Government Programs ; Laboratories ; Public Health

PURPOSE: The purpose of this study is to develop the optimal nursing fee for nurse-midwifery center (MC) in the national health insurance system. METHODS: The three methodologies used to calculate the conversion factors for the MCs in the national health insurance include cost accounting method, sustainable growth rate (SGR) model, and index model. In this study, the macro-economic indicators and the national statistics were used to estimate the conversion factors for the MCs. RESULTS: The optimal nursing fee for the MCs in 2011 was estimated to be an increase of 57.7% by cost accounting analysis, a decrease of 17.1% by SGR model, and a decrease of 16.1% by index model. The results from SGR model and index model could had been biased due to the upswing of medical spendings in the short-term period (2008~2009). A sensitivity analysis of pre-delivery subsidy program for OB & GYN hospitals and clinics showed that the program has substantially diminished the demand for the MC services. CONCLUSION: More reliable methodologies to estimate nursing fees precisely are required to prove the value of nurses' services and a government subsidy program for the MC services should be followed from a social perspective.
Accounting ; Bias (Epidemiology) ; Fees and Charges ; Financing, Government ; Insurance, Health ; Midwifery ; National Health Programs

Sludge dewatering and treatment may cost as much as the wastewater treatment. Usually large proportion of the pollutants in wastewater is organic. They are attacked by saprophytic microorganisms, i.e. organisms that feed upon dead organic matter. Activity of organisms causes decomposition of organic matter and destroys them, where the bacteria convert the organic matter or other constituents in the wastewater to new cells, water, gases and other products. Demolition activities, including renovation/remodeling works and complete or selective removal/demolishing of existing structures either by man-made processes or by natural disasters, create an extensive amount of wastes. These demolition wastes are characterized as heterogeneous mixtures of building materials that are usually contaminated with chemicals and dirt. In developing countries, it is estimated that demolition wastes comprise 20% to 30% of the total annual solid wastes. In Egypt, the daily quantity of construction and demolition (C&D) waste has been estimated as 10 000 tones. That is equivalent to one third of the total daily municipal solid wastes generated per day in Egypt. The zabbaliin have since expanded their activities and now take the waste they collect back to their garbage villages where it is sorted into recyclable components: paper, plastics, rags, glass, metal and food. The food waste is fed to pigs and the other items are sold to recycling centers. This paper summarizes the wastewater and solid wastes management in Egypt now and future.
Biodegradation, Environmental ; Egypt ; Environmental Microbiology ; Government Programs ; Humans ; Waste Management ; methods

PURPOSE: The purpose of this study was to explore the perception of infertile women on the use of the national support program that provides medical expense aid to infertile couples. METHODS: Thirty Korean infertile women participated in five focus groups. Data were collected from January to August 2014. After obtaining permission from the participants, each session of the focus group was audio-taped and transcribed. The responses were analyzed using qualitative content analysis. RESULTS: The main themes identified from the sessions with the participants were "feeling thankful for the reliable support program," "feeling happy or unhappy," "enduring inconveniences," and "hoping for a more comprehensive support service." Although most of the participants perceived the benefits of the national support service positively, they stated that the service was not comprehensive because it did not cover all the medical expenses for tests and other medical treatments. CONCLUSION: The benefits given to infertile couples by the program should be increased by covering all the medical expenses, expanding its criteria to include more eligible candidates, and by including special leave benefits for working women. Furthermore, it is essential to take measures for infertility prevention at the individual and national policy levels.
Family Characteristics* ; Female ; Focus Groups ; Government Programs ; Humans ; Infertility ; Women, Working

Medical professionalism in Korea is underdeveloped because of a strong state that has been in place for the past one hundred years. If the government actively controls policies and regulates the professional associations under state corporatism, deterioration of professionalism is inevitable. The current medical insurance in Korea is unified as a monopsony, but it is not the 'bipartite corporatism' between the government and the medical profession such as the National Health Services (NHS) in Britain. All insurance matters related to a physician's practice, including standards of treatment and the physician's reimbursement, are handled by the government. Therefore, the authority of medical expertise is subordinate to the authority of the government agency, and physicians are forced to follow the goals and policies that are set by the government. Physicians' professional ethics are the core of their occupational control. The declaration of "Codes of Ethics" by the Korean Medical Association, before it was revised in April 2006, defined a "sincere fulfillment in practicing medicine" as a full duty of the physician's life. If this declaration was intended to be interpreted literally, all physicians in Korea could be asked to pursue identical lives with the same goals as their professional life as a physician. If it was not intended to be interpreted literally, then physicians may develop their own ethical approaches according to their individual perspectives on life. The former case is an unethical form of state control while; the latter case would make legitimate occupational regulation impossible. The ideal of medical service is an institutional attribute of an occupation and not a duty of an individual's life. Therefore, it should be possible for physicians to work under an occupational control that requires specific standards for the members of the profession and embodies their professional values.
Codes of Ethics ; Ethics, Professional ; Government Agencies ; Hypogonadism ; Insurance ; Korea ; Mitochondrial Diseases ; National Health Programs ; Occupations ; Ophthalmoplegia

The late Professor Byung Yik Kim published an analysis of the financial crisis of Korea's National Health Insurance (NHI) in 2001, which derived from the introduction of the separation of prescribing and dispensing. Subsequently, Kim published another paper on policy suggestions to achieve financial stability of the national health insurance in 2002. In his paper of 2001, he had analyzed two causes of the crisis. First, the stepwise integration of health insurance funds had brought about financial instability since 1998, when regional health insurance funds were integrated into one fund. Second, the introduction of the separation of prescribing and dispensing without recognition of financial instability led to financial crisis. In his 2002 paper, he proposed several policy recommendations, including postpone of financial integration among insurance funds, increasing government subsidies, introducing new financing sources for health insurance, such as an alcohol tax, and implementing cost-containment policies. This paper reviews what was changed in accordance with his policy suggestions over the past 10 years. Many policymakers agreed with his analysis on the causes of financial crisis, however, they did not accept his policy recommendations. Consequently, the Korea National Health Insurance is still financially unstable.
Financial Management ; Financing, Government ; Insurance ; Insurance, Health ; Korea ; National Health Programs ; Taxes

Background: The Universal Health Care (UHC) Act is a landmark legislation that seeks to improve provision of comprehensive health services through the integration of local health systems. The Department of Health (DOH) conducted a series of roundtable discussions to gather stakeholders' inputs and concerns to refine the initial draft of the Implementing Rules and Regulations (IRR) of UHC. Methods: On April 4, 2019, the Department of Health led a roundtable discussion on the Local Health Systems sections of the UHC IRR in collaboration with University of the Philippines Manila. A total of 65 stakeholders from different sectors participated in a semi-structured roundtable event. The proceedings were audio recorded and transcribed. A thematic analysis was done using NVivo 12 software to document gaps and gray areas identified by the participants. Results: Concerns of the participants revolved around the following: role of the private sector in local health systems; the integration of different municipal and other component health systems into a province-wide health system; organizational design of the health systems; pooling and utilization of the Special Health Fund (SHF). Gaps andgray areas were concentrated on the transfer of personnel and other health resources to the province-wide system, the composition of the Provincial Health Board, and the utilization and management of the SHF. Conclusion The roundtable event acquired various perspectives from stakeholders that could help the DOH identify priority action points that could be resolved at the agency level. The identified themes from the study analysis could be of value to decision makers to clarify issues, address policy gaps, and to prioritize future research directions.
Universal Health Care ; Policy Making ; Medical Assistance ; Government Programs ; Health Policy ;

Recently, The Ministry of Health and Welfare(MOHW) introduced a new bill called the Law of Personal Care for the Elderly People(LPCEP). The bill has several important problems. First, the bill of LPCEP contains no comprehensive care but only personal care. Basically, the elderly would be in need of comprehensive care because they are weakened or in ill-health and must always be provided with medical treatment and personal care. However, MOHW has reduced the basic concept of services for the elderly from comprehensive care to personal care. Second, the design of the longterm care insurance scheme is distorted. Principles of insurance are not adopted making eligibility equal to the burden of insurance contribution. In addition, the burden of the nation is insufficient compared with that of Japan. Third, medical longterm care facilities(LTCF) are no longer provided for the elderly. It is inadequate for the elderly to be provided only non-medical LTCF. Fourth, in the beginning, the National Health Insurance Corporation would manage the LTC system, but in the long run, local government should manage it. Fifth, the assessment of eligibility scale is not estimated by professional medical man power. Half of the estimation committee is composed of public officers who have no professional knowledge or skills in simulative demonstration of long-term care insurance. Sixth, care management of core man power for LTC is not designed to adequately supply for the elderly. A personal caregiver only would be supplied. Therefore, the bill has to be put on hold. In case of a revision, the bill, which is designed inappropriately, should be reformed fully.
Aged ; Caregivers ; Humans ; Insurance ; Insurance, Long-Term Care* ; Japan ; Jurisprudence ; Local Government ; Long-Term Care* ; National Health Programs

This study was carried out to investigate the present status of nutrition services for infants in public health centers and the need for nutrition services of health workers and infants mothers. The study subjects were 146 health workers and 197 infants mothers. The results were as follows : At present, the only major nutrition services for infants were vaccination and dental care. Proper nutrition management services were available to infants. Nutrition knowledge scores were 16.8 for health workers and 15.3 for mothers out of 20 possible points. Health workers strongly demanded a well-organized nutrition education program, government support, audio-visual materials and the employment of a community nutritionist. The public health workers, in particular, demanded the development of education programs for breastfeeding and weaning. The infants mothers demanded services of nutrition information and teaching of cooking and menu planning. Based on this, the results suggest that the employment of a community nutritionist and the development of practical nutrition service programs for infants are needed very urgently for public health centers.
Breast Feeding ; Cooking ; Dental Care ; Education ; Employment ; Government Programs ; Humans ; Infant* ; Menu Planning ; Mothers* ; Nutritionists ; Public Health* ; Vaccination ; Weaning

Clinical trials have demonstrated the efficacy of lifestyle modification for the prevention of type 2 diabetes mellitus but it was achieved at higher cost than can be sustained in routine health services. The first clinical trial to report was the Finnish Diabetes Prevention Study. This paper describes how Australia worked with Finnish colleagues to adapt the findings of that study to achieve a statewide diabetes prevention program. Small evaluative, effectiveness trials have been conducted in a number of countries to see if the results of the clinical trials can be replicated in routine health services. The Australian evaluative trial, Greater Green Triangle Diabetes Prevention Program is described in detail to demonstrate the ingredients for success in moving a program from one country to another. Few countries have managed to scale up from evaluative trials to statewide or national programs. The Australian experience is described in detail including lessons learned about what reduced the effectiveness, particularly the need for policy makers in government, people from the implementing organisation and researchers to work together from the start of the evaluative trial and throughout the first 5 years of a national program.
Administrative Personnel ; Australia* ; Diabetes Mellitus, Type 2 ; Diet ; Government Programs ; Group Processes ; Health Services ; Humans ; Life Style