• Title/Summary/Keyword: Value-based health technology assessment

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Roles of Health Technology Assessment for Better Health and Universal Health Coverage in Korea (우리나라 보건의료 발전을 위한 의료기술평가의 역할)

  • Lee, Young Sung
    • Health Policy and Management
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    • v.28 no.3
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    • pp.263-271
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    • 2018
  • Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

Health Technology Assessment and Appraisal: Lessons from Reliability-Based Health Technology Appraisal in NICE, England (가치기반 체계에 근거한 의료기술평가: 영국 NICE의 신뢰 지향적 가치판단 과정을 중심으로)

  • Lee, Hyun-Ju;Kwon, Young-Dae
    • The Korean Journal of Health Service Management
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    • v.7 no.4
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    • pp.273-288
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    • 2013
  • This paper is a general review contextualizing the state of the domestic health technology assessment. The aim of the paper is to present an overview of health technology assessment in Korea based on examining clinical efficacy as well as cost-benefit analysis, and to suggest the issue of appraisal based on social value. We have included a discussion of a major case study of the technology appraisal process of NICE (the National Institute for Clinical Excellence) in the UK. The review of the existing process of NICE shows that the appraisal both gives interest in health technology a sense of value perspective and raises methodological issues in terms of reliability. Details of the appraisal process and several guidelines for best practice have emerged. Suggestions are listed and their role in assessing is explained as a conclusion.

Data-Linking Infrastructure for the Health Technology Assessment (의료기술평가 기반으로서의 데이터 연계)

  • Park, Chong Yon
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.81-87
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    • 2018
  • With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

Antibiotic Resistance and Safety Assessment of Enterococcus faecium CKDB003 for Using as Probiotics (프로바이오틱스 Enterococcus faecium CKDB003의 항생제 내성 및 안전성 평가)

  • Kim, Han Jun;Kang, Soon Ah
    • The Korean Journal of Food And Nutrition
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    • v.33 no.3
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    • pp.223-236
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    • 2020
  • In this study, a safety evaluation was conducted to confirm if the Enterococcus faecium CKDB003 strain obtained by selection from a mixed fermentation of fruit and milk is suitable for use as a probiotic. The MIC value for the 10 antibiotics specified in the EFSA guidance was below the acceptable cut-off value. The antibiotic resistance genes aac(6')-li, eatAv, and msr(C) exist by whole genome sequencing, but are in the chromosome and not in the plasmid, thus confirming that there is no possibility of transmission to other microorganisms. It was confirmed that cytolysin (cylA, cylB, cylI, cylL-l, cylL-s, cylM, cylR1, cylR2), aggregation substance (asa1, asp1), collagen adhesion (ace), enterococcal surface protein (esp), endocarditis antigen (efaA), hyaluronidase (hyl) and gelatinase (gelE) were not present in the genome by examining the genes of factors related to virulence. Also, the biochemical analysis showed no toxic enzyme activities, and no virulence genes were detected by the PCR method. Thus, the E. faecium CKDB003 strain can be safely used as a health functional food probiotic, based on the results of the safety assessment.

General Radiography Usage and Exposure Dose of Korean Elderly: Based on Data from Aged Patients in 2016 (한국 노인의 일반촬영 이용량 및 피폭선량: 2016년 고령환자데이터 기반)

  • Gil, Jong-Won;Yoo, Se-Jong;Lee, Won-Jeong
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.495-502
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    • 2021
  • This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.

Spatial resolution and natural image quality assessment evaluation of gamma camera image using pinhole collimator in lutetium-yttrium oxyorthosilicate scintillation detector

  • Kyuseok Kim;Youngjin Lee
    • Nuclear Engineering and Technology
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    • v.55 no.7
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    • pp.2567-2571
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    • 2023
  • Scintillator materials are widely used in the medical and industrial fields for imaging systems using gamma cameras. In this study, image evaluation is performed by modeling a gamma camera system based on a lutetium-yttrium oxyorthosilicate (LYSO) scintillation detector using a pinhole collimator that can improve the spatial resolution. A LYSO detector-based gamma camera system is modeled using a Monte Carlo simulation tool. The geometric concept of the pinhole collimator is designed using various magnification factors, and the spatial resolution is measured using the acquired source image. To evaluate the resolution, the full width at half maximum (FWHM) and natural image quality assessment (NIQE), a no-reference-based parameter, are used. We confirm that the FWHM and NIQE values decrease simultaneously when the diameter of the pinhole collimator increases. Additionally, we confirm that the spatial resolution improves as the magnification factor increases under the same pinhole diameter condition. Particularly, a 0.57 mm FWHM value is obtained using the modeled gamma camera system with a LYSO scintillation detector. In conclusion, our results demonstrate that a pinhole collimator with a LYSO scintillation detector is a promising gamma camera imaging system.

Pre-post comparison Analysis of Patient assessment education for Emergency Medical Technicians(EMTs) (구급대원을 대상으로 한 환자평가 교육 전·후 수행도의 비교)

  • Lee, Moo-Sang;Lee, Seul-Ki;Kim, Gi-Woon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.211-219
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    • 2016
  • The current study was conducted to make pre-post comparisons of education done for 119 emergency medical technicians (EMT) on the patient assessment performance. The data are expected to offer applicable training methods and educational resources for emergency medical services. Twenty six EMT from four cities and provinces participated in the study, which was carried out from 14 to 17 December, 2015. The technicians performed a patient assessment and marked reports on simulated patients. In the course of the assessment, a pre-post evaluation of education was done using a checklist regarding the respective symptoms, such as headache, chest pain, and dyspnea. The median value (quartile value) was used as the descriptive analysis. While patient assessment scores marked 66 points (54.00-80.25) out of 100 (p<0.01) before education, there was a significant increase in the after-education scores, which reached 88.5 points (80.00-93.00). The patient assessment performances revealed a significant increase (p<.0.01) in 5 chest pain, 7 headache, and 9 dyspnea items after education. Similarly, there was an increase in wanting to meet the EMT again scale in regards to categories involved in developing positive relations with patients. Moreover, the adequacy in the patient condition reports all marked a significant increase (p<0.01) in assessment categories. The present study shows that education based on simulation practices are necessary for improvements in patient assessment performance of 119 EMT. Therefore, practical and systematic patient assessment educations may serve as a prerequisite. Further opportunities should be provided for the EMT consistently.

Evaluation of Noise Power Spectrum Characteristics by Using Magnetic Resonance Imaging 3.0T (3.0T 자기공명영상을 이용한 잡음전력스펙트럼 특성 평가)

  • Min, Jung-Whan;Jeong, Hoi-Woun;Kim, Seung-Chul
    • Journal of radiological science and technology
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    • v.44 no.1
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    • pp.31-37
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    • 2021
  • This study aim of quantitative assessment of Noise Power Spectrum(NPS) and image characteristics of by acquired the optimal image for noise characteristics and quality assurance by using magnetic resonance imaging(MRI). MRI device was (MAGNETOM Vida 3.0T MRI; Siemense healthcare system; Germany) used and the head/neck shim MR receive coil were 20 channels coil and a diameter 200 mm hemisphere phantom. Frequency signal could be acquired the K-space trajectory image and white image for NPS. The T2 image highest quantitatively value for NPS finding of showed the best value of 0.026 based on the T2 frequency of 1.0 mm-1. The NPS acquired of showed that the T1 CE turbo image was 0.077, the T1 CE Conca2 turbo image was 0.056, T1 turbo image was 0.061, and the T1 Conca2 turbo image was 0.066. The assessment of NPS image characteristics of this study were to that could be used efficiently of the MRI and to present the quantitative evaluation methods and image noise characteristics of 3.0T MRI.

Assessment of Job Stressors for Dental Technicians in Ulsan City (울산지역 치과기공사들의 직무스트레스 요인 평가)

  • Hong, Young-Ho;Kim, Hae-Kyoung;Hwang, Hae-Young;Choi, Sang-Jun
    • Journal of Technologic Dentistry
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    • v.34 no.4
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    • pp.403-412
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    • 2012
  • Purpose: This study is conducted to evaluate the job stressors for dental technicians in Ulsan city. Methods: The Korean standard job stressors assessment tool developed by Korea Occupational Safety and Health Agency (KOSHA) was used to compare the survey result with Korean reference value. The questionnaire on the social, demographic and job characteristics of dental technicians was also used to find the factors affecting to job stressors by using multiple linear regression analysis. Results: A total of 155 questionnaire was collected from 2010 to 2011. Among the eight fields of stressors, the physical environment (men 50.0, women; 58.3) and job demands (men 57.1, women 57.1) were higher than the median value of the Korean Workers. By multiple linear regression analysis, the significant factors to the physical environment were the satisfaction degree of indoor odor, number of employee, duty and working hours. In terms of the job demand, duty, working hours, age, and the satisfaction to the efficiency of space utilization were significantly associated to the score of job demand. Conclusion: Based on these results, it is necessary to manage appropriate workload, control indoor odor and design an efficient work space for prevention of job stress of dental technicians.

Validity of the Self-report Assessment Forecasting Elderly Driving Risk (SAFE-DR) Applicable to Community Health Convergence (지역사회 보건 융합에 활용 가능한 노인 운전자용 자가-보고식평가(SAFE-DR)의 타당도 연구)

  • Choi, Seong-Youl
    • Journal of Convergence for Information Technology
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    • v.9 no.6
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    • pp.175-182
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    • 2019
  • This study was conducted to test the assessment validity and examine the cut-off scores for driving risk as a part of the Self-report Assessment Forecasting Elderly Driving Risk (SAFE-DR) development project. The 132 senior drivers were categorized as either risky of 58 or safe of 74 drivers through the Drivers 65 Plus. Based on this initial assessment, we analyzed the risk prediction cut-offs. Furthermore, we tested the construct, content, and predictive validity. The cut-off score for the prediction of driving risk was found to be 74.5 points. The positive predictive value was 88.6%, and the negative predictive value was 86.3% about the cut-off score, signifying an excellent level of discrimination. Convergent validity, nomological validity, and content validity were found to be appropriate. Therefore, this study confirms that SAFE-DR is an appropriate assessment that can be used to screen dangerous elderly drivers.