• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3357-3362
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• 2013

The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient healthrelated quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.

• Journal of Korea Water Resources Association
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• v.47 no.7
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• pp.629-641
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• 2014

This study explores methods of allocating costs incurring from construction of environmental infrastructure among local governments involved in the project. Principles for equitable cost-allocation are reviewed, and pros/cons associated with different methods are examined. Proportional Allocation method, Shapley Value method, SCRB (Separable Cost-Remaining Benefits) method are applied to a case of swage treatment plant in Gyeongnam province region, Korea. It is found that the SCRB method produces the most equitable result, followed by Shapley method. The Proportional Allocation method, although easy to understand and simple to calculate, is found to be skewed in favor of small town.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1547-1551
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• 2012

Background: Lung cancer is the leading cause of cancer morbidity and mortality. Its management has a significant economic impact on society. Despite a high incidence of cancer, so far, there is no national register for this disease in Morocco. The main goal of this report was to estimate the medical costs of lung cancer in our country. Methods: We first estimated the number of annual new cases according to stage of the disease on the basis of the Grand-Casablanca-Region Cancer Registry data. For each sub-group, the protocol of treatment was described taking into account the international guidelines, and an evaluation of individual costs during the first year following diagnosis was made. Extrapolation of the results to the whole country was used to calculate the total annual cost of treatments for lung cancer in Morocco. Results: Overall approximately 3,500 new cases of lung cancer occur each year in the country. Stages I and II account for only 4% of cases, while 96% are diagnosed at locally advanced or metastatic stages III and IV. The total medical cost of lung cancer in Morocco is estimated to be around USD 12 million. This cost represents approximately 1% of the global budget of the Health Department. According to AROME Guidelines, about 86% of the newly diagnosed lung cancer cases needed palliative treatment while 14% required curative intent therapy. The total cost of early and advanced stages lung cancer management during the first year were estimated to be 4,600 and 3,420 USD, respectively. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco. A substantial proportion of the burden of lung cancer could be prevented through the application of existing cancer control knowledge and by implementing tobacco control programs.

• Journal of Korean Society of Water and Wastewater
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• v.22 no.4
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• pp.429-436
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• 2008

Membrane system has been increasingly considered as a safe and cost-effective water treatment process especially in case of small scale water works. This research is a basis of membrane application in water works through a long period test with obtaining operation skills and evaluation of water quality and cost competitiveness. For the research, the UF membrane system was installed in small water treatment plant that uses river-bed water as raw water. The system was consisted of 2 stage membrane and operated in constant flow mode (Flux: 1.5, 1.0, 0.9, 0.6). In each different flux condition, TMP trends were showed better results at lower flux condition. And through the high flux condition test, it is certified that membrane system could deal with breakdown of one stage. Water quality of permeate was satisfied the water quality standards especially turbidity. To know what mainly causes fouling on membrane, the test by membrane with several cleaning agents and EDX analysis have done in lab. Through the tests, ferrous concentration in raw water, backwashing water and membrane surface etc. was high and it causes fouling inside and outside of membrane. So acid cleaning using organic acid such as oxalic acid is necessary in Chemical in Place (CIP). At the economical aspect the electrical cost of membrane system is higher than that of slow sand filtration but labor cost can be reduced by automation. However, the use of labor should be determined considering effectiveness and stability of operation. Because during the operation, there are several breakdown such as electrical shock by lightning, water drop in summer, etc.

• Environmental and Resource Economics Review
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• v.31 no.1
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• pp.31-50
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• 2022

This paper estimates the price of standard waste bags that satisfies the polluter pays principle. Unlike previous studies, this paper suggests a method that can find new equilibrium prices using a structural relationship between the demand and cost function for the wastes. To do this, we employ the fixed-point iteration. The main findings of this paper are as follows. Assuming that the polluter pays principle is achieved at the average cost for the waste treatment, the price need to be set at a level about 3.12 times higher than the current one. The estimation result using a structural model, however, shows that the price should be set at a level four times higher than the present. This results are because the quantities reduced of the wastes make the cost per quantity of wastes due to the fixed costs increase. If applying the estimated price to the demand function, the amount of discharge of waste generated nationwide can be reduced by 10%.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.248-256
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• 2020

This study aimed to evaluate the effects of national dental screening for children in Korea in the aspects of prevention of dental caries, the number of treatments related to dental caries, and cost of dental care. The study used the national cohort data on children health screening provided by National Health Insurance Service, and analyzed 32,937 1st dental screening, 22,608 2nd dental screening, 13,708 3rd dental screening, and 241,043 cases from the dental care of 27,944 children born in year 2008 and 2009. The decayed-filled teeth index and decayed-filled person rate, calculated from the results of the 2nd and 3rd dental screening, decreased as the number of preceding dental screening increased. Glass ionomer and amalgam restoration, pulp treatment of primary teeth and extraction of primary canine and molar were shown to decrease as the number of examined dental screening increased, and the total cost of dental care covered by national health insurance also decreased as the number of dental screening increased. In conclusion, national dental screening for children is an efficient and economical oral health care method that prevents dental caries and lowers the possibility of dental caries related treatment, thereby reducing cost of dental care.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.2150-2159
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• 2014

This study was designed to investigate the status of orthodontic treatment and facial plastic surgery among 389 patients who visited dental clinics located in Seoul and Gyeonggi Province. After the collection of data, an analysis was carried out using a spss statistical program. The analysis results are as follows. the level of satisfaction with orthodontic treatment from patients with experience of the orthodontic treatment turned out to be high(p<0.01). Women considered 3.01 to 4 million won to be reasonable cost for orthodontic treatment (p<0.05), which is higher cost recognized by men, and patients with experience of orthodontic treatment recognized 19 to 24 months as the proper orthodontic treatment period(p<0.01). In addition, women showed higher figures than men in their awareness on the need for orthodontic treatment checkups(p<0.001), and facial plastic surgery experience (p<0.01). With respect to the part of the face on which they hoped to have plastic surgery, eye plastic surgery was higher in women (p<0.01), and nose surgery turned out to be higher in patients with experience of orthodontic treatment(p<0.05). Meanwhile, women considered the eye as the most important part among other facial areas (p<0.001), and they recognized that dentist should perform plastic surgery on both jaws among facial areas(p<0.01). In conclusion, the dental medical staff should provide consultations and operate treatment systems in consideration of gender differences and needs of dental patients. In the case of orthodontic treatment for the improvement of facial appearance, especially double jaw surgery which is closely related to the oral function, professional dental medical staff needs to perform the operation, considering the special oral environment. In addition, it is determined that provision of relevant medical information and promotion of dental service is required to provide patients with correct knowledge about orthodontic treatment and facial plastic surgery.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.16-30
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• 2004

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

• Journal of Gastric Cancer
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• v.15 no.2
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• pp.87-104
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• 2015

Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

• Annals of dermatology
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• v.30 no.6
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• pp.668-675
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• 2018

Background: Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries. Objective: To determine the drug survival for ustekinumab in real-life settings and investigate the factors affecting drug survival for psoriasis patients in Korea. Methods: We evaluated 98 psoriasis patients who were treated with ustekinumab at a single center. We analyzed the efficacy and drug survival of ustekinumab. Cox proportional hazard analysis and competing risk regression analysis were performed to reveal the factors affecting the drug survival of ustekinumab. Results: The overall mean drug survival was 1,596 days (95% confidence interval [CI], 904~2,288). Among the 39 cessations of ustekinumab treatment, 9 (23.1%) patients discontinued treatment after experiencing satisfactory results. Multivariate Cox proportional hazard analysis revealed that paying on patients' own expense was the major predictor for the discontinuation of ustekinumab (hazard ratio [HR], 9.696; 95% CI, 4.088~22.998). Competing risk regression analysis modeling of discontinuation because of factors other than satisfaction of an event also revealed that ustekinumab treatment at the patient's expense (HR, 4.138; 95% CI, 1.684~10.168) was a predictor of discontinuation rather than satisfaction. Conclusion: The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.