• Title/Summary/Keyword: hospital economics

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A Cost-Utility Analysis of Home Care Services by using the QALY (QALY를 이용한 가정간호서비스의 비용효용분석)

  • 임지영
    • Journal of Korean Academy of Nursing
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    • v.34 no.3
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    • pp.449-457
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    • 2004
  • Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.

Difference of Caring Needs According to Caring Experience of the Elderly with Dementia and Caring Situation (치매노인 부양경험 유무에 따른 부양요구의 차이와 치매노인 부앵실태)

  • 최정신;권오정;김대년
    • Journal of the Korean Home Economics Association
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    • v.40 no.5
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    • pp.195-210
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    • 2002
  • The purpose of this study were to find out the difference of needs of caring between care-givers and non care-givers, and to suggest the way of lessening vigorous task of care-givers for the elderly with dementia. Data were collected from 130 nationwide respondents intentionally divided into two groups; care-givers and non care-givers in the middle aged with middle and upper income. Collected data were analyzed by frequency, percentage, t-test using SPSS package. Since the result of survey, unexpectedly, showed no difference between two groups, it could be explained as that these two groups commonly had same needs of caring for the elderly with dementia. Major findings were as follow; 1) Most Koreans stiff thought family should be the main care-giver for the elderly with dementia prior to nation or society. 2) Responsibility of caring for the elderly with dementia would be better to be shared with children instead of focusing to a child. 3) They thought ideal residential facilities for the elderly with dementia were small-scale professional dementia facility(group home) rather than home or general elderly housing. 4) Professional dementia care hospital was one of the most needed facilities for the elderly with dementia, followed by short-stay and dar-care center. 5) It was revealed care-giving task was vigorous showing that most care-givers spent 1-5 hours a day for caring, while 13% of respondents spent 11-24 hours a duty. 6) 90% of care-givers took the responsibility of main care-giver because of duty of offsprings or spouses, and wanted to be free from their current circumstances. From the result of this survey researchers would like to suggest the establishment of diverse facilities for professional dementia care to lessen the caring burden for the elderly with dementia: group home, chronic hospital, short-stay, day-care center. Financial support from the government for the housing renovation of the caring families should be considered seriously afterward. It is needed to give the opportunity to select proper paid dementia care facilities according to their income and situation of household.

An Economic Evaluation of Thread Embedding Acupuncture for the Treatment of Lumbar Herniated Intervertebral Disc in a Randomized Controlled Clinical Trial

  • Kim, Ha-Na;Kim, Jun-Yeon;Park, Kyeong-Ju;Hwang, Ji-Min;Jang, Jun-Yeong;Jo, Min-Gi;Ko, Min-Jung;Chae, Sang-Yeup;Kim, Jung-Hyun;Goo, Bonhyuk;Park, Yeon-Cheol;Seo, Byung-Kwan;Baek, Yong-Hyeon;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.312-319
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    • 2021
  • Background: Lumbar herniated intervertebral disc (LHIVD) is a frequently presented condition/disease in Korean medical institutions. In this study, the economics of thread embedding acupuncture (TEA) was evaluated in a randomized controlled trial comparing TEA with sham TEA (STEA). Methods: This economic evaluation was analyzed from a limited social perspective, and the per-protocol set was from a basic analysis perspective. The cost-effectiveness analysis was based on the change in visual analog scale score, and the cost-utility analysis was based on the quality-adjusted life years. The final results were expressed as the average cost-effectiveness ratio and incremental cost-effectiveness ratio, and furthermore sensitivity analysis was performed to confirm the robustness of the results observed. Results: The cost-effectiveness analysis showed that TEA was 9,908 won lower than STEA, while the decrease in 100 mm visual analog scale score was 8.5 mm greater in the TEA group compared with the STEA group (p > 0.05). The cost-utility analysis showed that TEA was 9,908 won lower than STEA, while the quality-adjusted life years of TEA was 0.0026 years higher than STEA (p > 0.05). These results were robust in the sensitivity analysis, but were not statistically significant. Conclusion: In treating LHIVD, TEA appeared to have cost-effectiveness and cost-utility compared with STEA. However, there were no significant differences between the groups in terms of cost, effectiveness, and utility indicators. Therefore, results must be interpreted prudently; this study was the 1st to conduct an economic evaluation of TEA for LHIVD.

Construction of a Novel Mitochondria-Associated Gene Model for Assessing ESCC Immune Microenvironment and Predicting Survival

  • Xiu Wang;Zhenhu Zhang;Yamin Shi;Wenjuan Zhang;Chongyi Su;Dong Wang
    • Journal of Microbiology and Biotechnology
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    • v.34 no.5
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    • pp.1164-1177
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    • 2024
  • Esophageal squamous cell carcinoma (ESCC) is among the most common malignant tumors of the digestive tract, with the sixth highest fatality rate worldwide. The ESCC-related dataset, GSE20347, was downloaded from the Gene Expression Omnibus (GEO) database, and weighted gene co-expression network analysis was performed to identify genes that are highly correlated with ESCC. A total of 91 transcriptome expression profiles and their corresponding clinical information were obtained from The Cancer Genome Atlas database. A mitochondria-associated risk (MAR) model was constructed using the least absolute shrinkage and selection operator Cox regression analysis and validated using GSE161533. The tumor microenvironment and drug sensitivity were explored using the MAR model. Finally, in vitro experiments were performed to analyze the effects of hub genes on the proliferation and invasion abilities of ESCC cells. To confirm the predictive ability of the MAR model, we constructed a prognostic model and assessed its predictive accuracy. The MAR model revealed substantial differences in immune infiltration and tumor microenvironment characteristics between high- and low-risk populations and a substantial correlation between the risk scores and some common immunological checkpoints. AZD1332 and AZD7762 were more effective for patients in the low-risk group, whereas Entinostat, Nilotinib, Ruxolutinib, and Wnt.c59 were more effective for patients in the high-risk group. Knockdown of TYMS significantly inhibited the proliferation and invasive ability of ESCC cells in vitro. Overall, our MAR model provides stable and reliable results and may be used as a prognostic biomarker for personalized treatment of patients with ESCC.

The Analysis of a Causal Relationship of Hospital's Culture Marketing on Customer Emotional Response and Satisfaction

  • Kim, Kyung-A;Kang, Hyung-Chul;Cho, Young-Hun;Won, Jun-Yeon
    • East Asian Journal of Business Economics (EAJBE)
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    • v.4 no.3
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    • pp.1-17
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    • 2016
  • Businesses are using culture marketing as a new promotional tool and as a marketing strategy since consumers have desire for not only economical fulfilment, but also emotional and psychological fulfilment. Similar to service industry, medical service industry has started to use culture marketing on its service industry management side. Therefore, this paper will propose necessity and usable culture marketing in hospitals to identify the current position of culture marketing in medical service industry. In conclusion, the present research offers the following implication. First, culture marketing has a partial offsetting impact to those who have negative emotion regarding the medical service industry. This is because of the positive impact of culture marketing on a customer response and customer satisfaction. Moreover, by considering the fact that only a culture synthesis and a culture style have a positive impact, focusing on a culture synthesis and a culture style would be treated as an advantageous strategy.

A Study on the Development and Effectiveness Verification of a Program Designed to Strengthen Family Resilience of Inpatients with Cancer and Their Families (암환자와 그 가족의 가족레질리언스 강화 프로그램 개발과 효과성 검증)

  • Yang, Moo-Hee;Yoon, Gyung-Ja
    • Journal of the Korean Home Economics Association
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    • v.50 no.1
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    • pp.121-139
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    • 2012
  • This study aims to develop a program for enhancing family resilience in cancer patients along with their family members and verify its effectiveness. The subjects were inpatients with cancer and their families, totaling 46 subjects at an university hospital in Busan. They were divided into two groups, the participating group who were in an experiment and the control group who were not taking part in the experiment. Then family resilience was measured before and after completing the program sessions. The program was conducted once a week, 4 times, for two hours. The participating group of family resilience strengthening program showed higher family resilience compared with that of the control group. The results suggest that family resilience can be enhanced through adversity. It also verifies that family resilience of family members with cancer patients can be strengthened by expressing emotion, conveying deep affection, and sufficiently supporting one another through the family resilience strengthening approach.

How to Develop Future Internet Medical Care?: A Case Study of China

  • SHEN, Sha-Sha;XIAO, Shu-Feng
    • East Asian Journal of Business Economics (EAJBE)
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    • v.10 no.4
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    • pp.65-74
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    • 2022
  • Purpose - With the increasing medical demands of the public, the development of future Internet medical care has come to represent a major problem. Therefore, the purpose of this study is to discuss future development strategies for Interne medical care while taking China's Internet hospitals as an example case. Research design, data, and methodology - This study conducted a case study of China's Internet hospitals to summarize the fundamental problems faced by Internet hospitals and propose future development strategies to overcome these problems for Internet medical care. Result - Although Internet hospitals have been regarded as the ultimate product of Internet medical care, from the perspective of the government, medical institutions, platforms builders and maintainers, and patients, they still face some basic issues. Conclusion - This study concludes that the government and medical institutions play an important role in the future development of Internet medical care and suggests that the government should make overall plans for the policies and standards and should play the main role in enhancing the public trust in Internet medical care, while medical institutions should take steps such as seizing policy opportunities, driving online and offline collaborations, and constructing suitable evaluation systems to promote the development of Internet medical care.

Risk Factors and Diet Therapy for Atherosclerosis -Emphasis on quality (P/S ratio) of fat- (동맥경화증과 관련된 대사장애와 예방 및 치료식이 -지방(脂防) (P/S 비율)을 중심(中心)으로-)

  • Lee, Ki-Yull;Ahn, Hong-Seok;Leekim, Yang-Cha
    • Journal of Nutrition and Health
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    • v.12 no.3
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    • pp.9-23
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    • 1979
  • The known risk factors for atherosclerosis include plasma low density lipoproteins (LDL)or Cholesterol, low PUFA in the diet, hypertension, and high Na intake, obesity, diabetes, lack of exercise, cigarette smoking, sugar, low fiber and nicotinic acid in the diet, sources of Protein foods, and Psychological factors. Among various dietary factors, fat is known as the most serious causative agent for atherosclerosis. The genetic factor is a18o known as an important one but is out of scope in this paper. Since atherosclerosis is a progressive disease which may develop for many years before showing any definitive symptoms, it is very important to develop preventive programs especially in the country like Korea that is not quite overdevelopted as some western countries. In this paper all the factors mentioned above were reviewed and the dietary suggestion were made on the basis of the content of polyunsaturated and saturated fat in the diet to prevent or/and to cure this disease. Most of the available data on diet therapy with emphasis. on P/S ratio were tabulated together. after tile patient's habitual dietary intake is analized the guidelines of personalized fat-controlled diet can be recommended. It is of utmost importance to develop Korean diets for beth prevention and cure of atherosclerosis emphasizing individual eating habit in the near future which can be more Practicaly used both at home and in the hospital.

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Economic Burden of Chronic Obstructive Pulmonary Disease: A Systematic Review

  • Hai Quang Pham;Kiet Huy Tuan Pham;Giang Hai Ha;Tin Trung Pham;Hien Thi Nguyen;Trang Huyen Thi Nguyen;Jin-Kyoung Oh
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.234-251
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    • 2024
  • Globally, providing evidence on the economic burden of chronic obstructive pulmonary disease (COPD) is becoming essential as it assists the health authorities to efficiently allocate resources. This study aimed to summarize the literature on economic burden evidence for COPD from 1990 to 2019. This study examined the economic burden of COPD through a systematic review of studies from 1990 to 2019. A search was done in online databases, including Web of Science, PubMed/Medline, Scopus, and the Cochrane Library. After screening 12,734 studies, 43 articles that met the inclusion criteria were identified. General study information and data on direct, indirect, and intangible costs were extracted and converted to 2018 international dollars (Int$). Findings revealed that the total direct costs ranged from Int$ 52.08 (India) to Int$ 13,776.33 (Canada) across 16 studies, with drug costs rannging from Int$ 70.07 (Vietnam) to Int$ 8,706.9 (China) in 11 studies. Eight studies explored indirect costs, while one highlighted caregivers' direct costs at approximately Int$ 1,207.8 (Greece). This study underscores the limited research on COPD caregivers' economic burdens, particularly in developing countries, emphasizing the importance of increased research support, particularly in high-resource settings. This study provides information about the demographics and economic burden of COPD from 1990 to 2019. More strategies to reduce the frequency of hospital admissions and acute care services should be implemented to improve the quality of COPD patients' lives and reduce the disease's rising economic burden.

Prognostic Role of Hepatoma-derived Growth Factor in Solid Tumors of Eastern Asia: a Systematic Review and Meta-Analysis

  • Bao, Ci-Hang;Liu, Kun;Wang, Xin-Tong;Ma, Wei;Wang, Jian-Bo;Wang, Cong;Jia, Yi-Bin;Wang, Na-Na;Tan, Bing-Xu;Song, Qing-Xu;Cheng, Yu-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1803-1811
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    • 2015
  • Hepatoma-derived growth factor (HDGF) is a novel jack-of-all-trades in cancer. Here we quantify the prognostic impact of this biomarker and assess how consistent is its expression in solid tumors. A comprehensive search strategy was used to search relevant literature updated on October 3, 2014 in PubMed, EMBASE and WEB of Science. Correlations between HDGF expression and clinicopathological features or cancer prognosis was analyzed. All pooled HRs or ORs were derived from random-effects models. Twenty-six studies, primarily in Eastern Asia, covering 2,803 patients were included in the analysis, all of them published during the past decade. We found that HDGF overexpression was significantly associated with overall survival (OS) ($HR_{OS}=2.35$, 95%CI=2.04-2.71, p<0.001) and disease free survival (DFS) ($HR_{DFS}=2.25$, 95%CI =1.81-2.79, p<0.001) in solid tumors, especially in non-small cell lung cancer, hepatocellular carcinoma and cholangiocarcinoma (CCA). Moreover, multivariate survival analysis showed that HDGF overexpression was an independent predictor of poor prognosis ($HR_{OS}=2.41$, 95%CI: 2.02-2.81, p<0.001; $HR_{DFS}=2.39$, 95%CI: 1.77-3.24, p<0.001). In addition, HDGF overexpression was significantly associated with tumor category (T3-4 versus T1-2, OR=2.12, 95%CI: 1.17-3.83, p=0.013) and lymph node status (N+ versus N-, OR=2.37, 95%CI: 1.31-4.29, p=0.03) in CCA. This study provides a comprehensive examination of the literature available on the association of HDGF overexpression with OS, DFS and some clinicopathological features in solid tumors. Meta-analysis results provide evidence that HDGF may be a new indicator of poor cancer prognosis. Considering the limitations of the eligible studies, other large-scale prospective trials must be conducted to clarify the prognostic value of HDGF in predicting cancer survival.