• Journal of Preventive Medicine and Public Health
• /
• 제55권5호
• /
• pp.415-423
• /
• 2022

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

• 보건행정학회지
• /
• 제24권3호
• /
• pp.219-227
• /
• 2014

Background: Current trends in Korea population aging with advances in public health and clinical medicine foretell rises in the prevalence of not only chronic diseases but also patients with multimorbidity. One important aspect in analyzing multimorbidity is to define the list of chronic diseases included when calculating multimorbidity index. The objective of this study is to describing the effect of multimorbidity on healthcare cost in Korea using US Office of the Assistant Secretary of Health (OASH) list. Methods: We analyzed the Korea Health Panel Data representing non-institutionalized Korean adult populations aged 20 and more. We calculated multimorbidity index based on OASH list and estimated the prevalence and healthcare cost for each OASH chronic disease. Results: In 2011, 15.2 million (39.6%) Koreans aged 20 and more were living with chronic condition. The health care cost due to chronic diseases, accounted for 80.2% of the overall healthcare costs and the prevalence of chronic conditions, the prevalence of multimorbidity and healthcare cost increased with ages. In the analysis using OASH list, 40% of the adult population over the age of 20 and 66.7% of the population over the age of 65 was affected with multimorbidity. In most of diseases in OASH list, prevalence of mulitmorbidity was high and healthcare cost increased with multimorbidity. Conclusion: OASH chronic disease list that accounts for 72.4% of prevalence and 86.7% of healthcare cost of persons with chronic conditions in Korea. OASH chronic disease list would be a useful and representative indicator for studying multimorbidity.

• 대한간호학회지
• /
• 제43권4호
• /
• pp.507-516
• /
• 2013

Purpose: The purpose of this study was to use cost-benefit analysis of activity to clarify the economic effect of prepared nurses versus atmospheric environment managing engineers as healthcare managers. Methods: For the study 111 workplaces were surveyed, workplaces in which nurses or atmospheric environment managing engineers were employed as healthcare managers. The survey content included annual gross salaries, participation in external job training, costs in joining association covered by the company, location and year of construction of the healthcare office, various kinds of healthcare expenditures, costs in operating healthcare office, health education, and activity performance in the work of environment management. Results: In the case of the healthcare manager being a nurse, benefit was larger than input costs at a ratio of 2.31. On the other hand, in the case of healthcare manager being an atmospheric environment managing engineer, input costs were larger than benefits (benefit-cost ratio 0.88). Conclusion: Results indicate that nurses are an effective healthcare human resource and can offer good quality healthcare service. Therefore companies should hire nurses and actively promote the economic efficiency of nurses in workplace.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제27권2호
• /
• pp.7-14
• /
• 2021

Purpose: The purpose of this study is to provide an effective construction project cost estimation tool for preparing a business plan of healthcare facilities which can be practically used for development projects. Methods: In order to provide a tool for calculating construction project costs, this study analyzed the Building and Related Laws, the Building Technology Promotion Laws, the Ministry of Land, Infrastructure and Transport notifications and directives, the Ministry of Trade, Industry and Energy notifications, the detailed guidelines of the Ministry of Strategy and Finance, the Building Service Industry Promotion Acts, various certification standards, actual project budget calculation cases, etc. with advices from related experts. Results: 1) Construction cost is classified into construction costs, architectural design costs, supervision costs, incidental costs, and each sub-element. In particular, since there are many incidental cost items, essential items to be reviewed during planning are derived and costs are calculated according to appropriate consideration criteria. 2) Criteria for Payment calculation mainly applies the construction cost rate method or the actual cost fixed amount method in consideration of the characteristics and scope of work. Implications: There are many calculation factors that need to be applied to the construction project cost. Therefore, it is necessary to organize the calculation process more clearly.

• Journal of Communications and Networks
• /
• 제16권4호
• /
• pp.465-474
• /
• 2014

Wireless sensor network (WSN) is considered to be one of the most important research fields for ubiquitous healthcare (u-healthcare) applications. Healthcare systems combined with WSNs have only been introduced by several pioneering researchers. However, most researchers collect physiological data from medical nodes located at static locations and transmit them within a limited communication range between a base station and the medical nodes. In these healthcare systems, the network link can be easily broken owing to the movement of the object nodes. To overcome this issue, in this study, the fast link exchange minimum cost forwarding (FLE-MCF) routing protocol is proposed. This protocol allows real-time multi-hop communication in a healthcare system based on WSN. The protocol is designed for a multi-hop sensor network to rapidly restore the network link when it is broken. The performance of the proposed FLE-MCF protocol is compared with that of a modified minimum cost forwarding (MMCF) protocol. The FLE-MCF protocol shows a good packet delivery rate from/to a fast moving object in a WSN. The designed wearable platform utilizes an adaptive linear prediction filter to reduce the motion artifacts in the original electrocardiogram (ECG) signal. Two filter algorithms used for baseline drift removal are evaluated to check whether real-time execution is possible on our wearable platform. The experiment results shows that the ECG signal filtered by adaptive linear prediction filter recovers from the distorted ECG signal efficiently.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권8호
• /
• pp.3383-3389
• /
• 2014

Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

• KSII Transactions on Internet and Information Systems (TIIS)
• /
• 제15권1호
• /
• pp.35-57
• /
• 2021

Fog computing aims to provide the solution of bandwidth, network latency and energy consumption problems of cloud computing. Likewise, management of data generated by healthcare IoT devices is one of the significant applications of fog computing. Huge amount of data is being generated by healthcare IoT devices and such types of data is required to be managed efficiently, with low latency, without failure, and with minimum energy consumption and low cost. Failures of task or node can cause more latency, maximum energy consumption and high cost. Thus, a failure free, cost efficient, and energy aware management and scheduling scheme for data generated by healthcare IoT devices not only improves the performance of the system but also saves the precious lives of patients because of due to minimum latency and provision of fault tolerance. Therefore, to address all such challenges with regard to data management and fault tolerance, we have presented a Fault Tolerant Data management (FTDM) scheme for healthcare IoT in fog computing. In FTDM, the data generated by healthcare IoT devices is efficiently organized and managed through well-defined components and steps. A two way fault-tolerant mechanism i.e., task-based fault-tolerance and node-based fault-tolerance, is provided in FTDM through which failure of tasks and nodes are managed. The paper considers energy consumption, execution cost, network usage, latency, and execution time as performance evaluation parameters. The simulation results show significantly improvements which are performed using iFogSim. Further, the simulation results show that the proposed FTDM strategy reduces energy consumption 3.97%, execution cost 5.09%, network usage 25.88%, latency 44.15% and execution time 48.89% as compared with existing Greedy Knapsack Scheduling (GKS) strategy. Moreover, it is worthwhile to mention that sometimes the patients are required to be treated remotely due to non-availability of facilities or due to some infectious diseases such as COVID-19. Thus, in such circumstances, the proposed strategy is significantly efficient.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권6호
• /
• pp.2317-2322
• /
• 2015

Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.

• ETRI Journal
• /
• 제36권5호
• /
• pp.730-740
• /
• 2014

The rapid increase in the number of patients with chronic diseases is an important public healthcare issue in many countries, which accelerates many studies on a healthcare system that can, whenever and wherever, extract and process patient data. A patient with a chronic disease conducts self-management in an out-of-hospital environment, particularly in an at-home environment, so it is important to provide integrated and personalized healthcare services for effective care. To help provide effective care for chronic disease patients, we propose a service flow and a new cloud-based personalized healthcare system architecture supporting both at-home and at-hospital environments. The system considers the different characteristics of at-hospital and at-home environments, and it provides various chronic disease care services. A prototype implementation and a predicted cost model are provided to show the effectiveness of the system. The proposed personalized healthcare system can support cost-effective disease care in an at-hospital environment and personalized self-management of chronic disease in an at-home environment.

• Journal of Preventive Medicine and Public Health
• /
• 제37권2호
• /
• pp.141-149
• /
• 2004

Objectives : To evaluate the cost and proportion of complementary and alternative medicines (CAM) in the total healthcare costs among the elderly in the last 6 months of life. Methods : The care-giving families of 301 persons older than 65 years, who died between July 1st and December 31st of 2001, and were also registered in Self-Employed Health Insurance Programs in Seoul, were interviewed. Results : The cost of CAM was 1.09 million Won, which as a proportion of the total healthcare cost was 38.1%. The elderly aged between 65 and 69 year-old, male, living with their spouse, Buddhist and having cancers had higher CAM costs in an ANOVA and simple regression analysis. After controlling of various factors, age was the only significant factor associated with the cost of CAM. The elderly above 80 years old, female, bereaved and Buddhist had higher proportional CAM costs, and the elderly having cancers or cardiovascular diseases had lower proportional CAM costs in an ANOVA and simple regression analysis. After adjusting for various factors, the elderly above 85 years old, female and Buddhist had higher proportional CAM costs, and the elderly having cancers had lower proportional CAM costs. Conclusion : The very old and Buddhist, and/or the ill with no clear diagnosis, may depend more on CAM. Further research will be needed on the meaning and impact of CAM and their costs to public health and the total healthcare system.