• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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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.

• 한국의료질향상학회지
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• 제12권2호
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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.

• 한국임상약학회지
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• 제28권2호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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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.

• 디지털융복합연구
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• 제11권12호
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• pp.145-154
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• 2013

본 연구에서는 벤처기업의 조직유효성으로 직무몰입, 조직몰입, 이직의도로 구성하고 선행요인으로 창업자특성, 기업역량특성, 전략특성으로 설정하고 규명하기 위해 벤처기업을 대상으로 실증분석하여 그 결과를 바탕으로 정책적 시사점을 제시하였다. 연구대상지역은 수도권 및 비수도권 총 301명을 대상으로 설문조사를 실시하였다. 연구결과 창업자의 심리적 특성, 역량특성, 기업역량 등이 조직유효성 하위요소로 구성한 직무몰입, 조직몰입, 이직의도에 유의한 영향을 미치는 것으로 분석되었으며, 전략특성 역시 창업자 및 기업역량과 조직유효성과의 관계에 긍정적인 매개효과가 있는 것으로 조사되었다.

• 가정∙방문간호학회지
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• 제20권2호
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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.

• 산업경영시스템학회지
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• 제21권46호
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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,

• 약학회지
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• 제50권2호
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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.

• 대한전기학회논문지:전력기술부문A
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• 제51권2호
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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.

• 한국경영과학회지
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• 제32권2호
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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.