Child ; Child Health Services ; organization & administration ; China ; Health Care Sector ; standards ; trends ; Humans ; Patient Care Team ; standards ; trends ; Primary Health Care ; organization & administration

Although primary care has been recognized as an essential element of the healthcare system, the primary healthcare of Korea has not been highly valued. Listening to the voices of physicians who are engaged in primary care should be the first step for improving the level of primary care in Korea. In this study, we conducted a questionnaire survey of general internists to investigate their perspectives regarding primary care, and which included the evaluation of current primary care, perception of the five, key attributes of primary care, and their opinions regarding the management system of chronic diseases. A total of 466 general internists' responses were used in this analysis. The results showed that primary care is considered to have an important role, according to general internists, although their evaluation of the overall status of primary care in Korea indicated that it is poor. The respondents also indicated that the functions of coordination and comprehensiveness in primary care, which can be integral for treating patients with chronic diseases, are most vulnerable. Given the high level of agreement regarding the need for a new medical management system for chronic diseases, based on physicians' autonomy and provided by clinics, establishing a policy encouraging the participation of general internists should be emphasized.
Adult ; Aged ; Attitude of Health Personnel ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Physicians/*psychology/trends ; Practice Patterns, Physicians'/*trends ; Primary Health Care/*trends ; Republic of Korea ; Surveys and Questionnaires

Aged ; Delivery of Health Care ; organization & administration ; Delivery of Health Care, Integrated ; organization & administration ; Humans ; Primary Health Care ; organization & administration ; trends ; Program Development ; Singapore

Ensuring timely access to specialist care is an important indicator of the quality of a health service. Demand for cardiology outpatient appointments has grown considerably in the last decade, leading to increased waiting time for cardiology appointments at public hospitals. This paper examines the effectiveness of past and ongoing strategies initiated by the National Heart Centre, many of which were in collaboration with SingHealth Polyclinics, documents the lessons learnt, and provides a framework for approaching this problem. Instead of a simplistic approach where institutions react to long waiting times by growing capacity to meet demand, this paper emphasises the need to focus on the final intended outcome (timely diagnosis and treatment) rather than on a single performance indicator, such as waiting time. A broad systems approach at the national level is advocated, rather than piecemeal, uncoordinated actions by individual hospitals.
Ambulatory Care Facilities ; Cardiology ; Cardiovascular Diseases ; therapy ; Cooperative Behavior ; Efficiency, Organizational ; Health Services Accessibility ; Health Services Needs and Demand ; Humans ; Primary Health Care ; Referral and Consultation ; trends ; Singapore

Specialists of developing countries are facing the epidemic growth of noncommunicable diseases (NCDs). From 2011 to 2013, I, as a Korean volunteer doctor, had been working in a local primary healthcare center in Bangladesh, assessing rates of NCDs. Proportion of patients with NCDs was increased from 74.96% in 1999 to 83.05% in 2012, particularly due to the spreading of diabetes mellitus, cardiovascular diseases, and tuberculosis. To succeed in medical mission in developing countries, volunteer doctors have to take measures for preventing chronic diseases along with proper treatment.
Bangladesh/epidemiology ; Cardiovascular Diseases/epidemiology ; Chronic Disease/*epidemiology ; Diabetes Mellitus/epidemiology ; Global Health/trends ; Humans ; *Medical Missions, Official ; Primary Health Care ; Tuberculosis/epidemiology

Data from recent studies have shown an increase in substance use and addictive behaviours in Singapore. However, training and services still lag behind this trend, which means the provision of adequate treatment is lacking in spite of good evidence that treatment approaches for addiction disorders are effective. There is a need to train more manpower for this purpose, especially in primary healthcare. Another challenge is to ramp up services as quickly as possible to manage the growing number of addicts. Research should also focus on special populations, while public health education and national policies can be improved, particularly to curb binge drinking. We need to be open to the use of harm-reduction therapies and substitution treatments, as addiction is a chronic relapsing disorder with significant health and psychosocial morbidity.
Adolescent ; Adult ; Alcoholism ; therapy ; Behavior, Addictive ; epidemiology ; therapy ; Female ; Humans ; Male ; Mental Health Services ; organization & administration ; trends ; Prevalence ; Primary Health Care ; organization & administration ; Public Health ; Singapore ; Substance Abuse Treatment Centers ; Substance-Related Disorders ; epidemiology ; therapy