• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.278-287
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• 2010

The main objective of this study is to evaluate the cost-effectiveness of tafluprost compared with latanoprost in primry open Angle Glaucoma (POAG) or ocular hypertension OH patients in Korea. A decision analytic model was developed from a societal perspective to estimate clinical outcome, drug cost and glaucoma related cost. The model assumes branch like following: successful treatment, switching to other drug, adding other drug, laser or surgery. Treatment success rate is defined as the percentage of patients with elevated IOP achieving <20% reduction, and discontinuation rate is the percentage of patients who were withdrawn due to severe adverse events. A model that is comprised of 1 month cycle length has 1 year. Treatment success rate and discontinuation rate were obtained from published literatures searched in database. Resource utilizations and costs were calculated with national health insurance data and clinical expert opinions. Sensitivity analyses were performed on crucial parameters. Tafluprost is less costly than latanoprost, $609.0 vs $651.2 expected cost. Thus tafluprost was shown to be dominant compared with latanoprost. The results of sensitivity analysis revealed stable across most of the included parameters. According to this study, tafluprost shows more clinical outcome for 1 year than latanoprost. In addition, first-line treatment of tafluprost is a more cost-minimizing strategy associated with POAG or OH compared with latanoprost.

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.64-80
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• 2003

The separation policy of prescription and drug dispensing which has been implemented since the 1st of July, 2000, has brought about great changes in patients flow within the healthcare delivery system. The changes in the patients flow, in turn, resulted in the change in the distribution of financial resources among the participating entities in the healthcare delivery system: pharmacies, clinics, small hospitals, general hospitals, and teaching hospitals. The purpose of this study is to shed some light in the change in the financial performance of teaching hospitals under the separation policy that has created environmental changes such as the decrease in the number of out patients visits, the increase in the capital expenditures, the rapid increase in labor costs and so on. For the purpose, this study has compared and analyzed the balance sheets, the income statements and other operational data of three teaching hospitals located in D area. The data include two periods: before(year 1999) and after(year 2001) the implementation of the separation policy. The analysis was conducted with an emphasis on the changes in the financial ratios such as liquidity, turnover ratio, performance ratio. and capitalization ratio. The results show that the financial performances of the hospitals under study were weaker than before the implementation of the separation policy, and that, while the operating expenses have increased remarkably, there was no tendency to corresponding increase in revenue. And the result of analysis of other operational indicators also show that the performance of the hospitals is getting worse. Based on the results, this study has suggested the directions of the healthcare policies. This study suggests to improve the current model of separation of prescription and drug dispensing, to grant subsidies for the training of residents in teaching hospitals, and to lower the rate of patients' out of porket payment in teaching hospitals.

• Journal of Families and Better Life
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• v.27 no.1
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• pp.61-71
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• 2009

The purpose of this study was to resolve the issues of inferior housing environment and the population decrease in rural community by improving the environment and attracting urban inhabitants. A simulation on the costs and the local programs was operated from a point of view that Pension Insurance House with Long-term Lease and a plan for the program in connection with local resources should be accompanied to attract urban inhabitants. The study was carried out through mainly documents analysis and specialists' opinions. The simulation results are as follows. Firstly, the pre-existing rural housing development projects have only emphasized the hardware, while underestimated the post-management with operating programs. The software should be underlined when Pension Insurance House is developed. Secondly, as a result of the simulation on construction expenditure and the operating and maintenance cost for 30 years, about 82.3 million Wons are necessary residential expenses for 15 years per unit. Thirdly, in case of MUJU County, it has made the most of its pre-existing institutions. It's medical institutions provide medical care system with health education, facilities related leisure and culture offer recreational programs and the local community center and its program of each town helps new habitants adopt to the rural life. Additionally, the employment project of a local welfare center allow people living in a rural community to continue their careers with their talents and interests through local class programs for a life worth living. Lastly, guide for getting information of rural life, local community gathering and preliminary education should be carried out to reduce expectant tenants' incompatibility and assist them settle down early. The community program expansion is also required at the local government level.

• Journal of the Ergonomics Society of Korea
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• v.33 no.5
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• pp.313-321
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• 2014

Objective: The purpose of this study is to develop products that prevent muscular skeletal disease of farm workers, which would bring improvement for an efficient harvesting work. Background: A pretest for product development and a survey research was carried out to inspect the problems of current harvesting work procedure. The product was developed and assessed based on ideas to supplement and improve these weak points. Method: A total of twenty men were recruited to evaluate the effects of harvest baskets on the upper-limb muscle activity, working hours. For the usability evaluation, electromyogram and working hours of previous working method (disuse of harvest basket, one-hand carriage of the basket) and new working method with the usage of newly-developed harvest basket was examined. The whole anterior deltoid, biceps brachii and erector spinae on both sides, which make a total of six muscle parts, were used for this experiment. The results were analyzed using ANOVA with muscle activity (%MVC) of each three forms of work and required work time from SPSS 18.0. Results: According to the test result, all muscles did not demonstrate any statistically significant difference, with an exception of the backbone erector (right). The muscle activity of backbone erector (right) in the work method that uses the harvest basket developed in this study was detected to be approximately 23% less than that of the previous working method. Moreover, compared to the previous working method, the required work time decreased to a statistically significant degree. Conclusion: As such, the decrease in the amount of waist muscle usage at harvesting work would enable the prevention of muscular skeletal disease and stabilization of lumbar spine. Application: Which in turn would increase the effectiveness and reduce personnel expense (labor costs) while enhancing productivity with a decreased working hours.

• Journal of the Korean Dietetic Association
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• v.4 no.2
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• pp.225-234
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• 1998

Nutrition during childhood is essential for growth and maintenance of health. Good food habits developed during the childhood will contribute both to the healthy growth and the prevention of the degenerative disease of later life. Both parents and the providers in child care centers play an important role for children's good eating behavior. Therefore all child care programs should achieve recommended standards for meeting children's nutritional and educational needs in a safe, sanitary, and supportive environment to promote the healthy growth and development of children. The purposes of this study were to evaluate the foodservice management practices and assess the needs for a Central Production Unit by contacting the child care center' providers. This approach was achieved using a variety of qualitative and quantitative information including the general foodservice management practices and the needs for a Central Production Unit. An indepth face-to-face interview with structured-questionnaires was undertaken at 32 representative child-care centers in Seoul. Statistical data analysis was done using the SAS program for descriptive analysis and ANOVA. The number of national/public and private sectors were 11 respectively, followed by 10 licensed home day-care centers. Total average number of children in child-care centers was 54.3 $\pm$48.5. The foodservice productivity index in child-care centers was 4.8 minutes per meal for public child care centers, 6.0 for private child-care centers, and 9.8 for home child care centers. Home child care centers were found to have the lowest productivity index which indicated inefficient foodservice practice. The important factors in group purchasing were menus(39.6%) or close distance(39.6%) > type of foodservice operation(32.8%) > total number of meals(19.9%) > food costs(16.2%) in order. Average score of the efficiency for central food production in child-care centers was 3.80 $\pm$0.84 out of 5.

• Physical Therapy Korea
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• v.21 no.3
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• pp.80-88
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• 2014

Previous studies have reported that decreased cognitive ability has been consistently associated with significant declines in performance of one or both tasks under a dual-task walking condition. This study examined the relationship between specific cognitive abilities and the dual-task costs (DTCs) of spatio-temporal gait parameters in stroke patients. The spatio-temporal gait parameters were measured among 30 stroke patients while walking with and without a cognitive task (Stroop Word-Color Task) at the study participant's preferred walking speed. Cognitive abilities were measured using Computerized Neuropsychological Testing. Pearson's correlation coefficients (r) were calculated to quantify the associations between the neuropsychological measures and the DTCs in the spatio-temporal gait parameters. Moderate to strong correlations were found between the Auditory Continuous Performance test (ACPT) and the DTCs of the Single Support Time of Non-paretic (r=.37), the Trail Making A (TMA) test and the DTCs of Velocity (r=.71), TMA test and the DTCs of the Step Length of Paretic (r=.37), TMA test and the DTCs of the Step Length Non-paretic (r=.36), the Trail Making B (TMB) test and the DTCs of Velocity (r=.70), the Stroop Word-Color test and the DTCs of Velocity (r=-.40), Visual-span Backward (V-span B) test and the DTCs of Velocity (r=-.41), V-span B test and the DTCs of the Double Support Time of Non-paretic (r=.38), Digit-span Forward test and the DTCs of the Step Time of Non-paretic (r=-.39), and Digit-span Backward test and the DTCs of the Single Support Time of Paretic (r=.36). Especially TMA test and TMB test were found to be more strongly correlated to the DTCs of gait velocity than the other correlations. Understanding these cognitive features will provide guidance for identifying dual- task walking ability.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.1-9
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• 2018

Polypharmacy is increasing owing to an increase in the elderly population and multimorbidities associated with the increased risk of administration of potentially inappropriate medications (PIMs). The negative effects of polypharmacy on various health conditions and aspects, such as fall, fracture, mortality, cognitive function, and dementia, have been reported. The management of excess and inappropriate polypharmacy through proper interventions and local or national guidelines has been highlighted. The purpose of polypharmacy management is to appropriately prescribe medicines that are essential to treat diseases in patients and to avoid inappropriate polypharmacy, such as interactive or duplicate medicines under prescription and PIMs for specific diseases. Community pharmacists in Australia, the EU, USA, and Japan are collaborating with prescribers to review medications to ensure that the patients can be prescribed appropriate medications. The service cost is reimbursed by public or private insurers. A study in the United States has shown that even with medication review costs, the overall medication cost has reduced. In Korea, various projects such as Drug Utilization Review service and safe use of medicines have been conducted; however, no national guidelines or management measures have been established. It is necessary to implement a national long-term plan on polypharmacy management. Furthermore, a phased implementation plan is required. Shortly, active medication review services and education programs for healthcare professionals with the support of the government should be considered in Korea with reference to other countries in order to raise awareness of seriousness and risks of inappropriate polypharmacy.

• Journal of Forest and Environmental Science
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• v.24 no.3
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• pp.127-135
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• 2008

The mission of the Forest Inventory and Analyis (FIA) program of the Forest Service, U.S. Department of Agriculture, is to conduct the national forest inventory of the United States of America for purposes of estimating the area of forest land; the volume, growth, and removal of forest resources; and the health of the forest. Users of FIA data, estimates, and related products include land managers, policy and decision-makers, forest industry, environmental organizations, and university researchers. To accomplish its mission, the FIA program has established a sampling design with an intensity of approximately one permanent plot per 2,400 ha across the entire country. Depending on the region of the country, each plot is remeasured at intervals of five or 10 years. The program releases data annually and reports estimates at the county level for each state every five years. Due to budgetary constraints and natural variability among plot observations, sufficient numbers of plots cannot be measured to satisfy precision guidelines for the estimates of many variables unless the estimation process is enhanced using ancillary data. Classified satellite imagery has been demonstrated to be a source of ancillary data that can be used with stratified estimation techniques to increase the precision of estimates with little corresponding increase in costs. A crucial factor restricting the utility of FIA data is that the exact locations of inventory plots cannot be released to the public. Thus, users are generally not able to obtain estimates for small areas or for their own areas of interest if exact plot locations are required. To compensate, satellite imagery, inventory plot data, and the k-Nearest Neighbors technique are being used to construct Internet-based maps of forest attributes from which estimates for arbitrary user-defined areas of interest may be obtained.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.245-252
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• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.9015-9019
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• 2014

The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.