• Title/Summary/Keyword: Medical Benefit

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Economic Evaluation of Vaccinations - a Methodologic Review (예방접종의 경제성 평가방법과 사례)

  • Chun, Byung Chul
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.20-29
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    • 2008
  • The basis of the economic evaluation of vaccination is the balance between the use of the resources (input) and the improvements that result from the vaccination (output). Techniques used for economic evaluation of vaccination are cost analysis, cost-minimization analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. Cost analysis seeks to characterize the costs of a given vaccination program. Cost-effective analysis is to helps policy-makers decide on the best use of allocated resources, whether cost-benefit analysis is to helps policy-makers decide on the overall allocation of resources. Cost-utility analysis is a specific form of cost-effective analysis in which outcomes are reduced to a common denominator such as the quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Many economic analyses have been conducted on vaccines in the world, but there have been a little studies on economic evaluation on vaccines in Korea. This paper reviewed the methodology used to economic evaluation on vaccines and immunizations and addressed some examples of the methods.

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The General Management and Treatment of Neuropathic Pain (전반적인 신경병성 통증의 조절 및 치료)

  • Chun, Yang-Hyun
    • The Journal of the Korean dental association
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    • v.49 no.6
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    • pp.327-333
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    • 2011
  • Clinically, treatment goal of neuropathic pain focused on not elimination of etiology but management and control of symptoms because we don't know certain about clear etiology of neuropathic pain yet. The drugs used for the management of neuropathic pain were classified as drugs with strong evidence for benefit(antidepressants, anticonvulsants, opioid analgesics etc.), modest evidence for benefit(mexiletine, carbamazepine, clonidine etc.), preliminary evidence for benefit(NSAIDs, dextromethorphan, topiramate etc.). Finally, the treatment for trigeminal neuralgia was outlined separately since this disorder responds to a different group of drugs than other neuropathic pain conditions.

A Study on the Social Security for Seafarers of Maritime Labour Convention, 2006 (2006년 해사노동협약상 선원 사회보장에 관한 연구)

  • Ji, Sang-Won
    • Journal of Navigation and Port Research
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    • v.32 no.3
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    • pp.237-244
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    • 2008
  • The General Conference of International Labour Organization adopted the Maritime Labour Convention, 2006 which created a single, coherent instrument embodying as far as possible all up-to-date standards of existing international maritime Conventions and Recommendations in its Ninety-fourth session on 23 February 2006. This Convention prescribes the social security for seafarers in the Regulation 4.5 in the Title 4. Regulation 4.1-Medical care on board ship and ashore and Regulation 4.2-Shipowner's liability are related to social security for seafarers. For the purpose of ratifying this Convention in our country, first of all, it is necessary to review the domestic laws and regulations concerned whether they fulfill or not the requirements of the Convention and have to make preparation insufficient sections. Therefore, this paper aims to find out different regulations between the domestic law and the Convention, as to be able to accept the requirements regarding the social security of the Convention, also suggest the solution on problems derived in this process.

Clinical Study on Safety and Efficacy of Qinin® (Cantharidin Sodium) Injection Combined with Chemotherapy in Treating Patients with Gastric Cancer

  • Zhan, Yi-Ping;Huang, Xin-En;Cao, Jie;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Xu, Xia;Xu, Lin;Xiang, Jin;Ye, Li-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4773-4776
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    • 2012
  • Objectives: To assess the efficacy, side effects, and the impact on quality of life with $Qinin^{(R)}$ (Cantharidin sodium) injection combined with chemotherapy for gastric cancer patients. Method: A consecutive cohort of 70 patients were divided into two groups: experimental group with cantharidin sodium injection combined with chemotherapy, while the control group received chemotherapy alone. After more than two courses of treatment, efficacy, quality of life and side effects were evaluated. Results: The response rate of experimental group was not significantly different from that of the control group (P>0.05), but differences were significant in clinical benefit response and KPS score. In addition, gastrointestinal reactions and the incidence of leukopenia were lower than in the control group (P<0.05). Conclusions: $Qinin^{(R)}$ (Cantharidin sodium) injection combined with chemotherapy enhances clinical benefit response, improving quality of life of gastric cancer patients and reducing side effects of chemotherapy. Thus $Qinin^{(R)}$ (Cantharidin sodium) injection deserves to be further investigated in randomized control clinical trails.

Direction Reorganization of Public Health Center Functions through Analysis of Medical Service Status by Public Health Care Institutions (지역보건의료기관의 진료현황 분석을 통한 보건소 기능개편 방향)

  • Park, Sun Hee;Lee, Mee Sun;Oh, Yumi
    • Health Policy and Management
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    • v.32 no.1
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    • pp.3-13
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    • 2022
  • Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

Priority setting for expanding health insurance benefit package using Analytic Hierarchy Process (계층화분석법(AHP)을 이용한 건강보험급여확대상병 우선순위 결정)

  • Choi, Sook-Ja;Ko, Su-Kyoung;Kim, Jung-Hee;Lee, Sang-Yi
    • Health Policy and Management
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    • v.16 no.1
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    • pp.73-94
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    • 2006
  • This study was carried out to show how the Analytic Hierarchy Process technique could be used in setting the priority among selected diseases to increase the range of health insurance benefit. Thirty experts, including doctors (group1), experts for preventive medicine or public health(group2), and representatives of the insured(group 3), participated in the study panel that is conducted for priority setting. They were asked to evaluate the priorities among 6 selected criteria and then 42 selected diseases. The results were as follows; First, representatives of the insured think that the magnitude of out-of-pocket payment should have high priority while doctors think that effectiveness of treatment should have high priority. Second, all experts think that catastrophic diseases such as malignant neoplasm, major heart disease, and cerebral vascular disease should have high priority in health insurance coverage even though there is little difference among groups. These results can be useful to establish a systematic strategy for expanding health insurance benefit package.

Usage of Medicinal Moxibustion for the improvement of Moxibustion Treatment Procedure (灸((구)쑥뜸)시술행위의 개선을 위한 藥灸劑(약구제)의 활용)

  • Lee, Bookyun;Kim, Chang-Min;Lee, Jang-Cheon
    • The Journal of Korean Medicine
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    • v.35 no.1
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    • pp.99-113
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    • 2014
  • Objectives: To provide theoretical basis for the classification of medicinal moxibustion(藥灸劑) in Health Insurance Medical Benefit in Korea through investigating trend of judicial precedents on indirect moxibustion and usage of medicinal moxibustion in "Donguibogam". Methods: We analyzed statistical data of moxibustion from Health Insurance Review & Assessment Service and National Health Insurance Statistical Yearbook. We investigated major judicial precedents on indirect moxibustion to find out some trend and we searched the usages of medicinal moxibustion in "ZhenJiuDaCheng" and "Donguibogam". Results: According to recent judicial precedents, indirect moxibustion with equipment is no loner regarded as Korean Medical Procedure. In composition of 'Oriental Health Treatment', amount for acupuncture has gradually decreased instead, amount for moxibustion has increased steadily for 5 years. Medicinal moxibustion(藥灸劑) is often used as a form of indirect medicinal moxibustion with moxa in "Donguibogam". Argyi Folium, Moschus, Natrii Chloridium, Radix Preparata, Realgar and Olibanum are most frequently used for medicinal moxibustion in "Donguibogam". Medicinal moxibustions are composed of simple prescription or herb-pair or multiple prescription in "Donguibogam". Conclusions: In Health Insurance Medical Benefit in Korea, under the division of moxibustion, direct medicinal moxibustion and indirect medicinal moxibustion should be classified in addition.

Peripheral Blood Immune Cell-based Biomarkers in Anti-PD-1/PD-L1 Therapy

  • Kyung Hwan Kim;Chang Gon Kim;Eui-Cheol Shin
    • IMMUNE NETWORK
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    • v.20 no.1
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    • pp.8.1-8.15
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    • 2020
  • Immune checkpoint blockade targeting PD-1 and PD-L1 has resulted in unprecedented clinical benefit for cancer patients. Anti-PD-1/PD-L1 therapy has become the standard treatment for diverse cancer types as monotherapy or in combination with other anticancer therapies, and its indications are expanding. However, many patients do not benefit from anti-PD-1/PD-L1 therapy due to primary and/or acquired resistance, which is a major obstacle to broadening the clinical applicability of anti-PD-1/PD-L1 therapy. In addition, hyperprogressive disease, an acceleration of tumor growth following anti-PD-1/PD-L1 therapy, has been proposed as a new response pattern associated with deleterious prognosis. Anti-PD-1/PD-L1 therapy can also cause a unique pattern of adverse events termed immune-related adverse events, sometimes leading to treatment discontinuation and fatal outcomes. Investigations have been carried out to predict and monitor treatment outcomes using peripheral blood as an alternative to tissue biopsy. This review summarizes recent studies utilizing peripheral blood immune cells to predict various outcomes in cancer patients treated with anti-PD-1/PD-L1 therapy.

A Study on Hypertensive Patients Compliance to Medical Recommendations (고혈압 환자의 치료지시 이행에 관한 연구)

  • 최영희
    • Journal of Korean Academy of Nursing
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    • v.10 no.2
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    • pp.73-85
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    • 1980
  • The purpose of this study was to investigate the compliance behavior of hypertensive patients in light of their health belief model that explains an individual's compliance with health maintenance or getting well. Although there are many effective regimens and treatments for hypertension nowadays. the most important point to be taken to consideration in their behavioral aspect is their compliance with regard to the control of body weight. eating habits as to salt and cholesterol intake. stresses. activity patterns and smoking as related to their life style. The important reasons for the failure in the control of hypertensive patients are the complexity of regimens to be complied to. irregular medication and the life long restrictions in their own life style. The compliance of patients to medical regimens and rocommendations or failure to do so is an essential factor. Accordingly. the degree of the patient's compliance is an important determinant as to the success or failure of hypertension control. The subjects for this study were 187 hypertensive patients selected from admitted and out patients of the medical department at seven University Hospitals in Seoul. Data was collected from Dec. 1, 1979 to Feb. 15, 1980 using the questionaire method and was analysed by the use of means. standard deviations, coefficient of correlations, analysis of variance and multiple regression analysis. The results obtained are as follows A. Of the seven independent variables in light of health belief model. benefit. barrier and severity are closely related to patient's compliance behavior. Therefore these variables could be used as determinants to predict and modify the hypertensive behavior. 1. Benefit is the most important and significant of the variables for explaining the dependent variables. It accounts for the highest variance of patient's compliance. (23.62%) 2. Then taking the former together with barrier. the variance of compliance showed on increase. (26.59%) 3. And with the addition of severity to the first two. the variance of compliance was also increased. (28.l2 %) B. Except for susceptibility all the independent variables such as severity. benefit, knowledge. motivation and barrier are correlated to dependent variable compliance. C. Sex. marital status and religion appeared to have significant influence on the dependent variables. Therefore one could conclude that the more the patients are aware that hypertension is a threat to health. the more they understand the benefit of taking actions to prevent such a threat. and the less they perceive any barrier when taking action. the more compliant they become in following medical regimens and recommendations. Age. marital status and religion played a significant influence to their compliance. Accordingly. the selected structural variables and demographic variables which have influenced sick role behavior of the hypertensive patient must be integrated to teaching and counselling programs for better hypertension control.

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Economic Value of Pharmaceutical Care for the Elderly Patients in Community Pharmacies (노인환자에게 제공하는 개국약국 약료서비스의 경제적 가치)

  • Sohn, Hyun-Soon;Shin, Hyun-Taek
    • YAKHAK HOEJI
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    • v.51 no.5
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    • pp.327-335
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    • 2007
  • This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.