Background: Laparoscopy-assisted gastrectomy requires a lot of disposable products. So we compared the cost between laparoscopy-assisted gastrectomy and open surgery.Patients and methods: For comparison we used five cases each of open distal gastrectomy (ODG), laparoscopy-assisted distal gastrectomy (LADG), open total gastrectomy (OTG) and laparoscopy assisted total gastrectomy (LATG). In this study, we defined the profit of gastrectomy as below and we used the list price for all products. Profit of gastrectomy=Fee for gastrectomy-(Costs of all single use products-Demandable fee for single-use products)Results: Mean profits of ODG and LADG were 278,756.2 yen and 190,292.8 yen. The difference was 88,463.4 yen. Mean profits of OTG and LATG were 395,922.6 yen and 330,653.6 yen. The difference was 65,269 yen. Mean hospital charges, mean length of hospital stay, mean hospital charges per day of ODG, LADG, OTG and LATG were 1,390,464 yen, 21.4 days, 65,140.0 yen and 1,484,254.0 yen, 18.8 days, 80,805.4 yen and 1,956,664.0 yen, 24.4 days, 82,397.1 yen and 1,686,936.0 yen, 18.4 days, 91,894.8 yen, respectively.Conclusion: The turnover of laparoscopic gastrectomy was higher than open gastrectomy, but, the profit was lower because of high costs of disposable products. Hospital charges were not higher but the charge per day was higher because of a shorter hospital stay.
Gastrectomy ; Laparoscopy ; Hospitals ; Mean ; Financial cost

Objective: To analyze the direct economic burden caused by measles cases in Shanghai from 2017 to 2019 and its influencing factors. Methods: A total of 161 laboratory-confirmed measles cases reported from January 1, 2017, to December 31, 2019, in Shanghai were included in the study through the "Measles Surveillance Information Reporting and Management System" of the "China Disease Surveillance Information Reporting and Management System". Through telephone follow-up and consulting hospital data, the basic information of population, medical treatment situation, medical treatment costs and other information were collected, and the direct economic burden of cases was calculated, including registration fees, examination fees, hospitalization fees, medical fees and other disease treatment expenses, as well as transportation and other expenses of cases. The multiple linear regression model was used to analyze the main influencing factors of the direct economic burden. Results: The age of 161 measles cases M (Q₁, Q₃) was 28.21 (13.33, 37.00) years. Male cases (56.52%) were more than female cases (43.48%). The largest number of cases was≥18 years old (70.81%). The total direct economic burden of 161 measles cases was 540 851.14 yuan, and the per capita direct economic burden was 3 359.32 yuan. The direct economic burden M (Q₁, Q₃) was 873.00 (245.01, 4 014.79) yuan per person. The results of multiple linear regression model analysis showed that compared with other and unknown occupations, central areas and non-hospitalized cases, the direct economic burden of measles cases was higher in scattered children, childcare children, students, and cadre staff in the occupational distribution, suburban areas and hospitalized, with the coefficient of β (95%CI) values of 0.388 (0.150-0.627), 0.297 (0.025-0.569), 0.327 (0.148-0.506) and 1.031 (0.853-1.209), respectively (all P values<0.05). Conclusion: The direct economic burden of some measles cases in Shanghai is relatively high. Occupation, area of residence and hospitalization are the main factors influencing the direct economic burden of measles cases.
Child ; Humans ; Male ; Female ; Adolescent ; Financial Stress ; Cost of Illness ; China/epidemiology* ; Health Care Costs ; Measles/epidemiology*

Objective: To investigate the economic burden of bacillus Calmette-Guérin (BCG) lymphadenitis in Shandong Province. Methods: From May 2011 to December 2019, 304 patients applying for the province-level compensation of BCG lymphadenitis was selected from Shandong Province in this study. The basic situation, vaccination, outpatient (inpatient) records, cost and relevant information of those patients were collected to calculate the direct economic burden (including direct medical costs and direct non-medical costs), indirect economic burden and total economic burden. Comparison of the difference of economic burden of cases with different characteristics was taken. Results: The M(Q₁,Q₃) of age of BCG lymphadenitis patients was 3 (2, 4) months, among which 239 cases (78.6%) were male, 71 cases (23.4%) had lymphadenopathy, and 227 cases (74.7%) underwent surgery.The number of outpatient only, inpatient only and outpatient then inpatient was 25.7% (78 cases), 7.2% (22 cases) and 67.1% (204 cases), respectively. The M(Q₁,Q₃) of direct, indirect and total economic burden of single case after discount was 9 910 (5 713, 16 074), 2 081 (1 547, 3 122) and 12 262 (7 694, 18 571) yuan, respectively.The direct medical expenses accounted for 89.4% of the direct economic burden, the direct economic burden accounted for 84.9% of the total economic burden, the total economic burden of 80.0% cases accounted for only about 20.0% of the compensation amount, and the total economic burden of only 2.3% cases accounted for more than 60.0% of the compensation amount.The direct, indirect and total economic burden of patients with inpatient only and outpatient then inpatient was higher than that of patients with outpatient only; the direct, indirect and total economic burden of patients with operation was higher than that of patients with non-operation; the direct and total economic burden of patients with unulcerated lymph node was higher than that of patients with ulcerated lymph node(all P values<0.05). Conclusion: The economic burden of BCG lymphadenitis cases in Shandong Province is influenced by the mode of diagnosis and treatment, with direct medical expenses as the predominant component.
BCG Vaccine ; Cost of Illness ; Financial Stress ; Humans ; Infant ; Lymphadenitis/epidemiology* ; Male ; Vaccination

Cost of Illness ; Financial Stress ; Hepatitis B, Chronic ; Humans ; Perception ; Self Report

Healthcare systems around the world share the common goals of improving clinical outcomes, optimizing cost reductions and efficiencies, and expanding access to care in a patient-centric manner, yet they are stymied by 2 critical challenges: wide variations in patients' clinical outcomes and soaring costs. In response to these challenges, many healthcare systems throughout the world are pivoting towards value-based healthcare (VBHC), to ultimately 1) move from volume-based to value-based care, 2) promote patient-centric care, and 3) reverse rising costs. While the United States and European nations are piloting alternative payment models, South Korea has a similar set of objectives to adopt value or performance-based payment systems. Two exemplary programs helping to move Korea towards a VBHC model are currently under way: the Support Fund Program for Care Quality Assessment and the Healthcare Benefit Appropriateness Assessment Program. However, in order to permanently establish a full-fledged VBHC system in Korea, the following prerequisites must be met: 1) normalization of provider payment rates, 2) development and dissemination of critical pathways, 3) implementation of pilot projects in the medical device sector that contain risk-share payment schemes, 4) implementation of registries to aid data-driven coverage decisions, and 5) implementation of bundled payment pilot programs for the medical conditions for which proven critical pathways already exist. Ultimately, the medical device industry is in a unique position to enhance ongoing endeavors by Korean health authorities and providers to achieve quality patient care and cost savings, all in the service of the transition to VBHC.
Cost Control ; Cost Savings ; Critical Pathways ; Delivery of Health Care* ; Financial Management ; Korea ; Patient Care ; Pilot Projects ; Registries ; Republic of Korea* ; United States

Being aimed at the management of investment equipments, the flow of data has been put forward and the two main modes of data calculating have been established by our relying on No.1 Network of Military Healthy. The real-time management has been realized by the system in regard to eguipments' contact, charges, payouts, interest, payment, forecast and decision-makiing. It has been steadily test-running for more than 10 months in our hospital, and data have been processed exactly and creditably.
Computer Communication Networks ; Computer Simulation ; Computer Systems ; Cost-Benefit Analysis ; methods ; Equipment and Supplies, Hospital ; economics ; Financial Management, Hospital ; methods ; Software

PURPOSE: The purpose of this study was to identify nursing needs and burden of family caregivers of middle-aged patients with hepatocellular carcinoma. METHODS: The participants of this study were 101 family caregivers from 3 university hospitals in D city, South Korea. The levels of nursing needs and burden of family caregivers were measured using structured questionnaires from August 1, 2011 to February 29, 2012. The collected data were analyzed using t-tests, ANOVA, Scheffe tests, and Pearson's correlation coefficients. RESULTS: The greatest nursing need was for information about patients' health status. Among subdomains of burden, financial burden had the greatest mean score. Family caregivers with worsened health status since starting caregiving had significantly higher levels of total nursing needs and total burden. Total burden and physical burden scores showed significant correlations with all subdomains of nursing needs as well as total nursing need scores. CONCLUSION: Findings of this study suggest that family caregivers of middle-aged patients with hepatocellular carcinoma need provision of information about patients' health status and treatment plans, and financial support the most. Also maintaining family caregivers' health needs to be considered when providing nursing intervention for patients with hepatocellular carcinoma and their family caregivers.
Carcinoma, Hepatocellular* ; Caregivers* ; Cost of Illness ; Financial Support ; Hospitals, University ; Humans ; Korea ; Liver Neoplasms ; Needs Assessment ; Nursing* ; Surveys and Questionnaires

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. METHODS: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. RESULTS: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. CONCLUSION: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.
Caregivers ; Cost of Illness ; Family Nursing ; Financial Support ; Humans ; Nursing Services ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors ; Social Class

In this study, we aimed to evaluate the economic loss due to the diagnosis of breast cancer within the female South Korean working-age population. A population-based cost analysis was performed for cancer-related diagnoses between 1999 and 2014, using respective public government funded databases. Among the five most common cancers, breast cancer mortality was strongly associated with the growth in gross domestic product between 1999 and 2014 (R=0.98). In the female population, breast cancer represented the greatest productivity loss among all cancers, which was a consequence of the peak in the incidence of breast cancer during mid-working age in the working-age population, in addition to being the most common and fastest growing cancer among South Korean women. Our study shows that breast cancer not only represents a significant disease burden for individual patients, but also contributes a real, nonnegligible loss in productivity in the South Korean economy.
Breast Neoplasms* ; Breast* ; Costs and Cost Analysis ; Diagnosis ; Efficiency ; Employment ; Epidemiology* ; Female* ; Financial Management ; Gross Domestic Product ; Humans ; Incidence ; Mortality ; Quality of Life

Efficient financial management is a critical factor in achieving school foodservice goals. The objective of this study was to suggest efficient financial management practices in secondary school foodservices. In pursuit of this objective, we first identified performance indexes for measuring the success of financial management. Second, we suggested financial management standards, financial data classification methods and a report system. Last, we analyzed operating ratios with the financial data of self-operated and contract-managed school food services. The data were collected through an open-ended questionnaire from 10 middle/high school foodservices in Seoul and Kyeonggi Provincial during on-sites visits and interviews with dieticians and managers. Student participation, sales goals, re-contract frequency and number and cost of disaster loss were identified as the performance indexes for financial management. Income statements were compiled by identifying and classifying financial data. Total revenues consisted of subsidies, meal sales, other revenue and interest. Expenditures consisted of purchased food, salaries and wages, utility costs, office supplies, kitchen supplies, purchased services, company overhead indirect costs, facility investment and maintenance, facility usage expenses, employee benefits and miscellaneous. Mean price of a meal was 2,326 won at self-operated foodservices when the subsidies were included as revenues and 2,360 won at contract-managed foodservices. When including the subsidies as revenues, the operating ratios of self-operated foodservice showed that the food cost percentage was 66.9%, labor cost 23.2%, operation cost 9.9% and profit 0%. The correspond figures at contract-managed foodservices were 57.6%, 21.5%, 15.3%, and 5.5%, respectively. Food costs in self-operated foodservices was significantly higher than that for contract-managed foodservices, however, facility investment and maintenance and facility usage expenses at self-operated foodservices was significantly lower than those for contract-managed foodservices. Based on this study, the methodology and classification system of financial data was found to be applicable to assess the financial structure of school foodservices.
Classification ; Commerce ; Costs and Cost Analysis* ; Disasters ; Equipment and Supplies ; Financial Management* ; Food Services ; Gyeonggi-do ; Health Expenditures ; Humans ; Investments ; Meals ; Nutritionists ; Salaries and Fringe Benefits ; Seoul ; Surveys and Questionnaires