• Journal of Preventive Medicine and Public Health
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• 제46권6호
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• pp.293-299
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• 2013

Objectives: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. Methods: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. Results: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. Conclusions: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.

• Fisheries and Aquatic Sciences
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• 제25권5호
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• pp.287-297
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• 2022

The objective of this study was to evaluate the probability of norovirus foodborne illness by raw oyster consumption. One hundred fifty-six oyster samples were collected to examine the norovirus prevalence. The oyster samples were inoculated with murine norovirus and stored at 4℃-25℃. A plaque assay determined norovirus titers. The norovirus titers were fitted with the Baranyi model to calculate shoulder period (h) and death rate (Log PFU/g/h). These kinetic parameters were fitted to a polynomial model as a function of temperature. Distribution temperature and time were surveyed, and consumption data were surveyed. A dose-response model was also searched through literature. The simulation model was prepared with these data in @RISK to estimate the probability of norovirus foodborne. One sample of 156 samples was norovirus positive. Thus, the initial contamination level was estimated by the Beta distribution (2, 156), and the level was -5.3 Log PFU/g. The developed predictive models showed that the norovirus titers decreased in oysters under the storage conditions simulated with the Uniform distribution (0.325, 1.643) for time and the Pert distribution (10, 18, 25) for temperature. Consumption ratio of raw oyster was 0.98%, and average consumption amount was 1.82 g, calculated by the Pert distribution [Pert {1.8200, 1.8200, 335.30, Truncate (0, 236.8)}]. ₁F₁ hypergeometric dose-response model [1 - (1 + 2.55 × 10^-3 × dose)^-0.086] was appropriate to evaluate dose-response. The simulation showed that the probability of norovirus foodborne illness by raw oyster consumption was 5.90 × 10^-10 per person per day. The annual socioeconomic cost of consuming raw oysters contaminated with norovirus was not very high.

• 대한안전경영과학회지
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• 제15권4호
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• pp.7-16
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• 2013

As workplace incidents has been being declining in Korea, there is criticism of the effectiveness of occupational safety policy implementation. It is unknown that which policy target group needs to be targeted to yield effective injuries prevention. The purpose of this paper is to analyze and reveal the policy intervention group with a high priority in terms of industrial incident prevention and the related investment cost. A Policy Priority Model(PPM) is composed of 6 indicators regarding influences of both the incident reduction and the cost reduction. Z-score analyses are used to confirm the high policy priority area or policy target group. Overall, workplace with worker below 50 persons, construction site with the sales of more than a hundred million won, workplace with relatively small percentage of female employees and relatively higher percentage of older worker should be prioritized to reduce workplace injuries. This paper provides an analytic way that can be used to decide the policy priority workplace in order not only to reduce work-related injuries&illnesses and the related investment cost but to further lessen the related societal costs.

• 대한한의학회지
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• 제36권3호
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• pp.98-110
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• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

• 한국병원경영학회지
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• 제25권2호
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• pp.45-56
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• 2020

Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

• 한국직업건강간호학회지
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• 제7권2호
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• pp.164-176
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• 1998

This study deals with the current medical utilization for migrant workers and the characteristics of them. The purpose of this study is to provide the basic information to establish proper medical policy. For the study self-made questionnaire was used, which was answered by 453 migrant workers working in the area of manufacturing and non-technical work in 10 cities like Seoul, Inchon, Namyangju, Sungnam, Kwangju, Pyungchon, Kunpo, Kimpo, Masuk in Kyungki-do and Chunan in Chungchungnam-do. Besides, 303 medical records of those who had visited free medical check-up center were analyzed. The period of accumulating data is 6 months, from November 1st, 1996 to April 30th, 1997. The characteristics of migrant workers and current medical utilization are analyzed by percentage and the relation between characteristics and current medical utilization were analyzed using ${\chi}^2$-test, t-test, ANOVA. The finding of this study was as follows : 1) The number of nationality was 16. The first majority was Philippians as 32.0%. Among 16 nationalities Southeastern and Northern Asians were 48.9%, Southwestern Asian was 46.5%, the rest was 7.3%. Men were 81.0%, those who are aged from 26 to 30 were 39.0%, Graduatee from high school 92.7%, Christians 56.3%, unmarried 55.4% and salary from 600,000 Won to 800,000 Won 53.8% averaging monthly payment 669,810 Won. As for their residence, those who resided over 3 years were 31.9% and the illegal residence reached 77.4%. As for Korean language, those who speak in middle level were 5.6%. 2) As for kind of work and circumstances, manufacturing was 81.1%, 4 off-days per month 72.2% and 9-10 working hours per day 42.1%. As for accommodation, residence in fabric was 62.6% and one or two members as roommate 40.2%. 3) The characteristics of health behavior showed that 89.4% of migrant workers had 3 meals, 70.9% of them did not drink alcohol, 73.5% of them did not smoke. 4) As a characteristic of health status, 71.8% of them perceived of their health. 76.1% thought that they had no illness before coming Korea. Among them who recognized their illness, those who had problem in circulatory system was 35.3%, respiratory system ENT 19.1% and nervous system 19.1%.66.2% of those having illness had already had sickness when coming to Korea. 5) During last one month, 79.2% of them were known as ones having no illness. Among the sick, those who had problem in circulatory system was 31.6%, nervous system 23.7% and respiratory system 21.1%. 60.3% of the sick were not cured at that time. 6) Sorting the symptom of those who visited free medical check up, dental care was 24.2%, orthopedic 14.0% and digestive system 13.8%. Teethache was 34.4%, stomach problem 11.6%, upper respiratory inflammation 10.2% and back pain 5.9%. Averagely they visited free medical check up 1-2 times. According to symptom, epilepsy 25.5 times, heart and vascular disease 9 times, constipation 2.8%, neurosis 2.38 times and stomach problem 2.34 times. 7) The most frequently visited medical service by migrant workers was hospital. The most mentioned reason was good healing as 36.3%. The medical service satisfied migrant workers mostly was hospital as 64.3%. The reason of satisfaction was also good healing as 45.9%. 8) 77.2% of respondents did not spend money for medical check. Average monthly medical cost was 25,100 Won, 3.7% of income. Those who had no medical security was 73.4%. In their case, 67.7% got discount from hospital or support from working place and religious organization. 9) As for the difference of medical utilization according for the characteristics of migrant workers, legal workers and no-Korean speaker used hospital more frequently. 10) Those who were satisfied most of all with the service of hospital were female workers, hinduists and buddhists, legal workers or manufacture workers. 11) Christians, those who have 3 meals or recognize themselves as healthy ones mostly had no illness. As a result, the most of migrant workers in Korea are from Asia. They are good educated but are working in manufacturing and illegal. Their average income is under 700,000 Won which in not enough for medical cost. They have no medical security and medical fee is supported by religious organization or discounted. Considering these facts the medical policy by government is to be established.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.305-308
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• 2012

Objective: To assess the health and economic burden of human papillomavirus (HPV)-related diseases (cervical cancer, cervical intraepithelial neoplasia (CIN) 1/2/3, and genital warts) in Singapore over a period of 25 years beginning in 2008. Methods: Incidence-based modeling was used to estimate the incidence cases and associated economic burden, with the assumption that age-stratified incidence rates will remain the same throughout the period of 25 years. The incidence rates in 2008 were projected based on data obtained from the National Cancer Registry for cervical cancer, and from a combination of published data and hospital registry review for CIN1/2/3 and genital warts. The population growth rate was factored into the projection of incidence cases over time. Direct cost data per cervical cancer and per CIN1/2/3 case were obtained from the financial database of large local hospitals while cost data for genital warts were obtained from the National Skin Center; these costs were multiplied by the number of incidence cases to produce an aggregate estimate of the economic burden over the 25-year period (in 2008 Singapore dollars) using a 3% discount rate. Results: The total number of incidence cases of HPV-disease over 25 years beginning in 2008 was estimated to be 60,183, including 8,078 for cervical cancer, 11,685 for CIN 2/3, 8,849 for CIN1, and 31,572 for genital warts. The estimated total direct cost was 83.2 million Singapore Dollars over 25 years: 57.6 million attributable to cervical cancer, 13.0 million to CIN2/3, 6.83 million to CIN1, and 5.70 million to genital warts. Conclusion: HPV-related diseases are expected to impose significant health and economic burden on the Singapore healthcare resources in the next 25 years.

• 센서학회지
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• 제25권3호
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• pp.196-201
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• 2016

Rehabilitation exercises are the treatments designed to help patients who are in the process of recovery from injury or illness to restore their body functions back to the original status. However, many patients suffering from chronic diseases have found difficulties visiting hospitals for the rehabilitation program due to lack of transportation, cost of the program, their own busy schedules, etc. Also, the program usually contains a few medical check-ups which can cause patients to feel uncomfortable. In this paper, we develop a remote rehabilitation system with bio-signals by a stereo camera. A Kinect stereo camera manufactured by Microsoft corporation was used to recognize the body movement of a patient by using its infrared(IR) camera. Also, we detect the chest area of a user from the skeleton data and process to gain respiratory status. ROI coordinates are created on a user's face to detect photoplethysmography(PPG) signals to calculate heart rate values from its color sensor. Finally, rehabilitation exercises and bio-signal detecting features are combined into a Windows application for the cost effective and high performance remote rehabilitation system.

• 보건행정학회지
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• 제10권3호
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• pp.169-187
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• 2000

Cigarette smoking has been identified as the most important source of preventable morbidity and premature mortality (WHO, 1995), The prevalence of smoking among men is very high in Korea. This study estimated productivity losses due to smoking in Korea, 1997. The derivation of cost estimates for mortality, disability, hospitalization and use of physician services related to cigarette smoking is bas 어 on the calculation of attributable fractions suggested by MacMahon and Cole and Smoking-Attributable Mortality, Morbidity, and Economic Cost(SAMMEC) software. To estimate the number of deaths from neoplastic, cardiovascular, respiratory diseases associated with cigarette smoking, estimates for adults(aged 20 years and over) were based on 1997 mortality data, 1995 data on smoking prevalence from Korea Institute for Health and Social Affairs. Smoking-attributable indirect morbidity cost data were obtained from the National Federation of Medical Insurance. As the result of cost estimation, these productivity losses were 336-430 billion won. During 1997, 8,620-10,804 deaths were attributed to smoking. Cigarette smoking resulted in 133,991-169,422 Years of Potential Life Lost (YPLL) to life expectancy. For smoking -attributable indirect mortality costs, the present value of future earnings(PVFE) for the age at death are 299-384 billion won. Smoking-attributable indirect morbidity costs, the costs of lost productivity for persons who are disabled by smoking-related chronic diseases are 37-46 billion won. In this study the productivity losses due to smoking were restricted to the health effects of smoking. It is possible that these costs were underestimated with the limitation of the data. Smoking is the leading preventable cause of illness and death. The results of this study can be used as elementary data for antismoking policy.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.347-357
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• 1996

Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.