1.Significance of implementation of digital card in comprehensive reform in health care system of mongolia
Mongolian Medical Sciences 2010;153(3):48-52
Medical service electronic card should be given to each citizen• This card should be owned by each citizen from the nearlis years and it should be the payment tool in all secondary and tertiary hospitals• The pledged cash distribution by the politicians during the election campaigns should be placed first, in card• The card balance should be no less than MNT200,000. when patients needs to certain medical service on secondary and tertiary Hospitals• This payment tool should be able to be converted to cash for diagnosis, treatment, medical consultation and health supporting activities.• It should be transferable to family members and friends.• Some percentage of unused balance at the end of each year could be given to the individual as a bonus for protecting his health and the remaining balance could be kept intact for next year’s medical services• The card can be transferable upon death of the owner• Make a policy when the amount needed for the medical services exceeds the card balance for a given year (certain percentage of expenses of medical procedures that are done few times, but expensive could be covered by health insurance fund or by the state. This will enable the outflow of money to be directed to Mongolia and it will serve as investment in hospitals in Mongolia)Benefits of using the electronic payment card:• Patients can freely choose one’s doctor and hospital and he is able to receive one’s desired medical services• One is able to control the medical services and is able to participate equally in the processThe state will be able to:• Provide consistent and outreaching medical services• Initially the state will take the responsibility for first aid, social health services and emergency aidThe electronic card should cover:• Secondary hospital services (fully)• Tertiary hospital services (majority)Other advantages of the electronic card:• As all hospitals are on the same starting point, the medical staff will be highly motivated for a constructive competition• Improvement in qualification, accountability and service quality of the staff• Completely stop the appointment of hospital management by political party affiliations or connections. The top management will strive to make a team of qualified and skilled staff• The staff will be able to receive compensation packages that are correlated to their knowledge, qualifications, experience, skills and performances• When hospitals have “state enterprise” status and it has independent operation and management, there will be no improper activities such as outside pressures on supply and renovation of equipment and services, bidding intrigues and forced consumption and the hospitals will be able to work in business like mechanismThe biggest advantage is that there will be an unprecedented large inflow of money into health care system of MongoliaTherefore, there will be the following benefits:• Hospitals will be able to renovate, introduce know-how, train their staff and will be able to have additional funding for pay increase for the staff• It will be instrumental in launching a high cost, world class treatment and diagnosis department in the near future (heart, brain surgery and organ transplantation etc.)• There will be more highly qualified clinician doctors (educated by both of eastern and western medicines) as the hospitals will function on the basis of demands and preference by patients.• Due to the real market mechanisms only the competent hospitals will continue working after competition• Health supporting organizations will be financially sound• Because patients will have their payment tools in a form of the electronic card, some bureaucratic procedures such as the provincial affiliation and 13th form will be eliminated• Main information about the patients could be entered into the card, for example, Thaiwan has this system, so, it will create a database• When the balance is not used some interest could be accrued on the balance, like in Singapore.• Any level of hospital will be able to transform to a private entity by market principles.• It will eliminate subsidized, inefficient, high cost medical service structure that was built in socialist time and create a demand-based, smaller, but powerful and qualified medical system in Mongolia.• There will be a database with true information• The state will be able to count the population again• The state budget will increase by profit tax collection• The equipment and assets of bankrupt hospitals (with poor management and not customer oriented) should be sold in bidding and the other hospitals will be able to introduce know-how, will have funding for loans, training and new jobs.
2.A situation of accidents and injury during the holidays among clients received emergency care at the national traumatology and orthopedic research center
Mongolian Medical Sciences 2014;170(4):55-61
Background. According to the reports of World Health Organization (WHO), every year over 5 millionpeople died because of violence, accidents and injury, and 600 million disabled. In 2020, 8.4 milliondeath is expected due to exposures of accidents and injury.By the end of 2013, population of Mongolia is 2.930.3 million and has increased by 2.2 percent,comparing to the year before. 68.1% of the total population is living in the urban, and the remaining31.9% is living in the rural. The 46.8% of the total population is residing and living in the capital cityUlaanbaatar, which counts at 1.372.1. million. 80% of residents (residential community) of Ulaanbaatarcity is receiving inpatient care, and 90% is receiving emergency care due to accidents and injury at theNational Traumatology and Orthopedic Research Center (NTORC).A number of clients received emergency care due to accidents and injury at the NTORC is continuallyincreasing for last 5 years. The number of inpatients in 2012 is reduced comparing to a year before.But in 2013, it has increased by 10.9% than in 2012. Also the increase by 10.0% is observed in the last5 year’s average. A major percentage of clients who received care traumatized when used alcoholicbeverages. This exposure is increasing during the holidays. Therefore it demands to find out reasonsof accidents and injury during the holiday celebrations.Goal. To define reasons of accidents and injury for clients who received care during the holiday at theNTORC.Methods. A descriptive case study is conducted based on client’s information which received emergencycare at the NTORC during 5 major holidays in 2012-2014. Selected five holiday celebrations were TheNew Year, Lunar New Year, International Woman’s Day, National Day for Armed Forces and Military(as known Men’s Holiday) and the Naadam (The Summer Festival). A selection of holidays consistedfrom series of days as of pre, post and during holidays when the celebration is for only one-day. Whenthe holiday celebration is for 3 days, all 3 days were chosen. The study described causes of trauma,diagnosis, age, gender and the residential of clients who received the emergency care due accidentsand injury.Results. A number of clients received emergency care during the major holidays, except the LunarNew Year is higher than non-holiday days. Number of clients received emergency care which usedalcoholic beverage is also more during the holidays. Over 60% of exposed is males and majority aged25-34. Causes of injuries during the holiday celebrations were all kinds of falls, interpersonal (domestic)violence’s, and traffic accidents. More exposures of interpersonal (domestic) violence’s during the wellknown Men’s Day holiday has been registered as well as more traffic accidents during the Naadam (TheSummer Festival).
3.Women blood, wind stagnation composed disorder or the IUD syndrome
Mongolian Medical Sciences 2016;178(4):58-60
BackgroundIn traditional medicine women blood, qi stagnation disorder (WBQS) is caused by many reasons,such as use of spicy, hot, sour quality food and drinks for long period; hard labor; excessive or notenough sexual intercourse; not adequate post-natal care are reasons to increase of the blood-bile heat,proliferation of bad blood in uterus, leading to stagnation and growth of blood mass. Uterus blood andQi stagnation leads into complex symptoms such as palpitations, anxiousness, depression, shoulderand neck stiffness, sleep disorder etc. There is a need to learn about current causes and treatmentsof this disorder and consolidate results of traditional treatments in order to give more treatment choicesfor patients.ObjectivePurpose of our study is to consolidate MTM treatment results of women blood, qi stagnation composeddisorder.Materials and MethodsA descriptive and retrospective study was conducted based on all medical history data of patientsdiagnosed and treated with this disorder during 1991-2016 in Mong-Em traditional medicine clinic.ResultsTotally 2000 cases were diagnosed with women blood, qi stagnation disorder and treated by traditionalmedicine methods. We have classified and treated using differentiation diagnosis of TMM theory. Forexample, clinical symptoms vary from palpitations, panting, sleep deprivation, chest acne, depression,mood swings, backaches, inner thigh pain, infertility, non-regular menstruations, menorrhagia,dysmenorrhea, amenorrhea, premenstrual symptoms; too thick menstruation blood, hypomenorrheawith dark, thick blood clots etc. For treatment, we used ancient prescriptions of herbal medicine, as wellas acupuncture.Conclusion:1. IUD is one of the main reasons of Qi and blood stagnation disorder of women.2. Based on TMM’s theory and treatment principles for women qi and blood stagnation disorder, TMMappears to be give far more efficient long term results where modern medicine has limited choice ofeffective treatment.3. Women qi, blood stagnation disorder is chronic disorder showing changes in laboratory examinationsonly in later period of time, thus reducing the possibility to be diagnosed with modern medical tests,leading to have few choices of modern medicine treatment, long term use of combined TMM drugs.4. There is need of the whole-body approach for this disease, where modern medicine uses too narrowdifferentiation of diagnosis, often delaying the possibility to be treated properly in short time.
4.Treating of arterial hypertension by Mongolian traditional medicine
Mendsaikhan Z ; Olzvoi T ; Ariunaa Z ; Purevjav M ; Gan-Urnukh B ; Narantsatsrat S
Mongolian Medical Sciences 2013;163(1):183-187
IntroductionAH is one of the widest spread diseases, as well as the leading cause of mortality in Mongolia. Even though the AH is well studied throughout the world, with no significant results in health complications caused by AH in different organs and systems, there is a necessity to study the use of other methods in hypertension treatment, such as Mongolian traditional medicine for an adequate management of hypertension, in order to extend the choices of treatments by combining harmless natural multicompound drugs prepared by ancient mongolo-tibetian prescriptions with Chinese acupuncture and other therapy methods such as massage, bloodletting, cupping etc.GoalThe authors have analyzed 260 patient records of hypertension that have been treated only with MTM treatment methods in MONGEM MTM hospital, in order to define: 1) the classification of arterial hypertension according to theory of disease in MTM ;2) the classification of arterial hypertension according to theory of cold and hot in MTM;3) The results of MTM treatments on hypertension.Methods and MaterialsWe have conducted this study by document review and case study by analyzing 260 patient records of “MONGEM” traditional medicine hospital and research center.ResultsAccording to our study almost 80% of arterial hypertension cases start as a hot disease and change into cold disease. Our research results have also shown that 90% of hypertension can be classified into congested, interdependent state of disease and that treatment by MTM methods of combined disease with consideration of changes in hot and cold states is efficient for relieving arterial hypertension.ConclusionOur study has concluded that carefully diagnosed hypertension using MTM disease and disorder classification, and treated with accordingly chosen methods of MTM treatment such as multi-compound drugs, mild and rough techniques, nutrition and behavioral lifestyle changes combined with Chinese acupuncture, gives satisfactory results in healing arterial hypertension, thus providing safe, efficient, affordable and accessible treatment choices for people.