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PHRP : Osong Public Health and Research Perspectives

OPEN ACCESS. pISSN: 2210-9099. eISSN: 2233-6052

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"cost"

Original Articles

Economic effectiveness of training personnel for infectious disease response and improving information systems in Republic of Korea: a cost-benefit analysis
Sunung Moon, Sangwon Lee, Yunhyung Kwon, Chaeeun Lee, Nahyun Kwon
Received January 27, 2026  Accepted June 18, 2026  Published online August 14, 2026  
DOI: https://doi.org/10.24171/j.phrp.2026.0019    [Epub ahead of print]
Objectives
This study assessed the economic value of 2 major initiatives within the national infectious disease response system of the Korea Disease Control and Prevention Agency (KDCA): the Training Programs for Public Health Workforce (TPPHW) and the Infectious Disease Information System (IDIS). Methods: We developed a structured estimation model to quantify the economic benefits of pandemic preparedness investments and applied it to the KDCA’s TPPHW and IDIS. The model incorporated parameters elicited from 29 senior officials into a cost-benefit analysis (CBA) framework, from which we calculated the net present value (NPV) and benefit-cost ratio (BCR) over a 10-year period, with sensitivity analyses. Results: Both initiatives yielded positive net benefits under baseline assumptions, although the margin was substantially greater for workforce training than for the information system. At the assumed discount rate of 4.5%, the CBA yielded a BCR of 2.120 and an NPV of 27.2 billion Korean won (KRW) for TPPHW. For IDIS, the corresponding values were a BCR of 1.071 and an NPV of 2.7 billion KRW. Sensitivity analysis showed that workforce training remained economically justified across all scenarios, whereas the information system remained viable only under more favorable assumptions. Conclusion: This study contributes to the literature by systematically applying CBA to infectious disease preparedness in the Republic of Korea. The findings support continued investment in skilled workforce training and integrated information infrastructure for future pandemic preparedness. The study is limited by its reliance on expert-elicited parameters and its focus on monetary benefits, excluding health outcomes such as disability-adjusted life years and quality-of-life improvements.
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Changes in the pattern and disease burden of acute respiratory viral infections before and during the COVID-19 pandemic
Chungmin Park, Donghan Lee, Bryan Inho Kim, Sujin Park, Gyehee Lee, Sangwoo Tak
Osong Public Health Res Perspect 2022;13(3):203-211.
Published online June 30, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0144
Objectives
We conducted a comparative analysis of the differences in the incidence of 8 acute respiratory viruses and the changes in their patterns before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Three sentinel surveillance systems of the Korea Disease Control and Prevention Agency and data from the Health Insurance Review and Assessment Service were analyzed. The average numbers of reported cases and the related hospital admissions and outpatient data were compared between April 2018–2019 and 2020–2021. Changes in the disease burden and medical expenditures between these 2 time periods were evaluated. Results: During the COVID-19 pandemic, the number of reported cases of all acute respiratory viral infections, except for human bocavirus, decreased significantly. Data from the Health Insurance Review and Assessment Service also showed decreases in the actual amount of medical service usage and a marked reduction in medical expenditures. Conclusion: Non-pharmacological interventions in response to COVID-19 showed preventive effects on the transmission of other respiratory viruses, as well as COVID-19. Although COVID-19 had a tremendous impact on society as a whole, with high social costs, there were also positive effects, such as a reduction in the incidence of acute respiratory viral infections.

Citations

Citations to this article as recorded by  Crossref logo
  • Performance Evaluation of a Respiratory Virus Multiplex Real-Time PCR Panel Including SARS-CoV-2 and Its Clinical Utility in the Post-Pandemic Period
    Sunggyun Park
    Keimyung Medical Journal.2025; 44(1): 30.     CrossRef
  • Machine learning forecasts for seasonal epidemic peaks: Lessons learnt from an atypical respiratory syncytial virus season
    Roger A. Morbey, Daniel Todkill, Conall Watson, Alex J. Elliot, André Ricardo Ribas Freitas
    PLOS ONE.2023; 18(9): e0291932.     CrossRef
  • 9,429 View
  • 205 Download
  • 1 Web of Science
  • Crossref
Cost of Tuberculosis Treatment: Evidence from Iran’s Health System
Vahid Bay, Payam Tabarsi, Aziz Rezapour, Sima Marzban, Ehsan Zarei
Osong Public Health Res Perspect 2017;8(5):351-357.
Published online October 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.5.09
<sec><title>Objectives</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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%).</p></sec><sec><title>Conclusion</title><p>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.</p></sec>

Citations

Citations to this article as recorded by  Crossref logo
  • Measuring the catastrophic cost of diagnosis, treatment, care, and support on people and families affected by tuberculosis in Iran and Afghanistan
    Enayatollah Homaie Rad, Bilal Ahmad Rahimi, Minoo Alipouri-Sakha
    IJID Regions.2025; 15: 100601.     CrossRef
  • Costs and psychosocial burden of tuberculosis to the treatment supporters in Ghana
    Robert Bagngmen Bio, Patricia Akweongo, John Azaare, Francis Adane, Kasim Abdulai, Richard Ali Laar, Abraham Titiati
    Health Policy and Technology.2025; 14(5): 101060.     CrossRef
  • Changes in incidence and clinical features of tuberculosis with regard to the COVID-19 outbreak in Southern Iran
    Mohammad Javad Fallahi, Mohammad Nazemi, Ali Zeighami, Reza Shahriarirad
    BMC Infectious Diseases.2024;[Epub]     CrossRef
  • Costs of services and funding gap of the Bangladesh National Tuberculosis Control Programme 2016–2022: An ingredient based approach
    Md. Zahid Hasan, Sayem Ahmed, Zeenat Islam, Farzana Dorin, Md. Golam Rabbani, Gazi Golam Mehdi, Mohammad Wahid Ahmed, Tazeen Tahsina, Shehrin Shaila Mahmood, Ziaul Islam, Kevin Schwartzman
    PLOS ONE.2023; 18(6): e0286560.     CrossRef
  • Distribution incidence, mortality of tuberculosis and human development index in Iran: estimates from the global burden of disease study 2019
    Hossien Fallahzadeh, Zaher Khazaei, Moslem Lari Najafi, Sajjad Rahimi Pordanjani, Elham Goodarzi
    BMC Public Health.2023;[Epub]     CrossRef
  • Spatio-temporal epidemiology of the tuberculosis incidence rate in Iran 2008 to 2018
    Behzad Kiani, Amene Raouf Rahmati, Robert Bergquist, Soheil Hashtarkhani, Neda Firouraghi, Nasser Bagheri, Elham Moghaddas, Alireza Mohammadi
    BMC Public Health.2021;[Epub]     CrossRef
  • Healthcare utilization patterns and economic burden of animal bites
    Vahid Bay, Aziz Rezapour, Mehdi Jafari, Mohammad Reza Maleki, Irvan Masoudi Asl
    Journal of Acute Disease.2021; 10(4): 142.     CrossRef
  • An Analysis of the Survival Probability of Tuberculosis Patients with Right Censored and Interval Censored Observation in Zahedan during 2014 - 2016
    Mohammad Hossein Dehghan, Seyyed Mohammad Hashemi Shahri, Mojgan Salari
    Zahedan Journal of Research in Medical Sciences.2019;[Epub]     CrossRef
  • Extent and determinants of catastrophic health expenditure for tuberculosis care in Chongqing municipality, China: a cross-sectional study
    Weixia Duan, Wen Zhang, Chengguo Wu, Qingya Wang, Ya Yu, Hui Lin, Ying Liu, Daiyu Hu
    BMJ Open.2019; 9(4): e026638.     CrossRef
  • Demographic, socio-economic and behavior as risk factors of tuberculosis in Malaysia: a systematic review of the literature
    Nur Adibah Mohidem, Zailina Hashim, Malina Osman, Rafiza Shaharudin, Farrah Melissa Muharam, Punitha Makeswaran
    Reviews on Environmental Health.2018; 33(4): 407.     CrossRef
  • 9,592 View
  • 56 Download
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Short Communication

What Makes Vietnamese (Not) Attend Periodic General Health Examinations? A 2016 Cross-sectional Study
Quan-Hoang Vuong, Quang-Hoi Vu, Thu-Trang Vuong
Osong Public Health Res Perspect 2017;8(2):147-154.
Published online April 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.2.07
<sec><title>Objectives</title><p>General health examinations (GHE) have become an increasingly common measure for preventive medicine in Vietnam. However, little is known about the factors among Viet-namese people who attend or miss GHE. Budget or time constraints remain to be evaluated for better-informed policy making. This study investigates factors affecting behaviors in attending periodic GHE. The main objectives are as follows: (1) to explore empirical relationships between influencing factors and periodic GHE frequencies, and (2) to predict the probabilities of attending GHE under associated conditions.</p></sec><sec><title>Methods</title><p>The study used a 2,068-observational dataset, obtained from a Vietnamese survey in 2016. The analysis was then performed using the methods of baseline-category logits for establishing relationships between predictor and response variables.</p></sec><sec><title>Results</title><p>Significant relationships were found among the expenditure and time consumption, health priority and sensitivity to health data, insurance status, and frequency of GHE, with most <italic>p</italic>-values = 0.01.</p></sec><sec><title>Conclusion</title><p>Generally, people attended the GHE when they had the resources and health priorities (72.7% probability). Expenditure and time remain key obstacles to the periodic GHE. Health priority and health data are important in improving rates for GHEs. Health insurance should play a positive role in promoting the GHE.</p></sec>

Citations

Citations to this article as recorded by  Crossref logo
  • Multiple Chronic Conditions and Disability among Vietnamese Older Adults: Results from the Vietnamese Aging and Care Survey (VACS)
    Christina E. Miyawaki, Joshua M. Garcia, Kim N. Nguyen, Van Ta Park, Kyriakos S. Markides
    Journal of Racial and Ethnic Health Disparities.2024; 11(3): 1800.     CrossRef
  • Sex Differences and Psychological Factors Associated with General Health Examinations Participation: Results from a Vietnamese Cross-Section Dataset
    Quan-Hoang Vuong, Kien-Cuong P. Nghiem, Viet-Phuong La, Thu-Trang Vuong, Hong-Kong T. Nguyen, Manh-Toan Ho, Kien Tran, Thu-Hong Khuat, Manh-Tung Ho
    Sustainability.2019; 11(2): 514.     CrossRef
  • Health Care Payments in Vietnam: Patients’ Quagmire of Caring for Health versus Economic Destitution
    Andre Pekerti, Quan-Hoang Vuong, Tung Ho, Thu-Trang Vuong
    International Journal of Environmental Research an.2017; 14(10): 1118.     CrossRef
  • Psychological and Socio-Economic Factors Affecting Social Sustainability through Impacts on Perceived Health Care Quality and Public Health: The Case of Vietnam
    Quan-Hoang Vuong, Thu-Trang Vuong, Tung Ho, Ha Nguyen
    Sustainability.2017; 9(8): 1456.     CrossRef
  • 8,657 View
  • 45 Download
  • Crossref
Original Articles
Analysis of Hospital Volume and Factors Influencing Economic Outcomes in Cancer Surgery: Results from a Population-based Study in Korea
Jung-A Lee, So-Young Kim, Keeho Park, Eun-Cheol Park, Jong-Hyock Park
Osong Public Health Res Perspect 2017;8(1):34-46.
Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.05
<sec><title>Objectives</title><p>To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume.</p></sec><sec><title>Methods</title><p>Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles.</p></sec><sec><title>Results</title><p>Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy.</p></sec><sec><title>Conclusion</title><p>Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals’ cost of care and risk-adjusted mortality.</p></sec>

Citations

Citations to this article as recorded by  Crossref logo
  • Impact of hospital volume on failure to rescue for complications requiring reoperation after elective colorectal surgery: multicentre propensity score–matched cohort study
    Marie T Grönroos-Korhonen, Laura E Koskenvuo, Panu J Mentula, Taina P Nykänen, Selja K Koskensalo, Ari K Leppäniemi, Ville J Sallinen
    BJS Open.2024;[Epub]     CrossRef
  • Volume-outcome relationships in laryngeal trauma processes of care: a retrospective cohort study
    David Forner, Christopher W. Noel, Matthew P. Guttman, Barbara Haas, Danny Enepekides, Matthew H. Rigby, S. Mark Taylor, Avery B. Nathens, Antoine Eskander
    European Journal of Trauma and Emergency Surgery.2022; 48(5): 4131.     CrossRef
  • Association between Stroke Quality Assessments and Mortality within 30 Days among Patients Who Underwent Hemorrhagic Stroke Surgeries in South Korea
    Mi-Na Lee, Wonjeong Jeong, Sung-In Jang, Sohee Park, Eun-Cheol Park
    Cerebrovascular Diseases.2022; 51(1): 82.     CrossRef
  • Impact of surgeon and hospital factors on length of stay after colorectal surgery systematic review
    Zubair Bayat, Keegan Guidolin, Basheer Elsolh, Charmaine De Castro, Erin Kennedy, Anand Govindarajan
    BJS Open.2022;[Epub]     CrossRef
  • Crucial areas of the economic analysis of public cancer care
    D. A. Andreev, K. I. Polyakova, A. A. Zavyalov, T. N. Ermolaeva, A. G. Fisun, A. D. Ermolaeva, V. A. Dubovtseva, T. E. Maksimova
    FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Phar.2020; 12(4): 310.     CrossRef
  • Initial Diagnosis of Colorectal Cancer through Colonoscopy or Emergent Surgery-Clinicopathological Features that Support Early Screening
    Konstantinos A Paschos, A Chatzigeorgiadis
    Hellenic Journal of Surgery.2020; 92(2): 51.     CrossRef
  • What Matters in the Performance of a Medial Institution?
    Hae-Wol Cho, Chaeshin Chu
    Osong Public Health and Research Perspectives.2017; 8(1): 1.     CrossRef
  • 7,843 View
  • 46 Download
  • Crossref
Are Free Maternity Services Completely Free of Costs?
Jeevan Acharya
Osong Public Health Res Perspect 2016;7(1):26-31.
Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.002
Objectives
The Government of Nepal revised free maternity health services, “Aama Surakshya Karyakram”, beginning at the start of Fiscal Year 2012/13, which specifies the services to be funded, the tariffs for reimbursement, and the system for claiming and reporting on free deliveries each month. This study was designed to investigate the amount of monetary expenditure incurred by families using apparently free maternity services.
Methods
Between August 2014 and December 2014, a hospital-based cross-sectional study was conducted at Manipal Teaching Hospital and Western Regional Hospital. Nepalese women were not involved with family finances and had very little knowledge of income or expenditures. Therefore, face-to-face interviews with 384 postpartum mothers with their husbands or the head of the family household were conducted at the time of discharge by using a pre-tested semi-structural questionnaire.
Results
The average monthly family income was 19,272.4 NRs (189.01 US$), the median duration of hospital stay was 4 days (range, 2−19 days), and the median patient expenditure was equivalent to 13% of annual family income. The average total visible cost was 3,887.07 NRs (38.1 US$). When the average total hidden cost of 27,288.5 NRs (267.6 US$) was added, then the average total maternity care expenditure was 31,175.6 NRs (305.76 US$), with an average cost per day of 7,167.5 NRs (70.29 US$). The mean patient expenditure on food and drink, clothes, transport, and medicine was equivalent to 53.07%, 9.8%. 7.3%, and 5.6% of the mean total maternity care expenditure, respectively. The earnings lost by respondent women, husbands, and heads of household were 5,963.7 NRs (58.4 US$), 7,429.3 NRs (72.9 US$), and 6,175.9 NRs (60.6 US$), respectively.
Conclusion
The free maternity service in Nepal has high out-of-pocket expenditures, and did not represent a system completely free of costs. Therefore, arrangements should be made by hospitals free of cost to provide medicine that is not included as essential during the hospital stay and at discharge time. Similarly, arrangements for liquid, food, and hot water, as well as clothes for mothers and newborns, should be made by the hospital in order to enhance hospital attendance.

Citations

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  • From Village to Clinic: Structural Barriers and Intersecting Challenges in Maternal Healthcare Access in Rural Nepal
    Lalita Kumari Sah, Eleni Hatzidimitriadou, Prabhu Sah
    International Journal of Environmental Research an.2026; 23(4): 454.     CrossRef
  • Organisation, Financing, and Implementation of Preconception Care in Primary Care: Implications for Women’s Health and Well-Being
    Lora Draeva, Eleonora Hristova-Atanasova, Georgi Iskrov, Rumen Stefanov
    Healthcare.2026; 14(17): 2706.     CrossRef
  • Postpartum length of hospital stay among obstetric patients in Ibadan, Nigeria
    Ikeola A. Adeoye, Blessing U. Aleka, Rotimi F. Afolabi, Timothy A.O Oluwasola
    BMC Health Services Research.2024;[Epub]     CrossRef
  • The magnitude of out‐of‐pocket expenditure for antenatal care in low and middle‐income countries: A systematic review and meta‐analysis
    Sajaan Praveena Gunarathne, Nuwan Darshana Wickramasinghe, Thilini Chanchala Agampodi, Indika Ruwan Prasanna, Suneth Buddhika Agampodi
    The International Journal of Health Planning and M.2023; 38(1): 179.     CrossRef
  • Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision
    Aisha Kuliya-Gwarzo, Tara Tancred, Daniel Gordon, Imelda Bates, Joanna Raven
    F1000Research.2023; 12: 288.     CrossRef
  • Out-of-Pocket Expenditure for Antenatal Care Amid Free Health Care Provision: Evidence From a Large Pregnancy Cohort in Rural Sri Lanka
    Sajan Praveena Gunarathna, Nuwan Darshana Wickramasinghe, Thilini Chanchala Agampodi, Indika Ruwan Prasanna, Suneth Buddhika Agampodi
    Global Health: Science and Practice.2023; 11(5): e2200410.     CrossRef
  • Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision
    Aisha Kuliya-Gwarzo, Tara Tancred, Daniel Gordon, Imelda Bates, Joanna Raven
    F1000Research.2023; 12: 288.     CrossRef
  • Maternal anaemia care in Kano state, Nigeria: an exploratory qualitative study of experiences of uptake and provision
    Aisha Kuliya-Gwarzo, Tara Tancred, Daniel Gordon, Imelda Bates, Joanna Raven
    F1000Research.2023; 12: 288.     CrossRef
  • Protocol for systematic review and meta-analysis: magnitude, reasons, associated factors, and implications of the out-of-pocket expenditure during pregnancy
    S.P. Gunarathne, N.D. Wickramasinghe, T.C. Agampodi, R.P.I.R. Prasanna, S.B. Agampodi
    Public Health.2022; 206: 33.     CrossRef
  • Length of Hospital Stay After Cesarean Delivery and Its Determinants Among Women in Eastern Sudan
    Bahaeldin Hassan, Omer Mandar, Nadiah Alhabardi, Ishag Adam
    International Journal of Women's Health.2022; Volume 14: 731.     CrossRef
  • Free delivery care and supply-side incentives in Nepal’s poorest districts: the effect on prenatal care and neonatal tetanus vaccinations
    Sujita Pandey, Angela Daley
    Journal of Development Effectiveness.2021; 13(1): 100.     CrossRef
  • How costly is the first prenatal clinic visit? Analysis of out-of-pocket expenditure in rural Sri Lanka - a country with free maternal health care
    Sajaan Praveena Gunarathne, Nuwan Darshana Wickramasinghe, Thilini Chanchala Agampodi, Indika Ruwan Prasanna, Suneth Buddhika Agampodi
    BMC Health Services Research.2021;[Epub]     CrossRef
  • Length of stay in health facilities after childbirth and associated maternal and neonatal factors in Ethiopia: a cross-sectional study from a national survey
    Yemisrach Belete Biru, Getasew Assefa Lemelem, Nahom Solomon
    BMJ Open.2021; 11(12): e055327.     CrossRef
  • Length of stay after childbirth in India: a comparative study of public and private health institutions
    Pradeep Kumar, Preeti Dhillon
    BMC Pregnancy and Childbirth.2020;[Epub]     CrossRef
  • Hidden Costs of Hospital-Based Delivery Among Women Using Public Hospitals in Bale Zone, Southeast Ethiopia
    Melese Merga, Tilahun Fufa Debela, Tesfamichael Alaro
    Journal of Primary Care & Community Health.2019;[Epub]     CrossRef
  • “We are called the et cetera”: experiences of the poor with health financing reforms that target them in Kenya
    Evelyn Kabia, Rahab Mbau, Robinson Oyando, Clement Oduor, Godfrey Bigogo, Sammy Khagayi, Edwine Barasa
    International Journal for Equity in Health.2019;[Epub]     CrossRef
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    Philip Ayizem Dalinjong, Alex Y. Wang, Caroline S. E. Homer
    Health Economics Review.2017;[Epub]     CrossRef
  • 5,762 View
  • 29 Download
  • Crossref
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