• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5133-5136
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• 2014

Objective: To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. Materials and Methods: The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. Results: Results from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. Results from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. Conclusions: The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.

• Gut and Liver
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• 제12권6호
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• pp.648-654
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• 2018

Background/Aims: Dual priming oligonucleotide-based multiplex polymerase chain reaction (DPO-based PCR) can detect the presence of clarithromycin resistance without culture. The aim of this study was to investigate the cost-effectiveness of DPO-based PCR for Helicobacter pylori eradication. Methods: From 2015 to 2016, medical records of patients who received H. pylori eradication therapy were analyzed. Patients were divided into two groups: tailored group patients who were treated based on DPO-based PCR and empirical group patients. Eradication rate and medical cost, including diagnostic tests, eradication regimens, and $^{13}C$-urea breath tests, were compared between the two groups. Cost for one successful eradication was calculated in each group. The expected cost of eradication for empirical treatment was investigated by varying the treatment duration and eradication rate. Results: A total of 527 patients were analyzed (tailored group 208, empirical group 319). The eradication success rate of the first-line therapy was higher in the tailored group compared to that in the empirical group (91.8% vs 72.1%, p<0.01). The total medical cost for each group was $114.8{\pm}14.1U.S.$ dollars (USD) and $85.8{\pm}24.4USD$, respectively (p<0.01). The total medical costs for each ultimately successful eradication in the tailored group and in the empirical group were 120.0 USD and 92.4 USD, respectively. The economic modeling expected cost of a successful eradication after a 7- or 14-day empirical treatment was 93.8 to 111.4 USD and 126.3 to 149.9 USD, respectively. Conclusions: Based on economic modeling, the cost for a successful eradication using DPO-based PCR would be similar or superior to the expected cost of a successful eradication with a 14-day empirical treatment when the first-line eradication rate is ${\leq}80%$.

• 한국물환경학회지
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• 제23권6호
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• pp.850-862
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• 2007

This study was carried out to survey the actual conditions of wastewater treatment facilities to obtain basic data for the management of wastewater from industrial complexes in Chungcheongnam-do province. Wastewater production flow per site area by watersheds was $49.2m^3/km^2/d$ for Sapgyoho, $8.1m^3/km^2/d$ for Anseongcheon, $5.7m^3/km^2/d$ for Seohae, and $2.9m^3/km^2/d$ for Geumgang. Sapgyoho showed 75% of the total production flow, which was the highest value, Geumgang showed 4% of total flow, which was the lowest value. Average total extra rate as production flow/capacity flow in the wastewater treatment facilities for industrial complex is 49%. Considering by watersheds, the extra rates of Seohae, Geumgang, Anseongcheon, and Sapgyoho, are 73%, 65%, 62%, and 33% respectively. This means that the design of capacity flow in wastewater treatment facilities was too large. Effluent concentration of wastewater treatment facilities did not exceed discharge limit mostly. The removal efficiency rate for water quality item was 90% in BOD, 70% in COD, 80% in SS, 30 to 80% in TN, and 20 to 90% in TP, so the organic removal was good, but the nutrient removal was low and interval of variation was high. The removal efficiency rate of the agricultural was industrial complexes is lower than the national and local complexes. The construction cost of the wastewater treatment facilities in Chungcheongnam-do was $1,756Won\;per\;m^3$, treatment cost was $189Won\;per\;m^3$, and they were about two times and 1.2 times higher than the nation-wide cost, respectively. The treatment cost consists of 39% for man power, 21% for chemical, 16% for power, 11% for sludge treatment, and 13% for others.

• 상하수도학회지
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• 제27권5호
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• pp.555-560
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• 2013

A cost analysis method for pretreament processes of a large scale seawater desalination plant was considered using a cost estimation model, WaTER (Water Treatment Estimation Routine). This model is based on cost functions of U.S. EPA to conduct economic analysis of water treatment facilities. A virtual seawater desalination plant which has pretreatment production capacity of $100,000m^3$ per day was chosen as a model plant. Dual media filtration and microfiltration systems were compared as pretreatment process, and the following reverse osmosis process was modeled. As a result, microfiltration showed a price competitiveness in condition of operating with reverse osmosis process by reducing the loads of water treatment and membrane cleaning despite it's high annual cost.

• Journal of applied mathematics & informatics
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• 제39권5_6호
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• pp.895-918
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• 2021

Human African Trypanosomiasis (HAT) also known as sleeping sickness, is a neglected tropical vector borne disease caused by trypanosome protozoa transmitted by bites of infected tsetse fly. The basic reproduction number, R₀ derived using the next generation matrix method which shows that the disease persists in the population if the value of R₀ > 1. The numerical simulations of optimal control model carried out to determine the control strategy that can combat HAT under the minimum cost. The results indicate that, the use of both education campaign, treatment and insecticides are more efficient and effective to eliminate HAT in African community but too costly. Furthermore, the cost-effectiveness of the control measures (education campaign, treatment and insecticides) were determined using incremental cost-effectiveness ratio (ICER) approach and the results show that, the use of education and treatment of infected people as the best cost effective strategy compared to other strategies.

• 한국물환경학회지
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• 제25권4호
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• pp.553-559
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• 2009

Currently, small scale sewage works are getting increase in Chung Nam Province and it is strongly required for those plants to get the information of optimized procedures and technologies. Most processes for sewage works in Korea were designed for large scale plants, so many difficulties are observed in small scale sewage works. This study was conducted to evaluate the propriety of O&M and construction cost for sewage treatment plants in Chung Nam Province. The treatment results and process stability of 32 public sewage treatment plants were also investigated. It is expected to provide optimum O&M and construction cost for future small scale sewage works and improving projects of existing plants by these results. Pollution problems caused by small scale plants are usually restricted to small areas; however, in view of the high cost per unit population, treatment requirements and alternatives have to be studied carefully. In comparison to larger plants, more pronounced and different boundary conditions such as unstable influent load, per capita costs and a large variety of feasible treatment and disposal systems were considered.

• 한국물환경학회지
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• 제26권4호
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• pp.557-565
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• 2010

Recently, regulations on toxic compounds in aquatic environment have been strengthened in korea due to the increasing public awareness of the water quality. Typically, these regulations include introduction of emerging toxic compounds and stricter effluent limitations for the already regulated compounds. However, too strict regulations may cause excessive burden on the industry. Therefore it is also important to assess the economic impacts when the new effluent limitation guidelines are introduced. The estimation of the additional cost for the wastewater dischargers to meet the new guidelines are based on the selected treatment technology to handle the hazardous substances and the regulatory levels for effluent limitations. To explore the procedures for cost estimation in enforcing new effluent limitations, a case study was performed specially for 1,4-dichlorobenzene. The pollutants of concern are surveyed for different industrial categories and various treatment technologies. For a given pollutant, the general performances of the treatment technologies are surveyed and a representative technology is selected. For a given technology, the capital cost and annual Operation and Maintenance (O&M) cost was calculated. The calculation of baseline costs to operate ordinary treatment technologies is also important. The ratio between the cost for introducing new treatment process and the baseline cost required for conventional technology was used to evaluate the economic impact on the industry. For 1,4-dichlorobenzene, steam stripping and activated carbon processes were selected as the specific treatment technologies. The cost effects to the regulation of the compound were found to be 6.4% and 14.5% increase in capital cost and O&M cost, respectively, at the flow rate over $2,000m^3/d$ for the categories of synthetic resin and other plastics manufacturing industry. For the case of petrochemical basic compounds manufacturing industry, the cost increases were 5.8% and 12.4%, respectively. It was suggested that cost effect analysis to evaluate the economic impacts of new effluent limitations on the industry is crucial to establish more balanced and reasonable effluent limitations to manage the industrial wastewater containing emerging toxic compounds in the wastewater.

• 한국임상약학회지
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• 제26권1호
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• pp.59-69
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• 2016

Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

• 대한간호학회지
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• 제38권3호
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• pp.363-371
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• 2008

Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

• 대한한방부인과학회지
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• 제27권4호
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• pp.69-87
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• 2014

Objectives: We analyzed retrospective clinical data of Korean medical institutes for infertility care and investigated current status and outcome of the Korean medical treatment of infertility as a part of foundational research for verifying validity of constructing national support system and developing appropriate policy on Korean medical treatment of infertility. Methods: We investigated data uploaded on the homepage of The Society of Korean Medicine for Subfertility (http://www.okinfertility.org) by Korean medical institutes for infertility care to get informations such as patients' age, body height, weight, methods of Korean medical treatment, cost and duration of treatment, success or failure of pregnancy and result of treatment. Results: The average age of patients was $33.1{\pm}3.8$ and the average body height was $161.2{\pm}5.3cm$ and the average body weight was $55.2{\pm}8.5kg$. The method of Korean medical treatment was Herbal medicine (97.5%), acupuncture (80.4%), moxibustion (57.7%), cupping (32.7%). The average cost of treatment was $1,160,625{\pm}882,499$ won, and the average medical cost per visit was $357,845{\pm}241,602$ won. The average duration of treatment was $11.26{\pm}10.58$ weeks, and the average number of visits per patient was $4.78{\pm}6.10$ times. The average duration of treatment was the longest in the group of infertile patients with the highest average medical cost per visit. The average pregnancy success rate was 30.9% overall, and that of the group of infertile patients was 25.8%. Conclusions: When we develop the standard project model with expectation for about 25% success rate of pregnancy and delivery in the group of patients who have idiopathic and ovulatory factors, it is desirable to perform acupuncture and moxibustion treatment 1-2 times a week with herbal medicine. The treatment period is set to at least 12 weeks. Average treatment fee maybe calculated by converting the averaged treatment cost of clinic's one month worth of daily treatment fee and medical hospital's ten day treatment fee into weekly treatment cost.