The number of studies related to health economics evaluation is increasing. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) contains 28 items. Based on CHEERS 2013, CHEERS 2022 adds a health economic analysis plan, model sharing, and community, patient, public, and other relevant stakeholders' participation in the statement, taking into account the future development direction of health economics evaluation. It provides a useful review tool for peer reviewers, editors, and readers and supports health technology assessment agencies in establishing standard reporting standards for health economics evaluations. In this study, we briefly introduced and interpreted the CHEERS 2022 statement and analyzed an example of health economics evaluation in infectious disease epidemiology to provide a reference for researchers to report studies regarding health economics evaluation standardly.
Humans ; Cost-Benefit Analysis ; Checklist ; Economics, Medical ; Reference Standards ; Research Report

Family and community practitioners sometimes will decide on what community-oriented interventions to propose and implement. The cost and effectiveness of such interventions are often debated by policy makers. A set of formal, quantitative methods for comparing alternative strategies in resource use and expected outcomes is known as health economic analysis. This article presents a tool to help family and community practitioners decide on the cost and effectiveness of such interventions.
Evidence-Based Practice ; Economics, Medical

Patient education is important for successful management of atopic dermatitis; however, due to limited time and resources, patient education remains insufficient. This study aimed to investigate the current state of education provided by Korean dermatologists, pediatric allergists, and allergists to patients with atopic dermatitis. A questionnaire survey consisting of items regarding educational programs for patients with atopic dermatitis was conducted via e-mail. In total, 153 participants responded to the questionnaires, and 26.8% indicated that they have had separate educational programs. The workforce involved in the educational program included nurses, residents or fellows, dieticians, pharmacists, and clinical psychologists. Most education protocols addressed the characteristics and natural course of atopic dermatitis and environmental management. Overall, 96.7% of the participants replied that an additional charge is needed for education; moreover, additional assistance from an academic society or association, in the form of medical staff, organized data, and advertisement, is required to develop and provide a well-structured educational program. A standardized education protocol will effectively provide appropriate education for patients with atopic dermatitis. Arrangement of education fees, covered by the National Health Insurance Service, will lead to the establishment of a structured educational program and participation of an additional medical workforce.
Dermatitis, Atopic ; Education ; Electronic Mail ; Fees and Charges ; Humans ; Korea ; Medical Staff ; National Health Programs ; Nutritionists ; Patient Education as Topic ; Pharmacists ; Psychology

fertilization and embryo transplantation (IVF-ET) technology is one of the main treatments for infertility. But IVF-ET is expensive and has not be covered by health insurance in most developing countries. Therefore, how to obtain the maximum success rate with the minimum cost is a common concern of clinicians and patients. At present, the economic studies on IVF-ET mainly focus on different ovulation stimulating drugs, different ovulation stimulating protocols, different transplantation methods and the number of transplants. But the process of IVF-ET is complex, the relevant methods of economic study are diverse, and there are no unified standard for outcome indicators, so there is no unified conclusion for more economical and effective protocol by now. Therefore, to analyze the economic studies of IVF-ET, and to explore appropriate evaluation methods and cost-effective protocols will be helpful for reasonable allocation of medical resources and guidance of clinical selection. It would provide policy reference to include the costs of IVF-ET treatment in health insurance in the future.
Economics, Medical ; trends ; Embryo Transfer ; economics ; statistics & numerical data ; Female ; Fertilization in Vitro ; economics ; statistics & numerical data ; Humans ; Infertility ; economics ; Insurance, Health ; economics ; statistics & numerical data ; Ovulation Induction

Surgery is a very hands-on area of medical care, in that surgeons identify problems in patients' bodies and directly change them through operations. Therefore, it is not only necessary for surgeons to have a high level of expertise, but also to take considerable responsibility for the outcomes of each operation. However, surgery, which was once an object of envy, has long been a process to avoid, due to various circumstances, such as abnormal medical expenses in the medical field and social phenomena that avoids difficult work. It is unfortunate that medical professionals do not receive sympathy from others within the same medical field because of the general difficulties of the profession. The fundamental problem in this situation is the abnormal profit structure of the Korean medical system. Efforts by various related organizations will be needed to objectively evaluate the problems of the current medical insurance system and to make reasonable adjustments considering the difficulty, frequency, and resource-intensiveness of medical care.
Diagnosis-Related Groups ; Fees, Medical ; Insurance ; Korea ; Surgeons

PURPOSE: This study aimed to investigate the diagnosis and severity of patients who were referred to tertiary medical centers according to the type and function of the referral hospitals. METHODS: First-visit patients referred from July 2015 to June 2016 were retrospectively reviewed with regard to referral hospital, final diagnosis, treatment necessity, and medical fees for the six months after their first hospital visit. Based on these data, differences in type and function of medical institution were examined. RESULTS: In a comparison of hospitals according to their number of beds, clinics, hospitals and, tertiary hospitals had no differences in the ratio of patients who needed treatment (p = 0.075) and their medical fees over six months (p = 0.372). When hospitals were classified by functional capability in terms of doctors' medical specialty, increasing ratios of patients requiring medical treatment (p < 0.001) and medical fees for six months (p < 0.001) were found in the order of non-eye specialists, eye specialists, and eye specialists in trainee hospital. CONCLUSIONS: Efficient healthcare delivery systems should classify medical institutions by functionality capability based on medical specialties rather than hospital size according to the number of beds.
Delivery of Health Care ; Diagnosis ; Fees, Medical ; Health Facility Size ; Humans ; Ophthalmology* ; Referral and Consultation* ; Retrospective Studies ; Specialization ; Tertiary Care Centers ; Tertiary Healthcare

There is a paucity of available research on knowledge of orthopaedic implant costs and healthcare schemes among orthopaedic residents. With the rising healthcare costs in Singapore, it is imperative for residents, who are the future surgeons, to understand these issues in order to provide proper counselling and cost-effective management. This study aimed to quantify how accurately they understood these issues and determine if senior residents had better knowledge given their increased experience. An online survey was administered to all orthopaedic residents within a residency programme. There was poor knowledge of implant costs and healthcare schemes among residents. Junior residents fared better at healthcare schemes, while senior residents fared better at estimation of implant costs. Education on these issues should be incorporated into the residency programme to bring about more holistic and cost-conscious clinicians.
Attitude of Health Personnel ; Clinical Competence ; Cross-Sectional Studies ; Education, Medical, Graduate ; Health Care Costs ; Health Knowledge, Attitudes, Practice ; Humans ; Internship and Residency ; Orthopedics ; economics ; education ; Physicians ; Prostheses and Implants ; economics ; Singapore ; Surveys and Questionnaires ; Workload

INTRODUCTION: Postgraduate medical education in Singapore underwent a major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of sponsoring institution (SI) for residency among medical students during this transition period. METHODS: A questionnaire-based cross-sectional study of Singapore undergraduate medical students across all years of study was performed in 2011. Participants rated the degree of importance of 45 factors (including research, academia and education, marketing, reputation of faculty, working conditions, posting experience and influence by peers/seniors) to their choice of SIs on a five-point Likert scale. Differences in gender and seniority were compared. RESULTS: 705 out of 1,274 students completed the survey (response rate 55.3%). The top five influencing factors were guidance by mentor (4.48 ± 0.74), reputation for good teaching (4.46 ± 0.76), personal overall experience in SI (4.41 ± 0.88), quality of mentorship and supervision (4.41 ± 0.75), and quality and quantity of teaching (4.37 ± 0.78). The five lowest-rated factors were social networking (2.91 ± 1.00), SI security (3.01 ± 1.07), open house impact (3.15 ± 0.96), advertising paraphernalia (3.17 ± 0.95) and research publications (3.21 ± 1.00). Female students attributed more importance to security and a positive working environment. Preclinical students rated research and marketing aspects more highly, while clinical students valued a positive working environment more. CONCLUSION Quality of education, mentorship, experiences during clerkship and a positive working environment were the most important factors influencing the choice of SI.
Accreditation ; Cross-Sectional Studies ; Curriculum ; Education, Medical, Graduate ; economics ; organization & administration ; Education, Medical, Undergraduate ; economics ; organization & administration ; Female ; Humans ; Internship and Residency ; Male ; Mentors ; Models, Organizational ; Schools, Medical ; Singapore ; Students, Medical ; statistics & numerical data ; Surveys and Questionnaires ; United States ; Universities

INTRODUCTION: Medical school fees are rising globally. Student debt and financial background may affect residency choices, but few studies have been conducted in Asia. This study aimed to explore the relationship between financial background, student debt and postgraduate residency choices among medical students in Singapore. METHODS: An anonymised survey of all medical students in Singapore was conducted and had a response rate of 67.9%. RESULTS: 40.5% of our study population would graduate with debt. Medical students with monthly per capita household income < SGD 1,000 were more likely to graduate with debt (unadjusted odds ratio [OR] 2.0, 95% confidence interval [CI] 1.6-2.7; p < 0.001) and feel burdened by the cost of medical education (unadjusted OR 2.8, 95% CI 2.0-3.9; p < 0.001). Students with monthly per capita household income < SGD 1,000 (unadjusted OR 1.818, 95% CI 1.338-2.470, p < 0.001; adjusted OR 1.692, 95% CI 1.202-2.381, p = 0.003) and those with debt (unadjusted OR 1.623, 95% CI 1.261-2.090, p < 0.001; adjusted OR 1.393, 95% CI 1.048-1.851, p = 0.022) were more likely to rank at least one economic factor as 'very significant' in influencing their postgraduate training choices. CONCLUSION It is concerning that despite financial aid schemes, the cost of medical education remains a burden to students from lower-income households in Singapore. Student debt and financial background may distort postgraduate career choices, creating an undue push towards high-paying specialties.
Career Choice ; Choice Behavior ; Education, Medical ; economics ; Humans ; Internship and Residency ; economics ; Odds Ratio ; Schools, Medical ; economics ; Singapore ; Social Class ; Students, Medical ; statistics & numerical data ; Surveys and Questionnaires ; Training Support

PURPOSE: This study was performed to suggest a realistic measure of charging for 119 emergency medical services (EMS) in Korea using Delphi study targeting emergency medical specialists. METHODS: The Delphi study was conducted four times targeting 24 emergency medical specialists. The first Delphi survey contained five categories as follows: Subjects of charging for 119 EMS, method of charging, strategy of implementation, utilization of fund, measure of quality improvement. In the second and third Delphi surveys, respondents were asked to indicate the level of importance with the questionnaire statements on a Likert scale, ranging from 0 to 5. The final consultation survey collected opinions on the system of charging for 119 EMS. RESULTS: The results from the first three Delphi surveys showed subjects of charging, method of charging, strategy of implementation, utilization of fund, and measure of quality improvement for 119 EMS. The fourth Delphi survey resulted in step 1 (classification of severity), step 2 (scene of accident), and step 3 (classification of severity at hospital). The classification of severity in steps 1 and 2 should be evaluated by first grade emergency medical technicians, and the classification of severity in step 3 should be evaluated by a person notified by the Ministry of Health and Welfare. Non-emergent patients should pay for the charge of 119 EMS to the hospital. CONCLUSION: Delphi study proposed charging for 119 EMS based on three levels of severity. This study suggests that charging for EMS can reduce unnecessary emergency calls and offer proper medical services to emergency patients.
Classification ; Delphi Technique* ; Emergencies* ; Emergency Medical Services* ; Emergency Medical Technicians ; Fees and Charges ; Financial Management ; Humans ; Korea ; Methods ; Quality Improvement ; Specialization ; Surveys and Questionnaires