• Title/Summary/Keyword: Cost-effectiveness model

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A Study on the Optimal LCC using AMSAA Model (AMSAA Model을 이용한 최적 LCC에 관한 연구)

  • Kim, Jun-Hong
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.29 no.3
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    • pp.135-142
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    • 2006
  • Engineers are always concerned with life cycle costs for making important economic decisions through engineering action like reliability of products. Decisions during the reliability growth development of products involve trade-offs between invested costs and its returns. In order to find minimal LCC containing the reliability improvement cost, production cost, repair and replacement costs, and holding cost of spare parts for failure items we suggest in this paper relationship between development cost and sustaining cost in values of growth parameter $\beta$ of AMSAA model. This model is applied to the reliability growth program based on AMSAA model during R&D phase, the warranty activities of items and the block replacement policy for maintenance of items in avionic equipment.

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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    • v.25 no.2
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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.

Cost Effectiveness of Bse-Isolation for Bridges in Low and Moderate Seismic Region (중저진 지역에서의 지진격리교량의 경제적 효율성에 관한 연구)

  • 고현무
    • Proceedings of the Earthquake Engineering Society of Korea Conference
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    • 1999.04a
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    • pp.178-185
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    • 1999
  • Minimum life-cycle cost helps to evaluate cost effectiveness of base-isolated bridges under specific condition. Life-cycle cost mainly consists of the initial construction cost and the expected damage cost. Damage cost estimation needs proper model of input ground motion failure probability evaluation method and limit states definition. We model the input ground motion as spectral density function compatible with the response spectra defined at each seismicity and site condition. Spectrum analysis and crossing theory is suitable for reseating calculation of failure probabilities in the process of cost minimization. Limit states of base-isolated bridges re defined for superstructure isolator and pier respectively The method is applied to both base-isolated bridges and conventional bridges under the same conditions to investigate cost effectiveness of base isolation in low and moderate seismic region. the results show that base-isolation of bridges are more effective in low and moderate seismic region and that the site effects on the economical efficiency may not be negligible in such a region.

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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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    • v.8 no.1
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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.

An Evaluation of the Operational Effectiveness of the Local Military Manpower Administrations Using IDEA Model (IDEA모델을 이용한 지방병무청 운영효율성 평가)

  • Lee Jae-Yeong
    • Korean Management Science Review
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    • v.22 no.1
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    • pp.1-13
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    • 2005
  • This paper proposed a quantitative evaluation method to measure the operational effectiveness of the local military manpower administrations. The proposed method compared the relative operational effectiveness level for 12 local military manpower administrations in Korea.. The method used the IDEA (imprecise Data Envelopment Analysis) model which Is able to measure relative operational effectiveness level, and also used two input variables (labor cost, operational cost) and three output variables (number of military applicants, number of civil application approved & processed, management accuracy level). Through the model output analysis, we presented the relative effectiveness scores, the reason for non-effectiveness, and the relationship between non-effective ness level and input/output variables for each local military manpower administration. We also presented a few recommendations how to improve the effectiveness level on particular local military manpower administration.

A Study on the Economic Effectiveness of the Artificial Fish Reef Project in the Tae-an Marine Ranching (태안시범바다목장해역내 인공어초사업의 경제적 효과에 대한 연구)

  • Choi, Jong-Du
    • The Journal of Fisheries Business Administration
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    • v.44 no.3
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    • pp.103-109
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    • 2013
  • This paper analyzed that the economic effectiveness of the artificial fish reef project in the Tae-an Marine Ranching. Benefit-cost(B/C) model used to indicate the effects of economic valuation. B/C model is based on the sub-models which are Benefit Cost Ratio(BCR), Net Present Value(NPV) and Internal Ration of Return(IRR). First, the Sum of Incremental Benefit and Cost for total vessel by year in Artificial Fish Reef Area(AFRA) estimated 2,381 million won. And then, using 5.5% discounting rates and the survey data, the sub-models showed economically feasible in the all of analysis and analyzed the results as follows. BCR is 2.66, NPV is 28,014million won, and IRR is 22.78%. In conclusion, these results indicated that the artificial fish reef project in Tae-an Marine Ranching would be increase the income of fishermen as well as fish biomass.

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

  • 김현아;양일선;이해영;이영은;박은철;남정모
    • Journal of Nutrition and Health
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    • v.36 no.5
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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)

Cost-Effectiveness Analysis for National Dyslipidemia Screening Program in Korea: Results of Best Case Scenario Analysis Using a Markov Model

  • Kim, Jae-Hyun;Park, Eun-Cheol;Kim, Tae-Hyun;Nam, Chung-Mo;Chun, Sung-Youn;Lee, Tae-Hoon;Park, Sohee
    • Health Policy and Management
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    • v.29 no.3
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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.

Cost-Effectiveness of Intensive Vs. Standard Follow-Up Models for Patients with Breast Cancer in Shiraz, Iran

  • Hatam, Nahid;Ahmadloo, Niloofar;Vazirzadeh, Mina;Jafari, Abdossaleh;Askarian, Mehrdad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5309-5314
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    • 2016
  • Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.

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.