Experience in the handover of manned space medical rescue support / 中华急诊医学杂志

To analyze how the handover were effected by the conditions of manned spaceflight medical support mission through the practice of medical equipment and drugs in Shenzhou-12 and Shenzhou-13 manned spaceflight medical rescue support missions, this article discussed the preparation, organization and implementation in the handover of medical equipment and drugs in the changing of medical rescue teams, summarized the notices in the work of handover, and provided experience for the smooth handover of different manned spaceflight medical rescue teams in the future.

Current Status and Discussion of Hemophilia Aid System / 罕见病研究

Hemophilia is a hereditary bleeding disorder where the only effective treatment is factor replacement therapy. The main contradiction of hemophilia in China is the contradiction between the increasing demand for quality of life of hemophilia patients and insufficient medical insurance, medical treatment and medicine. Expensive treatment costs are the main reason for patients to "be impoverished due to illness" and "return to poverty due to illness". This article analyzes the current status of the hemophilia aid system through the existing literature data and existing patient aid projects. Cooperation of social insurance, social relief and high-quality medical services is critical to a complete hemophilia comprehensive medical aid system, so that hemophilia patients can receive standardized diagnosis and treatment, and try to achieve the close quality of life as normal.

Analysis on the Destination Transformation of the Medical Aid Policy under the Perspective of Health Poverty / 中国卫生经济

The medical aid policy aimed at reducing medical expense of the poor group,which could not solve impoverished problem effectively.People who lack health ability could not get out of poverty ultimately.Health poverty became the direct reason for low income of residents,which blocked the realization of their rights to health and increased the difficulties to complete the objective of helping the poor by 2020.Medical aid policy was the last line of defense in social security system,therefore,policies to relieve health poverty could combine with medical aid policy.Given this,the destination of medical aid system should tend to combine reducing medical expense and improving health ability of poor people.To ensure the realization of citizen's right to health and reduce illness-related poverty,it needed to improve the system and public health service system,emphasize health education and promote social organization participation.

Study on discourse right construction of China’s medical aid to Africa / 中国血吸虫病防治杂志

Objective To analyze the discourse right construction of China’s medical aid to Africa,so as to provide evidenc?es for improving the effect and sustainable development of China’s medical aid to Africa. Methods The documents of the dis?course right that China constructed in the medical aid to Africa were selected at different periods as discourse samples. The achievement and deficiency were analyzed from four aspects,namely confident,charismatic,influential,and dominant. Re?sults China’s medical team made much in the discourse right construction in their aid to Africa,but some China’s medical team members were still too cautious and too low?key. China’s medical team gained the trust of the people of Africa,but the lan?guage communication difficulties still hampered in China’s medical aid to Africa. Chinese medical team were widely praised by the African society,but in the west,some African media,even China’s media still neglected to report China’s doctors. China’s international discourse right were greatly improved,but western countries still dominated the public opinion. Conclusion Chi?na should refer to the actual situation of medical aid to Africa to strengthen the construction of discourse right.

Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases / 재활간호학회지

PURPOSE: The purpose of this study was to compare the needs of case management between Medical aid beneficiaries with simple and multiple chronic diseases (SCD vs MCD). METHODS: The study employed secondary analysis method using a cross-sectional data from 2009 case management service enrollees. Data on 35,862 beneficiaries who have chronic disease(s) were used in the description of chronic disease characteristics, and data on 20,392 beneficiaries, excluding those who have depression and/or disabilities, were used to compare the group differences. RESULTS: Mean age was 68.8+/-11.63 years, and 73.3% were females. MCD group showed an older age, had more women than SCD group. Self-care ability and appropriateness of health care utilization were significantly different between the groups, but there was no difference in health-related quality of life. In subscales, there were significant differences in general health status, depression, symptom management, healthy lifestyle, hygiene and vaccination, and appropriateness of health utilization. CONCLUSION: Different characteristics between patients with simple and multiple chronic diseases indicate that different case management approaches are required for these groups. The study results could be used as a basis for the development of case management model tailored to the characteristics and needs of medical-aid beneficiaries.

Patient assessment of primary care under the Designated Practice Scheme for Medical Aid beneficiaries, using the Korean Primary Care Assessment Tool (K-PCAT): a district of Seoul, South Korea

To control excessive utilization of medical care services by Medical Aid beneficiaries (MABs), the Korean government has introduced the Designated Practice Scheme (DPS, July 2007). The purpose of this study was to assess the primary care quality of the DPS using the Korean Primary Care Assessment Tool (K-PCAT). Data were collected from the survey (2008-2009) of MABs who had to designate a community clinic as the first contact practice obligatorily in one district of Seoul. Among all eligible (n=164), we analyzed the data of 154 beneficiaries, excluding those who did not meet the K-PCAT criteria of a usual source of care. Primary care quality under the DPS was poor (58.1 points) on a 100-point scale, compared with those previously studied under the Korean health care system. More seriously it was very poor (48.9 points) in MABs without intention to continue participation in the DPS, who were 50% of all participants. Among 5 domains of the K-PCAT, comprehensiveness (44.7 points) and coordination (39.3 points) were lower in score than other domains, comparable to previous studies, representing the reality of primary care in South Korea. Primary care quality was better in MABs using primary care practices including general practice, family medicine, and internal medicine instead of other specialty practice groups (60.2 vs. 53.9 points, P=0.015), and in MABs with longer duration (> or =3 vs. <3 years) since the first visit (59.7 vs. 51.9 points, P=0.010). These patterns were maintained after multivariate analysis, controlling for confounding variables. This research suggests that a complete overhaul of the scheme itself, such as the introduction of pay-for-performance method, etc., is necessary to improve primary care quality of the DPS.

Impact of Health Insurance Type on the Quality of Hemodialysis Services: A Multilevel Analysis / 예방의학회지

OBJECTIVES: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. METHODS: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). RESULTS: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI=0.43-0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb> or =11 g/dL, blood pressure within the range of 100-140/60-90 mmHg, calcium x phosphate or =4 g/dL were not significantly different between the groups. CONCLUSIONS: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

The Medical Use of the Disabled Among Overusers of Medical Aid in Korea / 예방의학회지

OBJECTIVES: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. METHODS: Subjects (n=2,211) selected were > or =18-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. RESULTS: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(won), inpatient payment of 359,000won, and outpatient payment of 183,000won. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (82,000won), elementary school or lower educational level (64,000won), residence in a small city (82,000won), lack of family support (61,000won), kidney disability (673,000won), intellectual disability (151,000won), and multiple disabilities (119,000won). CONCLUSIONS: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

Baseline investigation of medical aid following Wenchuan Eathquake / 中华医院管理杂志

Objective This paper aims to make clear the post-disaster medical needs of residents in the disaster areas and changes among the poor population, for the purpose of policy recommendations on post-disaster medical assistance. Methods Such methods as in-home questionnaire survey and literature study were used to study the income, prevalence rate and mental health of 4 380 households in 10 counties (cities and districts) in the disaster areas. Results In the hardest hit areas, 80. 4% and 52. 8% of residents in rural and urban areas are dependent on government relief respectively;the proportion of poor population resulting from the disaster rose from 5% before the disaster to over 75% afterwards in the hard-hit areas, while such a population rose to 15% in the hardest-hit areas and about 10% in general disaster areas;It is estimated that the new medical aid funds in Sichuan Province will reach 350 million yuan, two-fold that of the budget for 2009;In the hardest hit areas, the two-week prevalence rate per thousand people is twice that found in the third survey of health services in 2003, characterized of acute respiratory illness and rheumatoid;In the hardest-hit areas, nearly 70% of the residents are exposed to high mental health risks. Conclusion Recommendations: Strengthening the raising and use of medical aid fund;dynamic management for the population in need of post-disaster medical aid;Developing appropriate medical aid packages to fit post-disaster health needs and postdisaster disease characteristics;and consolidating the connection between medical aid and primary medical insurance system.

Study on post-disaster emergency medical aid and contingency plan following Wenchuan Earthquake / 中华医院管理杂志

By means of field survey and expert consultation, the paper made a summary of the experiences learnt from medical aid in Wenchuan Earthquake, along with problems found. The summary and assessment covered the disaster-caused casualty and health among local residents, cost estimates for post-disaster medical aid, and targeted measures to improve medical aid plans. In addition, the authors proposed to emphasize the uniqueness of earthquake disasters and develop pre-plans in this regard, as well as such mid-and long-term plans for the promotion of disaster medicine, development of disaster medicine talents, upgrading of emergency medical rescue skills of medical staff, and volunteers management systems.

The Contributing Factors to Surplus Medicine by Long-Term Users of Medical Aid in Korea / 예방의학회지

OBJECTIVES: The amount of medical utilization by Medical Aid recipients was 3.7 times that of patients with Korean Medical Insurance. This study aims to describe the surplus medicine and the medication-related utilization, and to determine factors contributing to surplus medicine. METHODS: Among those who used copayment-free Class I Medical Aid in 2005, 146,880 subjects who were > or =19 year-old and received >365 days medical treatment per year were studied with their case managers by conducting face-to-face interviews. The analytic methods were description, chi-square, t-tests, ANCOVA and multiple logistic regressions. RESULTS: Most subjects were female (68.6%), the elderly (62.5%), and the separated (61.6%), had an elementary graduation or less (74.8%), and had disabilities (33.2%). The percentage of subjects with surplus medicine was 18.5%. However, the percentage of females, the elderly, those with non-disabilities, the separated, the uneducated, those with a very poor perceived health status and those with an economical burden for medical treatment was 19.3%, 18.9%, 19.0%, 19.3%, 19.0%, 20.2% and 24.3%, respectively. For subjects with surplus medicine, averages for the number of used pharmacies, the pharmacy-visit days and the medication costs were 4.6 drugstores, 34.9 days and approximately 1,124 thousand Won. These values were higher than those without surplus medicine (4.4 drugstores , 33.8 days, and 1,110 thousand won, respectively). The odds ratios of the contributing factors to surplus medicine were female 1.11 (95% CI=1.07-1.14), the elderly 1.06 (95% CI=1.02-1.10), those with non-disabilities 1.08 (95% CI=1.05-1.12), the separated 1.14 (95% CI=1.10-1.18), the unmarried 1.12 (95% CI=1.07-1.18), the uneducated 1.03 (95% CI=1.01-1.08), those with a very poor perceived health status 1.04 (95% CI=1.01-1.08) and experiencing an economical burden for medical treatment 2.33 (95% CI=2.26-2.40). CONCLUSIONS: 18.5% of subjects had surplus medicine with a higher mean of medication cost. Therefore, health education and health promotion programs to prevent surplus medicine and to improve the appropriate usage of medication are necessary.

Issues on the Eligibility Management System in Medical Aid

The Ministry of Health and Welfare introduced a new reimbursement system called the Eligibility Management System in Medical Aid in July 2007. The operation of this system is interlocked with patient care programs of medical institutions. The new system was expected to realize effective management of the eligibility of beneficiaries by interactive communications between medical institutions and the National Health Insurance Corporation (NHIC) and thereby improve financial stabilization of the reimbursement system and optimize healthcare practices by preventing moral hazards in the relationship between beneficiaries and medical institutions. For the effective operation of this system, however, several drawbacks need to be resolved; firstly, one can currently use the system only through the internet, secondly, there is a legal issue that medical institutions are the subject of the management of eligibility, and lastly, healthcare information needs to be transferred to NHIC in a real-time manner. Particularly the last one needs a special attention because it can raise critical concerns of potential violation of human rights of patients and unnecessary regulations of medical practices.

Equipment development for emergency medical aid station of Armed Police / 医疗卫生装备

The equipment development for emergency medical aid station of the Armed Police applies modern medical science and technology as well as management system.Based on the functional necessity,it accords with the theory of wartime health service support and draws on the experience of anti-terrorism struggle in foreign countries.It realizes serialization,modularizaion and motorization.This paper mainly introduces the development background,systematical structure and functional characteristics of the equipment for the emergency medical aid station.

Study on rapid & mobile first-aid unit from brigade,regiment medical aid station / 医疗卫生装备

This paper introduces the rapid & mobile first-aid unit from brigade or regiment medical aid station,especially discusses its equipment,performance,personnel structure,and working features.The rapid & mobile first-aid unit can perform emergency operation and anti-shock treatment for the serious wounded in frontier at any moment.It meets the requirements in such aspects as fast & effective first-aid,mobile & flexible treatment,high cure rate and good practicality.

Research on the cost estimation of community medical aid programs for the urban poor / 中华医院管理杂志

Objective To estimate the cost of community medical aid programs for the urban poor in Shenyang, Chengdu, Xining and Yinchuan so as to provide the primary basis for improving the compensation mechanisms for such programs. Methods A survey was made on the cost consumption of six major categories in the course of health service delivery and the amount of various community health services actually delivered by the pilot community health service institutions in 2003. The cost of each service program was estimated and then the cost of medical aid programs for the urban poor was estimated. Results The per capita cost of the medical aid programs for the poor in the cities was less than 5 yuan and the total cost of the medical aid programs accounted mostly for 0.05‰ or so of the financial expenditure of each of the cities. Conclusion The government ought to make rational compensation for community medical aid programs, the cost of which is low. Setting up community health service based mechanisms of medical aid for the poor conforms to the actual condition of our country.

Ethics Reflection on International Medical Aid / 中国医学伦理学

Along with the rapid development of globalization,the international medical aid enterprise is drawing more and more attention with its bright humanitarianism standpoint,non-national boundary,and non-political orientation characteristics.From the angle of medical ethics,this article encloses ethical issues and contradictions in realistic international medical service aid,reflects on relevant ethical principles,and comes up with feasible countermeasures to solve current problems.

Reflection on medical aid to the urban poor / 中华医院管理杂志

With the changes in the social structure of China, medical aid to the poor has become a hot issue in our society. The authors analyze the current state of medical aid to the poor in China, disenss the difficulties in providing medical aid to the poor at present, and put forward the idea of providing medical aid to the poor through specifying aid funds, conducting fundraising in every way, establishing foundations, adopting a variety of aid patterns, obtaining the active cooperation of local hospitals, and coordinating aid organizations.

Analysis on the Countermeasures of Medical Aid to the Urban Poor Population / 中国医学伦理学

The World Health Organization points out that everyone has right to acquire basic health care service and social guarantee. The government should adopt proper and legal means to gradually realize everyone's health right with current resource.As the aggravation of poverty problem in the city,the problem of urban poor population will become one of the most important political events in the 21st century.Through analysing the problem of urban poor population in health care,this article discusses the mechanism of medical aid and the countermeasures to meet the basic medical demand of urban poor population,which will help to improve the health of poor population in the city,the medical service utilization and health fairness.

Comparison of medical care utilization patterns between beneficiaries of medical aid and medical insurance / 영남의대학술지

A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance beneficiaries selected by simple random sampling from a Dong (Township) in Taegu. Well-trained surveyors mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease in medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was affordability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

Research on Equipment and Technical Requirements for Pilots in Distress Ambulance / 医疗卫生装备

Objective To demonstrate medical aid techniques and ways of rescue helicopter,explore the variety and quantity of equipped medicines and instruments,develop medical aid equipment on board and solve the problems of lacking standard medical aid equipment in the rescue helicopter of our army.Methods The service demand of medical aid equipment in rescue helicopter was demonstrated by means of investigating and material analyzing.The medical aid equipment was developed.Results The technical specifications of technical methods,treatment principles and drugs,the volume of equipment goods and equipment were formed.The medical aid helicopter has features of small size and light weight,and has a fully furnished on fixation and spread of medical equipment.The helicopter of vibration,noise,jolt,low pressure has no effect on job status of the equipment,which performance stability and reached the design requirements.Conclusion The medical aid technique,method and equipment of rescue helicopter are researched to meet the needs of curing the wounded pilots who had to parachute in emergency situation and solve the problem of training demand in the army.