, strengthening cancer prevention, implementing new cancer therapy and medical technology, and effective smoking-cessation interventions could offset some of the costs associated with lung cancer in Iran.

• Human Ecology Research
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• v.57 no.1
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• pp.143-157
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• 2019

This study analyzed per capita expenditure (food expenses, housing expenses, health care costs, and cultural & entertainment expenses) by the consumption quintile for middle and older elderly households in addition to personal characteristics, household characteristics and economic factors affecting it. A sample collected from the 6th KLoSHA in 2016, was 2,983 households. First, among each per capita expenditure, the largest expenditure was food expenses, followed by housing expenses, health care costs and cultural & entertainment expenses. Compared with the first quintile of personal consumption expenditure, the largest increase in the fifth quintile was food expenses, followed by cultural & entertainment expenses, housing expenses, and health care costs. Second, compared to the fifth quintile of per capita food expenses, all other quintile had negative effects, and only the first quintile showed a negative effect compared to the fifth quintile of per capita housing expenses. The first, the second, and third quintile had a negative effect compared to the fifth quintile of per capita health care costs. Compared with the fifth quintile of per capita cultural & entertainment expenses, only the third quintile showed a negative effect. Third, in all quintile of per capita food expenses, the most influential variable from the first quintile to the third quintile was marital status, while in the fourth and fifth quintile included household income. In all quintile of per capita health care costs, health status was the most influential variable from the first quintile to the fourth quintile, and residence was in the fifth quintile.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.51-58
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• 2024

Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.