Attitude to Health ; Female ; Health Policy ; Humans ; Informed Consent ; ethics ; legislation & jurisprudence ; psychology ; Male ; Singapore ; Students ; psychology ; Tissue and Organ Procurement ; ethics ; legislation & jurisprudence ; Universities ; Young Adult

Health Policy ; Humans ; Informed Consent ; ethics ; legislation & jurisprudence ; Singapore ; Tissue and Organ Procurement ; ethics ; legislation & jurisprudence

BACKGROUND: Acetylcholinesterase inhibitor insecticides (AChEIIs) were used extensively in the agrarian region of Anuradhapura for the past few decades. As a result, the region faced a heightened risk of toxicity. Carbaryl, carbofuran, chlorpyrifos, dimethoate, and fenthion were the five hazardous AChEIIs banned from Anuradhapura in 2014. Assessment of post-ban trends in acute poisoning will reveal the impact of the ban. Data on availability and sales of remaining AChEIIs will guide towards preventive measures against related toxicities. METHODS: Cross-sectional surveys were conducted at Anuradhapura district of Sri Lanka. Details related to acute AChEII poisoning were sorted from the Teaching Hospital Anuradhapura. Main insecticide vendors in Anuradhapura were surveyed to find information on availability and sales of AChEIIs. Chi-square for goodness of fit was performed for trends in acute poisoning and sales. RESULTS: Hospital admissions related to acute AChEII poisoning have declined from 554 in 2013 to 272 in 2017. Deaths related to acute AChEII poisoning have declined from 27 in 2013 to 13 in 2017. Sales of all five banned AChEIIs had reduced by 100%. Sales of the remaining AChEIIs were declining, except for acephate, phenthoate, and profenofos. However, one of the top selling, most frequently abused carbosulfan, had the highest risk of toxicity. Chi-square for goodness of fit showed a significance (P < 0.001) between the trends of hospital admissions for acute AChEII poisoning and the sales related to AChEIIs. CONCLUSIONS Hospital admissions related to acute poisoning was declining along with the overall sales of remaining AChEIIs, during the post-AChEII ban period. Nevertheless, future vigilance is needed on the remaining AChEIIs to predict and prevent related toxicities.
Agriculture ; legislation & jurisprudence ; Cholinesterase Inhibitors ; classification ; poisoning ; supply & distribution ; Commerce ; statistics & numerical data ; trends ; Cross-Sectional Studies ; Developing Countries ; Female ; Government Regulation ; Health Policy ; legislation & jurisprudence ; Hospitalization ; statistics & numerical data ; trends ; Humans ; Incidence ; Insecticides ; classification ; poisoning ; supply & distribution ; Male ; Poisoning ; epidemiology ; mortality ; prevention & control ; Risk Factors ; Sri Lanka ; epidemiology

For over 100 years, controlled human infection (CHI) studies have been performed to advance the understanding of the pathogenesis, treatment and prevention of infectious diseases. This methodology has seen a resurgence, as it offers an efficient model for selecting the most promising agents for further development from available candidates. CHI studies are utilised to bridge safety and immunogenicity testing and phase II/III efficacy studies. However, as this platform is not currently utilised in Asia, opportunities to study therapeutics and vaccines for infections that are important in Asia are missed. This review examines the regulatory differences for CHI studies between countries and summarises other regulatory differences in clinical trials as a whole. We found that the regulations that would apply to CHI studies in Singapore closely mirror those in the United Kingdom, and conclude that the regulatory and ethical guidelines in Singapore are compatible with the conduct of CHI studies.
Asia ; Clinical Trials as Topic ; economics ; standards ; Communicable Disease Control ; Communicable Diseases ; epidemiology ; Cost-Benefit Analysis ; Ethics, Medical ; Health Policy ; Humans ; Infectious Disease Medicine ; legislation & jurisprudence ; standards ; Quarantine ; Research Design ; standards ; Singapore ; United Kingdom

On July 23rd, 2010 a revised medical law (Article 58) was passed to change existing evaluation system of medical institutions to an accreditation system. The new healthcare accreditation system was introduced to encourage medical institutions to work voluntarily and continuously to improve patient safety and medical service quality. Changes regarding the healthcare accreditation system included the establishment of an accreditation agency, the voluntary participation of medical institutions, accreditation standards centering on the treatment process and patient safety, tracing methodology, and the announcement of comprehensive results concerning accreditation. Despite varying views on the healthcare accreditation system, including some that are critical, it is meaningful that the voluntary nature of the system acknowledges that the medical institutions must be active agents in improving medical service quality. Healthcare quality is not improved instantaneously, but instead gradually through continuous communication within the clinical field. For this accreditation system to be successful, followings are essential: the accreditation agency becomes financially independent and is managed efficiently, the autonomy and regulation surrounding the system are balanced, the professionalism of the system is ensured, and the medical field plays an active role in the operation of the system.
Accreditation/*legislation & jurisprudence ; Delivery of Health Care/*legislation & jurisprudence ; Health Policy/legislation & jurisprudence ; Humans ; Quality Improvement ; Quality of Health Care ; Republic of Korea

China ; Health Care Reform ; Health Policy ; Hospitals, Public ; legislation & jurisprudence ; Humans

OBJECTIVES: The regulatory changes in Korea during the national economic crisis 10 years ago and in the current global recession were analyzed to understand the characteristics of deregulation in labor policies. METHODS: Data for this study were derived from the Korean government's official database for administrative regulations and a government document reporting deregulation. RESULTS: A great deal of business-friendly deregulation took place during both economic crises. Occupational health and safety were the main targets of deregulation in both periods, and the regulation of employment promotion and vocational training was preserved relatively intact. The sector having to do with working conditions and the on-site welfare of workers was also deregulated greatly during the former economic crisis, but not in the current global recession. CONCLUSIONS: Among the three main areas of labor policy, occupational health and safety was most vulnerable to the deregulation in economic crisis of Korea. A probable reason for this is that the impact of deregulation on the health and safety of workers would not be immediately disclosed after the policy change.
Cost Control/legislation & jurisprudence/methods ; *Economic Recession ; Employment/*economics/legislation & jurisprudence/statistics & numerical data ; Government Regulation ; Humans ; Occupational Health/*legislation & jurisprudence/statistics & numerical data ; Public Policy ; Republic of Korea ; Workplace/economics/legislation & jurisprudence/standards

This study is designed to serve as a reference for the establishment of health security systems for children’s critical diseases. Through analysis of the operation of Shanghai Children Hospital Care Aid (SCHCA), this study explored the financing model and management of a children’s critical disease healthcare system and analyzed the possibility of expanding this system to other areas. It is found that a premium as low as RMB 7 per capita per year under SCHCA can provide high-level security for children’s critical diseases. With the good experience in Shanghai and based on the current basic medical insurance system for urban residents and the new rural cooperative medical scheme (NRCMS), it is necessary and feasible to build a health security system for children’s critical diseases at the national level.
Adolescent ; Child ; Child Welfare ; Child, Preschool ; China ; Delivery of Health Care ; Health Policy ; economics ; legislation & jurisprudence ; Humans ; Infant ; Infant, Newborn

In the 1950s and 1960s, Korea overcame the aftermath of the war and laid the foundations for modernization of economy and professionalization of medicine. The National Medical Services Law, enacted in 1951 was the first medical law to be legislated since the establishment of the Republic of Korea. The law provided a medical system for the traditional Korean medical practitioners, activated opening of hospitals through report-only system and prohibition of interference in medical practice, and facilitated mobilization of the doctors by the government. The Medical Law, legislated in 1962 by the Park Jong-Hee administration contained practice license system, regular practice reporting system and practice designation, thereby strengthening the government control on the medical practitioners, inducing professionalism and high-quality of medical practitioners and abolished unlicensed medical practitioners such as acupuncturists, moxa cauterists and bone setters. The Medical Assistant Law of 1963 was introduced so that medical examination and assistance could be carried out under supervision of professional doctors. To reduce areas without healthcare system, region-specified medical practitioners got licensure and a community doctor system was organized. However, due to expensive medical fees in comparison to economic status and medical needs of patients, shortage of doctors, low accessibility to hospitals led to the prevalence of illegal medical practice by unlicensed practitioners. Absence of national budget or policy on the health care system and the American-style noninterference medical system were other factors causing the situation. Government, Korean Medical Associations and Korean Dental Association tried, without success, to exercise control over the unlicensed medical practice. President Park Jong-Hee had to introduce a special law concerning the health-care related crimes with life sentence as the highest penalty. While the government put modernization before social welfare, operated on a policy of state-controlled medical care system, and doctors achieved specialization system similar to that of the United States, the public had to suffer, being treated by unlicensed medical practitioners. Inevitably, the need for a national medical practitioner supply plan and a policy to support health service was raised.
Health Policy/history ; History, 20th Century ; Humans ; Legislation, Medical/*history ; Licensure/*history ; Private Sector/history ; Public Health/history ; Republic of Korea ; State Medicine/*history

OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Child, Preschool ; Cost Sharing/*legislation & jurisprudence ; *Health Policy ; Health Services/*utilization ; Hospitalization ; Humans ; Insurance Claim Review ; Korea ; Length of Stay