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: One of the major mechanisms underlying myocardial injury during ischemia and hypoxia is oxidative stress. Under hypoxic conditions, excessive production of reactive oxygen species (ROS) disrupts the cellular antioxidant defense system, enhances lipid peroxidation, and ultimately leads to apoptosis and cellular damage. Superoxide dismutase (SOD) is a key intracellular antioxidant enzyme that neutralizes oxidative stress, whereas malondialdehyde (MDA), an end product of lipid peroxidation, reflects the extent of membrane damage. Therefore, investigating antioxidant compounds in hypoxia-induced cardiomyocyte injury is of significant importance. Pinocembrin, a bioactive compound derived from Dalbergia odorifera T.Chen, exhibits multiple pharmacological activities, including antioxidant and anti-apoptotic effects. Aim: To evaluate the effects of pinocembrin on oxidative stress in hypoxia-induced H9C2 cardiomyocytes. Materials and Methods: H9C2 cardiomyocytes were divided into five groups: a control group, a model group, and three pinocembrin-treated groups (low, medium, and high doses). Except for the control group, cells were cultured under hypoxic conditions (5% CO2, 1% O2, 37 °C) in glucose- and serum-free DMEM to establish a hypoxia-induced injury model. Cells were then treated with pinocembrin for 4 hours. Oxidative stress levels were assessed by measuring ROS accumulation, SOD activity, and MDA content. Result: Compared with the control group, the model group showed a significant increase in ROS production, a decrease in SOD activity, and a marked elevation in MDA levels, indicating severe oxidative stress under hypoxic conditions. In contrast, the pinocembrin-treated groups exhibited attenuation of hypoxia-induced oxidative stress. Specifically, ROS accumulation decreased, SOD activity was restored, and MDA levels were significantly reduced. These findings suggest that pinocembrin exerts protective effects by enhancing the cellular antioxidant defense system and inhibiting lipid peroxidation. Conclusion Pinocembrin reduces oxidative stress and protects against cellular injury in hypoxia-induced H9C2 cardiomyocytes. These results indicate that pinocembrin may serve as a potential therapeutic agent for ischemiaand hypoxia-related cardiac disorders and provide a valuable foundation for further research.

Background: Adhesion small bowel obstruction (ASBO) is a common complication following abdominal surgery and can significantly impair postoperative recovery. This condition necessitates the exploration of more effective therapeutic approaches. Aim: The aim of this study was to evaluate the clinical efficacy of Traditional Mongolian Medicine (TMM) combined with acupuncture in the management of postoperative ileus secondary to adhesion-related small bowel obstruction. Case Presentation: We report the case of a 47-year-old female patient who developed postoperative ileus. The therapeutic intervention consisted of a combined regimen of traditional herbal pharmacotherapy and electroacupuncture. The clinical outcomes were assessed based on the resolution of symptoms and the restoration of gastrointestinal function. Result: Following the administration of the integrated treatment, the patient exhibited a marked reduction in abdominal pain. Objective clinical improvement was noted through the successful restoration of intestinal peristalsis and the normalization of flatus and defecation. Conclusion The findings of this case study suggest that Traditional Mongolian Medicine, particularly when integrated with electroacupuncture, may be an effective and viable modality for promoting the recovery of gastrointestinal motility in patients with adhesion-related small bowel obstruction.

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: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

OBJECTIVES

This study aims to determine the prevalence of CF and compassion satisfaction (CS) among OBGYN resident physicians in selected hospitals in Manila and identify the associated contributory factors

MATERIALS AND METHODS

A cross-sectional study was conducted among 105 OBGYN residents using the Professional Quality of Life Scale Version 5 (ProQOL 5), which measures CS and CF—further divided into burnout (BO) and secondary traumatic stress (STS). Data were collected through an online survey and analyzed using Jamovi software. Descriptive statistics were reported as frequencies, percentages, means, standard deviations and 95% confidence intervals. Associations between variables were determined using independent t-tests and Kruskal-Wallis tests, with a significance level set at p<0.05.

RESULTS

Most residents scored moderate levels in CS (68.6%), BO (72.4%) and STS (73.3%). Significant associations were found between all three subscales and most work-related factors such as hours of sleep per day, working hours per week and frequency of being called in during offduty hours. Marital status and parity were also significantly associated with higher BO and STS scores.

CONCLUSION

The study highlights the presence of CF among OBGYN residents with reported associations with work and personal factors. These findings emphasize the need for institutional interventions to support the well-being of resident physicians, especially in demanding clinical environments.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Empathy ; Gynecology ; Fatigue ; Hospitals ; Personal Satisfaction ; Physicians ; Prevalence ; Obstetrics ; Compassion Fatigue

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Objective: Executive function correlates with the parasympathetic nervous system (PNS) based on static heart rate variability (HRV) measurements. Our study advances this understanding by employing dynamic assessments of the PNS to explore and quantify its relationship with inhibitory control (IC). Methods: We recruited 31 men aged 20–35 years. We monitored their electrocardiogram (ECG) signals during the administration of the Conners’ Continuous Performance Test-II (CCPT-II) on a weekly basis over 2 weeks. HRV analysis was performed on ECG-derived RR intervals using 5-minute windows, each overlapping for the next 4 minutes to establish 1-minute intervals. For each time window, the HRV metrics extracted were: mean RR intervals, standard deviation of NN intervals (SDNN), low-frequency power with logarithm (lnLF), and high-frequency power with logarithm (lnHF). Each value was correlated with detectability and compared to the corresponding baseline value at t0. Results: Compared with the baseline level, SDNN and lnLF showed marked decreases during CCPT-II. The mean values of HRV showed significant correlation with d’, including mean SDNN (R=0.474, p=0.012), mean lnLF (R=0.390, p=0.045), and mean lnHF (R=0.400, p=0.032). In the 14th time window, the significant correlations included SDNN (R=0.578, p=0.002), lnLF (R=0.493, p=0.012), and lnHF (R=0.432, p=0.031). Significant correlation between d’ and HRV parameters emerged only during the initial CCPT-II. Conclusion A significant correlation between PNS and IC was observed in the first session alone. The IC in the repeated CCPT-II needs to consider the broader neural network.