• 제목/요약/키워드: Cost- Effectiveness Analysis

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메타분석을 이용한 임상영양서비스의 비용-효과성 평가 (Evaluation of Cost-Effectiveness of Medical Nutrition Therapy : Meta-Analysis)

  • 김현아;양일선;이해영;이영은;박은철;남정모
    • Journal of Nutrition and Health
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    • 제36권5호
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    • pp.515-527
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    • 2003
  • Objectives: A meta-analysis of the literatures was conducted to evaluate the cost-effectiveness of medical nutrition therapy by dietitians. Methods : The 30 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and the PQD database until May, 2002 and a review of reference lists. The main search terms were“dietitian”,“dietary intervention”,“nutrition intervention”, “cost”,“cost-effectiveness”and“cost-benefit analysis”. The subgroup analysis was performed by publication year, study design, intervention provider, type of patient (in/out-patient) and type of cost (total cost/direct cost). Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. Results : The 30 studies were identified using the electric database search and bibliographies. The 17 trials were eligible for inclusion criteria, then the systematic review and a meta-analysis were conducted on effectiveness and cost-effectiveness of medical nutrition therapy. The quality of the studies was evaluated using the quality assessment tool for observational studies. The quality score was 0.515 $\pm$ 0.121 (range : 0.279-0.711, median : 0.466). The meta-analysis of 17 studies based on the random effect model showed that medical nutrition therapy was highly effective in treating the diseases (effect size 0.3092 : 95% confidence interval 0.2282-0.3303). The vote-counting method, one of meta-analysis methods, was applied to evaluate the cost-effectiveness of medical nutrition therapy conducted by dietitians. Two criteria (method 1, method 2) for voting were used. The calculated p-values for method 1 (more conservative method) and method 2 (less conservative method) were 0.1250 and 0.0106, respectively. Medical nutrition therapy by dietitians was significantly cost-effective in the method 2. Conclusion. This meta-analysis showed that the effectiveness of medical nutrition therapy was statistically significant in treating disease (effect size 0.3092), and that the cost-effectiveness of medical nutrition therapy was statistically significant in the method 2 (less conservative method) of vote counting. (Korean J Nutrition 36(5): 515~527, 2003)

철도차량 모의운전연습기의 훈련비용 효율성 분석 (Analysis on Cost-Effectiveness of a Train Simulator)

  • 김사길;변승남
    • 한국철도학회:학술대회논문집
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    • 한국철도학회 2007년도 추계학술대회 논문집
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    • pp.696-702
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    • 2007
  • The purpose of this paper is to analyze cost-effectiveness of a train simulators. The cost-effectiveness of training program is assessed by multiplying transfer effectiveness ration(TER) by training cost ration(TCR). If their product is less than one, the program is not cost effective. Even if a program is not cost effective, however, safety considerations may be important to consider.

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공공건물 건축설비 갱신 계획시 비용-효율분석 평가기준에 관한 연구 (Evaluation Standard of Cost-Effectiveness Analysis for Renew of Architectural Equipment in Public Building)

  • 정순성
    • 동력기계공학회지
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    • 제17권4호
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    • pp.131-138
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    • 2013
  • The purpose of this study is to suggest the evaluation standard of cost-effectiveness analysis for renew of architectural equipment in public building. Evaluation items of cost-effectiveness analysis for renew of architectural equipment in public building were used life cycle cost, energy consumption(ton of oil equivalent), green house gas emissions(ton of carbon dioxide) and maximum power demand. Life cycle cost is the process of making an economic assessment of an item, area, system, or facility by considering all significant costs of ownership over an economic life, expressed in terms of equivalent costs. The essence of life cycle costing is the analysis of equivalent costs of various alternative proposals. The social concern with green house gas and maximum power demand of architectural equipment field has been growing for the last several years.

The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis

  • Chun, June Sang;Har, Alix;Lim, Hyun-Pil;Lim, Hoi-Jeong
    • The Journal of Advanced Prosthodontics
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    • 제8권1호
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    • pp.53-61
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    • 2016
  • PURPOSE. This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. MATERIALS AND METHODS. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. RESULTS. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at $10^{th}$ year after the treatment, and more cost-effective regardless of the WTP from $20^{th}$ year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the $10^{th}$ year after the prosthodontic treatment, more than 35,000 won at the $20^{th}$ year after prosthodontic treatment. CONCLUSION. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the $10^{th}$ year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.

재가 뇌졸중 환자의 일상생활동작 향상을 위한 방문물리치료의 비용-효용 분석 (Cost-utility Analysis of Home Physical Therapy to Improve Daily Activities of Stroke Patient Living at Home)

  • 허재원
    • 대한통합의학회지
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    • 제10권2호
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    • pp.13-25
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    • 2022
  • Purpose : This study compared the cost-effectiveness ratio of physical therapy in health centers and home physical therapy, two physical therapy methods for home-bound stroke patients, and clarified the economic validity regarding the effect of home physical therapy. Methods : To measure and compare the cost and effectiveness of the two physical therapy methods for stroke patients, subjects were recruited based on in-hospital and home physical therapy. Among the entire data collected, 82 and 90 participants were selected for in-hospital and home physical therapy, respectively. To measure costs, regarding both in-hospital and home physical therapy, direct cost and indirect cost for patients, family, medical institutes, and the government were measured. In addition, activities of daily living were measured in both methods to measure their effectiveness. Through collected data, the cost-effectiveness and incremental cost-effectiveness ratios were analyzed. Results : Based on the analysis of cost-effectiveness, home physical therapy showed lower cost-effectiveness than in-hospital physical therapy. Furthermore, the incremental cost-effectiveness ratio also showed a difference, which implied home physical therapy could have high effectiveness compared to cost. Conclusion : Based on these results, home physical therapy could be considered as an alternativeto other methods of physical therapy, for home-bound stroke patients. In addition, the result of thisstudy contribute by providing evidence that home physical therapy offers economic benefits and canbe more effective in treating home-bound patients when policy decisions are made to establish a home physical therapy system.

의복 개선 설계의 비용 대비 인간공학적 효과 분석: 방연복의 평가 및 최적 설계 도출 (Cost-effectiveness Analysis for Clothing Design Improvement Using Ergonomic Methods: Evaluation of Flame-proof Clothing and Design Optimization)

  • 조자영;정정림;연수민;장준호;유희천;김희은
    • 대한인간공학회지
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    • 제27권4호
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    • pp.45-58
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    • 2008
  • Ergonomic techniques have been required to analyze the effectiveness of functional clothing design improvement in a systematic and analytic manner. The goals of the present study are to: (1) comprehensively and analytically examine the effectiveness of clothing improvement by using the relationship analysis between clothing design components (D) and ergonomic evaluation measures (E) and (2) prove the usefulness of cost-effectiveness analysis for clothing design optimization. The cost effectiveness analysis is comprised of the preliminary evaluation based on expertise and the in-depth evaluation where the D-E relationship analysis is applied. As a result of the cost effectiveness analysis applied to flame-proof clothing, an optimal design was identified by analyzing costs and qualitative/quantitative effects. In the preliminary evaluation, the expected effectiveness of each design alternative on wear efficiency and wear comfort was estimated. In the in-depth evaluation, however, the effectiveness of each design alternative was analyzed by quantitative evaluation in a wearing test using a questionnaire prepared based on the D-E relationship analysis. It was concluded that the D-E relationship analysis and the cost-effectiveness analysis are useful for comprehensive evaluation and optimization of functional clothing design.

COST AND OPERATIONAL EFFECTIVENESS ANALYSIS

  • Toomepuu Juri
    • 한국국방경영분석학회지
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    • 제4권1호
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    • pp.91-109
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    • 1978
  • The paper discusses Cost and Operational Effectiveness Analysis (COEA) in the context of a military study system. The objectives of a study system, development of study programs, and management of studies are addressed. Basic cost-effectiveness models are presented and the COEA planning steps, analytical processes, and implementation discussed.

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무기체계 단위비용을 고려한 K2 체계의 효과분석 방법 연구 (A Study on Effectiveness Analysis of K2 system with Weapon's unit cost)

  • 정병기
    • 한국시뮬레이션학회논문지
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    • 제26권2호
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    • pp.31-39
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    • 2017
  • 본 연구는 무기체계의 단위비용을 고려한 K2(KC와 KAMD) 체계의 효과분석을 수행하였다. 단일 KC와 다중(고층 및 저층) KAMD를 가정하고, 각 체계에 임의의 무기체계를 설정하여 각각의 조합에 따라 총 12개의 시나리오를 작성하였다. 효과도는 전체 탄도미사일 위협 수량 대비 감소된 탄도미사일 위협의 비율로 정의하였으며, 비용은 발사된 무장의 수량과 단위비용으로 계산하였다. K2 체계의 효과도와 총비용은 몬테카를로 시뮬레이션을 1,000번 반복하여 추정하였다. 각각의 시나리오를 대안으로 하여 비용대 효과분석을 실시하였고, 효과고정법을 사용하여 최적 대안을 선정하였다. 연구 결과 KC 능력이 K2 체계의 방어 효과와 총비용을 결정하는 가장 중요한 요소였으며, 적정 수준의 저층방어체계를 갖춰야 요구되는 방어 효과를 달성할 수 있음을 확인하였다. 향후 연구에서 실질적인 무기체계 제원과 수명주기비용을 고려한 비용대 효과분석이 이루진다면 더욱 현실적인 분석이 가능할 것이다.

공공사업 경쟁입찰에서 낙찰자 결정방법분석 및 국방획득사업의 합리적인 사업자결정 방안 (Contract Awarding Process and its Reasonable Improvement for Defense Acquisition)

  • 어하준;김성철
    • 한국IT서비스학회지
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    • 제14권2호
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    • pp.69-86
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    • 2015
  • The current contract awarding process regulated by laws and ordinances is analyzed and more reasonable processes are suggested. To this end, the principle of economic analysis is described with emphasis on the cost-effectiveness analysis, and the laws and ordinances regulating the process are thoroughly examined. The current contract awarding rule is based on the weighted sum of effectiveness score and cost score. This may not conform to the framework of economic analysis where effectiveness is supposed to be measured as an output and cost measured as an input. An improvement is attempted to the defense acquisition system and it is recognized that the economic analysis and policy consideration should be performed separately. Concept of statistical testing is introduced to see if the results of the cost effectiveness analyses show the significant difference between the alternatives. It is suggested that the contract awarding process can be improved by performing significance test followed by the aggregation of the two analyses. A minor improvement is also suggested on the application of current rules.

Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients

  • Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
    • Journal of Hospice and Palliative Care
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    • 제25권2호
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    • pp.76-84
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    • 2022
  • Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.