1.Characteristics of Business Conditions of Small-Scale Multifunctional In-home Nursing Care Facilities: Secondary Analysis with Text Mining
Kenji AWAMURA ; Manabu NII ; Rika WATANABE ; Eiko NAKANISHI ; Masashi MANABE ; Takanori KAWANO ; Kuniko HAGA ; Makiko MUYA ; Reiko SAKASHITA ; Hiroshi ONO
An Official Journal of the Japan Primary Care Association 2023;46(4):132-141
Introduction: The purpose of this study was to clarify the relationship between the available service information on small-scale multifunctional in-home nursing care (KANTAKI) and its operational status via text mining.Methods: We obtained nationwide textual information on KANTAKI from the Nursing Care Service Information Disclosure System and the Ministry of Health, Labour, and Welfare, and analyzed the characteristics of the word usage using KH Coder. The number of users and employees and the implementation of services were compared among the facilities that used terms relating to medical dependency and end-of-life care, which are KANTAKI characteristics, and with other facilities.Results: The facilities that used terms relating to medical dependency and end-of-life care showed significantly more users requiring nursing care level 5 and more full-time nursing staff than those not using such terms. Moreover, regarding service provision, the rate of procedures was significantly higher in 11 of 12 items, except for stoma.Conclusion: The facilities that use terms relating to medical dependency and end-of-life care in their information have more users and provide a greater variety of services. In the future, educational support is required to enable facility managers to understand the services and translate them into their work.
2.Disparities in Access to Systemic Treatment for Breast Cancer in Thailand and Major Asian Territories
Suthinee ITHIMAKIN ; Napa PARINYANITIKUL ; Sung-Bae KIM ; Yoon-Sim YAP ; Janice TSANG ; Inda S SOONG ; Yukinori OZAKI ; Shinji OHNO ; Makiko ONO ; Jack Junjie CHAN ; Hung Chun Skye CHENG ; Thitiya DEJTHEVAPORN ; On behalf of BIG-Asia Collaboration
Journal of Breast Cancer 2022;25(3):207-217
Purpose:
Breast cancer (BC) treatment has shifted from chemotherapy to targeted therapy.Several targeted agents have demonstrated an improvement in survival. Given that national healthcare resources were correlated with the cancer mortality-to-incidence ratio, we compared access to BC drugs in Thailand with that in other Asian countries.
Methods:
BC experts involved in the Breast International Group (BIG)-Asia in six representative groups for countries or special administrative region (SAR) in Asia (Hong Kong SAR, Japan, Korea, Taiwan, Thailand, and Singapore) were invited to participate in the survey. The questionnaire addressed national health reimbursement schemes, molecular testing for early BC (EBC), availability and accessibility of BC drugs. Accessibility and reimbursement of the drugs were reported based on their listing as essential medicines in the World Health Organization Model List of Essential Medicines (WHO-EML) and their nomination as effective drugs in the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS). The study was approved by all participating BIG-Asia organizations in November 2021.
Results:
Genomic tests for EBC were non-reimbursable in all surveyed territories.Reimbursement and co-payment of BC drugs vary between and within these regions (particularly Thailand). Most drugs in the WHO-EML and ESMO-MCBS (A/B for EBC and 4/5 for advanced BC) were accessible in all surveyed territories. However, the accessibility of effective but costly WHO-EML and ESMO-MCBS drugs was not uniform in Thailand. There was an evident disparity for individuals covered by the Thai Social Security/Universal Health Coverage schemes.
Conclusion
Essential BC drugs are generally accessible in selected BIG-Asia countries or SAR. There is a disparity in accessing high-cost drugs in Thailand compared with other Asian territories.