• Title/Summary/Keyword: Economic Burden

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Final Impact of Anti-Vascular Endothelial Growth Factor Treatment in Age-related Macular Degeneration (연령관련황반변성 환자에서 항혈관내피성장인자의 치료 방법과 재정 영향 분석)

  • Yang, Jangmi;Shin, Sang Jin;Suh, Jae Kyung;Cho, Songhee;Tchoe, Hajin;Kang, Min Joo;Jee, Donghyun
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1039-1048
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    • 2018
  • Purpose: To evaluate the effects of anti-vascular endothelial growth factor (VEGF) treatment on the healthcare-related finances of patients with age-related macular degeneration. Methods: Changes in health care financing due to newly introduced benefit standards were predicted over the coming 5-year period (2018-2022). We also analyzed the financial impact of scenarios in which agents similar to anti-VEGF, such as the over-licensed drug bevacizumab, were introduced. For this purpose, the future number of patients receiving anti-VEGF treatments was estimated for various scenarios based on National Health Insurance Corporation claims data followed by an estimate of the financial burden. Results: In the case of age-related macular degeneration, the current standard of care (14 times in a lifetime) was maintained in scenario 1. In 2018, the insurance budget for the coming 5-year period was estimated at approximately 440.3 billion won. The insurance cost for that period was estimated at approximately 560.1 billion won under the revised standard of December 2017 (scenario 2). For scenarios wherein, after 2020, similar treatments (scenario 3) and bevacizumab (scenario 4) were introduced, the estimated health insurance costs were 521 billion won and 419.7 billion won, respectively. Conclusions: Health insurance costs are projected to increase substantially due to the elimination of the 14 time pay standard; however, the actual budget will only moderately increase, due to new limitations of visual acuity ${\leq}0.1$ or in case of scarring/atrophic lesions. Clinically similar agents and bevacizumab could be considered as alternatives to anti-VEGF treatment for age-related macular degeneration.

Review of Family Planning / Health Integration Efforts and Evaluation Results in Korea (가족계획과 보건사업의 통합시도 및 평가결과)

  • Bang, Sook
    • Korea journal of population studies
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    • v.10 no.2
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    • pp.58-81
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    • 1987
  • The purpose of this study is to examine major factors that affect patterns of living arrangements of older Korean noncitizens in the United States using the 1990 8% Public Use Microdata Sample(PUMS). In order to do so, I analyzed the effects of four factors including acculturation(English proficiency and Age at migration), economic circumstances(Personal Income and Supplemental Security Income: SSI receipt), health status(Mobility and Personal care limitation), and the ethnic community. The results show that acculturation and economic circumstances play an important role in determining the patterns of living arrangements among older Korean aliens, whereas the health status and the ethnic community do not show consistent effects. Regardless of marital status, the impact of age at migration is positively associated with solitary living of older Korean noncitizens, though, the effect of English proficiency show the opposite direction in accordance with marital status. That is, among nonmarried elders, those who cannot speak English are more likely to live alone. The case is reverse for married elders. The impact of economic feasibility is also positively associated with independent living arrangements. Those who receive SSI are much more likely to live apart from family, and elders whose annual personal income between $5,001 and $10,000 have the greatest propensity of solitary living-a large proportion of their income source is SSI. Individuals who receive SSI are also qualified to collect Medicaid, food stamps, rent subsidies, and other welfare benefits. In a sense, the economic feasibility provided by welfare benefits is the key determinant of independent living of older Korean noncitizens. Therefore, the recent welfare reform which denies legal aliens welfare benefits such as SSI and food stamps will severly affect the present living arrangements of older Korean aliens, and give economic burden to their family member The findings also show that there are significant differences within the elderly Korean Americans in terms of demographics, income, fertility, health status, and patterns of living arrangements by U.S. citizenship status. In particular, after controlling for age at migration as a proxy for acculturation, there is a statistically significant variation in living arrangements between elderly Korean noncitizens and naturalized citizens. For both theoretical and methodological reasons, future research on minority aging needs to investigate the concept of U.S. citizenship status for its impact on patterns of living arrangements among the minority elderly.

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Estimation of the Expected Socio-economic Benefits of the Largescale Comprehensive Agricultural Development Project and Jointcost Allocation -In the Case of Kumgang Project Area- (대단위 농업종합개발사업의 사회경제적 기대편익 추정과 결합비용의 배분 -금강지구를 중심으로-)

  • Lim, Jae Hwan
    • Korean Journal of Agricultural Science
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    • v.23 no.1
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    • pp.159-176
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    • 1996
  • This study is aimed at reviewing the methods of joint cost allocation and allocating the joint cost of estuary dam with specially repect to Kumgang Large-scale Agricultural Comprehensive Development Project. Apart from the water resource development project propelled by Water Resource Development Corporation in connection with Law of Multipurpose Dam Development, the Largescale Comprehensive Agricultural Development Projects couldn't ins-titutionally be carried out cost allocation of common facilities, even though it were concerned with irrigation, municipal and industrical water supply, flood control, sightseeing and industrial zone development components. To decrease farmer's burden of the project costs and, operation and maintenance costs, the joint costs of common facilities like estuary dam included in agricultural development projects have to be allocated by suitable method as alternative cost-remaining benefit method and the analytical activity should be supported by revising the concerned laws as Rural Development and Promotion and, Rural Rearrangement conpatible with the law for multipurpose dam development. Kumgang Agricultural Comprehensive Development Project was selected as a case study for the estimation of socio-economic benefits by project components and joint cost allocation of the estuary dam. The main results of the study are as follows; Joint cost allocation and unit charges by components 1. The project area will be 25,554ha with total project cost of 624,860 million won including the estuary dam cost of 120,843 million won. The project costs were ex-pressed by 1994 constant price. 2. Total quantity of water was estimated 365 million tons which were consisted of 245 million tons for irrigation, 73 million tons for municipal water and 47 million tons for industrial water. 3. The rates of joint cost allocation were amounted to 34.2% for agriculture, 2.5% for sightseeing, 45.7% for transportation, 11.8% for M & I water supply and 5.8% for flood control respectively. 4. The unit financial charges by project components were estimated at 7.88 won per ton for irrigation, 16.11won for M & I water, 1,686won per vehicle one pass, 977won per Pyeong according to the capital recovery method. The financial charges using straitline method for depreciation were estimated at 7.88won per ton for irrigation, 9.12won per ton for M & I water, 624won per vehicle one pass for transportation and 331won per Pyeong for sightseeing area. 5. The unit economic charges by project components were estimated at 21.1 won per ton for irrigation, 15.2won for M & I water, 977won per vehicle one pass, 977won per Pyeong according to the capital recovery method. The economic charges using straitline method for depreciation were estimated at 11.72won per ton for irrigation, 8.61won per ton for M & I water, 331won per vehicle one pass for transportation. Policy recommendation 1. The unit operation and maintenance costs for irrigation water in the paddy field couldn't be imposed as the water resource cost untreated. 2. The dam costs including investment cost and O & M cost, as a joint cost, had to be allocated by each benefited components as transportation, M & I water supply, flood control, irrigation and drainage, and sightseeing. But the agricultural comprehensive project have been dealt as an irrigation project without any appraisal socio-economic benefits and any allocating the joint cost of estuary dam. 3. All the associated project benefits and costs must be evaluated based on accounting principle and rent recovery rate of the project costs and O & M costs should be regulated by the laws concerned. 4. The rural development and promotion law and rural rearrangement law have to be revised comprising joint cost allocation considering free rider problems. 5. The government subsidy for the agricultural base development project has to be covered all the project costs. In case of common facilities representing joint cost allocation problems, all the allocated casts for other purposes like transportation and M & I water supply etc. should be recovered for formation in investment fund for agricultural base development and to procure O & M costs for irrigation facilities.

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A Study on Living Arrangement of Older Korean Noncitizens in the United States (재미 한국 영주권자 노인들의 주거형태에 관한 연구)

  • 이금룡
    • Korea journal of population studies
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    • v.20 no.2
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    • pp.99-134
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    • 1997
  • The purpose of this study is to examine major factors that affect patterns of living arrangements of older Korean noncitizens in the United States using the 1990 8% Public Use Microdata Sample(PUMS). In order to do so, I analyzed the effects of four factors including acculturation(English proficiency and Age at migration), economic circumstances(Personal Income and Supplemental Security Income: SSI receipt), health status(Mobility and Personal care limitation), and the ethnic community. The results show that acculturation and economic circumstances play an important role in determining the patterns of living arrangements among older Korean aliens, whereas the health status and the ethnic community do not show consistent effects. Regardless of marital status, the impact of age at migration is positively associated with solitary living of older Korean noncitizens, though, the effect of English proficiency show the opposite direction in accordance with marital status. That is, among nonmarried elders, those who cannot speak English are more likely to live alone. The case is reverse for married elders. The impact of economic feasibility is also positively associated with independent living arrangements. Those who receive SSI are much more likely to live apart from family, and elders whose annual personal income between $5, 001 and $10, 000 have the greatest propensity of solitary living-a large proportion of their income source is SSI. Individuals who receive SSI are also qualified to collect Medicaid, food stamps, rent subsidies, and other welfare benefits. In a sense, the economic feasibility provided by welfare benefits is the key determinant of independent living of older Korean noncitizens. Therefore, the recent welfare reform which denies legal aliens welfare benefits such as SSI and food stamps will severly affect the present living arrangements of older Korean aliens, and give economic burden to their family member The findings also show that there are significant differences within the elderly Korean Americans in terms of demographics, income, fertility, health status, and patterns of living arrangements by U.S. citizenship status. In particular, after controlling for age at migration as a proxy for acculturation, there is a statistically significant variation in living arrangements between elderly Korean noncitizens and naturalized citizens. For both theoretical and methodological reasons, future research on minority aging needs to investigate the concept of U.S. citizenship status for its impact on patterns of living arrangements among the minority elderly.

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Physical Aspects and Community Conditions of 'Dagagu' Housing and Tenant's Perception of the Quality of Housing (다가구 매입 임대주택 입주자 주거 실태 및 의식조사)

  • Kim Mi-Hee;Lee Kyung-Rhee;Kim Young-Joo;Chae Hye-Won;Kim Jin-Hwa
    • Journal of the Korean housing association
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    • v.17 no.4
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    • pp.47-55
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    • 2006
  • As a new way of stabilizing the housing for the urban poor, the Korean government proposed 'Dagagu' Housing Purchase and Public Rental Program (DPPRP) and implemented a pilot program in 2004. The purpose of this study was to find out whether DPPRP could be an alternative measure to solve the housing problems facing the urban poor. Physical aspects and community conditions of 'Dagagu' housing purchased by the government will be evaluated. The changes in the tenants' perception of the quality of housing after moving in the current dwellings will be studied. 46 households were temporarily selected, who moved in the purchased public rental housing in 5 districts (DPPRP pilot area). And among them, 32 households were designated as the final subjects, which could do the interview. The surveyors made door-to-door visits to tenants' houses and conducted in-depth interview by using a questionnaire The effects of 'Dagagu' Housing Purchase and Public Rental Program can be summarized according to housing environment aspects and economic aspects as follows: After moving in the public rental housing, the respondents saw improvements in overall housing environment and were satisfied with the current housing. According to a survey on the rental fee before and after moving in public rental housing, the rental fee of the latter had greatly declined. Given that the quality of previous housing was inferior to the current housing, the lessened rental burden was very meaningful.

Association of Biomarker Levels with Severity of Asbestos-Related Diseases

  • Park, Eun-Kee;Yates, Deborah H.;Creaney, Jenette;Thomas, Paul S.;Robinson, Bruce W.;Johnson, Anthony R.
    • Safety and Health at Work
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    • v.3 no.1
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    • pp.17-21
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    • 2012
  • Objectives: Asbestos-related diseases (ARDs) have increased globally over the decades, causing an economic burden and increased health care costs. It is difficult to predict the risk of development of ARDs and of respiratory disability among workers with a history of asbestos exposure. Blood based biomarkers have been reported as promising tools for the early detection of malignant mesothelioma. This study investigated whether serum soluble mesothelin-related peptide (SMRP) would reflect severity of disablement in compensable ARDs. Methods: SMRP levels were measured in a cohort of 514 asbestos-exposed subjects. Severity of ARDs was assessed by a Medical Authority comprising four specially qualified respiratory physicians. Severity of ARDs and SMRP levels were compared. Results: Mean (standard deviation) serum SMRP level in the population with compensable ARDs (n = 150) was 0.95 (0.65) nmol/L, and was positively associated with disability assessment (p = 0.01). Mean SMRP level in healthy asbestos-exposed subjects was significantly lower than those with pleural plaques (p < 0.0001) and in subjects with ARDs who received compensation (p < 0.01). Conclusion: This study indicates that serum SMRP levels correlate with severity of compensable ARDs. Serum SMRP could potentially be applied to monitor progress of ARDs. Further prospective work is needed to confirm the relationship between SMRP and disability assessment in this population.

A STUDY ON THE SATISFACTION FACTORS OF THE DISABLED WHEN USING DENTAL CARE SERVICES (장애인의 치과의료서비스 이용 시 만족 요인에 관한 연구)

  • Cho, Hye Lim;Kim, Yung Jae;Yoon, Tai Young
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.9-21
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    • 2014
  • This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

An Analysis of Convergence Factors on the Unmet Health Needs of the Indigent Elderly (빈곤노인의 미충족 의료와 관련된 융합적 요인 분석)

  • Park, Sun Joo;Lee, Won Jae
    • Journal of the Korea Convergence Society
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    • v.8 no.1
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    • pp.221-229
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    • 2017
  • The purpose of this study is to identify the convergence factors affecting the unmet health needs of the indigent elderly. The data the study is the Korean medical panel of 2011 and the parameters belonging to each factors were selected based on the Anderson model. We analyzed the general characteristics using frequency analysis and the correlations between variables using cross analysis. Finally, logistic regression analysis was conducted to examine the factors affecting unmet health needs. The indigent elderly with no education and elementary school graduates were 1.5 times more likely to experience unmet health needs than the poverty elderly with high school graduates. The indigent elderly who does not work for income, who were employers and self-employeds were 1.5 times more likely to experience unmet health care need than unpaid family workers. The indigent elderly with disabilities in activites of daily living were 2.9 time more likely to experience unmet health care needs than the indigent elderly with no disability in activites of daily living. The results of this study confirm that the increase in the economic burden of medical care for the indigent elderly can lead to the unmet health needs.

The Comparison Study between Tuberculin Skin Test and Interferon Gamma Release Assay in BCG-Vaccinated Healthy Donors

  • Choi, Yoon-Sung;Kim, Sunghyun
    • Biomedical Science Letters
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    • v.24 no.2
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    • pp.138-142
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    • 2018
  • The incidence of tuberculosis (TB) in the Republic of Korea remains high when compared to the incidence in other Organization for Economic Cooperation and Development (OECD) countries. The prompt diagnosis and effective treatment of latent TB infection (LTBI) are very important in terms of controlling the burden of TB. The tuberculin skin test (TST) has long been the "gold standard" assay for the diagnosis of LTBI. However, it can show false positive results due to Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) vaccination and infection with many environmental nontuberculous mycobacteria (NTM). The interferon gamma release assay (IGRA) using Mycobacterium tuberculosis (MTB)-specific antigens, was developed for the detection of LTBI. The QuantiFERON-TB Gold In-Tube assay is one of the most commonly used forms of the IGRA. In order to compare the diagnostic efficacy of the TST and IGRA in relation to LTBI among BCG-vaccinated healthy donors, whole blood samples were collected from 51 participants, and the results of the TST and IGRA were compared. Of the 51 cases, 18 cases (35.3%) were positive and 33 cases (64.7%) were negative when using the TST, while four cases (7.8%) were positive and 47 cases (92.2%) negative when using the IGRA. There was no correlation between the size of the induration in the TST and the $IFN-{\gamma}$ protein level. In conclusion, the TST showed higher cross-reactivity among the BCG-vaccinated healthy participants, therefore, the IGRA might be the most suitable assay for the rapid screening of LTBI in BCG-vaccinated healthy population, or for TB contact investigation.

Years of Potential Life Lost and Productivity Costs Due to Premature Cancer-Related Mortality in Iran

  • Khorasani, Soheila;Rezaei, Satar;Rashidian, Hamideh;Daroudi, Rajabali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1845-1850
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    • 2015
  • Background: Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. Materials and Methods: The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. Results: There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. Conclusions: The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.