• 한국임상약학회지
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• 제31권2호
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• pp.153-159
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• 2021

Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

• 대한화장품학회지
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• 제25권1호
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• pp.89-106
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• 1999

폐수 처리장 관리자들로 하여금 경제적으로 효과적인 폐수처리를 위하여 화장품 제조시설을 중심으로 폐수처리공정을 파악한 후 폐수처리 및 관리에 필요한 운전인자 중 폐수 처리비 영향인자 분석을 시행하였다. 폐수처리는 대부분 활성 슬러지법을 이용하여 각업체에 적합하게 설치하여 사용하고 있으며, 폐수처리장의 일평균처리량/설계량이 0.29∼0.56으로 일평균 처리량에 비해 폐수처리장의 설계량이 큰 것으로 나타났다. 오염물질 제거율이 폐수처리비에 큰 영향을 미치고 있으며, 이를 조절하기 위한 폐수처리 운전인자는 MLSS이다. 또한, 폐수처리비를 줄이기 위한 관리 항목은 약품비와 Sludge량이며, 이를 줄이기 위해서는 SV3O의 철저한 관리가 필요하다.

• KIEAE Journal
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• 제10권4호
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• pp.111-116
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• 2010

The environmental management is essential for construction projects. The environmental management cost for construction projects is used for various purposes to control the environmental pollution and treat the wastes generated from the construction sites. Six construction cases were analyzed to compare the environmental management cost. The proportion of environmental management cost for total construction budget should be higher than 0.70% in redevelopment projects and 0.30% in newly constructed buildings, respectively, but every six construction cases did not meet the legal requirement. Redevelopment projects expanded more environmental management cost than the newly constructed projects especially in noise control and wastes treatment. In case of apartment construction projects, the proportion of environmental management cost of redevelopment buildings is 2.4 times higher than the newly constructed buildings, but in all cases, paid more attention to the noise and waste controlling measures than the wastewater treatment. It is needed to ensure the cost-effectiveness of environmental management for achieving the eco-friendly construction sites.

• 한국임상약학회지
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• 제20권3호
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• pp.278-287
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• 2010

The main objective of this study is to evaluate the cost-effectiveness of tafluprost compared with latanoprost in primry open Angle Glaucoma (POAG) or ocular hypertension OH patients in Korea. A decision analytic model was developed from a societal perspective to estimate clinical outcome, drug cost and glaucoma related cost. The model assumes branch like following: successful treatment, switching to other drug, adding other drug, laser or surgery. Treatment success rate is defined as the percentage of patients with elevated IOP achieving <20% reduction, and discontinuation rate is the percentage of patients who were withdrawn due to severe adverse events. A model that is comprised of 1 month cycle length has 1 year. Treatment success rate and discontinuation rate were obtained from published literatures searched in database. Resource utilizations and costs were calculated with national health insurance data and clinical expert opinions. Sensitivity analyses were performed on crucial parameters. Tafluprost is less costly than latanoprost, $609.0 vs $651.2 expected cost. Thus tafluprost was shown to be dominant compared with latanoprost. The results of sensitivity analysis revealed stable across most of the included parameters. According to this study, tafluprost shows more clinical outcome for 1 year than latanoprost. In addition, first-line treatment of tafluprost is a more cost-minimizing strategy associated with POAG or OH compared with latanoprost.

• 성인간호학회지
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• 제22권3호
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• pp.229-238
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• 2010

Purpose: The purpose of this study was to examine the effect of maximal sterile barrier precaution on the central venous catheter-related infection and subsequent cost savings. Methods: Study subjects were 462 hospitalized patients with central venous, catheter of more than 48 hours duration. Data collection period was from April 2008 to February 2009 at a tertiary university hospital in Seoul. Subjects were randomly assigned to either the treatment or the usual care group. Patients in the treatment group (n=209) were treated by staff using maximal sterile barrier precautions and the comparison group(n=253) received traditional care. Results: Central venous catheter-days was2,821 in treatment group and 3,515 in comparison group. The incidence density of central venous catheter-related infection was 2.1 times higher in the comparison group (8.2 per 1,000 catheter-days) compared with the treatment group (3.9 per 1,000 catheter-days). The incidence density of central venous catheter-related bloodstream infection was 4.54 times higher than in the comparison group (3.2 per 1,000 catheter-days) compared with the treatment group (0.7 per 1,000 catheter-days). The attributable cost of central venous catheter-related infection in the treatment group was 10,174,197 won and that of the comparison group was 22,224,554 won. Attributable cost by area was also significantly lower compared with that of the comparisons. Conclusion: The maximal sterile barrier precaution during central venous catheter insertion was an effective intervention to reduce central venous catheter-related infection rate and provides a significant cost savings.

• 보건행정학회지
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• 제32권2호
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• 보건행정학회지
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• 제32권2호
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• pp.125-136
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• 2022

The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• 산업기술연구
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• 제31권A호
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• pp.135-145
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• 2011

This study was conducted to analyze the cost effectiveness in line with total phosphorus standard enforcement of public sewage treatment facilities. The additional cost for the total phosphorus removal process was calculated to analyze the cost effectiveness of the advanced water purification process. The analysis results showed that the T-P removal by coagulation sedimentation was more efficient than the advanced water purification facilities in terms of facilities investment cost, and if the coagulation filteration was used for T-P removal, the activated carbon process among the advanced water purification techniques was more efficient in terms of facilities investment cost. In this study, the effects of the T-P removal process that will be additionally introduced according to the tightening of the effluent T-P standard were analyzed within a limit. The actual benefits of improved T-P concentration in the water source will provide diverse values, including the leisure water, environment improvement water, eco-system in the water source and industrial water, in addition to the advanced water purification.

• Journal of Chest Surgery
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• 제47권1호
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• pp.20-25
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• 2014

Background: Symptomatic or asymptomatic patients with significant carotid artery stenosis (range, 70% to 99%) generally undergo either carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) to prevent stroke. In this study, we evaluated the cost effectiveness of these two treatment modalities. Methods: A total of 47 patients (mean age, $67.1{\pm}9.1$ years; male, 87.2%) undergoing either CEA (n=28) or CAS (n=19) for the treatment of significant carotid artery stenosis were enrolled in this study. Hospitalization costs were subdivided into three parts, namely pre-procedure, procedure and resource, and post-procedure costs. Results: Total hospitalization costs were similar in both groups of CEA and CAS (6,377 thousand won [TW] vs. 6,703 TW, p=0.255); however, the total cost minus the pre-procedure cost was higher in the CAS group than in the CEA group (4,948 TW vs. 5,941 TW, p<0.0001). The pre-procedure cost of the CEA group was higher than that of the CAS group (1,429 TW vs. 762 TW, p<0.0001). However, the procedure and resource cost was higher in the CAS group because the resource cost was approximately three times higher in the CAS group than in the CEA group. The post-procedure cost was higher in the CEA group because hospital stays were approximately two times longer. Conclusion: The total hospitalization cost was not different between the CEA and the CAS groups. The pre-procedure cost was high in the CEA group, but the cost from procedure onset to discharge, including the resource cost, was significantly lower in this group.

• 상하수도학회지
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• 제12권4호
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• pp.33-42
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• 1998

The optimum design and preliminary cost estimations of air stripping towers ASTs with granular activated carbon adsorption (GAC) systems as the off-gas treatment were done and compared to liquid-phase GAC system. The optimum design and preliminary cost estimations were done for either single or multicomponent systems. A computer program was developed for this study. 15 single compounds and their multicomponent systems were studies. Even with off-gas treatment, AST was generally a less expensive process for treatment of volatile organics than liquid-phase GAC system. Treatment costs of small systems were sensitive to system capacity. Accumulative effect of treatment costs was found in multicomponent systems. The cost of a multicomponent system was highly dependent on the least strippable component in ASTs even with gas-phase GAC or the least adsorbable component in liquid-phase GAC system.