Background: Health insurance systems are a core component of social protection, aimed at safeguarding populations from financial risks, ensuring equitable access to health care services, and ultimately achieving universal health coverage. In recent years, Mongolia’s health insurance system has faced significant policy-level challenges related to efficiency, accessibility, and financial sustainability. Therefore, there is a growing need to conduct comparative analyses of internationally successful health insurance models. Aim: To comparatively examine Mongolia’s health insurance system in relation to the health insurance systems of selected countries. Materials and Methods: A comparative document review methodology was employed to analyze the health insurance and health financing systems of Canada, Germany, Japan, the Republic of Korea, and Kyrgyzstan. The analysis was based on policy documents, legal and regulatory frameworks, reports from international organizations, and relevant statistical data. Result: In countries such as Canada, Germany, Japan, and the Republic of Korea, health expenditure as a share of GDP exceeds the global average, while out-of-pocket payments by households remain relatively low. In contrast, Mongolia and Kyrgyzstan exhibit high levels of out-of-pocket expenditure, weaker financial protection, and comparatively lower performance indicators of the health system. Conclusion The findings suggest that increasing health expenditure as a share of GDP toward the global average, improving the management of health insurance funds, and reducing out-of-pocket payments by households are important considerations for enhancing the performance of Mongolia’s health system.

Background: The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive framework for assessing body functions, body structures, activity limitations, participation restrictions, and environmental factors. The combined use of the International Classification of Diseases (ICD) and the ICF can contribute to more comprehensive and person-centered approaches to rehabilitation planning, disability assessment, and compensation systems for work capacity loss. Aim: To assess individuals with occupational diseases and work capacity loss using the ICF framework and to evaluate impairments in body functions and impairments of body structures. Materials and Methods: A cross-sectional analytical study was conducted among individuals with work capacity loss due to occupational diseases. Data were collected using two sections of the ICF Checklist Version 2.1a, Clinician Form, focusing on body functions (b) and body structures (s). Statistical analyses were performed using IBM SPSS-26.0. Result: A total of 180 participants were included in the study, of whom 80.6% (n=145) were male and 19.4% (n=35) were female, with a mean age of 60.5±10.7 years. The mean duration of employment under hazardous occupational conditions was 19.5±5.2 years. Respiratory system disorders were 57.2% (n=103), and nervous system disorders were 20.0% (n=36). The internal consistency of the ICF assessment was high for the body functions impairment domain (Cronbach’s α=0.904) and acceptable for the body structures impairment domain (α=0.788). Sensory functions and pain impairments (b2) differed significantly across all occupational disease groups (p<0.001), while impairments of the structures of the nervous system (s1) also showed a statistically significant difference (p=0.015). Multivariable logistic regression analysis showed that an increase in the percentage of work capacity loss was significantly associated with body function impairment (OR=1.065; 95% CI: 1.003–1.131; p=0.030), while increasing age was significantly associated with impairments of body structures (OR=1.112; 95% CI: 1.013–1.234; p=0.042). Conclusion 1. The body functions and body structures domains of the ICF Checklist Version 2.1a, Clinician Form, demonstrated adequate internal consistency, indicating that the ICF may be applicable for assessing individuals with occupational diseases. 2. Sensory function and pain impairments were common among individuals with occupational diseases. Furthermore, a higher percentage of work capacity loss was associated with greater body function impairment, while increasing age was associated with a higher risk of body structure impairment.

Background: Tuberculosis (TB) remains a major public health concern worldwide and continues to be a leading cause of morbidity and mortality. Delays in diagnosis and care seeking exacerbate disease severity and increase financial burdens on healthcare systems and patients. In Mongolia, comprehensive evidence on diagnostic delays and direct hospitalization costs for TB patients remains limited. Aim: To evaluate the duration of diagnostic delay and estimate direct medical costs incurred during hospitalization among TB patients, as well as to identify associated factors. Materials and Methods: A retrospective cross-sectional study was conducted using medical records of 285 newly diagnosed TB patients hospitalized at the National Center for Communicable Diseases (NCCD) in 2024. Statistical analyses were performed using SPSS version 26 and MS Excel. A p-value of <0.05 was considered statistically significant. Result: The mean age of participants was 42.6±16.0 years, and 56.5% (n=161) were male. Median patient delay was 14 days (IQR: 5–31), median diagnostic delay was 4 days (IQR: 0–14), and mean hospital stay was 21.0±16.0 days. Median direct costs per patient were: diagnostic cost 262.0 thousand MNT (IQR: 187.0–363.0), treatment cost 490.9 thousand MNT (IQR: 234.4–884.1), and total cost 761.7 thousand MNT (IQR: 460.4–1247.6). Multivariate linear regression revealed that patient delay >14 days was significantly associated with higher total costs (=659.333, p=0.004). Conclusion 1. The median patient delay among patients with tuberculosis was 14 days (IQR, 5–31), while the median diagnostic delay was 4 days (IQR, 0–14). Overall, 61.6% of patients experienced patient delay, and 63.5% experienced diagnostic delay. 2. The median total direct medical cost among hospitalized patients was 761.7 thousand Mongolian Tugriks (MNT). A patient delay of more than 14 days was significantly associated with increased total direct medical costs (β=659.333, P=.004).

Background: The World Health Organization (WHO) recommends using both the ICD and ICF frameworks in combination when assessing work disability. The ICF evaluates patients in terms of body functions, disability, and health-related functioning. Integrating ICD and ICF classifications is essential for accurate disability assessment, effective rehabilitation planning, and compensation processes. Aim: To investigate environmental factors influencing rehabilitation services among patients with work-related diseases who have experienced loss of work capacity, using the International Classification of Functioning, Disability and Health (ICF) framework. Materials and Methods: This analytical cross-sectional study was conducted at the Department of Occupational Medicine of the Occupational Health Center. Data were collected from 150 patients with occupational diseases resulting in work disability. The ICF assessment tool developed by WHO was utilized. A total of 150 indicators across four main domains were assessed: 27 items on general information and health-related issues; 31 items on body functions (Group 1a); 16 items on body structures (Group 1b); 48 items on activities and participation (Group 2); and 32 items on environmental factors (Group 3). Statistical analysis was performed using SPSS version 26.0 Descriptive statistics, including frequencies, percentages, means, and standard deviations, were calculated. Results: A total of 150 patients with work disability due to occupational diseases were included in the study. The mean age was 60.5±10.9 years, with males comprising 80% (n=120) and females 20% (n=30). The reliability of the ICF questionnaire was acceptable across all domains (Cronbach’s alpha > 0.7). Respiratory occupational diseases accounted for the largest proportion 58.7% ( n=88), followed by neurological conditions 19.3% (n=29) and surgical conditions 8.7% (n=13). Environmental factors affecting rehabilitation, support from health professionals (e360) showed moderate facilitation (2.0±1.0). In contrast, climate (e225) (-2.7±0.6), education services (e585) (-3.4±0.8), and employment services (e590) (-3.5±0.7) were identified as substantial barriers. Environmental factors were significantly associated with age and duration since diagnosis of occupational disease (p<0.05). Conclusions 1. The integrated application of the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) allow for a more comprehensive evaluation of work-related disability. This approach moves beyond a purely diagnosis-based assessment to incorporate functional status and environmental determinants. 2. The findings highlight its significant value in optimizing rehabilitation service planning, identifying key barriers, and ultimately improving both the accessibility and effectiveness of rehabilitation services.

Background: The World Health Organization defines healthcare quality by the degree to which services optimize population health outcomes while addressing individual patient needs. In January 2026, a Presidential Decree in Mongolia established a legal and regulatory mandate to enhance the organizational, operational, and clinical infrastructure of traditional medicine. Aligning clinical practices with this framework necessitates rigorous, evidence-based evaluation of service quality and safety within traditional medicine facilities. Aim: To systematically evaluate patient safety indicators, medication practices, and procedural outcomes in inpatient traditional medicine settings. Materials and Methods: A retrospective record-based study was conducted utilizing a sampled cohort of inpatient medical records from a traditional medicine facility. Key clinical indicators—including patient identification compliance, fall-risk stratification, high-alert medication utilization, pharmacovigilance outcomes, and peri-procedural safety measures—were systematically extracted and analyzed. Results: High-alert medications were administered to 25.6% of inpatients, with 10.0% receiving concurrent therapy with multiple high-alert agents. Three adverse drug reactions (ADRs) were documented during the observation period, all occurring on the initial day of hospitalization. Analysis of ADR-associated regimens identified multi-ingredient traditional formulations, specifically Sojid-11, Agar-35, and Marchin-13. Procedural safety adherence for acupuncture demonstrated high compliance: written informed consent (95.0%), post-treatment infection surveillance (98.0%), and post-procedural bleeding evaluation (100.0%). For the therapy, baseline complete blood counts were performed in 100.0% of cases; however, baseline coagulation profiles were documented in only 4.0%, and post-treatment follow-up laboratory testing was completed in 23.0%. Correct patient identification procedures achieved an 86.1% compliance rate. Although fall-risk screening identified 62.0% of inpatients as high risk, two inpatient fall events occurred during the study period. Conclusions Inpatient traditional medicine practices exhibit strong adherence to basic procedural monitoring but critical gaps remain in pharmacovigilance and laboratory monitoring. Mitigating clinical risk requires mandatory baseline coagulation profiling prior to invasive procedures such as hirudotherapy, heightened surveillance when initiating complex multi-ingredient botanical drugs, and standardized fall-prevention protocols. Strengthening these targeted safety metrics is essential to minimize preventable adverse events, optimize clinical efficiency, and fulfill national quality improvement mandates.

Background: Individuals requiring liver transplantation began receiving this procedure in Mongolia in 2011, following initial treatments abroad in 2004. As survival rates of post-liver transplant continue to improve, it is imperative to understand the factors influencing the quality of life for patients during these years and to explore modifiable determinants. The interplay between socioeconomic and environmental factors significantly impacts social and personal development, as evidenced by quality of life metrics. Research indicates that 6% of liver transplant recipients are classified as unable to work based on activity and international disability assessments, while 23% to 61% of recipients achieve full employment following liver transplantation treatment. However, there is a notable lack of studies examining the physical, psychological, and social well-being of patients post-liver transplant in Mongolia. This study aims to address this gap and provide insights into the overall health status of these individuals. Aim: Examining quality of life and employment status following liver transplantation treatment Materials and Methods: A descriptive study design and questionnaire method were used to collect data from 144 cases of individuals who underwent liver transplantation. The study was based on the SF-36 Health Survey, categorized into eight domains, with scores calculated according to predefined criteria. Results: Among the 144 cases included in the study, 81 (56.3%) were male and 63 (43.8%) were female. By age group, 120 (83.3%) were between 19 and 60 years old, representing the working-age population, while 24 (16.7%) were over 60 years old. Post-liver transplant employment status revealed significant differences, with 41 (28.5%) employed full-time, 19 (13.2%) parttime, and 84 (58.3%) unemployed or receiving disability benefits (p=0.024). Among these, 62 (43%) expressed a desire to work, 17 (12%) did not wish to work, and 65 (45%) were uncertain, showing no statistically significant differences (p=0.173). When calculating the quality of life assessment, the physical function index was 63.52±25.32 for working patients and 52.90±25.75 for non-working patients (p=0.018), and the psychological status index was 64.94±14.53 for working patients and 53.63±17.87 for non-working patients (p<0.001), and there was a statistically significant difference. Conclusion Health-related quality of life in people who are employed after liver transplantation is high, and overall physical function and overall psychological well-being improve year after year.