OBJECTIVES To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. METHODS The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(...

Denial of an insurance claim for occipital nerve blocks raises questions about utilization review by insurance companies and peer reviewers. Who reviews the reviewers? CLINICAL HISTORY A 40-year-old man presented with a 3-week history of right-sided more than left nuchal-occipital and parietal throbbing pain of moderate intensity daily on an intermittent basis and lasting for several hours. The...

Background: Chronic kidney disease is a catastrophic ranked second in Indonesia for high health costs. The number of renal units has rapidly increased since the launch National Health Insurance program 2014. Its increase was accompanied by patients. Aim: This study analyzed effect service quality dimensions on patient satisfaction with hemodialysis care. Methods: used cross-sectional design and...

A key instigator of the fragmentation in the healthcare system is that access depends on age, income, occupation, employer, geographical location, or, as in the Oregon health insurance lottery, good fortune (Oregonians who do not qualify for Medicaid, but are too poor to buy their own insurance, can apply for state-subsidised health insurance. The winners are randomly selected). While healthcar...

Four key challenges to reforming health care organizations can be addressed by a clinical integration model patterned after Advocate Physician Partners (APP). These challenges are: predominance of small group practices, dominant fee-for-service reimbursement methods, weaknesses of the traditional hospital medical staff structure and a need to partner with commercial insurance companies. APP has...

The Korean health care system has been recognized by other countries for its rapid expansion of national health insurance. The government's policy of promoting the private sector, relying on market forces for various allocation decisions, and using the fee-for-service payment system has created a number of challenges for the Korean health system. Among these are rapid growth of health care expe...

in a recent issue of the asia pacific journal of medical toxicology (apjmt), the importance of empowering medical toxicology in the asia pacific region has been discussed. in the editorial by dr. afshari, it has been stated that national societies of medical toxicology are important infrastructure for the development of medical toxicology, and the asia pacific association of medical toxicology ...

The universal health coverage in Indonesia is organized by Badan Penyelenggara Jaminan Kesehatan (BPJS) which gives a protection to population as medical insurances. This essential protect and maintain the quality of Indonesian population. However, there were some burden for coverage, including accessible National Health Insurance (JKN). Therefore, we may learn on improving from United States w...

This paper examines health care reform in urban and rural China. Before health care reform, Chinese health service facilities were run entirely by the state and basically they performed a social welfare function. This health care system greatly improved the population health conditions but many problems started to emerge in 1980s when the economic reform started. Since then, the government has ...