Background: The enactment of the Universal Healthcare (UHC) Act affirms the commitment of the State to safeguard the health of all Filipinos. One of the objectives of the Act is to integrate the different local health systems at the provincial level in order to minimize fragmentation in the delivery of health services. This significant undertaking needs effective inter-sectoral collaborations of various stakeholders both at the local and national levels. Methods: A systematic review of literature was conducted to generate evidence-based policy tools. A roundtable discussion (RTD) was organized in collaboration with the Department of Health (DOH) to frame the current issues of the devolved health system and the anticipated challenges surrounding the integration to the provincial level. Policy discussion was guided by specific operational concerns put forth by the DOH such as the roles and functions of key local actors, organizational models, and metrics of integration. Results: Inputs in the proposed organogram for the province-level integrated health system and assessment tool for identifying readiness of provinces were discussed and agreed upon. Critical issues in the composition of the members of the Provincial Health Board (PHB) and the line of command among constituents were raised. Conclusion and Recommendations Eight consensus key policy recommendations have been identified. These could be translated into operational guidelines for the DOH, local government units (LGUs), and other related national government agencies (NGAs) in implementing the local health systems integration as prescribed in the UHC Act.
Health Care Reform ; Delivery of Health Care, Integrated ; Policy

The National Academy of Science and Technology (NAST), in cooperation with the Philippine Primary Care Studies (PPCS), organized the Stakeholders’ Meeting on Training Objectives for Primary Care in the Philippines on February 1, 2018, at Hotel Jen, Pasay City. The stakeholder’s meeting arrived at a consensus on the objectives of primary care workshops, training the existing cadre of doctors, nurses, midwives, and BHWs in the country. Competencies built upon these training objectives will strengthen the capacity of health care workers to render patient-centered primary care services. The expected output was not intended to replace the objectives of existing professional training curricula. Instead, the consensus obtained through this meeting works to establish the framework from which future primary care training workshops can be built upon.
Primary Health Care ; Health Care Reform ; Education ; Health Equity ; Congress

OBJECTIVE: For the ubiquity of medical service, when user who has proper authority want to access medical data, user accessability should be assured. And the security of the disclosed medical data is important. This paper presents single user access interface on multiple patient reservoirs and elaborate access control using the Role-Based Access Control(RBAC) system. METHODS: Proposed system consists of 4-tier architecture that is client application, Access Control Central(ACC) agent, Local Access Control(LAC) agent and Hospital Information Systems(HIS). User requests medical data with client application. ACC notarizes user identity and controls access of user request and selectively encrypts medical data. LAC charges data conversion for communication between ACC and HIS. HIS has repositories of medical datum. System provides security service with digital certificate, X.509v3, of user. RESULTS: User requests medical data of several HIS approaching single ACC not by each HIS. Through conversion process of LAC, data that is described XML and is used for communication inter system enables information exchange with single common data format that is independent to several HIS. CONCLUSION: In the proposed system, user accesses medical datum of several HIS regardless of location and has consistent access interface. And using independent format against each HIS makes easy information exchange between several HIS. Transferred data maintains security about significant datum by selective encryption and increases encryption efficiency. Unified access control about multiple patient reservoirs that are scattered in other places provides unified and precise diagnosis of patient information. And it functions the portal of collaborate treatment in inter-HIS.
Computer Security ; Delivery of Health Care, Integrated ; Diagnosis ; Health Services Accessibility ; Hospital Information Systems ; Humans

Artemisinins ; therapeutic use ; Complementary Therapies ; economics ; Delivery of Health Care ; Humans ; Malaria ; drug therapy ; Practice Patterns, Physicians' ; Treatment Outcome

This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point. Elements of an integrative healthcare delivery model including philosophies/values, structure, process and outcome were used to conduct a quality assessment of the integrated health system in Ghana. Each element clearly showed that Ghana is currently not running a coordinated health practice model, thus making it a tolerant, rather than an inclusive, health system. Therefore, the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana. The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics. As such, governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings. Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings. This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population. Please cite this article as: Ampomah IG, Malau-Aduli BS, Malau-Aduli AEO, Emeto TI. From talk to action: Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system. J Integr Med. 2023; 21(5): 423-429.
Ghana ; Medicine, Traditional ; Delivery of Health Care, Integrated

PURPOSE: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. METHODS: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the ‘National Survey of Multicultural Families 2015.’ Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. RESULTS: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. CONCLUSION: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.
Causality ; Delivery of Health Care ; Discrimination (Psychology) ; Emigrants and Immigrants ; Family Characteristics ; Female ; Grief ; Health Behavior ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Korea ; Logistic Models ; Marriage ; Multivariate Analysis ; Nursing Services ; Prevalence ; Social Discrimination ; Women, Working

BACKGROUND: Limited data exist on real-world treatment patterns for diabetic macular edema (DME) in Korea. In this study, we investigated DME treatment patterns from 2009 to 2014 and the impact of baseline treatment on healthcare resource utilization and visual acuity (VA) outcomes. METHODS: A retrospective cohort chart review of DME patients treated at 11 hospital ophthalmology clinics between January 1, 2012 and December 31, 2013 was conducted. We collected data on demographics, healthcare resource utilization (clinic visits, treatment visits, and visits for ocular investigations), distribution of DME treatments, and VA. RESULTS: Overall, 522 DME patients (men, 55.2%; mean age, 59 years; mean HbA1c [n = 209], 8.4%) with 842 DME eyes were evaluated. For all treatments, healthcare resource utilization was significantly higher during the first 6 months versus months 7–12, year 2, or year 3 (P ≤ 0.001), but was highest for patients whose first treatment was an anti-vascular endothelial growth factor (VEGF) treatment (visits/quarter; anti-VEGF, 1.9; corticosteroids, 1.7; laser, 1.4). Use of macular laser therapy decreased (44% to 8%), whereas use of anti-VEGF injections increased (44% to 69%) during the study period. However, VA improvement was not commensurate with healthcare resource utilization of anti-VEGF treatment (mean VA gain, 2.7 letters). CONCLUSION: A trend toward increasing use of intravitreal anti-VEGF injections for DME treatment was observed in Korea. However, the frequency of dosing and monitoring was lower in clinical practice versus major clinical trials, which may have led to the less-than-favorable improvements in visual outcomes.
Adrenal Cortex Hormones ; Cohort Studies ; Delivery of Health Care ; Demography ; Endothelial Growth Factors ; Humans ; Intravitreal Injections ; Korea ; Laser Therapy ; Macular Edema ; Ophthalmology ; Practice Patterns, Physicians' ; Retrospective Studies ; Visual Acuity

No abstract available.
Delivery of Health Care* ; Health Care Reform*

No abstract available.
Delivery of Health Care* ; France* ; Health Care Reform*

No abstract available.
Delivery of Health Care* ; France* ; Health Care Reform*