BACKGROUND: The purpose of this exploratory study is to explain where, when and how the introduction of user fee system works in low and middle income countries using context, mechanism, and outcome configuration. METHODS: Considering advanced research in realist review approach, we made a review process including those following 4 steps. They are identifying the review question, initial theory and mechanism, searching and selecting primary studies, and extracting, analyzing, and synthesizing relevant data. RESULTS: User fee had a detrimental effect on medical utilization in low and middle income countries. Also previous and current interventions and community participation were critical context in user fee system. Those contexts were associated with intervention initiation and recognition and coping strategies. Such contexts and mechanisms were critical explanatory factors in medical utilization. CONCLUSION: User fee is a series of interventions that are fragile and dynamic. So the introduction of user fee system needs a comprehensive understanding of previous and new intervention, policy infrastructure, and other factors that can influence on medical utilization.
Consumer Participation ; Fees and Charges*

No abstract available.
Fee Schedules* ; Fees and Charges*

No abstract available.
Fees and Charges* ; Insurance*

Today's diagnosis related group (DRG) services system has improved medical insurance fees and subdivisions of disease compared with the past DRG system, but does not appropriately take into account the development of complications of severe disease and does not properly compensate care providers for the costs of using the newest medical devices. The Korean DRG system model needs to reflect the medical environment and the latest developments. Therefore, Cooperation with the government, medical service personnel, and citizens is necessary for the improvement of the DRG services system.
Diagnosis ; Diagnosis-Related Groups* ; Fees and Charges ; Insurance

PURPOSE: The purpose of this study was to analyze the differences in perception between the students and faculty on course evaluation by the students and to pursue the improving of the course evaluation system. METHODS: This study targeted 61 faculty and 88 students of the School of Medicine at A University. A questionnaire survey was administered. RESULTS: Both the students and faculty members agreed with the need of a course evaluation system, but there were differences in perception between the two groups in terms of efficiency and factors affecting evaluation results. CONCLUSION: The department in charge of course evaluations of the school of medicine should review the differences in perception between students and faculty and use the reviewed content to improve the present course evaluation system.
Fees and Charges ; Humans ; Schools, Medical ; Surveys and Questionnaires

The purpose of this study is to review communication skills education in medical education. This analysis looks at the reasons why communication skills education is difficult and how to design an effective curriculum for communication skills education. Problems in communication skills education are discussed, especially in relation to the complexity of the communication between patients and physicians, the changing of the communication model, and curriculum composition. Findings show that it is necessary to design a spiral curriculum for communication skills education, to harmonize theory and practice of communication, to encourage student participation, and to provide feedback to students. To educate communication skills, this paper concludes, professors in charge of communication skills education must seriously consider their teaching and evaluating methods and practice what they teach.
Curriculum ; Education, Medical ; Fees and Charges ; Humans ; Learning

This study was conducted to characterize well-being menus and to examine the service frequency and profitability of those served in the contract-managed workplace foodservice. In-depth interviews were conducted with six persons who were in charge of menu management in the headquarters of six different foodservice management companies during March, 2007. In addition, 122 set menus consisting of 777 menu items, which were on one month menus served during January to April, 2007, were collected from three workplace operations managed by three different foodservice management companies. As a result of the in-depth interviews, four categories of well-being menu items were extracted: 'medicinal, functional menu item', 'environmentally- friendly menu item', 'natural food menu item', and 'harmful components-limiting menu item'. Accordingly, a well-being menu item was defined as 'a menu item with increased nutrition value or decreased health risk by changing food material or cooking method'. When the menu items (n=777) were analyzed by applying the definition and categories, approximately 14% of the items were identified as well-being menu items and most of them were either medicinal, functional (65%) or natural food menu items (33%). Approximately 59% of the 122 set menus included at least one well-being menu item, and therefore they were named the well-being set menus. These well-being set menus, however, were not significantly different from the rest set menus in terms of profitability as measured by the contribution margin. The results of this study could be useful for foodservice management companies to develop and plan well-being menus targeting workplace foodservice operations.
Cooking ; Fees and Charges ; Humans ; Nutritive Value

The present study was performed to evaluate the job training needs of school nutrition teachers in order to enhance their specialty. Three hundred and forty questionnaires were distributed to school nutrition teachers working at primary and high schools in the Gyeongbuk area while 45 were distributed to professors during 2010~2011. Three hundred and two questionnaires from school nutrition teachers and 33 from professors were returned and analyzed. The rate of teachers practicing nutrition education was 54%, and the educational content was obtained mainly from the internet. The top three problems the teachers encountered were 'lack of standardized educational materials', 'inexperience of teaching', and 'insufficiency of expert knowledge'. The teachers recognized 'training program' as the best solution. However, the job training program operated immediately after teachers were appointed scored only 3.03 out of 5.00. Important contents of the training program ranked highly by the teachers were 'development of education materials', 'nutrition counseling', and 'teaching method'. The professors included 'expert knowledge' in their top three contents. Both the teachers and professors agreed to increase the frequency of 'practice' in training methods. Other factors the teachers considered to be important were high quality, diversity, ability of the instructor, training cycle, and the institution in charge. From these results, it can be concluded that efficient job training programs are needed for school nutrition teachers according to the importance of the education contents and training methods. It is therefore suggested that a cooperation committee be composed of an educator, educatee, and related personal in a local education office in order to operate the program.
Fees and Charges ; Humans ; Internet ; Surveys and Questionnaires

Currently, 10% of cancer chemotherapy is provided to patients by oral formulation; however, by 2013 this percentage is predicted to increase to 25%. Chemotherapy is traditionally given by injection. Oral chemotherapy has been developed as a more convenient method for treating patients. Oral chemotherapy offers many advantages including the elimination of pain often caused by injections, the lack of fees for administering intravenous drugs, more time at home for patients, and a patient's increased sense of autonomy. The role of oral chemotherapy has been expanding because of the potential advantages in convenience and better quality of life for patients, and in the cost-effectiveness of treatment as compared to intravenous chemotherapy. A number of novel oral targeted and cytotoxic chemotherapeutic agents are entering the market or are in development. Many of the agents display significant clinical activity against various cancers. The growing availability of effective oral chemotherapy treatments, especially the new class of 'targeted biologic therapies', is one of the wonderful recent advances in cancer care. This manuscript describes the progress of clinical development and efficacy of these newly developed chemotherapeutic agents.
Administration, Oral ; Fees and Charges ; Humans ; Quality of Life

The purpose of this study was to evaluate the patient perception of clinical nutrition service. The research was performed by using questionnaires and conducted from February 14 to March 15 at 42 hospitals (over 400 beds). 41.7% of patients experienced nutritional education and counseling. The mean score of the patients' perception on clinical nutritional service was 4.62/5.00 for "nutrition care is important for treatment of the disease", 4.49/5.00 for "diet therapy is necessary for treatment of the disease", 4.16/5.00 for "nutritional counseling call-centers are necessary", 4.13/5.00 for "nutritional consultation fee is required to apply insurance benefits", 4.12/5.00 for "one-to-one nutrition system is necessary", and 3.56/5.00 for "nutrition services I am willing to pay". The patients who had no past experience in nutritional education and counseling showed significantly higher scores for "nutrition care is important for treatment of the disease", "one-to-one nutritional care system is necessary", and "nutritional counseling call-centers are necessary" (P<0.05). The mean scores for the importance (4.26/5.00) and performance (3.88/5.00) of nutrition counseling service were significantly different (P<0.01). "Nutritional counseling is available whenever I want" had the highest gap score between performance and importance among nutrition counseling service items. The importance and performance grid showed that highly important items had high performance (doing great area) and less important items have low performance (low priority).
Counseling ; Fees and Charges ; Humans ; Insurance ; Surveys and Questionnaires