Cost-of-Illness Trends Associated with Thyroid Disease in Korea

현경래,강성욱,이선미 대한내분비학회 2014 Endocrinology and metabolism Vol.29 No.3

Background: The purpose of this study is to analyze the scale of and trends associated with the cost-of-illness of thyroid disease in Korea at 2-year intervals during the last 10 years for which data are available. Methods: Cost-of-illness was estimated in terms of direct and indirect costs. Direct costs include direct medical costs due to hospitalization, outpatient and pharmacy sectors, transportation, and care-giver costs. Indirect costs include future income loss due to premature death and loss of productivity as a result of absence from work. Results: The cost-of-illness of thyroid disease in Korea was estimated at 224.2 billion won in 2002, 303.4 billion won in 2004, 400.3 billion won in 2006, 570.4 billion won in 2008, and 762.2 billion won in 2010. For example, the cost-of-illness of thyroid disease in 2010 was 3.4 times greater compared to 2002. The direct cost of the total cost-of-illness was 69.7%, which accounted for the highest proportion of costs. Cost-of-illness for individuals between the ages of 30 and 50 accounted for the greatest share of costs. Conclusion: The cost-of-illness of thyroid disease was relatively large in economically active age groups, and demonstrated a very rapid growth rate compared to other major diseases in Korea. Therefore, we suggest nationwide recognition of the importance of prevention and management of thyroid disease and prioritization of the management of thyroid disease among current and future health promotion policies in Korea.

The evaluation of cost-of-illness due to use of cost-of-illness-based chemicals

양지연,Yongjin Lee,Geonwoo Lee,Hanseul Lee,Jiyeon Yang 환경독성보건학회 2015 환경독성보건학회지 Vol.30 No.-

Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

The evaluation of cost-of-illness due to use of cost-of-illness-based chemicals

Hong, Jiyeon,Lee, Yongjin,Lee, Geonwoo,Lee, Hanseul,Yang, Jiyeon The Korean Society of Environmental Toxicology 2015 환경독성보건학회지 Vol.30 No.-

Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.

식중독의 사회경제적 비용추정: 삶의 질 개념을 적용한 질병비용추정법을 이용하여

신호성,이수형,김종수,김진숙,한규홍,Shin, Ho-Sung,Lee, Sue-Hyung,Kim, Jong-Soo,Kim, Jin-Suk,Han, Kyu-Hong 대한예방의학회 2010 예방의학회지 Vol.43 No.4

Objectives: This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Methods: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. Results: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 -76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Conclusions: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

혈중 중금속의 사회·경제적 질병비용 추정

진현정 ( Jin Hyun Joung ),조성민 ( Cho Sung-min ) 한국보건사회연구원 2016 保健社會硏究 Vol.36 No.4

위해물질의 관리 및 규제는 소비자의 효용 증대와 질병비용 부담 감소뿐만 아니라 정부의 질병비용을 줄이는 효과가 있다. 따라서 해당 위해물질의 사회·경제적 질병비용에 대한 예측은 관련 식품 및 보건 정책에 필수적이라 할 수 있다. 이에 본 연구에서는 식품을 통한 납, 카드뮴, 비소 섭취에 따른 질병과 관련된 사회·경제적 비용을 분석하였다. 이를 위해 이 세 가지 중금속과 관련된 질병들의 목록을 도출하고, 중금속 평균혈중 농도와 질병들의 연관성을 추정하였다. 그리고 질병비용추정법을 이용하여 선별된 각 질병들이 야기하는 직·간접 질병비용을 도출하고, 세 가지 중금속의 혈중 평균 농도가 야기하는 총 질병비용을 도출하였다. 연구 결과 납의 경우 만성질환 중 4가지, 카드뮴은 6가지 그리고 비소는 5가지 질병의 유병률에 유의한 영향을 미치는 것으로 나타났고, 이러한 질병들이 야기하는 총 질병비용은 약 23조 7천억원 정도로 추정되었다. 또한 우리나라 국민들의 납, 카드뮴, 비소 평균 혈중 농도가 야기하는 총 질병비용은 카드뮴이 346.8억원, 비소 341.9억원, 납 165.0억원으로 나타났다. 이 결과는 중금속으로 인한 질병비용에 대한 보다 정밀화된 정보를 제공하고, 더 나아가 안전하고 건강한 식품을 위한 정책 효과를 가늠하는데 활용될 수 있을 것으로 여겨진다. This study attempts to estimate socio-economic costs of illness due to heavy metals, in particular, lead, cadmium, and arsenic, which have drawn special attention recently in food hazard management. For our analysis, we listed illnesses related to the three heavy metals and examined, using a logistic regression, their association with the blood concentration of each of these heavy metals. Next, by using COI (cost-of-illness) method, socio-economic costs caused by illnesses which were found to be related to one of the three heavy metals were calculated and finally total costs of illness due to lead, cadmium, and arsenic were derived. The results indicate that among chronic diseases, four illnesses were related to lead and six and five illnesses were related to, respectively, cadmium and arsenic. The total socio-economic costs of the illnesses which were found to be related with three heavy metals were about 23.7 trillion won and the total costs of illnesses caused by blood concentration of lead, cadmium, and arsenic among the public were 165.0 billion, 346.8 billion won, and 341.9 billion, respectively. The contribution of this study lies in providing reliable information regarding costs of illness which would be a lower bound for the cost due to heavy metals and providing an useful tool to judge the effect of food and health policies dealing with other hazardous substances.

건강보험 청구자료를 이용한 우리나라 천식환자의 질병비용부담 추계

박춘선,권일,강대룡,정혜영,강혜영,Park, Choon-Seon,Kwon, Il,Kang, Dae-Ryong,Jung, Hye-Young,Kang, Hye-Young 대한예방의학회 2006 예방의학회지 Vol.39 No.5

Objectives: We estimated the asthma-related health care utilization and costs in Korea from the insurer's and societal perspective. Methods: We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had ${\geq}$2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines, Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to health care providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits. Results: A total of 699,603people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct health care costs accounted for 84.9%, transportation costs for 15.1 % and time costs for 9.2% of the total costs. Conclusions: Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.

The Economic Burden of Cancer in Korea in 2009

Kim, So Young,Park, Jong-Hyock,Kang, Kyoung Hee,Hwang, Inuk,Yang, Hyung Kook,Won, Young-Joo,Seo, Hong-Gwan,Lee, Dukhyoung,Yoon, Seok-Jun Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. Materials and Methods: The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. Results: In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Conclusions: Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

우리나라 모성 관련 질환의 사회적 비용

조민우,조보금,이상일,안정훈,오인환,이예린 한국보건의료기술평가학회 2018 보건의료기술평가 Vol.6 No.2

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

건강보험 청구자료를 이용한 우리나라 뇌졸증 환자의 사회경제적 비용 추계

임승지,김한중,남정모,장후선,장영화,김세라,강혜영,Lim, Seung-Ji,Kim, Han-Joong,Nam, Chung-Mo,Chang, Hoo-Sun,Jang, Young-Hwa,Kim, Se-Ra,Kang, Hye-Young 대한예방의학회 2009 예방의학회지 Vol.42 No.4

Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

Review : Cost-of-illness studies: concepts, scopes, and methods

( Ik Jo Chang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.4

Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. (Clin Mol Hepatol 2014;20:327-337)