BACKGROUND: The shelf life should be determined by health care facility's infection control program. The current standards for preserving the sterility can be changing. So, to measure and compare the recontamination time of sterile packs among wrappers and storage conditions, and develop a practical standard for the shelf life and storage conditions of sterile products. The purpose of this study was placed on measurement of the recontamination time in packs wrapped in all kinds of wrapping materials used in Il-San hospital and extra-costs. METHODS: The first phase study was from June to November 2002 and tile second phase study was planned to extend further the shelf life of the pouch bag from December 2002 to June 2003. Total 504 sterile sample packs containing cotton ball (5 cm-length) prepared and wrapped in four wrapping materials (randomized reprocessed two folds of lines, a fold of new craft paper, a fold of new nonwoven fabric, a fold of new pouch bag) and stored in three location (open shell of one of typical wards, open shelf of one of ICUs, open shelf of CSSD). Each type of packs were opened weekly and the cotton balls inoculated into thioglycollate broth at 35degrees C for seven days by infection control nurse. The temperature and relative humidity was monitored monthly. RESULTS: There was on growth found for any types of the pack and storage conditions studied. The temperature and relative humidity of storage locations were 24.8degrees C and 35.5 %. The extra-cost of reprocessing in Ethylene-Oxide gas sterilization was \32,800,000 and Steam sterilization was \36,900,000 by year. CONCLUSION: This study was conducted in attempt to identify the possibility of extending the current shelf life for sterile goods we use in a sense of cost effectiveness. It was possible to extend shelf life from four weeks to six months in the study hospital. We are going to continue this study and take all steps need to apply this new concept to our practice, and then trying to extend to other hospitals.
Cost-Benefit Analysis ; Costs and Cost Analysis* ; Delivery of Health Care ; Humidity ; Infection Control ; Infertility ; Steam ; Sterilization

OBJECTIVES: Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. METHODS: We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. RESULTS: The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. CONCLUSIONS: We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.
Arthroplasty* ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Knee ; Cloud Computing ; Cost Savings ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Database Management Systems ; Delivery of Health Care* ; Diagnosis ; Follow-Up Studies* ; Health Care Costs ; Hip ; Hip Joint ; Humans ; Joints* ; Knee ; Mobile Applications ; Orthopedics ; Telemedicine

OBJECTIVETo investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics.

METHODSA total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year (from November 2009 to November 2010) were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed.

RESULTSThe average annual drug cost in hypertension was (621.50 ± 1337.78) yuan per patient; while the cost was (616.13 ± 1248.40) yuan in management group and (626.44 ± 1414.30) yuan in control group respectively. The average annual drug cost of hypertensive patients who took medicine therapy was (702.05 ± 1401.79) yuan per person, while the cost in the management group ((688.50 ± 1300.70) yuan) was much lower than it in control group ((714.64 ± 1489.60) yuan). The annual average drug cost in urban was (731.88 ± 1403.31) yuan per person, which was higher than it in rural as (407.44 ± 1171.44) yuan per person. The average hospitalized rate was 12.2% (1014/8326), and the average annual cost among the hospitalized patients was (9264.47 ± 18 088.49) yuan per person; while the cost was (7583.70 ± 13 267.00) yuan in management group, which was lower than it in control group as (11 028.00 ± 21 919.00) yuan. The average annual hospitalized cost in hypertension was (1064.87 ± 6804.83) yuan per person; while the cost was (936.73 ± 5284.90) yuan in management group, which was lower than it in control group as (1181.50 ± 7937.90) yuan. The average annual direct medical expense in hypertension was (2275.08 ± 8225.66) yuan per person; while the expense was (2165.10 ± 6564.60) yuan in management group and (2375.20 ± 9487.60) yuan in control group. The average annual direct medical expense in urban ((2801.06 ± 9428.54) yuan per person) was higher than it in rural ((1254.70 ± 4990.27) yuan per person).

CONCLUSIONThe community health or standardized management of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.

Aged ; Community Health Services ; economics ; Cost-Benefit Analysis ; Drug Costs ; Female ; Health Care Costs ; statistics & numerical data ; Humans ; Hypertension ; drug therapy ; economics ; Male ; Middle Aged ; Public Health ; economics

OBJECTIVES: The aim of this study was to estimate the economic costs and benefits of a water fluoridation program in the city of Jinju, Korea. METHODS: In 2009, dental surveys were conducted on 2,315 children aged 6-12 years in Jinju, which had been fluoridated for 11 years. The decayed/missing/filled teeth (DMFT) scores of children in Jinju were compared to the DMFT scores of same-aged children in non-fluoridated small- and medium-sized cities in the fourth Korean National Health and Nutrition Examination Survey conducted from 2007 to 2009 by the Korea Centers for Disease Control and Prevention. The reduced number of decayed permanent teeth by the water fluoridation program was estimated as the difference between the DMFT scores of children in Jinju and those in non-fluoridated small- and medium-sized cities. The economic benefits were estimated by the savings from reduced dental treatment costs by using the reduced number of decayed permanent teeth from the water fluoridation program. All annual costs and benefits were calculated from 1998 to 2009. The social rate and untreated rate of decayed teeth were applied as 3% and 20%, respectively. The annual benefit-cost ratio was estimated by using the annual benefits and cumulative program costs. RESULTS: The economic benefit in 2009 from a water fluoridation program was estimated as 57,496,000,000 Korean Won (KRW), and the cumulative cost in 2009 was estimated as 1,387,000,000 KRW. The net present value in 2009 from a water fluoridation program was 56,109,000,000 KRW. The benefit-cost ratio in 2009 was estimated as 41.4. CONCLUSIONS: The economic benefit of a water fluoridation program in Jinju city was evaluated as excellent.
Centers for Disease Control and Prevention (U.S.) ; Child ; Cost-Benefit Analysis* ; Dental Caries ; Fluoridation* ; Gyeongsangnam-do ; Health Care Costs ; Humans ; Income ; Korea ; Nutrition Surveys ; Tooth

BACKGROUND/OBJECTIVES: By the year 2050, thirty-eight percent of the Korean population will be over the age of 65. Health care costs for Koreans over age 65 reached 15.4 trillion Korean won in 2011, accounting for a third of the total health care costs for the population. Chronic degenerative diseases, including coronary heart disease (CHD), drive long-term health care costs at an alarming annual rate. In the elderly population, loss of independence is one of the main reasons for this increase in health care costs. Korean heath policies place a high priority on the prevention of CHD because it is a major cause of morbidity and mortality. SUBJECTS/METHODS: This evidence-based study aims to the estimate potential health care cost savings resulting from the daily intake of omega-3 fatty acid supplementation. Potential cost savings associated with a reduced risk of CHD and the medical costs potentially avoided through risk reduction, including hospitalizations and physician services, were estimated using a Congressional Budget Office cost accounting methodology. RESULTS: The estimate of the seven-year (2005-2011) net savings in medical costs resulting from a reduction in the incidence of CHD among the elderly population through the daily use of omega-3 fatty acids was approximately 210 billion Korean won. Approximately 92,997 hospitalizations due to CHD could be avoided over the seven years. CONCLUSIONS: Our findings suggest that omega-3 supplementation in older individuals may yield substantial cost-savings by reducing the risk of CHD. It should be noted that additional health and cost benefits need to be revisited and re-evaluated as more is known about possible data sources or as new data become available.
Aged* ; Budgets ; Coronary Disease ; Cost Savings ; Cost-Benefit Analysis ; Surveys and Questionnaires ; Fatty Acids, Omega-3 ; Functional Food ; Health Care Costs* ; Hospitalization ; Humans ; Incidence ; Income* ; Korea ; Mortality ; Risk Reduction Behavior

PURPOSE: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. METHODS: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in ‘Public Hospitals Alert’, was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. RESULTS: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as ₩29,128 The nursing cost per inpatient per day was calculated as ₩157,970, and the administration cost per patient was calculated as ₩133,710. CONCLUSION: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.
Budgets ; Cost Allocation ; Costs and Cost Analysis ; Health Care Costs ; Hospital Costs ; Hospitals, Public ; Humans ; Inpatients ; Methods ; Nursing Services ; Nursing*

OBJECTIVES: This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran. METHODS: In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district’s health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider’s perspective using an activity-based costing (ABC) method. RESULTS: The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%). CONCLUSION: Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.
Budgets ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Delivery of Health Care ; Disease Management ; Health Care Costs ; Hospitalization ; Humans ; Iran ; Methods ; Public Health ; Radiography ; Retrospective Studies ; Transportation ; Tuberculosis* ; Tuberculosis, Pulmonary

OBJECTIVETo conduct with a cost analysis of the colorectal neoplasm screening program in Beijing, and provide data evidence for decision making.

METHODSBased on stratified cluster sampling method, we carried out a 2-stage colorectal neoplasm screening program within 6 districts, Dongcheng, Xicheng, Chaoyang, Haidian, Fengtai and Shijingshan, of Beijing city between October, 2012 to May. 2013. The first stage of the program was to conducting a cancer risk level evaluation for community residents who were forty years older and the second stage's task was to providing clinical exam for those high risk people who were selected from the first stage. There were about 12 953 residents were involved in this program. We calculated the main cost of the colorectal neoplasm screen program in Beijing. Then estimate the cost of detecting one Colorectal Neoplasm patient of this program and compare it with the total treatment cost for a patient.

RESULT2 487 high risk residents were selected by the first stage and 1 055 of them made appointment for the colonoscopy exam but only 375 accepted the exam, participate rate was 35.5%. 9 neoplasm cancer patients and 71 pre-cancer patient were found at the second stage, the detection rate were 69.2/100 000 and 546/100 000, respectively. The direct input for this neoplasm screening program was 227 100 CNY and the transport expense was 4 200 CNY in the calculations. The cost for detecting one cancer patient was about 19 900 CNY. Comparing with the total medical care cost of a cancer patient (1 282 800 CNY), especially for those have been diagnosed as middle to end stage cancer, the screening program (cost 842 800 CNY) might help to reduce the total health expenditure about 128 700 CNY, based on 12 953 local residents age above 40 years old.

CONCLUSIONAn colonoscopy based colorectal neoplasm screening program showed its function on medical expenditure saving and might have advantage on health social labor creating.

Adult ; Aged ; China ; Colonoscopy ; Colorectal Neoplasms ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Early Detection of Cancer ; Health Care Costs ; Humans ; Mass Screening ; Middle Aged ; Risk Assessment

OBJECTIVETo evaluate the costs of preventing AIDS transmission from mothers to children in a high-incidence area and to investigate relations between costs and effects, as well as to study the economical effects of this approach.

METHODSAccording to the number of patients and each strategy on prevention of AIDS transmission, following aspects were calculated as: the cost of preventing each patient with HIV infection, to avoid the cost of one disability adjusted life year (DALY), to evaluate the cost of each patient with either HIV infection or HIV-infected thereafter,and to calculate the HIV-positive rates in mothers at the same levels between costs and effects.

RESULTSThe costs-effects for stopping pregnancy:it was 2264 Yuan for preventing one DALY, the costs of avoiding one case with HIV infection was 46 963 Yuan, but it was 211,000 Yuan from each patient after HIV infection, the ratio between effects and costs was 4.5:1. The costs-effects for comprehensive strategies showed that the cost was 60 853 Yuan for avoiding one case with HIV infection. It was 211,000 Yuan for each patient after HIV infection and the ratio between effects and costs was 3.5:1.

CONCLUSIONThe cost-effect of preventing HIV transmission from mothers to children was significant on the basis of economical level. It was more effective to evaluate the relation between costs and effects according to economical level in screening and preventing transmission from mothers to children under the situation that the HIV-positive rate in pregnant mothers was more than 0.03%.

Acquired Immunodeficiency Syndrome ; economics ; prevention & control ; transmission ; Child ; China ; Cost-Benefit Analysis ; Disabled Persons ; Female ; Health Care Costs ; statistics & numerical data ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; economics ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious ; economics ; prevention & control

PURPOSE: The International Subarachnoid Aneurysm Trial (ISAT) revealed that in ruptured intracranial aneurysms (RA), endovascular coiling (EC) yields better clinical outcomes than neurosurgical clipping (NC) at 1 year. In unruptured aneurysms (UIA), EC is being increasingly used as an alternative to NC due to patients' preference. There is a lot of difference in treatment cost (EC vs. NC) between countries. There is one recently published study dealing with the comparative cost analysis only in UIAs in South Korea. But it is a hospital-based study. So, the authors performed a nation-wide cost effective comparison in our country. MATERIALS AND METHODS: This study was a retrospective analysis of healthcare big data open systems in Health Insurance Review & Assessment Service (HIRA). Hospital cost data of the recent 5 years (from January 2010 to December 2014) were analyzed according to patients' age and sex and the presence of subarachnoid hemorrhage. RESULTS: When comparing the total hospital costs for NC of a UIA (n=13,756) and EC of a UIA (n=17,666), NC [mean±standard deviation (SD): ￦7,987,179±3,855,029] resulted in significantly lower total hospital costs than EC [￦10,201,645±5,001,626, p<0.0001], although a shorter hospital stay with EC of a UIA [8.6 ±7.4 days] vs. NC [15.0 ±8.3 days, p<0.0001]. When comparing the total hospital costs for NC of a RA (n=7,293) and EC of a RA (n=6,954), NC [￦13,914,993±6,247,914] resulted in significantly lower total hospital costs than EC [￦16,702,446±7,841,141, p<0.0001], although shorter hospital stays for EC of a RA [19.8 ±11.4] vs. NC [23.0 ±10.3, p<0.0001]. CONCLUSION: The total hospital costs for the NC of both UIAs and RAs were found to be lower than those for EC in South Korea.
Aneurysm ; Cost-Benefit Analysis* ; Costs and Cost Analysis ; Delivery of Health Care ; Health Care Costs ; Hospital Costs ; Insurance ; Insurance, Health ; Intracranial Aneurysm* ; Korea ; Length of Stay ; Republic of Korea* ; Retrospective Studies ; Subarachnoid Hemorrhage