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Cost-Effectiveness Analysis of Breast Cancer Screening in Rural Iran

  • Zehtab, Nooshin;Jafari, Mohammad;Barooni, Mohsen;Nakhaee, Nouzar;Goudarzi, Reza;Zadeh, Mohammad Hassan Larry
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.609-614
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    • 2016
  • Background: Although breast cancer is the most common cancer in women, economic evaluation of breast cancer screening is not fully addressed in developing countries. The main objective of the present study was to analyze the cost-effectiveness of breast cancer screening using mammography in 35-69 year old women in an Iranian setting. Materials and Methods: This was an economic evaluation study assessing the cost-effectiveness of a population-based screening program in 35-69 year old women residing in rural areas of South east Iran. The study was conducted from the perspective of policy-makers of insurance. The study population consisted of 35- to 69-year old women in rural areas of Kerman with a population of about 19,651 in 2013. The decision tree modeling and economic evaluation software were used for cost-effectiveness and sensitivity analyses of the interventions. Results: The total cost of the screening program was 7,067.69 US$ and the total effectiveness for screening and no-screening interventions was 0.06171 and 0.00864 disability adjusted life years averted, respectively. The average cost-effectiveness ratio DALY averted US$ for screening intervention was 7,7082.5 US$ per DALY averted and 589,027 US $ for no-screening intervention. The incremental cost-effectiveness ratio DALY averted was 6,264 US$ per DALY averted for screening intervention compared with no-screening intervention. Conclusions: Although the screening intervention is more cost-effective than the alternative (noscreening) strategy, it seems that including breast cancer screening program in health insurance package may not be recommended as long as the target group has a low participation rate.

Cost Analysis of Using a Closed-System Transfer Device (CSTD) for Antineoplastic Drug preparation in a Malaysian Government-Funded Hospital

  • Chan, Huan Keat;Lim, Yik Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4951-4957
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    • 2016
  • Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal(R) closed-system transfer device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic drugs was compiled. The amount of the materials used, including drugs, infusion bottles, the PhaSeal(R) CSTD and other consumables, was recorded on a daily basis for three months in 2015. The total cost was calculated based on the actual acquisition costs, and was compared with that of a hypothetical scenario, whereby conventional syringe-needle sets were used for the same amounts of preparations. Results: The use of the PhaSeal(R) CSTD incurred a cost of MYR 383,634.52 (USD 92,072.28) in three months, representing an average of MYR 170.5 (USD 40.92) per preparation or an estimated annual cost of MYR 1,534,538.08 (USD 368,289.14). Compared with conventional syringe-needle approach, it is estimated to lead to an additional spending of MYR 148,627.68 (USD 35,670.64) yearly. Conclusion: Although there was a reduction of drug wastage achieved by extending BUDs of unfinished vials using the PhaSeal(R) CSTD, cost saving was not observed, likely attributable to the wide use of lower-priced generic drugs in Malaysia. Future studies should further evaluate the possibility of cost saving, especially in health settings where branded and high-cost antineoplastic drugs are more commonly used.

A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus (제1형 당뇨병을 동반한 조현병 환자의 총 의료비용 및 입원 위험)

  • Lee, Sang-Uk;Kim, You-Seok
    • Korean Journal of Schizophrenia Research
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    • v.22 no.1
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    • pp.8-13
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    • 2019
  • Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

Water-Environment-Economic nexus analysis of household food waste impacts: A case study of Korean households

  • Adelodun, Bashir;Cho, Gun Ho;Kim, Sang Hyun;Odey, Golden;Choi, Kyung Sook
    • Proceedings of the Korea Water Resources Association Conference
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    • 2021.06a
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    • pp.148-149
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    • 2021
  • Food waste has increasingly become a global issue of concern among the researchers and policymakers due to its significant environmental and economic impacts, and other associated unsustainable use of resources, including water resources. While food wastage occurs at each stage of the supply chain with food loss at the upstream and food waste at the downstream, the impacts of food waste occurring at the consumption side are enormous due to the accumulated added values. In this study, the embedded water resources, greenhouse gas emissions, and economic loss of household food waste were investigated. The primary granular data of household food waste was collected through direct sampling from 218 selected households of the Buk-gu community in Daegu, South Korea from July 2019 to May 2020. The water footprint, which was based on the water footprint concept, i.e., indirect water use, and GHG emission potential factor for each of the food items were adopted from the literature, while the retail prices and disposal cost were used to assess the economic cost of wasted food items. The water footprint, GHG emission associated with environmental impacts, and the economic cost of 42 major identified wasted food items were conducted. The findings showed that an average of 0.73 ± 0.06 kg/household/day edible food waste was generated among the sampled households, with leafy vegetable, watermelon, and rice responsible for 10, 9, and 4%, respectively, of the total weight of the 42 food wasted items. The water footprint and environmental impact of the household food waste resulted in 0.46 ± 0.04 m3 and 0.71±0.05 kg CO2eq, respectively. Beef, pork, poultry, and rice accounted for 52, 9, 5, and 4% of the total water footprint, while beef, pork, rice, tofu/cheese had 52, 8, 6, and 6% of the total emissions, respectively, embedded in the food wasted. Furthermore, the average estimated economic cost associated with wasted food items was 3855.93±527.27 Korean won, with beef, fish, and leafy vegetable responsible for 21, 13, and 10%, respectively, of the total economic cost. A combined assessment using water-environmental-economic nexus indicated that animal-based food had the highest footprint impacts, with beef, pork, and poultry indicating high indices of 0.3, 0.08, and 0.06 respectively, on a scale of 0 to 1, compared to corn and lettuce with lowest impacts of 0.02. Other food items had moderate impact values ranging from 0.03 to 0.05. This study, therefore, provides insight into the enormity of environmental and economic implications of household food waste among Korean households.

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Analysis of the Korean Filatures Management (우리나라 제사공장의 경영분석)

  • 최병희;남중희
    • Journal of Sericultural and Entomological Science
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    • v.10
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    • pp.99-105
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    • 1969
  • The results of investigation and management analysis for the silk filatures in Korea until 1968 are evaluated as followings. (1) The average cocoon purchasing amount for a filature was found as 10,800kg and they are processed 105kg per man on the cocoon assorting process, 8,683kg per day during the drying process of which 42 percent are dried with low temperature drying system. (2) The average cocoon cooking capacity is 50 g, cocoon per minute, but the cooking capacity per man is smaller in case of larger factory. (3) The silk production capacity per month per a filature is 6,000kg and the amount gets smaller in case of larger factory. (4) The employee cost per one kg of raw silk production was found as high in smaller factory and it was found that 200~300 sets size was the optimum capacity for operation. (5) In case of multiends silk reeling machine, the employee cost for the silk reeling process acts as the most peculier factor among six different cocoon processes and it is reached to conclued to deduct the number of employees for this process in order to deduct the production cost. (6) The correlation coefficients between cost factors and total labour cost was found as 46 percent, therefore the rest (54%) will be the production cost other than labour cost.

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Fruit Quality Characteristics in Second Generation (F2) Hybrid Cultivar of Minipaprika (Capsicum annuum L.)

  • Luitel, Binod Prasad;Lee, Taek Jong;Oyuntugs, Tserendendev;Kang, Won Hee
    • Korean Journal of Breeding Science
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    • v.43 no.2
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    • pp.120-125
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    • 2011
  • A field experiment was conducted to examine the fruit quality characters in second generation ($F_2$) hybrid cultivar and to compare the fruit characters with original $F_1$ hybrid cultivar of minipaprika (yellow and orange type) at the Research Farm, Hwacheon in July, 2010. Fruit characters varied within $F_2$ population of each minipaprika type. In minipaprika yellow, fruit weight varied from 12.2 g to 50.8 g (average 28.5 g) and fruit length/width varied from 1.4 to 2.8 (average, 2.0). Pericarp thickness ranged from 1.8 mm to 4.1 mm (average, 2.9 mm). Total soluble solid (TSS) varied from $6.2^{\circ}Brix$ to $13.5^{\circ}Brix$ with an average of $8.7^{\circ}Brix$. Fruit volume varied from 10.3 cc to 46.7 cc with an average of 24.4 cc. In minipaprika orange type, fruit weight ranged from 19.7 g to 42.4 g (average, 29.0 g) and fruit length/width varied from 1.5 to 2.6 (average, 2.0). Pericarp thickness varied from 2.1 mm to 4.1 mm with an average of 3.0 mm. TSS varied from $5.0^{\circ}Brix$ to $12.2^{\circ}Brix$ (average, $7.9^{\circ}Brix$) and average fruit volume was 24.6 cc ranging from 10.7 cc to 35.0 cc. The average fruit quality characters in $F_2$ population in both yellow and orange minipaprika did not differ from their $F_1$ hybrid parent and $F_2$ seed can be an additional way to supply high yielding hybrid cultivars at lower cost to the minipaprika growers.

Study on Natural Wastewater Treatment Systems by Constructed Wetland for Rural Area (인공습지에 의한 농촌오수처리에 관한 연구)

  • 윤춘경;권순국;김형중
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.39 no.4
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    • pp.55-63
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    • 1997
  • Constructed wetland system which can be applied to the rural wastewater treatment system was examined by pilot plant in Kon-Kuk University. Hydraulic loading rate of wastewater was about 0.16m$^3$/m$^2$. day and theoretical detention time in the system was 1.38 days. The effluent of the septic tank for the school building was applied as inflow to the system. The influent concentration of DO was zero but effluent was up to 4.37mg/${\ell}$ which implies that oxygen was supplied enough from atmosphere by reaeration to support biological activity of the system. Average influent concentration of BOD was 104mg/${\ell}$ and effluent was 24mg/${\ell}$ with average removal rate of 76%. Average influent concentration of COD was 215mg/${\ell}$ and effluent was 63mg/${\ell}$ with average removal rate of 70 % . Average influent concentration of SS was 78mg/${\ell}$ and effluent was 10mg/${\ell}$ with average removal rate of 87%. Two components, BOD and SS, are regulated by law to keep maximum water quality standard of 80mg/${\ell}$ when daily outflow rate is less than 100$m^3$/day which is the case of most rural communities. Therefore, the results from the experiment showed that constructed wetland system can meet the water quality standard easily. Average influent concentration of total nitrogen was 165mg/lwhich is relatively higher than normal wastewater, and effluent was about 156mg/${\ell}$ with average removal rate of only 6%. Average influent concentration of total phosphorus was 41 mg/${\ell}$ and effluent was 6mg/${\ell}$ with average removal rate of 87%. Overall, constructed wetland system was thought to be effective to treat wastewater if nitrogen removal mechanism is improved. Considering low cost, less maintenance, and high treatability, this system can be a practical alternative for the wastewater treatment in rural area The experiment was performed during the summer and fall season, and treatment efficiency of the system is expected to decrease in low temperature. therefore, further study including temperature is required to evaluate feasibility of the system more in detail.

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BODY WEIGHT GAIN, FEED CONVERSION AND FEED COST OF KOREAN NATIVE GOATS FED CORN-MANURE SILAGES

  • Kim, J.H.;Ko, Y.D.
    • Asian-Australasian Journal of Animal Sciences
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    • v.8 no.5
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    • pp.427-431
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    • 1995
  • This study was carried out to investigatigate feed cost of com-manure silage and growth performance of Korean native goats which was fed com-manure silage. The average weight about 11.6 kg of twenty one Korean native male goats (4 months used to determine the effect of the feeding trial. The goats were individually reared in metabolism cages and fed diet daily of 2% of the body weight on the dry matter basis. The treatments were divided into whole crop com silage(CS silage), whole crop com ensiled with cage layer manure (CLM; Com-manure silage or MS silage) and whole crop com silage supplemented with urea at feeding time (US silage). The content of crude protein, lactic acid and the ratio of ammonia nitrogen to total nitrogen ($NH_3-N/Total$ N) in MS silage were increased from 7.7 to 14.9%, 5.7 to 7.5% and 8.2 to 16.6%, and the differences were significantly (p < 0.05) different in all observations. Total body weight gain of those goats for 90 days was 6.0 kg (66.7 g/day; MS silage 4.3 kg (47.8 g/day; US silage) and 3.9 kg (43.4 g/day; CS silage), and feed conversion of MS silage (5.98) for 90 days was increased by far the best in the other groups and decreased about 30% in proportion to CS silage. Feed cost per 1 kg MS silage (1,606 won) was the lowest (p < 0.05) in the body weight gain and cut down expenses than fed CS silage by 37% of feed cost.

A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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The Study on the total direct cost of years of cerebrovascular disease (뇌혈관질환자의 년간 총직접비용에 대한 연구)

  • Yoo, In Sook
    • The Journal of the Convergence on Culture Technology
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    • v.3 no.2
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    • pp.21-30
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    • 2017
  • This study investigated the total annual direct cost of cerebrovascular disease patients. For this study, 265 respondents who answered that they used more than one emergency, inpatient, and outpatient services for cerebrovascular disease during the year of 2012 among Korean medical panel investigators in 2012 were included. In general, patients with cerebrovascular disease responded to cerebrovascular disease among Korean medical panel respondents in 2012. Percentage of respondents using inpatient and outpatient services. Total direct cost was calculated. According to the results of the study, the per capita annual medical expenditure per person is about 561,934 won, 669,557 won for men and 448,696 won for women. In the case of health insurance subscribers, the per capita self burden due to cerebrovascular disease averaged 634,459 won and the medical benefit recipients 160,236 won. The average total direct cost of 265 people with cerebrovascular disease is about 162,165,690, 193,223,955 won for men and 129,486,685 for women. The total direct cost per person due to cerebrovascular disease was 183,095,125 won and the medical benefit recipient was 46,241,705 won. According to household income, the highest rate of 672,268 won in the third income group of the household income, and 108,970,650 won in the fifth income group, the lowest total direct cost of the patients with cerebrovascular disease.