• Health Policy and Management
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• v.17 no.3
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• Economic and Environmental Geology
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• v.46 no.1
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• pp.85-91
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• 2013

OECD(2008) gives the concepts of inaction costs on key environmental challenges including: direct financial costs; total financial costs; total use costs; and total social welfare costs. In analyzing the losses of environmental goods' various values conducted by domestic and foreign researchers, this study suggests the value-cost category of OECD(2008) and other studies; and the indirect use and non-use values of groundwater and other natural environment using the concepts of inaction costs. The studies on the damages and their relationships among human, property, and ecosystem are essential to monetary valuation on the qualitative or quantitative degradation of groundwater and other natural environment.

• Proceedings of the Korea Concrete Institute Conference
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• 2004.05a
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• pp.720-723
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• 2004

This study is intended to propose a systematic approach for determining optimum Life-Cycle Cost (LCC)-effective seismic design for continuous PSC bridges considering lifetime expected seismic risks. In the paper, a set of cost function for LCC analysis of bridges is proposed. The total LCC functions consist of initial cost and direct/indirect damage costs considering repair/replacement costs, human losses and property damage costs, road user costs, and indirect socio-economic losses. The damage costs are expressed in terms of Park-Ang median global damage indices (Park and Ang, 1985) and lifetime damage probabilities. The proposed approach is applied to model bridges of both moderate seismicity regions like Korea and high seismicity regions like Japan. Since, in case of bridges, a number of parameters may have an influence on optimal target reliability, various sensitivity analyses are performed in this study. It may be expected that the proposed approach can be effectively utilized for the development of cost-effective performance criteria for design and upgrading of various types of bridges as well as continuous PC bridges.

• Proceedings of the KSRS Conference
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• 2004.10a
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• pp.656-660
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• 2004

The Mobile Mapping System is an effective method to acquire the position and image data using vehicle equipped with the GPS (Global Positioning System), IMU (Inertial Measurement Unit), and CCD camera. It is used in various fields of road facility management, map update, and etc. In the general photogrammetry such as aerial photogrammetry, GCP (Ground Control Point)s are needed to compute the image exterior orientation elements (the position and attitude of camera). These points are measured by field survey at the time of data acquisition. But it costs much time and money. Moreover, it is not possible to make sufficient GCP as much as we want. However Mobile Mapping System is more efficient both in time and money because it can obtain the position and attitude of camera at the time of photographing. That is, Indirect Georeferencing must use GCP to compute the image exterior orientation elements, but on the other hand Direct Georeferencing can directly compute the image exterior orientation elements by GPS/INS. In this paper, we analyze about the positional accuracy comparison of ground point using the Direct Georeferencing and Indirect Georeferencing.

• The Korean Journal of Pain
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• v.31 no.1
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• pp.27-38
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• 2018

Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

• Journal of Nutrition and Health
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• v.38 no.9
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• pp.786-792
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• 2005

With dramatic transitions from a traditionally food-insecure to a food-sufficient society, over weight and/or obesity are an increasing health concern in Korea. In 2000, $35.9\%$ of Korean adults were over weight (BMI>25) with increasing trends. It is well known that obesity is highly correlated with chronic diseases, such as diabetes, hypertension, cardiovascular disease, cancer and high cholesterol. In 2003, the social cost of obesity is estimated at $529.5\~799.3$ billion won (direct cost) and at $1,200\~1,817$ billion won (including indirect cost). The share of the direct cost is estimated at $2.6\~3.9\%$ of total medical bill 20,742 billion won. These costs are underestimated and would surely be higher if the expenditures outside of the official medical insurance system of Korea were included. Based on the rapid increase of obesity rate among the Korean youth, it is crucial to develop and implement appropriate policies to curb the obesity epidemic.

• Journal of the Korean Society of Safety
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• v.25 no.4
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• pp.84-89
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• 2010

In Korea, the method of assessing uninsured costs is not adopted in a direct way, but in an indirect way on the basis of the insured cost. From this method, the cost of accidents can be approximately calculated, but accurate calculation of uninsured costs is not easy. Therefore, a better method of assessing uninsured costs caused by industrial accidents is necessary. In this study, the system program and database for assessing uninsured costs from industrial accidents were developed on the basis of the results of previous studies. This program and database could quantitatively assess uninsured costs more accurately and quickly than other studies. This system would contribute to the efficient analysis of industrial accident costs.

• Journal of Korean Academy of Nursing
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• v.38 no.3
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• pp.363-371
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• 2008

Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

• The Journal of Engineering Geology
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• v.25 no.4
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• pp.459-472
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• 2015

A recently developed tunnel section enlargement method can maintain traffic flow during construction by using a protector. By keeping traffic flowing, it can minimize the lost time and costs associated with diversions and also the accompanying environmental pollution. On the other hand, installing the protector can lengthen the construction period and increase the direct cost. This paper presents a method for analyzing the economic feasibility of tunnel section enlargement methods considering the direct construction cost and the indirect social cost. The indirect costs are divided into categories of: vehicle driving cost, travel time delay cost, and environmental pollution cost. The economic efficiency of existing technology is compared with the new method in an case study of Namsan Tunnel 3.

• Journal of Preventive Medicine and Public Health
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• v.42 no.1
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• pp.5-11
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• 2009

Objectives : This study was conducted to estimate the socioeconomic cost of injuries in South Korea. Methods : We matched claims data from national health insurance, automobile insurance and industrial accident compensation insurance(IACI), and mortality data obtained from the national statistical office from 2001 to 2003 by patients unique identifier. Socioeconomic cost included both direct cost and indirect cost: the direct cost was injury-related medical expenditure and the indirect cost included loss of productivity due to healthcare utilization and premature death. Results : The socioeconomic cost of injuries in Korea was approximately 1.9% of the GDP from 2001 to 2003. That is, 12.1 trillion KRW(Korean Won) in 2001, 12.3 trillion KRW in 2002, and 13.7 trillion KRW in 2003. In 2003, direct medical costs were 24.6%(3.4 trillion KRW), the costs for loss of productivity by healthcare utilization were 13.0%(1.8 trillion KRW), and the costs for loss of productivity by premature death were 62.4%(8.6 trillion KRW). Conclusions : In this study, the socioeconomic cost of injuries in Korea between 2001 and 2003 was estimated by using not only health insurance claims data, but also automobile insurance, IACI claims and mortality data. We conclude that social efforts are required to reduce the socioeconomic cost of injuries in Korea, which represented approximately 1.9% of the GDP for the time period specified.