Vietnam has pursued universal health insurance coverage for two decades but has yet to fully achieve this goal. This paper investigates the barriers to achieve universal coverage and examines the validity of facilitating factors to shorten the transitional period in Vietnam. A comparative study of facilitating factors toward universal coverage of Vietnam and Korea reveals significant internal forces for Vietnam to further develop the National Health Insurance Program. Korea in 1977 and Vietnam in 2009 have common characteristics to be favorable of achieving universal coverage with similarities of level of income, highly qualified administrative ability, tradition of solidarity, and strong political leadership although there are differences in distribution of population and structure of the economy. From a comparative perspective, Vietnam can consider the experience of Korea in implementing the mandatory enrollment approach, household unit of eligibility, design of contribution and benefit scheme, and resource allocation to health insurance for sustainable government subsidy to achieve and sustain the universal coverage of health insurance.
Eligibility Determination ; Humans ; Income ; National Health Programs/*economics ; Republic of Korea ; Socioeconomic Factors ; Universal Coverage/*economics ; Vietnam

BACKGROUND: The determination of blood donor eligibility has become critical and challenging to blood operators as so many conditions and restrictions should be considered to correctly decide the donor eligibility. Since the launching of the BIMS (Blood Information Management System) in May 2003, the demand of developing a more intelligent system to assist the determination of donor eligibility has been growing. The Korean Red Cross Blood Service intended to develop an expert system for donor eligibility determination with high efficiency and ease of use. METHODS: The content of the system was determined through the activity of a team consisting of medical doctors, nurses, safety managers, and the system developers. Algorithms were developed according to the donor history taking process. The efficiency of the system was tested by the comparison of the time needed for inquiries and the number of inappropriate blood collections before and after the implementation of the new system. RESULTS: The new system's user interface integrated many complicated work processes with a user-friendly flexibility. The types of decision included the restricted donations. The donor interviewers were highly satisfied with the system because almost all cases were correctly determined in a relatively short time. Using this system, the number of inappropriate blood collections was significantly lowered. CONCLUSION: We developed an expert system that can aide the donor eligibility determination process and prevent the violation of the related regulations. This system will contribute to enhancement of the blood safety as well as donor protection for our blood services.
Blood Donors ; Blood Safety ; Eligibility Determination ; Expert Systems ; Humans ; Information Management ; Pliability ; Red Cross ; Social Control, Formal ; Tissue Donors

BACKGROUND: The determination of blood donor eligibility has become critical and challenging to blood operators as so many conditions and restrictions should be considered to correctly decide the donor eligibility. Since the launching of the BIMS (Blood Information Management System) in May 2003, the demand of developing a more intelligent system to assist the determination of donor eligibility has been growing. The Korean Red Cross Blood Service intended to develop an expert system for donor eligibility determination with high efficiency and ease of use. METHODS: The content of the system was determined through the activity of a team consisting of medical doctors, nurses, safety managers, and the system developers. Algorithms were developed according to the donor history taking process. The efficiency of the system was tested by the comparison of the time needed for inquiries and the number of inappropriate blood collections before and after the implementation of the new system. RESULTS: The new system's user interface integrated many complicated work processes with a user-friendly flexibility. The types of decision included the restricted donations. The donor interviewers were highly satisfied with the system because almost all cases were correctly determined in a relatively short time. Using this system, the number of inappropriate blood collections was significantly lowered. CONCLUSION: We developed an expert system that can aide the donor eligibility determination process and prevent the violation of the related regulations. This system will contribute to enhancement of the blood safety as well as donor protection for our blood services.
Blood Donors ; Blood Safety ; Eligibility Determination ; Expert Systems ; Humans ; Information Management ; Pliability ; Red Cross ; Social Control, Formal ; Tissue Donors

Vitamin D is a cofactor responsible for autoimmune disorders. There is no agreement in the studies investigating the association between vitamin D and fibromyalgia. This study aims to combine the conflicting results of the primary studies which compared these patients with control groups regarding the serum concentration of vitamin D. This meta-analysis has been designed based on PRISMA guidelines. Relevant keywords were searched in PubMed, Science direct, Scopus, Cochrane, and Google scholar and primary studies were selected. After screening the eligible studies according to inclusion/exclusion criteria, we investigated the risk of bias in the selected studies and also the heterogeneity between the primary results using Cochrane (Q) and I-squared (I2) indices. The primary results were combined using inverse variance method and Cohen statistics as well as a random effects model. Publication bias was assessed using Egger test. Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Suspected factors in the heterogeneity were assessed using meta-regression models. We entered 12 eligible studies in the meta-analysis including 851 cases compared with 862 controls. The standardized mean difference of Vitamin D between the two groups was −0.56 (95% confidence interval: −1.05, −0.08). Our meta-analysis showed that vitamin D serum levels of patients with fibromyalgia was significantly lower than that of control group.
Bias (Epidemiology) ; Eligibility Determination ; Fibromyalgia* ; Humans ; Mass Screening ; Methods ; Myofascial Pain Syndromes ; Population Characteristics ; Publication Bias ; Vitamin D* ; Vitamins*

Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.
Chronic Disease ; Dementia ; Eligibility Determination ; Heart ; Hospice Care ; Hospices ; Humans ; Korea ; Liver Diseases ; Lung ; Palliative Care ; Practice Guidelines as Topic ; Stress, Psychological

BACKGROUND/AIMS: Home oxygen therapy (HOT) costs a great deal every year and demand for the service is growing. In Korea, health insurance has covered HOT since November 1, 2006. The objective of this study was to evaluate clinical features of patients who used long-term HOT due to chronic respiratory failure and to determine the appropriateness of oxygen prescriptions. METHODS: Between November 2006 and April 2010, patients prescribed long-term HOT were enrolled in the study at a tertiary university referral hospital and their medical records and telephone survey information were evaluated. In total, 340 patients were evaluated retrospectively. RESULTS: Regarding the initial indications for HOT, their mean PaO2 was 49.8 mmHg and mean SpO2 was 82.2%. Underlying diseases included chronic obstructive pulmonary disease (COPD, 19.8%), lung cancer (12.6%), and interstitial lung disease (11.2%). The admission rate within 1 year was 53.4% and the average number of admissions was 1.64/patient. Other underlying diseases for which oxygen was prescribed, despite not meeting the insurance coverage criteria, were lung cancer (36.6%) and interstitial pneumonia (16.6%). CONCLUSIONS: Home oxygen prescriptions have increased since health insurance coverage was extended. However, cases of oxygen prescriptions frequently do not meet the coverage criteria. It is important to discuss extending the coverage criteria to other disease groups, such as interstitial lung disease and lung cancer, in terms of cost-effectiveness. Further, physicians prescribing oxygen therapy should be educated regarding the criteria.
Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Chronic Disease ; Eligibility Determination ; Emergency Service, Hospital ; Female ; *Home Care Services, Hospital-Based ; Hospitalization ; *Hospitals, University ; Humans ; Insurance Coverage ; Insurance, Health ; Kaplan-Meier Estimate ; Male ; Middle Aged ; *Oxygen Inhalation Therapy ; Patient Compliance ; Program Evaluation ; Republic of Korea ; Respiratory Insufficiency/diagnosis/etiology/mortality/*therapy ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult