1.Evaluation of Intervention Policies for the COVID-19Epidemic in the Seoul/Gyeonggi Region through a Model Simulation
Jeongjoo SEOK ; Yunjeong LEE ; Jun Yong CHOI ; Jae-phil CHOI ; Haesook SEO ; Seul LEE ; Jeehyun LEE
Yonsei Medical Journal 2022;63(8):707-716
Purpose:
To evaluate the efficacy of intervention policies on coronavirus disease-19 (COVID-19) dissemination.
Materials and Methods:
An age-structured compartmental model for the COVID-19 outbreak was proposed to predict the impact of control measures in the Seoul/Gyeonggi region. The model was calibrated based on actual data and realistic situations, including daily vaccine doses, proportion of delta variant cases, and confirmed cases by age. We simulated different scenarios for non-pharmaceutical interventions by varying social distancing and school attendance strategies.
Results:
Two-step mitigation of social distancing without in-person classes would result in a rapid increase in confirmed cases up to 10000 but would keep severe cases within the manageable range of the health care system. The overall impact of taking down the distancing level by one step with twice the increase in contacts at school was comparable to the above scenario. Implementation of two-step mitigation of social distancing along with a two-fold increase in contacts among the school-age group would dramatically increase confirmed and severe cases by over 80000 and 100, respectively, as early as the beginning of December. This policy would cause the situation to spiral out of control, considering the scale of the response and time to prepare. On the other hand, the burden on the current healthcare system caused by two-step mitigation of social distancing and 40% increased contacts in the school-age group was manageable if prepared.
Conclusion
A compromise between social distancing and school attendance policy and timely preparations for the spread of COVID-19 are required.
2.Cost-Effectiveness of Age-Expanding Strategy of Latent Tuberculosis Infection Treatment in Household Contacts in South Korea
Hyunwoo CHO ; Jeongjoo SEOK ; Youngmok PARK ; Hee Jin KIM ; Eun Hye LEE ; Jungeun PARK ; Dong Ah PARK ; Young Ae KANG ; Jeehyun LEE
Yonsei Medical Journal 2023;64(6):366-374
Purpose:
The strategy of latent tuberculosis infection (LTBI) treatment in household tuberculosis (TB) contacts has been expanding in South Korea. However, there is little evidence of the cost-effectiveness of LTBI treatment in patients over 35 years of age. This study aimed to evaluate the cost-effectiveness of LTBI treatment among household TB contacts in different age groups in South Korea.
Materials and Methods:
An age-structured model of TB was developed based on the reports from the Korea Disease Control and Prevention Agency and the National Health Insurance Service. Quality-adjusted life-years (QALY) and the averted number of TBrelated deaths were estimated along with discounted costs for a measure of incremental cost-effectiveness ratios.
Results:
The number of cumulative active TB cases would decrease by 1564 and 7450 under the scenario of LTBI treatment for those aged <35 years and <70 years, respectively, relative to the no-treatment scenario. The treatment strategies for patients aged 0 to <35 years, <55 years, <65 years, and <70 years would add 397, 1482, 3782, and 8491 QALYs at a cost of $660, $5930, $4560, and $2530, respectively, per QALY. For the averted TB-related deaths, LTBI treatment targeting those aged 0 to <35 years, <55 years, <65 years, and <70 years would avert 7, 89, 155, and 186 deaths at a cost of $35900, $99200, $111100, and $115700 per deaths, respectively, in 20 years.
Conclusion
The age-specific expansion policy of LTBI treatment not only for those under 35 years of age but also for those under 65 years of age among household contacts was cost-effective in terms of QALYs and averted TB deaths.
3.Socioeconomic Burden of Cancer in Korea from 2011 to 2015
Young Ae KIM ; Ye-Rin LEE ; Jeongjoo PARK ; In-Hwan OH ; Hoseob KIM ; Seok-Jun YOON ; Keeho PARK
Cancer Research and Treatment 2020;52(3):896-906
Purpose:
Though the socioeconomic burden of cancer on patients is increasing in South Korea, there is little research regarding the type of cancer that incurs the highest costs. This study analyzed the socioeconomic burden on cancer patients from 2011 to 2015 according to sex and age.
Materials and Methods:
A prevalence-based approach was applied utilizing claim data of the National Health Insurance Service in Korea to estimate the socioeconomic burden of cancer on patients. Patients who received treatment for cancer from 2011 to 2015 were the study subjects. The total socioeconomic burden of their disease and treatment was divided into direct and indirect costs.
Results:
There was an increase of 50.7% for 5 years, from 821,525 to 1,237,739 cancer patients. The cancer costs for men and women increased $8,268.4 million to $9,469.7 million and $3,626.5 million to $4,475.6 million, respectively. Furthermore, the 50-59-year-old age group accounted for a large portion of the total disease cost. Liver, lung, stomach, and colorectal cancers created the heaviest economic burdens on patients.
Conclusion
Overall, this study indicates new policies for cancer prevention, early detection, and postcancer treatment management are necessary to help limit the costs associatedwith cancer, especially in the elderly, and provides a foundation for establishing cancer-related health care policies, particularly by defining those cancers with heavier disease burdens.