• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 추계학술대회
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• pp.114-115
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• 2018

본 논문에서는 클라우드 환경에서 빅데이터를 비용 효율적으로 분석하기 위한 기법을 연구한다. 전자의무기록의 클라우드 저장이 최근 가능해짐에 따라 중소병원에서의 클라우드 기반 빅데이터 분석 요구가 증가하고 있다. 이에 본 논문에서는 대중적으로 많이 사용되고 있는 아마존 EMR 프레임워크를 분석하고, EMR 환경에서 비용 효율적으로 빅데이터를 분석하기 위한 비용 모델을 제안한다. 제안한 기법을 적용하면 클러스터 비용 대비 처리시간이 가장 효율적인 클러스터 규모를 계산할 수 있으므로, 보다 적은 비용으로 빅데이터 분석을 효과적으로 처리할 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7701-7706
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• 2013

Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

• 보건행정학회지
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• 제29권3호
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• pp.357-367
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• 2019

Background: This study evaluated the cost-effectiveness of 21 different national dyslipidemia screening strategies according to total cholesterol (TC) cutoff and screening interval among 40 years or more for the primary prevention of coronary heart disease over a lifetime in Korea, from a societal perspective. Methods: A decision tree was used to estimate disease detection with the 21 different screening strategies, while a Markov model was used to model disease progression until death, quality-adjusted life years (QALYs) and costs from a Korea societal perspective. Results: The results showed that the strategy with TC 200 mg/dL and 4-year interval cost \4,625,446 for 16.65105 QALYs per person and strategy with TC 200 mg/dL and 3-year interval cost \4,691,771 for 16.65164 QALYs compared with \3,061,371 for 16.59877 QALYs for strategy with no screening. The incremental cost-effectiveness ratio of strategy with TC 200 mg/dL and 4-year interval versus strategy with no screening was \29,916,271/QALY. At a Korea willingness-to-pay threshold of \30,500,000/QALY, strategy with TC 200 mg/dL and 4-year interval is cost-effective compared with strategy with no screening. Sensitivity analyses showed that results were robust to reasonable variations in model parameters. Conclusion: In this study, revised national dyslipidemia screening strategy with TC 200 mg/dL and 4-year interval could be a cost-effective option. A better understanding of the Korean dyslipidemia population may be necessary to aid in future efforts to improve dyslipidemia diagnosis and management.

• 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.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1996년도 하계학술대회 논문집 B
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• pp.692-694
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• 1996

Recently, rapid increase in electricity demand, tremendous financial need for new power plant construction, and environmental problem have led to search for more efficient energy production and energy conservation technologies. Due to the potential energy and cost savings to electric utilities, DSM plays an important role in the electric resource planning. However, implementation of cost-effective DSM program requires appropriate analysis methodologies and procedures. In this study, we present the cost-effectiveness analysis model for DSM program evaluation. We also present a case study to analyze DSM program.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• 한국항해항만학회지
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• 제31권10호
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• pp.819-824
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• 2007

이 연구는 해상교통안전시설에 관한 운영효과를 분석한다. 해상교통안전시설의 운영효과는 크게 안전편익, 수송편익 그리고 기타편익으로 나눌 수 있다. 안전편익은 해상교통안전시설을 설치 및 운영함으로써 해양사고가 감소됨에 따른 해상교통의 손실회피비용으로 산출된다. 이를 위하여 각 해당 시설에 대한 해양사고 감소율을 산정하고, 손실회피비용의 세부 모델을 구축한다. 또한 이에 대한 각 변수를 정의하고 계산식을 제시한다. 이 모델을 목포청의 항로표지집약관리시스템에 적용하여 안전편익을 산출하였다.

• 지식경영연구
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• 제20권3호
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• pp.91-106
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• 2019

In the era of the 4th Industrial Revolution, the importance of information protection is increasing day by day with the advent of the 'hyper-connection society', and related government financial investment is also increasing. The source of the government's fiscal investment projects is taxpayers' money. Therefore, the government needs to evaluate the effectiveness and feasibility of the project by comparing the public benefits created by the financial investment projects with the costs required for it. At present, preliminary feasibility study system which evaluates the feasibility of government financial investment projects in Korea has been implemented since 1994, but most of them have been actively carried out only in some fields such as large SOC projects. In this study, we discuss the feasibility evaluation of public projects for the purpose of information security. we introduce the case study of the personal information protection program of Korean public institutions and propose a cost-effectiveness analysis method that can be applied to the feasibility study of the information protection field. Finally, we presented the feasibility study and criteria applicable in the field of information security.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1761-1766
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• 2012

Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

• 간호행정학회지
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• 제8권2호
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• pp.323-334
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• 2002

Purpose: This study was designed to analyse economical efficiency of home care service by comparing a cost-effectiveness ratio(CER) between hospitalization and home care service. Method: The analytic framework of this study was constructed in 5 stages; perspective of the analysis, measurement of costs, measurement of effects, analysis of CER, and sensitivity analysis. The SAS program was utilized for the general characteristics of the subjects, descriptive statistics, homogeneous test, normality test and difference test. Result: The results were as follows; 1) CER was 35,248,256 of ADL, 7,996,026 of nursing satisfaction, 6,144,946,000 of QALY of patients in the hospital and 11,168,863 of ADL, 2,322,239 of nursing satisfaction, 3,674,556,000 of QALY of patients in the home care center. ICER was 438,067,932 of ADL, -190,044,176 of nursing satisfaction, 8,615,336,000 of QALY. 2) In the sensitivity analysis of sex, age and discount rate, the CER of patients in the home care center was lower than the CER of patients in the hospital. Conclusion: With these findings, it affirmed that home care service had an economical efficiency compared with hospitalization in cerebrovascular disease patients. Therefore, these results will be used to develop governmental policy or expansion of the home care service.