• Title/Summary/Keyword: Cost Effectiveness

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Cost-effectiveness Outcomes of the National Gastric Cancer Screening Program in South Korea

  • Cho, Eun;Kang, Moon Hae;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Park, Eun-Cheol
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2533-2540
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    • 2013
  • Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

Introduction to Utilization Review (의료이용심사에 대한 소고)

  • Shin, Euichul
    • Quality Improvement in Health Care
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    • v.12 no.2
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    • pp.75-83
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    • 2006
  • Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

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Cost-Effectiveness of Denosumab for Post-Menopausal Osteoporosis in South Korea (폐경기 골다공증 환자에서 데노수맙 사용에 대한 비용-효과 분석)

  • Bae, Green;Kwon, Hye-Young
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.131-137
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    • 2018
  • Background: In South Korea, 22.3% of women ${\geq}50years$ of age and 37% of women ${\geq}70years$ of age visit the doctor to obtain treatment for osteoporosis. According to the analysis of the National Health Insurance Services claim data between 2008 and 2012, the number and incidence of hip and vertebral fractures increased during the same period. Denosumab, a newly marketed medicine in Korea, is the first RANK inhibitor. Methods: A cost-utility analysis was conducted from a societal perspective to prove the superiority of denosumab to alendronate. A Markov cohort model was used to investigate the cost-effectiveness of denosumab. A 6-month cycle length was used in the model, and all patients were individually followed up through the model, from their age at treatment initiation to their time of death or until 100 years of age. The model consisted of eight health states: well; hip fracture; vertebral fracture; wrist fracture; other osteoporotic fracture; post-hip fracture; post-vertebral fracture; and dead. All patients began in the well-health state. In this model, 5% discounted rate, two-year maximum offset time, and persistence were adopted. Results: The total lifetime costs for alendronate and denosumab were USD 5,587 and USD 6,534, respectively. The incremental cost-effectiveness ratio (ICER) for denosumab versus alendronate was USD 20,600/QALY. Given the ICER threshold in Korea, the results indicated that denosumab was remarkably superior to alendronate. Conclusion: Denosumab is a cost-effective alternative to the oral anti-osteoporotic treatment, alendronate, in South Korea.

The National Cancer Screening Program for Breast Cancer in the Republic of Korea: Is it Cost-Effective?

  • Kang, Moon Hae;Park, Eun-Cheol;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Cho, Eun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2059-2065
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    • 2013
  • This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

The Affects of Characteristics of CEO, Competence on Corporate Strategy and Organizational effectiveness in Venture Companies (벤처기업의 창업자특성과 역량, 기업전략이 조직유효성에 미치는 영향에 관한 연구)

  • Lee, Sang-Baek;Yang, Hae-Sool
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.145-154
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    • 2013
  • This research draws the factors of managerial performance that was verified by research model and hypothesis after considering research type, factors of performance and research model. The result of this research is as below. Firstly, psychological traits, capabilities of CEO is positively correlated with cost superior tactic and organizational effectiveness Secondly, entrepreneurial capability of CEO is positively correlated with organizational effectiveness for and managerial capability of CEO is positively correlated with cost superior tactic and technical capability of CEO is positively correlated with organizational effectiveness. Thirdly, technical resource is positively correlated with product innovation differentiation tactic, and organizational effectiveness and finance resource is positively correlated with marketing differentiation tactic and organizational effectiveness, and marketing capability is positively correlated with product differentiation tactic, marketing. Fourthly, product innovation-differentiation tactic, marketing differentiation tactic, and cost superior tactic are positively correlated with organizational effectiveness.

Home Care Nursing: An Economic Analysis (가정간호의 경제성 평가에 관한 문헌분석)

  • Lim, Ji Young;Kim, Ji Young
    • Journal of Home Health Care Nursing
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    • v.20 no.2
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    • pp.141-151
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    • 2013
  • Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.

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Rectified TPM Activities in the Depression Period (저성장기의 TPM 활동 방향 전환 -COST 절감을 위한 생산혁신 활동 방향-)

  • 유정상;최진욱
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.21 no.46
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    • pp.93-101
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    • 1998
  • A great number of firms have used overall equipments effectiveness index to evaluate the effect of TPM activities. Overall equipments effectiveness is very useful index to emphasize the need of decreasing equipments loss time when TPM system is first implemented. And it is powerful to evaluate prductivity growth rate according to TPM activities when GNP growth rate is high level. However, during the depression period, the increase of overall equipments effectiveness does not contribute fully to the cost down, the reason is that demand is falling. In this paper, we present the rectified TPM activities which can be applied to the depression period, and analysis the improvement activities of production part how to contribute to the cost down,

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Cost-Effectiveness Analysis of Etanercept in the Treatment of Methotrexate-resistant Rheumatoid Arthritis (메토트렉세이트 치료에 실패한 류마티스관절염 환자에서 에타너셉트 사용에 대한 비용-효과 분석)

  • Kim Jong-Joo;Park Eun-Ja;Park Se-Jung;Sung Yun-Kyung;Bae Sang-Cheol;Lee Eui-Kyung
    • YAKHAK HOEJI
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    • v.50 no.2
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    • pp.70-77
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    • 2006
  • A cost effective analysis was performed for comparing leflunomide+methotrexate, etanercept monotherapy and etanercept+methotrexate for 6 months. For the patients with methotrexate-resistant RA, ACR20 data were extracted from the published clinical trials searched from Pubmed. The direct medical cost was estimated based on ACR guideline and Korean National Health Insurance reimbursement. Combination therapy of etanercept+methotrexate was found to be more cost-effective than etanercept monotherapy, which meant it was a better therapeutic strategy for methotrexate- resistant RA.

Introduction of Power Flow Tracing Method for Determination of Power Transmission Network Charge and Verification of Its Effectiveness (송전요금 결정을 위한 전력조류 추적법의 도입 및 효용성 검증)

  • No, Gyeong-Su
    • The Transactions of the Korean Institute of Electrical Engineers A
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    • v.51 no.2
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    • pp.53-58
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    • 2002
  • This paper describes methodologies to charge for power transmission network use. These methodologies are normally divided into two categories such as marginal cost method and embedded cost allocation method. This paper, first, discusses the possible problems that can occur when the marginal cost method is applied to pricing the transmission services. Next, the paper proposes a method to apply the electricity tracing method to the transmission network charge. The result of the electricity tracing method is then used in MW-mile method to charge individual loads for the use of transmission network. Effectiveness of the algorithm is verified by computer simulations and it is estimated that the results can be used to compute the cost of electric power transmission under deregulated environment in electric power industries.

A Evaluation System Integrating Cost-Cross Effects of Big Scale R&D Projects (R&D프로젝트군의 우선순위 결정을 위한 비용 - 상호효과 통합평가시스템)

  • Kwon, Cheol-Shin;Lee, Soon-Cheon;Park, Jooh-Ho
    • Journal of the Korean Operations Research and Management Science Society
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    • v.32 no.2
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    • pp.163-175
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    • 2007
  • [ $ulcorner$ ]Cost-Effectiveness Analysis$\lrcorner$ has been wifely used to evaluate economic efficiency of R&D projects, but most of cost-effectiveness evaluation systems have some problems such as systematic method for setting and evaluating cost factors, estimation of single effect on each R&D project, and estimation of cross effects among R&D projects. To solve these problems, we have designed a new evaluation indicator called a $ulcorner$Cost-Cross Effect Integration Indicator$lrcorner$ including cross effects developed in this research. The major research findings are summarized as follows : (1) $ulcorner$Coist Estimation Model$lrcorner$, which estimates the cost factors divided into two classes of assembly product and system product and then integrates the total cost values, has been designed. (2) A new method for estimating parameters of cross effects among R&D projects has been developed. (3) $ulcorner$Cross Effects Estimation Model$lrcorner$ to estimate multi-effects and cross effects by completion time among several projects has been designed. (4) $ulcorner$Integration Estimation Indicator$lrcorner$ for setting priority on a project group has been extracted by combination of total cost value and total effect value.