The determinants of physician and pharmacist utilization and equity of access under Korean universal health insurance

This study examines the social and behavioral determinants of two types of primary care, seeing a physician or a pharmacist, for Koreans and evaluates the equity of the Korean national health insurance system. The study applies the Aday and Andersen access framework to cross-sectional data from the 1992 Korean National Health Interview Survey (N = 21,841).^ The study found that in Korea, the elderly were most likely, and children least likely, to have used physician services. Women, household heads, those in small families, and the less educated were more likely than their counterparts to use physician and pharmacist services. Health status and need were important determinants of Koreans seeing a doctor or a pharmacist. Differences in need substantially accounted for the original differences observed between subgroups. Resources associated with having insurance coverage, a regular source of care, and place of residence (rural/urban) ameliorated to some extent the subgroup differences in the use of physicians' and pharmacists' services among Koreans. They were also major independent predictors of access. Having insurance remains a particularly important predictor of who uses physician services. Among the insured, trade-offs in the use of physician and pharmacist services were found in the current system, i.e., uninsured and poor Koreans were more likely to use pharmacist services, while insured and rural Koreans were more likely to use doctor services. Among the insured, cost sharing rates are lower for physician than for pharmacist services. Self-employed persons were less likely than government and industrial workers to use physician services. An underlying expectation under universal health insurance was that the Korean health care system would be equitable. The research results, however, did not fully support this expectation.^ The policy implications of these findings are that measures are required to extend insurance coverage to the uninsured, to equalize differences in benefit packages between health plans, and to expand the availability of physicians in rural areas. Further research is also needed to understand those who do not currently have a regular source of care and why and the access barriers that may exist for selected demographic subgroups (those in large families and unmarried or divorced/widowed persons). ^

Intrapartum detection of Group B streptococci colonization by rapid PCR-test on labor ward

OBJECTIVE Group B streptococci (GBS) may lead to early onset neonatal sepsis with severe morbidity and mortality of newborns. Intrapartum detection of GBS is needed. The objective was to compare a PCR-based test performed in the laboratory versus labor ward. STUDY DESIGN 300 patients were included prospectively. In phase I, swabs were analyzed by selective culture and rapid PCR in the laboratory. In phase II, swabs were analyzed accordingly, but the PCR test was conducted in labor ward. Test performances were analyzed and compared. RESULTS In phase I the rapid PCR test had a sensitivity of 85.71% and a specificity of 95.9%. The GBS colonization rate was 18.67%. Overall 8.5% of the PCR results were invalid. In phase II the PCR test showed a sensitivity of 85.71% and a specificity of 95.65%. The GBS colonization rate was 23.3%. Overall 23.5% of swabs tested with PCR were invalid. Initiation of specific, short 2-hour training for operating personnel in the labor ward reduced the invalid test rate to 13.4%. CONCLUSION The rapid PCR-based test yields adequate results to identify GBS colonization when performed in labor ward. In order to reduce the number of invalid tests a short training period is needed.

Wie ward das Prinzip der Glaubensfreiheit in der kurhessischen Verfassungsurkunde auf die Juden angewandt

[J. Weil]

Phylacterium oder Arganton und Philo im Schooße der wahren Glückseeligkeit. Betrift die treue Darstellung des übernatürlichen Wunders, welches am 25. August 1799 in Posen mit ausgezeichneter Pracht gefeiert ward; die Geschichte der Israeliten, und die zu wünschende bürgerliche Verbesserung derselben

von Wolf Meyer Dessauer

Lieder, gesungen bei der feierlichen Beerdigung unserer am 18. und 19. März 1848 gefallenen Brüder: Aus der Zeiten finsterm Schooß Ward der helle Kampf geboren ...

Welsch (Projektbearbeiter): Abdruck zweier anläßlich der Beisetzung der Berliner Märzgefallenen verfaßter Liedtexte

Eene drömerige Viehsion: Det neue Stück, die Revlution, Is jetzt beim dritten Akte schon, Der zweete ward damit geschlossen, det man zwölf Menschen doot geschossen: Det war'n proprer Zug, der Leichenzug an'n 20. Oktober! ...

Welsch (Projektbearbeiter): Bitter-sarkastische Kommentierung der Beisetzung der am 16. Oktober 1848 in einer gewalttätigen Auseinandersetzung mit der Bürgerwehr getöteten Arbeiter: "Die zehn Särge voll Errungenschaften ... waren ... ufgeputzt mit Blumen un Kränze wie der 19. März mit Versprechungen; aber mit den eigentlichen Inhalt sind et hier wie da reene Leichen."

Der feierliche Empfang, welcher mir in Frankfurt zum Theil ward, ...

Dank des Erzherzogs für die freundliche Aufnahme in Frankfurt

Wie aus einem Juden ein Deutscher ward

Abraham Schwadron

Anno tausent funff hundert vnd neun vnd dreissig : Ward diß Monstrum von einer kh°u gemacht ...

Abbildung eines zweiköpfigen Kalbes. - Bibliogr. Nachweis: Faust: Zoolog. Einblattdrucke ... III, 436

Ain Neüw Lied vonn dem Schittensamen und seinem falschen knecht : und ist inn dem thon, wie man singt vonn dem Künig Paris, der sein Tochter beschlieff und schwanger ward

[der uns das liedlein neüwes sang, ..., Hans Kugler ist er genannt...]

Noch steht manch altes Haus, verehrt als seines Wirkens Stätte, kein neues ward erbaut, das nicht sein Lied durchklungen hätte : Österreichs Beethovenfeier

Signatur des Originals: S 36/F08177

Noch steht manch altes Haus, verehrt als seines Wirkens Stätte, kein neues ward erbaut, das nicht sein Lied durchklungen hätte : Österreichs Beethovenfeier

Signatur des Originals: S 36/F08178

Genevieve Ward, Brustbild

Signatur des Originals: S 36/F10207