OBJECTIVE

This study analyzed the factors influencing the implementation of the disability benefit package for children with developmental disabilities (CDDs) in the Philippines.

Data collection was done through document review of policy documents and focused group discussions (FGDs). Guided by Walt and Gilson’s policy triangle framework, data were analyzed through content analysis.

Twenty-two (22) policy documents were reviewed and a total of 16 participants joined the FGDs. Facilitators and barriers were identified and categorized through the policy elements: 1) context is anchored by presence of laws and policies but is hindered by issues on politics, governance, and labor force; 2) policy actors are hopeful in the continuous implementation of the policy but there is a lack of participation from all potential policy actors and limitations with human resources; 3) content is sound and comprehensive but there are costing issues and compliance concerns with requirements; and 4) processes emphasize quality assurance and promising initial dissemination efforts but the lack of stakeholder engagement activities and the tediousness of requirements discourage potential service providers.

While the launch of the disability benefit package for CDDs in the Philippines seemed promising, the policy remains underutilized as the identified barriers outweigh the facilitators. Specific recommendations for the improvement and implementation of the benefit package were outlined and framed based on the policy triangle framework.

In the late part of the 20th century, due to the change of disease spectra, rapid increase of health expenditure and imbalanced distribution of health resources, the health management sectors and doctors increasingly demand the scientific decision-making. With the development of clinical evidences and research, evidence-based medicine (EBM) became emerged in the early 1990's. EBM, the medical science in compliance with the best available clinical evidence, integrates clinical epidemiology (CE), systematic reviews (SRs) and health technology assessment (HTA) as the major technology, to emphasize that the clinical practice should be based on the combination of the best available clinical evidence, medical experiences and patient desire to cope with the demand of medical decision-making. Some governments and international organizations like WHO, and Australia have now adopted the high-quality evidence of EBM for decision-making. As the largest developing country, China is challenged by variety of health problems. The introduction, adaptation and implementation of EBM will improve the decision-making and health care services, which should enhance the competitive capacity of medical and pharmaceutical manufactures, as well as promote the popularization of EBM, and protect the doctors and patients rights.
Epidemiologic Methods ; Evidence-Based Medicine ; Forecasting ; Health Policy ; trends ; Humans ; Meta-Analysis as Topic ; Policy Making

No abstract available.
Advisory Committees*

BACKGROUND: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. METHODS: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level (500×500 m) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. RESULTS: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. CONCLUSION: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.
Ambulatory Care ; Decision Making ; Health Policy ; Humans ; Internal Medicine* ; Korea ; Linear Models ; Multivariate Analysis ; Outpatients* ; Seoul ; Spatial Analysis

OBJECTIVES: The objective of the present study was to compare prognosis of patients with gastric or colorectal cancer according to places where they received surgeries. METHODS: The cancer patients underwent surgeries in sampled hospitals located in Daegu were matched 1:1 to the patients who visited sampled hospitals in Seoul using propensity score method. After the occurrences of death were examined, Kaplan-Meier method was used for survival analysis and the log-rank test was performed to compare the survival curves. RESULTS: A total of six out of 291 gastric cancer patients who had surgeries in Daegu died (2.1%) and ten deaths (3.4%) occurred from patients went Seoul hospitals. Out of 84 gastric cancer patients who had chemotherapy after surgeries in Daegu, 13 (15.5%) patients died while 18 (21.4%) deaths occurred among patients underwent surgeries in Seoul. Six deaths (6.9%) out of 87 colorectal cancer patients who had surgeries in Daegu were reported. Five patients (5.7%) died among the patients underwent surgeries in Seoul. Among the colorectal cancer patients with chemotherapy after surgeries, 13 patients (12.4%) who visited hospitals in Daegu and 14 (13.3%) patients who used medical centers in Seoul died. There were no significant differences according to places where patients used medical services. CONCLUSIONS: The result of this study is expected to be used as basic data for policy making to resolve centralization problem of cancer patients and to help patients to make rational choices in selection of medical centers.
Colorectal Neoplasms* ; Daegu ; Drug Therapy ; Health Services ; Humans ; Methods ; Policy Making ; Prognosis ; Propensity Score ; Seoul ; Stomach Neoplasms ; Survival Analysis*

The Korean Neuropsychiatric Association (KNPA) was founded in 1945 and has now grown to over 2000 members as of 2003. The Association's academic meeting has also been increasing in size every year. To further develop the academic meeting of the KNPA, the task force team conducted this project. We suggest several points based on analysing the abstracts of the meeting that has been conducted during the last 5 years, the survey results performed at the 2002 annual meeting, the annual meeting of the American Psychiatric Association, and the academic activities of a Korean medical assoction, the Korean Society of Otolaryngology.
Advisory Committees ; Otolaryngology

OBJECTIVES: To estimate the value of statistical life (VSL) and health damage cost on theoretical mortality estimates due to environmental pollution. METHODS: We assessed the health risk on three environmental problems and eight sub-problems. Willingness to pay (WTP) was elucidated from a questionnaire survey with dichotomous contingent valuation method and VSL (which is the division of WTP by the change of risk reduction) calculated from WTP. Damage costs were estimated by multiplying VSL by the theoretical mortality estimates. RESULTS: VSLs from death caused by air pollution, indoor air pollution and drinking water contamination were about 0.3, 0.5 and 0.3 billion won, respectively. Damage costs of particulate matters (PM10) and radon were higher in the sub-problems and were above 100 billion won. Because damage cost depends on theoretical mortality estimate and WTP, its uncertainty is reduced in the estimating process. CONCLUSION: Health damage cost or risk benefit should be considered as one scientific criterion for decision making in environmental policy.
Air Pollution ; Air Pollution, Indoor ; Cost-Benefit Analysis ; Decision Making ; Drinking Water ; Environmental Policy ; Environmental Pollution ; Methods ; Mortality* ; Radon ; Risk Assessment ; Uncertainty

Systematic review had become one of the important research area in medicine. Systematic review can be demonstrating benefit or harm of an intervention when results of individual studies are inconclusive. While narrative reviews can often include an element of selection bias, systematic reviews typically involve a comprehensive plan and search strategy with the goal of reducing bias by identifying, appraising, and synthesizing all relevant studies on a particular topic and investigation of heterogeneity among included studies. Systematic reviews typically include a meta-analysis component which involves using statistical techniques to synthesize the data from several studies into a single quantitative estimate or summary effect size. Systematic review overcomes the limitation of small sample sizes by pooling results from a number of individual studies to generate a single best estimate. Although systematic reviews are published in academic forums, the Cochrane Collaboration is a widely recognized international and not-for-profit organization that promotes, supports, and disseminates systematic reviews and meta-analyses on the efficacy of interventions in the health care field. Systematic review has become a popular and powerful tool. If rigorously conducted, it is essential for evidence-based decision making in clinical practice as well as on the health policy level.
Bias (Epidemiology) ; Cooperative Behavior ; Decision Making ; Delivery of Health Care ; Evidence-Based Medicine ; Health Policy ; Meta-Analysis as Topic ; Population Characteristics ; Publication Bias ; Sample Size ; Selection Bias

The management of dyslipidemia is one of the crucial components in the prevention of atherosclerotic cardiovascular disease. Recently, the task force for the management of dyslipidemias of the ESC (European Society of Cardiology) and the EAS (European Atherosclerosis Society) updated their clinical guideline for the first time in 5 years. Although the new guideline maintained the previous recommendations in almost every aspect, there were some updates and modifications in the risk categorization and therapeutic modalities. In this review, I'd like to summarize the updated recommendations and differences compared to the previous version.
Advisory Committees ; Atherosclerosis* ; Cardiovascular Diseases ; Dyslipidemias*

The purpose of this study was to investigate the perceptions of teachers to the learning objectives (specific behavioral objectives, SBO) of their own specialty subjects at real educational situation and also to examine how and when teachers use the SBO. A questionnaire was constructed through a series of discussion at the task force meetings. Opinions from the members were gathered and a list of 21 items of question was generated and finally rephrased each question item to make 20 closed-type and 1 open-type questionnaire. The questionnaires were administered to all the faculties who have been engaged in teaching a subject of basic medical sciences. Although the response rate of the questionnaire was 43%, fairly even distribution of rank proportion of responded faculties were analyzed that could give strong convince of acceptable level of the results. The analysis showed that most of the faculties have fairly high perceptions to the necessity of SBO in teaching situations, while only 25% of thorn administered the SBO to their students. About 33% of the responded faculties construct SBO individually, and 25% have joined to a group work in their own department. A booklet, "Specific Behavioral Objectives in Basic Medical Sciences", has been well known and 85% of them used the booklet as a reference to make their own SBO. 65% of the faculties keep the booklets and the remaining groups answered that they don't have it although some of them have been seen it before.
Advisory Committees ; Humans ; Learning ; Pamphlets ; Surveys and Questionnaires