• Journal of Preventive Medicine and Public Health
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• 제44권3호
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2721-2728
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• 2012

Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.

• Journal of Preventive Veterinary Medicine
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• 제42권4호
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• pp.163-170
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• 2018

The cost-effectiveness of foot-and-mouth disease (FMD) control strategies was evaluated using a simulation model fitted to the 2010/11 FMD epidemic in the city of Andong, Republic of Korea. Seven FMD-control strategies were evaluated with respect to the direct cost of a FMD-control strategy, such as slaughtering, movement restriction, and vaccination. All the strategies included pre-emptive slaughtering, movement restriction, and vaccination, but the levels of each control option were different. The simulated median cost of the baseline FMD-control strategy (three kilometers of pre-emptive slaughtering area, 100 days of movement restriction and vaccination of all FMD-susceptible animals in the study area) was estimated to be USD 99.7 million. When a five kilometer vaccination area was applied (with the other control measures being the same as the baseline strategy), the simulated median cost was reduced to USD 81.1 million from USD 99.7. The simulated median costs were USD 107.6 million for a five kilometer radius slaughtering area and USD 168.8 million for 60 days of movement restriction. The FMD-control strategy cost decreased with increasing number of farms depopulated per day. The probability of passive surveillance being effective or the probability of the successful implementation of movement restrictions were increased. Cost-effectiveness analysis is a suitable tool for evaluating the financial consequences of FMD-control strategies by comparing the cost of control strategies for a specific area.

• 대한한의학회지
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• 제28권1호통권69호
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• pp.72-86
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• 2007

Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

• 한국신뢰성학회지:신뢰성응용연구
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• 제18권3호
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• pp.229-239
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• 2018

Purpose: There is a difficulty in Environmental Stress Screening (ESS) test design for weapon system's electrical/electronic components/products in small and medium-sized enterprises. To overcome this difficulty, I propose an easy ESS test design approach algorithm that is optimized with only one environment tolerance design information parameter (${\Delta}T$). Methods: To propose the mass production weapon system ESS test design for cost-effective optimization, I define an optimum cost-effective mathematical model ESS test algorithm model based on modified MIL-HDBK-344, MIL-HDBK-2164 and DTIC Technical Report 2477. Results: I clearly confirmed and obtained the quantitative data of ESS effectiveness and cost optimization along our ESS test design algorithm through the practical case. I will expect that proposed ESS test method is used for ESS process improvement activity and cost cutting of mass production weapon system manufacturing cost in small and medium-sized enterprises. Conclusion: In order to compare the effectiveness of the proposed algorithm, I compared the effectiveness of the existing ESS test and the proposed algorithm ESS test based on the existing weapon system circuit card assembly for signal processing. As a result of the comparison, it was confirmed that the test time was reduced from 573.0 minutes to 517.2minutes (9.74% less than existing test time).

• Journal of Preventive Medicine and Public Health
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• 제35권2호
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• pp.99-106
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• 2002

Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.3-10
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• 2014

The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized an international session as part of the official program of the 72nd Annual Meeting of the Japanese Cancer Association to discuss the topic "What is cost-effectiveness in cancer treatment?" Healthcare economics are an international concern and a key issue for the UICC. The presenters and participants discussed the question of how limited medical resources can be best used to support life, which is a question that applies to both developing and industrialized countries, given that cancer treatment is putting medical systems under increasing strain. The emergence of advanced yet hugely expensive drugs has prompted discussion on methodologies for Health Technology Assessment (HTA) that seek to quantify cost and effect. The session benefited from the participation of various stakeholders, including representatives of industry, government and academia and three speakers from the Republic of Korea, an Asian country where discussion on HTA methodologies is already advanced. In addition, the session was joined by a representative of National Institute for Health and Care Excellence (NICE) of the United Kingdom, which has pioneered the concept of cost-effectiveness in a medical context. The aim of the session was to advance and deepen understanding of the issue of cost-effectiveness as viewed from medical care systems in different regions.

• 수산경영론집
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• 제33권1호
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• pp.1-18
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• 2002

The observer program is being utilized In various fishing areas and fisheries internationally and nationally due to the its expected effectiveness in fisheries management and the collection of bioeconomic data necessary in fisheries management policy. The timely gathered data by observers play substantially a major role in decision-making fisheries policy such as the change in management measures, the application of season closure and area closure and etc. The expected effectiveness of the observer program In fisheries management, generally mentioned, is that it would lead to the increase in stock size from which the level of harvest would consequently increases. This study is aimed to analyze this tentatively expected effectiveness of the observer program in fisheries management. The changes in stock size and the level of harvest over time are analyzed under the observer program assuming the fishermen bear the cost of the observer program by investigating the change in fisherman's fishing activity under the observer program and by combining this changed activity with the biological model. The level of fishing efforts of fishermen was decreased from the results of the increase in fishing cost caused by the observer cost and the decrease in catchable stock size restricted by observers. This reduced level of fishing efforts enables stock size to increase over time and therefore, the expected level of harvest increases as time goes on. Another benefit under the observer program is to reduce management costs from the fact that fishermen are responsible for the cost of the observer program and the avoidance cost of fisherman responding to the fisheries regulation could be eliminated from the surveillance of observer. Therefore, it may possible to accomplish the cost-efficient fisheries management policy.

• 한국국방경영분석학회지
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• 제15권2호
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• pp.147-159
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• 1989

This paper presents a formalized methodology for conducting cost-effectiveness analysis on the ROK Navy's maritime patrol aircraft. The methodology involves a Delphi method application for determining the group of appraisal variables as well as their weight values in the area of aircraft effectiveness analysis, Life-cycle costing was employed to produce cost in terms of present worth values of all costs that occur over the common 20-year life cycle. A wide range of experts was selected so that their opinions could be effectively collected and synthesized to form the framework of the effectiveness model. Such a model development strategy provides easy acceptance of the analysis result and assure fairness of the analysis.

• 보건행정학회지
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• 제30권4호
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• pp.513-521
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• 2020

Aging populations and the increasing mental health issues among them have set a new challenge for the international community, governments, and people. Given this, society's role is very important, and involving the local community in resolving the problems can play a pivotal role. The current study presented the systematic review of the financing mechanism and cost-effectiveness of the "social prescribing" (SP) project in the United Kingdom and how SP can be adapted for other settings. The data showed comparatively low running costs and the overall effectiveness of SP projects. The running cost of SP projects varied between £54,525 and £1.1 million. The cost-effectiveness of the projects reported as 12% and the return of investment was about 50% depending on the type of analysis and the activities implemented. This type of intervention can be one of the options that support solving the issues of aging populations and their accompanying mental disorders.